Dirty Work Read online

  ‘… was admitted to the ITU of this hospital straight from theatre suffering the acute effects of major haemorrhage. E.S. required a transfusion of twelve units of blood in the first twenty-four hours. After two days of ventilation on the unit, a tracheostomy was performed and is still patent. The patient’s main problems currently are disseminated intravascular coagulation and respiratory distress syndrome.’

  Alive, alive, thank God. Still alive, although of course she is far from safe. I watch the GP’s face. He looks up at me and smiles.

  ‘The good news is that her haemoglobin is … well, it’s actually seven-point-nine,’ he says.

  He places his hands in front of him on the desk and I hear a quiet tap as his wedding ring makes contact with its surface. His features are cast in shadow by the light from behind, but I know his face is a gentle one. And my patient is still alive.

  ‘It’s not such a bad result now, is it?’ he says.

  I was nine years old when my dad came home one day and announced that we would be moving to America for a few years. He was leaving the following month to get things ready, and my mum and sister and I would follow him a few weeks after that. With this one statement, he changed the course of my life.

  The transformation in me began even before we left England. As soon as my dad arrived in our new home he began sending us parcels, each one contributing to the imagined scenery of the new life that awaited us. There were photographs of a cherry-red car, of sunshine on a pretty house and garden, of my dad smiling and wearing his first ever pair of blue jeans. And scratch-and-sniff stickers, each paper circle smelling of a foreign and wonderful junk treat – pizza, popcorn, bubblegum, Coke. Best of all was the package in which he sent my sister and me each a kazoo, a bizarre little plastic toy which, applied to the mouth, turned one’s voice into a wonderful sonorous buzz. My mum was amazed to see me making so much noise on mine as I tootled away, all around the house.

  When my dad met us off the plane, I saw the bright truth of the story his missives had told us. In the airport car park, the vehicle he led us to was enormous, and scarlet with bright yellow seats. The front part, where the adults sat, was a whole bench stretching across from steering wheel to passenger side, not like the frigid arrangement back at home. And there were two whole rows behind this for children, one facing forward and one backward so that you could choose whether to gaze into the future or look back into the past. My dad showed us all how the windows went up and down at the push of a button, and he blasted us with air conditioning and turned up the radio loud.

  Our new house was on a main road, opposite one of the city’s biggest hospitals. But it was set back behind a tall hedge so that once the car was in the driveway you could forget that you were really in the hub of a metropolis. Viewed from just inside this hedge, the house looked to me like something from a storybook. It was made of red brick, and it had a shiny tiled roof with a perfect little chimney, and a path covered in white gravel leading up to the door, which was glossy green with a brass knocker. Only the house number, on a matching brass plaque, reminded one by its four digits what an endless urban road we were on, for the character of the place was all intimacy. Flowers banked the gravel path and these same blooms filled bright window boxes outside each of the gabled windows.

  My dad had arranged for my sister and me to sleep on the landing where he and my mother were, one of us on each side of them. I felt great pleasure at the glamorous prospect of having a whole room to myself. Dad had brought some familiar things over with him from England. I noticed straight away the blue Picasso poster, which looked so pretty here on my new yellow walls, and one of my mother’s colourful handmade quilts. My father had cosied my bed up in a corner of the room so that its head end was right next to a window through whose fly-netting I could look down on the cupcake-pink petals of a magnolia tree and, beyond it, the green slope of our new neighbour’s miniature golfing range.

  At the foot of the bed was an orange corduroy beanbag for sitting on. Against the facing wall, whose window looked out on the hedge and the main road beyond, I found a perfect bureau-style desk. The fact that it was made from real wood gave it a certain grown-up cachet, but it was child-sized. It had a curved roll-top and a small swivel stool, and two deep square drawers next to the space in which my legs would be tucked. Against the only remaining free wall my dad had put all my toys, the box of Lego, the red cot with the white rubber rim and my teddies.

