David Sutton: Clinically Dead

Russell's mother was seriously ill in intensive care.

The sneaking suspicion was that he should never have been away on holiday when she went in for her operation. At the back of his mind he'd known he was tempting fate, but who ever believed in that? Nevertheless, his one nagging thought, as he lay on hot, gritty beaches, dozing, was that something would inevitably go wrong if he took his vacation rather than cancelling. Because his mother's aneurysm operation was to be performed a mere twelve hours before the 757 deposited him back at the airport, it hardly seemed logical to miss out on two weeks in the sun. But guilt struck any form of rationality stone dead.

He rushed to the hospital dazed, in shock, wondering if the situation could have been avoided by treating himself to a bit of healthy selflessness. To keep lady luck sweet.

Before Russell was allowed in to see his mother, he was spoken to by the senior anaesthetist, having been required to sit for fifteen minutes in a small office adjacent to intensive care.

"The operation went without a hitch," he said without preamble. "The procedure is well established and usually straightforward. In fact, your mother was coming out of surgery as we expected when there were complications." The face of the anaesthetist was alarmingly boyish; Russell thought he looked too young to be responsible for life and death in the operating theatre.

Unable to maintain eye contact, Russell stared at the man's shoes. Unexpectedly, they were white leather mules with thick wooden soles, the sort of shoes which are supposed, somehow, to do your feet good. The leather was spotted with dried blood.

"Is she -?" Russell could not finish what he wanted to ask. He'd never had to face precisely this situation before. His father had died ten years ago, at work. His death was a fait accompli. Having his mother halfway between this world and the next was proving to be altogether more difficult to handle. He wished that his mother and father had not had him so late, then he wouldn't have had to cope with aged parents whilst he was still relatively young.

"Your mother is, what age?" the anaesthetist asked, as if deliberately trying to avoid answering the question he must have known Russell was trying to ask.

"Sixty-six," Russell replied.

"She smoked?" There was an indifferent callousness in his tone of voice that Russell could not comprehend the need for. Nobody's perfect, after all.

Looking up, Russell nodded. "But not for the last few years," he qualified.

"Well, her age and the state of her arteries are against her, you must understand that. However, we're hopeful she'll recover, I can say that."

For a few seconds Russell's heart leaped. He could feel the beat in his chest stagger into another gear. Maybe taking his holiday and enjoying it had not, after all, destroyed his mother's life.

"But don't get me wrong," the anaesthetist continued, "she is very poorly indeed. And we expect her to be in intensive therapy for some time."

Only the next day would Russell be able to remember what else the man had told him in the little cluttered office that threatened to suffocate its visitants. All he could concern himself with now was the sight of his mother when he was finally allowed to briefly see her, his body trembling with the fear of death.

She was unconscious, her long, grey hair in disarray, her face absent of colour. The bed seemed huge, swamping her diminutive body, and it was raised up as if she was being offered to some malignant god on a steel framed altar. The space around her was dimly illuminated. The continuous, quiet bleeping from a computer monitor was the only sound which accompanied her agonized, open-mouthed breathing, drawn in and exhaled with wheezing rapidity.

Russell watched the monitor high on the wall behind the bed. Red, yellow, blue and purple lines zig-zagged across it. Numbers tripped higher and lower, instantaneous calculations, forever updated. To the side of the bed were the drips, the syringe pumps and the intravenous pumps which were filling her arteries with painkillers and blood, and her stomach with food. A clear plastic tube taped to her nose was draining from her lungs a filthy brown liquid that kept hesitating in the U-bend, before being pushed on by more of the same.

A nurse appeared and emptied a urethral catheter bag, making a note of the quantity extracted. She smiled at Russell and the simple gesture reassured him more than had the anaesthetist. These people were dedicated. They were making sure his mother had every chance of survival, every chance for her own defences, her own will to live, to triumph. Her recovery was as much their concern as his.

At work the next day, he finally recalled what had been explained to him about his mother's condition. Russell was lifting and tipping what felt like the thousandth sack of the day, a bulk mailing of magazines, when a nylon strap holding the pack together split, and the magazines separated, slithering into the sorting trolley, their slippery, clear plastic envelopes helping them on their way. The bright red logo of the periodical repeated itself as the pile cascaded out of the sack. Corpuscles was dripping printed blood down the cover of the horror film magazine, Sissy Spacek's eyes glaring out as if shocked that the logo could do what it was doing to her face.

