The Post-Birthday World (57 page)

Philosophically, Irina believed in Britain’s National Health Service. It was a fine idea, that all medical provision be free at point of care, although critics, surprisingly few considering the size of the National Insurance levy on the average paycheck, were quick to point out that the service was anything but free. Yet however sterling in theory, in practice the NHS was chronically underfunded. Its waiting lists for treatment were infamously and sometimes fatally long. Scandalous cases made headlines in which cancer patients had the wrong breast removed, the wrong kidney, the wrong leg. Public hospitals coursed with a “superbug” called MRSA that by 2002 was killing twelve hundred patients a year. A full third of the NHS budget was dedicated to paying off malpractice suits. It may have sounded horrid, but once they dragged from Dr. Saleh’s office Irina no longer cared about sounding horrid, or being horrid: the NHS was fine for

other people.

Thus for the tests that would establish the baseline of Ramsey’s condition, Irina insisted on going private. At least they didn’t have to wait. She shepherded Ramsey to get a second PSA test and prostate biopsy, to cover the possibility that the NHS labs had been playing silly buggers with his samples and those of some unfortunate who was truly sick, and the whole business was another inside-pages mistake. Once an independent lab stubbornly, maliciously produced the same findings, a private oncologist ordered a computer tomography X-ray, a radio nuclide bone scan, a lymph-node biopsy, and an MRI. But by giving in to the American impulse to buy

the best,
Irina fell under the sway of the deeper motivation that drove many of her countrymen to exhaust their reserves for the same purpose. She did not want to buy the best of tests. She wanted to buy the best results.

In which case, her money was wasted—and a great deal of money that was. After extinguishing the greater part of her savings, Irina had to concede that they would have to return, tail between legs, to the NHS. Since many National Health doctors augment their incomes with private patients, after a hair-tearing delay the system coincidentally shuttled them back to the very same oncologist whom they’d seen privately, and who was at least—oh, God, something about mortal illness exposed what a terrible person you were, and apparently had been all along—white. “So,” he said wryly on their return, “back with the proles.”

It was as Dr. Saleh had foretold. This Dr. Dimbleby recommended hormone therapy in combination with radiation, and chemo if and when—it was usually when—hormone therapy grew ineffective. Burdensomely clued up on the side effects of these gruesome treatments, Irina suppressed her dread in Dimbleby’s office by reciting the we’re-reallygonna-fight-this and I-know-you’re-no-quitter resolutions that she must have learned from a host of made-for-TV movies, films that seemed to confuse a life-threatening illness with a come-from-behind election campaign by the Conservative opposition. Yet Ramsey himself asked quietly if maybe one option was not for him to simply go home and let nature take its course, since if the disease didn’t kill him, the cure surely would. He seemed under no illusion that hormone therapy bore the least resemblance to last year’s brave Tory challenge to an entrenched Labour majority. Moreover, he appeared strangely resistant to the notion that, in addition to being poked and prodded and needled, losing his ability to be a real man with his wife, feeling increasingly

off form
and facing the prospect of feeling far worse in the days to come, he was now expected to marshal his little remaining energy to grandstand on the stump and shout rousing slogans to the faithful as if spearheading a get-out-the-vote drive.

When Irina expressed frustration that Ramsey wasn’t joining in her refrain of

Thus brandishing a sword at the heavens or tossing it into the Thames was no more than a matter of whim.
we’re gonna fight this,
the oncologist, who had a mischievous side, intervened. “Contrary to common perceptions,” he said, “extensive studies have compared patients who are determined and optimistic versus others who, quote,
give up.
Surprisingly, demeanor makes no statistically significant difference in survival or recovery rates.”

After the batteries of tests and his humble resumption of his place at the back of the NHS queue, Ramsey was not scheduled to begin his treatments until nearly his fifty-second birthday. Assured that a few days would not make any difference, Irina appealed privately to Dimbleby to delay the first round of antiandrogen drugs and relentless radiation therapy until after the sixth of July.

However disreputable their finances, one night back at Omen or another sumptuous spread of homemade sushi would not have broken the bank. But Irina didn’t like to repeat herself.

That evening, she lit two candles on the big wooden kitchen table, otherwise barren. It stayed light so late in July that she had waited until eleven p.m., at which point in the candles’ golden glow she flourished a great silver tray before Ramsey’s place. On the tray, in the very middle, lay a single bright blue pill.