  He left me, jet-lagged, to settle into my new bedroom. Light fell on the pink carpet, and all around the room in rays. I put down my aeroplane bag, in which I had carried my books and crayons and favourite doll across thousands of miles. And I took off my shoes and started very slowly to walk barefoot around the edge of the circular rug at the centre of the room, heel to toe, as if in miniature I were padding out the journey I had just made so fast and so massively, assimilating this transatlantic fact in my own little sphere of world, in my own new universe. And as I carefully trod, feeling the crushing of new plush beneath and between my toes, I allowed myself to unhinge from the distinctness of the new environment. I let my nine-year-old head loosen itself from the outside to fall back into the inside and, soundlessly to start with, I found myself chanting, ‘I am me. I am me. I am me,’ with only the keep-turning curve of the rug at my feet to look at. I kept going with this slow mind-spiral until I was saying the words right out loud, yet I was still so much inside myself that all at once I was afraid I might never get out again. I stopped sharply, to shake my head a bit, and looked around my new room and saw that it was beautiful and that I belonged in it. And I marvelled at the fact that this journey, from one country to another, seemingly so accidental, so entirely out of my hands, could have made me feel suddenly and irreversibly so very important.

  When I look up again, the room is full of sunshine. It frames my judges. I see the soft outline of the hair on their heads. Their faces are hard to make out, but I note that it is Miss Mansfield who is talking now, asking me questions. I’m not sure when this happened, this change from the GP to her. She is enquiring about my choice of career. Were there any medics in my family? That sort of thing. No, I answer her. I look over to the window. Somewhere, down below, I hear angry traffic. My judge’s voice seems more distant than ever. I feel like I’m there but also not there. She is asking me about becoming a doctor. She wonders when I made that decision. Was I a child? No, it happened later than that. I think that’s what I tell her.

  At my new school, daily life was as far from what I’d known as could be. No more the cold rough playground, the crabby teachers, the sadness. This institution seemed built for fun. It was mainly constructed of pale wood, and decked out in primary colours. Signs above every door reminded us that we were all ‘Welcome’ and ‘Free to be you and me’.

  My third-grade teacher, Mrs Ranger, knew all about me. On my arrival, she announced to the class, in an excited voice, that everyone should stop their work at the little round tables at which they sat in groups, and go straight to the soft corner for show-and-tell. As she did this, she clapped her hands together, the bracelets on her wrists chimed, and her pearly fingernails made me notice her matching pretty mouth. Everyone sat in a horseshoe at Mrs Ranger’s feet and she settled on one of the low chairs and held me next to her with her cool, soft hands on my shoulders. She swept an approving glance all the way along the row of children and told them it was a wonderful day, for they were about to make a new friend all the way from London, England. And then, one by one, each child came up and stood before me and said, ‘Hi, I’m Mimi’ or ‘Hi, I’m Candy’ or ‘Hi, I’m Ned’, until I had been talked to and smiled at twenty-odd times, and each time I said ‘Hello’ in return. I think I uttered more greetings in one half-hour than I had in my whole life.

  At intervals in this introduction, Mrs Ranger turned me slightly towards her to check my expression then back again to the open faces of my new friends. Sometimes, one of her hands lightly left my shoulder to stroke my hair as she spoke.
She smelled of oranges and lemons.

  Next, I was asked to speak a sentence or two about where I came from. I amazed myself by managing this easily, because it was my lovely new teacher who had requested it and because my new friends looked at me as if it was a natural thing to do. I didn’t get further than the first few sentences, though, before the children all started clapping and squealing things like ‘Wow’ or ‘That’s so cute’ just because of how I spoke. And my teacher didn’t discipline this outburst: she joined in, laughing along so that I could see a single piece of gold twinkling at the back of her mirthful mouth.

  By the end of my first semester I was taking my turn to stand in front of the class to recite the preamble to the Declaration of Independence, my famous accent already beginning to soften and the tremble in my voice came from pride now, not from fear. I could not believe in these first few months in my new home how easy it was to be happy, nor why it had taken so long for it to happen.

