One
WHEN CHARLES ACLAND regained consciousness, he thought he was dreaming about a visit to the dentist. Certainly, the numbness in his mouth suggested novocaine even if the rest of the fantasy was absurd. He was lying on his back, staring up at a moving ceiling, and a bell was ringing loudly behind him. An alarm? He tried to raise his head to see where it was, but a hand descended on his chest and a woman’s disembodied face loomed over him. The dentist? He watched her lips move, but couldn’t make out what she was saying over the insistent clamour of the alarm. He toyed with asking her to turn if off, but doubted that novocaine would allow his words to be understood. She wouldn’t be able to hear him anyway.
Somewhere at the back of his mind was a lurking fear that he didn’t recognize. For no reason that he understood, the closeness of the woman worried him. He’d been in this position before – flat on his back and unable to move – and there was a strong association in his mind with pain. Fleetingly, another woman, slender, dark-haired and graceful, appeared in his line of vision. There were tears in her eyes, but Acland had no idea who she was. His instinctive reaction was dislike.
His only points of reference were the alarm and the ceiling moving above his head. Neither had any meaning for him. He could have floated forever in morphine-induced detachment if increasing awareness hadn’t told him this wasn’t a dream. He started to experience sensations. A jolt as the trolley crossed a threshold. The sympathetic tightening of stretcher straps as his body shifted. A low ache at the back of his jaw. A brief stabbing pain that knifed up his neck. A puzzled realization that only one of his eyes was open.
With a sense of dread, he knew he was awake . . . with no idea who he was, where he was or what had happened to him...
*
Subsequent awakenings increased his dread. He came to understand that the ringing was inside his head. It grew more bearable with each return to consciousness, but he couldn’t hear what was said by the faces that stared down at him. Their mouths opened and closed but nothing reached him. Nor did he know if his own mouth was relaying the signals his brain was sending to it. He tried to speak of his fears, but the lack of response in the faces above him persuaded him his lips weren’t moving. Time was meaningless. He couldn’t tell how often he drifted in and out of consciousness or how long his periods of sleep lasted. He convinced himself that days and weeks had passed since he’d been brought to this place, and a slow anger burned inside him as threads of insight began to knit together. Something cataclysmic had happened. He was in hospital. The talking heads were doctors. But they weren’t helping him and they couldn’t see that he was awake. He had a terrifying anxiety that he was in the hands of enemies – why? – or that he was trapped forever in a paralysed state that allowed him to think and reason, but left him unable to communicate. The dark-haired woman suffocated him. He hated the smell of her and the touch of her hand on his skin. She was always there, weeping soft, round tears down her pale cheeks, but her sadness failed to move Acland. He knew intuitively that the tears were for show, not for him, and he despised her for her lack of sincerity. He felt he should recognize her. Every time he woke and watched her through a half-closed lid, a sense of familiarity swam just below the surface. He knew his father before he knew her. Recognition of the tired-looking man who hovered at the edges of his vision came like an electric shock. In the next moment, he knew who the woman was and why her touch repulsed him. Other memories flooded back. He recalled his name. Charles Acland. His occupation. Lieutenant, British Army. His last deployment. Iraq.
He had a clear recollection, which he played over and over in his mind because it offered an explanation, of boarding an RAF Hercules on the day he left for the Middle East. He guessed the plane must have crashed on take-off, for his last memory was of buckling himself into his seat.
*
‘Charles. Wake up, Charles.’ Fingers pinched the skin on his hand. ‘There’s a good boy. Come on, now. Wake up.’ He opened his eye and looked at the middle-aged nurse who was bending over him. ‘I heard you,’ he said. The words came out as a long slur but he knew he’d said them. ‘You’ve had an operation and you’re now in recovery,’ she told him, answering the question she thought he’d asked. Where am I? ‘If all goes well, you’ll be returned to your own bed this afternoon. You’re connected to a PCA pump –’ she guided his left hand towards a control set – ‘otherwise known as patient-controlled analgesia. It allows you to be in charge of your own post-operative care. You shouldn’t need any pain relief for a while, but if you begin to feel discomfort press the white button. The morphine will help you sleep.’ He jerked his hand away immediately. ‘It’s up to you,’ she said easily, ‘but this way you can manage the pain yourself. The doses are measured and the machine overrides any attempt at self-indulgence.’ She smiled cheerfully. ‘You won’t be on it long enough to become an addict, Charles. Trust me.’ He didn’t. He had an instant understanding that he didn’t trust any woman, although he had no idea why that should be. The nurse held up a black plastic egg-shaped object. ‘I’m going to put this in your right hand. Tell me if you can feel it.’
