The World I Fell Out Of Read online

  The brain was still functioning. I held lucid conversations with the paramedics from Perth, who had arrived and were preparing a neck brace. Then, still face down, I heard the helicopter, felt the shock waves of noise, an implacable clatter descending above us. At the time, I convinced myself there were two; could have sworn I heard someone say: ‘Here’s another helicopter.’ What a bloody waste, I remember thinking grumpily. Which was one way of expressing the whole catastrophe, although I didn’t see the irony until later. Later the Royal Navy air-sea rescue pilot who picked me up told me I was wrong; there was only one chopper. But that’s the tragi-comic essence of disaster: the everyday runs head-on into the bewildering.

  They turned me, releasing me from the earth, slowly, carefully – I don’t know how many of them, I couldn’t feel their hands – onto a spinal board. I remember my vision spinning, the sky suddenly unbearably bright, but my head and neck were trussed with pads, so I could only look straight up, a small dinner plate of vision. My friend Katie was bending over me, telling me that I was going in a Sea King to the Southern General Hospital in Glasgow, where the main emergency specialities were. ‘Check out the winchman, he’s really dishy,’ she told me. ‘I’m coming with you.’ She always could be inappropriate, but I think she was trying to buoy me up. Of all the emotions, the pressing one in my head was annoyance: one, for causing all this fuss, and two, for not being able to sit up and enjoy my trip in a helicopter. Perhaps shock was setting in.

  The inside of the chopper was furiously dark, crowded, vibrating and noisy. I felt sick and claustrophobic, strapped down. Panic started to rise. He was indeed dishy, the winchman, in the rare moments he crossed my limited field of vision. He’d taken off his helmet. Mostly it was his voice I hung onto. I told him that I couldn’t breathe and he leant over me, speaking softly but urgently to me above the noise: ‘Yes you can. Keep breathing for me, girl. We’ll be there in six and a half minutes. Do it for me.’ Pure Mills & Boon. It felt profoundly intimate, romantic – but also heart-splintering, because in that same instant, deep down, I knew with absolute certainty that never again would a man lean over me wanting to make love to me. Those paralysed thighs would never part. A brief wave of insight and intense loss washed over me. I can be that precise: in a few seconds, in that maelstrom of noise, my sexual identity died. Lust is only one letter removed from lost.

  The crew of the Sea King from HMS Gannet, based at Prestwick, treated me as an emergency, aware that with a high spinal injury I could easily lose the power to breathe. The pilot requested a direct route and air traffic control temporarily cleared our path of commercial aircraft so that the helicopter could fly straight to the hospital. In those days, before the Southern General was rebuilt into a high-rise city, the helicopter pad was on the ground, just next to A&E. I remember being transferred to a trolley, remember trying to be polite and thank the RAF crew as they wheeled me away. Already, by then, there was the sense of detachment. This is just too bad; it can’t be happening to me, and I felt weary.

  Things got a bit blurry after that. Time and cognitive slippage. Apart from everything else, it’s very hard to discern what’s happening when all you can see is a very small patch of ceiling. There was a warm, pretty female doctor in A&E who bent down to my ear and told me: ‘You’re going into resus now – it’s going to be very noisy, lots happening, but don’t worry,’ and I clung to her words and her humanity. She had blue eyes and blonde curls. A feeling of almost unbearable loneliness was settling upon me with the knowledge that I was absolutely on my own in this. Only in my brain was there sanctuary.

  Snippets only thereafter, those dreadful hours, as shock and morphine kicked in. I was struggling with the unfairness of it; I couldn’t believe what had actually happened. Good Friday, it was; how inappropriate was that; and I’d taken the day off work to take part in the cross-country instruction. At some point my poor husband appeared at my bedside, his handsome, ever-optimistic face crushed with shock. Already, I think, he knew more than I did. At one point I remember being slid into an MRI scanner, immobile, staring at the plastic tube wall just a couple of inches above my face. White noise, claustrophobia: the very stillness made my ears boil. I was utterly passive; all will was gone; I no longer had a body. Is this what it feels like, I thought, losing everything?

  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.