Isolation By Kathy George I come in from walking the dog and notice I have a text message. I have to get my mind around the time difference. My son s in New Zealand, snowboarding with mates. It s 9:00AM there, and very cold. Hey, Tristan writes, don t want you worrying but I crashed and hurt my right shoulder. It s hard to move and lift stuff and my left knee is also swollen. I can t bend it. Hopefully I just need rest. Frowning, I write back, advising ice packs, sending hugs, but next day there s another text. I m in hospital on antibiotics. I have some infection. Have to get my flight rescheduled, but feeling a lot better. My response is typical of a parent. Wow! Sorry to hear. Hope u come good. Do u need money? Have you got travel insurance? What can we do to help? The reply is probably what I suspected. I don t have travel insurance. I got a quote but didn t get around to paying. Will talk money when I get back. Don t need help. Just know I m gonna be fine. The smiley emoticon so typical of my son doesn t prepare me for a phone call on Sunday night. A possum is running along the back fence making the dog crazy, when a male voice introduces himself: Julian Speight, Head Surgeon at Invercargill Hospital. 1
Phone pressed against my ear I walk through to the study, where it s quieter. Invercargill? Where s Invercargill? I m calling from the operating room, he says. I m about to take your son into surgery. Are you aware he s not well? He doesn t give me time to answer. An infection has taken over his body. It s not responding to antibiotics, and is busy shutting down his vital organs. Mr Speight tells me that unless he cuts Tristan open to flush out the infection these things have a habit of lurking in damaged tissue his chances are not good. He may have to remove dying flesh. He doesn t actually say my son might die, but that s the implication. I ll call you after the surgery to let you know how it s gone. I ll be a couple of hours, he says, and passes me on to the theatre sister, Barbara. I ve got your son here and I ll care for him as if he were my own, she says, which just about undoes me. Then, Hello, Mum. Tristan is on the line! His voice is groggy. I say Sweetheart, before my voice breaks and have to swallow hard, then he s gone. My husband appears at the doorway, and I go into his arms, haltingly explain things. I m searching for a flight to New Zealand when Julian Speight calls again. Tristan has come through. He has six incisions: three up his right arm, one across his ribcage, and two on his left leg. The longest and deepest of these runs across the top of his foot, where the infection is eating away his flesh. But Mr Speight hasn t had to remove any tissue. I babble and tell him I m on the first plane in the morning, that I ll be there tomorrow evening, and look forward to meeting him, as if this were a social engagement with a long lost cousin. I have to catch three planes: Brisbane/Auckland/Christchurch/Invercargill a route that takes the entire day. Invercargill is at the tail-end of New Zealand. It has a big base hospital and I know from a telephone conversation with one of Tristan s mates that the day after his fall he checked himself into Queenstown s mountain clinic and from there was transported by ambulance. In Auckland while I wait for my connection a man with a teenage son halts in front of me. Are we at the right gate? Yes. Gate 29, it says so up there. 2
Ta, he says. You going skiing, too? No, my son is in hospital I start to say but my eyes fill with tears, and from the pained expression on the man s face I know I ve ruined the start to his holiday. The plane to Invercargill is a turboprop with propellers. I sit up front, facing a stiff breeze from the open door where they re loading dog cages behind the cockpit. The dogs are jittery but I don t mind the howling. We flutter down the runway and soar into the sky, and the snow-capped mountains and plunging ravines below make me forget everything for just a little while. Invercargill Airport is like a shoe-box, the luggage carousel an abandoned shed in droopy grass. I ve rugged up, but it s much colder than I imagined and I can t remember where my gloves are. There are no shuttles into town and I share a taxi with a businessman. I sit in the back and say nothing. It s safer that way. The roads are dark and quiet. The houses huddle together for warmth. At the hospital, visiting hours are over but I m expected in Intensive Care. Outside glazed glass doors, I disinfect my hands then press the buzzer. A nurse arrives and introduces himself. Guy tells me he s looking after Tristan. He seems positive and cheerful, and I follow him in. I see my son immediately, although there s so much to absorb from the tubes in his neck to the heavy bandaging to the electrodes on his chest to the growth on his chin. Hello, Mum, he murmurs, but he doesn t smile. Guy explains the squiggly lines moving across the monitors, and later I feed my son yogurt. His refusal to swallow more than a few spoonfuls takes me back to childhood fights over food. Later, I nod off alongside his bed and wake to find it s tenthirty. The patient is asleep. I need not remain vigilant at his bedside. I lean over to kiss him goodbye, and he opens his dark blue eyes and stares at me. I was dreaming, he objects. I was dreaming a nice dream. And you woke up and found yourself in a nightmare, I think. In the morning they isolate Tristan as a precaution, and a team of gloved and masked interns is with him when I arrive. I collar one coming out of his room. What is it? What s this infection called? 3
