Control, p.20
Control, page 20
Kash smiled nervously. ‘Mr Trenchard, this is Doug.’
Doug nodded briefly at Trenchard, and together they pushed the wheelchair into the gloom along the corridor, flanked by locked doors on each side, until, finally, they reached a corner where a spill of yellow light pooled like urine. Doug led them into a room deep with clutter, the hulks of old machines nestling under tarpaulin sheets.
Hospital basement corridors were generally used for storage – of beds, wheelchairs, and equipment unused or obsolete that could nevertheless be cannibalized for parts whenever things went wrong – which they invariably did – in the hospital above. But there was a corner that Kash had cleared to use as a workshop, and it was here that Doug had set up the interface. This was specialist equipment not available in most hospitals, and certainly not in the Victory. Smuggling it in, piece by piece, had been a logistical challenge, to say the least.
Trenchard could see the green glow of the monitor, a knot of cables leading to a simple ball and joystick set up on a coffee table ahead. Doug gestured to a spot in front and Kash wheeled Trenchard alongside.
Doug kneeled down and lifted Trenchard’s hand. He turned to Kash.
‘And you are sure?’
‘The EEG was consistent with oxygen starvation – severe diffuse hypoxic cerebral injury . . . But then we found this.’ He turned to Trenchard. ‘Can you show him?’
They both looked – and Trenchard’s finger danced.
Doug nodded to himself. ‘When they made the diagnosis it was likely correct. But things change. The human brain, it’s an incredible thing. It can find a way. Give a man a few months, some flickers of his old self can sometimes – just sometimes – start to emerge. If he’s in there, we can get him out.’
Lifting each of Trenchard’s limbs, Doug moved them passively through all ranges of movement.
‘He’s paralyzed, but that doesn’t mean the body’s just a shell. There are still involuntary movements. Mr Trenchard, I’m just going to rub hard on your sternum. Sorry if it’s a bit uncomfortable . . .’
Doug pressed his knuckles over Trenchard’s breastbone and rubbed hard. Instinctively, Trenchard’s arms flexed and his legs extended, like a newborn chick kicking from its shell. Kash knew those were just so-called decorticate responses; they didn’t mean there was any actual voluntary brain activity going on. Nor did the reflexes Doug revealed when, placing his own fingers over the tendons in each of Trenchard’s limbs, he tapped them with a patellar hammer and watched them leap forward.
Doug went around the body, going through the motions one after another. Trenchard’s big toes curled upwards when he stroked the outer margin of his soles firmly. He exhibited the palmo-mental reflex, pouting when Doug ran his fingers across his palm – a primitive reflex seen in babies. Next, he stroked Trenchard’s cheek and Trenchard involuntarily turned a fraction towards the stimulus. Another primitive reflex; the body’s way of helping a baby first find the breast.
‘OK,’ he concluded. ‘The damage is diffuse. The motor cortex is impaired. So are his frontal lobes, judging from those release reflexes.’ He raised an eyebrow to Kash in secret signal. If he was sexually disinhibited before, he was likely to be a whole lot worse now.
Doug reached into one of the drawers at the computer desk and came back holding a pen torch between his fingers. ‘It’s just this finger, is it? You’ve seen no movement anywhere else?’
Kash shook his head. ‘Not a thing.’
Doug nodded. ‘Sorry for the bright light, Mr Trenchard. Here it comes . . .’
Doug flashed the light into each eye in turn, observing the responses. The pupils were of irregular shape, of slightly different size, and responded sluggishly to direct light. The opposite pupil was, in each case, unresponsive.
Then, when Doug was just about to hide the pen torch again, he stopped.
Kash had noticed it first. It took Doug a second to catch up.
Trenchard’s pupil was flicking repeatedly a fraction of a millimetre to the left, in time with a rhythmic jerking of the tip of his left thumb.
Doug stepped back. ‘All right! He’s in there. All of him. Mr Trenchard, if you can hear me . . .’
The finger jumped erratically to the tugs of an invisible puppetmaster. And above, the right eye glanced rightwards in synchrony.
‘The eye.’ Kash whispered. ‘That’s new. I didn’t know about that. It’s happening, isn’t it? He really is waking up.’