Russell looked away, towards the high ceiling. A haze of dust hung in the air of the sorting office, fluorescent lights glinting off specks in the middle distance. The faint sounds of radio muzak came from somewhere to his right, but the speaker could barely cope over the thump and rattle of conveyor belts and other machinery.

Then he remembered. His mother had been coming round from the first operation, but had lapsed back into unconsciousness unexpectedly. The circulation to her legs had ceased. She was rushed back to theatre as it was deemed that blood clots were preventing the circulation to the lower parts of her limbs. In a second lengthy, five hour operation, the surgeon had inserted arterial lines into both her legs, down from inner thighs to ankles. However, no blood clotting had been discovered. Instead the problem was… What was it Russell had been told? He couldn't really understand it. A condition called trashing, where fine crystals of blood block the capillaries. It was hoped the second operation would solve the problem in any event.

Time would tell.

On Thursday Russell wondered what had happened to all his time. He pressed the intercom button at the entrance to ITU. He was allowed through right away; some nights he had been forced to wait for up to twenty minutes while they did things: washing, physiotherapy, blood tests. As he approached the bed he was led aside by one of the sisters.

He could still see his mother wrapped in a sheet and trailed with twitching tubes. A mask covered her nose and mouth.

"As you know," the sister was saying, "Mary has had difficulty breathing and the infection on her chest has worsened. Mr Hastone considered it necessary to do something to alleviate what's becoming a life threatening condition."

Russell blinked at the sister. She was rather tall and beautiful, her lips wide, her blue eyes bright with life and intelligence. Her forehead wore a frown, as if to ensure he meekly accept the diagnosis and its necessary treatment. For a moment, with dread upon him, Russell could only see her as part of the machinery, a fleshy cog in the whirr of ITU's vast array of equipment and plastic piping.

He hadn't said anything, but his expression must have been puzzled, because the sister continued without prompting.

"Consequently we've had to perform a tracheotomy. It's actually what we call a mini-tracheotomy, a very simple procedure done under a local anaesthetic. And it'll help us to draw off the congestion." The sister was being very matter-of-fact about what she knew must have been a further shock to Russell.

A few seconds later he was allowed to the bedside, his head like a balloon filled with scalding water, his legs trembling.

His mother's neck was covered in a mass of untidy sticking plaster surrounding one inch of plastic tube with a little pull-off cap attached. Just like you'd see on an inflatable beach-ball. A slimy brown film was drying on it, as if the nurses hadn't cleaned off the latest extraction of sputum properly.

Russell began to feel ill. Along with the new method, fluid was still being drawn off his mother's lungs from the nose tube, but it was now a dense black colour, as if her lungs were rotting away, turning into fecal slime.

He grasped her hand, more to take his mind off how he was feeling than to offer comfort to the unconscious patient. Under her skin he imagined he could see withered fatty tissues, the membranes connecting internal organs stretched and atrophied. Her rapid breathing was unchanged, the oxygen mask over her mouth and nose steaming up with each raspy exhalation. The flesh on her face looked as if it was sloughing off, drawn down around her chin, leaving the skin surrounding her eyes and forehead taut and skeletal.

She's dying, Russell whimpered to himself. The nursing staff must only have been telling him half-truths…

On Saturday, as he stared at the large, framed wall-mounting holding the photographs and names of the intensive care staff, one of the consultants came into the corridor where he was sitting.

"Ah, Mr Bray, isn't it?"

"Yes." He stood up.

"I'm Mr Hastone. I'd like to have a chat before you go through," he said, making Russell's heart plummet. He could not make eye contact, he was so frightened he would be unable to withhold his emotions if the news was bad.

"Did Mr Chambers explain to you about the operation and the after-effects?" he asked.

Russell nodded, trying to remember who Mr Chambers was. Numerous members of the staff had spoken to him over the last few days.

"Then you'll be aware that your mother's kidneys more or less 'shut down' after surgery?"

It had been explained to him that the shock of the operation to repair the aneurysm in her aorta, and the subsequent one following, had caused his mother's kidneys to stop functioning properly. That they'd ceased doing what they were supposed to do and it might take a few days for them to begin working again.

