S. Bolton - Dead Scared

‘CAN YOU TELL me about the dreams?’ Evi asked.

Jessica had left her chair and was at the window. Two weeks ago, she’d been a young girl with a history of anxiety and eating disorders who’d been struggling to cope with being away from home for the first time and the rigorous academic demands of the university. Now she seemed a seriously disturbed young woman, exhibiting behaviour that was making Evi think about hospitalization.

‘We all have bad dreams, Jessica,’ she said, when her patient didn’t reply. ‘I’m not going to get all Freudian on you, but I do think they can point towards what’s worrying us.’

‘Do you?’ asked Jessica, without turning round. ‘Have bad dreams?’

The question caught Evi by surprise and she answered without thinking. ‘You have no idea,’ she said.

Jessica had turned on the spot and was looking Evi full in the face now. ‘What do you dream about?’ she said.

‘Something that happened to me just over a year ago,’ said Evi. ‘I can’t give you details, because other people were involved, other patients, but it was a very difficult time. It became a very frightening time. And although it’s over now, I still dream about it often.’

‘Do you ever want to talk to someone about it?’ asked Jessica.

‘I do talk to someone about it,’ replied Evi. ‘And you have very cleverly turned this conversation into one about me. I’m going to turn it back again, if that’s all right with you.’

The girl seemed calmer now. She sat down again, her hands rubbing her upper arms, as though for warmth. She really was horribly thin. Evi waited.

‘I’m scared of clowns,’ said Jessica, after a moment.

‘A lot of people are,’ replied Evi. ‘It’s a very common phobia.’

‘But really scared,’ said Jessica. ‘I can’t see a picture of one without feeling cold.’

‘And are clowns what you dream about?’

‘I think so.’

Evi waited. Nothing. She raised her eyebrows. Still nothing.

‘You think so?’ she prompted.

‘I can’t really remember,’ said Jessica. ‘That’s the weirdest thing. I know I’m in a fairground. I can remember the lights spinning and the music. I was lost in a fairground, you see, when I was about four. I just got separated from my parents in the crowd. When they found me I was beside one of those mechanical laughing clowns in a big Perspex box. I didn’t speak for a week.’

‘That would have been a terrifying experience for a four-year-old,’ said Evi. ‘Being lost in an unfamiliar place that was noisy and crowded, and then coming face to face with a clown. And, you know, coming to university is putting you in an unfamiliar place, away from your parents for the first time. It’s not surprising that your mind is harking back to a scary experience you had as a child.’

‘You’re probably right,’ said Jessica. ‘It’s just … not knowing what happens in the dreams is the worst thing.’

‘How do you mean?’

‘I remember lights, music, laughing and bright colours. Swirling things like those horses on poles … but nothing else.’

‘Perhaps that’s all you can remember from what happened to you as a child.’

‘So why do I wake up exhausted?’ said Jessica. ‘And sore, like I’ve been beaten up in the night. Why do I wake up screaming?’

I WALKED AHEAD of the man with rust-coloured hair, out of Bryony’s hospital room and into the corridor. He indicated a coffee machine close to the ward’s reception desk. When the foul-smelling liquid had been poured, we sat down on nearby chairs.

‘You OK?’ he asked me.

I nodded. ‘Sorry,’ I said. ‘I just wasn’t expecting …’

‘No one ever is. I’m Nick Bell, by the way. Bryony’s GP.’

Nick Bell smelled of the outdoors, of wet mud and woodland in winter. Compared to the chemical smell of the hospital corridors and the putrid stench of the burns unit, being close to him felt like striding home through crisp winter air.

‘Is she likely to recover?’ I asked, after I’d told him the name that was still feeling odd on my tongue.

He shrugged. ‘Bryony is one of the most serious cases they’ve had here for some time,’ he said. ‘She has a mixture of first, second, third and even fourth degree burns over nearly 80 per cent of her body,’ he replied. ‘At 90 per cent, it’s nearly always fatal.’

From my reading over the weekend, I knew that first degree burns were superficial, like sunburn, that second degree went deeper and damaged the underlying, dermal layer of skin, and that third degree burns, the ones I’d believed to be the most serious, invaded the fat and muscle layers beneath the skin. ‘What are fourth degree burns?’ I asked.

‘Fourth degree burns damage the bone,’ he told me. ‘The surgeons couldn’t save her left arm.’

I bent down to put my coffee on the floor and found I didn’t want to straighten up again. So I stayed there, elbows on knees, looking at the floor tiles. Then a hand touched down lightly on my shoulder.

‘Laura, given the severity of her injuries, she’s not doing too badly.’ The hand lifted away again. ‘The flames were extinguished pretty quickly, which meant the damage to her respiratory system wasn’t great. She should be breathing on her own again quite soon. The biggest challenges now are getting her wounds to heal.’

‘Will they?’ I asked, spotting a beautiful tortoiseshell-coloured feather on the sleeve of his sweater.

‘The more superficial burns should heal by themselves,’ he said. ‘The epidermis is pretty clever at replenishing itself. The deeper ones will require a skin graft from a donor site elsewhere on the body. Are you sure you want to hear all this?’

I nodded. Strangely, it was helping.

Bell was drinking coffee as though it wasn’t scalding hot and foul. ‘The difficulty is that because so much of Bryony’s skin was damaged, there isn’t much they can harvest to use as grafts,’ he said. ‘They’ve created a donor site on the small of her back and they’ve used it to graft over the worst wounds, which were on her left shoulder. So far, they’re taking quite well.’

‘So that’s good news,’ I said.

‘It is. But they have to wait now until the donor site replenishes itself before they can harvest it again. It’s a long and painful process and there’s no getting round it, I’m afraid.’

‘One small area on her back has to grow enough skin to cover her whole body?’ I said.

‘Exactly.’ Bell nodded at me, as if I were a student who’d just grasped some important principle. ‘In the meantime,’ he went on, ‘the cadaver skin is keeping her wounds covered, reducing the pain that exposure to the air would cause and helping to guard against fluid loss and infection. And, although it’s from a corpse, technically it’s still alive, meaning blood vessels from the wound can grow into it. Surgeons have been using it for thousands of years. It’s called an allograft.’

He put his coffee on the floor and ran a hand through his hair. It was still damp from the rain outside. I looked back at the closed hospital door, to where the sedated girl lay, kept alive by a dead person’s skin.

‘Do you think she’ll ever be able to tell us why?’ I asked.

I sensed, rather than saw, Nick Bell shake his head at my side. ‘Even if she survives, she’ll probably remember very little about it,’ he said. ‘We’ll probably never know what happened to her.’

‘MEG I THOUGHT he was going to come through the kitchen window,’ said Evi. ‘That he would just spring from the tree branch, straight through the glass, and that would be it.’