An episode

I was editing an urgent report when the date on the toolbar caught my eye: 24/10/2012. The day after my birthday. That’s odd, I thought, we must have forgotten to celebrate. But how could that be? I went through to the bedroom, to Giuseppe. How come we didn’t do anything yesterday? I said. And then, pointing at a rack of drying clothes, What’s all this washing doing in here? Who did the washing? Giuseppe told me later that he didn’t recognize me, that I was someone else. We did do something yesterday, he said. It was your birthday, don’t you remember? And I said no, I don’t remember. I don’t remember what we did. My birthday? I felt confused, lost to myself, angry as though something had been snatched from me without my knowing what or how.

It took maybe twenty minutes for us to reconstruct the previous day together, to a point at which I could say that, yes, I remembered doing this or that. I remembered the roses and the cakes, and what we ate. We sat in the square, outside our usual bar, and pieced it together, until I could no longer say that I’d forgotten anything. But the impression I had was that the day we’d salvaged had been lived by someone else, and that I was helping this someone else remember. The more I regained the day, the more displaced it seemed. Looking back, I can’t imagine why this worried me so little. Despite Giuseppe’s obvious, and understandable, consternation, I felt that nothing needed to be done other than to see if anything similar happened again, and then to take action.

The following day, after a morning’s work in Rome, talking with colleagues, assisting students, I met a friend, Clarissa, for lunch. During the meal, I mentioned what I referred to as my ‘odd incident’. She listened and then said I should have a brain scan immediately. I was startled, and I think now that what had protected me from the potentially serious implications of what had happened the previous morning was precisely that sense of its not having happened to me, a dissociation that may have been symptomatic of the event, or a consequence of it. Do you think so? I said, actually concerned for the first time. It doesn’t hurt to check, Clarissa said wisely. I said I would.

My doctor’s surgery is open in the afternoon. I got there early and was second in the queue. He came round from his side of the desk and sat beside me while I told him why I was there, feeling foolish and a bit of a time-waster. He took my hand, and said I should have an urgent brain scan. How do I do that? I asked, foolish in a different, alerted-to-danger way, actually frightened for the first time. He explained what I had to do, and reassured me in his usual brusque but avuncular way that I shouldn’t worry, but that the sooner I had the scan the better.

***

By the time I get back home, I’m scared. So is Giuseppe when I tell him he needs to drive me to the local Pronto Soccorso (Italy’s ER) immediately. Ten minutes later we’re at Fondi hospital and an orderly is telling me they can’t do CAT scans on Friday afternoon because no one is there to interpret the results. Back in the car, a twenty minute drive to Terracina. We’re reassuring each other as we pass the lake where, according to Giuseppe, the spirit of Morgana le Fay still lives, so we salute her as the road turns away, following the coastline north. I’m concentrating on the road, on Giuseppe’s driving, his nervousness evident, or maybe it only seems that way. Maybe it’s my nervousness that makes the journey seem to have such hazardous potential. The sea’s rough, the sky dark grey with cloud; the almost uninterrupted good weather of the past month looks set to break, and I start to think about pathetic fallacy and how I might use it in my new novel, much of which is set beside various deathbeds. These thoughts, which I keep to myself, don’t help.

It isn’t the first time we’ve been to the hospital in Terracina, but we manage to mistake the road and find ourselves in a one-way system, wilfully deprived, I feel, of the place we need to get to. When we do arrive, the ramp leading up to the Pronto Soccorso is forbidden to everything except ambulances and we leave the car badly parked on a corner, and walk to the waiting room, where ten, maybe twelve people, are sitting on the rows of plastic chairs. There’s a window in one wall, with a desk behind it, unoccupied. Giuseppe and I stand there until someone tells us to ring the bell. The bell is a small button on the wall, at waist-height, some way from the window, unlabelled. I press it and a young woman appears from a door and asks me what the problem is. I show her my doctor’s prescription.

