Thursday 2 September 2010

I wake up early, just after dawn, back in my teenage bedroom at the age of forty-four. Well, I’m in a bigger version of it. The partition wall was knocked down a few years back, Mum returning the house to its original two-bedroom configuration. The strange, universal sense of depersonalisation it brings, waking up here. The peeling away of adulthood, of all you have accumulated since you left this room. All the plans you made in here, in the crucible of your adolescence. All the anxieties and insecurities you tried to work your way through. You can feel them gathering, the person you were then, trying to seep back into your bones. The curtains are thin and, at night, the orange street light seeps in, the same street light that lit the thousands of nights I spent hunched over the record player, the NME, the guitar, dreaming of being somewhere else, someone else. The bed, the room, the house, the town – they all feel much, much too small. I lie there thinking about the little warren of rooms around me, Linda still asleep in Mum’s bed next door, Mum, up for a while now, shuffling around downstairs, making more coffee, turning on Radio 2. I am already wanting all of this to end, to move on to the next phase: grief, mourning, whatever. I want to get in the hire car and drive to Glasgow Airport. I want the attendant to bring my Bloody Mary as we fly back to Heathrow, away from all this mess, away from all the stuff that you can’t leave behind. But we must go back to the hospital.

So we go.

We meet the latest in a long line of doctors, this one a senior consultant, who tells us that they have finally performed an MRI scan and that the results are ‘not very encouraging’, but that we’re going to ‘wait just a little bit longer’.

‘Can we see the scan please?’ I ask.

He hesitates. ‘I don’t know if that would help you.’

‘Why not?’

‘Well, would you even know what you’re looking at, Mr Niven?’

‘Of course not. You can explain it to me.’

‘I don’t think I can do that,’ he says.

‘Why not?’

‘Umm, patient confidentiality,’ he says, incredibly. And he’s reaching. There is almost a question mark left hanging in the air after that ‘confidentiality’.

And a voice in my head says – ‘That’s enough.’

I take him lightly by the elbow and walk him a few paces away from my mother and sister. ‘The patient,’ I say, nodding towards my brother in the bed, my voice very quiet and calm (my voice icy, a bad sign – in his diaries Alan Clark describes this as being ‘just one step away from bellowing with rage’), ‘is unconscious and, as you just implied, unlikely to ever regain consciousness.’ I am speaking through my gritted bottom teeth now, just like Dad when in fury. ‘If he does, he’s going to be severely brain-damaged. I want to know exactly what’s happened to Gary so we can explain it to my mum. I want someone to show me the scan and walk me through exactly what he’s done to himself. Do you understand?’ By the end of this little speech, I am doing talking-to-a-child cadence. We face off. He’s angry, this guy. Unused to being spoken to like this. After a moment he says, ‘I don’t know if I can make that decision.’

‘Then go and get the person who can.’

Another beat. He holds my gaze. ‘Just a minute,’ he says. And the modifying, Elmore Leonard-enraging adjective here would be ‘curtly’.

He leaves. It’s real, then. The growing feeling I’ve had since I got here of closing ranks and protecting flanks. Of people running scared.

A few minutes pass with the now utterly familiar sound: the steady hiss and click of the ventilator as it makes Gary’s chest rise and fall, those pale blue coils on the monitor screens, the smell of disinfectant. The three-day stubble on Gary’s face. His eyes still gummed shut. Mum is holding his hand again as she talks to him. Telling him about our night, about what we had for dinner, about when we got up that morning, about what went on with PopMaster.

The consultant finally returns. ‘Mr Niven?’

‘What the hell goes on in your bloody heid, Gary?’

I remember Dad asking this more than once, after whatever fresh outrage had been committed. Here it is, Dad. All laid out like a split cauliflower. We’re in a small cubicle off the ICU. Up on the light box on the wall are the scans of Gary’s brain, bone white standing out against smoked grey. The consultant’s silver pen glides across the scans as he explains the clinical picture. Gary has effectively caused a monumental stroke. All the upper brain functions – memory, perception, motor skills, cognition – have been wiped out. Logic and reason are gone. (Again, and God help me, but how would we tell the difference?) So, there’s no other way to ask it. ‘Why are we keeping him alive?’

‘Because we cannot say with total certainty that Gary is technically brain-dead.’

He explains that there might be a chance of Gary being able to breathe on his own if some of the brainstem’s core functions are still intact. Based on his complete non-response to stimuli so far this is unlikely, but the only way to properly find out would be to take him off the ventilator and see what happens. They will need our permission to do this and the consultant still wants to wait another twenty-four hours.

‘What might change?’ I ask.

He looks at me and says, ‘You’re a very inquisitive person.’ This is not meant as a compliment.

I take a deep breath and say, ‘As you might be, if your brother had walked into a hospital perfectly healthy and found himself a vegetable the next day.’ He was admitted into your care with suicidal ideation and was allowed to hang himself in a cubicle a few feet from a nurses’ station. He came to you for help.

‘Yes,’ he says, snapping the light box off, his own temper showing. ‘But another way to look at it would be that if this had happened to him somewhere else and he wasn’t already in a hospital then he’d definitely be dead.’

This certainly strikes me as what, a couple of years from now, will become known as ‘a hot take’. I don’t know what I can even begin to say in response, so I settle for my own curt ‘Thank you for your time,’ and go off to find my sister.

I take Linda outside, where I smoke, and we discuss how to break all this to Mum. Linda has a fifteen-month-old daughter at home. She needs to get back to Glasgow. We agree that after I tell Mum what the scan shows, I should, as gently as possible, try and steer her towards the idea of agreeing to turn the ventilator off, so that we can see if Gary can breathe on his own. We go back and collect her – she leaves Gary with a kiss on the forehead and the promise that she will ‘see him later’ – and I drop Linda at the train station, then drive us on down to the beach park.