‘Oh, yes,’ said Doug. ‘Not “waking up” – that may have happened a long time ago. But it’s probably only quite recently that he’s found the capacity to control movement at all, and show that he is.’ He looked nervously at Kash. ‘Are you sure you don’t want to get the rehab teams onto this? There’s Ronan Astin in speech and language – I trained with him – or stroke unit or our rehab unit . . . I mean, has he even been seen by a neurologist since . . .’
Kash put a hand on his arm. ‘Look, Doug, if this is freaking you out, if you want to back away, I totally understand. And I wouldn’t blame you one bit. But this has to stay a secret for the moment – just until he can tell us who did this to him. Then we go straight to Carney, straight to the police, and Mr Trenchard gets everything he needs.’
Doug looked down at Trenchard and bit his lip. ‘I don’t know . . .’
‘And you’ll be the hero of the hour. The Dragon down here in the Dungeons.’
Doug turned back to Kash. ‘You’re a manipulative little fucker, you know that?’
Kash smiled, then checked his watch. ‘If we’re going to do it, Doug, we need to be quick. The longer we wait, the greater the chance his absence will be noticed.’
‘I know, I know. Time is of the essence.’ Doug straightened himself. ‘Let’s get started.’
He crouched at the computer terminal and started tapping at the keys, loading a programme up from the hard drive.
‘BCI,’ Doug said. ‘Brain computer interface. It’s in its infancy, but it’s the best we’ve got. One day there’ll not only be computers on every hospital ward, but computers you can jack straight into your head. We’ll just be thinking thoughts and there they’ll be, up on the screen. Thirty years’ time, and a man like Mr Trenchard here might be writing and delivering lectures and – well, I’m getting ahead of myself. This one’s more rudimentary. If I’d known about his eye . . .’
Doug stooped down so that he could look into the milky film of Michael Trenchard’s eyes for a moment, then turned to Kash.
‘We’ll fit a sensor thimble over his finger. To start with we’re just measuring what he can do. Can he make it move on command? Does he have the ability to control the scale of the movement with precision? Its direction? If we get it right, there’s a chance he’ll learn to put his own lights on and off, activate an alarm . . . even type on a computer screen. It can be painstaking, but he could have a conversation.’
‘How long is it going to take?’ asked Kash.
‘A piece of string. It takes as long as it takes. Sometimes just days. But I’ve seen stroke victims spend six months learning to do this stuff – and that’s with therapy day in and day out. How much time do we have?’
‘Tonight? Shorter the better. We are relying on the patients all being stable long-stayers and the fact that most of the night team are bank nurses who tend to kip for most of their shifts. Longer term? Not six months, that’s for sure,’ Kash said. ‘I don’t know how long we’ll be able to keep all this under wraps. There’s a limit to the number of times he can vanish from a ward without someone noticing. Just do it as fast as you can.’
Doug nodded, stepping away from Mr Trenchard. He lowered his voice. ‘He was a brilliant surgeon, wasn’t he?’
‘Surgeon? The best,’ said Kash. ‘Person? The jury is still out on that. But I’m not the judge.’
‘A mind like that . . . well, maybe it could survive what happened. Maybe it is still lurking in there somewhere. But . . .’ Doug paused, his eyes flicking between Kash and Trenchard. ‘A brilliant mind, used to being challenged, used to being stimulated – imagine what it must be like to be locked up in there. Like a prisoner in solitary confinement – in a strait-jacket. He can’t even scratch his nose. And gagged.’ He glanced at the tracheostomy tube in Trenchard’s neck. ‘His screams have never been heard. He can’t even scream and be heard.’
Kash looked at him. ‘What are you trying to say, Doug?’
‘I’m just . . . what if the man who’s in there, raging to get out – what if he isn’t the man you think he is any more? What if he’s lost his mind?’
42
Liz Murray was dancing.
