My mind goes blank; a torpid slurry.
Any hope of clarity, or reason, or sense, is abandoned as she stares back at me, her words by implication dissecting me, ripping at my chest as if I undergo cardiac ablation without sedation, searing me as if my aorta is being clumsily and inexpertly cauterised.
I can think of innumerable exclamations but not a single sentence. I feel a visceral reaction but cannot translate it to a sentiment that can adequately express the abject panic that I feel. And, when I do find my voice, I flail wildly, fire randomly, and critique her plan with such illogical negativity that surely she must understand that the only thing that drives me now is pure, cold fear. As she sweeps tempestuously from the flat, taking all the oxygen with her, my mouth forms her name, but no sound eventuates, leaving me standing in her wake; breathless, aghast and eviscerated.
For the rest of the day, the tightness in my temples is excruciating, and the dull ache behind my eyes only seems to intensify. My attention is splintered, any span childishly short, yet somehow I force myself to focus on the afternoon clinic, a litany of complex presentations, co-morbidities, and poor prognoses, by reminding myself frequently that, for many, Imperial is indeed their last chance. As I update the last set of patient notes, the room begins to swim. The patterned carpet becomes an optical illusion, distance becomes indeterminable, and details fade in and out. I rub my eyes but I do not dare close them, as a rising tide of exhaustion threatens to drag me beneath the waves. Instead, I splash my face with ice water and and drink my third espresso of the day.
My last appointment is in the office of a noted cardio thoracic surgeon, a well respected senior consultant with whom I've had the honour to work with once before. With a highly competent anaesthetist in attendance, amongst others, we discuss a surgery scheduled for later in the week, the replacement of the entire aorta of a Marfan case. As a team, they've both performed this procedure previously but this will be my first occasion, and that alone is enough to galvanise me. As we outline potential complications, I lose myself willingly in the science, poring over the notes, invigorated by this immersion in cutting edge medicine. The plan is agreed upon, he will take the aortic root, down to the renal arteries, and I will work from the renal to the iliac artery. Now, as we go our separate ways, I am buoyed; my calmness, and confidence, and self-assurance momentarily restored.
In the stuffy back seat of the overheated taxi, I begin to fade once more. The air is as hot and dehydrating as a Saharan sirocco, my eyelids droop and I press my knuckles into my temples vigorously, trying to recall the last time I might have eaten. My circadian rhythms are now so scrambled that sleep patterns seem a distant memory and, after a moment of panic, I'm forced to check my diary hurriedly, in case I have confused the actual appointment date. Outside, the rain pours incessantly and the shop windows are as illuminated as if it were night. The windscreen wipers keep up their rapid and insistent beat, part slap, part squeak; a mesmerising and hypnotic soundtrack to a journey that sees me struggle to remain awake. Indeed it is only a vague nervousness, this almost indiscernible elevation of my respiratory rate, that enables me to maintain consciousness at all.
The fact is, ever since I first spoke to my solicitor, I have been aware of an underlying anxiety, an urgent necessity to both expunge my parents from my life completely, and to cement Louisa's place at my side, in whatever way I can. I have just under two hours before I am back on call at St Mary's and, as the legal clerk shows me into a private waiting room, I am already on edge, impatient to have this business finally concluded. Leslie, my solicitor, appears promptly, wasting little time on pointless pleasantries, sliding the documents across the table to me as he takes the unnecessary trouble to explain what, to me, is already patently clear. After I reassure myself that there is no mis-match between my instructions and the details in the drafting, and I am assured that the document is watertight, I sign and initial where directed. An innocuous and unremarkable witness is produced and, just like that, Louisa and I are now intrinsically linked in a way that provides me with an inordinate degree of reassurance and relief.
"And the other business?" I ask, when Alan Leslie and I again have the office to ourselves.
"In hand." He replies with a faint smile, grasping my palm and squeezing my fingers a little bit too firmly in a fervent handshake. "I will be in touch…"
Back at street level, I pause in the doorway, under cover from the rain. London is the only place I've ever really known but, in this moment, I have a strong sense of why Louisa wants to get away. The low cloud is oppressive, the wind bitter and the gutters run with grey and oily water. The sea, the coastal breeze, the treeless fields, they are as much a part of her as this congestion, these diesel fumes and this bone-chilling dampness are of me. Where I am unfriendly, drab, and impersonal, she is bright, and unpredictable, and so very full of life. The excitement on her face as she read the postcard, the beseeching look she gave me when she told me what it said, and yet I'd crushed her, out of selfishness and fear. Sighing, I turn my collar up against the cold, and turn, and walk back the other way.
