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£35 Halifax

Lewis Justin

Once he walked like a hippopotamus on fire; his wife, only ever at his bidding, even when she was alone, therefore never walked, but shuffled, like a giraffe hauling a great weight of water, added to daily by rain and mist, and never condensing; but now, he, persecuted by slabs of a rare psoriasis called pustular psoriasis, and not without good reason, good people, he moves, if he remembers to, like a crocodile with AIDS. His kidneys have been done in by it and by the medication they give to calm it down; immuno-suppressants, they are, meaning things that say 'Boo!' to the leucocytes and t-helpers, and sprinkle water on the spiteful fire, but oh, nasty side-effects. The wind blows his skin off and it glides through the tidal air more gracefully than he walks, and in the air the skin looks like sheets, tissues and pillow-slips, but the immuno-suppressants are working because now only a November wind blows it off, where before it was even a May breeze. I imagine that, in May, more than a handful of tissues of his skin did decoupage to the innocent strawberry ice cream of consecrated passing child; don't you think so too? As long as it's not my ice cream………………………………and yours, and yours, yes.

But it won't be, because soon, he dies, and I must spend ten minutes comforting his Giraffe wife, who, maybe, won't be a Giraffe any longer after he drifts away in the steel box to the hospital mortuary, the porters pushing the empty, over-flowing box with vicious delicacy and ruining all the empty space they pass through. They spit; I've seen them; they spit. Ten minutes; oh, god; ten; I could eat in that ten, or piss, or best of all do nothing but talk with my colleagues; which is worse; the space they ruin with the box or the ten minutes I spend patting her shoulder and being drowned by awkwardness and the inexplicable, explicable, revulsion I suddenly feel for her as she sobs and retches and gasps and says she's going to faint while I sit patting her bony, foul shoulder, saying to the walls and the filthy magazines, 'There there, there there, little you, how about tea or coffee?'? And then I get someone else, someone who eats the air of the underneath echelons, to make it, biscuits too. 'Get tea,' I'll say, one for me too, to assuage my grief and the grief I feel at her grief. Can someone take over please, I'll say. I finish in five minutes and I can't be late; can someone please allow me to toss her grief in their direction so I might buy socks and wine.

He'd better not vomit up the last of his life and capitulate miserably while I'm on duty; irritating in death as well as life, just like everyone else, except me. At least not until my shift is close to ending, so that I might then devolve the juvenilia that comes with the final slump; a senior nurse, not me, they passed over me, the shithouses eaters, and gave it to a fat, wide-eyed bitch called Stephanie who trembles when asking is asked of her that is above the resoundingly menial; all the time she looks like a fish having spasms on the river bank; her mouth sucks like a dying fish's; they gave it to her and told me to stay just as I am; I hope the person who told me and the person who decided and the person who didn't have to tell me but did decide all get bowel cancer and end up with stomas so that when they lure someone to bed at the weekend and they undress the person they're about to penetrate or be penetrated by looks at the bag of shit on their stomach and screams and jumps from the window and tells everyone about it.

So it's Stephanie, not little nurse Oliver Marlow, who looks potent and is respected by the eyes that look lovingly at her as she does what must be done to confirm that someone who looks as if he's taken the final slump and jump has taken it, rather than become acutely lazy, or deeply sleepy, or is seizuring pre-death, or is beginning, without knowledge of what happens at the end of the preamble, to creep down the florid, hilly road to his own little Armageddon, where the brain goes cold and forgets everything it remembered; she draws the curtain quickly, it whips; she draws the curtain so that the other three patients are protected from death, even though they know it's behind the curtain, giggling; or is she protecting the corpse from those who are still alive, so that it might not see what life really looks like? Isn't that when you see what life really looks like; when you're dead? She whips the curtain around the bed; it might also be to prevent the relatives of the deceased from making a comparison between their dead one and the warm patients in the other beds, and vice versa. There is much protection and prevention to be done in death; more than is done in life; so says Oliver.

A little light from a little pen-torch is shone with enormous respect and delicacy in to the prised-open eyes; when in Stephanie's hand the light flicks over the eye lashes and nose and finds the stiff pupil only fitfully. Do I want it to respond or not? Do I want it to swell under the light? Do I want Stephanie the drowning fish to feel a torrent of diarrhoea rush down her innards as the pupils dilate, meaning he's not at the end of the road, and has plenty to go yet? Do I want her to drop her torch and feel it smash in to lightless shards by the bed? Would it be good if her stethoscope snapped as she jerked back upon hearing a spastic suck of dusty air settle in his dusty lungs sounding for all the world like a feeble wave collapsing upon the metal junk and glass flora of a beach in mid-winter? 'Oh, your hearing thing!,' says wife, reaching to repair it, saying, 'What happened, what happened, is he still breathing, was it a breath that made you jerk? If so oughtn't I tell Ian who at this moment is on the phone telling all our kin and strange friends that Arthur, dear Arthur, had passed on to be with his mamma and pappa, and, because of the breeze you've just heard he should stop telling them all that Arthur, dear Arthur is no longer with us, saying instead that he is with us, he is?'