  Mrs Ranger did have a strict side. I saw her bring unruly boys quite close to her for a telling-off in her firm voice, and at these times her eyebrows would lower and her glossy hand would jut a finger out as she uttered some chiding sentence. But, even when she was formidable, her language seemed to reference the wholesome side of life. ‘Now don’t you get fresh with me,’ was the severest thing I ever heard her say.

  At the end of the day, all of us pupils sat chatting to each other, alongside our backpacks, in a corridor made of glass which let in the light of each intense season, waiting for one of the kindly teachers to announce through a megaphone which car was coming up the school’s winding driveway to take us home.

  There is a point in each of our lives when it seems that the real story begins, when we become the self that all our ensuing life somehow trails out from. This may just be the time, around three or four, when memory begins. But my birth, in this sense, occurred during one glowing American fall. This is when I became myself. The girl before this time is a shadow, like a soul who is practising how not to become. She is the background, the hole in the fabric from which the real shape is cut.

  Light empties from the room, as surprising as a sound. For a moment, everything goes quite dark, before the sunshine returns, playing on the windowpanes, casting a geometric map on the plain carpet. It glints off something on Miss Mansfield’s hands. I assume it must be a diamond until I see, as she passes leather folders along the table to her colleagues, that it is in fact the GMC badge on the front of one of the binders that has caught the light.

  ‘I’d like to rule out a physical cause for what happened in theatre, Nancy.’ Miss Mansfield’s two helpers open their files as she addresses me. ‘Were you unwell at the time, with anything at all, in the days leading up to the accident?’

  I shake my head. She refers back to her notes. ‘And you don’t have any medical or psychiatric history?’ I wait for her to look up at me, then shake my head again.

  ‘Okay. Well, I’m going to read out what I have here about the events of that day. It’s compiled from what others witnessed in theatre – the anaesthetist, scrub nurse, anaesthetic assistant, you know. It’s what happened from their point of view. And I want you to stop me if anything doesn’t seem right. Okay?’

  I nod but I don’t get far. I sit very still in front of my judges but I only manage to hang on to what Miss Mansfield says for a very short while.

  America wasn’t all rosy. A shiny girl I might now be, but I knew that the darkness that had seeped into me before our move from England, making me heavy as soil, was still at large. I sensed it at night when I heard the ambulances careening in and out of the hospital across the road, their lights making my whole room a ghoulish scintillation of red and blue. I felt it each time I walked past the vacant lot next to our house, a scrubland where poison ivy and goldenrod wooded out the sky, dwarfing even my parents, a place that my mother told me never to go because of dangers there; Baba Yagas and Jabberwocks, she said, not realising I knew of worse things than these.

  It was something to be able to walk past the vacant lot and not into it. That was an easy decision. But how was I to keep all the other threats at bay? How should I anchor the happiness that had come to me so surprisingly? I was tormented by this mystery and, not knowing what else to do, I resolved merely to walk away from all that was shaded or sad, to stick by glowing things. I kept on the sunny side of the road. I played with chirpy girls. And so it was, in what came with one such friendship, that I stumbled on the answer to the question that preoccupied me, learning that there was a better way to trick darkness than by just turning hopefully away from it.

  One day, a new family moved to our street, into a house I hadn’t noticed before, situated as it was at the far edge of the vacant lot, almost hidden within the jungle of rubbish and high weeds and wildness. Soon after their arrival, my mother and I were invited to go and have tea with our new neighbours. They had two daughters, a teenager and a girl just older than me. My mother told me that both girls had been adopted.

  I could tell by the way she looked at me when she used this new word that the business of having parents who hadn’t always belonged to you was not meant to be abnormal. I did not tell my mother that she was the only person I could ever imagine crawling in next to on a weekend morning, pushing my back up against her warm, soft scentlessness, just faintly picking up the smell of my dad’s sweat on their green cotton sheets. I wouldn’t have wanted to do this melting thing with any other woman.

