A Proper Family Christmas (9 page)

‘We don’t really know. We think you might have taken some bad drugs. Fake ecstasy. You might have had a reaction to one of the ingredients.’

A part of Izzy’s brain still told her that she had to deny it. She would be in such deep shit if her parents found out she’d taken a pill. But she was already in hospital. By definition they already knew. Izzy turned her face away from her father in shame and focused on a drip that had been placed to the right of her bed. She followed the see-through tube down to the back of her hand. A swirl of Izzy’s blood decorated the clear liquid that was being pumped into her. When she saw that, Izzy was suddenly very frightened and knew that the machines and liquid that surrounded her were keeping her alive.

‘Mummy,’ she whispered. ‘Am I dying?’

‘God, no,’ said Annabel. ‘Not on my watch. Never.’

Annabel pressed her lips to Izzy’s forehead. Izzy could only cry.

Izzy spent the next few days in ICU while doctors monitored her progress and measured the damage caused. Unfortunately, she hadn’t actually been through the worst by the time she got to hospital. Instead of getting better, her condition deteriorated. Izzy was retaining fluid. Her face and her joints began to look swollen. She couldn’t seem to pee. Her kidneys were slowly closing down.

Richard and Annabel both held Izzy’s hands when Dr Devon, the hospital’s consultant nephrologist, arrived to deliver the bad news.

‘Will my kidneys get better?’ Izzy asked.

Dr Devon wouldn’t be drawn but for now, she had no choice but to put Izzy on a regime of haemodialysis. Both Izzy and Annabel wept as a temporary catheter was duly fitted into Izzy’s neck.

‘You’ll feel much more comfortable once the dialysis starts,’ Dr Devon assured her.

Izzy didn’t think she would ever feel comfortable again.

The days were full of tests and measurements and handfuls of medicine. Izzy was never alone. There was always someone wanting to take her blood pressure or her pulse. The ICU staff were uniformly lovely but still Annabel and Richard made sure that Izzy was never without a family member too. Together with Sarah, they formed a tag team so that the grey plastic visitor’s chair by Izzy’s bed was never empty. When she was awake, Izzy apologised to them all – her mother, her father and grandmother – a hundred times an hour.

‘I thought it would be OK,’ she said. ‘I thought ecstasy was supposed to be safe. Saul told me I would be fine.’

Jessica’s words kept coming back to haunt her: ‘When you buy drugs you don’t know what you’re getting. You just don’t. And that’s why I won’t touch anything like that.’

Why had Izzy been so stupid? Remembering that terrible moment, when she made the wrong decision and stayed with Saul rather than follow her school friend, Izzy wanted to weep. She had been such an idiot and now she was paying the price.

‘You’ve got every right to be angry with me,’ she told Annabel and Richard. ‘I promised you I wouldn’t take anything. I thought I could get away with it.’

Annabel smoothed Izzy’s hair back from her forehead.

‘Don’t worry about that now,’ she said. ‘Just concentrate on getting better.’

Izzy went back to her silent prayers. If God would just let her get well enough not to have to stay on this dialysis machine, she would never disobey her parents, or anyone else who cared for her, ever again. But though Izzy prayed harder than she had ever done, even when she was a kid and she really believed it could make a difference, God didn’t seem to be listening.

Of course, Annabel had googled ‘kidney failure’ and ‘ecstasy’ and ‘MDMA’ and ‘benzylpiperazine (BZP)’ the moment she got her hands on an iPad. Apparently, cases such as Izzy’s were rare. Especially after just one dose, which Izzy swore was all she had ever taken. Kidney damage in the documented cases Annabel read about was usually cumulative, after a long history of drug abuse. Even then, it was almost always reversible. There was good reason for the Buchanans to believe that Izzy would make a full recovery. That was the normal prognosis. Izzy longed to be normal.

After a week in ICU, Izzy was moved to a renal ward. That felt like a big step towards her recovery. Dr Devon took over her care now. The nephrologist was kindly and unflappable. Her big smile made the Buchanans feel as though everything would turn out well, even as she was ordering another blood test or scan. With Dr Devon at the helm, everything was moving in the right direction, they were sure. Izzy would surely come off dialysis soon. They’d be able to bring her home.