Do I want to see little Steph's tools smashed; steth broken, pen-torch sharded? Is it better if she comes from behind the curtain shaking her lumpen head profoundly and saying, 'He's gone now, let's move him in to the side-ward where he might be alone.' I say he doesn't want to be alone; he definitely doesn't want to be alone, but I don't say it. Or is better that he's dead? Where are the greater demands? In his life, or death? That is the question in my profession. Never vocalized to anyone but those whose bed is sometimes called yours, and even then in jest, slightly, deviously; what antagonizes us? Bathing him each morning; if only we could just hose them down; here we must first remove the dressings that cover his Nazi lesions, slowly, slowly, slowly, lest he gasp and shudder. Such exclamations of pain and regret in a patient, are, to little angel nurses, the same as feeling a raping phallus in the bearded children-evacuated tent between legs, or, otherwise, the rectum. So they must be removed so that the patient never gasps or shudders, for such things are simply too much to bear. Sterility, sterility, sterility too, too, too. Gloves, irradiated tools; yes, irradiated, so that little sick boy doesn't get pillaging, deplorable bacteria on his table-cloth flesh. So our eyes castigate his lighthouse pustules that coat and cover the red lesions beneath; dare he gasp when I'm doing it this bloody slowly? Of course not, he dares not; don't make Oliver feel guilty, patient. Be a patient patient, as the posters everywhere say. What chimpanzee on a pig's back wrote that, I want to know now?

Let's peel the dressings off and drop them in to the yellow human tissue bags while we pretend you're beautiful and talk of beef pies. It's warm saline that cleans the lesions, you salacious ones; pushed out from a syringe like heroin over the lighthouses and Nazi continents of red carpet skin and scales of tissue, pillow-slip and sheet that stay still only because there's not a gasp of breeze in this dazzling cupboard; they moan and giggle, the scales and lighthouses, as the saline washes blissfully over them. Hope you're grateful, patient, for what Olly does for thee! Then his unlesioned body must be cleaned with desultory water, but he can do that himself, he can do that himself, do it yourself while I supervise, do it yourself, it's just washing, I'm not here to everything. Then he must be shaved; he hasn't got an electric one, he hasn't got an electric one! Oh, Christ; a wet shave, a wet shave; I must feel the contours of his bulbous chin that must've been punched a hundred times beneath quickly drawn and pushed, pushed, razor blade; it scrapes like feet in fresh snow; kudos is mine, kudos is mine, say thank you for my rewardless remedy and palliative; see how there's fortune in disease? Didn't you realize that anyway? Just a child, aren't you?

I dress him; we draw the clothes over leaden limbs and sometimes it's like dressing a terrified rabbit and other times it's the same as pulling a giant woollen sweater over the branches of an Oak tree and then hoisting trousers over its barely-exposed roots. Oh, the analogies come freely in my grief. Then come the requests that only the sick dare make; pass the tea, pass the fan, pass the magazine, I've no energy to wipe my arse, you do it for me, lovely nursie, and don't look at me like that because you know you shouldn't and you know you can't and if you do I've every right in the world to tell doctor and manager and fill in complaints forms and have people in suits and bitches who want children in blouses to come and sit atop my dirty bed so that I may cry and sob and tell them all about my foul lesions and my pustular lighthouses and all I asked him to do was pass me the magazine and you should've seen the look on his handsome face it fair made me weep and I shouldn't be made to weep sir madam doctor because I'm sick you see I'm sick look at my fascist lesions I fought the fascists you know and the lesions itch and throb and all I wanted was a little patience and compassion from nursie Oliver and now look at what he's reduced me to I can't believe it I can't oh dear I'm sorry for embarrassing myself like this let me sleep; I'll make your life unbearable until I'm satisfied and I click my fingers and say enough punishment for looking at me funny, and manager doctor says oh my Mr. Curtis we're so sorry so very sorry for what daemon Oliver has done to you how dare he look at you you messiah Curtis the magnificent one the best patient ever to grave us with us disease we'll deal with Oliver oh yes we'll pull him in to an office and make sure he never insults you like this ever again please forgive us but don't forgive him when you fill a piss bottle feel free to pour it over his head with our compliments we'll make him piss his pants and cry and beg for forgiveness dear sir Mr. Curtis your munificence amazes us still all you wanted was for him to pass the magazine so that you might pass the time poor you poor you pour you pour you let us mop your brow and fellatio you and use your shit for lipstick and your puke for after-shave.

Then toilet; oh, toilet; when he's acute, when his redness is fresh and the pustules vibrant green, when he shivers and shakes and complains and complains and whines like a puppy dying of a broken back as birds come down to pick at it, he must use the commode chair by the bed, and he presses his button to tell us that something in his body needs to be evacuated now, now, now; his soul, I hope, but it never is; it's only ever shit, puke or a peculiarly bright orange piss. When he presses the button a little red light comes on over the bay of four beds in which he resides, and over his bed, as if confirmation were needed, as if confirmation were needed of a falling guillotine. Also, a low buzz, like a broken child's toy, is heard, a mechanical replacement for the patients' effortless pleading ululation. I walk to the bed and I pretend I take it in my stride; there are, after all, people much worse than I; people with no job, or people whose job is to cook burgers and wear dungarees as uniform.

