That morning the miner got up, dressed, and kissed his sleeping wife, who stirred and mumbled, “Take care, love”, as he went downstairs. The feeling in his chest that had kept him awake all night wouldn’t go away, so he drank a glass of milk to try to rid himself of it. That didn’t help, so he got on his bike and pedalled off to the pithead. But the feeling became more intense, like something growing deep inside his gullet, filling his chest with fear. In the car park the pit gear vaulted the silver ribbon of the distant sea. “I’ll be OK”, he said as his workmates helped him to his feet.
“You’d better get yourself off to sickbay” said the foreman, but the miner said no. They might lose their bonus if he didn’t work that day, so, lifted by the company of his mates, he descended in the cage.
But he slowed as he walked from the cage, and clutched his chest suddenly before falling heavily to the ground. The thump moaned through the caverns, and his fall stirred clouds of dust that hung on the still air. His workmates huddled around his body, their grimed faces creased with concern. Blood flooded from the miner’s mouth setting quickly on the grit-strewn rocks.
“Get him up! Get an ambulance, quick!” shouted the foreman.
The young doctor had also been lying awake through the night waiting for the dawn. He was barely two months into his first job. The phone brooded on his bedside table, a crouching black shadow. It hadn’t taken long for it to become an outpost of his body. Within four weeks of starting work he could feel the surge rising in his body moments before it rang, or so it seemed. He even wondered if he had precognition. At first when he was on call, he had tried to put the phone out of his mind. But whenever he managed to achieve this its shrill alarm jolted him to wakefulness. So he feigned sleep, lying in the dark next to his girlfriend, keeping the phone’s malevolent squatness in his mind’s eye, telling himself over and over “It will ring before my next heartbeat,” but for the moment it remained defiantly mute as though to spite him.
His girlfriend stirred. “What time is it?”
“Just getting light, and chucking it down” he replied, lifting a corner of the curtain. The east was heavy with grey bank holiday clouds; the sullen sea rolled back towards the dawn. She sighed, and took the warm hand he offered.
“You’ve not slept again.”
He half-yawned, half-sighed his response.
“Why not? What’s wrong?”
“That!” He jerked his thumb towards the phone. “And dreams, crazy dreams whenever I do manage to doze off.”
She stretched out her arms, freeing her hand. “Shall I make some tea?”
“No! Wait!” he replied. ”Dreams like I’ve never had before. I see their faces floating in front of me, the taxi driver who had a cardiac arrest in the traffic jam, the company director who had a stroke when teeing off.”
She sat up and encircled his neck with a slim brown arm.
“And then I see their insides, their pathology displayed before me like illustrations from a textbook, only the cadavers have their faces, and they grin at me inanely.
She drew his head to her breast. “You poor love; that’s terrible.”
“Next, the faces and corpses vanish and I’m on stage in front of a packed audience. They are all waiting expectantly for me, but when I come to speak I’ve forgotten my lines and my mind’s a blank, so I just stand there, silent and useless, wanting the earth to open up and swallow me. They’ve paid the price, but I’ve let them down.”
“That’s just not so”, she exclaimed. “You’re so dedicated to your work. You’ll be a wonderful doctor.” She embraced him and kissed his head. He felt the reassuring warmth of her body pressing against him. After they had made love the night before he couldn’t tell her how terrified he was because it was all a waste of time, and that it would come to an end sooner or later. Despite their intimacy she was another island in the dark. And so he waited through the night.
The ambulance arrived to take the stricken miner to hospital. As it neared the casualty department it passed the young doctor walking along the promenade into the teeth of the autumnal gale. The town was empty; the half-term holidaymakers were hiding in their beds before being ejected into the storm. The doctor’s solitary figure gambled with the raging sea as it crashed over groins and thumped against the sea wall. The saline squalls thrashed the life back into him, rousing his body and flooding his veins with life.
In the hospital he attended the moribund miner, putting up a drip and kindling a spark of life back into his heavy limbs, before taking blood and examining him carefully. His supple fingers felt the miner’s enlarged and irregular liver two fingers’ breadths beneath his rib cage. And over on the left side of his swollen abdomen the spleen’s notched snout gently nudged his fingers like the muzzle of a favourite dog.
