Here they come. Sounds like nearly a dozen of them. It’s all about the shoes. The surgical consultants, nearly all male, wear shoes with leather soles that make plenty of noise as they stride around the hospital. The rare female consultants or registrars often wear stilettos to assert themselves among their male colleagues. The ward sister – still a powerful figure, as you’ll soon discover if you cross her – wears low heeled shoes that announce her presence discreetly but firmly. Young doctors wear quieter shoes, but not as quiet as those worn by nurses. Junior doctors slap around in running shoes, and trainee nurses tend to creak in their hesitant new footwear. Cleaning staff are almost inaudible.
The consultant sweeps into the ward, displacing a disproportionate quantity of the atmosphere with his importance. He leads a flying V of medical geese, their white coats flapping in his wake. His visit is intrusive, a continuation of that earlier intrusion when he reached into your gutted body while you were in a distant, dreamless place.
After the first operation, when I believed I was recovering, I still took the trouble to open my eyes when something happened in the ward. I was eager to interact with the whole cast of supporting characters in my medical drama. I flirted with the nurses, bantered with the doctors and was knowledgeable with my consultant. I inhabited my role as a patient enthusiastically, and I let them all know that although I had to ask them to do things for me that were last done by my mother, at an age when I had no say in the matter, I was not to be patronised.
It was during this early, engaged phase that I learned everything I’ll ever need to know about status and power by watching the ward rounds. Each time the gaggle of registrars, doctors, nurses and students trailed in behind the consultant, I got better at deducing the precise position of each person in the hierarchy entirely from their body language. Later, when I chose to remain submerged in my warm cocoon of morphine, I refined it down to the feet.
They have an enlightened painkiller policy in this hospital, and patients with severe pain can self-medicate with regulated opiates. You push a button, and a machine next to your bed delivers a shot directly into your vein. It’s a sensible approach for most patients, but not for an irresponsible one with a history of substance abuse. Hello.
It took me a long time to get anything like an admission that they’d screwed up my second operation. Eventually, I unearthed a simple fact behind their repeated evasions: the surgeon had cut something that shouldn’t have been cut.
I was told that many people in my condition live rich, fulfilling lives. There were some wonderful support groups, they said, terrifically helpful web sites, inspiring examples of triumph over the kind of adversity I was facing. The encouragement was truly nauseating, and I retreated from it into the embrace of morphine.
They should be reducing my dose. I know that, and they know that I know. But it’s easier for all of us to get to the end of another day without them doing anything about it.
There’s one exception to the rule that cleaners move with a soundless shuffle, and that’s Sal. He’s Somalian and his name is Salifah, or Salifeyah, but everyone calls him Sal. He walks with a light, firm step, making no more sound than he needs to, but he’s not trying to efface himself from the surface of the earth, either. In the days before I retreated into my private world, I used to watch him. He moved the mop around the floor with great economy and grace. He rarely spoke and never smiled.
Until one day, when I said to him, ‘Sal, you clean that floor like a dancer.’
He stopped and regarded me gravely. Then he smiled.
‘You know,’ I said, ‘sometimes I can’t tell if you’re moving the mop or the mop’s moving you.’
A slow chuckle bubbled up from deep inside him. Then he walked to my bedside and placed his hand gently on my shoulder for a moment. Then he turned and picked up his bucket and walked out of the room.
I begin to get worried when I notice that Sal’s step is getting hesitant and his tread is less firm. He’s lost his rhythm, as if he’s no longer certain of his place in the world. It’s a long time since that moment when he laid his hand on my shoulder. By now everyone has accepted that I’m in a world of my own. I don’t want to emerge from it to check on what’s happening with Sal. I’m afraid that if I look at him, even for an instant, I might find out what’s wrong. But I find out anyway.
Late afternoon. A quiet time on the ward. The visitors who came in after lunch have gone, and the next wave won’t start arriving until around five-thirty. I’m in a room with six beds, and my bed is one of the two nearest the door. I can hear most of what happens outside in the corridor: in one direction all the way to the main doors into the ward, and, in the other, to the nurses’ station.
I hear the main ward doors swing open. Male footsteps, I decide. Purposeful. My room is the second one along from the main doors. The visitor pauses by the first room. Moves on. Now he’s in the doorway of my room. He’s breathing through his nose and I can sense his glance sweeping the room quickly. He moves on, pausing briefly by each room. He walks past the nurses’ station, without making any enquiries, and the nurses chatting there ignore him. He turns the corner and moves out of my earshot. This wing of the hospital is constructed around a central courtyard and if he keeps going he’ll do a complete circuit and emerge by the main ward doors again.
I hear a different set of footsteps, in a big hurry. I recognise them: it’s Sal. He’s between shifts, and sometimes he sits in the day room to read. I think he’s studying. He hurries past my room, heading towards the main doors. Then I hear the visitor’s footsteps again, approaching fast from the side corridor, completing his circuit. He intercepts Sal right by the doors. They talk, very quietly. I can tell this is not a friendly conversation. I concentrate, tune in. I begin to hear fragments. The visitor has an accent. Eastern European. I hear a long burst from him, ending with: ‘… was agreed!’
Then Sal’s voice. Anger subdued by caution or fear: ‘… agreed… paid already!’
The stranger again: ‘… expenses and interest. It is not a free gift!’