‘Yes.’
‘Good man.’ She placed his thumb on a button at the top. ‘Push that if you need me. I’ll be keeping a close eye on you, but in case of emergencies, holler. You’re a lucky fellow. If God hadn’t given you a skull like a rhinoceros, you wouldn’t have survived.’
She started to move away but Acland used his free hand to catch at her skirt. ‘How did it crash?’
‘Say again.’
He took the words back into his throat like a ventriloquist and repeated them in slow, guttural fashion. ‘Khow . . . di’ . . . i’ . . . khrash?’
‘How did what crash?’
‘The plane.’ He tried again. ‘Khe khlane. I was on a khlane.’
‘Don’t you remember what happened?’
He shook his head.
‘OK. I’ll ask someone to explain it to you.’ She patted his hand again. ‘But don’t worry, love. You’ve got a few wires crossed, that’s all. They’ll right themselves eventually.’
*
Time passed and nothing happened. The nurse returned at intervals, but her complacent smiles and inane comments annoyed him. Once or twice, he attempted to remind her that he needed explanations but, out of stupidity or bloody-mindedness, she refused to understand what he was saying. A scream was circling around his head and he found himself struggling with anger in a way that he didn’t understand. Everything, from the curtained cubicle he was lying in to the sounds from outside – muted voices, footsteps, a phone ringing – conspired to ratchet up his irritation. Even the nurse had lost interest. He counted off the seconds between her visits. Three hundred. Four hundred. When the interval reached five hundred, he put his finger on the buzzer and kept it there. She bustled in with a stupid laugh and attempted to remove the plastic egg from his hand, but he wrestled it away from her and held it against his chest. ‘Fuck you.’
She had no trouble understanding that, he thought, watching her smile disappear. ‘I can’t turn it off if you keep your finger on it,’ she said, indicating a bleeping light on a remote receiver clipped to her waistband. ‘You’ll have everyone in here if you don’t let go.’
‘Good.’
‘I’ll disconnect it,’ she warned. ‘You’re not the only patient who’s had surgery today.’ She held out her palm. ‘Come on, Charles. Give me a break, eh? I’ve made the call. It’s not my fault it’s taking so long. This is a National Health Service hospital, and there’s only one psychiatric consultant on call at the moment. He’ll be here before long. You have to trust me on that.’
He tried to say he didn’t need a psychiatrist. There was nothing wrong with his brain. He simply wanted to know what had happened. There were other men on the plane. Had they survived? But the concentration needed to speak the words (which were incomprehensible even to his own ears) was so intense that the woman easily deprived him of his buzzer. He swore at her again.
She checked the PCA, saw that he hadn’t used it. ‘Is it pain that’s making you angry?’
‘No.’
She didn’t believe him. ‘No one expects you to be a hero, Charles. Pain-free sleep will do you more good than staying awake and becoming frustrated.’ She shook her head. ‘You shouldn’t be this alert anyway, not after what you’ve been through.’
*
When the psychiatrist finally arrived, he said much the same thing. ‘You look brighter than I was expecting.’ He introduced himself as Dr Robert Willis and drew up a chair beside Acland’s recovery-room trolley. He was mid-fifties, thin and bespectacled, with a habit of staring into his patients’ eyes when he wasn’t consulting a computer printout of their notes, which he placed on his knees. He confirmed Acland’s name and rank, then asked him what his last memory was.
‘Khetting o’ kh’ khlane.’
‘In England?’
Acland stuck a thumb in the air.