A floor of black and white squares receded into the distance as her silver-shod feet whirled over it. Her partner was her husband Ken, even though he looked exactly like Fred Astaire. He gazed into her eyes as a warm breeze gently ruffled her pale-blue chiffon gown. Above was a midnight sky awash with stars, which meant the ballroom had no roof, which was odd. Also odd was the hospital cleaner in her blue uniform, who was making slow circles over the floor with her floor polisher, as if the pair of them were doing a waltz. Liz and Fred who was also Ken whirled gracefully past, and Liz filled her lungs with the warm evening air, scented with honeysuckle. The ballroom seemed to have no end, and Liz began to feel slightly dizzy as they whirled on and on, faster and faster. At least there’s no one else to bump into, she thought. Then, out of the corner of her eye, she saw them: another couple. As they moved closer, she saw it was Mr Trenchard. He was wearing a saffron evening gown, cut very low, revealing the noose around his neck, the end of which flapped behind him in the breeze. His partner, her slim frame sheathed in an elegant evening suit, was a woman with silver-blonde hair tied back in a simple bun. ‘He’s such an oaf,’ she laughed as they went past. Her hand, Liz saw, had slipped from his waist to rest on his buttock.
‘Would you like a bedpan?’ Fred asked, his eyes sparkling as if he were offering champagne.
‘No, thank you, darling,’ she said, and woke up.
Sister Vale was standing at her bedside. ‘You were making some funny old noises,’ she said in a conspiratorial whisper. ‘I thought perhaps you needed the loo.’
‘No, thank you, dear,’ Liz said, recovering herself. ‘I’m quite all right.’
She reached for her new glasses as Sister Vale disappeared back to her office. Even in the gloom of the night-time ward, things were so much clearer with them on. She’d actually forgotten how things really looked, bright and sharp and not blurry at all. Funny how you could get used to things.
She looked over at Mr Trenchard. Had he got used to it, too? Probably not. The staff all said that he wasn’t aware anyway. What was the point, really, in carrying on in such a state? If there really was nothing going on in there, why not just put him out of his misery now, poor dear, and have done with it?
*
On the other side of the ward, Michael Trenchard was actually having quite a pleasant time. He was playing the piano, his fingers, which seemed to him extraordinarily long and dextrous, flying over the keys as he hummed along. Really, he’d never played better in his life. He looked over, and an audience of about a dozen women, all dressed in black as if for a funeral, sat listening, their overly made-up faces impassive. He started to feel anxious. He realized that the only sound he could hear was that of his humming, which was actually becoming more of a gurgle. The piano itself was resolutely silent, however firmly he hit the keys. He played faster, stabbing the keys with increasing force, but still no sound came. He heard a cough from the direction of the seated women. He was beginning to sweat, beads of moisture forming on his brow. His bow-tie began to feel very tight. He looked over again and one of the women was looking at her watch, her eyes hidden behind dark glasses His bow-tie was getting tighter. He desperately wanted to loosen it but he dared not take his hands away from the piano, otherwise . . .
He felt, rather than saw, her enter the hall. She walked slowly towards the seats, just visible out of the corner of his eye, then past, until she was standing by the piano, a dark shadow looming in his peripheral vision. He couldn’t turn. He couldn’t look. He forced his fingers to play faster, pressing down on the keys with all his strength, willing them to make a sound. He heard the scrape of chairs being pushed back as the other women began to get up and leave.
‘But the performance isn’t finished!’ he wanted to say.
He saw her arm reach over. She was wearing pale green gloves. With one hand, she gently took hold of the piano lid between her finger and thumb.
He wanted to scream. ‘Come back! Don’t go!’ But all he could hear was the clack of heels on the wooden floor, and the frenzied pumping of his heart.
In one swift movement, with a sound like thunder, she slammed the piano lid on his fingers.
*
When his breathing had slowed sufficiently for his mind to know where it was, he realized he was awake. His hands felt somewhere far away, the dream agony gone.
Across the ward, Liz Murray was peering at him through her new glasses.
‘What the hell do you want, you asinine old bitch!’
*
Don’t worry, thought Liz. I’m going to keep a proper eye on you now. Any more hanky panky and I’ll make sure someone knows about it.
43
The next time Kash had a day off, it coincided with Claire’s, a rare occurrence. Seeing each other had been hard – especially since Claire was also inexplicably unavailable so often. She had taken to ‘going out with a friend’, without ever actually saying where and with whom. She wasn’t having an affair, of that he was certain. Her affection, when they met, was genuine, and she had promised to ‘introduce him’ at some point.