“Has he ever been abroad?” the doctor asked.
“His wife said he was in Aden with the army”, replied the nurse.
Each year on their anniversary the miner and his wife dug out the box of dog-eared photos. They laughed and cuddled as they looked through the old black and white shots of their wedding. There were photos too of young faces featureless in the brilliance of an alien sun, their virile bodies stripped to the waist. In one, a Woodbine dangled from the corner of the miner’s mouth, propping up a self-conscious smile. He wasn’t even shaving when he began National Service. He never spoke about it, just proud to have served his country.
It rained the day they arrived. “Would you believe it?” he said, passing round a packet of fags. ‘First time away from Blighty and it’s pissing down. Just like the day I had last year in Margate with me mum and dad.” After the rain the heat was so intense they went for a dip in a pool. The M.O. warned them not to, something about snails and a tropical disease, but no one listened. Afterwards in the sticky heat he hardly noticed the itchy rash on his legs. It soon disappeared and he forgot about it.
He clowned and frolicked with his mates in the water under the searing sky, but when he put his feet in that pool he entered a world of changes. A curious world in which the mythologists, had they known of it, would have delighted. A world populated by restless denizens who constantly sought foreign lands. They chose the moment of their departure with great care. The experience of countless generations had taught them that warm-blooded animals always came to drink when the sun was at its highest point. They followed the miner’s shadow and closed in on the scent of his flesh. They corroded their way through his skin through chemical guile, and sought the deepest blood-red channels, where they became lugubrious gondoliers. When they reached the wine-dark lagoons of his liver they anchored and rested in preparation for a final metamorphosis.
There they grew and elongated into sexual beings who consummated their urges in a trematode embrace. In time the fruitful female disgorged her eggs into the lagoons, and the infant travellers set course for his gut and on into the light. But the miner’s defences arose, and laid siege to the worms in his liver, encircling them and binding them fast in fibrous bands, imprisoning them behind thick walls, and thus neutralising and vanquishing them. But this was a Pyrrhic victory, which, in time, would bring the miner down.
The young doctor knew from his physical examination that something had seized the miner’s liver. Once supple tissue had become lignified and laced with brittle veins. He remembered hearing a pathologist’s knife hissing and spitting as it cut its way through such a diseased organ at an autopsy he attended as a student. Once healthy channels long-since blocked had filled with bile and blood, bloating the miner’s liver, distending it, creating new channels in a vain attempt to contain the back flow. Over the years the pressure backed up, even into the smallest blood vessels that lined his gullet and stomach wall, causing them to balloon to bursting point, until that morning when the dam was breached. The venous blood flooded away and the pressure sighed and died. The tide had turned, and surged forward driven by vast reserves as the viscid gore surged past his lips.
At first his heart tried to cope, but struggled to keep up with the loss. Its imperative was to man the brain at all costs, and so it pumped faster in a frantic race against the laws of physics. But it could not push out more blood than it received, so it accelerated in its doomed attempt to perfuse the brain, while the blood flowed ever more freely from his gullet. The pressure dropped further until gravity weighed heavily on the miner’s heart, which could no longer pump blood the eighteen inches to his brain. At that point feedback mechanisms tripped the fuse of consciousness and brought his body to the floor. This resulted in temporary relief as pump and brain were now on the same level, but still the crimson fluid sluiced away, until exhausted, his heart quivered in its futility and night descended.
The blood was still coming up as quickly as they could put it into him. The doctor checked the miner’s pulse, but it was so weak he thought he had imagined it. ‘He’ll die unless we do something fast’ said the nurse.
‘I’ll ask the surgeons. They have ways of stopping the bleeding’ he replied.
‘They saw him in casualty. He’s too ill; they said he wouldn’t stand the anaesthetic’, replied the nurse.
The doctor thumbed through the miner’s notes. He paused, lifted his head and raised his eyes to the heavens as though desperately trying to remember his lines.
‘What shall we do?’ the nurse prompted.