There seems to be nothing else for it than to turn up at the door. Appointments for private viewings had been hopeless, I'd had to cancel every one. To meet with him in my office was unthinkable, and it was obviously impossible for him to call on me at home. But I needed a starting point, a place from which to begin my task. Though, to be honest, it's not a conversation I anticipate with any degree of confidence but I can't see how else I might proceed. The circumstances are so far out of my area of expertise I barely know what it is that I should ask. It's obvious too, that the answer I crave is the one he will not be able to provide: will a ring upon her finger make any difference to the odds of her return from the other side of the world? I press the buzzer, daunted and extemporaneous, and barely allowing myself to hope.
And so I am ushered in, and the manager summoned. Immediately, it is obvious that I have never been so poorly prepared for a discussion in my life. As I wait, I glance at the staff who stand equidistant behind the long display cases, as inscrutable and motionless as the most expressionless of waxworks, and my limitations and lack of experience seem shamefully exposed. I lift my chin and clear my throat, in an attempt to smother an impending yawn, greeting the manager with an ambivalent nod as he smiles and proffers his card. For a moment we stand in silence because I am ignorant even of where I should start. I have spent most of my life avoiding situations such as this, keeping to my own well-worn paths, seldom venturing far from my carefully demarcated areas of expertise but this exposure now seems wholly unavoidable, an uncomfortable means to a keenly anticipated end.
I start poorly, unable to respond with any degree of confidence when he asks if I am considering a new manufacture, or an antique piece. I feel my eyes widen helplessly as I stare back at him, frozen to the spot, abjectly mortified.
"Lez thtart with the ethstate range…" he murmurs, indicating that I should follow him as he glides toward the brightly lit cabinets on the other side of the showroom.
I struggle to understand him, and concentrating only serves to make my headache more intense. Before me are rows and rows of enormous gemstones, in a myriad of shapes and styles, some vaguely reminiscent of the rings my grandmother always wore, each displayed in dusky velvet boxes, their contents dazzling, disarming and utterly overwhelming. My mind is blank when he asks what setting I find the most appealing and I am distracted by the way he holds a handkerchief in his hand and dabs frequently at the corner of his mouth. As he explains the benefits of what, in reality, is simply second-hand jewellery, each of his sentences slides into the next. I lean in and listen rather closely, attempting to smell his breath as I confirm my suspicion that's he is indeed slurring his words.
"Hash she eshpreshed any particular preferenze for shtyle, or cut or shtone?"
"No." I tell him firmly, narrowing my eyes at him appraisingly.
"I shee. Well, in that cache, may I ashk, shir, ish'ere a level of ekshpektashin from the young lady?"
"Expectation?" I repeat and I frown at him. "What do you mean expectation?"
He smiles, lopsidedly. "Many of the young bridesh we cater for have firm ideash on how mush their betrothed should be prepared to invesht when it comes to a shymbol of their love…"
"No." I reply firmly, watching him in fascination as only one of his eyes appears to blink. "She doesn't."
Glancing down again, my eyes sting as I peer through the spotless glass and every time I squeeze them shut, even momentarily, I seem to lose my place. Suppressing a yawn, I force myself to focus on why I am here. Even at my sharpest, this conversation would be a challenge but, at the moment, it's almost more demanding than I can bear. And all the time I'm trying to think, to make a decision, he insists on droning on in the background, his condescending helpfulness more irksome with every word he mutters. Facets and settings, baquettes and collets, step cuts, and filigrees, and Royal provenance.
But Louisa's preference seems to be rings that are solid feats of engineering rather than the art of a master jeweller. As I recall, they are usually silver, often more like knuckle dusters than rings, and set with what look like colourful pebbles or polished glass. Occasionally I will find one in the washing machine, down the side of the sofa, or underneath the bed, and they are as heavy and rough as if they were forged by a blacksmith. As I gaze at the array of finely crafted antiques before me, exhaustion seems to overwhelm me. I am indecisive, vague and utterly out of my depth. Far from this being an occasion of huge significance, a moment if I am honest I never dreamed would come to pass, I actually feel horribly claustrophobic. My nerve is crumbling and I contemplate making my excuses and skulking shamefaced and empty-handed from the premises. Clearing my throat, I glance up at him helplessly.