Now he knew something else had gone wrong.

"Mr Chambers has become very concerned that her kidneys aren't beginning to do their job sufficiently well to remove all the poisons in her system, and he decided she would need extra help. To give her kidneys time to recover without having the additional burden they have to contend with at the moment."

"Help?"

"So your mother has been put on a dialysis machine for the time being. We're not really equipped with the best here, but we do have a portable machine. We'll see how she progresses, but it may be that she'll need to be transferred to a hospital with a renal unit."

"Dialysis." Russell rubbed his forehead with the fingers of his right hand. There appeared to be an intangible ball of cotton wool surrounding his head, suffocating hearing, cutting off his vision and choking him.

The sight of the machine, with its aspirated sounds and the dark blood visibly pumping to and from it was a bad enough memory, but seeing his mother's feet was even worse. When he'd entered the ward, the blanket was loose at the bottom of the bed after being draped over a cage to keep her legs untouched. He peeped beneath and saw that the toes on both feet were a blotched and revolting grey-black.

What with everything else, he had been too terrified to ask what was happening to them.

On the way home rain was pummelling the pavements as if it wanted to indent the concrete. What it had succeeded in doing was soaking him so completely he knew it was foolish to have left home without an umbrella. After a few minutes walking, a cold wetness crept around his feet as if his shoes were filling up with chilled blood.

A month must have passed because, as he sorted mail, amongst the business envelopes was the plastic wrapped cover of another issue of Corpuscles. "Where are the living dead?" a banner headline shouted across its cover. Behind the red lettering lurked a mummified face from a film he did not recognize.

"In this place, Russ!"

Russell turned around, confused. Derek, one of his friends, with whom he'd spent his holiday, was looking over his shoulder. Russell realized he had been staring at the magazine and Derek had responded to the rhetorical question on its cover. His idea of a joke.

"Most of this lot," he nodded in general at his colleagues, "are more dead than alive."

"Right." Russell was in no mood for laughs.

"How's your mum?" Derek asked, changing tack and snatching the magazine from Russell's fingers and tossing it into a distant skip.

"She's holding her own," he replied. In fact he was unaware of whether she was nearer this life or the one beyond. What was almost unbearable was that, each time he visited the hospital, the news always got worse. So he never knew whether to believe and trust the doctors or not. And he found he couldn't talk about it to anyone.

"Bum deal," Derek said. "Watch out, here's the gaffer." He began to lift a sack and tip out piles of little boxes, groaning. "Why the fuck do they pack things up so small you can't even get a fucking label small enough to fit on 'em!"

He began tossing them without looking, accurately dispensing boxes, magazines and other envelopes into their appropriate containers.

Russell slid an elastic band off a pack of envelopes from the electricity board. The rubber smelled sickeningly familiar, the envelopes too, a sort of antiseptic tang.

"Why don't you take some time off?" Derek said, returning to Russell's obvious depression. "You'd get special leave," he added.

Russell knew he looked pretty washed out. He was existing merely to attend the hospital every evening, where he would remain for up to two hours mutely watching his mother fight for breath and for life..

"I'm better off coming in," he said. "I'd brood at home."

"Looks like you're doing that here," Derek stated. "Watch out, here's the gaffer."

Russell smiled at Derek's oft-repeated epigram.

At the end of his shift, the tips of Russell's fingers were numb from handling plastic envelopes that had begun to feel like living tissue. His fingers felt as dead as he knew his mother's feet to be.

Outside, the city centre looked changed. The rain had decided to let up, but the surface of the street was wet and gutters had become little rivers. It was the rush hour and the pedestrian zones were choked with shop and office workers heading for the bus stops. Russell felt sure they were mobile only because something else drove them, not their own desires. They were fulfilling a role, playing, unconsciously, the parts destined for them. This was a conclusion that had been forced upon him by the events of the last few weeks.

Hospital patients are like that too, Russell decided. They're unwitting actors, or movie stars, taking the stage for a day or two, swelling larger than life in the limelight of their disease, before vanishing into obscurity. And he knew them all in detail by now: the baby who'd swallowed a plastic top and nearly asphyxiated; the coronary patient on a ventilator; the car accident victim swathed in bandages; the vegetative sleeper for whom life may as well have already departed; and his mother, with a rolling panoply of complications, as if she played several parts in the drama.

