To hold a hidden pearl, p.4
To Hold a Hidden Pearl, page 4
I’ve always enjoyed manual labour, and finding a rhythm, I get through quite a few logs and begin to build up a sweat. Pausing briefly, I remove my hoodie.
“Have you done this sort of thing before, Jay?”
For a second, I’m unsure what he’s asking. Jilted a fiancée? Given a stranger a blow job?
“Chopping firewood, I mean. You’re awfully good at it.”
“Oh, no,” I reply, although I wish I had. I’m finding splicing the dry timber extremely satisfying, particularly after my unbelievably stressful couple of weeks. Perhaps I should take some logs home with me and vent my frustration there, in our tiny backyard. With the added bonus of keeping out of Ellie’s way.
“I grew up in a three-bedroomed semi with central heating. You should think about getting it installed, Dr Avery. It can be quite effective, saves doing this when you get home from a busy day at work.”
“I do have central heating,” he replies, eyeing me lazily. “It just seems pointless turning it on and heating the whole place when I’m in only one room. Anyway, my father always said that wood warms you twice. Once when you chop it and then again when you burn it.”
So he’s tight with money as well as grumpy. I’m not really surprised.
“You don’t have to heat every room, Dr Avery. You can put thermostats on individual radiators and stuff. Timers that switch on and off. You can even control the heating via a phone app when you’re at work.”
Neither of us says anything; he quietly smokes, and I noisily chop.
“Why did you do it, Jay?” he asks suddenly, stubbing out his fag end. “You said that you’d never done it before. So why did you come to the club that night?”
I sigh deeply. “Dunno, really. Maybe I just got pissed and fancied something different.”
Not the whole truth, obviously. It hadn’t been completely spur of the moment—I’d been building up to it for a lot longer than that.
“Gosh! When most people get pissed and fancy something different, they have a kebab instead of a Chinese,” he observes, showing me those pointy teeth again. I hide a smile; I didn’t realise people still used the word ‘gosh’ without irony. And I bet he’s never been drunk, then eaten a kebab in his life; he’s way too posh.
I do need to offload my apparent meltdown onto someone though. My head is such a mess from thinking about it twenty-four seven. I can’t remember the last time I slept for longer than five hours straight. He’d be as good a sounding board as anyone else, and he wouldn’t sugar-coat his opinions, that’s for sure. But not right now, it’s still too raw. Having made a good dent in the pile of logs, I lay down the axe.
“This is weird, Dr Avery,” I gesticulate vaguely. “You, this conversation, me being here. I think I need to go. I’ll come back and finish the logs for you some other time soon, if you want.”
He calls to me as I head back to the car. I carry on walking.
“I lied, by the way,” he says, his clear, quiet tones carrying in the still air. Or that’s what I think I heard. I stop and turn around.
“Huh?”
“I lied. About the cock sucking. It was good actually, really good.”
Heat burns up my neck. I feel something approaching pleasure for the first time in many, many days.
“I know, Dr Avery. I lied about your name too. I like Lucien; I think it’s very manly.”
“Cocky little shit, aren’t you?”
Chapter Five
Lucien
Action Man completed the task with twice my efficiency, and I was more than happy to conserve my energy and watch him. Granted, it was a pleasing spectacle; I’m beginning to see the point of all those rippling muscles. He’s a rather big boy, at least two or three inches taller than me, not to mention significantly wider. Observing him at work, my slumbering cock had stirred without any manual assistance for the first time in months. And when he reached over his head to strip off his hoodie, he presented me with a wonderful flash of several inches of taut, olive-skinned six-pack, as if a Diet Coke advert was being filmed right in front of me. And if the good people at Lynx can so confidently declare that ‘nothing beats an astronaut’, then they clearly haven’t witnessed Dr Jay Sorrentino chopping wood in a very snug-fitting grey T-shirt.
In his haste to leave, he’d left the pale-blue hoodie behind, and I bring the soft material to my nose, inhaling Fahrenheit combined with the delicious, unmistakeable aroma of fresh boy. Dr Jay Sorrentino is a bit of a puzzle, and he wasn’t forthcoming with clues how to solve him tonight. I take the hoodie into the house and intermittently sniff it for the rest of the evening.