  The two sisters were starkly unmatched. My mother said this was because they had come from separate homes, where they had had different experiences. The elder one, Spencer, was an adolescent. She had a sad and textured face and I hardly ever saw her leave her bedroom. She must have done, though, because I heard that now and then she would jump from her bedroom window and break a leg or an arm on the concrete below. She never finished herself off, but was occasionally taken over the road to the hospital to be wrapped in plaster. The time my mum and I took her there, she was greeted by the nurses like a regular.

  I wondered how Spencer had got the experiences which made her so forlorn, and how Victoria, the other sister – whose friendship I immediately craved – had come by hers, which made her so beautiful. And where I fitted in. Did a girl not have any say in how things turned out?

  On that first visit to her house, I realised I had seen Victoria before. She had been standing beside the bus stop exactly halfway between her house and mine. My sister and I had been playing a spy game with the new walkie-talkie set we had been given for Christmas. This involved one of us sitting at the kitchen table recording information about people descending from the bus, dictated by the other one, who was usually parked at the end of the driveway. Each person we observed got an individual piece of paper, and we filed our descriptions away in a lever-arch folder which was brown with vicious corners.

  I had experienced a strange thrill of gladness at being the person on the outpost that day. Usually I preferred being the amanuensis, because my writing was neater than my sister’s and my powers of embellishment more advanced. I knew that a person had to be transmogrified for the written report, made slightly more significant than they really had seemed, or our game would collapse under its own mundanity.

  But with Victoria, there was no need for flourishes. She was slim and strong. Her muscles had definition and I would soon envy the way she looked in exactly the same Speedo I felt so ungainly in. When I first saw her, she had on an emerald-green top made of Lycra with a deep V-neck and plunging back to match. I discovered later that this was actually a leotard. Over it, she wore a pair of old tracksuit bottoms and white Nike tennis shoes. One of her feet was pointed forwards, the other out at a marked angle, ballet-style. My eyes surveyed her: shoes, trackies, body like a snake in green, all the way up to her perfect blonde head. She was the most compelling character study I had yet made in my antics with my sister. I actually wondered whether our game, previously so slack, had acquired some kind of momentum or point in it after
all, for I felt an urgency and purpose in the way I examined Victoria, that strange greedy thrill of not knowing if a girl you observe is someone you want to be, to have, or to destroy.

  A year or so later, I inherited the green leotard from Victoria. In a big bin bag of malodorous hand-me-downs, among all the greys, was a crushed little jewel of a green thing. My excitement at receiving this garment, which so emblematised my friend’s great beauty, was matched only by my disappointment when I put it on one evening, alone in my bedroom, and confronted my jade body in the full-length mirror of my cupboard door. Looking at myself, my callow hope for glamour immediately dashed, I saw I could not escape myself. And though I was as dismayed as any girl who realises she is not lovely, I was soon to discover that I had other strengths I could be proud of.

  Victoria was a conventional girl. We played ponies. We made tiny, stapled storybooks and clothes for our dolls. We set up camp. This making of dens was probably my favourite activity: I liked establishing with my friend a cosy corner in a house which I found a little spooky. If our home was sun-dappled, hers was shrouded, a colour chart of darks. And while ours was so tidy that when any of it was a mess it meant a family statement like, ‘We’ve just had lunch’ or ‘Dad’s in the shower’, theirs was chaotic. The kitchen surfaces were covered with stuff. The girls’ rooms were like laundry cupboards, soft piles of clothes heaped on floors and beds and chairs. Toys were allowed to colonise spaces over time, and were never packed away.

  What I enjoyed most was when my friend and I lay next to each other under a duvet in one of our makeshift camps, and she would tell me all about the weird stuff her older sister did. She said that Spencer had been a part of their family for just a few months and that her parents said it would take her time to settle in. That everyone needed to accommodate her behaviour.