The Grass Castle (37 page)
They have been here at least an hour now, filling time behind the curtains, listening to the ebb and flow of voices and footsteps and beeping machines. Mostly they sit in silence. Daphne is weary. All this fuss has been too much for her, and the bright lights are uncomfortable for her eyes. She lies back and lets her eyelids droop, trying to find some peace and rest.
The doctor—when she finally arrives and yanks back the blue curtains—is a slim young woman with a dark-brown ponytail and cool hands, and a stethoscope strung round her neck like a necklace. She looks too young to be qualified, but her white coat adds a degree of authority, along with the concerned pucker of her brow as she asks Daphne to elaborate on what happened. Under direct questioning, Daphne has no choice other than to articulate what has been going on these past months. She mentions the falls and the funny thumping sound that has lodged itself in her head.
As she talks, she sees Pam’s face tighten. ‘Why didn’t you tell me any of this?’ Pam hisses while the doctor checks the records made by the nurse.
‘I thought it was just old age,’ Daphne says quietly. Guilt is settling on her like a blanket. Perhaps she should have told someone about those funny little symptoms. Maybe she should have acted on that referral instead of tossing it in the bin.
The doctor examines Daphne carefully, taking her pulse and listening to her chest with the chilly stethoscope which draws goose bumps on Daphne’s skin. She gently probes Daphne’s neck. ‘Is the thumping on any particular side, or does it radiate over your whole head?’
‘I don’t know,’ Daphne says. ‘Maybe it’s more on the right than the left.’
‘Any numbness? In your arms or fingers or anywhere else?’
Daphne remembers waking at night unable to feel her arm. She recalls a period of three or four days when the numbness persisted. That was weeks ago but she reports it anyway, and thinks perhaps the doctor’s face changes slightly as she speaks, as if suppressing a reaction.
‘It’s lucky you had that fall and came in here today,’ the doctor says, ‘or something serious could have happened. If we hadn’t seen you, you may have had a stroke.’ She scribbles on a form and hands it to Pam. ‘I need you to take her across to imaging for an ultrasound of her neck. Then I’ll see you again.’
‘There’s nothing wrong with my neck,’ Daphne grumbles as Pam wheels her along the empty hospital corridors in a wheelchair provided by the emergency department. They are searching for the imaging rooms, which are supposed to be somewhere in this wing of the hospital. ‘We’ll probably be waiting for hours,’ she adds. ‘Nothing happens fast in these places unless you’re actually dying.’
Pam swings the wheelchair round a corner. ‘Sounds like you’re extremely lucky,’ she says. ‘Sounds like you’ve dodged a bullet.’
Think about that
, hangs unspoken in the air. Daphne supposes perhaps she
should
think about it—maybe she
is
lucky to be here. It’s a steadying thought, makes her feel less like whinging and complaining. Every minute is precious.
They locate the imaging rooms and settle themselves in the waiting room. It must be a quiet afternoon because soon a smiling nurse in a green uniform emerges and scans the form Pam hands to her. Then she looks down at Daphne. ‘This won’t take long,’ she says. ‘And it’s not at all invasive. It won’t hurt a bit.’
She wheels Daphne into a room and helps her clamber from the wheelchair onto another hard white bed while Pam seats herself on a plastic chair in the corner. The nurse tells Daphne to lie down, and drapes a cotton blanket over her. She says she is a sonographer and that she is going to lubricate a probe with warmed gel and run it over Daphne’s neck. Pictures will appear on the TV screen up on the wall, showing the blood vessels in Daphne’s neck and the flow of blood through those vessels.
It all sounds very scientific and Daphne is only minimally interested. The probe is hard and uncomfortable where it presses near her throat, and the pictures on the screen are like those on an old TV set when reception was bad—mostly black and white and fuzzy and meaningless. Patches of red and blue appear from time to time, but there’s no shape to anything. Daphne keeps her head still on the pillow as instructed and closes her eyes.
Pam, however, is full of questions which the sonographer says she can’t answer. Her job is to take the pictures and pass them on to the doctors, who will do the interpretation. Daphne supposes this is why doctors are paid so much—they are the ones who make the decisions and deliver the bad news. She keeps her eyes closed and wishes it was over.
