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Authors: Adam Mars-Jones

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It took me a week or two to recover from the assault on my throat – slow progress. Another day another dolor. I didn’t have all that much incentive to get better, not when I was only getting back to square one. Finally I was pronounced ready for a second go at being operated on. The operation to install the first McKee pin, referred to by others but not by me as my ‘op’.

I rather resented the abbreviation. I felt that styling the coming ordeal was my privilege rather than anyone else’s. Others should follow my lead
and say ‘operation’, unless and until I gave the signal to authorise the short form. They should defer to me in this matter, since it was the only little bit of surgery in my power.

It wasn’t Jack Juggernaut but another nurse who shaved my groin when it became time again. Not that my pubic thatch had made much of a comeback in those weeks. It was still at the itchy stage. I wondered if the change of personnel showed that I was in disgrace for my excitement the last time I was shaved.

The new nurse was the same delicious colour as Jack Juggernaut, and had a lovely faint smile playing about her lips while she went to work. I wasn’t worried – that is, I was mildly anxious about the operation but not about the shaving. Later I found out she was Jack’s sister. I wondered madly if they had compared notes about Tom Dooley, hardly likely in their culture but something which would nevertheless explain the smile. When she saw him, Tom was dozing even before the anæsthetist arrived with the gas. Naturally it was gas this time.

Mum’s warning about how difficult it was to sew together three pieces of cloth – and therefore also of skin – had given me pause, but I wasn’t seriously bothered, even after the botch-up of the anaesthetic. I’d seen the excellence of Mum’s work as a seamstress. She rose to every challenge, and there was no reason to think that the surgeon was any less skilled. Mum wasn’t even a professional dressmaker, just a gifted amateur working for pin money, so it made sense that there should be many levels of expertise beyond hers, Himalayas beyond the foothills where she practised her useful domestic skills. A surgeon operating at a proper hospital must be more than just handy with the scissors and the pins and the needles, with basting and seams. He would be a scientist who was also an artist, a visionary thinker, a Leonardo of the surgical blade. Would my case even be distinctive enough to hold his interest? I hoped at least it would take his mind off the cryptic crossword he had been doing before he entered the sterile area. It would be sad to disappoint a person of such qualities.

I wasn’t entirely wrong. The surgeon had skills. He wasn’t intrinsically a bodger. Maybe the problem was simply that we were treating the body as a machine, and if the body is a machine then pain is one of the things it produces. The surgeon who operated on me specialised
in arthroplasties, in McKee pins, metal on metal. He even had experience in performing them on patients with Still’s Disease. So he was a specialist within a specialism. It’s just that I turned out to be, once again, even more special than anyone had anticipated.

I was sick to the back teeth of special, but I couldn’t make myself ordinary by an act of will or I might have been tempted to try it a long time ago, provided it was on the Ellisdons mail-order catalogue basis, On Approval, your money back guaranteed if not perfectly satisfied.

The worst of the whole darn bunch

I surfaced, by incredulous degrees, from the anæsthetic, into an experience of pain that was beyond anything I had suffered at Manor Hospital, where they tickled the bone with a little hook to get a biopsy sample, or at CRX when Miss Krüger had made us dance for her pleasure. It was worse because it was constant, without modulation. It was some time before I could bring it down into something as mild as an internal scream of betrayal. Ansell had lied to me. Ansell of all people.
Et tu, Barbara!
If this was ‘a certain amount of discomfort’, then she was a devil who enjoyed making people hurt, who got a thrill out of offering reassurance and then kicking it away, leaving me to dangle on a rope of pain. She was a compendium of all the ghouls I had ever known or heard of: she was Miss Krüger with her invisible pointe shoes of agony, she was Vera Cole wielding her razor on sick boys because she hated to see them suffer, she was Judy Brisby with her nerve punches, she was Anna Mitchell-Hedges letting demons out of their travelling-case. She was the worst of the whole darn bunch because she had seemed so much like a friend.

