Adam Mars-Jones: Pilcrow

Mum argued the toss and made a little headway. It was agreed that it would be all right for me to have some Weetabix just this once, but it wouldn’t be right to make a habit of it. There were other children being looked after in the hospital who didn’t have mummies to bring them in Weetabix. It wouldn’t be fair on them. There was socialism of some punitive sort evident in the hospital’s thinking about cereal.

Manor Hospital doesn’t get many marks from me, as a giver of care. Some of the procedures they subjected me to may have been medically sensible, but as no one explained anything they were humanly degrading. They kept putting swabs down my throat, looking for streptococcus, I suppose. Before the swab came the spatula. The spatula was horrible because it made me retch. I remember the feeling of being about to be sick, and also trying to work out how far back in my throat the spatula went to produce that hideous sensation. So I took the straw they gave me with a glass of water and practised taking it into my mouth as far as possible. When the sick feeling came I learned to overcome it. It was a sort of game. Soon it was easy.

The doctor didn’t play along, though. When he came in again, I didn’t retch, or even flinch, when he got to what had previously been the point of my gagging reflex. He gave me a funny look, as if he didn’t enjoy being outsmarted, and pushed the spatula further in, until he got the painful, humiliating reflex he seemed to want so much.

It was a useful discovery, that there were other factors in the world of doctors and hospitals than the welfare of the patient. However much I trained myself to accommodate his probings, this particular doctor would keep on pushing until he got the desired paroxysms. Other children on the ward gagged the moment the spatula entered their mouths, and the doctor was perfectly satisfied. If I’d had any sense I’d have done the same, from the beginning. As it was, by the time he came to scrape his swab against the back of my throat, the tissues were so tender it felt as if he was trying to strike a match there, to set my throat alight.

There was another doctor who came in at one point to carry out the same procedure. His hands smelled of the same soap, but they followed a different code. They were gentle. His voice and manner were full of love. His spatula wasn’t pushed any further than the minimum, and my body reacted as if it was a different organism entirely. My throat opened like a flower to his swab.

Tickling the bone

There were also bone biopsies, which no doctor could have made painless. They involved scraping the bone of the conscious patient with an instrument that had a little hook attached to it, to gouge out a sample. It’s hard to describe pain, even to compare one pain with another mentally, all you can say is pain or no pain. This was pain. The scraping was deep inside me. I cried out for ‘Suzie’ and the nurse asked, ‘Is that your sister, dear?’ No, Suzie was a straw dog, given to me by my Uncle Roy for my first birthday.

Many years later, reading accounts of tortures used on political prisoners in South America, I came across a very similar technique, which went by the grimly poetic name of ‘tickling the bone’. If I’d known that what the doctors were doing was a form of torture, though carried out in my own best interests, I might have tried confessing my meagre sins, crying out, ‘I ate a red Spangle that I knew was dirty! I saved up my tuppennies and did them in the bath! I wanted to see them float!’

I was as incidental to what was being done to my body as the abductees on television programmes, when aliens probe and scrape. No one is actively drilling for pain, in the hospital, on the mother ship, but it spouts from its bottomless wells. Perhaps the writers of those shows had hospital experience as infants, and are using fantasy to work through their traumas. Good luck to them. I find such things hard to watch. I find such things hard to turn off.

They stuck sharp things into my bottom and they pushed blunt ones up it. The sharp things were the needles that administered injections of iron, and the blunt ones were enema nozzles. I squealed as the funnel was inserted and the liquid began to flow. I remember the smell of the rubberised sheet beneath me mixed with the smell of my opened bowels. There was someone at each corner of the sheet holding it up, so as to prevent my helpless slurry from spilling onto the bed or the floor. Not quite the four angels, one at each bed-corner, that I had been encouraged to visualise in infant prayers, who were to guard me as I slept. The slurry formed a shallow pool with me at the centre. The whole event was shaming, with no explanation given. Why was I being made to go to the lavatory in bed? ‘It’s only soapy water!’ said a nurse in a rather cross tone, as if there had never been such a fuss made over nothing. And as if the exact composition of the warm liquid that was being driven into me, reversing the proper direction of travel, was something I could be expected to know. I was baffled as well as humiliated. Holding on was a relatively recent achievement for me, and now the right and clever thing seemed to be letting go. I just wished they’d make up their minds.

The only good thing to come out of my Manor Hospital days had nothing directly to do with medicine. From my bed I could see a chimney on one of the hospital buildings which was pouring out black smoke. It was a windy day. A gust of wind suddenly snatched the smoke and whisked it past my window. I knew I was stuck where I was, but the smoke rushing past the window produced an optical illusion — as if the whole ward was moving at speed in the opposite direction. Objectivity went on the slide, just as it does when the train next to yours starts moving, and for a while you don’t realise that your own is still waiting at the platform. I lost my bearings in a way which amounted to revelation.

This was a glimpse that stayed with me, a mystical inkling. One suggestive thing about the experience was that its materials were so humble. It wasn’t frankincense taking on a meaning beyond itself, only smoke from incinerated hospital refuse. A sense of the meaning of life can be constructed from any material however unpromising, from whatever lies to hand. Perhaps burning was a necessary aspect of the experience, from the point of view of getting my attention, since I’ve always been so attuned to combustion.

I don’t know how long they looked after me at Manor Hospital. It was long enough for Mum to bring me Suzie the straw dog eventually, who gave me some comfort. When I came home I was no better but I had a diagnosis attached to me: rheumatic fever. It wasn’t an uncommon condition in those days, a side-effect of streptococcus infection. Three per cent of individuals with untreated streptococcus go on to develop acute rheumatic fever, when antibodies are generated which attack the membranes in joints — the synovial linings. It was thought that I might have had streptococcus without any noticeable symptoms. So perhaps there was a reason for them to be so keen on pushing swabs down my throat.

At three I was well below the usual age of onset for the disease (six to fifteen), and the arthritic pains I was experiencing didn’t really fit the definition of ‘migratory’. They seemed pretty stubbornly resident. New areas were beginning to be inflamed, but not because old troubles were clearing up. There were squatters in my knees wrecking the premises, and they showed no signs of moving on. In fact somehow they were inviting their cronies to join the party, to occupy my hips and elbows, ankles, wrists and shoulders, until there was a general involvement of the joints in misery, pain and swelling.

I had my diagnosis, or rather Mum and Dad did. But diagnosis without cure or even treatment is cold comfort. There was nothing to be done for me. To be more accurate: nothing was to be done by me. I was to do nothing. In rheumatic fever it is the heart that gives concern. Permanent damage can be done to it. Additional strain must be avoided.