He was waiting at the bus stop for home when he realized he should have been going to the hospital. He moved off, made uneasy by his forgetfulness. A hot dog man was serving through a cloud of steam. His customer squeezed a bloody, watery line of red along his onion covered meat.

Russell turned away in disgust, heading for the bus he needed. His stomach growled for food, but he knew he couldn't eat yet. Not if he wanted it to stay down long enough to digest. His whole body felt raw, abused. As if he was starving himself.

He couldn't recall the details of his life over the past month. Memories faded in and out. He was dreaming his life, it being better than facing the truth, he could hear his mind telling him as if from far away.

At eleven-thirty he was trying to forget that the consultant was worried that his mother's circulation remained a serious predicament, slowing her recovery. She was in a lot of pain, despite the cocktail of analgesics she was being administered, and the pain was further disabling her recuperation.

Nevertheless, that evening his mother had briefly surfaced into consciousness.

Nifedipine, hydrocortisone, atropine. The words he'd sneaked a look at on his mother's chart became a litany, until he realized she was gripping his hand.

"Tell them to let me go," she hissed as he replaced the clipboard. Russell's heart swelled with hope, forcing tears into his eyes. He blinked them away as he stared at his mother. She was awake but, in spite of what she had said, did not appear to be aware of her surroundings or whose hand it was she held. At least the consciousness must mean she was beginning make progress.

He could not face telling her that her feet might have to be amputated. Yet her words hinted that she already knew. When she closed her eyes again he was saved from the necessity.

In his darkened living room, the picture on the blank television screen a reflection of his own vacant face, Russell convinced himself they were experimenting on his mother. The whole medical thing, from start to finish, was a sham. His mother was a guinea-pig. The intensive care unit was a laboratory. The doctors were testing drugs. The surgeons were performing vivisection for the gratification of their immoral souls. The machines that were keeping his mother alive were doing so only that more of the same grisly work might be accomplished.

The long road to the hospital entrance was a patchwork of autumn leaves, flattened by rain, patterning the paving slabs with brown and black blotches like rampant melanomas. The streetlamps highlighted other pedestrians skidding on the slimy mucus each leaf hid beneath itself; runny sores under scabs.

"Oh, hi! Russell Bray, isn't it?" The nearest skidder was a nurse Russell recognized as one of the ITU staff.

He nodded, unable to speak for fear of showing his emotions, knowing she was part of the conspiracy he'd finally uncovered the previous night.

"You might have to wait a bit this evening," she said, halting him with a hand on his arm.

"Oh?" His questioning voice was betraying his fear, but he hoped she wouldn't notice. If they knew he was on to them things could become awkward.

"There's a bit of a panic on in IT. Couple of emergencies came in. They're very busy," she added.

So why wasn't she there, helping them, Russell speculated. "Thanks for telling me," he replied evenly, trying to avoid her spectacled eyes.

"Watch the leaves!" the nurse stated as she stalked off, planting her flat-soled shoes firmly with each step. There was a sort of robotic motion to her walk, but it must have been the nurse's fear of falling over, and not some other vaguely mechanical workings of her body parts, that controlled her gait.

Russell ventured down the long corridor, past the coffee shop, past the chapel, past various wards announcing their function with bright red and white signs, until he turned familiarly, but uncomfortably, into the ITU reception area and waiting room. There was always an atmosphere of calm here, but it never relaxed Russell and never would now he was aware what was going on.

He lifted the phone and jabbed the button. In the earpiece he heard the echo of the distant buzzer. Seconds passed. The phone wasn't answered. He tried again, staring at the notice pinned to one of the double doors: "Absolutely No Admittance - Use Telephone". He looked from that to the photographic portraits of the staff. Some of the pictures had been removed, he saw, their names and occupations printed below blank rectangles, as if they'd suddenly been snuffed out of existence. Others continued to smile amiably, subtly concealing their real motives.

Replacing the receiver, he moved into the waiting room and sat down, intending to give himself five or ten minutes before trying the intercom again. Whenever he'd had to wait before, he always imagined the worst, but all that was happening was that his mother was undergoing physiotherapy, or some other treatment which they thought it better not to allow him to witness.