*
Every third week, I’m the consultant in charge of the ICU—the intensive care unit. Nearly all intensive care units are led by anaesthetists. Most members of the public have no idea what happens in an ICU, and they are the lucky ones because it means they’ve never had people they love admitted to one. Basically, an ICU is the specialist ward to which the sickest patients in the hospital are admitted after every other avenue of conventional hospital treatment has failed. Intensivists are not that interested in what disease the patient suffers from, or what sequence of events brought them to such a sorry state. For us, it’s about seeing each patient as an amalgamation of organ failures—heart, liver, kidneys, lungs, brain—that need support until the illness is cured. So, if the illness has caused the lungs to stop working, we give an anaesthetic and support the patient on a breathing machine for days, weeks, or even months. If the heart is knackered, we give drugs to buff up the blood pressure, while the cardiologists figure out the best treatment. We dialyse kidneys. We deliver intravenous feed. And so on. We don’t admit all desperately ill patients, just the salvageable ones, and unlike other healthcare systems, our wonderful NHS doesn’t discriminate according to an individual’s wealth. If treatment will ultimately prove futile, we don’t treat, no matter how deep the patient’s pockets. And if a patient is homeless on the streets, care will be equal to that of an earl. Like me.
Is it stressful playing God? Does it sap one’s humanity? How to cope with all that death? Common questions with simple answers. Most doctors qualify at around the age of twenty-three, and as anybody in their thirties, forties, and fifties will tell you, that’s desperately young. But youth is probably a good thing because young doctors become accustomed to bad things happening to older people, generally before they become that older person themselves and start panicking. Fortunately, young deaths are few and far between as they always hit hard, no matter how old and cynical the doctor.
We all have a private list of patients we can never forget. Mine is depressingly short, but if I grieved for every patient who died, I’d never get out of bed in the morning. None of the patients on my list would make an episode of a TV medical drama. There are no heroes on this list, neither the patients nor the doctors attending them. Still, they regularly drift into my thoughts in the small hours.
My first ever night on call as a junior doctor was in a sleepy hospital in Suffolk, and I attended my first-ever cardiac arrest. A stout old woman by the name of Nellie Blood, who’d probably already been dead for a couple of hours before the night staff checked on her. Never have I come across such a wonderful Dickensian moniker before or after. As much as I remember poor old Nellie Blood, I remember the anonymous, desperate, and emaciated old woman in the bed next to her, slumped in a pool of urine, gasping for breath after sixty years of smoking fifty fags a day. She died the next night. With irreparably damaged lungs like hers, admission to ICU would have been futile.
After that job, I worked on a neonatal ICU. Most of the babies were dreadfully premature. To my callous young eyes, they resembled hairless pink rats. We were only permitted to touch them with gloved hands through the holes in the transparent plastic walls of the incubator. Occasionally, we had babies who had been born after a normal nine months pregnancy but required surgery shortly afterwards—heart surgery or bowel surgery. Those babies were podgy lumps of gorgeousness. Perfect on the outside, yet all twisted guts on the inside. At night, if they were well enough, we would take them out of their cots and feed and cuddle them under the watchful eye of the nurse in charge. One of them, I grew fond of; I can still recall his sweet baby smell even now. He had young, hopeless parents, barely out of their teens. Returning to work after a weekend away, I discovered an empty cot and naïvely assumed he’d gone home. It was a few hours until I found out he’d gone to the big cot in the sky.
Another death, not long afterwards: I joined the ambulance crew on a call out to a girl the same age as me, who’d set fire to herself in her car. She lived for a few hours afterwards, reduced to a crispy piece of charcoal, incredibly still breathing in and out—there wasn’t anything we could do for her. I could smell her for days afterwards. Even my parents noticed that I struggled with that one.
