The World I Fell Out Of. Andrew Marr

the sustained gale of laughter following him up the corridor that day. People laughed and then kept on laughing and then laughed some more. You simply don’t hear that in hospital. He provoked a similar outbreak of mirth in the gym when, bored and restless as he often was, he wheeled around asking all the women present how much they would charge to lap-dance for him.

      The physios gathered their professional dignity and tried not to join in.

      ‘Get lost, Snafu.’

      ‘Go away! Aren’t you supposed to be on the triceps press?’

      He was utterly persistent. ‘No, you have to tell me. How much?’

      Eventually, casting their eyes around to make sure no NHS suits with clipboards were lurking, the physios played his game.

      ‘Four million,’ said one.

      ‘At least. Because my career would be finished if I was found out.’

      ‘Six million.’

      ‘I wouldn’t do it.’ A humourless junior physiotherapist on rotation in spinal.

      His eyes lighted wickedly on me, purple-faced, toppled helplessly over my own knees. ‘Hey Mel, what would you charge?’

      I was flattered to be asked. He tolerated me, just about, as a mate, although his banter was brutal – I was as old as his granny, plus he’d decided I was officer class. I’d been a horse rider, after all, and he’d found out my house had an orchard – so in the gym he loudly dubbed me a caviar-eating snob. In private, when he found me in tears, he was kindness itself. He was a year younger than my own son.

      ‘Half a million,’ I said. ‘Because my freak value doesn’t outweigh the fact I’m too old.’

      ‘Nah,’ he agreed.

      Snafu got particularly bored at weekends, when there was no gym. One Sunday evening, the place packed with visitors, his terrible screams echoed down the ward: ‘Aaaaargh!! Nurse!!!! Come quick!!!! I can’t feel my legs!!!’ For amusement, he regularly soaked the auxiliaries when they helped him shower, or when the fire alarm went off, as it did often, he sped up the ward screaming, ‘Fire! Everyone out! This one’s for real.’ It was Snafu who yelled triumphantly across the gym, ‘Susaaaaan! Ah’ve pished masel’!’ when his catheter tube became disconnected from his leg bag; who invented wheelbarrow races for the paralysed; who decided to practise commando crawl across the gym, dragging his legs behind him, and of course wriggled straight out of his tracksuit bottoms, exposing himself to the world, and leaving the physiotherapists initially too helpless with laughter to cover him up; and it was Snafu who, despite his impaired hands, beat everyone in the target-shooting competition one Wednesday afternoon, part of our weekly games session. As a flourish, to demonstrate he was in the company of amateurs, he also shot the clock on the gym wall: the holes remain in the glass to this day. He had wanted to be a soldier since he was four and before he was paralysed he’d been in line for specialist sniper training and promotion. A man-child: incorrigible, charismatic, vulgar, cynical, careless, self-destructive, heroic, vulnerable, shrewd. Of all the people I encountered in the tiny, little-understood world of spinal injury, he was the one that made me the most sad.

      Approaching bedtime on the rehab ward was the worst. The conveyor-belt sequence kicked in again, in reverse, and we sat by our beds, queueing for the team of two nurses to come and hoist us out of our chairs onto the sheets and attach our overnight urine bags. Then we waited for the final drugs trolley. Long-term incarceration in hospital teaches you tolerance, patience and the knowledge that we are all very, very human. Even now, years later, when I close my eyes I can hear the banter of Rosebud in the distance and the squeak and rattle of the night-time trolley she is pushing. And around me I can sense some of my fellow patients starting to flutter and jangle. Respectable middle-aged women, with husbands and flowerbeds and Vauxhall Astras, but now hungry for whatever opiate or benzodiazepine they needed to soothe the mental anguish of their state, their personal paradise lost. They hungered, bodies paralysed but writhing inside for medication, just as mine had writhed in the high-dependency ward. When was the trolley coming? One woman would press her buzzer anxiously and then others would follow. The drone of multiple alarms would sound down the long ward.

      ‘What kept you?’ Mrs Bennett would cry.

      Rosebud, ever insouciant, was having none of it.

      ‘What do you think this is? BUPA?’ she cried. ‘I tell you, you’re lucky it isn’t. I’ve worked in private hospitals and they bill you for every single pill you take. Even a paracetamol. Youse are lucky youse are here and not there.’

      Apart from when the staff came to turn us onto the other hip on a four-hourly rota, we were then undisturbed until the morning. That was the theory. Nights change when you are in hospital. In fact, as I was to learn, nights change forever when you are paralysed. Any joy went. Your favourite sleeping positions ceased to exist, partly because you could not feel them and partly because you could not achieve them on your own. You adopted the protocol position you were put into – on one hip or the other, pillow wedged into your back, another under the upper knee, more pillows stuffed into the bottom of the bed blocking your feet from going into a flexor spasm downwards. Thus comfort was outsourced: someone else arranged your limbs and your torso in a way which was safe for your skin and for your tubes to survive unblocked. Your frozen hands were put into customised splints, the fingers strapped flat against the formed plastic so they could not contract, and all autonomy was removed. You could no longer scratch your nose, let alone pick it. The private geometry of your night, your ability to cuddle into shapes practised from childhood, was gone for ever: a very personal autonomy to lose. Meanwhile, the hour hands stuck, as if glued, to the face of the clock – T.S. Eliot’s ‘Only through time time is conquered.’ Peace was as lost as paradise. The nurses’ station on night shift was notoriously noisy; there were a handful of the staff who seemed unable, or disinclined, to lower their voices as they sat chatting. When buzzers rang, they would push back their chairs, the metal legs screeching on the floor. Weirdly, my paralysed bladder used to spasm at that noise: a peculiar sensation – somewhere deep inside an insensate body, in a dormant vital organ which contained a foreign body, a catheter, there was a horrid jump of indignation at the discordant pitch. Imagine. I could hear with my bladder! Was it transmitted via my ears, down some remaining nerve pathways, or was it a vibration in the air that affected my bladder alone, its catheter acting as a misplaced aerial?

      In between interruptions, we learnt to endure the passive tyranny of those long hours, where no limbs stirred, no sheets rustled. These were not normal wards. You have no idea how eerily morgue-like paralysed patients are in bed when they cannot move. Nurses are notoriously superstitious; there are rich stories of ghostly scares on night-time wards with darkened corridors. Delphinium, one of the regular night shift, told me of the fright she had when a patient, paralysed from the neck down and normally as still as a corpse, sat bolt upright as she passed, the result of a sudden, unexpected spasm. Muscle spasms could happen, but rarely as extreme as that.

      ‘I was like, waaaaaaah. Nearly crapped myself,’ she said. ‘He didn’t even wake up.’

      Night time. Even if our bodies were by necessity quiet, our minds were their own torture chambers, forever churning the random nature of the accidents, the screaming bad luck which had damned us to stillness. Why us? Why me? And often, if we did dream, our dreams tormented us by putting us back on our feet again. Dreams so vivid that when we woke, it was especially desolate to rediscover reality. One night I dreamt that Vitamin D tablets were a miracle cure for spinal injury, and because I already took them as supplements I was able to walk again. There I was up on my feet, walking unsteadily round the ward helping my fellow patients reach things from their bedside tables, and waiting for the doctors to arrive so I could tell them the good news. I woke up, convinced it wasn’t a dream, fighting a sickening lurch of hope and then disappointment before cold logic kicked in. I remember one night I even said to myself in my subconscious, now don’t be fooled, this is a dream, you can’t really walk again, and then I dreamt that to test it, I had woken up, and it was true – I could actually walk again. Double-dip dreaming. A plot within a plot. But of course everything remained