"Perhapsh, if you could give me an idea of the budget, shir, I could asshist you better." He says serenely, and he smiles.
"…The budget?"
"Yesh shir, how mush you want to shpend. The generally accepted figure ish two munsh shalary…"
For a minute, I am lost for words. When, eventually, I do speak, my indignation pours out in one long, spluttering, almost indecipherable sentence.
"How…on earth…I mean…you seriously expect me…nothing is….am I supposed to…how can I be expected to…I don't see…there are no….all I…all I want is …something…simple…yet…elegant and…"
He clears his throat briskly and, for a moment he stares back at me, and his face seems to sag even more noticeably as he opens his mouth, appearing to use infinite caution.
"Perhapsh, if you will jusht shtep acrosh to this cabinet, I can show you shum itemsh in the…ahh…medium price range…"
I clear my throat self-consciously.
"Yes, fine, right…and umm, by the way, it…ahh….appears that you are suffering from a unilateral facial paralysis….I suspect Bell's palsy, but you should really see your GP straight away, if you already haven't, so they can, umm, rule out a stroke….or a tumour…"
"Thank you shir, I will bear that in mind." He says, gazing back at me evenly, his tone unhurried and dignified as he selects three rings from the display case and places them carefully on a black velvet mat atop the counter.
I stare at him in disbelief, having delivered a diagnosis that he clearly considers inconsequential. I open my mouth to remonstrate with him before thinking better of it. The fact is, I'm tired of offering advice in good faith only to be summarily ignored, I'm tired of people refusing to take responsibility for their own health, I'm tired of people in denial, making terrible choices and expecting others to clean up their mess. As I stand there hopelessly, I just feel so very very tired.
Eventually, I turn my attention back to the counter, finding my eye drawn immediately to the ring closest to me, and I realise I'm almost smiling with relief.
"An exshellent choish shir, circa nineteen fifty. A two point three carat, emerald cut diamond, in a platinum shetting." He explains regally as a young female assistant appears at his side.
He slips the ring onto her finger and she holds her hand out toward me, inclining it gently in every direction, the stones glittering brilliantly beneath the lights. The idea of it, the significance of everything, suddenly hits me like a punch to sternum and I feel a tiny surge of excitement, way down deep in my abdomen. The thought of placing such a ring on Louisa's finger both terrifies and exhilarates me and, despite how sore and strained my eyes are feeling, I can't stop staring at it, so much so that I'm almost transfixed.
"The detailing of the shmaller, baguette-cut diamonds adds originality. Nothing mass-produshed about this ring, shir, it's most definitely a one-off…a beshpoke artishan pieshe…"
"I think…I think I…I think that might be the one…" I tell him and my heart hammers so furiously in my chest that I swear I can see the lapel of my suit coat pulsating.
The jeweller gives an ingratiating smile, produces a fountain pen from his top pocket, and, in a strange, looping hand, inscribes a figure on a small piece of crisp white card. He passes it to me, my eyes widen for the briefest of moments but I remain composed, nodding almost imperceptibly. Inhaling resolutely, I withdraw my cheque book from my inside pocket and, as he assures me that any necessary resizing comes at no extra cost, I, Martin Ellingham, complete the purchase of an engagement ring, and hope that no one notices that my famously steady hands are actually trembling.
Securing the box in my inside pocket, I again hail a taxi, and, for one horrible moment I am unable recall my destination. The driver looks at me sideways but says nothing and I climb into the back seat, feeling distracted and jittery, and utterly spent. As we move out into the traffic, I glance down and notice a discolouration of my shirt cuff, a greyish-green smear of unknown origin, and it causes an oddly intense feeling of aggravation, followed by an even more disconcerting sense of confusion. I am not even sure I have a clean shirt on hand and, if I do, I cannot think where it might be. Offices, wardrobes, lockers; they all merge and become one. For a few terrifying seconds, I am utterly devoid of normal cognisance, so confused and panicked that I almost forget to breathe.
