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Cinders

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Marylebone Platform 5: Departure

It was Jane that they called. He had listed her as the emergency contact; she wasn’t sure whether it was out of habit, some muscle memory from when they were married, or because there wasn’t anyone else. Nobody that had stuck around at least. 

She’d known that he was having the surgery. He’d asked to meet up and she’d agreed to a coffee at 31 Below, listened as he’d talked about things she didn’t really understand; enlarged prostate, strictures, bladder neck incisions. He’d made light of it at first – pretty sexy, right? – but she knew him well enough, behind the bullish bluster and bravado, to see that he was scared. And alone. That part was also unsaid but she sensed it and realised that he was trying to draw her into this, trying to lean on what they were before to help him get through it. 

They had argued. Paul had told her that the surgery meant that he wouldn’t be able to have children. Some more medial jargon she didn’t understand. At first she thought that he was expressing some remorse about the thing he’d always denied her – or, at the very least, the thing they’d never been able to agree on. It’s not the right time. I’m not sure if I’m ready. It’ll change our lives so much. Then he said it. I always thought I’d be a dad and now I won’t. It wasn’t remorse for what they might have lost, just regret for something denied to him alone, something he could have had with her but had always pushed away. 

She had wanted to scream at him. She sat stirring a spoon in her coffee, watching frothed milk spin around the cup until the urge to yell incoherently at him subsided, her anger dissipating in the swirling foam. “Why are you telling me this, Paul?”, she said finally.

“I thought you should know. I thought I owed you that,” he said.

“You owed me that?” Jane was incredulous. “Of all the things you might owe me, Paul, this is really the least of them.” He started to try to speak but Jane continued, cutting across him. “You owed me not fucking some old college friend at The Landmark on a regular basis. The fucking Landmark. Was she really that classy? Couldn’t you have taken her to the King’s Cross Premier Inn and saved some money on your infidelity? It might have been better for her. They have a good night guarantee and I can’t believe you would be as reliable as them in that promise.” Her voice was raised slightly now but controlled. A couple on the next table had paused their conversation, listening but pretending not to listen.

“Jane, just let me…”

“No, Paul, I won’t just let you. You owed me ten years of marriage and a series of broken promises about having a child. You owed me missed appointments at the IVF clinic. You owed me not being too proud to wank into a pot so they could test whether it was you or me that was ‘the problem’. So you don’t get to call me out of the blue and start acting all ‘poor me’ because you’ve got to have an op that’s going to stop your juices flowing.”

“It’s retrograde…”

“You’re not listening. I don’t care what it is. I’m sorry you have to have whatever it is that you have to have but I don’t really care. I’m done caring about you – for you – Paul and I want no part of this, whatever this is supposed to be.” Jane had left him sitting there, leaving the cafe in a rush, seat scraped back across the floor, coat flung on as she walked out. The chill of the outside air had felt like a slap around her face as she pulled open the door and her anger cooled as quickly as it had risen, leaving her feeling numb, suddenly exposed. She paused in the doorway. What did he want from her? She left without looking back.

The hospital was off Wellbeck Street. Jane thought about hailing a cab but it would be jammed at this time of day and she wasn’t far from Picadilly Circus so she jostled her way through the tourist throng to the tube station. As she came up the escalators at Marylebone she was briefly overwhelmed with a flood of memories, a sudden sense of anxiety which surprised her. She passed the flower stall which had been their meeting place in the early days, when everything was blooming, and slowed slightly, thought about stopping to pick up some tulips. Those were the ones he’d always picked out for her. It’s urgent, Mrs Roberts, your husband is in the high dependancy unit and we’d strongly advise you to come. She quickened her pace and left the station.

The hospital reception was calm and quiet, a smiling woman, glassed pushed back onto her forehead, looked up from a computer as Jane approached. She listened as Jane explained why she was there, gradually allowing the smile to soften on her face to something more neutral. She picked up a phone and spoke quickly, reassured Jane that someone would be right down to take care of her. After a few minutes a nurse arrived and took Jane up to a different floor, briskly escorting her down a corridor until they reached a set of signs for high dependency and intensive care.She ushered Jane into a small waiting room, pale pastel shades, a box of tissues discretely placed on a side table, and said that someone would come soon. They would keep her updated. Please wait.

Jane closed her eyes and tried to concentrate on her breathing, forced her focus to the steady rise and fall of her chest and the sensation of air entering and leaving her body. She curled her toes in her shoes as if she was forcing them into the floor, felt the shape of the chair support her body, tried to notice all the places where it came into contact with her. Each time she took her attention away from the simple physicality of the chair her mind raced away.