For all those reasons, he was desperate to see her, part of him wanting to ban all talk of Mr Trenchard when they did, so that they could pretend for a few hours that they were a normal couple – the sort of people who went to movies or visited art galleries and museums, who went shopping and watched TV together. But he’d told Claire, of course, and the other part of him wanted to do nothing else but talk about it: trying to figure out why progress was so slow, and whether Doug had been right all along when he’d wondered whether Mr Trenchard was conscious, but so psychologically impaired by his experiences that whatever communications did finally emerge would be worse than useless, just the incoherent ravings of a lunatic.
What if he identified his attacker, but it was all a fantasy? That there was none?
In the end, reluctantly and with a heavy heart, he decided that spending time with Claire in these circumstances would be counterproductive, at least as far as their relationship was concerned, and besides, there was someone else he needed to talk to more urgently. Ever since Sister Vale had told him about Angela Warner being suspended, he’d been feeling guilty. Guilty that he’d been so consumed with Mr Trenchard that her being suspended had passed him by. His doubts, his suspicions – call them what you will – shouldn’t have stopped him behaving like a friend. Innocent until proven guilty. He needed to make amends, if he could.
The approach to Angela Warner’s flat was cut off by roadworks, so Kash crossed the expanse of Vauxhall Park, listening to the underground trains rumbling underneath, and slipped through a neighbour’s untended garden to reach her front door. By the time he got there, his shoes were scuffed and his trousers torn where he had scrambled over one of the fences, making him feel even less prepared than when he’d set out.
When Ange answered the door, he almost didn’t recognize her. In a stained pullover and torn jeans, with her hair down and half-covering her face, instead of tucked into a surgical cap or tied back in a neat ponytail, it was hard to imagine her as the cool-cutting surgeon. Her face was puffy, her eyes red-rimmed.
‘Hello, Kash. I wondered when you were going to turn up. Just checking to see if I’m still alive? Well, now you know.’
‘Can I come in?’
Ange gave a bitter laugh. ‘I suppose I might just have a window for you in my busy schedule.’
She led him down a narrow unlit hall and up the stairs to her flat.
‘There’s coffee, if you don’t mind it stewed.’
‘Sure.’
The walls were decorated with photographs and prints depicting her student travels, and the year she had spent with Médecins Sans Frontières in rural Mozambique. The living room was stripped back, with pride of place given to a record player. Predictably, the little portable TV was covered in the dust of disuse. Nearby, a pile of medical journals slumped. On a sofa was a blanket, slick of newspapers and magazines spilling to the floor.
Ange handed Kash a mug of coffee and opened the doors to a little balcony, just big enough for two chairs, and let the spring evening air in. There they sat, overlooking the tumbledown gardens underneath.
‘Sorry about the mess,’ she said. ‘If you’d come yesterday, you really would have been shocked. I went on the ciggies big time. Not any more, though. “A healthy mind in a healthy body”, isn’t that what he used to say?’ She laughed again.
Kash was silent. He’d smelled the lingering, acrid aroma when he’d first walked in, not to mention the sour reek of booze on her breath.
‘Look, Ange, I’m so sorry about not coming before. There’s been so much going on – I didn’t even know Carney had suspended you.’
Ange waved a hand dismissively. ‘Don’t worry about it, Kash. It’s my own fault. We can’t have the Victory’s reputation being tarnished, can we?’ She almost spat out the word. ‘I mean, it’s one thing when your top surgeon puts a noose round his own neck on the premises to get his jollies, but you can’t have the staff complaining when somebody dies on the operating table because the sick bastard can’t be bothered to turn up, can you?’
Kash had briefly wondered whether Ange’s anger towards Trenchard would blow over, if she regretted her outburst at the coroner’s court and that maybe it had just been her way of dealing with Edmund Chaloner’s death and her part in it. She’d needed a scapegoat to deflect the guilt away from herself, and Trenchard fitted the bill. Unconsciously, he’d been hoping she would admit as much, allowing him to lay to rest the notion that she was guilty of, or complicit in, leaving Trenchard like this. She’d been Kash’s trusted colleague, standing shoulder to shoulder in the operating theatre, and, he hoped, his friend. He didn’t want to believe that she was a . . . what was the word? Not murderer, because Mr Trenchard wasn’t dead. There wasn’t a word to describe it, but assailant certainly didn’t do it justice, because what had been done to him was even crueller than murder.