Willis smiled. ‘Right. I think it might be better if I do the talking. We don’t want to make this painful for you ...orfor me. Give me a thumbs-up for yes and a thumbs-down for no. Let’s start with a simple question. Do you understand what I’m saying?’
He watched the lieutenant’s thumb shoot up.
‘Good. Do you know what happened to you?’
Acland jabbed repeatedly towards the floor.
The man nodded. ‘Then we’ll take this slowly. Do you remember arriving in Iraq? No. Do you remember anything about Iraq?’ Repeated downward jabs of the thumb. ‘Nothing at all? Your base? Your command? Your squad?’
Acland shook his head.
‘Right. Well, I can only go by the medical and regimental reports that came with you, and the newspaper coverage that I’ve just taken off the net, but I’ll tell you as much as I know. If there’s anything you want repeated, raise your hand.’
Acland learned that he’d spent eight weeks attached to one of the UK military bases near Basra. He had taken command of a four-Scimitar, twelve-man reconnaissance troop whose task was to search out insurgent crossing points along the Iraq/Iran border. He and his troopers made two recce patrols, each of three weeks’ duration, which were described by his CO as ‘extremely successful’. Following a few days R&R, his troop was then deployed to recce ahead of a convoy on the Baghdad to Basra highway. As commander, Acland was in the lead Scimitar with his two most experienced troopers, Lance Corporals Barry Williams and Doug Hughes. The vehicle had been attacked by an improvised explosive device buried in a roadside culvert. The two lance corporals had died in the explosion, but Acland had been thrown clear. All three men had been recommended for decoration.
Willis turned a piece of paper towards the young lieutenant.
It was a printout of a newspaper article with a banner headline saying: Our Heroes. To the side, under a photograph of him at his passing-out parade, were two portraits of smiling men, posing with their wives and children, over the caption: devastated families mourn brave dads. His own caption read: seriously injured but alive. ‘Do you recognize them, Charles? This –’ he touched a face– ‘is Barry Williams and this is Doug Hughes.’
Acland stared at the pictures, trying to find something he remembered – a feature, a smile – but he might have been looking at strangers for all the recognition he had of them. He suppressed a surge of panic because he’d shared a Scimitar with these men on two extended recce trips and knew how close he must have grown to them. Or should have done. It didn’t make sense that he could forget his men so easily. ‘No.’
Perhaps Willis noticed his concern, because he told him not to worry about it. ‘You took a hell of a knock to the head. It’s not surprising you have holes in your memory. It’s usually just a question of time before things start to return.’
‘Khow khong?’
‘How long? It depends how bad your concussion is. A few days, perhaps. You won’t remember everything all at once . . . We tend to retrieve memory bit by bit, but—’ He broke off as Acland shook his head.
‘Khow khong –’ he pointed to himself – ‘khere?’
‘How long have you been here?’
Acland nodded.
‘About thirty hours. You’re in a hospital on the outskirts of Birmingham. It’s Tuesday, 28 November. The attack happened on Friday and you arrived here early yesterday. You had a CAT scan during the afternoon and an operation this morning to plate the bones in your left cheek and above your left eye.’ Willis smiled. ‘You’re in pretty good shape, all things considered.’
Acland raised his thumb in acknowledgement, but the conversation had done little to allay his fears or his sense of resentment.
How could he forget eight weeks of his life? How could thirty hours have turned into an eternity? Why had the nurse said his wires were crossed?
What was wrong with him?
