Notes to Self Read online

  for Ronan

  CONTENTS

  Title Page

  Dedication

  Notes on Intemperance

  From the Baby Years

  Speaking / Not Speaking

  Notes on Bleeding & Other Crimes

  Something About Me

  This is Not on the Exam

  Acknowledgements

  Copyright

  NOTES

  TO SELF

  NOTES ON

  INTEMPERANCE

  BY THE TIME WE FIND HIM, he has been lying in a small pool of his own shit for several hours.

  Corfu General Hospital is bewildering. The foyer is crowded with patients smoking, and there is no sign of an information or registration desk. I text him to ask where he is but get no response. Somehow, like bloodhounds, we track him to the fifth floor. He lies weakly in the bed. It is evening now and he says he hasn’t seen a nurse or doctor since midday. He says he needs a bedpan. My sister and I have been travelling for over twenty-four hours, and neither of us has slept. ‘Call the nurse,’ I tell him. He says he did, but nothing happened. ‘Well, do it again.’ He holds the call bell in his hand and presses, repeatedly. After a while a harassed-looking nurse appears, shouting at him, at us. I feel guilty for not speaking Greek. With useless gestures, I point to the man in the bed, I try to signal that he needs a bedpan, to be washed, and the sheets changed. None of this makes any impression. The nurse says something else, throws up her hands and leaves. He looks at us in desperation. I ask my sister to stay with him and I go out into the corridor. I can see only other patients, and their families. I go to the nurses’ station but there is no one there. As I walk away, at a loss for what to do, a woman speaks to me. When I don’t respond, she asks me in English if I am alright and I latch on, asking her if she knows where the nurses are. ‘There are no nurses,’ she tells me. An older man leans over. ‘Without your family here, you die.’

  This will become a mantra to us over the weeks that we spend in Greece, trying to nurse our father back to life. Very quickly we learn just how understaffed the hospital is. There are no doctors after 2pm, and after 5pm there is only one nurse per ward. On this corridor, I count six rooms, each with up to six patients. The nurse is barely able to cover the basic medical needs of all these people, and she does not have time to deal with incontinence. We also learn that this floor – officially for patients requiring ‘internal medicine’ – is dubbed ‘the dying ward’.

  The English-speaking local tells me that I must take care of my father. She explains gently where to buy incontinence pads and wipes and paper towels. I barely take this in, but go back into the private room my father’s crisis status has secured him, and explain to my sister the state of play. She looks at me in disbelief. She is standing at the head of Dad’s bed, and fixing his pillows. I realise that I have hardly spoken to him, though I have travelled across Europe to be here. ‘You’re alive anyway,’ I say. He nods. He looks very small in the bed, small and lost. I decide that this can’t be the way it is – there must be someone in authority somewhere in this hospital. I go back into the corridor and ask the sympathetic woman if she will help me to find a doctor. She talks quickly with her family and then walks off down the corridor, with me following. We take a lift to another floor, but there are no doctors there. We get back in the lift and try again. We do this over and over, down and down, until we’re in the basement, searching its corridors. Eventually we find the blood donation clinic with its attending medic. My new friend ushers me in, then waves goodbye.

  On the far side of the room, a man is lying on a couch, his sleeve rolled up and his arm attached to an IV. He is giving blood, and the clinic attendant seems to think I am there to donate too. Seeing my surprise, the doctor explains to me that there is a national blood shortage in Greece, and it is law that patients’ families give blood. I think of my sister, five floors above, wondering where I am. I shake my head, but the words won’t come. I can’t seem to explain in any language that we are both anaemic and unable to give blood. I take his hand and ask him to see my father. I tell him that I don’t understand, that my father is alone in a room and there are no doctors. I tell him that we just need someone to explain it all, though what I really want is someone to tell me what to do. The jolt of adrenaline which propelled me this far has suddenly gone and all I feel is empty. I just keep standing there, asking the doctor to come to see my father. Extremely reluctantly, he says something to the woman at the desk, and leaves the clinic. We take the lift back up to the fifth floor, retracing my route past the doleful visitors and into the room.

