The World I Fell Out Of

It was in the scanner, though, that I had an epiphany. So weird was this experience, so unimaginable was it, at the cutting edge of catastrophe, immured like a mummy in a high-tech tube, that I suddenly thought – I’ve got to tell people about this, I’ve got to write about it. It’s just so interesting. Who knew? On reflection, that point of deliberate detachment from myself was hugely important. It was self-preservation: a way of ensuring I kept control of my emotions. Steel shutters were clanging down in my head: I dared not even think about my son, just emerging from his teenage years, or of my sorry future. But I could safely bear witness and carry on writing in my head. A correspondent from a hidden war.

Another fragment of memory. A consultant came to talk to us. He was an orthopaedic surgeon, the director of the spinal unit. He placed one fist on top of the other, upwards, in a tower, like the playground game one-potato-two-potatoes, little fingers of one hand resting on the clenched thumb of the other. ‘Horses, eh?’ he said. ‘Used to keep them myself. Dangerous things.’ He seemed almost cheerful, as if I was more satisfying than a road accident. ‘You have fractured your spine at T12,’ he said, ‘but that’s not so important. You have broken your neck at C6; the two vertebrae have gone like this’ – he angled his fists, bending the tower in half, ‘and compressed the spinal cord on one side and stretched it on the other. That’s where the damage is.’

‘Is the cord severed?’ I asked.

No, he said. And that was all I wanted to know. If it wasn’t severed then there was hope.

What I didn’t know was that Dave had already been taken aside and gently told to prepare for me being in a wheelchair for the rest of my life. He was to go home, this proud, tough, man’s man, and spend the next two nights howling in despair and grief. Who can comfort anyone after news like that? And how can I ever escape the guilt of loading so much pain on him and on Douglas, my son – the two people who love me most in all the world? Even now, that is a kernel of grief which nestles at the centre of my being. I did this to me. But I did it to them too.

While wider family life was in meltdown, the news rippling out, by contrast I was removed to a place of eerie, enforced calm. My first night of my new life was spent in the high dependency unit, doped to the eyeballs on opiates. ‘Serious but stable,’ said the bulletin released to my colleagues in the media. I would need a delicate operation to stabilise my neck, but my timing had been exquisitely inappropriate: just as I ploughed into the soil, Jesus was believed to be rising from the dead, everyone was on holiday, and no neurological spinal surgery would take place until Tuesday. In the meantime, with a spine unstable in two places, I must be kept totally immobile, nil by mouth, fighting nausea.

The unit was a calm, bewildering, slow-motion cocoon. The room seemed soft round the edges, orangey in colour. I lay and stared at the dinner-plate bit of ceiling available to me, listening to a deranged woman nearby, raving in broad, angry Glaswegian. All I could move were my eyeballs. Hours passed without sleep, while my brain churned with despair. I was dimly aware, though, of a kind presence forever at my shoulder, stopping me from being alone, murmuring kind words. Early in the morning, before I was transferred to the spinal unit, someone – I presumed the same nurse – spoke. ‘When you’re better, come back and see me. My name is Bridget,’ she said. The words strung themselves into a banner in my head, as fragile and as sturdy as Tibetan prayer flags. I grasped them as a lifeline. In the apricot dark, she had given me the gift of human company, connection, hope, a future. One day I would go back. It was the first positive thought I had had.

Years later, by sheer chance, I found Bridget. Who was in fact called Brenda, and it was her co-worker Kate who had sat at my shoulder all night. Morphine turns many nurses, in the perception of their patients, into the Angel of Mons, and many more, unfairly, into Nurse Ratched; but these women were special. What continues to astonish me is that they remembered me amongst the thousands of smashed-up bodies they see in a major trauma hospital.

‘You were a fairly unusual case for us,’ Kate told me. ‘You were covered in mud from your fall. But what I remember was the way you lay awake all night, just looking at the ceiling. I could see your mind turning over and over. And I remember desperately wishing I could do something to put it right, to turn back the clock for you …’ her voice trailed off ‘… but all I could do was sit beside you sponging your mouth. We washed the mud off you in the morning. And I’ve often thought about you since, wondered what happened to you.’

As I have wondered myself.

CHAPTER TWO

Put Your Finger in the Crow’s Nest

The Warden owns the shade.