*
The days that followed were difficult ones. Acland lost count of the number of times he was told he was lucky. Lucky he’d been thrown clear before the vehicle turned over. Lucky the insurgents were too few in number, or too poorly armed, to follow up the attack by shooting him. Lucky the shrapnel hadn’t entered his brain. Lucky he still had the sight of one eye. Lucky the blast hadn’t destroyed his hearing completely. Lucky he was still alive... For whatever reason, he’d been put in a side room away from other patients. Acland suspected it was his mother’s doing – she had a habit of getting her own way – but he didn’t complain. If the choice was between being stared at by his parents or being stared at by every Tom, Dick and Harry who entered the ward, he was better able to tolerate his parents. But he found their constant presence draining. His father was the worst culprit on the ‘lucky’ front. Unable to understand what his son was saying, or too impatient to work it out, he would take up a stance by the window and keep repeating phrases like ‘The gods were smiling on you that day’, ‘Your mother can’t believe how close we came to losing you’, ‘They told us it was touch and go at the beginning’, ‘Damnedest thing I’ve ever come across.’ For the most part Acland pretended to be asleep, because he was bored with playing the ‘thumbs-up’ game. He didn’t feel lucky and he saw no reason why he should pretend that he did. At twenty-six, he had his whole life in front of him, but it didn’t look like being the life he’d chosen for himself. He felt a cold knot of fear every time his father mentioned the future. ‘The army gives grants for retraining, Charles. What do you think about signing up to an agricultural course for a couple of years? You might as well learn the modern way of doing things at
the taxpayers’ expense.’
Acland stared at the wall in front of him.
‘It was just a thought. Your mother’s keen to have you home. She suggested we put you in the annexe so that you have your own space.’
The idea was abhorrent to Acland. He tolerated his mother’s presence in his room because he had to, but he was becoming increasingly resistant to her touch. Whenever possible, he crossed his arms to avoid having his hand stroked, wondering what she’d been told about his condition that meant he had to be treated like a child. It wasn’t as if she’d caressed him when he was a child. Demonstrations of affection never happened in the Acland household.
The only respite he had was when the medical staff took over and his parents were asked to leave. He appreciated the consultant surgeon, Mr Galbraith, who talked him through his injuries and told him what he could expect in the coming months. Galbraith explained that the damage was to the left-hand side of his face, that he’d lost a considerable portion of soft tissue due to the splitting and burning effects of the shrapnel, and that his eye had been damaged beyond repair. Nevertheless, reconstructive surgery had improved immeasurably in the last decade through the use of microvascular techniques and tissue expanders, and the surgical team was confident of a good outcome.
Galbraith warned Acland that to achieve the best results might take months. Operations could last up to fourteen hours; the patient needed recovery time of weeks between ops; and other specialisms, such as neurosurgery and ophthalmology, might have to be brought in for assessment and assistance. The aim of the team would be to keep impaired nerve functioning to a minimum and to source a donor site that wouldn’t result in a visible difference between the colour and texture of the grafted skin flaps and the skin of the face, particularly in the reconstruction of the lid and socket tissue to accommodate a glass eye.
The surgeon looked for a reaction, but didn’t find one. ‘I hope that’s gone some way to putting your mind at rest, Charles,’ he said. ‘I realize it’s a lot to take in at one go, but the message is an optimistic one. When you’re talking more freely, you can fire as many questions at me as you like.’ He offered a hand. ‘I look forward to knowing you better.’
Acland grasped the hand and held on to it to keep the man from going. What he wanted to say was, ‘Why would I need a neurosurgeon?’ but the words were too complicated. Instead, he touched the side of his head with his other hand and asked, ‘Is brain OK?’
Galbraith nodded. ‘As far as we can tell.’
He released the man’s hand. ‘Why can’t I re – emb – er?’
‘Because you were unconscious for three days and amnesia is a common symptom of traumatic head injury. Are you having problems understanding what’s said to you?’
‘No.’
‘You certainly don’t look as if you are. Dr Willis described you as extremely alert for someone who’d been out cold for three days. Do you remember talking to him?’
‘Yes.’
‘Do you remember the details he gave you about the attack?’
‘Yes.’
Galbraith smiled. ‘Then you’ve nothing to worry about. It’s short-term memory loss that’s disabling. Sufferers struggle to understand or retain information . . . They lose skills they once took for granted and have to undergo prolonged therapy to relearn them. Yours is localized or retrograde amnesia, which means you’ve forgotten events within a defined time period. It’s quite normal after concussion . . . but rarely permanent.’ He examined Acland’s inexpressive face. ‘Does that reassure you?’
No ... But the lieutenant stuck his thumb in the air anyway. He couldn’t bear the thought of any more fussing. He’d have no privacy left if anyone knew what was going on inside his head.