When I arrive at the hospital, I take the lift; the idea of running up the stairs feeling like an attempt to ascend the North Face of Mt. Everest. I recall preparing myself some lunch and depositing it in a refrigerator but I cannot recall the actual day or even the actual fridge. I collect the portable phone, and the incessant pager, and attempt to make sense of the day. In ICU, I have a minor altercation with a nurse over the frequency of a dressing change, and on the ward I am forced to reprimand a house surgeon when I discover that my instructions have not been followed meticulously. In between phonecalls, I talk to the nephrology registrar at length about a troublesome dialysis stent before making my way wearily down to A &E to consult on an moronically aggressive teenager who has done an exceptional job of almost severing his arm.
Upstairs again to change, and back down again to scrub for theatre; another avoidable plate glass incident, another brachial artery torn to shreds. I perform a resection with end-to-end anastomosis, I've done them so often, I could probably repair them in my sleep. Then I shower again but I don't put my suit on, I crawl into fresh scrubs and then into the tiny single bed in the OnCall Room, the one that feels more like a cell. As I lie in the dark, I feel almost inebriated, digging my fingers into the edge of the mattress as the room spins; nauseated, light-headed and utterly spent. When the telephone rings and wakes me up, I am sleeping so deeply that I have temporarily forgotten where I am. The seriousness of the conversation changes that however, and as I listen I am instantly wide awake. A child on his way from a provincial hospital, and I need to get down to the meeting, to access the patient notes and formulate a plan. I glance at my watch and see that it's three o'clock in the morning. Three hours of undisturbed sleep feels like a luxury.
While everyone else seems to waste time arguing the course of treatment, I focus on reading a rather incomplete set of notes. The more I read, the more critical specialist intervention appears to be. A four year old boy whose legs were crushed yesterday, under a large wooden picnic table is now exhibiting significant bilateral limb ischemia. My heart sinks at the thought of his parents, taking him home home, plying him with paracetamol, and placing bags of frozen peas upon his knees. In my experience, trauma around the knee joint is notorious; popliteal artery injuries are commonly overlooked, yet a delay in diagnosis is extremely serious, potentially leading to a nonfunctioning limb or even amputation. And because of his age, and the increased risk of thrombotic complications, they won't have performed an angiogram so, even at the hospital his parents rushed him to, without an experienced set of eyes or a vascular specialist, they would have absolutely no idea what is going on.
Instinctively, I believe this to be the case and, in the end, it just seems easier to take over. Firstly, I glare at all the assembled experts, and tell the arguers and dissenters rather firmly to shut up. Then I inform the orthopaedic consultant and the vascular registrar that they will assist me, and ask the theatre team to prepare for surgery. Lastly, I instruct the loitering house surgeon to go and find me something healthy that I can eat, an unspoken threat hanging in the air should he fail to complete his task. In the hallway, a familiar theatre sister grimaces at me, and growls that it's nice to have me back. A tougher, more cynical nurse you would struggle to find in the whole NHS, and it doesn't dawn on me til later when I am scrubbing, that she might actually have meant just what she said.
Of course, it's always more difficult with emergency presentations, especially when you haven't had a chance to run the tests yourself. And of course, you've never spoken to the patient so, up until the point the air ambulance arrives, you can only prepare by relying on a second hand examination, in this case on information that's patently lacking crucial detail. But now, I must be patient, and keep my mind occupied since all I can do is wait. So I perch on the tiny sofa in the consultant's lounge, concentrating on the meal of fresh fruit, yoghurt, and the chicken salad sandwich that the house surgeon has miraculously conjured up for me. On the way home it will dawn on me that the idiot has simply given me his lunch, but he'll soon realise there's no point in sucking up.
It's nearly ninety minutes later when the air ambulance finally lands. The paediatric consultant and I check the child over but it's obvious that there is only once course of action, he needs immediate surgical intervention if I am to have any chance of restoring the blood flow to his lower limbs. Frustratingly, it's clear that sensory and motor loss is already complete and, beneath the bruising, both limbs below the knee are pale and cold. As I scrub again, it weighs heavily on my mind that the tibialis posterior, the dorsalis pedis, and the popliteal arterial pulses cannot be felt. The odds of performing a successful limb salvaging procedure are abysmal, but laid out on the table, his body is so tiny, I know that I must try with every ounce of skill that I possess.
Later, I will ask myself repeatedly was there something I missed. I will ignore the glassy-eyed glances from the nursing staff, the sympathetic murmurings, the unwanted physical contact as the anaesthetist pats me consolingly on my shoulder. I will turn my back on the despondent paediatric consultant as she reassures me that I did everything I could possibly have done, resisting the urge to point out that she wasn't there, she can't possibly know, but it all seems just so utterly pointless and so I grit my teeth and silently walk away.