‘… my passport,’ says Sal. ‘It is essential.’
‘… your family? No, another thousand.’
Panic in Sal’s voice now: ‘… not right. Please!’
‘… not possible…. of your family. It’s not my choice, it’s business.’
The doors swing open and then closed. The visitor has gone. Sal walks back this way with slow, subdued steps. I could call out to him as he passes. But I don’t.
al doesn’t show up the next day. Or the next one. The other cleaners do the rounds. After three days I hear Mr Cheerful asking Dawson, ‘Where’s your mate, then?’
‘Sal. Where’s he gone, then?’
‘No idea. I don’t know the man.’
He means well, Mr Cheerful, but he assumes that because Sal is black, and Dawson is black, they must be friends. Dawson is Jamaican. Sal is Somalian. But that means nothing to Mr Cheerful. He’s in here to have his leg off. Diabetes. But he works on his upper body strength, has consultations with the physio, stays positive. His fiercely supportive girlfriend comes in every day. He laughs and jokes. Unbelievable.
Sal turns up the next day. He’s slow, very slow.
‘Cheer up, mate, it may never happen!’ shouts Mr Cheerful.
In the afternoon, at the quiet time, I hear the stranger entering the ward. This time, Sal is waiting and comes to meet him. His walk sounds defeated. The visitor hustles him into a bathroom opposite the doorway to my room. They don’t close the door, and I can hear almost everything. It’s horribly predictable. Sal hands over the thousand pounds, but the guy wants more before he returns the passport. Another thousand, in a week. He mentions the immigration authorities. More veiled threats about Sal’s family back in Somalia. Sal pleads with him, he can’t possibly raise another thousand in a week. Okay, says the visitor, three hundred a week. For four weeks. To cover the interest. First payment on Monday – five days away. He leaves. Sal stays in the bathroom for a while. When he leaves he’s become one of them: one of the shufflers. I can’t bear it.
Two in the morning. Everyone’s asleep. I charge my mobile phone and call Liz.
‘Good God,’ she says, ‘I thought you were in a coma or something.’
‘I’m not in a coma. I want you to do something for me.’
‘Do you realise it’s the middle of the night?’
‘Yes. Just listen, please. I need your help.’
‘Well, yes, of course. God, how are you? What’s happening? Are we still banished? We heard all kinds of things. Are you dying, or what? How are you?’
‘I’ll tell you later. But I need you to do this for me. It might be a bit weird.’
‘What a surprise.’
Later, Liz confirmed that she did find it weird, sitting silently at my bedside for half an hour in the afternoon sunlight, aware that I knew she was there even though I gave no sign I was awake. But I needed it to seem like a genuine visit by a concerned friend. Which it was, partly.
At one point, Mr Cheerful called out to her, ‘Waste of time, love, he’s off with the fairies!’
Weirder still, she said, was slipping the envelope with a thousand pounds in it under my pillow just before she left.
I’m not rich but a few years ago I wrote the screenplay for a trashy film that made a lot of money. My accountant – the new one, not my old accountant who was also my coke dealer – helped me invest what I earned. I can spare a grand for a good cause.
Monday. He comes at the same time. I hear Sal trudging to meet him: he must have been waiting in the day room. I get out of bed quickly. And nearly fall over. I haven’t stood up for weeks. Mr Cheerful gazes at me in astonishment, lost for words for once. I lurch out into the corridor. Sal and the visitor stare at me. He isn’t a big guy but he looks mean. I, however, am a big guy and Christ knows what I look like. Crazy, I hope. I’ve got an IV drip in each arm and I’m dragging their stands behind me, along with the morphine dispenser. My hair hasn’t been cut for a long time, nor has my beard. I’m not in good shape but I’m still an imposing package of meat. I get right in the guy’s face. He recoils: my breath stinks.
Good. I slap the envelope against his chest.
‘There’s a thousand,’ I hiss. ‘Take it and give my friend his passport, you little piece of shit.’
He recovers from his surprise and I see the calculations in his eyes. He begins to say something but I cut him off:
‘No. That’s all you’re going to get. Take it and get out and don’t try to contact this man again. I know about people like you. I’ve got powerful friends. Understand? Give him the passport.’
He hesitates. I press the envelope against his chest, hard. He takes a green passport from his pocket. I grab it and he grabs the envelope; he backs away for a few steps, then turns and leaves. I give the passport to Sal. He takes it, looks searchingly at me for a moment, then turns and walks away without a word. I wonder what he’s thinking. Have I loaded him with a different kind of debt now, by acting the white saviour? I hope not, but if it’s true, I want to believe I’m the lesser of two evils.
Next day, Sal cleans the room as usual on his second shift. He doesn’t look at me. Mr Cheerful is whispering about me to his girlfriend. Someone is sitting by my bed, talking to me about social services and what will happen when I leave hospital. I’m awake and the system is processing me. It’s exhausting.
Later. I open my eyes to see Sal standing beside me. He’s not wearing his cleaner’s coat. He takes my hand and holds it in his for a moment.
‘Be well, my friend,’ he says.
Then he leaves. I know I’ll never see him again.
‘What was all that about, mate?’ asks Mr Cheerful.
I don’t particularly want to talk to him, but I do. He’s part of the world I’m rejoining. It turns out he’s actually a nice guy. His name is Steve.