Dead Tomorrow

12

A quarter to six, and for the third time today, Lynn was sitting in a doctor’s waiting room, this time the consultant gastroenterologist’s. A bay window looked out on to the quiet Hove street. It was dark outside, the street lights on. She felt dark inside too. Dark and cold and afraid. The waiting room with its tired old furniture, similar to Dr Hunter’s, did nothing to lift her gloom, and the lighting was too dim. A tinny sound of music leaked from the headset plugged into Caitlin’s ears.

Then Caitlin stood up suddenly and began staggering around, as if she had been drinking, scratching her hands furiously. Lynn had spent all afternoon with her and knew she had drunk nothing. It was a symptom of her disease.

‘Sit down, darling,’ she said, alarmed.

‘I’m kind of tired,’ Caitlin said. ‘Do we have to wait?’

‘It’s very important that we see the specialist today.’

‘Yeah, well, look, right, I’m quite important too, OK?’ She gave a wry smile.

Lynn smiled. ‘You are the most important thing in the world,’ she said. ‘How are you feeling, apart from tired?’

Caitlin stopped and looked down at one of the magazines on the table, Sussex Life. She breathed deeply in silence for some moments, then she said, ‘I’m scared, Mummy.’

Lynn stood up and put an arm around her, and unusually Caitlin did not shrink and pull away. Instead she nestled against her mother’s body, took her hand and gripped it hard.

Caitlin had grown several inches in the last year and Lynn still had not got used to having to look upwards at her face. She had clearly inherited her father’s height genes, and her thin, gangly frame looked more like some kind of bendy doll than ever today, albeit a very beautiful one.

She was dressed in the careless style she always favoured, a grungy grey and rust-coloured knitted top over a T-shirt, with a necklace of small stones on a thin leather loop, jeans with frayed bottoms and old trainers, unlaced. Additionally, in deference to the cold, and perhaps to conceal her swollen, pregnant-looking belly, Lynn guessed, her camel-coloured duffel coat that looked like it had come from a charity shop.

Caitlin’s short, spiky, jet-black hair protruded above the Aztec patterned band that covered much of her head and her piercings gave her a vaguely Gothic look. She had a stud in the centre of her chin, a tongue stud and one ring through her left eyebrow. Out of sight at the moment, but which the specialist would no doubt expose when he examined her, were the ring on her right nipple, the one through her belly button and the one in the front of her vagina, the insertion of which she had coyly confessed to her mother, in one of their rare moments of closeness, had been rather embarrassing.

This truly had turned into the day from hell, Lynn thought. Since leaving Dr Hunter’s surgery this morning, then returning with Caitlin this afternoon, her whole life seemed to have been upended, as if it had gone through a seismic shift.

And now her phone was ringing. She pulled it out of her handbag and looked at the display. It was Mal.

‘Hi,’ she said. ‘Where are you?’

‘Just coming through the lock at Shoreham. We’ve had a shitty day – dredged up a corpse. But tell me about Caitlin.’

She filled him in on her consultations with Dr Hunter, all the time eyeing Caitlin, who was still pacing around the waiting room, which was about a third of the size of Dr Hunter’s. She was now picking up and putting down one magazine after the other with great urgency, as if she needed to read all of them but could not decide where to begin.

‘I’ll actually know more in about an hour. We’ve just come from Dr Hunter straight to the specialist. Are you going to be in range for a while?’

‘At least four hours,’ he said. ‘Might be longer.’

‘OK.’

Dr Granger’s secretary appeared. A matronly woman in her fifties, with her hair in a tight bun, she had a distancing smile on her face. ‘Dr Granger will see you both now.’

‘I’ll call you back,’ Lynn said.

Unlike Ross Hunter’s spacious surgery, Dr Granger’s consulting room was a cramped space, on the first floor, with barely enough room for the two chairs in front of his small desk. Angled so that they could be clearly seen by all his patients were framed photographs of a perfect, smiling consultant’s wife and three equally perfect, smiling children.

Dr Granger was a tall man in his forties, with a big nose and a thinning thatch of hair, dressed in a pinstriped suit, with a crisp shirt and a neat tie. There was a slight aloofness about him, which made Lynn think he could as easily have passed for a barrister as a doctor.

‘Please sit down,’ he said, opening a brown folder, inside which Lynn could see a letter from Ross Hunter. He then sat down himself, reading it.

Lynn took and gently squeezed Caitlin’s hand, and her daughter made no effort to remove it. Dr Granger was making her feel uncomfortable. She didn’t like his coldness, or the over-the-top display of family photos. They seemed to give out a message that read, I am OK and you are not. What I have to say will make no difference to my life. I will go home tonight and have dinner and watch TV and then perhaps tell my wife I want sex with her, and you – well, tough… you will wake up tomorrow in your private hell, and I will wake up as I do every morning, full of the joys of spring and with my happy children.

Having finished reading, he leaned forward with the faintest thaw in his expression. ‘How are you feeling, Caitlin?’

She shrugged, then was silent for some moments. Lynn waited for her to speak. Caitlin extracted her hand from her mother’s and began scratching the back of each hand in rotation.

‘I itch,’ she said. ‘I itch everywhere. Even my lips itch.’

‘Anything else?’

‘I’m tired.’ She looked sulky suddenly. Her normal look. ‘I want to feel better,’ she said.

‘Do you feel a little unsteady?’

She bit her lip, then nodded.

‘I think Dr Hunter has told you the results of the tests.’

Caitlin nodded again, without making eye contact, then rummaged in her soft, zebra-striped handbag and pulled out her mobile phone.