But they can fall in a pot of boiling fat or suicide in their un-employability; what matters to me is that I will, in a few moments, have to tug away a commode, hinting at its fresh weight, and when in the sluice room I must remove the cardboard tray full of shit and deposit it down the masticator. I must hold, like a tray of food, a tray of shit; that is the vastness of my empathy. Who my empathy deceives is interesting; sometimes it is the patient I yearn to deposit down the tornado masticator, with her gasping excrement on top. How I loathe the waiting that follows the placing of patient on commode; gloves and gown, gloves and gown, no mask in case it upsets, gloves are all that protects hands from the dung and corruption; but is smell not a solid; therefore what of nose and eyes? Gown keeps uniform unsullied; or does it? Does anything? The wait, the wait, the weight, the weight; the wait for that light to pulsate red and the child's toy to be switched on; then, those who have no such thing to do, they smile and write, they smile and sip coffee, they smile and take blood pressure; I, my accoutrements still in the slothful breeze that now moves over slothful me, as I answer the call, as I must, as I'm paid to do, as I'm expected to; expected to; oh, yes, expected to; it's assumed that I will, oh salacious ones; it's presumed that Olly or equivalent will come-a-trotting and say, 'Oh, Mr. Mr, have you finished, are you done, is it over, are you sure, not rushing you, am I? What's that you say? Will the other patients mind eating their supper with the smell of your excreta usurping the smell of their soup in their little nostrils? Of course not, you little muffin! Here, let me help you get back on the bed so that you might exert yourself, then I'll wheel the little cart of filth away for you; there, there.'

It's assumed correctly, because I do, I must, I will. I wait for the buzzer and the red light as if they're an injection in a thin muscle; a cotton bud swabbing the inside of a penis in a VD clinic; a sample of eye taken from eye; a petal of eyeball peeled away. Oh, yes. So I prefer that dying fat cat with dry milk on her lips doesn't gasp as pupil shrinks to light, and doesn't seizure and snap stethoscope as raspy air tumbles through lung like dry ice; it is better if she comes out and shakes her head; better if she comes out and shakes her head and says, 'Let's move him to the side-ward; tell doctor Pajo and doctor Tortoise that good Mr. Curtis has moved on.' That is better, truthfully; that is my wish; and it will happen soon; I can tell; I know failing kidneys when I see them; the immuno-suppressants have suppressed the exuberant white cells and the kidneys; shame. I know because I have his blood; I have his blood; I have drawn it so that it may be monitored for things called urea and electrolytes. This is how we know how his kidneys are working and this is how we've concluded that he's fucked.

I know but he doesn't; he thinks he's doing dandy. I've drawn his blood; the upside, people, the upside, is thus; in the name of empathy I pierce his waxy tarpaulin skin with needle to find a vein which I seek with fierce prods and manoeuvres, in the name of morbidity and knowledge and all that is correct and relevant I peel back wrapping from immensely small needle, sterile, on whose surface nothing walks, on whose surface virus and bacteria yearn to cavort; what an insult to their genius; but no no, not yet; not until my turgid breath has painted the needle with my paint brush mouth; then I say to him, I say, 'We need this very moment to know just how the renal part of you is bearing up under the bilateral assault of immuno-suppressant and pustular psoriasis, otherwise known as Von Zumbusch's type, but you know that, don't you?' But what you don't know is that your albumin and calcium levels are low, so low, lower than hell's sewers, and your electrolytes are more deranged than a paedophile's ejaculation over inappropriate photographs. I do, you don't; shame. You've got your little drip up to keep you moist, but you don't think anything of it, do you, you feeble-minded bastard. What's in your head? Yet more shit? A vacuum? Does nature abhor what's in your skull? Is your brain covered in scales and ice cream cone pustules too? So here's a needle to slip beneath the mattress of flesh on your arm; I'm permitted to stab you. Isn't that odd? Don't you mind? Of course you don't. Then again, you're sedated, aren't you? Just a little something to take the edge of the acute phase of old Von Zumbusch's generalized pustular psoriasis, isn't it. I could poke it through your ear drum and you'd say, 'Check how the kidneys are getting on, is it?' Oh, yes, sir, check how the kidneys are getting on; no matter that I've just wheeled away a cart of your beastly dung and it thrust under my nose as if it were cake; I won't hold that against you; this is science, sir, and egalitarianism, and empathy, with a touch of compassion. Just you sit back there while I press this clean little rapier in to the soft of your soft arm and suck the blood like a baby at its mother's teat. After all's said and done, everything just coalesces in to one lumpish pile of love and admiration from which we all shovel now again, doesn't it? So give it not a second think and let Oliver do what's the best for you and I and us.