It doesn’t take long for me to be seen; the word urgente, underlined three times, has the required effect. I’m taken into a small room; a woman in a white coat is sitting behind a computer while various people in green and blue nurses’ outfits mill around. The woman looks at me and ask how long the left half of my face has been lower than the right. I’m rattled. I didn’t know it was, I say, not believing her. I’ve looked at myself in the mirror surely in the past two days. Giuseppe has looked at me a thousand times. She nods. Before I can say anything else, or think of anything that might usefully be said, I’m told to open my shirt and lie down on a stretcher. A blood sample is taken, the small plastic tap affair left taped in my arm, and then my ankles, wrists and chest are rubbed with alcohol and I’m wired up for an ECG.

Five minutes later. Another waiting room, large and bare, windowless, lit by six fluorescent tubes, pale wood seating attached to the walls. Italian hospitals, to their credit, are scrupulously clean but at the cost of anything that might render them pleasing, or give comfort. The only relief from the pastel walls, apart from the obligatory crucifix high on one wall, is an oil painting of one hand offering what might be a heart, or a bread roll, although it strictly looks like neither, to another hand. A plaque underneath says that the painting is a gift from the artist, which doesn’t surprise me. I turned my mobile off before my ECG and I suspect that I should leave it off, but the handful of people in the room with me are talking on theirs, or playing games, or looking at photographs, and so I turn mine on again and tell Giuseppe what’s happening, turning it off surreptitiously when someone calls my name.

I’ve never had a CAT scan before and I expected something longer, noisier, more claustrophobic. Lying there, my head as still as I can make it, I’m beginning almost to enjoy the double sense of being looked after and of having all decisions taken from me. I wonder if the scan can be affected by thought and if I should also be trying not to think. But I don’t have time to ask and it’s over. I’m back in the large bare room. Three young men opposite me, one in a wheelchair, are absorbed in their iPhones. People come and go. I call Giuseppe again; he’s still in the first room, or standing on the ramp to smoke. I can tell from his voice he’s worried sick, far more than I am. Before long, I’m alone in the room with a plump, disgruntled teenage boy. We glance at each other, but don’t talk.

An indefinite period of time later, we’re taken into another room and told to stay there ‘for a few minutes’. The boy’s mother arrives and begins to complain about having to wait all this time to a third patient, because I assume that’s what we are. She’d be complaining to me as well if I hadn’t decided to ignore her. It’s the fault of politicians, apparently, and I wonder who she voted for in the last elections. I know where I’d put my money. Time passes. When she runs out of things to say, or say again, or say in slightly different words, she begins to make a harrumph sort of noise and slap her hands on her cheeks. She is standing in the doorway, blocking my view of the room from which relief of some sort might come. Her son, slumped on a chair, is playing with his phone, oblivious to his mother’s whining, I imagine, after years of practice. When someone comes for him, I discover that he’s eighteen and that his mother can’t go in with him, which is comfort of a sort for me and a source of added anguish for her. She pulls out a mobile from her handbag and begins to complain to someone in the outside world. The use of cell phones, according to a sign above her head, is forbidden throughout the building.

It’s eight o’clock in the evening before I’m called back into the first room, where the doctor still sits behind her desk. I’ve been there for more than three hours, but that’s the  time it takes, she tells me, to assemble the results of the various tests, for none of which I’ve paid or will be expected to pay, and I believe her. She tells me the CAT scan is negative but that, despite this, she’d like to keep me in for observation. What happened to you isn’t normal, she says. I have a free bed, she says, but of course it’s up to you. I’m astonished. I don’t have any pyjamas, I say, the first thing that comes into my head. She smiles. I need to talk to my friend, I say.