Eventually, I had to face the inevitable. Having fought for hours to restore blood flow, having tried every weapon in my arsenal, as the lead surgeon, only I could make the call. Amputation without complications is not a lengthy procedure, especially with an orthopaedic surgeon on hand to cut the bones. I'm not even sure why but I insisted on closing the boy up myself so I was in theatre for the entire procedure. Odd though, how I thought neatly sutured and symmetrical incisions might one day matter to a double amputee. In recovery, he looks almost angelic, like a putti from an alabaster fountain, the oxygen mask ringed by a shock of golden curls. I stare down almost vacantly for a minute, finding myself silently apologising to him for what I had to do. When I think of all the difficulties that inevitably lie ahead for him, I feel nauseated, and filled with impotent rage.
Walking upstairs again to talk to his parents, my body is leaden and unresponsive. My neck is stiff and my eyes are gritty and I wonder how it is that, as a surgeon, you're always expected to know exactly what to say. As usual I keep it succinct and baldy factual, staring over the mother's head glassily as she slumps into the arms of her bewildered and speechless husband. She wails and I stand like a statue, she sobs and I glance half-heartedly around for a box of paper tissues. The fact is, there's no nice way to tell an ordinary set of parents that, due to their inaction and inattention, I've had to amputate their four year old's son's chubby, perfect legs. So I am expressionless as they cling to each, weeping inconsolably before they're summarily ushered away to a private room, to drink tea and watch mindless television until they're allowed to visit the boy in ICU. I watch them until they disappear, and that's when I'm left standing alone, still in my scrubs, more shattered, more frustrated, more devastated by my inability to help a patient, this time an innocent child, than I can ever recall feeling before.
I am subsequently rather short-tempered, but news spreads fast on the hospital grapevine, and anyone who hears about a surgeon's dismal failure knows to give that man a very wide berth indeed. I dictate my notes, I shower and shave, I find a clean shirt and wearily put on my street clothes. Once I complete handover, I make my way upstairs for a final check on my patients, cravenly leaving the little boy until last. With the covers arranged over the bed cradle, it's almost as if I've imagined the last six hours. I retrieve his chart and the numbers begin to slip and slide before my eyes, causing me to swallow hard and clench my jaw. It's the unfairness of it all that has upset me, and I have allowed it to upset me in a way that I'm aware is professionally unwise. Later, when I confess this to Bernard, my mentor, he simply chuckles and tells me that discovering one is a mere mortal is difficult for any surgeon to acknowledge, let alone readily accept.
So, I compose myself, pushing my shoulders back and lifting my chin, inhaling deeply and ferociously in the hope it might give me the strength to fight my way home. Everything feels like an uphill battle, my mind is thick and heavy, my body weak and tired. All I can hope for is that fortune smiles on me, and Louisa will still be there. As much as I resist her apparent need to understand me, at this moment, I don't think I've ever needed her understanding more. As I make my way along the empty corridors, I pass the boy's father and it seems as if he has finally found his voice. For a moment, out of scrubs, he doesn't recognise me, but the penny drops and he turns and pursues me to the lift.
"There must of been something you could of done!" He shouts, and his voice is strangled with pain and anger. "You can't just go cutting off his legs! He's only four!"
"I'm sorry." I tell him as the the sliding door mercifully closes between us. "But we really did everything we could."
And then I am alone. Inhaling deep, shuddering breaths, and staring straight ahead as the elevator journey down seems to take forever. Any hope I'd had of striding through the downstairs corridors, unapproachable, aloof and indifferent, evaporates. My gait feels stiff and awkward, as if I'm marching to an impossibly slow beat, my legs constrained as if they've been clapped in irons. I can't summon disappointment, or even surprise; it all just feels inevitable since I don't walk anywhere any more. Time is a precious commodity and my need for sleep overrides everything, even maintaining any semblance of fitness. In fact, any form of self care seems like an indulgence when, unwittingly, life has become about survival. I make my way outside into the daylight, recoiling at the clutch of the damp cold as I glance up at the battleship grey sky.
