Waiting Room | Will Rees | Granta

Waiting Room

Will Rees

Some time ago while riding the Tube, I came across an advertisement that stood out among the familiar roster of ads for nutritional supplements and blended Tennessee whiskey. This was in the days before the pandemic emptied Tube carriages and transformed indoor public spaces into chambers of contagion. Unfolding across several posters, it went like this: ‘Explore risks that may be common in your family tree.’ ‘See how DNA affects your health.’ ‘Put your worries to test.’

The advertisement was clearly suggesting that the knowledge it sold would be beneficial to the customer, although why and in what ways were questions on which it demurred with an undergraduate essayist’s dictional prudence: not ‘mitigate’ or ‘minimise’ but ‘explore risks’. The claim seemed to be that knowing about one’s genetic predispositions to disease would be inherently good. Knowledge itself would be improving.
Yes, I thought. I could see myself doing that, in the spirit of exploration.

*

A few years earlier, my aunt died. It was very sudden, no one saw it coming. She was young – about forty – and not manifestly in ill health. One evening she went to bed, and the following morning she was carried downstairs.

In the desultory, strange days that followed, we were told by the pathologist that she had suffered a cerebral event – an aneurysm or a stroke. Afterwards, this was corrected. No, it had in fact been her heart that malfunctioned.

For years afterwards I could never remember whether it was my aunt’s brain or her heart which was defective, and even now I am uncertain. I only remember that there was some initial confusion, now long since resolved, but which is the correct explanation and which the false I continue to forget. I’ve asked my mother countless times to clarify matters, but – and not for any lack of interest on my part or clarity on hers – I do not seem capable of retaining the knowledge. My ignorance on the matter persists in spite, or perhaps because, of the possibility of a genetic link.
 

*

 
Throughout my early twenties I spent a lot of time seeking to acquire knowledge about my body. It was unwell, this much was certain, and the question of how was one to which I applied myself studiously. Of course, I had theories. Looking back, these tended to change quite frequently. My researches required me to enlist the help of doctors. Above all, I sought a scan that would light up every region of my body; that would reveal, clearly and distinctly, what was the matter with it. It is a long story; it went on for some time. Then something happened.

One evening I fell sick. I had a fever, I didn’t sleep. Nevertheless, the following morning I felt fine, and went to work. But that evening the fever came back, this time worse. This cycle continued for a week or two.

At the time, I was an outreach worker. This was in 2012, or possibly 2013, the early days of austerity. It was January. The work involved traipsing the streets of north London to inform its elderly inhabitants of which services remained. I was working under the aegis of a new charity whose main funders were the councils in which it operated (in many ways it was, I’d later come to understand, a roundabout and insidious form of privatisation). I was paid handsomely for this work, but by the hour. What was more, it was seasonal; once temperatures reached double digits, this brief and surprisingly lucrative employment would cease.

I quickly adapted my routine to these new realities. I’d get up, without having slept, and put my bed sheets in the washing machine (time delay: seven hours). Then I’d cycle across the river. I’d walk around the council estates of north London, which were now mostly privatised, and knock on some doors. Then I’d cycle back to Camberwell, move my bed sheets from the washing machine to the dryer, eat dinner, wash up, read something and reinstall the freshly laundered sheets. Then I’d fix myself a drink and sit in bed and wait until, just after 11 p.m. and always before 11.20, the fever began to gather. This proved to be surprisingly sustainable, until one day I collapsed on the stairs.

I took a morning off work to visit my GP. It was an expensive visit from the perspective of earnings potential. As usual, Dr C was patrician and inscrutable. His body had been trained over many years to be semantically neutral, to give nothing away. He nodded as I explained what had happened, and then, as if dismissing everything I’d just said, he said, ‘OK, let’s have a look at you.’ He placed a stethoscope on my back in order to listen to my lungs, placing his other hand against my chest to steady himself. His grip tightened, signifying something. He cleared his throat and composed himself. ‘Did you have any plans today, Mr Rees?’

Dr C instructed me to go to A & E. They would X-ray me today; it would have to be today. I agreed to go straight there. After I left his office, Dr C followed me out into the stairwell and called out, ‘You will go straight there, won’t you, Mr Rees?’

At the hospital I explained all this to the triage nurse. I was careful to leave nothing out, but also to make no embellishments. She nodded sympathetically and drank in every detail: his tightening grip, the atmosphere that hung about the room. His haunted tone as he called out to me across the waiting room. When my narrative was over she handed me a piece of paper and asked me to hand it in at reception. The paper read: ‘Feels unwell.’

Later that day I had an X-ray. True enough, there was a ‘mass’ in my lungs. Certainly, it was of some concern. But it was impossible to say what the mass was (‘an X-ray machine is not a precise instrument, young man’). A long period of waiting followed, interrupted by the women who occasionally appeared to take samples of my blood. I regretted having brought nothing to read.