With the assault on my throat after the botched anæsthetic I had thought my dolor rating, my theoretical Uppsala score, was close to the maximum, but now I had to reconsider my settings. The new sensation was off the scale. Perhaps there came a point, as with my tape recorder, when the needle flicked far into the red and the apparatus began to fail, the signal unrecognisably distorted.

Again I was told that Mum was on her way, as if that was the answer to everything, to anything. I still didn’t know what I had
done to deserve this black jackpot. I was a dolor millionaire, no doubt about it, and I couldn’t help suspecting that they’d done the little man wrong all over again.

Burning spiders in the socket

I had only one consolation as I lay there, with a spouting volcano of agony newly installed in my hip, which I lacked even the power to protect by curling up around, though instinct continued to dictate that impossible reflex. At least the pain was in the right place. The intolerable signals were being broadcast from a transmitter at the proper address, where the left hip was. There was far too much of the pain, and the surgeon had sewn burning spiders into the new socket, he was a hateful monstrous illegitimate brute but at least he wasn’t incompetent. He was torturing me in the right place. The left hip was the one chosen for the first operation. The right hip had the benefit of a little movement, but the left was always a hopeless case.

People came in every now and then and spoke to me, but I couldn’t take in what they were saying. And sometimes I answered them, but I didn’t know what I was saying either. I was howling with pain, and when they gave me pain-killers they didn’t kill the pain at all, only muffled the howling. The pain shrugged off the pain-killers, the pain had been inoculated against pain-killers, but at least I wasn’t making so much noise and upsetting other patients along the corridor.

Over time I realised that Jack Juggernaut was in my room, smiling and saying something reassuring. ‘Don’t worry,’ he was saying. ‘We’ve heard it all before.’ Heard all what before? I didn’t understand.

Eventually he was able to get through to me. It turned out that when I started to come round I used every swear word I knew. I didn’t know many. I had had very little experience of using swear words, since the time at Woodlands camp when I had learned a useful word and for a few days fucked everything that fucking moved. I had no real feel for the grandeur of the expletive, and there wasn’t any artfulness involved in what I howled. I didn’t swear like a trooper, I swore like a raw recruit to the world of taboo slang, howling the same thing again and again.

My untutored combination, though, had found favour with those
who witnessed my agonies. ‘“
Fucking buggers!
”’ said Jack Juggernaut appreciatively. ‘That’s downright catchy. Once you’ve heard it you can’t get it out of your mind. We have to watch ourselves round Sister these days. In case it slips out.’

Jack Juggernaut felt the need to reassure me about my swearing because when I wasn’t swearing I had been apologising for swearing. I’d go, ‘Fucking buggers fucking buggers,’ and then, ‘I’m so sorry, I’m so sorry.’ And then ‘Fucking buggers fucking buggers,’ the same rough music as before. ‘I’m so sorry,’ all over again. Jack wasn’t trying to stop me from swearing, only from apologising.

Rabble of shits

What Jack Juggernaut told me showed that even when I wasn’t fully present in mind and able to control my language, I was ashamed of its foulness. It wasn’t just middle-class scruple – there was something else involved. In spite of the dominance of the pain, a part of me remembered that swearing isn’t a real recourse for the disabled. You can achieve a brutal short-term effect with foul language, you can make people reel back a bit, but you incur a great loss of prestige over time (and your prestige, however forlorn, is your trump card). It’s not remotely fair but that doesn’t stop it being true. Whatever goes for women goes twice over for the disabled. A foul mouth isn’t ladylike, and it isn’t disabledlike either. People will make way for you all right, if you bellow, ‘Fuck off and clear a path, you rabble of shits.’ The wheelchair will meet no further obstruction – but it’s not the best bargain you can strike with the world of your fellows.

Swearing is dirty, and we’re above it. That may be the mechanism. Swearing is powerful. We’re not entitled. Perhaps the two notions converge in some way I don’t see.

