Dead Scared

I WALKED AHEAD of the man with rust-coloured hair, out of Bryony’s hospital room and into the corridor. He indicated a coffee machine close to the ward’s reception desk. When the foul-smelling liquid had been poured, we sat down on nearby chairs.

‘You OK?’ he asked me.

I nodded. ‘Sorry,’ I said. ‘I just wasn’t expecting …’

‘No one ever is. I’m Nick Bell, by the way. Bryony’s GP.’

Nick Bell smelled of the outdoors, of wet mud and woodland in winter. Compared to the chemical smell of the hospital corridors and the putrid stench of the burns unit, being close to him felt like striding home through crisp winter air.

‘Is she likely to recover?’ I asked, after I’d told him the name that was still feeling odd on my tongue.

He shrugged. ‘Bryony is one of the most serious cases they’ve had here for some time,’ he said. ‘She has a mixture of first, second, third and even fourth degree burns over nearly 80 per cent of her body,’ he replied. ‘At 90 per cent, it’s nearly always fatal.’

From my reading over the weekend, I knew that first degree burns were superficial, like sunburn, that second degree went deeper and damaged the underlying, dermal layer of skin, and that third degree burns, the ones I’d believed to be the most serious, invaded the fat and muscle layers beneath the skin. ‘What are fourth degree burns?’ I asked.

‘Fourth degree burns damage the bone,’ he told me. ‘The surgeons couldn’t save her left arm.’

I bent down to put my coffee on the floor and found I didn’t want to straighten up again. So I stayed there, elbows on knees, looking at the floor tiles. Then a hand touched down lightly on my shoulder.

‘Laura, given the severity of her injuries, she’s not doing too badly.’ The hand lifted away again. ‘The flames were extinguished pretty quickly, which meant the damage to her respiratory system wasn’t great. She should be breathing on her own again quite soon. The biggest challenges now are getting her wounds to heal.’

‘Will they?’ I asked, spotting a beautiful tortoiseshell-coloured feather on the sleeve of his sweater.

‘The more superficial burns should heal by themselves,’ he said. ‘The epidermis is pretty clever at replenishing itself. The deeper ones will require a skin graft from a donor site elsewhere on the body. Are you sure you want to hear all this?’

I nodded. Strangely, it was helping.

Bell was drinking coffee as though it wasn’t scalding hot and foul. ‘The difficulty is that because so much of Bryony’s skin was damaged, there isn’t much they can harvest to use as grafts,’ he said. ‘They’ve created a donor site on the small of her back and they’ve used it to graft over the worst wounds, which were on her left shoulder. So far, they’re taking quite well.’

‘So that’s good news,’ I said.

‘It is. But they have to wait now until the donor site replenishes itself before they can harvest it again. It’s a long and painful process and there’s no getting round it, I’m afraid.’

‘One small area on her back has to grow enough skin to cover her whole body?’ I said.

‘Exactly.’ Bell nodded at me, as if I were a student who’d just grasped some important principle. ‘In the meantime,’ he went on, ‘the cadaver skin is keeping her wounds covered, reducing the pain that exposure to the air would cause and helping to guard against fluid loss and infection. And, although it’s from a corpse, technically it’s still alive, meaning blood vessels from the wound can grow into it. Surgeons have been using it for thousands of years. It’s called an allograft.’

He put his coffee on the floor and ran a hand through his hair. It was still damp from the rain outside. I looked back at the closed hospital door, to where the sedated girl lay, kept alive by a dead person’s skin.

‘Do you think she’ll ever be able to tell us why?’ I asked.

I sensed, rather than saw, Nick Bell shake his head at my side. ‘Even if she survives, she’ll probably remember very little about it,’ he said. ‘We’ll probably never know what happened to her.’