  ‘He’s a doctor,’ I say, with more hope than certainty. He takes Dad’s chart, looks it over, nodding, then says, ‘Your father has lost a lot of blood. He will need transfusions. You must give blood.’ It seems easier to agree, though I had hoped for a more thorough examination. In the weeks that follow, this will be the pattern that our time takes: hours of waiting, followed by a struggle to attract official attention, only to be told something that we already know. After years of teaching Beckett plays, I am finally living in one.

  Having delivered his pronouncement, the doctor nods again and leaves. In his wake, I look to my father for guidance, but he only looks back at me for a reassurance I cannot give. I try to smile. We’ve now been here for more than an hour and though I know he is relieved to see us, and my sister has stroked his hand and made him feel much less alone, he is still lying in dirty sheets. Since no one else is going to help us, I ask my sister to come with me. ‘We’ll be back soon.’ Downstairs we find the hospital shop, which sells a useful combination of hot snacks and drinks, and the products necessary for looking after a patient. We buy wipes and pads and, as an afterthought, my sister buys a box of surgical gloves. These, it turns out, will prove invaluable.

  When we explain to Dad what we are going to do, he is distressed and embarrassed. But the smell in the room is now awful, and it drives us to be as efficient and business-like as we can. We clean him. Once the dirty sheets are bundled up, I take them to what looks like a utility room and guiltily leave them there. In an abandoned-seeming ward, I take clean sheets from one bed, and blankets from another, figuring that if you don’t take, you don’t get. When I come back into the room, my sister has managed to make Dad laugh. As we tuck the new sheets around him, it becomes clear how much our sense of humanity depends on these basic things. Nothing has really changed, and I am no clearer on Dad’s exact medical status, but it feels as if we have achieved something huge.

  It gets late. We agree that I will stay in the hospital overnight, and my sister will go to a hotel in town. I want to go with her, but from now on we will take it in turns to stay with Dad. She makes it out of the ward just in time – they lock the doors at 11pm. It is accepted that family members will stay, but the door prevents coming and going. After hugging her goodbye, I turn back to the room. I don’t envy my sister her solitary journey to find a place to stay, but neither have I any idea how to navigate the night ahead in the hospital. Dad has slipped into unconsciousness. I listen to his breathing, hold my hand on his chest to feel his heart, which beats steadily, though it feels very faint. The bag of blood hanging by his head is now almost empty. I eye it warily, thinking that I don’t have the energy to figure out what to do once it is gone. I dial the number for his insurance company but only get an automated message. When I realise that I have left my charger in my sister’s bag, I give up the idea of phoning anyone else.

  I turn off the lights and look out the window at the hills north of the hospital, and listen as the late night quiet spreads through the ward. It gets so cold that I heap blankets on Dad. I sit in my coat and wait. After a while, the door opens and the harassed nurse re-enters. I watch silently as she takes down the empty
blood bag, replaces it with a fresh one and squeezes to check that it is going in. She is wearing an apron that would look suitable on a butcher in an abattoir. It is only after she leaves that I realise she did not wear surgical gloves or wash her hands.

  Later in the night, a different nurse appears and I manage to smile and proffer the box of gloves. She cautiously takes a pair and puts them in her pocket. ‘No, no,’ I say, smiling ingratiatingly. I mime for her to put them on but she only waggles her fingers to show she is already wearing gloves. Her pair, though, has blood and stains on them, and I mime for her to remove them and use the fresh ones. All this miming must seem ridiculous, but like the madwoman she presumably takes me for, I keep going until she sighs and changes the gloves. The old ones go in her pocket. This only becomes comprehensible several days later when another visitor explains that the hospital provides no disposable products at all – no cotton wool, no paper, no plastic. The nurses have to buy their own supplies, out of wages that are already insufficient. The glove pantomime becomes a regular occurrence and every time I give a nurse a fresh pair I feel like crying.