He’s still outside, waiting. I bring him in. She asks me to grasp her hands in mine and squeeze as hard as I can. Harder, she says, you won’t hurt. She says my left hand is weaker. The three of us talk about my face and if it’s changed in any way, and Giuseppe confirms that he can see no change, but I can she isn’t convinced. All right, I say, I’ll take the bed. It’s a two-bed ward with a private bathroom. My bed is nearer the door. The other bed, beside the window, is occupied by an older man and surrounded by his family. It’s almost nine o’clock by this time, but they’re still there. When we walk in, a woman tells the man in the bed that he’ll have some company. My heart sinks. I sit on the bed. I’ve got nothing to wear; no soap or toothbrush or towel; even worse, nothing to read. I need my Kindle, I say, and Giuseppe says I might be able to find something to read in a TV room on the other side of Medicina Generale, which is where I’ve been put. I leave him for a moment in the room to go and look; at that moment, I can’t think of anything else. The fear of having nothing to read is the strongest of all the various fears I’ve experienced up to now, and I’m near panic as I search the department. I find a room with a television and a magazine rack beside a sofa. Inside the rack is a dog-eared copy of a magazine called Oggi, a homelier version of Hello, from last February. I pounce on it, like a starving man on bread. Back in the room, the other man’s family has gone, a doctor’s due to arrive, and the miserable weather outside has turned into a rainstorm.  You go home, I tell Giuseppe. I’ll be fine. Reluctantly, he goes. I take off my shoes and lie on the bed to read about the Sanremo Song Festival, lingering as long as I can manage on each detail. I’ve had nothing to eat since lunch, but don’t feel hungry. I have no pen or paper. I’m bereft.

A different doctor arrives. She’s older than the one downstairs and slightly sniffy about the eagerness with which Pronto Soccorso fills available beds, often without due cause, which reassures me. She takes my details. When she asks me how much I drink, I’m economical with the truth. I apologise for my socks, striped sky-blue and fluorescent green, mercifully without holes at the toes, and she tells me a little merriment is always welcome in a hospital. When I ask her how long she thinks I’ll have to stay, she tells me until Sunday. She measures my blood pressure, which is high, and prescribes an injection. Twenty minutes after she’s gone, by which time I could offer the 2012 Sanremo Song Festival as my special subject on Mastermind, a nurse who looks too young to have left school turns up with a syringe. I bare my arm. No, no, she says, and gestures down the bed. I lower my trousers and, for the first time in my life, get injected in my buttock. At this point, all excitement over, I decide to try and rest. I strip down to my underpants and get into bed, listening to the rain on the roof above my head. To my surprise, I feel tired and calm enough to sleep.

***

I’m woken at five for a blood sample to be taken, by six by someone leaving a pill I have to take after breakfast and taking my blood pressure, and at half past six by an orderly asking me what I’d like for breakfast. What is there? I ask. Tea, barley or milk, she tells me. Tea, I say, and I’m given a tray with a small plastic cup of tea, without milk or lemon, a packet containing two fette biscottate (see image), which I have never willingly eaten, and a tiny tub of peach jam, accompanied by a paper napkin and a plastic dessert spoon. The fette have already crumbled a little inside their packet and my attempts to use the spoon to spread the jam produce only a midge-like cloud of orange crumbs, so I eat the fette as they are, and spoon the jam into my mouth – fette, jam, fette, jam – until they’re both finished. The tea, unexpectedly, is rather good. Just after seven, Giuseppe calls and I give him the news that I should be home tomorrow and a list of the things I’ll need to keep me happy until then. My teeth feel rough to my tongue, and I need a shave. I’m convinced my mouth looked crooked because my moustache is over-long and unkempt. I stay in bed because I have nothing to wear, unless I get dressed again, and I’m worried that might not be allowed. I have no idea what hospital protocol is, and don’t want to be told off. My instinct to behave is strong in situations like this. And so, because I’ve finished reading Oggi, I lie back and wait to see what will happen next.

