Reviews would be appreciated. Of course, nothing belongs to me, including the Singing Detective who gets a look in near the end of this chapter.
January 14th
I feel I should write all this down while I still remember it clearly.
The first surgery was 'simple housekeeping' – cutting away the burnt and dead tissue to ensure that I didn't succumb to infection. They applied several skin grafts taken from cadavers, not designed to replace my skin permanently but to keep infection out and give me a chance to do what healing I could underneath them. Daily bandaging and unbandaging was 'too disturbing for the underlying tissues' apparently. Well I'm sorry Doctor, but I found having a dead man's skin stitched into mine a little too disturbing for my underlying sanity. I really wish they'd asked me first.
Thankfully they're long gone now. Rejected within days and suggesting to the doctors that my immune system may be rather over developed. That explains a lot.
The bandaging continued for a couple of weeks or so. It wasn't really that painful, a blessing of having burned most of my nerve endings to buggery. No nerves means no pain. The only areas where I could feel anything, at that time, was around my eyes and my left ear – is it still your left when you only have one? – inside my left elbow, the palm of my left hand and around my inner thighs and private parts. Those areas represent the twenty per cent of me only that got a partial thickness burn and thus still had sensation. Mainly a sensation of agonising pain, but sensation nonetheless. Why did those parts fare better than the rest of me, you ask? Simple enough - just before I triggered the explosion I buried as much of my face as possible into the crook of my elbow, protecting my eyes and one of my ears. I had Valerie's letter balled in my left hand, clenched into a fist as tightly as I could manage - more in an effort to draw the required strength from her than in any real hope of protecting it. My other hand, after throwing the detonator, was used in an attempt at protecting my other favourite parts. In retrospect, it would probably have been better utilized further north but instinct is instinct.
The worst thing about the majority of the bandaging was seeing how much of my skin was coming off with them each day. Surgery had removed the obviously dead tissue, but plenty more was slowly giving up, coming off in lumps where the bandages had adhered to it. I tried not to look, as the sight of it made me feel sick, but it was perversely fascinating seeing myself falling apart before my very eyes. Curiously detached too – my brain telling me that is should be hurting but it generally didn't.
The partial thickness burns hurt like hell though. I couldn't see my face but I knew it was badly swollen because I couldn't open my eyes properly. Every time the doctors changed my dressings on these parts, it was as if they were ripping off my skin. The air hitting the open burns was enough to make me scream. Cleaning the wounds with water would send me into a rage. It is safe to say I would have rather been back in the fire than go through a daily dressing change.
Lying in bed, sick with pain and doing a credible impression of Tutenkahmun, I was approached by a doctor who said I was an excellent candidate for a new form of treatment.
The kinds of burns I suffered over most of my body are among the worst imaginable, as they destroy all three layers of skin. These are burns that can't heal by themselves. The only solution is to graft them with skin from other parts of the body. But I didn't have any skin left to graft with, so the proposed solution was a technique devised by an Australian scientist where new skin cells are grown and literally 'painted' on, giving the body something to work with to re-grow tissue.
He was quick to point out that I was never going to grow fresh perfect virginal skin, but that it was really my only option if I wanted anything other than a lifetime spent in bandages and short-lived patches of synthetic skin. So I consented.
I'm tired now. Did eleven laps of the ward today as well as some physio and a plate of shepherd's pie. Will write more tomorrow.
January 15th
So I was an experimental subject once again, but this time I had been asked and had consented. Fortunately this country still has the National Health Service, and I had no qualms about costing the government as much money as was needed to repair me. I think they owe me that at least.
Cells were taken and a week later, I was scheduled for my first operation. The plan was to work on my back first, as it's an area that's comparatively easy to keep immobile. Plus, if the treatment was a success, being able to lie comfortably would make the remaining surgeries easier to bear.
The first day was alright. Lying on my stomach, still woozy from the anaesthetic, with delightfully cool dressings covering me from neck to bottom. I felt a bit raw, but nothing I couldn't deal with.
Day two, things started to hurt. The doctor was amazed to see how quickly the new tissue was starting to form. He reassured me that the pain was a good thing – it meant that there was some level of sensation returning.
I had considered myself quite skilled in the handling of pain and discomfort. After all that I went through at Larkhill, after all the treatments I'd already had here in hospital I thought I'd experienced the worst pain the human body can create. I was wrong.
