Costa First Novel award-winner Christie Watson, whose recently released book The Language of Kindness is being turned into a TV show, tackles taboos around health and guilt in her short story, “Exit Wounds.” This story was originally written for and published in Index on Censorship magazine.
In The Language of Kindness, Christie Watson addresses not only the incredible mental and physical challenges that nursing staff face as they battle through a multitude of health crises, but also the other emotional demands such as patients with no family to care for them and mounting demands on their time.
In her short story, below, Watson uses fiction to talk about some of the same issues, telling thepowerful story of an older woman, Margaret, who lives alone, and who is struggling with her health and her ability to pay for her care.
The novelist brings readers to understand how hard it is for Margaret, how alone she is and why she cant bring herself to speak about these struggles to her family.
Watson said: Even though she is lonely, I dont think she would express it, as many older people wouldnt. We have got a real issue. The thing is that we are [all] living separately.
Watson acknowledged that, in many societies, people still found talking about death taboo. She said: We dont talk enough about death, and it is quite a secretive processpeople dont know what happens after you die. For example, when my dad died we didnt know about organizing a funeral and we relied quite heavily on people who had gone through it before, but hadnt thought to ask them about the process before.
Then it becomes a very frightening thing, because it is secretive and everything that is secretive is more frightening than the actual reality.
Watson, who lives in south London, hit the literary scene with her first novel, Tiny Sunbirds Far Away. She believes strongly that, in Britain, there are issues around aging that are not being discussed.
One of reasons why I love Index so much as an organization is that its about giving freedom of expression, giving a voice, to the voiceless. Although we have got a rising open dialogue with, particularly young, people[some of whom] are shouting very loudly about social issues, which is greatthe one thing that still needs tackling, increasingly, is that there are a huge number of elderly people in Britain who havent got a voice at all, who might not be able to vote, who cant see or get out, or havent worked out how to do online voting.
These are the people who fought for our country and who founded the NHS. Weve got a big problem with, not only loneliness, but lack of voice for elderly people in our country who are almost disregarded, put to the bottom of the pile and are almost invisible.
Its also pride. Its complicated. Not just that they are afraid or embarrassed.
She believes that there is a need for more discussion about mental health and other illnesses in arts, television and film.
Rachael Jolley, editor,Index on Censorship magazine
Margaret didnt like to make a fuss. But despite the number of blankets shed wrapped around herself it was still bitterly cold. She thought about getting up and heating soup. She had a can left. Tomato. But shed planned that for tomorrow, and then what? She wasnt really hungry. But ever so cold. And cold, when it bites you in your bones, makes you forget about hunger anyway.
Small mercies, she muttered, before turning the television up louder to drown out the silence. Jeremy Kyle. These people. Where did they find these people?
She fell asleep at some stage. Must have done, because the telephone jolted her awake. Nan, its me, Simon. How are you?
She heard the great-grandchildren in the background, squealing and shouting. Imagined them. Smiled. Im good, love. It took a few minutes to turn down Jeremy Kyle. She liked to fill the living room with loud voices. She used to like the newspapersfelt part of something biggerbut the voices all became the same. Even the headlines. As if one person was writing for the Mirror and the Guardian and the Daily Mail. Still, at least TV had a variety of people. A man with no bottom teeth was shouting at a woman wearing a too tight vest. How are the kids?
Oh were all good, you know, busy busy, Im just checking in. And I know we said half term wed be down but theres a slight change of plan. It might have to wait until Easter. Ive got a conference and its really important or I wouldnt ask. I hate to cancel. We were so looking forward to visiting.
Margaret watched the Jeremy Kyle people blur in front of her. She thought of the day Simon was born and how impossibly light hed felt in her arms. Thats OK love, I understand.
Anyway, how are you, Nan? Is it cold down there? Manchester is freezing. I hope youre wrapping up warm.
Yes, love. Its not too bad. I saw the snow youre having on the news. I expect the children are enjoying it? She heard the voices once more, in the background.
Stop it. I mean itstop! Shouting. Come speak to Great Nan.
There was a pause. Then: Hello grape nan.
Margaret laughed and for a few seconds there was no cold at all.
The district nurse, Ellie, came on Tuesday mornings. She was ever so patient, waiting while Margaret pulled herself up onto the frame and shuffle-walked to the door to unlock it. It must have taken a full 10 minutes. Hello Mrs Venn, how are you? Gosh its freezing in here. Let me get the kettle on.
She was a tiny thing, a dot of a girl, cant have been much older than 20. Made a terrible cup of tea. But Margaret liked her anyway. She was much better than the first one who used to come every day before the cutbacks, the one who picked up and commented on Margarets ornaments and photographs as if she and Margaret were old friends.
Lovely cuppa for you. My goodness youre freezing. Its like a freezer in here. Have you no heating?
Oh I dont feel the cold, love, said Margaret. She pulled the blanket around her and stretched out her bad leg to Ellie, who was already crouched on the floor with a new dressing, wearing plastic gloves ready to take off the old.
You know there is an emergency fund for gas and electric, she said, if you wanted I could send an assessor out? Cant promise but still. Anyway I could come and help with the forms at least?
Oh no, Im fine. Leave it to those who really need it.
This leg isnt so good, Mrs Venn. Shed wound the bandage off to reveal a stench like rotten meat and it was twice the size of the other leg, swollen shiny redness.
We might need to get the doctor out, but Im not sure it will be today. And you might need to pre pay. She sighed. Im sorry about that.
Margaret looked down. The ulcers had grown and there was clear fluid running down them. Chop it off, she said. All it does is cause me trouble.