Giuseppe wakes me up. He has a honey-filled wholemeal croissant for me, and a rucksack containing a newspaper, my Kindle, pyjamas, a soap bag, my notebook and my favourite new pen, a transparent Fuji with a 0.38 nib. He’s telling me about the phone calls he’s made and received, and his dreadful drive home through the rainstorm the night before, when a third doctor arrives on her round of the ward and orders all relatives out of the room. Giuseppe goes and the doctor tells me that all the results they have so far are good, and that the next stage is a chest X-ray. This, she says, is standard practice and once again I think, I have paid for none of this, and I’m grateful to Italy, and to a health system that meets the needs of everyone, without exception; something that should never be taken for granted. She confirms that I can leave tomorrow and adds, at the latest, which gives me hope but also – incredibly – scares me a little, as though I’m already institutionalised. As soon as she leaves I get up, dress and wander around the hospital in my M&S pyjamas to find Giuseppe. Italian hospitals are fairly relaxed about visitors, not seeming unduly concerned about the number or relationship, only sending them out of the room when doctors arrive and not always then, but this morning, having left my ward to find him, I end up being locked out and, when I ring the bell to get back in, I’m not allowed to bring him with me. I tell him what the doctor said and send him home.

Lunch arrives at 11.30, by which time I’ve had my chest X-ray and a second ECG. I’ve noticed that the doctors treat me as though I were a reasoning human being, worthy of respect, capable of joined-up thought and able to use the only language we have in common – Italian – to communicate. All of which is, I hope, true. The nurses and orderlies, on the other hand, tend to use the familiar ‘tu’, call me by a variety of versions of my name, none of them correct, and look at me in an anxious way, as though I might not be following, and they will be held responsible. What makes it worse is that the more telegraphic the communication is, the harder it becomes to understand, which only confirms the suspicion that I am, in fact, not all there. (Otherwise, of course, I wouldn’t be here at all.) At which point, communication is reduced to a sort of primitive sign language and I have no idea what to do but follow the direction their gestures and brutally reduced language seem to indicate. Downstairs, for example, while waiting in an empty corridor for my X-ray, I wandered into a doctor’s private office because the nurse who’d taken me there began waving his arms towards the doctor’s door. The younger nurses, on the other hand, both male and female, are struck dumb or mutter in a worried, slightly affronted way, and all my attempts to relax them only make things worse. I’m just seen as odd, or feel I am. Which is why, when my lunch arrives, and I’m faced by three flimsy plastic plates covered by heat-sealed sheets of plastic that won’t be detached however hard I tug, I don’t ask for help. When I do, eventually, remove enough of the plastic to reach what’s beneath it – farfalle with sauce, a hamburger in a similar sauce, sliced carrots, all alas unsalted, utterly institutional – I’m hungry enough to eat the lot.

As soon as lunch is over, the ward doors are opened and relatives allowed in. My room-mate, who has been almost comatose apart from a brief episode in which he tried, unsuccessfully, to remove his catheter (I offered to call for a nurse, but he didn’t want that), is suddenly surrounded by the people I saw last night. There are six, then eight, then twelve; the room is filled with relatives, and relatives of relatives. Some of them hardly seem to know the man in the bed, who seems to be increasingly lost and uncommunicative. The leader of the gang is a woman who could be his daughter, or daughter-in-law, or even wife. She starts to interrogate him. Did you sleep? Have you eaten? Have you been to the toilet? Have they made your bed? The man doesn’t answer, or answers with a grunt that might be yes or no to my untutored ears. But the woman understands no more than I do. She greets every noise the man makes with a nasal Eh?, to which the man responds with the same indefinite grunt, to which the woman, etc. It’s hard to imagine a less affectionate exchange. She then turns to me. Did he sleep? Has he eaten? Has he been to the toilet? I’ve no idea, I say. I was asleep myself. I’m about to leave the room when the doctor comes in and tells me that, if I want to, I can be discharged as soon as I’ve picked up my medicines. Thank you, I say. So I’m clear?

***

Just under twenty-four hours after visiting my doctor I was back home. Twenty-four hours after that I’m writing this, at least in part as a wilful and conscious act of remembering. I am clear although I’m still not quite sure of what. I have high blood pressure and high cholesterol, neither of which are dangerously so  but I’ve been given (free, once again) medicines to bring both conditions under control. There is no sign of any damage to the brain, and my ECG and X-ray are both fine. My sister says what I had may have been a transient ischaemic attack, Clarissa’s talked about an ischaemic episode. Either way, it’s left no trace of itself. Unlike, fortunately, memory.

Oh yes, I had a wonderful birthday.