The consultant’s eyes widened as Caitlin stabbed some buttons, reading the display. ‘Yes,’ she said distantly, as if to herself. ‘Yup, he told me.’

‘Yes,’ Lynn stepped in hastily. ‘He has, he’s – he’s told us the news – you know – what you have told him. Thank you for seeing us so quickly.’

Somewhere outside, along the street, a car alarm was shrieking.

The consultant looked at Caitlin again for a moment, watching her send a text and then put the phone back in her bag.

‘We have to act quickly,’ he said.

‘I don’t really understand exactly what has changed,’ Caitlin said. ‘Can you sort of explain it to me in simple terms? Sort of, like, idiot language?’

He smiled. ‘I’ll do my best. As you know, for the past six years you’ve been suffering from primary sclerosing cholangitis, Caitlin. Originally you had the milder – if you can call it that – juvenile form, but recently and very swiftly it has turned into the advanced adult form. We’ve tried to keep it under control with a mixture of drugs and surgery for the past six years, in the hope that your liver might cure itself – but that only happens very rarely, and I’m afraid in your case it has not. Your liver has now deteriorated to a point where your life would be in danger if we did not take action.’

Her voice very small suddenly, Caitlin said, ‘So I’m going to die, right?’

Lynn grabbed her hand and squeezed hard. ‘No, darling, you are not. Absolutely not. You are going to be fine.’ She looked at the doctor for reassurance.

The doctor replied impassively, ‘I’ve been in touch with the Royal South London Hospital and arranged for you to be admitted there tonight for assessment for transplantation.’

‘I hate that fucking place,’ Caitlin said.

‘It is the best unit in the country,’ he replied. ‘There are other hospitals, but this is the one we work with normally from down here.’

Caitlin rummaged in her bag again. ‘The thing is, I’m busy tonight. Me and Luke are going to a club. Digital. There’s a band I need to see.’

There was a brief silence. Then the consultant said, with far more tenderness than Lynn had imagined he was capable of, ‘Caitlin, you are not at all well. It would be very unwise to go out. I need to get you into hospital right away. I want to find you a new liver as quickly as possible.’

Caitlin looked at him for a moment through her jaundiced yellow eyes. ‘How do you define well?’ she asked.

The consultant, his face thawing into a smile, said, ‘Would you really like my definition?’

‘Yes. How do you define well?’

‘Being alive and not feeling sick might be a good place to start,’ he said. ‘How does that sound to you?’

Caitlin shrugged. ‘Yup, that’s probably quite good.’ She nodded, absorbing the words, clearly thinking about them.

‘If you have a liver transplant, Caitlin,’ he said, ‘the chances are good that you will start to feel well again and get back to normal.’

‘And if I don’t? Like – don’t have a transplant?’

Lynn wanted to butt in and say something, tell her daughter just exactly what would happen. But she knew she had to keep silent and play this out as an onlooker.

‘Then,’ he said baldly, ‘I’m afraid you will die. I think you have only a short time to live. A few months at the most. It could be much less.’

There was a long silence. Lynn felt the grip of her daughter’s hand suddenly and she squeezed back, as hard as she could.

‘Die?’ Caitlin said.

It came out as a trembling whisper. Caitlin turned to her mother in shock, stared at her face. Lynn smiled at her, unable to think for a moment of anything she could say to her child.

Nervously, Caitlin asked, ‘Is this true? Mum? Is this what they already told you?’

‘You are very seriously ill, darling. But if you have a transplant it will be fine. You’ll be well again. You’ll be able to live a completely normal life.’

Caitlin was silent. She withdrew her hand and put a finger in her mouth, something Lynn had not seen her do in years. There was a beep, then a fax machine on a shelf near the doctor printed out a sheet of paper.

‘I’ve been on the Net,’ Caitlin said abruptly. ‘I Googled liver transplants. They come from dead people, right?’

‘Mostly, yes.’

‘So I’d be getting a dead person’s liver?’

‘There is no absolute guarantee we’ll be lucky in getting you a liver at all.’

Lynn stared at him in stunned silence. ‘What do you mean, no guarantee?’

‘You both have to understand,’ he said in a matter-of-fact way that made Lynn want to rise up and slap him, ‘that there is a shortage of livers and that you have a rare blood group, which makes it harder than for some people. It depends if I can get you in as a priority – which I am hoping I can. But your condition is technically “chronic” and patients with “acute” liver failure tend to get priority. I’ll have to fight that corner for you. At least you tick some of the right boxes, being young and otherwise healthy.’

‘So, if I get one at all, it’s likely I’m going to spend the rest of my life with a dead woman’s liver in me?’

‘Or a man’s,’ he said.

‘How great is that?’

‘Isn’t that a lot better than the alternative, darling?’ Lynn asked, and tried to take her hand again, but was brushed away.

‘So this is going to be from some organ donor?’

‘Yes,’ Neil Granger said.

‘So I would be carrying around for the rest of my life the knowledge that someone died and I’ve got a bit of them inside me?’

‘I can give you some literature to read, Caitlin,’ he said. ‘And when you go up to the Royal, you will meet a lot of people, including social workers and psychologists, who will talk to you all about what it means. But there is one important thing to remember. The loved ones and families of people who have died often take great comfort from knowing that the death wasn’t completely in vain. That that person’s death has enabled someone else to live.’

Caitlin was pensive for some moments, then she said, ‘Great, you want me to have a liver transplant so that someone else can feel good about their daughter’s, or husband’s, or son’s death?’

‘No, that’s not the reason. I want you to have it so I can save your life.’

‘Life sucks, doesn’t it?’ Caitlin said. ‘Life really sucks.’

‘Death sucks even more,’ the consultant replied.