Ramsey looked from his minimalist entree, like a serving on

The Jetsons,
to his wife. “This what I think it is?”
“Dimbleby said there’d be no harm done, and it might be worth a try. He also said that after you start these treatments . . . you’re likely to want to ‘concentrate on getting well.’ ”
“Meaning, I’ll feel like a dog’s dinner,” Ramsey translated.
“Well, you know doctors.”
“They’re liars.”
“They’re
understated.
You game?”
“Lady, I’m game if it means using lolly sticks for a splint.”
She poured him a goblet of his favorite sauvignon blanc—£30 a bottle, and the last in the rack. He toasted, “Here’s mud in your eye—or something a bit more untoward,” and knocked back the pill.
They sipped, and waited. Put in mind of the story, Irina told him about getting hold of a batch of magic mushrooms back in high school through a dubious source. She and her friend Terri had sat at Terri’s kitchen table on an evening when her parents were out. They poured hot water over the shriveled brown twists, and after a few minutes downed a cup each of the bitter, lukewarm tea. Then they sat, just like this, looking at the yellow walls, staring down the paint and waiting for the color to change, for the letters of the crocheted bless this happy home to dance, for the refrigerator to hum show tunes. Too late to turn back from a slight anecdote whose resolution she now realized boded analogously ill, Irina said, well, nothing happened. But, she added, in the expectant interim between chugging that foul brew and resigning themselves that Irina had bought nothing more mind-altering than dried shiitakes from Chinatown, lo, the color of the walls had vibrated without help, the yellow paint pulsing exuberantly in the mellow lantern light. The cliché in crochet was already dancing, and the refrigerator hum, that deep thrumming reassurance that all was well, constituted a show tune of a kind. The mushrooms were duff, but Terri’s kitchen was a revelation, and each visit to that room thereafter had filled Irina with narcotic joy.
Meantime, it was like that, with Ramsey’s face: a revelation, with or without the middle-aged magic mushrooms. She kissed him. She said, “It doesn’t matter if it doesn’t work.”
“I know,” he said, and they finished the wine. “But I think it’s working.”
They slipped down to the snooker hall. Ramsey switched on the light over the table; this evening the baize invited them to picnic again. The scarlet, canary, and beryl-green balls naturally psychedelic, the triangle gleamed with the secret of Terri’s kitchen: that the visual world courses with psilocybin of its own accord. Promoting bygone tournaments in Malaysia, Hong Kong, and Bingen am Rhein, Ramsey’s glassed snooker posters framed the fact that he had led a fine life. It was new, and unwelcome, to begin to think of his achievements as finite and finished, but better to marvel at a job well done than to fall once more into the trap of obsessing, like his fans, over the only tournament that he’d never won. As Ramsey slowly unbuttoned her shirt, Irina grappled with the thought:
This is it? These last five paltry years, this is it?
Funny how you’re always waiting for your life to begin, like staring down those walls in Terri’s kitchen and waiting for them to seem beautiful when they already were. You can spend an awfully long time anticipating the arrival of what you’ve had all along, like finger-drumming for a delivery from FedEx while the package sits patiently unopened outside the door.
They undressed each other in a leisurely fashion. Ramsey’s finely muscled abdomen flickered like a school of small fish, and his penis was what she’d once thought of as its normal size. “You know, we used to go for months,” she said, running a finger over her old friend, “and I’d never see it any smaller. I imagined that you walked down the street with this—baseball bat.”
“I did,” he said. “Them weeks we was apart, in hotels on the road—I done
terrible things
to you in my head.”
“. . . Do you feel all right?”
“I feel better,” he said, moving against her, “than
all right.
”
Not wanting to tax him, Irina began to roll on top, but Ramsey was having none of that. “No, pet. I’m fucking you like a man tonight, make no mistake.”
Irina was glad. She enjoyed his towering overhead; she liked the view. It had been long enough for that protective amnesia to move in, since you don’t miss what you can’t remember; when he first pierced through to that aching spot at the top, her eyes widened in surprise.
“Irina?” Ramsey so rarely used her name—as if it belonged to her old life with Lawrence, or perhaps to Lawrence himself. “I’m sorry about—”
Shh,
she hushed, but he pressed on. “I’m sorry about the rows. I’m so in love with you, but I ain’t always known—”
Ahh.
“—how to go about it.”
“By and large,” she whispered, “especially
large
—you’ve gone about it very well indeed.” If the thought came to her that sex with Ramsey should always have been like this, the thought rebounded that it had been.
“You’re dead decent, pet. But I been a proper toe-rag, I have. I just hope that—whenever—you find it in your heart to forgive me.”
It would not do to say so outright, but they both knew that this was the last time. Then again, presumably for everyone there came a point that you did everything for the last time. Tie your shoes. Look at your watch.

Ramsey may have been a baby about head colds or constipation, but he accepted real suffering with manful stoicism—as if for years he had been getting all the whining out of his system in preparation for facing true disaster without complaint. The radiation treatments, five days a week for two solid months, gave him a painful rash on his perineum, induced bouts of diarrhea, and so debilitated him that on return from the hospital he would take to bed. Nausea being more or less constant, the meals she served him there—whose delicate seasoning did not come naturally—often went untouched. He would have been dropping weight, were it not for the androgen-blockage treatment, which made him puffy. Testosterone, apparently, fed the cancer, but it had its uses, didn’t it; under the influence of drugs intended to choke the hormone’s supply, Ramsey no longer slipped a hand up her thigh. His physique softened. The tiny fishes of abdominal muscles swam away. The subtle mounds of his chest filled to small breasts. The sharp, defined lines of his body began to blur, much as the keen cookie-cutter features of a gingerbread man loll and spread when you slide the cold dough into the oven.