It raced back through a series of memories of their time together; a slide show of moments set on fast forward, images tripping over themselves, just snap shots suggesting the essence of them. Running for the last train, him bounding on to it and wedging the door open so she could duck under his arm. Drinking cocktails in Soho, watching a hen party dance on the tables, Paul eventually joining them, laughing as they draped a feather boa around his neck. Walking through Regent’s Park in the Spring, late afternoon, arm in arm, listening to him talk about cricket. Walking the steps at the Town Hall on their wedding day, pretending not to notice a group of her friends scuttling in just before her having misjudged how long they’d stayed in the pub. Walking the aisle, the ridiculous wicket themed aisle, and seeing him standing at the other end, his eyes never leaving her as she walked down towards him. The flat in Willesden. Later, the house in a village, the one with the good schools they’d never need.

She gripped the arms of the chair, dug her nails into the fabric, stilled her thoughts again. If her mind raced she tried to keep it on the good stuff but each thread, when pulled, unravelled just as they had unravelled in the end. The thread she pulled the most ran back to the night she had realised, the night her stupidity had been revealed. He’d been away and, unusually, had picked up when she’d called him. They’d been rowing a lot recently so maybe he felt bad or maybe he was worried that she’d start to suspect. She could hear a noise in the background on the call, almost like static. I’m just running a shower. Just freshening up before meal with the team. When she thought about it later she figured that maybe he’d answered because he’d assumed that he was safe, his secret stashed in the shower, out of danger. But his secret, unknowingly, disclosed herself. Are you coming in to join me? Female voice. Flirtatious. Some laughter. Called loud enough to be heard over the falling water and called loud enough to be heard down the receiver of a phone.  

It was the consultant that came, flanked by the nurse that had brought her up before, holding a glass of water. He was in pale blue scrubs but had pulled the cap off his head and was holding it in one hand, playing it between his fingers and thumb. He introduced himself but Jane didn’t register the name, she was fixated on the glass of water and the restless motion of his fingers. Why would they bring a glass of water? He was speaking quietly but firmly, precisely. She caught him say “as his wife” and only then looked up.

“We split up,” she said, sadly. “We’re separated. Paul’s not my husband anymore, doctor. I don’t know… I don’t really understand why I’m here.”

“I’m so sorry, Mrs Roberts,” he said. “He has listed you as his wife in all his documentation. Including,” he paused. “Including as his next of kin.”

Jane looked at him again. “What are you saying?”

“I’m sorry but there was a complication in the surgery. Your husband, your ex-husband, is dead.”

Part five of the Marylebone set of stories. One to go. Obviously no happy ending for Paul but let’s see what awaits Jane.

This was another piece in my 26,000 words for Great Ormond Street Hospital (not the hospital referenced in this story) during July ’23. Fundraising details here.

Baptism

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I was running on hard packed sand, bare feet flying, skirting the shoreline as the tide rose and fell. I felt fine mists of sea spray on my face, the wind whipping my hair in a tangle behind my head. A kind of baptism. I ran until my legs ached and I could feel each step pound up through my heels and my toes. I ran until my lungs burned and I had to slow, double over and gulp at the air to catch my breath.

I was almost gone. That was what they told me later. Not in those first moments when I came back around, swimming up into consciousness, surfacing for air, catching a few snatches of words, and then slipping back into sleep again. When I slept I ran. Always running until my muscles throbbed and my chest tightened and I gasped for air. I never had any sense of where I was running and I never looked back. I just ran until it hurt too much to carry on.

Those first few hours were all like that. Eyes flickering open, feeling the heaviness of my head in a pillow, the impossibility of movement, hearing voices, fragments of sentences, and then giving in again to the weight of sleep. After a while it was the pain that kept me conscious until someone adjusted something on a machine next to me and it receded enough for the weight to pull me back down again. Back down for my body to rest but my mind to run.

They must have told me several times what had happened. I could tell, when I was finally able to hear their words, process the sentences, that they’d said all of this before. They were patient but it was too fluent, too rehearsed. I did process the sentences but I don’t think, then, that I really grasped what they were saying; I was drifting in and out of a dream and surely the story about a girl who caught a virus and developed complications and almost died couldn’t be real. Could it? And yet the evidence was all there for me to feel in my ravaged body, in each rasping, ragged breath, in each attempt to move my legs or my head.

I remembered the ICU and the night that we’d all sung to each other across our video connection was still vivid. After that, it was fractured, fragments of memory as if someone had torn them up and scattered them through my head, a paper trail of clues. Flicking through old photos, a message to James, fleeting conversation with the girls, trying to disguise my demise, and then a jumble. Images of my trip to South America that might have been from the photos but might have been from a feverish delirium. And then nothing until the sensation of running, running, endless running to exhaustion, to standstill, to waking, to lying in this bed, battered but alive.