LOUIS SACHAR, HOLES

An apricot-coloured world, shading to russet, was actually rather an intriguing place to inhabit. You don’t sleep, when you’re on morphine, you just travel to strange places behind your eyelids, restless journeys through an orange landscape, journeys which leave you exhausted and confused. At night, I frequently found myself at the bottom of a cave, looking up like a potholer at rock faces which were clad with thick, hand-knitted russet wool – chunky cable-stitch, knitted on a giant’s great big fat knitting needles, as if to give you hand-holds when you climbed, but I didn’t need them because I was on some kind of cherry-picker, floating effortlessly up, up, up, exploring the openings and ledges on the woolly surface. Close to, I leant in and examined the texture, the thick twists of cable stitch. Up, up, I go, high into the stifling dark of orange woolliness.

That was one of the nicer destinations to which morphine took me. Other times, when it was daylight, and I was gazing at the ceiling tiles in the ward, I saw crude graffiti had been scratched. Evil messages to me. I caught the words subliminally. Fuck off, it said. But when I trailed my eyes slowly back to look more closely, the words had disappeared. Sometimes the tiles lifted at the edges, and I saw eyes peering down at me – sometimes rats’ eyes, other times, illegal immigrants’. Somewhere, in some sane fragment of my brain, I was horrified – my illiberal subconscious was betraying me, my inner Daily Mail reader emerging. The other part of me was preoccupied with the need to tell the authorities. Surely they shouldn’t be there. Not living in the ceiling. I knew things were bad in the NHS but surely not that bad. I felt under threat. But before I could call out, express it, the morphine carried me away somewhere else, and I forgot.

For three days, over the Easter holiday weekend, I lay motionless in the high-dependency ward of the spinal unit, waiting for my surgery. They had me on a specialist spinal bed, which tilted from side to side, to relieve pressure on my skin, and I was allowed neither to eat nor drink. Every so often the nurses wet my lips with a sponge on a stick. I pleaded for water, but they could not give me any. I pleaded with them to turn my pillow, to relieve the pressure on my head, but they refused to do it as often as I would like, because the neck was unstable. It took three of them to do it – two keeping my head motionless. The other one flipping the pillow. For three days I was unaware of anything else from the real world. I don’t know if Dave was there; I drifted.

My only certainty was that the ward was a dangerous, volatile place and I was a silent witness, buffeted and bewildered by the drugs. My instinct was to hang onto consciousness and concentrate very hard on survival. My view, when I was with it enough to open my eyes, was still that bit of ceiling. Out of the dark, in the periphery of my vision, emerged a face. A tiny woman with short grey hair; a kindly, self-effacing sprite whose voice offered me a mooring. ‘I’m Christine. I’m your named nurse,’ she told me. ‘I’ll look after you now. Together, we’ll get you through this. Things are going to get better.’

The connection she made held me, steadied me, a rope to the shore. She told me she had been a spinal nurse for more than forty years; she spoke with confidence and calm optimism. When she was not there I drifted alone again, fearful. Over the time I spent in hospital, I was cared for by dozens of nurses who were, like all human beings, a mixture of sensitive and insensitive, flawed and uncannily dedicated. With all of them, I sought kindness and a connection; the essence, surely, of any benign human relationship. And with most I found it, with few it was lacking. There was no other nurse, though, who gave me utmost sanctuary in the way Christine did when I was most in need.

Days and nights merged and I was unaware.

I could not feel my body, but I sensed strongly that my legs were raised up in the air in front of me. Floating up high. Later I learnt this was a common phenomenon of a new spinal injury, because they weren’t; they were flat on the bed. The other pressing physical sensation was of a steel band tightening around my ribcage, like the hoop holding together a whisky barrel. I could feel nothing else in my torso but that band. Most peculiar. Later I discovered this was my diaphragm. Our bodies, brilliantly evolved to survive, breathe in two ways – via the intercostal muscles around the lungs, and by the action of the diaphragm. The connections for each emerge from the spinal cord at different levels, like a safety net, a fallback system: I had lost the first but retained the second. My injury had paralysed my chest muscles and I was breathing solely by the rise and fall of my diaphragm. Had the break happened a few millimetres higher, both would have been knocked out and I’d have needed a tracheotomy and a machine to breathe for me. But I didn’t know this. I knew very little. I had no skin sensation at all … could only feel my head and back of my neck on the pillow. Just to test I was alive, and to release some distress, I chewed angrily at my bottom lip, the only autonomous action left to me. Just then I vividly appreciated the attraction of self-harm. Soon I could taste blood, but felt absolutely no pain. Why wasn’t it hurting? Only much later did I realise that this was the effect of the morphine.