After the ultrasound they go back to emergency to wait for the results. All the beds are full, so they sit in reception. The faces of the waiting people haven’t changed . . . or perhaps they have, but there is a sameness to boredom that makes people look identical. Daphne and Pam wait for what feels like forever before the young ponytailed doctor calls them through again. Pam wheels Daphne into a small room where the doctor puts black films like X-rays up onto a white screen. She talks and points, tossing around technical words like
carotid artery
and
sclerosis
and
surgery
and
cerebrovascular episode
, which apparently simplifies to
stroke
.
The short version is that Daphne has a blocked artery in her neck and could have a major stroke at any time. She’s a time bomb waiting to go off unless she has surgery to clear the blood vessel. All these strange symptoms she’s been having are to do with the impeded blood supply to her brain; the thumping she’s been hearing is her heart trying to push the blood through the blockage. The falls she’s been having are due to small clots lodging in her brain. If a major clot breaks off she could have a stroke. The solution is to visit a vascular surgeon, which Daphne’s regular doctor can arrange for her. The hospital will pass on all the information so an appointment can be made as soon as possible.
Pam seems happy to have some answers, but Daphne sinks in the wheelchair, knowing her doctor will not be happy. How long is it now since the GP recommended having those tests done? No doubt he will ask about the referral that ended up in the bin.
The ponytailed doctor is asking if Daphne has private health insurance. If she does, it’s likely the surgeon will operate soon, otherwise she’ll probably have to go on the list. For years, Pam has insisted on paying those ludicrously expensive insurance bills. Daphne has always thought it was a waste of Ray’s hard-earned money. But now perhaps it’s just as well.
Daphne likes the vascular surgeon—she finds she has a reluctant admiration for him. His rooms are modern and flash and expensive-looking (which will probably be reflected in his bills), but he is surprisingly human. He is smartly dressed, fit-looking and affable with a distinct twinkle in his eye which sets Daphne’s concerns temporarily at ease. He talks her through the details of the operation, showing her several ghastly pictures of the anatomy of the human neck with railway tracks of coloured veins and arteries running through it.
‘This is your carotid artery,’ he says, pointing with his pen. ‘Yours is more than ninety per cent blocked. We need to clear it out and then your risk of stroke reduces dramatically.’
As he leans forward across his desk, explaining it all to her, Daphne catches the scent of aftershave. It’s tangy and masculine, not too strong. Having lived with a man with a beard all her life, aftershave is a simple pleasure Daphne has never experienced. But then women who’ve never made love with a bearded man have missed one of life’s great intimacies, she thinks. She flushes. Here they are talking about an operation and she is thinking about sex. The good thing is no-one would suspect her of it. All they see is an old woman and they think she is past imaginings like that.
Memories of Doug have been coming to her frequently this week, more than usual. She sees him in the night, strong visions of his face, the lovely texture of his beard, the gentle intensity in his eyes when he looks at her, love written into them. Sometimes she imagines his smell—the bushy, earthy aroma of his skin. One night she finds herself reaching across the bed for him, which she hasn’t done in years, decades. That was one of the hardest things to accept after he died: the loss of his comforting presence in bed, the solidity of him beside her, the reassurance that came with closing her hand over his and feeling him grasp hers any time of night, always there for her.
The surgeon is asking Daphne if she has any worries, and all the anxieties of the past week resurface: the arguments she’s had with Pam, the visit from the policemen. Daphne doesn’t know what to think about anything anymore, other than the fact that she doesn’t want to have this surgery done. Despite her newfound enthusiasm for life, she’s not sure she should allow anyone to cut into her with a knife. It might be a death sentence to dodge the operation, but the anaesthetic is a risk too. And she’s lasted months without any issues, hasn’t she? Who knows, she could go a few more years without any problems. If she has a stroke and goes out quickly, that’s fine. She’s had a good life. Why tempt fate with operations?
The surgeon places some sheets of paper on his desk in front of Daphne and offers a pen and points to where she should sign.
‘I’m too old for surgery,’ she says.
The surgeon nods slowly, as if taking her concerns seriously, which is more than Daphne expected of him. She thought he would strong-arm her into seeing things his way. ‘I understand why you might be worried,’ he says. ‘But actually you are quite healthy for your age. I wouldn’t recommend surgery unless I thought it was the best solution for you.’