One perverse advantage to the long hours Ramsey languished in a half-sleep upstairs, Irina could now arrange to see Lawrence if she liked without detection. It was a freedom she’d gladly have abdicated, but the urge to speak with him was strong. The very fact that after all they’d been through the two were still miraculously on speaking terms seemed to promise recovery beyond the worst of traumas, if not to dangle the possibility of eternal life.

They met in late August in a Starbucks on the Strand near his office. Ramsey had just finished one of his last radiation treatments, and would not be cognizant for hours. She and Lawrence had e-mailed each other over the months, but it had been nearly a year since they’d met at the Pierre Hotel. She registered a little shock; she’d forgotten what he looked like.

Lawrence’s shock may have been the greater, and he made no effort to disguise it.

“Irina Galina!”
he cried nostalgically. “You look fucking awful.”

Irina glanced at her hands, their dirty nails jagged, the skin newly striated with fine parallel lines. “Ramsey looks worse.”

“Are you eating anything?”
Apathetically, Irina had noticed the last time she bathed that her breastbone was prominent, and the skin over her stomach had slackened; she was old enough now that it was starting to crenellate. “I pick at the dinners I make for Ramsey that he’s too sick to eat, but you can understand why I might not have the appetite for polishing them off.”
“You’re so gaunt! You can’t take care of him if you don’t take care of yourself.”
Homilies. “I assure you that I’m not the one you should be feeling sorry for.”
“What’s his attitude like? Because if you really resolve to buck it, mind-set can make a huge—”
“His oncologist says to the contrary. You can apparently be as dismal and fatalistic as you want, and negativity has no effect whatsoever on the outcome.”
Lawrence frowned. He was a great believer in the power of will, his own being prodigious. “I don’t know about that. I wouldn’t take one doctor’s—”
“Just because you don’t like the idea,” she cut him off, “doesn’t make it a lie. And if you think about it, expecting someone who’s in agony to get out the pom-poms and cheerlead for the team is a little unreasonable. That said, he keeps his chin up. When it’s not sunken flat on his chest. He sleeps a lot.”
“What’s the prognosis?”
She shrugged. “We can’t get a straight answer. And it doesn’t matter what they tell us; all that matters is what happens. He’ll probably do chemo over the winter.”
“Hair loss . . . more nausea . . . all that?”
“All that.”
“I guess he’s not playing much snooker.”
“Funnily enough, when his energy rises, he does. He says it relaxes him. And for the first time since he was a kid, he can play for fun—for the sheer pleasure of watching the balls go in, for that cracking, glassy resonance when they meet. And with nothing riding on his game anymore, he doesn’t beat himself up when he’s
off form.
”
Ramsey’s condition was such a vortex that she had to be mindful about discussing only her own concerns. “But you must tell me—how’s the marriage?” In an e-mail, she had made up for the faux pas of not asking the woman’s name in New York.
“It’s different. From you and me. More . . . tempestuous, if you know what I mean.”
She smiled. “I’m afraid I
do
know what you mean. Do you prefer that? Or would you rather have back that peaceable, ongoing thing we had? Quiet. Warm. The clockwork day. The passion turned to simmer and unspoken. It wasn’t so terrible, you know. Anything but.”
“Apples and oranges.”
“True, but there are points in life that you have to decide whether to eat an apple or an orange.”
Lawrence squirmed. “I guess I’m not into looking backwards.”
“I am. I go back to certain junctures and what-might-have-been my heart out.”
“Waste of time.”
“Probably,” she agreed cheerfully.
“You know, even if . . . the worst happens. At least you’ll be well provided for.”
The financial situation Irina had nimbly edited from her correspondence. “Not exactly,” she admitted. “Ramsey’s broke.”
“That’s impossible!”
“All those restaurant bills he picked up when the four of us went out? Just multiply that devil-may-care by several thousand times.”
“How are you managing?”
“Not very well. I used up most of my savings on private medical care. And for the last six months, I’ve had to put illustration on ice.”
Lawrence couldn’t bear to hear of misfortunes that he could not ameliorate in a practical fashion—he was a
doer
—and his eyes lit before she could stop him. “Well, let me help you! I could spare ten grand no problem, probably even twenty! It wouldn’t even need to be a loan. You could have it.”
She put a hand on his arm. “No, I couldn’t. That’s incredibly sweet, but Ramsey wouldn’t hear of it, and neither would I. Don’t worry. I’ve other resources.”
When they parted, Irina said, “Maybe I shouldn’t, but sometimes I miss you. Your steadfastness, your solidity. That’s not too traitorous, is it?”
“Nah,” said Lawrence. He added a bit too lightly, “Hey, sometimes I miss you, too! Rhubarb-cream pie, and piles of chilies.”
“You miss my
cooking
?”
“Better than being glad to get away from it. And I didn’t mean that’s all I miss. But yeah—I do miss your cooking. If you don’t mind. You’re one of these women who takes care of people. I didn’t realize it until recently, but all women aren’t like that.”
Irina idled down the Strand, bemused. All those years she’d thought Lawrence was taking care of her.
* * *