  But that first night, as I half dozed, half listened anxiously for my father to take his next breath, I was too stunned to cry. I had expected the call for years, and had imagined the scenarios, so that when it came I was able to react, to make the necessary decisions. It was only in the quiet and the dark of the hospital room that I understood the call was only the beginning.

  I HEAR THE BEEP, too early on a Sunday morning to be a casual message. The text reads: ‘Am bledng. Dont fon’. I phone him. He sounds awful. He sounds like what he is: a man who is bleeding to death. He chokes and coughs, only barely able to speak, as the blood vomits out of him. I tell him to hold on. I ring his friend P, who lives on the other side of the island, and she rings the ambulance. But the driver refuses to go out on the call. He is spending Sunday with his family. He seems to think that it will be a wasted journey, that my dad will be dead already, and so he can wait until Monday. P berates and cajoles. It takes a long time for her and her husband to persuade the driver that despite it being a Sunday, and despite it being an hour’s drive, he has to go. P doesn’t tell me any of this until later. For now, she only makes me promise to ensure that Dad’s front door is open. If the door is locked, they will leave again. I phone Dad back. He is, luckily, still conscious, and he crawls to the door, and turns the key in the lock. When the ambulance gets to his village, his neighbours direct them to his house. The emergency crew pick him up from the floor where he lies, now unconscious, and take him to the hospital.

  In winter there are no direct flights from Ireland to Greece. Hours after the call, my sister and I fly from Dublin to Heathrow for our first stopover. Men in scarves crowd the plane, and I realise there must be some important football match on. At the new Terminal Four we eat in an Italian restaurant. Though it is grotesque to care about food while your father lies dying, I order truffle pasta and it is delicious.

  Over dinner I tell my sister that I don’t know what we will find when we get to Greece. I tell her that I am tired. I tell her about one evening several years earlier when I asked Dad to stop drinking. About how he poured himself another glass of wine as I was speaking. About how I was crying and he was telling me to stop being so stupid. I tell her that I threatened him, that I told him I would stop loving him. I tell her, though I am barely able to admit it to myself, that at one point that night I looked at him and thought, ‘Just die now.’

  As we eat and talk we keep checking our phones, a reflex that is both hopeful and fearful. We haven’t heard from him since he was taken to hospital and we both know that he may be dead. My phone beeps, and I grab for it, but it’s just an automatic update. My sister looks at me. She knows I could never stop loving him. The next morning we take the first plane to Athens, where we transfer to a flight to Corfu.

  THEY CALL HIM ‘THE CORPSE’. He’s attached to machines that monitor his heart and other major organs. He has two IV lines, though the nurses struggle to find a vein that will take them as he has lost so much blood. He is barely awake most of the time. We’re oblivious to his nickname until a Greek visitor lets us in on the joke. Typically, as with most things concerning Dad, it’s both funny and not funny. Nobody, not even the nurses, thinks he’s going to live through this. And yet – he refuses to die. After a week in the main hospital, on this end-of-life ward, where one or other of us is with him night and day, he’s deemed stable enough to withstand a transfer to the ‘English’ clinic, which translates, basically, as ‘clinic for people with health insurance’. It’s a huge improvement: there are two nurses per shift and half the number of patients. Dad is bathed for the first time and the nurses insert a catheter. They don’t see it as the family’s duty to supply and oversee bedpans.

  Each day we arrive at the clinic at 11am, stay till 5pm, leave for food, then come back for another few hours. We sit side-by-side and watch him, for hours, barely talking ourselves, just monitoring the man in the bed; we still expect him to die and we stay with him constantly, as if willing him to live will make a difference. The long hours are broken by a series of brief and frustrating conversations with elusive doctors. They cursorily examine him, then pronounce that we should take him back to Ireland. After all, they say, Ireland is a better country to have liver disease in, the doctors have plenty of experience, we’re told, ‘over there’.