All around me is the hum of the industrious, a swirling mass of people, shifting patterns of light and shade. Some colours recede, others seem to envelop me. There is noise and there is silence and the two seem to co-exist side-by-side in my mind. The splash of a car tyre in a rain soaked gutter is like a shotgun blast inches from my ear, but a cautious hello from someone whom I should apparently know is swept away to disappear unacknowledged into the ether. Jackhammers sound lilting, plate glass windows appear to stare at me as I pass. Human faces shrouded in respiration-caused condensation appear almost ghostly, pigeons flap like angry angels above their heads.
When the rain starts again, I realise I'm still walking, the icy droplets sting my face like a well aimed slap. The clouds darken and descend ever lower, I step out on to the zebra crossing, and I hear the squeal of brakes. Through the windscreen the driver glares at me, but all I am aware of is how warm the bonnet feels beneath my outstretched palm. Eventually, she sounds her horn and The sound distracts me. I throw back my shoulders and attempt some dignity as I walk away. If only they had started him on heparin much earlier, immediately when he presented at A & E. If only his parents had taken him there in the first place, if only they'd been supervising him more closely none of this might have happened. Why bring a child into the word if you don't want the responsibility? How can you look at your own flesh and blood, and feel no duty of care? And now I must live with the fact I failed him, his father was correct in one assertion, a four year old boy should not be a double amputee.
I need to escape the tumult of the High Street; the rush, the effluvium and the clamour seems today to drain me, in a way I've never known before. Why are so many buses emblazoned with sodding QANTAS, why are so many shop fronts boarded up? This time of year, the park is seldom busy. The bare earth is brown, and the smell of organic dampness lingers in my throat. One of Louisa's favourite walks is to the Italian Gardens. I like it best at twilight, when she holds my hand and we walk in silent communion, side by side. But now the trees are dormant and the twigs are somehow dismal against the somber sky, appearing like angry stick figures, or ancient runes predicting dire portents still to come. Please let her be there when I get home. Even her anger, her disappointment, will be better than that which torments my blistered and lassitudinous mind.
The flat might only be two flights up but it feels like it's two hundred, and I fumble helplessly for my keys. The housekeeper greets me in the hallway and I don't even try to hide my disappointment, nor the fact that I've completely forgotten her name. Our arrangement of scarcely speaking to each other in person has always suited me right down to the ground and though I acknowledge her briefly, as she comments somewhat impertinently that I appear to be rather tired, I turn my back on her and simply walk away. I wonder if she can tell that my legs are rubbery, and that I feel so light headed my shoulder strikes the door frame as I misjudge my entry into our room. I lean on the door as I close it behind me, the hiss of the welcoming silence shattered by the distant sound of the vacuum cleaner winding up. I'm desperately thirsty but it doesn't seem to matter. I saw Louisa's hand bag on the table so, somewhere, I know she must be here.
And then everything becomes oddly hazy, confusing and obscured. There seems no reason why I might have found her in the wardrobe, but the only feeling I am capable of is relief. I look at her and I'm filled with a sense of deliverance, of a miraculous yet undeserved reprieve; might everything between us actually be okay? But how can I tell her of the fear that has gripped my heart, when she wraps herself around me with such obvious intent? How can I communicate the pain of inadequacy that haunts me, the grim series of images playing endlessly in my mind? So much regret, and an overwhelming sense of failure, which doesn't vanish just because her mouth is pressed so insistently against mine. The idea of a small child in terrible pain, yet unable to trust his own parents to take care of him appropriately, to put his needs just once before their own just appalls me. I see his little balled-up fists, his face contorted and streaked with tears. Knowing how bewildered he would have felt, how forsaken, how frightened makes the bile rise ferociously and burn at my throat.
Yet her breast is so firm and silky to the touch and I could obliterate so much of what exhausts me by burying myself in the softness and the solace that she offers. But I can't help but feel nothing could be more wrong, more callous, or more inappropriate; he had a plaster on his big toe, printed with what looked like Mickey Mouse. But her fingers on my temples feel so soothing, and it's as if she finds a way to draw me from myself. Five minutes with a naked and passionate Louisa is an assuaging balm for even the most tortured of souls and if ever I needed her comfort it is now. But the sound of the vacuum cleaner draws ever closer, it sounds like a tractor so delirious am I from lack of sleep. So I gather her to me, tightly, as if I could never dare to ever let her go. She is my home, she is my shield, my absolution and I wonder if she could ever imagine how bankrupt I feel, how exhausted, how deficient, that I might have to tell her no