Because my neck was unstable, they needed to secure the vertebrae at the front with a small metal plate. Before the operation, there were chats, which I only very vaguely remember, with both the anaesthetist and the neurosurgeon. The operation was tricky because my neck had swollen so much that from the ears down my neck flared out towards my shoulders, like some monstrous steroid-happy body-builder. It looked so grotesque Dave did not allow Dougie to visit me for several days.

‘You made an international prop forward look swan-necked.’

So swollen was my throat that the act of intubating me for the anaesthetic was risky and the operation, to plate the front of my sixth cervical vertebrae, took several hours. Afterwards they were worried that my throat would close up with the additional trauma, so they kept me on a ventilator to breathe for me, a big fat air tube in through my mouth and down into my lungs, and I was even more sedated. I couldn’t speak. A drip fed my body with fluid; a catheter drained it out. Of all this I was oblivious. I also had a nasal-gastric tube up my nose and down my throat, through which they passed the ground-up drugs into my stomach. When I was with-it enough to cry, the tears ran into my ears and soaked the tape securing the feeding tube to my face. I could do nothing about this; it was the same exquisite misery as when you have a streaming cold but are unable to blow your nose. The only thing to do was try not to cry. Christine had told me things would get better and she never let me down – I just had to take shelter in my head and hang on.

To enable me to communicate while on the ventilator, the nurses hung a laminated card with an alphabet by my right arm. After my fall, Pam, a dear friend of many years, rushed from France to support Dave. I have snatches of memory of them both at my bedside, with me conducting irritable, faltering mime conversations with them, spelling out the words by waving my right forefinger at the letters. My mind – I was convinced – was as clear as a bell; I became increasingly exasperated when they failed to keep up with my slow-motion spelling and grasp the words. They can’t be this stupid, I thought crossly. One day they arrived and said happy birthday – I remember feeling a genuine sense of shock and surprise. My birthday was 13 April, surely not yet. But I had lost control of time; I’d been on a ventilator for more than a week and the sound of its rhythm, sucking and sighing, the persistent beep-beep-debeepbeep behind my head, had become the vortex of my entire life. My real world was inside the apricot. I waited, while the scene changes came thick and fast and the only constant was the machine, sighing and pinging apologetically.

Some nights, my bed was in the corner of a room that was being used for a party. They’d opened an Indian restaurant on the ward. There were vast buffets of curry spread out, people came and went, laughing. My bed kept being moved. Every day I was in a different room and strived to orientate myself. One night I had a bird’s-eye view overlooking a city, which lay across the curve of a bay. In the dark the lights of the city were twinkling, reflecting across the water. Another night, workmen, wearing high-vis jackets, were digging up the floor around me. Then my bed split in two across the middle and I was sliding down into the gap, suspended over dark, deep water, and I kept crying out to the nurses to tell them I was going to drown, but they didn’t understand. One nurse was lying on the floor behind my bed snogging a workman. Another night, I was kidnapped – strangers used a fork-lift truck to take me, on my bed, out the back of the ward and stow me in a horsebox. They wanted me to go back to the cross-country course and testify that my accident was not their fault.

A family game from childhood haunted me, the rhyme shimmying around in my head. It had come from my mother, who played it in Northern Ireland in the 1920s on the way to picnics on the beach, sometimes Tyrella, sometimes Ballywalter. We played it too, obediently, on the back seat of the car. You crossed two fingers from one hand, opened a little, over the two fingers on the other hand, creating a neat, square, inviting hole in the middle. As you offered the gap to the person next to you, you chanted:

Put your finger in the crow’s nest

The crow’s not at home

He’s gone to Ballywalter to gather shelly stones …

And then, squeezing on the other person’s finger, you shouted:

He’s coming

He’s coming

He’s nipping!

He’s nipping!

