A couple of years ago, just before Christmas, my four-year-old son was admitted to hospital. He’d developed an infection called preseptal cellulitis in the skin around his right eye – his eyelid was angry red and swollen shut. Doctors worried the infection could travel into the optic nerve and then into his brain. He was given intravenous penicillin and monitored around the clock. For seven days, my wife and I stayed with him, and fell into step with life on the children’s ward – our son’s regular doses of medicine, the nurses’ twelve-hour shifts, the doctor’s morning rounds. The snow-muffled streets increased our sense of isolation.

On his first night back home, my son refused to take his antibiotics. My wife and I were alternately pleading, tearful and angry, all to no avail. Finally, I told him a story about the time I had to have my tonsils out, and had run away from two nurses when they came to take me to the operating theatre. ‘I just didn’t want to go,’ I said. My son considered this and, after a few minutes, agreed to take his medicine. At bedtime, with the stories read and the lights shut off, he asked me to tell him again about the time I ran away from the nurses.

That night I was startled awake by a dream, which began to dissolve as soon as I woke. I had an image of myself reaching out to catch a small grass-green lizard that had shot down a dark space between two rocks, vanishing into the earth. The dream felt like a memory – it had the colours of an old photograph, perhaps something that had actually happened to me when I was a boy. I thought the dream might have something to do with my son’s illness, but what? Then I remembered another detail from the dream, the four letters S, I, D, A.

I lay in the dark for a few moments running after the dream but failing to remember any more. Frustrated, I got out of bed, went to the kitchen and ran myself a glass of water from the tap. The green digital clock on the oven said 01.25. I took my glass and went to the living room at the top of the house. I sat there in the quiet, the hush interrupted only occasionally by an all-night bus changing gears on the hill around the corner.

As a psychoanalyst, I feel uncomfortable when I can’t remember a dream. It’s irrational, of course, but failing to remember a dream makes me feel a bit embarrassed, a bit of a fraud. ‘You can dish it out, but you can’t take it,’ I’ve thought to myself on more than one occasion. That night, I did what psychoanalysts tell their patients to do when trying to recapture the details of dream: I let my mind free-associate – allowing any thought I had float to the surface, no matter how illogical or embarrassing.

My first thought: a Spanish poem. Was it by Pedro Salinas? I knew it wasn’t exact, but I remembered: ‘I forgot your name; the letters of your name move about now unconnected, unknown to each other / Rearranged they form advertisements on buses, they’re on envelopes shaping other names / you’re somewhere now, but all in bits, dismantled, impossible.’

In a rush, I recognized the four letters: SIDA is Spanish for AIDS, but also the very same letters rearranged – like the letters in the poem, moved about.

I remembered a young man who had come to see me years ago for two consultations. He’d been referred by his family doctor because he was HIV-positive and refusing treatment for pneumonia. Could I find some way of encouraging him to listen to his doctor or parents?

During our first meeting the young man told me that he was born and raised in Cornwall, in a small village at the tip of the Lizard. ‘The Lizard is a peninsula, the southernmost point in Britain, in fact – the Spanish Armada was first sighted from the field next to my parents’ house,’ he said. We talked about his illness, but his lack of concern for himself disturbed me. I did my best to reach him. We discussed his fear of dying, and I suggested that his defence against this anxiety was to deny that he was ill and to refuse treatment. He left unconvinced of the need for help, but promised to return for a second meeting the next day.

He was late for our appointment. When he arrived, he told me that he’d realized I was right, that he needed to look after himself. But instead of accepting treatment, he’d decided that the best thing to do was to take a break. He’d already booked a trip to Rio for Mardi Gras – why not go earlier?

The following autumn I heard from his doctor that he had died – not from pneumonia, but from dysentery.

Outside, another night bus went by. These two consultations, which did not seem that long ago, must have taken place at least twenty years earlier. The young man was only twenty-six years old when he died. His parents were probably still alive. I imagined their home by the sea and the field next to it blanketed with snow. I saw them as they might be now, wrapping gifts, listening to the radio, remembering their beautiful boy in his flannel pyjamas, opening his presents on Christmas morning.

I wish I could have somehow persuaded him to take his medicine, to come into hospital, to let his physicians treat him. But he was, like the lizard in my dream, out of reach.

I did not know the words then, and I probably could not find the words now that would persuade him to stay. Looking up, I became aware of my reflection in the large dark window. I again felt my helplessness of the previous evening – my momentary powerlessness at my son’s refusal to take his medicine, and my fear that he too could disappear into the earth.

Now, so many of the patients I saw when I was young are gone or dead, but sometimes, as when waking from a dream, I find myself reaching out to them, wanting to say one more thing.


Stephen Grosz’s book, The Examined Life, is published on 3rd January (Chatto & Windus, £14.99).

Photograph by Katunchik

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