  Dad is in full liver failure. For years his other organs have been compensating for his diminished liver capacity. Now, after four decades of alcoholism, his system is shutting down. I had always assumed it would be cirrhosis that would end his life, but it turns out there’s a host of other deadly illnesses to grapple with. The bleeding, from a rupture in his oesophagus, though it has almost killed him, is only the most obvious symptom. I remember an earlier sign of this: Dad stopping the car one day to retch and spit blood by the side of the road. Now his kidneys are also critical. The specialist tells us, though, that his heart is still in good shape. ‘Perhaps medically speaking,’ I want to say.

  After a week, the doctors decide his oesophagus is sufficiently healed. They allow him to eat soft, plain food. But he won’t eat. Or he won’t eat what’s on offer: eggs.

  ‘I don’t like eggs.’

  ‘You have to eat.’

  ‘But you know I don’t like eggs.’

  ‘I don’t care, you have to eat.’

  This role reversal, with the child feeding the parent, is bitterly ironic. We are all here because he likes to drink and now he has the temerity to refuse to eat. We do a deal. If he eats one hardboiled egg, I will buy him pens and paper. Later I promise a stapler too if he eats a second egg. Because he is a writer, he feels insecure without the means of writing things down and organising them. He gives me animated and detailed descriptions of where to buy these essential supplies. Yet, in the end, he only eats half of one egg.

  No stapler, I tell him.

  He doesn’t speak to me for an entire day.

  Neil phones me every day, sometimes twice a day; his is one of the few numbers I can answer easily. Neil is Dad’s best friend. When Dad is refusing to eat, or the insurance company says that they won’t pay the bill for the private clinic, or the doctor says Dad is probably going to die, I fear I will cry out in pain. But then the phone rings and it’s Neil, and as I listen to his reassuringly buoyant voice I begin to think it’ll be okay. He asks about Dad, about the doctors, he makes me feel like we can get through this. He knows that, from Dublin, there’s little he can do, and he knows that phoning me cannot change the doctors’ prognosis. But he also knows that this daily call is what I need. Neil gives me the number of a doctor friend in Ireland who will translate what the Greek doctors are saying. I phone this friend and describe Dad’s condition, his list of ailments. He tells me to get Dad home. Now.

  Z, Y, X, W, V…

  That’s how I was taught the alphabet. ‘My five-year-old daughter can say the alphabet backwards faster than you.’ That’s how it
went, the bet. I was taken out of bed, and brought downstairs to perform the feat in front of a tableful of drunk grown-ups. The bet was won, I was returned to bed. Why my dad chose to teach me the alphabet backwards I don’t know – I’ve asked him, and he doesn’t know either. I put it down to the fact that he likes to stand at an angle to the world, that for him to follow the standard rule of a, b, c seems oppressively normal, and that, as his first child, I was fallow ground for testing his theories. And I was a quick study. Because above all else, I wanted to be like – and to be liked by – my dad. Nowadays, when I’m filing student record cards, I still mix it up – is it p, q, r or r, q, p?

  Dad’s unusual approach to parenting was not limited to the alphabet. When I was four years old, he took me to the beach. I made sandcastles by myself, while he sat on a folding chair, reading. He had not packed a picnic, so when I said I was hungry, he sent me to find some other children in the hope that their parents would feed me. It worked. To this day, Dad tells this anecdote as a sign of his ingenuity. He has never been shy about sharing how happy he is to relinquish the duty of care towards his children.

  As we grew up, we knew not to ask anything of him. When I was ten years old, Dad left us in a pub. He was angry because I hadn’t stopped my five-year-old sister from pouring her orange squash into his gin and tonic. He drove away and he did not come back for us. We found someone else to give us dinner. We found someone else to drive us home. We put ourselves to bed. These did not feel like out-of-the-ordinary things to have to do. Like all children of heavy drinkers, we developed a particular kind of watchfulness. We learned, through experience, not to trust. We learned to cope with crisis. And if ever we put ourselves in his way he would say the most creatively hurtful things. When I became a teenager he started calling me a ‘slut’, which, in his special way, could be wielded as both an insult and a compliment.