And you squeezed and squeezed, and held them, trapped tight by the finger, until they squealed for mercy.

At one of the ward rounds, in a window of comparative sanity, I remember meeting my consultant for the first time. Mariel Purcell was young, a tall cool stylish Irishwoman, with long dark hair she wore loose. She wore sassy dresses and high heels. ‘We are keeping you on the ventilator,’ she told me. ‘You have a lung infection and we are giving you antibiotics.’ Later, when I was off the ventilator, she was more expansive. It was pneumonia. I was strangely thrilled, in the way you are when you’re a kid and you’re going to have something to boast about when you go back to school. It was like being eight again, falling off roller skates and cracking a bone in your wrist. But at that point I was just frustrated. I’m fine, I tried to tell her with my eyes. The purgatory of the ventilator jammed in my mouth was becoming unbearable. I wanted it taken out. I pleaded with the nurses on my alphabet card. W-H-E-N? T-O-D-A-Y? At the weekend, they said. Soon. They lied. Lied repeatedly and prodigiously. The weekend never came. Day followed day. I inhabited some lost bit of space, some cul-de-sac on the dark side, all alone, floating along in my own ghastly spaceship of tubes and sighs. Beep-beep-debeepbeep. Beep-beep-debeepbeep.

I remember when they took the ventilator out – there was an unpleasant rippling sensation as the corrugated ridges of the tube were withdrawn from my throat, I had a fleeting vision of those perforated blue drainage pipes, the kind you dig into the soil of your garden. Then it was over and I was drawing in my own air, could talk again. My jaw and my ears ached, despite the morphine, my tongue so dry and fat I was barely decipherable. I pleaded for a drink, but they refused: it was still too dangerous for me to try swallowing. At one point Christine moved across my line of vision, dragging a machine on wheels.

‘You don’t know this, but today is a very good day, a very significant day for you.’

I looked quizzical.

She smiled her shy smile. ‘I’m taking the ventilator away from your bed space. You’re making real progress.’

At some point during that time, on a morning ward round, the doctors clustered inside the curtains round my bed and asked to do an anal examination. What I didn’t know was that this was the test to see how paralysed I was. The spinal cord ends in the perineal area, your bottom, and if you have sensation in your anus, it indicates how badly injured your spine is.

I was rolled on my side and they stood behind me. Can you feel that? Can you clench your bottom? No, I said. Nothing. They were silent, grave. I decided, in my morphine haze, to be a good hostess and fill the silence to cover up any embarrassment. After all, my body was the party, wasn’t it? ‘That’s the nicest anal examination I’ve ever had,’ I said in a jolly more-tea-vicar sort of voice, trying to lighten the atmosphere, turning my head so I could grin at them. I didn’t understand why they didn’t smile back.

The severity of a spinal injury is measured on a scale developed by the American Spinal Injury Association – the ASIA impairment scale. If you are Asia A, you’re completely buggered, basically: you have no power or sensation preserved below the injury to your spine. You will not recover function. Asia B, you have sensory feeling below the injury but your muscles don’t work. Asia C, some muscles do work but they’re very weak. Asia Ds have muscles, at least half of which have reasonable strength and they can walk. And Asia Es, lucky creatures, are normal healthy people.

I was diagnosed Asia A. Completely buggered. They didn’t tell me that. Not then.

Only the ward was real. My other life had receded to some distant place. My sanity, my compensation, was to pretend I was indeed that war correspondent on the front line, compelled to start recording this crazy story, to make sense of it to myself. Besides, it was good copy. I was finding things quite fascinating, in a rather grotesque way. By writing, I figured, I could justify my absence to my bosses at my newspaper, The Times. It’s peculiar how much of a priority this felt at the time – a measure, I suppose, of my desperate determination to hold onto something familiar and re-establish some control. Work could save me, keep me viable. At the same time, it represented escape from emotional anguish. Very few things made chronological sense to me. Unbeknownst to me, Dave came every day. Other visitors were discouraged by the hospital and he was like a Rottweiler keeping people at bay. Later I heard some of the details of events outside: Dougie had been away on an Easter ski trip in the Alps and apparently it took him a couple of days to get home; his mates performed a heroic drama-filled dash to get him to Geneva. I honestly don’t remember the moment when I first saw him at my bedside; grief and morphine have kindly erased the memory of the encounter. I hope he has forgotten too: but even now, years later, I am unable to ask him, in case I reawaken the pain. In some dark corner, I have a terrible memory of trying to give him a thumbs-up gesture with my right hand as he left, and realising with shock that I couldn’t; my thumb wouldn’t move – simultaneously realising that he had perceived the same thing. At the time I was aware only of the unbearable hurt I had inflicted on my child … and him being extraordinarily brave and composed and trying to comfort me.