When they thought that I’d understood they asked me about the pain. I could scarcely speak which seemed to signal to them that they didn’t need to ask; they administered some sort of sedative and let me slide back into a state of restless rest. That seemed to be us for days, perhaps a week, time lost its grip, and the only cycle I recognised was sedated or not sedated. Minutes vanished in a woozy, dislocated haze; hours evaporated; days passed.

They connected me to my family, holding a video call up on a tablet, my parents wearing their best faces of reassurance but I could see the lines under Mum’s eyes and I heard the worry in Dad’s voice. I don’t know how much they’d been told but it was obvious that this hadn’t been a routine stop in the ICU. I didn’t recognise where they were until they told me they’d driven up to Bristol, were staying in a hotel until they were allowed to see me. They couldn’t visit whilst I was in the HDU. I managed to raise my arm to wave. I was still surprised at how thin, how frail and forlorn it looked. It didn’t look like mine.

When I finally croaked out words I asked the medics about my friends. They told me about Leah and Cora’s release and said they were doing fine. There was a yawning gap in the conversation where April should have been; they seemed reluctant to fill it. I insisted, forcing out a wheezing question: where’s April? They moved to a corner of the room and seemed to confer, exchanging whispers before reaching a consensus. That decision meant a deferral to a different doctor, someone I hadn’t seen before, some older guy who peered down at me through black rimmed glasses.

He told me.

He told me that she saved me. That she was immune and they thought that her blood plasma might contain enough antibodies to manufacture a vaccine. That she had offered herself up, a donation paid in blood, to see if it would work on me, an immediate and massive transfusion to pull me back from the brink. That I would have been lost without her intervention, our connection. That it worked. He told me that she saved me.

Where is she?

He paused, looked away briefly, but then he told me that too. The loss of blood had been too fast, they didn’t really understand the reaction, were still trying to figure out what had happened. They had induced a coma to stabilise her. That’s where she was. Unconscious and alone, here but not here, somewhere between.

I tried to cry out but there was no sound, just the hollow rattle from my healing lungs, and then tears running from the corners of my eyes down into my ears. No wind and spray from the endless beach in my mind, just the thin whistle of air and leaking of water from my body. I didn’t want this baptism. I didn’t want to be reborn if this was the cost.

Transfusion

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It helped to think of it as an act of connection. April liked to imagine that they would run a tube from her arm straight over to Aps, joining them together, allowing her blood to flow directly across. She knew it wouldn’t be like that. They had explained it to her as simply as they could, how they’d take her donation and then need to filter it, clean it, then they’d do the transfusion. She preferred to think of it as her giving a part of herself to her friend. An act of connection.

She had signed something to say that she understood the risks. They needed an unusually high volume of blood plasma because of Aps’ worsening condition. It had emerged that the Victory program, as intended, had involved infecting a low risk patient and then testing them with a synthesised vaccine borne from an immune host’s blood. April had listened to the rational, detached description of it all but all she could think was that their low risk patient was currently in high dependency, fighting for her life. Their grand test of whether her immunity was transferable had become pretty binary: Aps lives or Aps dies. In that analysis April weighed all the risks to herself as secondary.

There was more, though, in her blood contract. No disclosure. She wasn’t sure what exactly they would do if she told her story but they gave strong hints that they would just deny and discredit her. Just another hysterical conspiracy theorist to add to the pile. It was true that nobody really fully trusted official sources anymore but they didn’t trust  the alternatives either; truth couldn’t stand buried under lies. She had to submit to an extended stay in the ICU so that they could run more tests, make sure they could successfully develop a vaccine that didn’t rely on permanently draining her of fluid, like she was a bath they had to refill before pulling the plug, sluicing another body full of blood down the drain.

There was a time, not that long ago, where the prospect of the additional stay of isolation wouldn’t have bothered her. Six months, twelve months, make it as many months as you like. She liked being alone and would live inside her own head. It might not always be happy but it was home. It felt different now, it felt like she was giving up a community that she wanted to be part of, people that had coaxed her out of her own head and helped her stand outside, blinking in the sunshine. She knew she could do it, she had the resources to disappear back into herself and hide away, but she wasn’t sure how easy it would be to come back out again. Maybe this would be her last act of connection.