The magazines lying on top of an empty bookcase were so out of date they were thumbed to tatters, as if their covers were desiccated skin. Plastic flowers in vases looked as waxy as his mother's face. The notice board on the wall held the same information as always, advising visitors to wash their hands.

Yet, something had changed. Russell was unsure yet what it was. The two framed prints on opposing walls, one of two cute puppies, the other a pair of cute kittens, were both still askew. An oval red stain on the carpet, that must have been ink rather than blood because it had never faded, lured Russell's eyes. Every time he'd had to wait he stared at the stain, trying to see a pattern, as if it were a Rorschach test. Somewhere deep within its colour and the green of the carpet was encoded the real reason why his mother was being kept alive.

Above all he must remain controlled. He should act as subtly as the medical staff who were fooling him.

Then he knew. He walked out of the room and looked at the intercom phone on the wall. Its normally green light was red. It had never been red before. There might simply be a fault, of course.

Pressing the button again, he heard the familiar, distant buzzer hiss at the nurses' station. It sounded all right.

Yet the call remained unanswered.

Well damn the sign forbidding his entry. He looked the the blinking display on his watch and realized, dismayed, that he'd waited half an hour. That was plenty long enough.

He barged through the double doors, rehearsing his script for ignoring the mandate of the notice.

The corridor beyond was empty of life. The door to the office where he'd been informed about procedures was open. Russell peered in, ready with his explanation, but there was no one there.

He leaned his head around the entrance to the storeroom/kitchen next and saw that it was dishevelled. A tap was running into a sink unchecked and packages of dressings were strewn about the floor. An instrument tray had toppled off a table, its gleaming contents scattered amongst the dressings in a distribution reminiscent of hieroglyphics.

The emergency must be bigger than even the nurse had suggested, if the staff had found it necessary to treat the tools of their trade so carelessly.

Returning to the corridor, Russell finally came to the darkened ward. The lights were always kept turned low, but nevertheless he could not help feeling suddenly anxious at the ballooning shadows that lurked beyond curtains. There was an absence of the usual sounds. Not the bleep of a monitor, nor the swish of a nurse's starched uniform interrupted the silence.

At first this was all disorienting and unexpected. Additionally there appeared to have been some changes in the layout of the unit, particularly with regard to the whereabouts of his mother's bed. He was about to ask a member of the staff where they'd moved her to, when he realized there were no nurses, doctors, anaesthetists. ITU had become a medical Marie Celeste.

Russell frowned, aware that he was hanging onto the door as if in doubt about entering. His thoughts raced through a litany of words that he knew he must somehow suppress: inflammation, allergies, shock, coronary vasodilator, hypertension, sputum, gangrene.

Sweeping aside a curtain surrounding the nearest bed was both a reaction and an attempt to stem the tide of his thoughts, which he knew were turning themselves into an incantation. He knew what incantations were capable of, and how they led to unconscious acts, to a shackling of the will.

On the bed in front of him, a tube, ripped from some anonymous limb, squirted colourless liquid onto the sheets from the syringe pump to which it was attached. The bed's occupant must have been removed in a great hurry, perhaps for emergency surgery, and the nurse had failed to switch off the equipment.

A more sensible part of Russell told him they never worked like that. This place was so ordered. He was trying to work out what was happening, when a rustle of paper returned his attention to the vacant nurses' station.

He could see no one standing behind the high-fronted desk dealing with the paperwork. Perhaps a nurse had dropped a patient's notes and was bending down to pick them up? He walked back towards the desk, blinking, moisture swelling behind his eyelids, desperately wanting to know what had become of his mother and hating not having someone to comfort him.

A hand appeared, slapping against the telephone, bouncing the receiver off its cradle. The fingers looked odd and displaced and curiously transluscent before Russell realized why. The pudgy hand which appeared to be waving at him was that of a baby. Its partner rose into view, grasping the wooden ledge of the desk on its inner side. Russell was unable to see what was happening behind, in the rhombus of one of the ward's shadows.

He ceased walking towards the desk, fright halting him. There was a wheezy intake of breath, not unlike his mother's hideous gurgle, and the child's face was hauled into view by the pale hands. Its features were familiar; it was baby William, who'd come into hospital after swallowing a bottle-top, nearly choking on it. His rotund face still displayed a blue tinge from his near asphyxia. For the first time Russell took notice of the infant's eyes, which were unblinking, staring, but unseeing.