‘I’ll phone the consultant.’ He went to the nursing station and dialed the number.
The phone rang in the clinic on the other side of town. The consultant answered.
‘Mainwaring here. Oh yes. What’s that? You want some advice, of course dear chap. No, I don’t know him, has he been seen before? I see, yes. Have you spoken to the surgeons? They might be able to tackle it directly. What? They say that it’s too risky. Hm, I see. So they don’t think he’ll take the anaesthetic, and he’s losing it as quickly as you can put it in. Yes, that is unfortunate. Not sure really what to say old fellow. Hang on, there was a paper in the Lancet a year or so ago about the use of antidiuretic hormone. It’s supposed to increase blood pressure, and reduce the pressure in the swollen veins of the portal system. It might just be enough to stabilise him. I’d suggest you give it a try. Don’t know the dose, but pharmacy will tell you. Push it slowly into his drip; check his pulse and blood pressure. See how it goes. What’s that? Yes of course, do get back if you need more help. Have to dash. Cheerio.’
The nurse returned from pharmacy, and drew the colourless fluid into a syringe. The doctor tried to check the miner’s pulse and blood pressure again without success. His eyes were fixed upon his face. He was struck by how peaceful he appeared to be, as if he was care-free.
She handed him the syringe, and he inserted the needle into the junction on the drip.
‘Have you seen this used before?’ he asked the nurse, but she remained silent as he administered the drug, counting silently, “One tick tock, two tick tock, three tick tock,”a rosary of seconds for the miner.
He scanned the miner’s face for signs of hope, but his eyes were shut; a frown shadowed his forehead. His hair was tousled carelessly, his skin a sheet of white, extravagantly pure, as though anointed with fine oil, but still peaceful. “Twenty-eight tick tock, twenty-nine tick tock, thirty tick tock”,the beads were counted through as the syringe emptied. That was when he noticed the smell, unlike anything he had encountered before. It rose warm and sour from the miner’s body, the cloying smell of entropy, the incense of death. He removed the empty syringe, and turned away. Outside the leaden clouds moved south, and as they left the sea behind the rain ended. The sun climbed into a brilliant sky, determined not to let the clouds return. Children laughed and shrieked as they headed for the beach. Holidaymakers left the smoke-filled cafes and amusement halls in search of fun and games. And as the lees of life drained from the miner’s flesh, leaving it to cool and stiffen, his jaw slackened, and his eyelids gaped to reveal sightless eyes glazed with unshed tears. The doctor’s head was bowed, deep in thought, but his pager sounded summoning him to the next emergency. The nurse gently closed the miner’s eyes and covered his face before going to tell his wife who waited outside.
That evening he walked onto the beach with his girlfriend. They wandered in silence by the sea leaving the day behind them, bathed in the golden light of the setting sun. They paused at the sea’s margin and looked out towards the horizon.
‘It happened again today’ he said, putting his arm around her. ‘I forgot my lines. But afterwards, new words filled my mind, a poet’s words.’ She turned towards him. ‘You don’t think I’m crazy do you? You don’t think I’m cracking up?’ he asked.
She squeezed his arm. ‘Of course not’ she replied. ‘But why?’
He freed himself to skim a pebble across the calm sea. A wave gently lapped his feet washing the sand off his shoes. ‘At medical school they filled our heads with death in all its forms.” He laughed. “Back then we walked quite friendly up to Death. In pathology they taught us all there was to know about infection, malignancy and degeneration. We were on nodding terms with Death in specimen jars awash with formalin, under the microscope, on the surgeon’s table, and in the morgue where our breaths caught on his stink. We brushed shoulders with him in dusty texts and lifeless tomes, and plucked his rotten fruit from high shelves laden with ancient journals. We shook his hand each day in the clinic, peered at his bloody tumours through endoscopes, and interpreted his chiaroscuro on the X-Ray plate. We understood his Latin names, and crafted bawdy memory aids to help us pass exams. Then, when we had done jousting with the examiners, we caroused with his names in the pub all night until we fell insensate to the floor. They taught us all there was to know about Death, but they did not tell us about dying. Until today I did not know what dying was.’