Mum took the bus to Slough from Bourne End. We might live on the desirable Abbotsbrook Estate, but we were like poor relations in that prosperous parish, and Mum relied on public transport unless a friend with driving skills happened to be free. She was on her own this time, but she still talked mainly about Audrey, sounding variations on the old theme of I’m-at-my-wits’-end. After Mum cut her hair short, Audrey developed a new obsession – the hairpins she had
once hated so much for putting Mum’s hair out of reach. Now instead they represented what she had lost, hair that could be worn either up or down. Now hairpins became relics, almost fetishes. She exhumed rusty hairpins from where she had hidden them in the garden, and wore them herself. Finally she insisted on having her own hair cut short, and the hairpins lost their poignancy for her. This whole period of her development was just mourning after mourning – a trailing after symbols that had only ever been symbols of other symbols. This is the pathology of attachments. No wonder psychiatrists are so busy! Sensible religions set out to break attachment before it starts, to nip it in the bud.

Talking to anyone, even Mum, was like trying to concentrate on a chess problem while someone applied a soldering iron to my bones from the inside. Asking about Audrey became as much of an achievement as it would be to work out a dazzling move (
RxKtch!
), with the smell of burning marrow in my nostrils making me want to retch up my empty stomach to the last square inch of its lining.

My wounded hip was reluctant to heal. It was very sorry for itself, and couldn’t forgive the insults it had received. After a time it even started to weep. It cried thick tears of pus. I was put on antibiotics, but they didn’t help. Finally the command was given to wheel the bed outside, thereby exposing the damage to sunlight and air. The effect was miraculous, on the hip and the whole person. I think the crucial element was actually breeze, the movement of air. The sense that I was taking breaths from a live environment, a larger world that was going about its business without any intention of leaving me behind.

By the time I was moved back to CRX for my rehabilitation I had made a little breakthrough, discovering my own trick for fighting pain. At times when my medication was beginning to wear off, but there were still hours to wait until it was topped up, I found that by concentrating on my breathing I could get a certain amount of relief. The technique may have gone all the way back to my years of bed rest, in which case I was only dusting it off and putting it back into use.

The trick seemed to work differently from the medication. Instead of the pain going away, I went away from the pain. I was practising a sort of home-grown meditation. It was hardly surprising that my
method wasn’t very sophisticated. Transcendental meditation hadn’t hit the headlines just yet – I dare say the Beatles were only just beginning to hear of it. But it was a lot better than nothing, however rough and ready my technique.

Only when I had been transferred to CRX for my rehabilitation, did I get an explanation of why the discomfort had disregarded the promised limits. How my body had failed to coöperate in its mauling as everyone had assured me it would.

CRX seemed to be where I ended up when no one else knew what to do with me. Sometimes I wondered what would happen if I died – would I wake up in CRX on Ward One Thousand, with the tea trolley looming and Ansell doing her rounds, ready with another display of medical words I didn’t understand?

When I was installed in Men’s Surgical Ansell sat on the bed and came as close to an apology as an authoritarian ever can. ‘John,’ she said, ‘I’m not in the habit of lying to my patients – in fact in the past I’ve got into trouble for telling them too much of the truth. But in your case, though I didn’t lie, I discounted a crucial aspect of your case and seriously misled you as a consequence. My excuse can only be that you – my dear John – are so very unique.’ Ansell was teetering on the brink of tenderness, such a joyous novelty that it even interfered with my pedantic urge to point out that there can be no degrees of uniqueness. We’re each of us unique, or at least that’s the idea we all (identically) cling to.

There were considerate actions as well as kind words. Ansell scrounged up a set of linen sheets from somewhere, for old times’ sake. My wardmates made do with cotton, but flaxen whispers lulled this battered body to a threadbare sleep.

Ansell at her softest got through to me. My sense of natural justice, which had become badly inflamed and even infected in the aftermath of the operation, began to heal over at last.

Brimpton or Frilsham

The reason for my swearing, all my foulmouthed groggy screaming, was that from a surgical point of view I was such a special case. One of a kind. It’s possible to get just a little sick of being Mr Special.

There was something different about my history. It had been in my medical notes from my first week at CRX – in red ink, by rights – and still it had somehow been forgotten. ‘
The illness has raged
’, as Ansell had said the first time we met, and there was nothing to be done about that.

There had been no point in putting me on steroids so late in the day. In my whole life I had only been put on cortisone for two weeks. No time at all.

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