‘It’s just a matter of rest and recovery, yes?’ said Annabel, when Dr Devon did her rounds as Izzy entered her second week on the renal ward.

‘We’re doing our best to get her home as quickly as possible,’ said Dr Devon. ‘But it’s not going to be anytime soon.’

Though Izzy was out of ICU, the haemodialysis machine was still doing the hard work.

At the end of her third week in hospital, Izzy’s kidneys were still not showing any sign of getting better. They were operating at just a fraction of their normal function. Dr Devon still espoused a ‘wait and see’ approach, but gradually, it started to sink in that Izzy’s was not a ‘normal’ case of acute kidney injury thanks to MDMA or BZP. Perhaps she had a congenital weakness or a prior infection had made her kidneys less able to cope. Perhaps there had been some additional toxin in the tablets that the initial tests had not picked up. Three weeks in hospital soon turned into a month. Five weeks. Six weeks. There was still no improvement. Dr Devon made the decision to move Izzy on to peritoneal dialysis.

‘So she can do it at home,’ Dr Devon explained when she met with Izzy’s parents.

‘Izzy’s going to need to dialyse at home?’ asked Richard.

‘Of course.’

‘For how long?’

‘For as long as it takes,’ said Dr Devon.

‘What are you saying?’ asked Annabel.

‘Izzy’s kidneys are not getting better. I’m going to advise that she’s put on the transplant list.’

Annabel was in shock. In less than six weeks her privileged, carefree life had completely fallen apart. She had gone from being a woman who considered the local supermarket running out of organic eggs to be a ‘disaster’ to being the mother of a child on the kidney transplant list. Annabel was dumbstruck as she and Richard left Dr Devon’s office and returned to the ward after a long discussion about transplants and the possibility of a living or altruistic donation.

Still asleep for the moment, their daughter looked so perfect. The dialysis had gone some way to getting rid of the puffiness of retained fluid and Izzy’s face was clean of the make-up she had taken to wearing whenever she wasn’t at school. Without it, she looked her real age. Even younger. She was like a princess, just waiting to be woken from a spell, with a lifetime of magical adventures ahead of her. It just didn’t seem possible that inside Izzy’s young body, vital parts of her were actually grinding to a halt.

‘What are we going to do?’ Annabel whispered to Richard.

‘We’ll get tested to be donors of course. One of us is bound to be a match. We’re both healthy and it’s perfectly possible to live a normal life with one kidney, just like Dr Devon said. It’s going to be fine. Once she’s got a new kidney she can come off that awful machine.’

Annabel nodded. And as Izzy stirred to wakefulness, she plastered on another smile.

The NHS could not move quickly enough for the Buchanans. Annabel and Richard decided they would pay whatever they could to speed the process along and just a few days after Dr Devon suggested living donation as a possibility, Annabel went to be tested. They had decided that she should be the first because Richard was the breadwinner . They needed him to be able to work, not least for the private medical cover that came with his job. Plus, Annabel felt so angry with herself for having ever let Izzy go to the festival in the first place, she needed to feel the prick of a needle as some sort of self-punishment.

She tapped her feet with impatience as the necessary paperwork was completed and a phlebotomist took a sample to compare against Izzy’s blood. She was tired of waiting. She couldn’t concentrate. Everything – all the paperwork, all the questions – was just keeping her from doing her duty as a mother.

‘No history of high blood pressure?’ the clinician asked.

‘Of course not,’ said Annabel. ‘No.’

‘Diabetes?’

Annabel shook her head.

Annabel had no reason whatsoever to believe that she would be refused. Her last well-woman check at the GP’s had shown her to be in fine health. Her blood pressure was always right on target. Her cholesterol counts were good. She may be carrying a little more weight than she liked, but her cardio fitness was exemplary, thanks to years of hard work aimed at keeping her figure under control. She was sure that she would pass every test with flying colours and Izzy would have a new kidney within months.

Indeed, Annabel’s blood test results were all good news – she was a perfect blood and tissue match for her child. An appointment was quickly made for the next step: an ultrasound scan to ascertain the size, structure and general fitness of Annabel’s kidneys themselves. There was no need to hang around.

She told Izzy.

‘You won’t be on dialysis for a moment longer than you have to,’ Annabel promised.

Izzy cried with relief.

