Susan Lewis - One Minute Later

As they drove on she took in those who were picnicking or napping on the grass verge between the four lanes of the Promenade; others filled the cafés spilling onto the pavements, and still others, not visible from the car, were no doubt baking themselves on the beach or paddling in the slushy waves.

Did they realize how important it was to cherish every minute of every day?

She was just learning the lesson herself, and still had a very long way to go.

Almost two months had passed since she’d gone from being a perfectly healthy person (or so she’d thought) to someone who was only alive thanks to tireless and dedicated expert care, and the massive cocktail of drugs she was now dependent on. Learning what life was going to be like for the foreseeable future – no more work, limited and careful exercise, constant assessments, pain management where needed, special diets: the list was endless – had been a shock she hadn’t yet come to terms with, and she didn’t feel confident that she ever would. This was nothing like the life she had planned for herself. She was an invalid now, someone who could only survive on medication and the hope of a new heart. It was as though she’d suddenly become old. The worst of it might have been the advice to refrain from physical intimacy until she was strong enough to cope with the strenuous nature of it, but since she didn’t have a partner it was hardly an issue. And it was never going to be one, for what chance did she stand of ever finding anyone in Kesterly, or anywhere, who’d want to take on the hassle of a sick woman whose condition was only going to get worse, unless a miracle came along in the shape of someone dead so she could live?

The horror of that was too hard to think about, so she didn’t.

While being assessed for a new heart she’d read stories online about those who’d managed to get their lives back on track after the transplant, and who’d even gone on to greater things. There was no reason, she’d been told, for her not to be one of their number. There was no guarantee that she would be, either, for in amongst the many upbeat stories had been just as many – more, even – telling a much sadder tale: waits that had gone on for years only to end in death; mad dashes to a transplant centre to find the donor heart wasn’t suitable; post-operative immunosuppressive drugs causing cancer … The only good news in all this, as her mother saw it, was that she hadn’t been rejected for transplant, which could have happened, since some people were too sick for the procedure. If she were one of their number she’d know for certain that she wasn’t likely to make it beyond a few months. As it was, she probably wouldn’t anyway.

Her mother had been there every day throughout the transplant assessment and the surgery, only a few days ago, to fit her with an ICD – implantable cardioverter defibrillator. There had been much discussion about going straight for a VAD – Ventricular Assist Device – and Vivi had prayed with all her might that it wouldn’t happen. She’d read much about that too, the open-heart surgery to attach the pump to the left ventricle and aorta with drivelines connecting her heart, through the skin, to a controller and batteries that she’d have to take everywhere with her. Plenty had been written by those who had one about the pain of it, the fear of it stopping, and the dreadful things that sometimes happened if it did.

She’d wept with relief when the decision had been taken to hold the VAD in reserve for the time being.

Gina had shared the relief, but Vivi had turned away when her mother had broken into a smile. She was glad her mother was there, but she couldn’t bear to see her clutching at straws that were little more than thin air. Nor did she want to see her fear and worry, nor how shattered and gaunt she looked as one setback was overcome, only to be replaced by another. This was obviously affecting her deeply, but there were times when Vivi had needed to wallow in her terrible, wrenching emotions alone. Surely running a marathon for such a deserving cause was a good thing, not something to be punished for, so why had it turned into this? It was small comfort – maybe no comfort at all – to be told that it would have happened sooner or later anyway. Her heart had been weakening for a long time without her knowing it, and now it was a virtually useless vessel of such pathetic performance that it could fail at any time. It was a pump that had run out of thrust, a muscle that was atrophying like a flower past its bloom.

This time next year, or maybe even before that, there would very likely be an empty space where she was now, just Mark in the back seat of the car, an empty chair at their table, a bedroom that would no longer be used, someone they wouldn’t have to consider when they bought gifts and made plans. All that would exist of her would be the memories her friends and family shared, or maybe she’d be a ghost, moving amongst them unseen, unheard and unable to reach out and touch them.

‘It’s quite natural for you to be feeling blue and frightened right now,’ the psychologist had told her before she’d left hospital. ‘It’s a lot to take in, but you’ll find it becomes easier as you gain strength and your coping mechanism comes to the rescue.’

‘What if none of it shows up?’ she’d asked. ‘No strength, no coping mechanism, no hope even?’

The psychologist hadn’t seemed to doubt that it would all kick in at some point, and probably sooner than she expected. He’d then talked about the counselling that would be available any time Vivienne required it.

Reading reports from other heart patients, Vivi knew that the counselling promise wasn’t one to rely on. There had been too many cuts to the NHS budget to guarantee anything, least of all treatment for mental health when the costs of her physical needs were running into many tens of thousands of pounds.

Why didn’t they save the money and let her go now? What was the point of trying to keep her alive when they already knew they were going to lose the battle?

Vivi’s eyes moved to her mother’s blonde head. The little parting that had appeared at the crown made her seem vulnerable, as though she was the one who needed to be taken care of. What the worry of it all was doing to her mother kept agitating Vivi, upsetting her a lot, making her feel guilty and frustrated, even angry and resentful at times. She didn’t want to concern herself with it, but as soon as Gina was out of sight Vivi’s overwhelming relief at seeing her go was quickly smothered by an almost panicked, childlike need of her.

‘What are you thinking about?’ she sometimes wanted to ask, but afraid of the answer she stayed silent. She wondered how much pressure the turmoil of her own emotions was putting on her heart, if the quick flare-ups of bitterness and anger, followed by painful, anxious surges of love and guilt, were damaging it further. Maybe it would be better if she and her mother weren’t together, and yet she couldn’t bear to think of how much it would hurt Gina if she tried to shut her out. Worse would be attempting to manage without her – of course she couldn’t – and all tied up in this terrible, tormenting tangle of feelings was the undeniable gratitude that she had a mother who cared. It wouldn’t be true for everyone in her position; they might not have a wonderful stepfather either, or a brother who was doing his young man’s best to navigate the thorny and explosive territory that existed between his mother and sister.

Wanting him to know how much she appreciated him being here today, Vivi reached for his hand and curled her fingers around his. His grip tightened, but she kept her gaze fixed on the passing hotels and town houses with their hanging flower baskets and wide-open windows, too tired to turn her head to look at him. Later, when she was feeling stronger and they were alone, she’d tell him that he didn’t have to stay, that he shouldn’t stay. His exams might be over, but the plans he’d made to travel through Italy with friends for the summer must go ahead. Just because she couldn’t live a normal life any more was no reason for him to put his on hold. In fact, knowing he was out there making the best of everything the world had to offer would do far more for her than thinking of him wasting away at home.