Dougie’s best friends from university, I much later discovered, came to stay at our home with him to comfort him during the first couple of weeks. I thought that was wonderful, that he had friends as fine as that. He was always more of a doer than a dreamer and I realised after my calamity that he was happiest when l asked him to do practical things; it was welcome distraction. When he knew I wanted to record what was happening to me, he brought in his Dictaphone. After he had gone I asked the nurses to place it beside me on the pillow and switch it on. I spent half an hour or so rambling gently about how I’d got here, trying to be professional, coherent. I had a job to do. A job to try and keep. I expressed anger at my own stupidity in falling off. Then I ran out of energy and the machine kept running, recording my breathing and the voices of the visitors in the bay opposite mine. Perhaps in my head that corner of the ward was still a curry shop at the time, or maybe by then I was at the stage of being convinced that a crowd of football casuals had got in and were trying to steal from my bedside cabinet. Shimmying between sanity and madness, I managed to summon the wit to ask a passing nurse to hit the off switch.

The next day Dougie took the Dictaphone and promised to email the recording to London.

They must have transcribed it and put something in the paper because at one point Su Pollard phoned the ward to talk to me, which was precisely the moment I knew my spaceship had landed on another planet. Su Pollard, for those under forty, is a wacky English character actress best known for a sitcom in the 1980s called Hi-de-Hi, which I had been aware of, as a young twenty-something, as a piece of cheesy middle-brow telly for my parents’ generation. A totem of its time, like Morecambe and Wise. Su is famous for eccentrically outsize glasses and a funny voice. Good-humoured Eighties kitsch. I had never met her in my life.

‘Call for you,’ said a nurse, holding the phone, eyebrows raised, a rather amused expression. ‘It’s Su Pollard.’

It must be a morphine moment. She would drift away in a minute.

‘THE Su Pollard?’ I said.

‘Sounds like her.’

‘But I don’t know her.’

‘It’s you she asked to speak to.’

Too random. Had to be opiates. The nurse held the phone to my ear and I had a short, apparently lucid conversation with someone who sounded exactly like the hapless holiday camp chalet maid Peggy Ollerenshaw whom I’d occasionally seen on TV thirty years ago.

Of all the people I least expected to discuss my plight with, it was Peggy Ollerenshaw. (© Getty Images/United News/Popperfoto/Contributor)

‘Your article moved me so much I had to phone you and speak to you. You’re very brave and I send you lots of love,’ she said.

‘That’s really sweet of you,’ I said lamely.

‘I’m rooting for you.’

‘Thank you.’

I still don’t know if it really happened or not.

At night, I experiment with the only bit of my body that still answers me, that has a glimmer of feeling. My right hand, weak and floppy and fast becoming numb, fumbles down past layers of exhausting obstacles, past sheets and tubes and swaddling gowns to reach the bare skin of my hip. Exploring in the dark. The one-way sensation of touching my own warm skin, and feeling nothing back, is most peculiar, as if it is an alien I am attached to. My fingers are not giving me trustworthy signals, because their nerve connections are damaged too, and retreating further into shock. What’s so devastating is that the skin I touch feels fleecy, beautiful, devastating; all these things at the same time. Because it belongs to me but it doesn’t belong to me. It’s someone else’s; it’s like reaching down and touching your lover’s body in the night. How peculiar. Four-fifths of my body has divorced me, but it’s still attached to me. I’m two people – me and the rest of me. I am eerily still … but inside I’m screaming and waving. I’m helpless as a beetle on its back, except my legs don’t even wave to express it. My name, it would seem, is still Melanie and I am a doubly-incontinent tetraplegic. Where do I go from here, seeing I have already blurted out something about Switzerland and Dr Purcell didn’t respond?