For many hours I sat there, bookless and bored, until eventually a junior doctor appeared to tell me how things stood. The results that had come back were normal. Others would take longer. It was possible that I had a virus of some sort. That would explain the chest X-ray: it would be a lymph node, that was all. On the other hand, there were reasons to doubt it. My white cell count was normal. One would expect it to be raised. Things did suggest that something more sinister might be going on, but it was too soon to be jumping to conclusions. I wasn’t to worry. I was to go now, get some rest. I was to come back tomorrow, when I would report to the Medical Assessment Centre.
 

*

 
Honestly, this was not unwelcome. In general, the parameters of any medical investigation are determined by the story that one tells about oneself. When one leaves a doctor’s office having been told, after a brief examination, not to worry, that what one had taken to be a concerning symptom is merely one of the ordinary vexations of embodiment – that one is, in a word, healthy – the feeling tends to be reassuring only in the short term. Before long, doubts set in. What if one has failed to give the really essential piece of information? What if the small detail which in the blur of the encounter slipped one’s mind, or which, in embarrassment at one’s paratactic excesses, one deliberately withheld, what if this detail were the truly important thing, the stray thread which would have enabled the doctor to unweave the veil of health and reveal the sick body beneath?

Such, at least, tended to be my experience. In King Lear Cordelia laments, ‘I cannot heave my heart into my mouth.’ She is referring to her inability to give voice to interiority, to perform a private feeling of love. A patient must heave their entire body into their mouth. They must rally the forces of intellect in order to give an account of a body whose nature is independent of their ability to account for it in language but whose fate now depends on that ability. There is always more one can say, and if the patient fails to say the correct thing then any reassuring words uttered by the doctor will be worse than null; they will be a lure. And yet giving a good account of oneself, an account which will convince a doctor that one is worthy of their time, a reliable witness to one’s own body, is also about knowing what not to say. More really isn’t always more. It is a writer’s problem: what to put in, leave out. But the stakes are different.

The Medical Assessment Centre promised deliverance from the usual cycle of relief and regret. It promised that medicine’s investigations into my body would no longer depend upon my skill as a narrator. At the Medical Assessment Centre I would be reduced to a mute object of medical knowledge, anonymous and transparent like an anatomical drawing. The thought delighted me.
 

*

 
When I arrived the next morning at the Medical Assessment Centre, the receptionist, whom I had never met, knew my name. Actually, everyone there seemed to know me. Over the course of that morning people of various professions made reference to my ‘case’.

I changed into a hospital gown. A nurse came to take some blood and, to my surprise, left a cannula in my arm. ‘Oh?’ I said. ‘Don’t worry, Mr Rees,’ she said meaningfully. ‘For your procedure.’ A few minutes later a hospital porter arrived with a wheelchair. ‘All right, Mr Rees, hop in.’ It dawned on me that I might actually be a patient. It was an unlovely realisation that felt nothing at all like vindication. I declined, politely I believe, and said I was perfectly well enough to walk. The porter appeared hurt. He mumbled that he would have to check with the doctor. I nodded that he should do whatever he felt necessary as I gathered my belongings into my rucksack.

The porter returned, bearing no evident resentment, and as we made the short walk to the Imaging Unit he prattled cheerfully about this and that, the weather, his two young children, the extension he was building at his parents’ house. When we arrived, he withdrew quickly so that my delayed and oddly inflected ‘Goodbye’ was addressed to his back as he receded through the double doors.

At the IU, I was injected with a coloured dye that made my asshole dilate and passed several times through a noisy, large machine. It was the moment I’d been waiting for, my dream come true. Afterwards I was told (without the offer of a wheelchair) to retrace my steps to the Medical Assessment Centre. I sat around for an hour or two, time now completely lost to me, although its passing was tortuous, until the kindly, brusque Dr L appeared. ‘Look, it’s going to be a while. Go for a walk, get something to eat. OK?’

Dr L said he’d call me as soon as he had the results. Soon I was sitting in a dimly lit coffee shop holding a book, and after an hour, or some hours, I received the call from Dr L. His voice now sounded completely different, grave, formal, although it was difficult to know what to make of this since he belonged to a class and a generation whose members still possessed a ‘phone voice’.

I sensed that my fate was now known – not yet to me, but to someone. The facts of the matter had come to light; it only remained for them to be conveyed to me. As I stepped out into the street I had a sudden rush of appreciation for ignorance, which I now realised could be something more than a mere deficit. Ignorance could have a reality of its own, it could be a state of plenitude and possibility. It was a state in which I’d have liked to abide a little longer, perhaps indefinitely.