Daphne shakes her head firmly. She sets her feet on the ground and prepares for battle.
The surgeon smiles persuasively. ‘All your blood tests are good. Your heart is in good shape and your blood pressure is excellent—not in your carotid artery, obviously, but overall it’s fine. There’s no reason why you shouldn’t have the operation. There’s some risk of course, as there is with any surgery, but we work to minimise that. I have a fantastic anaesthetist who’ll look after you. And you can relax knowing I’ve done lots of these operations before.’
Relax! Daphne almost laughs. Only a surgeon could say something like that. Relax while I cut open your neck. Relax while I slash into your blood vessel.
They talk through risks and percentages again; the chances of a stroke if she doesn’t have the operation, the risk if she does. It feels to Daphne that she is caught between a rock and a hard place. Risk both ways.
Then Pam intervenes. ‘Mum, the doctor is telling you that if you don’t have this operation there’s a very real possibility you’ll have a major stroke that will leave you incapacitated. You don’t want to be left half-paralysed and unable to speak or do things for yourself, do you?’
Daphne meets the surgeon’s eyes. ‘Is that what you’re telling me?’ she asks. She refuses to have Pam putting words in his mouth.
He nods.
Daphne leans back in her chair and considers this. The concept of being brain-damaged and dependent is horrifying—she definitely doesn’t want that. But Pam is being manipulative to get the result she wants. After the visit to the hospital with the ponytailed doctor, she and Pam had argued on the way home.
Why didn’t you tell me about all those collapsing episodes?
Pam had asked indignantly.
You knew
, Daphne had defended.
You were there when the first one happened. It was out at the valley that day Abby helped me.
You said it was nothing
, Pam had protested.
It
was
nothing
, Daphne had insisted.
I recovered
.
Each one of those collapsing episodes was probably a small stroke
, Pam had said.
But we didn’t know because you didn’t tell me.
The argument was circular, as arguments so often are, and Daphne had found herself staring out the car window, switching off to her daughter’s rave.
Now she feels resentment bubbling in her chest. ‘I’d rather be dead than paralysed,’ she says, turning to Pam angrily. ‘I don’t want to be kept alive on machines.’
The surgeon clears his throat and smiles gently. ‘It’s not always that simple—not unless the stroke is so major it wipes your brain out. For lesser strokes we can’t always tell how a patient will recover. It takes time. We have to wait and see.’
Daphne tastes sourness in her mouth.
Wipes your brain out
is a bit blunt, she thinks, especially coming from a doctor, but perhaps he’s decided to dispense with medical terms and speak plainly. ‘What would
you
do?’ she asks.
The surgeon sits back, steeples his hands and regards her thoughtfully, as if he is giving this due consideration. But Daphne already knows what he’s going to say. She has posed the wrong question and he knows he has won. Pam is looking distinctly smug.
‘I would have the surgery,’ he says, and his response is no surprise. He’s a surgeon after all, and surgeons like to use their scalpels.
Daphne looks to Pam and knows she is defeated. She hasn’t the energy to stand against the two of them. ‘When should we do it?’ she asks. And everyone around her is smiling.
Great
, she thinks,
now they’re all happy except me. If I’m lucky I might just die
.
But on the way home she realises she doesn’t want to die. She isn’t ready yet. And with that a great lump nestles itself in her guts and refuses to budge.
‘I’m so sorry. The skull was my fault.’
It is a few days after the appointment with the surgeon, and Abby is visiting again. She insisted on coming to see how Daphne was doing after the dramatic collapse in the presence of the policemen, and she’s wearing a look of guilt and apology that reminds Daphne of a reprimanded dog. The discovery of Doug’s skull is only one of the many things that has been occupying Daphne’s mind. There are other issues of importance she must attend to before the operation: her will, her few possessions, what she should take to the hospital.
The policemen returned only yesterday to discuss their investigation. Years had lapsed since Doug’s disappearance, and Daphne hadn’t expected any further evidence to turn up. Weather, snow, wildfire, predators—she’d considered the lot and come to terms with the loss of his remains. A sky burial was how she liked to think of it.