The intern has dark feathery eyelashes and a middle-eastern look. He pulls down his mask and mentions a word I don t catch. How do you spell that? I ask. S-t-r-e-p-t-o-c-o-c-c-u-s P-y-o-g-e-n-e-s. I google it on the ipad, and immediately regret doing so. There are photographs. Graphic images. My son is in pain. He breathes shallowly, his eyelids flickering. Every little movement is agony. He seems on the verge of tears, but the act of sobbing and shuddering will cause him torment because he has deep incisions all over his body. Underneath the bandages the wounds are open to let fluid ooze out. The nurse, Shelly, tells me the wounds must be stitched up in a week, regardless of whether the infection has been conquered, otherwise there ll be scarring. Can we do something about the pain? I ask her. In time I will forget all the nurses names. Only Guy and Shelly I ll remember. Guy because he s my first point of contact. Shelly because she takes my concern about the pain to the doctors. Because she has a boy with the same name. I have a Tristan, too, she tells me as she checks the level of the catheter. My younger son. You must be a romantic, like me. I am, I say. Tristan was one of King Arthur s knights, as you d know I glance at him, sleeping. Will he will he He ll come through, she whispers, because knights save people. They re needed in the world. Mr Speight is in his forties with a jolly face, plump cheeks and glasses. He wears blue scrubs, and has an English accent. Many of the doctors are foreign, on exchange programs, I find out later. I am quietly optimistic, he tells me. He s young and healthy and strong. If he d been older I ve only had a case like this once before, many years ago. They re very rare. Luckily I recognised the symptoms. Your son s arm was swollen up three times the size it should be 4
What would ve happened, if you hadn t cut him open? Oh, the skin would have burst, and then of course it would have started necrotising. There s a place on his foot where it is dying, but I didn t cut it away. I think it might come right. People can lose limbs, amputation and all that. He pauses, focuses on me. I shouldn t be frightening you. But it s so interesting. You can get the same thing from a certain spider bite. The flesh dies all around the bite and keeps dying, working its way backwards. His beeper goes off and he pats it absently. And all from this little graze on his thumb. We think that s where it got in. It has to have a portal to enter the body. And he says he fell over in the street on the first night probably had a few drinks, you know what young lads are like and, oops, he s got gunk on his hands. And then it was only a matter of time before it reached the site of the injury. We just have to wait now. We just have to wait and see. But as I said, I m quietly optimistic. On day three they take Tristan back into surgery to remove the bandages and flush out the wounds. The whole procedure leaves him in agony again. And when a nurse appears to ask if his bowels have moved I have to stop myself from shouting at her. I m no good to anyone in this state. I leave the hospital and walk aimlessly outside. I don t put my hands in my pockets and I leave my coat unbuttoned. I want to feel the icy wind. I want my fingers to go numb. I want to feel something other than despair. On another day, I volunteer to shave him the stubble is itchy but I don t tell him I ve never shaved a man before. He helps with his good hand and I m gentle around his neck where the tubing is. Afterwards he slumps back against the pillows, eyes closed, face pale against his curly dark hair. He looks so young without the beard, so vulnerable, and so much more like a little boy. He s forgotten to put his nasal prongs back in and I ease the elastic band over his head. I put away the razor and shaving cream. I fill his water bottle, tidy the trolley table, tiptoeing around the bed so I don t bump it. I do motherly things until there s nothing left but to look at the screen with the coloured squiggly lines again. His heart rate is still too fast, his breathing too shallow, his blood pressure too low. 5
I stare out the window. Scraps of cloud scuttle across an ashen sky. It s about three-thirty but already the shadows are lengthening, bedding down for the long, cold night ahead. Little black birds hop stiff-legged in the green grass, burrowing their beaks into the earth, and somewhere a lamb bleats for its mother. Behind my back, a machine beeps, startling me and waking Tristan. His first reaction is a grimace, the shock of pain in his eyes. Then he sees me. Mum, he says. Something wonderful happens, then. Something I ve been waiting for. Something I ve been looking for every day. He smiles. 6