The sky was luminous and white. It was one of those overcast days that give one the appalling sensation of living inside a fluorescent light bulb. I thought about walking in the opposite direction to the hospital, to the Thames, perhaps, or to the City, where I rarely ventured, but whose shadowy and impersonal labyrinth of skyscrapers seemed to offer the very opposite of what lay in store for me at the Medical Assessment Centre. I thought about never returning, taking my chances.

Of course, I walked straight to the hospital. It wasn’t only that a will to knowledge turned out to be the stronger drive. The pleasures of not knowing are necessarily belated. One can always choose not to know. But ignorance, consciously chosen, is nothing at all like innocence.
 

*

 
When I returned, Dr L greeted me at the door. He told me to follow him into a private room, his voice still grave. I sat on the bed, he on the lid of a metal bin marked biowaste. On the computer screen were the results of a CT scan: my body, illuminated. I was surprised to find myself not feeling very anxious. It was not a feeling of calm that came over me, however; only abandonment to the implacable logic of the situation.

Dr L was going to cut to the chase. The scan showed what he had hoped it would not show, that all through my body my lymph nodes were enlarged. They were, in Dr L’s phrase, ‘standing to attention’, although he could not say why. What he was saying was, the image was clear enough. But he could not explain what it meant.

A disease was mentioned whose name had long been prominent in my daydreams and internet browsing history. Hearing its name said aloud (I think for the first time), this felt obscene and electrifying. Infection was mentioned too, although it was with a tone of regret that Dr L reiterated that there was no elevation in my white cell count. It was of some concern that the enlarged nodes were distributed evenly above and beneath my diaphragm. ‘That will make it late stage,’ I offered. ‘The ones that concern me are in your chest,’ he said. ‘They’re very deep.’

That I liked Dr L was partly because he always spoke as though enlisting your assistance to some shared task. He started every sentence with an imperative, ‘Look’, and ended it with a rhetorical, ‘OK?’. These were obvious affectations, which did not make them less effective; his style made any response feel weirdly pedantic, and in an infantilised desire to prove myself to Dr L by matching his aloofness I could almost forget that the item under discussion was my own body.

‘Look, nothing is certain yet. There’s still a chance that this is just an infection. In which case, in a couple of weeks you’re going to forget all about it. Get on with your life. But in the meantime, we’re going to have to do a lot more tests. OK?’ I nodded. ‘Look, I know all this is frightening. But I can promise that we’re going to get to the bottom of this. So, come back here tomorrow at nine and we’ll get started, OK?’ I nodded.
 

*

 
What followed was a fortnight during which I reported each morning to the Medical Assessment Centre. Sometimes I spent an entire day there, other times it was only a fleeting visit to deposit a little blood en route to north London, whose elderly population awaited news about what would survive the cutbacks to public expenditure that were reported to be ‘swingeing’ (one of those words that, everywhere for a short time, one rarely hears afterwards).

Many tests were performed, and aside from ordinary pleasantries I was rarely required to speak. I simply handed myself over. That the fever had gone by this time was not considered a reason to desist; now, and for the very first time, medicine had taken an interest in my body that had nothing to do with my experience of it.

One day I had a fine-needle biopsy to determine whether the cells that had clumped into masses inside my right armpit were cancerous; it would take a week or more for the results to come back. The intervening period was colourless and strange, and the waiting rooms in which I often sat came to seem like a metaphor for life itself.

On the other hand, I was learning a lot. Partly by osmosis – I was spending so much time on the ward – and partly because of the hospital’s practice of copying patients in to all correspondence between its consultants and the patient’s GP. Due to a time lag of three or four days, these letters would always arrive a little out of sync with where things currently stood. This did not render them an irrelevance, however, since, addressed not to me but to my GP, they presented information about my case in a way that was completely unfamiliar.

The feeling when reading these letters was similar to overhearing a conversation about one’s behaviour at a recent party. The deviation from one’s own memory need not at all be great for it to kill one on the spot. In these curt yet suggestive letters there would frequently be reference to things that had never been discussed with me (‘ACE level elevated’; ‘liver function abnormalities’; ‘inconclusive’) while matters which I’d considered settled days earlier were repeatedly thrown back into question. And so while the letters fizzed with information – information that I would immediately augment with further information drawn from Google searches – I tended to come away from having read them feeling more, not less, in the dark.
 

*

 
In the third volume of the Spheres trilogy – a towering philosophical history of the West – the philosopher Peter Sloterdijk argues that modernity is underwritten by ‘explication’, a process by which previously unthematised background aspects of life are drawn into the foreground. As this occurs, what had passed for simple is revealed in all its previously unimagined complexity: for instance air, previously the undifferentiated medium of existence, is shown to be a mixture of gases subject to countless fluctuations. On the one hand this increases our technical mastery over the environment; on the other, it brings a sense of vulnerability. There are so many ways that something complicated can go wrong.