Shivering, Russell realized the baby was too young to have crawled, let alone walked, yet as this impossibility dawned, the child began to move along the desk, scattering papers and pens with its crab-like shuffle. In a moment it crashed noisily to the floor, but the fall did not appear to halt its forward momentum.

Further sounds behind him made Russell spin around, gasping. A curtain was being drawn aside from another bed, the hand that grasped it straining the hooks to breaking point.

The naked man who stepped into view trailed plastic tubing, held in place by plasters on his chest and arms. They dangled limply as if they were atrophied appendages sutured into his flesh by the vivisectionists who worked here. Blood ran sluggishly down the patient's belly, staining his pubic hair red. The face above the body tried to smile, but failed. But the expression was familiar. Russell had smiled and nodded to the man each day as he passed his bed on his way to his mother's, a gesture of support. He was the desperate coronary case who should, this very second, have been on a life-support unit.

Russell slipped suddenly, landing on his behind. His palm slid in something wet and sticky on the floor tiles which he was too scared to look at. From this new angle he could see that the man had left someone behind him, lying on the floor by his bed. It took only a second to realize it was the senior anaesthetist, his torso twitching from some severe shock or unseen wound.

Backing away, Russell dared himself to turn, wondering whether baby William had crawled near to him. He might trip over the child as he stood up, but he was no longer worried about hurting it.

He moved rapidly to his left, realizing now that his mother's bed was tucked away in the corner. He was thinking that maybe they hadn't reached her yet, the experimenters had perhaps overlooked her. Hadn't they had enough with the baby and the man?

Russell now knew for certain that it was the drugs that were causing the patients to rise up. There was too much unsupervised testing, too much willingness to inject and cut and excise. The painkillers and the narcotics were inside his mother, diluting her consciousness. No one would believe him, but he knew that, as with all the others, they had been slowly drawing off all her body fluids, in order to replace them with the secret substances which would animate her flesh once she was dead.

His mother's bed was raised high, and he felt like a small boy as he approached the mattress. There was a high-pitched whine in his head. The monitor on its adjustable arm was stretched over the bed and displayed itself towards him. On its surface, there were now six steady lines with no oscillation to impair their symmetry or the message they conveyed without words. The squeal that he imagined was emitted from the monitor should have been loud enough to summon a nurse, except that it was coming from his own throat.

The thin hollow of the bed sheet was empty, as if the occupant had been sucked from between it and the mattress. At the bottom the protective cage still hunched beneath the cover, inviting examination.

Russell drove the knuckles of his hands into his temples, a roar starting low in his throat, deep down, so deep it hurt; so deep that it wouldn't come out, his larynx strangling him.

He heard more shuffling sounds and turned. The baby and the man were moving towards him, along with other patients who had also fared for the worse. They moved with a slow synchronous grace that was none the less menacing for its lack of speed. Quickly, he looked back at the space where his mother should have been.

The gap under the leg-cage loomed as he lifted the sheet from it. Two shrivelled, black fleshy objects lay side by side as if desperately in need of further medical treatment.

Moving to one side, he dodged around the advancing figures, wrenching curtains as he went in a furious bid to find what remained of his mother. Behind one screen he discovered the bulk of the medical staff, some with hypodermics unremoved from the limbs and torsos where they had been implanted. It was plain that the experiments had taken their revenge.

"1 wanted them to let me go," a voice spoke in Russell's head as he found her at last. The accusation was as barbed and venomous as the stainless instruments and the pharmacopoeia that had been used upon her.

Russell's mother was trying to stand up and it seemed likely she'd been mutely attempting the same procedure for some time. Her hospital nightgown was hanging off her withered shoulders, and purple blood smeared the floor next to the stumps of her ankles.

"Come on, mother," Russell said tenderly. "It's time to go home." He knew that he'd allowed her to remain in hospital far too long, but perhaps there was still time to help. He lifted her surprisingly light body in his arms and shouldered angrily past the RTA victim in his stained bandages, too fast to be cornered now.

Outside, in the corridor, he recalled what he'd almost forgotten in his haste. He must retrieve those other parts of his mother, before they began to move by themselves. Before they started to shuffle with involuntarily life to the subcutaneous beat of the drugs.