They’d let her see Aps again before they took her to take the blood. She’d stood at the glass and seen a pale facsimile of the person she’d talked and danced and drank and sang and joked with. April closed her eyes and conjured an image of them, the four of them, Leah and Cora were there too. She remembered them walking arm in arm by the harbour in the early evening, winding their way to another pub, laughing about some guy that had just hit on Leah, anticipating another night out. She remembered them in a circle on the dance floor, baiting each other to pull some ridiculous shapes, watching Aps always, always default to the Watusi because she’d seen Uma Thurman do it in some 90s movie. The one time they’d persuaded her to join them in some star jumps she’d slipped over on a stray spillage and had just lay on the floor laughing until they’d helped her up. Movin’ On Up had permanently been rechristened as Fallin’ On Down from that moment on. And look at us now. April opened her eyes. We’ve never been this far down before.

They took her to another room in HDU and waited whilst she changed into a loose hospital gown behind a screen, fumbling at tying a bow in the draw strings behind her head. She lay down on a bed in the middle of the room and stared at the ceiling, grimacing slightly at a sudden scratch on her arm and the feel of something sliding under the line of her skin. She closed her eyes and tried to shut out the chatter of voices from in the room, calls to monitor her blood pressure, someone calling out measurements, litres upon litres. The voices faded as the numbers rose higher.

 

Immunity

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As the entered the HDU the doctor was still talking to April but she didn’t hear him, her senses screening out everything except the window in front of her. Behind the glass a girl lay on a bed, a thick, snaking tube lodged in her mouth, her eyes closed. Her chest rose and fell slowly, steadily. Her heartbeat pulsed out in a regular, luminous green line on a monitor next to the bed. April placed her hands and forehead on the window and whispered Aps’ name over and over again.

“She’s stable,” said the doctor. April turned towards him, took a deep breath and tried to compose herself. Tried to think.

“What does that mean?” she said. “Is she going to be alright?”

“It means that her condition isn’t deteriorating at the moment.”

“Is she going to be alright?” repeated April.

The doctor didn’t break her gaze but remained silent for a few moments. He walked over to stand next to April at the window and they stood looking in on Aps. April caught a faint scent of his aftershave, an incongruous soft hint of sandalwood amid the sanitised, sharp bleach smells. She stated to repeat her question a third time but he stopped her.

“We don’t know. Honestly, we don’t know. Her condition was not supposed to worsen like this, it’s not something that we had expected when she was infected…” He paused, “…when we infected her.”

April felt her chest tighten and all of her senses sharpened; it seemed too bright, too loud all of a sudden. The hint of his aftershave filled her nostrils and she was hit with a wave of nausea.

“…what do you mean?” she managed, turning to face him. Her initial shock was rapidly turning to anger. “You can’t be serious? You infected her with this?”

The doctor folded his arms. “What do you know about the vaccination efforts in the last nine years?”

“I don’t give a fuck about the vaccination efforts,” shouted April. “I want you to tell me what you’ve done to my friend, then I want my phone, and then I’m getting out of here and going straight to the police.” She was shaking, close to tears but met with a steady, implacable stare.

“Vaccination Initiative, Covert Transmission. Project Victory. For the past decade we have chased shadows trying to cure the Covid outbreaks, every time we got close it mutated and eluded us again. The longer it has gone on the more people lost faith in medicine to protect them and the fewer and fewer people would come forward for testing programs. Nothing like enough…”

April was shaking her head in disbelief. “…so you give people the virus without them knowing?”

“Put bluntly, yes,” he said. “We are at war. And we are losing. There are choices that we have had to make that none of us would have wanted to but they are necessary.”

“Go tell her they’re necessary,” said April, jabbing her finger at the window. “Now give me my phone.”

“I don’t think you understand,” said the doctor. “Who would you ring? The police? Who do you think manages the covert transmission for us?”

April reached for something to steady herself, she felt the room lurch slightly as she was flooded with another jolt of adrenaline. She remembered them picking Aps up after her arrest. Remembered them all talking later. What tests? What did they do to you? Just bloods I think. Just bloods I think. They hadn’t been testing her for a prior infection, they’d been injecting her with a new one.

“This is unfortunate,” said the doctor. “We were very careful who we arranged to be in the house with you. Everyone had to be the right profile, the right age, previous exposure to the virus without complication, healthy. We didn’t foresee this.”

“What do you mean?” said April. “Why would you arrange people to be in a house with me? What do I have to do with this?”

“You’re the key to the program,” he said. “You have been ever since you left ICU when you were fourteen. We weren’t sure then but later tests confirmed it. You’re immune to every mutation we’ve ever seen and we think that you are the key to the vaccine.”

“I want no part of this,” said April. “I want no part of your experiments. You can’t play games with people’s lives.”