Ellie looked up and patted Margaret on the arm. Itll be OK, she said. But I do think Doctor Zadin needs to pop in. You need antibiotics.
Dont worry, love. Anyway, I cant understand a word he says.
Ellie laughed. Folded up the stinking bandage into a bag, rolled a new one carefully around Margarets leg. Even so Ill ask him to come. You dont want to end up in hospital.
Margaret shook her head. She looked past Ellie, next to the TV and the small silver pot. She thought of the day they found that pot, her and her husband Reg. Theyd been on holiday in Malta and walking through winding cobbled streets, lined with what hed called tut shops, hand in hand. Reg had a stripe of sunburn on his neck above his T-shirt. The pot that was so full now contained only seven pounds and 50 pence. A prescription 10 pounds.
Margaret didnt know how long shed been there before they came.
First was the Indian doctor shouting through the letterbox. Mrs Venn, I can see you, stay there help is coming.
She pressed her body into the ground. Opened her eyes. Her kitchen. The same wall clock, mug tree, spice rack. The washing-up cloth hanging over the tap. And now the can of soup on the floor, the soup splashed all up her cardigan like fresh blood. Her leg stuck out the wrong way and the pain was burning. Her head skipped back. Her mind danced across years as though time was a ballroom. She thought of Reg, being shot during the war, the entry wound a small, neat 50 pence piece, yet the exit left half his back blown off. Life was devious like that.
There was loud banging, then smashing and the door thrown open. Doctor Zadin knelt by her. You stay still, Mrs Venn. Theres an ambulance on the way. He touched the soup splashes on her cardigan. Oh. Soup, he said. Thats a relief.
Im not going to hospital, Margaret whispered. But her voice sounded funny. Far away and young. Stupid. Simple. Like Patricias voice sounded in her head. Like she was told it would be after they took her away from Margaret without letting her see. She could still hear her mothers words: You cant keep her. You wouldnt cope with a baby at your age anyway. But a mongol? Youll have another baby. When youre married. Older. There will be others. In any case, she wont live long. Best just forget about this.
And then she was lifted onto a trolley and she tried to call out in pain and scream but her mouth fish opened noiselessly.
Her leg was fire.
She closed her eyes as they slid her trolley into the back of the ambulance. She did not want to see her neighbours watching her. Covered in soup.
Im Jay, a voice said. One of the paramedics. Were taking you in to get you checked over. He put a needle into her arm. This will help with the pain, he said, and before she could stop him, the darkness following his voice like an echo.
Lights and noise and screaming and shouting. Margaret tried to lift her head but couldnt. She felt the leg and the pain and the cold. She smelled the soup on her cardigan and sweat and heard the siren reduce to nothing.
They pushed her into the corridor and there were nurses and doctors and shouting and police around a man who was punching a wall. Full this side, shouted a nurse wearing dark blue scrubs and a pen pushed into her ponytail. Keep her in the ambulance or push her to the line in the corridor.
Jay smiled and held her hand. But Margaret felt her eyes flood with fear. I need to get back, he said. I have another shout. Too many sick people are not being treated and then becoming really sick. False economy isnt it? But were not allowed to call it privatisation. Its written in our contract. He rolled his eyes and looked down the corridor.
Margaret followed his eyes when theyd stopped rolling, down the corridor where trolleys lining the wall on which people like her were lying. Old people. Alone people.
Jay squeezed her hand. Listen to me moaning when youre the one whos ill! Ill try and get some extra blankets Mrs Venn. You still feel cold.
She didnt want to let Jay go. She wanted Dr Zadin to come back. The man who couldnt even speak English. Imagine that. Her head flicked up the corridor where her trolley was so near the wall it grazed her elbow. What was Simons number? There was no point phoning her son, David. What could he do from Australia? Simons number was written next to the phone at home but anyway she didnt want him to worry either and come all that way. Wiltshire wasnt Australia but still, it might as well be. Another trolley went past them with a nurse on top of the patient pressing on his chest, another pushing the doors that swung open to public resuscitation area. Margaret glanced inside though it hurt to lift her head up. It was like a war. Something you see on TV.
Her leg was at such an angle that every time another person or trolley or wheelchair went by it brushed past it, and the fire became ice. Numb. Thats when Margaret knew how bad it was. Her head flew backwards still. She was giving birth again in the barracks hospital, this time to David. Reg was outside, thinking it was her first time. The matron gave her a cloth. Bite on it, she said. Bear down and bite. The pain means youre alive and the baby is alive. Pain is life.
And he came out with perfectly round, non-almond shaped eyes.
She could no longer feel her leg. The wall against her arm was the only real thing. She pushed her elbow towards it until the trolley moved a fraction. Shapes of people whizzed past her. Outlines of nurses and doctors and patients and relatives. She stopped shivering. Stopped moving at all. Even her goosebumps flattened out until her skin, too, was unmoving. She ran back. Margaret was a child, at her parents farm in the valleys drinking milk from the bottle that had a creamy layer so thick it gave her a moustache and everybody laughed. They were all in the same room. Her father was holding her mother, her uncle and aunt sitting playing cards at the table, their grandmother sitting on the chair singing to her cousins who were sitting by her feet:
Ni wna undyn thi gam;
Hunan dawel, annwyl blentyn
And then Margaret was singing the same song to another baby. A newborn baby in her arms. A girl. Everything was dark, and softly quiet, muffled. There was no more shouting, no more fire, no screaming or police or patients or doctors. She wasnt alone any more. There was no more cold. But Margaret could see a nurse walking towards them with extra blankets. She was sure of it.
From the current issue of Index on Censorship magazine, copyright Christie Watson, 2018.