More recent times, at the start of my consultant career: A sick schoolkid with sepsis, diagnosed too late, silently dying on the end of my needle as I tried to stabilise him for transfer to the paediatric ICU. I beat myself up for months after that one. I still do from time to time in the wee small hours. Should’ve. Could’ve. Would’ve.
There are a few more on my list but thinking about them is depressing. And then there’s my dead family, of course, but I’ll never be able to talk about that.
And now we have Billy-Ray. He’ll warrant a special list all of his own, the others relegated to the second tier. When I admitted him to the ICU three months ago, I knew without a shadow of doubt he wasn’t long for this world, but we still have to try to save him first. Only nineteen, he lived with his mum and younger sisters in a shitty rental property owned by a shitty landlord who only cared about getting his money on time, not giving a fuck about tedious stuff like smoke alarms or condemned gas boilers. So, the flat burned down, mum and sisters perished, and Billy-Ray nearly died trying to get them out. Granted, he’s still alive at the moment, but I wouldn’t place any bets on him being here in a few weeks’ time. Seventy per cent burns are not generally consistent with longevity.
Billy-Ray rarely receives visitors because his close family are all dead—I can relate to that—and the sort of friends he hung around with can’t be arsed to trek over to the hospital to see him. He’s off the breathing machine now, after the third attempt, and the burns are healing as well as expected. His guts are a different story; they’re falling apart, so we can’t get any nutrition into him, and he develops one infection after another that doesn’t respond to treatment. Not unreasonably for someone in his unenviable position, he wants to die. He’s in continual pain and practically everyone he’s ever loved is dead. I can relate to that too. No amount of counselling by the well-meaning burns psychologist will ever bring them back.
The right side of Billy-Ray’s face is fairly normal, his features pale and sharp, his light-brown eye bright. He was possibly quite good-looking once, in a sly, foxy sort of way. But a shocking Jackson Pollock canvas of purple now dominates the left half of his face, like wax dripping down the side of a red candle. And his torso, back, and left leg are a patchwork of angry skin grafts. If he had been much older, he’d have died weeks ago. He will die—I’d lay my entire inheritance on it—but modern medicine is ensuring that he suffers a slow, painful decline first.
The first time I enter Billy-Ray’s room alone, after he’s been off the ventilator for a few days, he pretends I’m not there. He fixes his gaze through the window and onto the view of an untidy cemetery (great town planning, guys), pretty much as he does when we have our daily team ward round to discuss his progress, or lack of, as if he’s deaf as well as burned So I busy myself with his obs chart and calculate his fluid balance.
“You’re gay, aren’t you?” he says as I bend to measure his urine output in the catheter bag. His hoarse rasp reminds me to request the ENT surgeons to have another look at his burned vocal cords, an inevitable consequence of severe smoke inhalation.
“Yes, and so are you,” I answer bluntly, deliberately not looking at him. From the corner of my eye, I can see his fingers worrying the frayed edge of his gown.
“How do you know?” he demands, letting go of the fabric and staring at me full on.
“Because I spotted you checking me out on Thursday when I came in with the dietician.”
“Have you got a boyfriend?”
“Is it any of your business?”
He doesn’t answer, and I think that’s probably the end of the conversation. Pulling out volume three of his enormous set of notes, I begin writing.
“You’re a twat to everyone who works with you.”
I ignore him and continue writing.
“You are, you’re a twat. A pasty, miserable twat. And you’re old.”
“You know, Billy-Ray,” I say mildly, endeavouring not to laugh. “There is a big red sign on the door on the way into this hospital that advises, ‘Abuse to members of staff from patients and relatives will not be tolerated’.” I continue writing.
“Forgive me for not having read it, Doc. I was half dead at the time.” He pauses. “Twat.”
I stop writing and try to keep a straight face. “If you call me that again, I shall be forced to put you back on the ventilator. Without sedation and for a very long time.”
A raspy, choking sound emanates from the bed, and I look up in alarm. I relax as I realise what it is. Through parched, scarred vocal cords, Billy-Ray is laughing.