On the day of the scan, Annabel drank the necessary liquid to enlarge her bladder and waited to be called in. The wait was terrible. She had never needed to pee so badly in her life. Not only that, she was anxious for more good news. She was almost certain she would get it. This scan was a technicality. Annabel was already planning ahead for the operation. Her mother Sarah would come and live with them while both Izzy and Annabel recovered.

When it was Annabel’s turn, the radiographer smoothed the conducting gel on to her abdomen and applied the transducer. Annabel strained to watch the fuzzy images that appeared on the screen, though she wouldn’t have know whether she was seeing her kidneys or her ovaries. It was all so much ‘noise’ to her amateur eyes. Still the radiographer seemed to be ranging over quite a wide distance, right down to her pelvic bone. Weren’t the kidneys higher up than that?

‘Is everything OK?’ Annabel asked.

‘Yes. I think so. We usually look a bit further down to see that the bladder and whole urinary tract are as they should be too.’

‘But my kidneys? They’re good, aren’t they? That’s what matters.’

‘Your doctor will let you know,’ the radiographer said. Like so many of the medics the Buchanans had encountered over the last seven weeks, she was infuriatingly inscrutable. But then she pressed down on Annabel’s belly to get a better look at something and a frown crossed her face. Annabel saw the expression before the radiographer could hide it.

‘What’s the matter?’

‘Are you sure you’re not pregnant?’

‘Why do you ask?’

‘I think I’m seeing something.’

‘No,’ said Annabel. ‘That’s ridiculous.’

But Annabel’s imagination started to roam. What if the weird way she’d been feeling lately was not due to the perimenopause, as she had self-diagnosed online? What if the way she had reacted to the smell of the wine the weekend of the festival was not because the wine was corked? When she was pregnant with Izzy, she hadn’t noticed a thing for the first three months. No morning sickness. No peculiar cravings. She had just carried on as normal until Richard made a classically cack-handed comment about her looking a little bloated.

‘Can you check?’ Annabel asked. ‘Can you look now?’

‘I can’t say for sure. That’s not part of my remit, I’m afraid. Maybe you should take a test when you get home.’

Frustrated in her search for an instant answer, Annabel went via Boots on her way home from the clinic. She picked out the cheapest pregnancy test she could find. Not that they were exactly cheap. Annabel had a sharp memory of an awful afternoon many years before, when she was just sixteen and convinced she was pregnant by her then boyfriend. The pregnancy test had taken a day’s wages from her Saturday job, though the feeling of knowing that she wasn’t up the duff just as she was about to sit her O levels was priceless.

Once home, she didn’t even take her jacket off before she went to do the test. She peed on the stick, then closed the loo seat and sat back down on it to wait.

Two blue lines.

‘What?’ she said, to no one in particular.

Two blue lines.

She picked up the box and read the back: ‘A positive result is indicated by two blue lines …’

It wasn’t possible. Convinced that there must be some mistake, Annabel quickly did the other test in the box. She sat on the closed toilet seat again and watched as the first line appeared to show that the test was working. Then the second.

Two more blue lines.

‘I can’t be bloody pregnant!’ Annabel cried out. ‘I can’t!’

Annabel didn’t know whether to laugh or cry. It really couldn’t be possible. Perhaps she should have bought a more expensive test. But on the other hand, why shouldn’t it be right? When was the last time she’d had a period? Three months earlier at least. And the woman who did the scan had obviously seen something even if she wouldn’t be drawn.

Meanwhile, Richard had texted, asking when she was going to come back to the hospital. She had promised she wouldn’t be long. Richard needed to get to his desk. His colleagues at work were very understanding but there were questions that only he could answer and deals that would have to go ahead no matter how Izzy was doing.

‘We have to talk before you head off,’ Annabel told him. She had to share her news right away. The bad news.

They went to the coffee shop in the hospital lobby. The coffee was reasonable. The cakes were awful, but Annabel ordered one anyway. She felt like she had to have something or she might throw up. She supposed that was the baby making itself known. The baby! She still didn’t quite believe it was possible.

Annabel bagged a table in the corner while Richard went to the counter. She watched him help a woman on crutches take her coffee to a table before he placed their order. Tears sprang to her eyes. He was such a good man it made her heart hurt. Such a good father. But what would he say about this? Now?