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48

general anaesthetic for the entire head was of raw flesh, a bland

expressionless head, a head like a child's drawing, crude lines and

harsh colours, hairless, earless, streaked and mottled with yellow runs

and patches of soft pus and corruption.

We are getting a response from the Cloxacillin, it's looking a lot

healthier, sister.  The naked flesh of his eyelids had contracted,

pulling back like the glistening petals of a pink rose, exposing the

eyeballs to the air without respite.  They had filled the eyes sockets

with a yellow ointment to soothe and moisten them, to keep out the

loathsome infection that covered his head.  The ointment prevented

vision.

I think we'll go for an abdominal pedicel now.  Will you prep for

afternoon theatre, please, sister?  Now it was time for the knife, and

David was to learn that the pain and the knife lived together in

terrible sin.

They lifted a long flap of skin and flesh from his belly, leaving it

still attached at one end, and they rolled it into a fat sausage, then

they strapped his good arm, the one without the plaster cast, to his

side and they stitched the free end of the sausage to his forearm,

training it to draw its blood supply from there.  Then they brought him

back from theatre and left him trussed and helpless and blind with the

pedicel fastened to his arm, like a remora.  to the belly of a shark.

Well, we have saved both eyes, the voice was proud, fond almost, and

David looked up and saw them for the first time.  They were gathered

around his cot, a circle of craning heads, mouths and noses covered by

surgical masks, but his vision was still smeary with ointment and

distorted by the drip irrigation that had replaced it.  Now we will go

for the eyelids.  It was the knife again, the contracted and

bunchedelids split and re-shaped and stitched, the knife up ey and pain

and the familiar sickly taste and stink of anaesthetic that saturated

his body and seemed to exude from the very pores of his skin.

Beautiful, really lovely, we have cleaned up the infection nicely.  Now

we can begin.  The head was cleansed of its running rivers of pus, and

now it was glistening and wet, bald and bright red, the colour of a

cocktail cherry as granulation tissue formed.  There were two gnarled

and twisted flaps for ears, the double row of teeth startlingly white

and perfect where the lips had been eaten away, a long white blade of

exposed bone outlined the point of the jaw, the nose was a stump with

the nostrils like the double muzzles of a shotgun, and only the eyes

were still beautiful, dark indigo and flawlessly white between lids of

shocking crimson and neatly laid back stitches.

We'll begin at the back of the neck.  Will you prep for this afternoon's

theatre, please, sister?  It was a variation on the theme of the knife.

They planed sheets of live skin from his thighs and meshed them to allow

a wider spread, then they laid them over the exposed flesh, covering a

little at each session, and evaluating each attempt while David lay in

his cot and rode the long swells of pain.

That one is no good.  I'm afraid we will have to scrap it and try again.

While his thighs grew a new crop of skin, they planed fresh sheets from

his calves, so that each donor-site became a new source of pain.

Lovely!  An edge-to-edge take with that graft Slowly the cap of skin

extended -up across the nape of his neck and over his scalp.  The

meshing of the skin grafts gave them a patterned effect, regular as the

scales of a fish, and the new grafts were hard-looking and raised.  We

can move the pedicel up now.  'This afternoon's theatre, doctor?  'Yes,

please, sister.  David came to know that they operated every Thursday in

the burns unit.  He came to dread the Thursday morning rounds when the

consultant and his staff crowded around his cot and touched and prodded

and discussed the restructuring of his flesh with an impersonal candour

that chilled him.

They freed the fat sausage of flesh from his belly and it dangled from

his arm like some grotesque white leech, seeming to have a life of its

own, drawing blood and sustenance from its grip upon his forearm.

They lifted his arm and strapped it across his chest, and the raw end of

the pedicel they split and stitched to his jaw and to the stump of his

nose.

It's taken very nicely.  We will begin shaping it this afternoon.  We'll

have him at the head of the theatre list.

Will you see to that please, sister?  With the living flesh that they

had stolen from his belly they fashioned a crude lump of a nose, taut,

narrow lips and a new covering for his jawbone.

The oedema has settled.  This afternoon I will go for the bone-graft on

the jaw.

They opened his chest and split his fourth rib laterally, robbing it of

a long sliver of bone and they grafted this to the damaged jaw-bone,

then they spread the flesh of the pedicel over it and stitched it all

into place.

On Thursdays it was the knife and the stink of anaesthetic, and for the

days in between it was the ache and pain of abused and healing flesh.

They fined down the new nose, piercing it with nostrils, they finished

the reconstruction of his eyelids.

They laid the last grafts behind his ears, they cut a double zigzag

incision around the base of his jaw where the contracting scar tissue

was trying to draw his chin down on to his chest.  The new lips took

firm hold on the existing muscles and David gained control of them so he

could form his words again and speak clearly.

The last area of raw flesh was closed beneath the patchwork of skin

grafts, flesh grafts and stitches.  David was no longer a high-infection

risk and he was moved from a sterile environment.  Once again he saw

human faces, not merely eyes peering over white surgical masks.  The

faces were friendly, cheerful faces.  Men and women proud of their

achievement in saving him   from death and refreshing his ravaged head.

You'll be allowed visitors now, and I expect you'll welcome that, said

the consultant.  He was a distinguished-looking young surgeon who had

left a highly paid post at a Swiss Clinic to head this burns and plastic

surgery unit.

I don't think I will be having any visitors, David had lost contact with

the reality of the outside world during the nine months in the burns

unit.

Oh, yes, you will, the surgeon told him.  We've had regular inquiries on

your progress from a number of people.  Isn't that correct, sister?

"That's right, doctor.  You can let them know that he is allowed

visitors now.  The consultant and his group began to move on.

Doctor, David called him back.  I want a look at a mirror, and they were

all silent, immediately embarrassed.  This request of his had been

denied many times over the last months.

Damn it, David became angry.  You can't protect me from it for ever. The

consultant gestured for the others to leave and they filed out of the

ward, while he came back to David's bed.

All right, David, he agreed gently.  We'll find you a mirror, though we

don't have much use for them around here!  For the first time in the

many months he had known him, David glimpsed the depths of his

compassion, and he wondered at it.  That a man who lived constantly

amongst great pain and terrible disfigurement could still be moved by

it.

You must understand that how you are now is not how you will always be.

48

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