“Then all we can do for your friend is hope.”

April turned back to look at Aps through the glass; almost peaceful, sleeping. She remembered that first time they met, how she’d blundered into the conversation about her childhood ICU time, how April had liked her despite her clumsiness. She’d had a hunch then that there was something honest about her, something decent, and nothing since had changed her mind. Us April’s got to stick together.

She didn’t turn back to face the doctor, she didn’t want to look at him anymore.

“What do I have to do? What do you need from me?”

“Your blood, April. We need your blood.”

Breakout

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April had tried to force them to talk to her. At first, when they said they couldn’t tell her anything, she had pleaded, insisted that she just wanted to know what was happening to her friend. It had been almost three days since anyone had heard from Aps. When that didn’t work she grew increasingly angry, pulling repeatedly at her emergency call cord and yelling for someone to speak to her. They stationed a nurse at her door who would peer in through the porthole window to check she was okay; rarely she would key the code to unlock the door, the airtight seal would hiss as the room decompressed, and she would try to reason with her patient.

The next morning April reached for her phone. If they wouldn’t tell her anything then perhaps the others could search Aps’ things, contact the University, try to get hold of her parent’s details and find out from them what was going on. Her phone wasn’t there. She fumbled around on the floor, swept her arm under the bed: nothing. The room was so small it only took a couple of minutes to search. There was no sign of it. She started to slap the window in her door, shouting for attention, until eventually someone came.

April knew the protocol. In six months in ICU as a kid she must have seen someone unlock the door, release the seals, pull the door slightly towards themselves and then slide it across. When they knew you, when you’d been there for a while and you weren’t showing symptoms, some of them would get a little lax in sliding the door back behind them and would carry out their checks with it open to the corridor. Some of them never did that, even when they’d gotten to know her. None of them had this time. If April had been thinking straight she probably wouldn’t have even tried but fuelled with rage and worry she jumped straight at the nurse as the slid back the door.

As April moved she had a vague thought that maybe she would be able to duck under an arm, squeeze through the gap between person and doorframe. As the door began to slide open she could already see that wasn’t going to work, the space was barely more than a person wide, designed to be either filled with a shut door or a person. There wasn’t supposed to be a gap. In sheer frustration she jumped at the door as it opened and screamed; a combination of her weight and an instinctive, protective, backward step from the startled nurse carried both of them out into the white-walled corridor. April moved quickly, not knowing which way to go, but heading away from the nurse who had started to shout for help.

They’d brought them in separately. They’d all been taken together to a waiting area and then individually led down to their own ICU rooms. She had no idea where Aps would be. April started to frantically look through windows, aware that the nurse was approaching from behind and two other people, both dressed in blue scrubs, were walking towards her from the other end of the corridor. She remembered coming down from that end when they’d brought her to the room, there was a nursing station further up, at an intersection, she thought it just led back to the waiting area. She wouldn’t be there.

The nurse she’d barged past on escaping her room was close, holding her hands up and reassuring her that everything was okay, that she just needed to calm down and return to her room. April nodded her head and raised her own hands in response and took a step back towards her room. As the nurse lowered her arms April broke into a run, sprinting past her up the corridor. She heard footsteps behind her also break into a run now. She didn’t stop at the windows but pounded down the length of the passage, towards a set of double doors at the end. She pushed through those and a set of plastic strips hanging from the ceiling behind them into a room that seemed to be set up as a disinfectant area, a run of showers along one wall, sets of hazmat suits along another. On the opposite side of the room was another set of doors, above it a biohazard symbol and the letters HDU. She didn’t notice the grey box set in to the wall, a small red light above it. The doors wouldn’t budge. People spilled into the room behind her.

April sank to the floor, her back against the immovable door, and wept. They watched it for a moment, wary, before a doctor she hadn’t seen before crouched down in the middle of the room. He pulled his face mask down from across his mouth and nose. April hadn’t seen him before, older, maybe mid fifties, thick black rimmed glasses. He was staring intently at her, mouth fixed in a straight line, expressionless.

“Just tell me she’s okay,” said April quietly.

He was silent for a long time, eyes never leaving her. Eventually he stood up and walked over to her, pulling an ID card from his pocket and swiping it against the grey box on the wall. April shifted forwards slightly as she felt the doors open behind her. He offered her a hand and helped her up before he pulled his mask back up over his face.

“Come on then,” he said. “Your friend is in high dependency. I can tell you more there.”

April looked at him. “Like this?” She gestured at herself. “Shouldn’t I put a suit on or something. A mask?”

He shook his head. “There’s no need, April. Not for you. You’re immune.”