Aminatta Forna - The Memory of Love

He shakes his head. ‘Mr Sesay.’

‘Who’s that, your boss?’

A nod.

At the nurse’s station Kai gives his diagnosis. Likely severance of the spinal cord at T8. To be confirmed by X-ray.

‘Shall I admit him?’ asks the nurse.

Kai shakes his head. ‘Ask him to let us call his family. Someone will need to explain to them.’ He exhales. He hates this most of all. ‘And to him.’ He hands her the notes. She takes them without looking up.

‘Who will explain to them?’ No doubt she is already worried the job might fall to her.

‘I’ll do it. Call me when the X-rays are ready. Otherwise I’ll come back and check after theatre.’

Outside he calls Mr Sesay’s name. The foreman steps forward, pulling off his woollen hat. Kai explains to him, in a way he hopes he can understand, the nature of the injury. The foreman isn’t stupid. He has lost a worker. He listens attentively, shakes his head, promises to bring the family himself. He is still standing there holding on to his woollen hat as Kai walks away. Kai thinks of all the things he has not told the foreman. In particular of Mrs Mara’s decision not to admit any more spinal-injury patients. In past times they’d kept men alive for months only to have them die within weeks of being discharged back to their panbodies , where nobody had the time or the expertise to care for them, to manage their bowel and bladder movements, to turn them several times a day; no money to buy catheters and equipment. Better let them die sooner than later — the brutal fact of it. He considers how much to tell the family, whether to confine himself to explaining how to care for their father and wait for the inevitable. The bed sores are the worst of it. With luck pneumonia would take him first. Kai glances at his watch. He will have to move if he is to be ready for the start of the operation. If they miss the slot they might have to reschedule.

In the theatre they are ready to begin. Foday has been wheeled down and is already on the table, one arm hooked up to the blood-pressure monitor. He is lying on his back, the massive chest rising above him, both his muscular arms outstretched, the shape of a crucifix. His penis lies flung to one side, shaved balls nestle between strong thighs tapering into underdeveloped calves, one splayed, one now straight, down to the out-turned ankles. On the light box on the wall, X-rays of those same frog legs. Kai bids Foday good morning, earns a smile, silent and serene. Foday’s confidence should be heartening. Instead Kai feels a quickening of the stomach muscles. The team is the same as before. Seligmann, the lead surgeon. Kai. The anaesthetist, Salamatu. All except Wilhemina. In her place the nurse who called him to the emergency unit. She is busy layering sterile drapes over Foday’s body, returning him to modesty. Her hands are quick, professional, her face unsmiling. She is the sole OR nurse now. From the instrument trolley Kai picks up a kidney bowl of water, iodine and ampicillin and begins to swab Foday’s leg. Seligmann is photographing Foday’s left leg. He steps forward, shifts the position of the leg and returns to take the photograph. The flash bounces off the white walls causing Foday to raise his head.

‘Photograph,’ explains Salamatu. She slides a needle into his arm. Reaches up to the IV line and injects a fluid into it.

‘Passport photo,’ says Kai. ‘For your honeymoon.’

Foday rolls his head in Kai’s direction and grins at him. He seems about to respond, when his eyes lose focus, the lids flutter closed.

‘Good,’ says Seligmann, putting down the camera. He peers at Foday.

They are ready to begin. The nurse tightens the tourniquet around Foday’s thigh.

‘Over or under?’ asks Seligmann. ‘Under or over?’

They assess the point of entry, agree to go in under the muscle. Seligmann makes the first incision. Blood oozes from the wound. ‘Tourniquet,’ he says. The nurse tightens the tourniquet further. Kai meanwhile stands by with the diathermy wand. He glances down. The tip of the wand is waving. He takes a quick, deep breath, tries to steady his arm and his hand to stop the involuntary movement of the wand. He looks up to check whether anybody else has noticed. The nurse is finishing off the tourniquet. Seligmann waits to continue the incision. Salamatu is sitting next to Foday’s head. None of them are looking in his direction. Kai flexes his arm, at the same time lowering the wand below the level of the table. He counts and breathes. One, two, three. It’s worked before. He concentrates all his energy into stilling his hand and arm. The waving is arrested sure enough, but the tip of the wand continues to shiver. He can do nothing to control it. Any moment now, Seligmann will ask him to begin cauterising the ends of blood vessels left by his incision. The nurse has tied off the tourniquet and now resumes her place next to Seligmann. Seligmann bends his head, adjusts his grip on the scalpel and prepares to begin again.

‘Sorry,’ says Kai. ‘Can you excuse me a moment?’

‘What?’ Seligmann, bent over Foday’s leg, looks up at him, incredulous. ‘Are you kidding?’

‘Yes. I mean, no. Sorry.’ He indicates to the nurse to come and take the diathermy wand from him. ‘I have to go.’

‘Something up?’

Kai rolls his eyes. ‘Ate at the Beach Bar last night.’

Seligmann emits a snort of muffled laughter into his mask. ‘So even the locals aren’t immune. Bad luck. Go! Go! For Christ’s sake!’ He waves the scalpel in the direction of the door. ‘I can manage here for a while.’ Chuckles as he returns to work.

‘Thanks.’ Kai makes his way to the door, stripping off his gloves as he goes, conscious of the nurse’s eyes upon him above her mask.

Ten minutes elapse before he returns to the OR; the most delicate part of the procedure is over. Kai had spent the time sitting alone in the changing room, trying to locate the presence of mind required to continue, aware he couldn’t stay away too long. He must see this through. Thoughts of Foday. Of the altered technique he and Seligmann were pioneering. In time he rose, changed his robe, scrubbed back in and re-entered the theatre. The nurse helped him with his gloves. He catches a trace of a question in her eyes, wonders how much she noticed.

‘Just in time.’ Seligmann is wielding a steel hammer and chisel. ‘Come and mark off the bone for me, would you?’

At that moment Foday’s arm rises from the table of its own accord.

‘Anaesthesia, we are moving,’ calls Seligmann.

Salamatu pumps more ketamine into Foday’s system. Slowly, as if buoyed on invisible currents, Foday’s arm drifts back down. Kai marks a groove in the exposed bone. A moment later Seligmann positions the chisel, draws back his arm and with a blow of the hammer drives the chisel through the bone. Behind him the display light box on the wall flickers faintly.

On the operating table Foday sleeps with the angels, while his shin bone is methodically smashed.

* * *

Seven o’clock and he is on his way home. Almost twelve hours since he arrived at the hospital. He has barely rested or eaten. He and Seligmann had sewn up Foday’s wound together, the older man talking and telling jokes, full of good spirits on that day. Kai was grateful for it, grateful Seligmann was distracting himself, allowing Kai to concentrate on each suture as though it were the first he had ever performed.

Afterwards Seligmann had accepted Kai’s offer to write up the notes and exited the theatre swinging his arms and whistling. Opposites on the surface, the same beneath the skin, both men thrive only in the theatre, a scalpel in their hand, a human body on the table. Seligmann had faced his retirement without equanimity, with the belligerence of a bull. Within six months his marriage had fallen apart. His wife made it a condition of their eventual reunion that he find a way to go back to work. Now here he is, in a country far from home, operating where he is still needed. His wife stays in the house, occupied with their grandchildren, lunches and life-drawing classes. Seligmann calls her every day, never returns home for more than two weeks at a time. In this way they have found contentment.