What really interests me about Sloterdijk’s argument is this: far from steadily eroding the regions of latency, replacing hazy ignorance with solid facts, explication in fact serves to generate new latencies. As the critic Steven Connor has noted, revelation is always haunted by a feeling of not knowing; as previously unexpected areas of complexity are revealed, thoughts and suspicions loom about what else remains to be brought to light. Where previously there had been nothing at all, now there are depths waiting to be plumbed.

When, after a fortnight or so, it was revealed that I’d had glandular fever – this had initially been ruled out on the basis of an antibody test, but showed up on a subsequent test – I was delighted. It was like one of those criminal judgements in which the accused is given some trivial sentence and, having served this time awaiting trial, is free to go.

The feeling did not last, however. On the day the receptionist told me over the phone about the glandular fever result, I was due to report to the Medical Assessment Centre to get the result of the biopsy. I asked the receptionist if I should still make the appointment, now that we had an explanation. She asked me to hold the line while she discussed this with the consultant – a distant murmuring I could hear but not make out – and when she returned told me, emphatically, that I was indeed required to keep the appointment.

At the appointment, however, which so emphatically was necessary, and which I attended with a frank terror I had not experienced in the two weeks hitherto, the consultant said, after a long preamble about the marvels of the human immune system, that he was confident that the glandular fever result explained the abnormalities he’d found in my biopsy.

‘So there were abnormalities in my biopsy?’

‘No, no. Well, not once we take into account the glandular fever. I can tell you, I was happy to see that.’

‘What about my ACE level?’

‘What about it?’

‘It’s elevated.’

‘Oh, it is? Hmm.’

‘And my liver function, it’s abnormal.’

‘Well, in any case it’s nothing to worry about. You’re fine, Mr Rees.’ The consultant cheerfully handed me a form discharging me from the care of the Medical Assessment Centre. It was his way of asking me to leave.

I’d been an outpatient of the Medical Assessment Centre for a fortnight, or thereabouts. Now I was leaving, healthy. At home, letters continued to arrive for several days.
 

*

 
The charity I worked for did not give its casualised staff sick pay, and so I did not rest, as was advised. Quite the opposite, since my recent absences had been expensive. Probably the work did me good. My period of employment ended in the spring.

My memories of the period that followed are more clotted, much harder to give an account of besides the vaguest outlines. It is when I came closer than I ever have to madness. Following a brief period of respite, doubts set in. There were so many things which did not make sense. I’d kept much of the correspondence between the hospital and the GP, which, now thumbed and coffee-stained, was full of incongruous details; it seemed to me to provide a lengthy record of leads unpursued.

I started to resemble poor Miss Flite from Bleak House, making myself a continual presence at the GP surgery and at the hospital, always, of course, with ‘my documents’. There were a good many things that I’d have liked to know, things I would have liked to clear up. A scan, I thought. That would do it. A scan that would light up every region of my body, revealing what was the matter with it. That would require me to enlist the help of doctors. It was a task to which I applied myself vigorously.

It was a dark time, which went on for many months, during which ordinary life, as it is wont, went on too. And then at some point, without ever really concluding, that period of my life ended.
 

*

 
Now, I prefer not to know. I rarely visit doctors; my internet browsing history no longer resembles a diagnostic manual. It has been this way for some years. I don’t know how this happened exactly; like any transformation in Weltanschauung it had no present tense. It was only possible, afterwards, to observe that I no longer paid any heed to my health. A few years ago I began writing about all this; the fact might be relevant. If I were to become sick now I’d probably be the last to realise. I don’t know that this necessarily represents an advance but certainly it has made life pleasanter.
 

*

 
A few weeks ago I noticed a lymph node the size of a conker in my right armpit, and then another. A few days later I visited the doctor, who suggested sending me for an ultrasound. A few days after that, a text message arrived containing a link through which I could book the hospital appointment: the earliest one was four days later, but I could choose from the many available appointments, in various convenient locations, the one that suited me best.

I have not yet booked the appointment, although I have thought of doing so many times. The lymph nodes remain enlarged. I do not feel frightened, but I do continue to put it off. I have been busy, writing. It is only now, in the very final stages of editing this essay, that the thought occurs to me (it is a thought which makes me smile) that these two things – the appointment that I haven’t made, and the essay that I have been writing – could be related.

 

Photograph © Lewis Khan, from Theatre

Will Rees

Will Rees is a writer and editor living in London. He is a director of Peninsula Press, which he co-founded in 2018. He is currently working on his first book, a cultural essay about hypochondria.

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