Day three, and I was in agony. Absolute complete total agony. Getting burnt in the first place had nothing on this. My skin and its nerve endings was growing back at an accelerated rate, and the pain was such that I became completely unraveled. Fortunately the same nurse who'd sat with me that first night was on duty, and she knew how much pain I had to be in – screaming until my lungs were fit to burst when previously I had lain quietly and dealt with it. They put me on a cocktail of narcotics and things went gloriously soft and fuzzy for a couple of days, before they started to cut them down and the pain returned, albeit with the edge very much taken off.
It was about a week later that the agony had subsided to merely 'painful' and I was off the narcotics and feeling vaguely human again. The doctor was extremely impressed with my skin growth – it was angry red and white scar tissue, paper-thin and weeping, but it was the required barrier between the outside world and my insides, and as such was considered a great success.
He was keen to continue with the treatment, raving about how he would have me on my feet by the end of January at this rate, so I consented for a second operation on the understanding that I'd get the narcotics earlier in the healing process this time.
Four more operations after that, working a limb each time with only a couple of days recovery time in between them, and he was finished with 'phase one'. Screw that - I was done full stop. Done with being drugged out of my mind, done with pain, exhausted from doing nothing for weeks except try and heal myself. I just wanted to sleep for a while.
Of course, it wasn't that simple – the grafts were just the first stage of the healing process. Natural sleep was a rarity because of the wound vac - a slang medical term that will give me goose bumps for the rest of my life. You see, where the new tissue was struggling to grow, a suction device was placed over the wound order to increase blood flow from underneath. These devices are called wound vacuums, and they ensure that the tissue does not die, but rather joins with the new skin to create a layer of dermis where none would have grown without the graft surgery. It feels like a leech, a constant sucking on the most painful abrasion you've had in your entire life. Multiply your worst skinned knee by 50, add it to 80 percent of your body, and then let someone suck on it with a hoover for 24 hours a day; only then will you know what it is to experience a wound vacuum on a fresh skin graft. Every inch of each graft received a dose of the painful sucking and not until three weeks after the final surgery was I free from the noisy machines.
January 16th
My face was really hurting today so the doctor gave me a couple of steroid injections, one in my forehead and one in my right cheek. The scarring is so bad that it has to be a high pressure injection in order to permeate the dense tissue – the damn things hurt more than the pain they were supposed to alleviate. But I'll admit that several hours later I'm feeling a little better and hopefully I'll get a decent sleep tonight. Apparently these type of flare ups will be common for the next few months – they say I can have the injections in my face because it's a cosmetic issue, anywhere else it's down to moisturizer and massage. They've started me on antihistamines to try and calm things down, if they work I'll be staying on them for years. Well at least I shouldn't have any trouble with hayfever when I get out of here.
Nope, I still can't sleep. It's about one o'cock and terribly quiet out in the ward but every time I try to nod off my brain just starts thinking about my sore old face. It's not so bad when I'm distracted, but I've finished my book and can't go and get another one til the morning so I'm just going to have to ramble to you, dearest diary.
Claire, my main nurse, is about my age. Blonde and petite with the most gorgeous brown eyes. Don't worry, it's not the cliché 'patient falls in love with nurse' story, I'm just very fond of her. Okay, maybe I've got a bit of a crush on her and maybe I try and impress her now and then, but I don't have any illusions that she could possibly find me attractive. Of course, this crush is a terribly unfortunate position to find oneself in when the object of one's affections has to apply moisturizing grease to your slowly-healing second degree burns.
Let me tell you, having a nubile young nurse handling your private parts on a daily basis is a tortuous mix of agony and ecstacy.
From the second she'd don her plastic apron and latex gloves, my brain would start going into overload with anticipation of what was to come. She'd help me struggle out of my pyjama bottoms and then I'd lie there completely exposed as she delved her hand into a vat of cream, scooping out a generous handful and rubbing it between her gloves to melt and warm it.
"Just relax, I'll try not to hurt you" she'd say, starting to massage it into my inner thigh.
Oh god. Think of something boring, think of something very boring. A speech, no… tax returns… a Welsh male voice choir…. Songs Of Praise… Antiques Roadshow… Readers Digest special prize draw….
It would hurt and I'd wince - she'd apologise, asking 'was that too hard?'. Hard? No, no, not hard, come on brain, back to the Guardian crossword…
She'd move further north, the inevitable would happen and I'd apologise profusely, explaining that it was one of the few parts of me that still had any feeling. Of course, she'd be entirely professional whilst I lay there thanking god that I could no longer visibly blush, partly willing her to finish as quickly as possible, partly enjoying the sensation despite my embarrassment.
These days I'm fit enough to moisturize my own private parts, and find it much easier to look Claire in the eye.