*
Once a year, as part of my supervisor role, I am obliged to join a jolly band of enthusiastic educationalists throughout the region and accompany my assigned junior doctor on a course. There, we flatten hierarchical barriers, and he grows up to become a well-rounded, forward-thinking consultant. Like me. The course is named Lead and Be Led, although they should just save time and retitle it Do It Dr Avery’s Way.
The venue for this ghastly meeting is a bland Hilton Hotel, naturellement, just off the M4 heading into Bristol. The programme lasts an entire dreary day, followed by an equally dreary celebratory course dinner to bring us all together as a united, happy educational family. I had no plans whatsoever to hang around for the course dinner, except that this year the whole shebang has been organised by Annabel and Emily. Not only have they informed me that if I don’t turn up they will kick me out of the office and make me share with Dr Leitner, but they have also bought my ticket and paid for my meal. And thankfully booked me a hotel room so I can at least drink my way through it.
Fortunately, the precourse preparation is brief: Jot down on a scrap of paper, in no more than two sentences, a recent achievement which makes you proud. Before you get too carried away, please note that your comments may be anonymously shared with the other delegates.
Does managing to get out of bed and attend this bloody stupid course count as an achievement? Probably not. I decide to skip the homework.
The usual suspects are here, all bright-eyed and bushy-tailed. I recognise a few faces from Allenmouth, but there are many from other hospital training programmes I don’t. Nevertheless, they are all carved from the same mould. Casually dressed, ambitious young professionals and a smattering of jaded-looking older consultants, who somewhere along the line found themselves having to endure this new world of self-discovery navel-gazing courses and Myers-Briggs personality analysis. I’m gratified when Jay grumpily slumps down in my eyeline. He looks knackered. Clearly not his scene either. Gosh, those manly thighs sure look good in a pair of jeans. Maybe he’ll be amenable to slipping down to the bar at lunchtime. I idly wonder what he’s put down as his proudest recent achievement. Ditching his bride at the altar? Sucking a bloke’s knob for the first time? I’ll be extremely impressed if he declares that one.
The room is filling up, already uncomfortably warm. I spy Dr Leitner manspreading in the front row, with sweat circles visible under his flabby armpits. Yuck. After hanging my Tom Ford jacket neatly on the back of my chair and loosely rolling up my shirt sleeves, I glance up to catch Jay giving me a once-over. I smirk, and he looks away, a slight pink flush to his cheeks.
Introductions over with, and having helpfully alerted us to the location of the nearest fire exits and toilets, Annabel moves on to the ice-breaking preliminary section of the programme, the part where we are all supposed to suddenly develop trust and openness amongst this group of relative strangers and feel sufficiently comfortable to discuss our deepest fears. Or some such dire nonsense like that.
“So, guys,” she says brightly, her enthusiasm easily carrying around the room.
I loathe the term ‘guys’ and nearly head on out right then.
“You all hopefully filled out some ‘proudest achievement notes.’ I certainly did; I can’t expect you to do your homework if I don’t do mine!”
A few titters and I inwardly cringe. Annabel’s proudest achievement is managing to strong-arm me into sitting here today. Only seven hours of purgatory to go.
“I’m going to read a sample of them shortly. The point of this exercise is to think about everyone’s achievements as I read them out and focus on their diversity. Try to picture what success looks like to different people, yeah? Hopefully, anyway—this game has never let me down yet, guys, but there is always a first time!”
A ripple of polite laughter follows, and as Emily carries the box of papers over to Annabel, she continues earnestly rabbiting on.
“The diversity will demonstrate that not all leaders are cut from same cloth, that we are all different, from different backgrounds and cultures; we have different personalities and very differing ideas of what constitutes success.”
There’s a hell of a lot of ‘differents’ in that sentence. She pulls out the first piece of paper from the box and begins to read.
“My proudest achievement is when my wife gave birth to our gorgeous twin boys last year.”
Annabel smiles, and there is a predictable collective ‘aah’ around the room. A thin, tired-looking Indian man sitting in the row in front of me smiles proudly. Achievement by proxy there, young fellow, I feel like saying. All you did was shag her. God, it’s going to be a bloody long day.
