Ink in the Blood: A Hospital Diary

Ink in the Blood: A Hospital Diary
Hilary Mantel

During the summer after Hilary Mantel won the Man Booker Prize for Wolf Hall, she fell very ill. Just how ill is described in her extraordinary hospital diary, orginally published in the London Review of Books.Originally published in the London Review of Books, this diary by the acclaimed author Hilary Mantel explores in forensic detail her loss of dignity, her determination, the concentration of the senses into an animalistic struggle to get through, and the attendant hallucinations she was plagued by during her stay in hospital.With her health now improved, and the acknowledgement of the Man Booker prize-winning follow-up to Wolf Hall, Bring Up the Bodies as one of our greatest works of fiction, Ink in the Blood remains a significant testament to the traumas of illness, and one of the most incredible and haunting essays published in a very long time.

Ink in the Blood

A Hospital Diary

HILARY MANTEL

Copyright

Published by HarperCollinsPublishers Ltd

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London SE1 9GF

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First published in Great Britain in the London Review of Books, November 2010

Copyright © Hilary Mantel 2010

All rights reserved.

Ebook Edition 2010 ISBN: 9780007427758

Version 2019-06-10

The moral right of the author is asserted

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Contents

Copyright

Ink in the Blood (#ucd83db7f-741e-5315-ab3c-0f9f2bbe84c0)

About the Author

About the Publisher (#litres_trial_promo)

Ink in the Blood

Three or four nights after surgery – when, in the words of the staff, I have ‘mobilised’ – I come out of the bathroom and spot a circus strongman squatting on my bed. He sees me too; from beneath his shaggy brow he rolls a liquid eye. Brown-skinned, naked except for the tattered hide of some endangered species, he is bouncing on his heels and smoking furiously without taking the cigarette from his lips: puff, bounce, puff, bounce. What rubbish, I think: actually shouting at myself, but silently. This is a non-smoking hospital. It is impossible this man would be allowed in, to behave as he does. Therefore he’s not real, and if he’s not real I can take his space. As I get into bed beside him, the strongman vanishes. I pick up my diary and record him: was there, isn’t any more.

This happened in early July, 2010. I had surgery on the first of the month, and was scheduled to stay in hospital for about nine days. The last thing the surgeon said to me, on the afternoon of the procedure: ‘For you, this is a big thing, but remember, to us it is routine.’ The operation was to relieve a stricture in my bowel, before it closed completely and created an emergency. But though we had used the latest scans in preparation, neither patient nor doctor could imagine the damage left by the endometriosis for which I’d had surgery 30 years before. Organs were stuck together, pulled out of shape. It took six hours to disentangle the wreckage. When I woke up, my surgeon was standing at the end of the trolley in the recovery room, grey and shrunken as if a decade had passed. He had expected to be home for dinner. And now look!

Hospital talk is short and exclamatory. Oops! Careful! Nice and slow! Oh, dear! Did that hurt? But the night after the surgery, I felt no pain. Flighted by morphine, I thought that my bed had grown as wide as the world, and throughout the short hours of darkness I made up stories. I seemed to solve, that night, problems that had bedevilled me for years. Take just one example: the unwritten story called ‘The Assassination of Margaret Thatcher’. I had seen it all, years ago: the date and place, the gunman, the bedroom behind him, the window, the light, the angle of the shot. But my problem had always been, how did the Armalite get in the wardrobe?

Now I saw that it just grew there. It was planted by fantasy. If a whole story is a fantasy, why must logic operate within it? The word ‘planted’ started another story, called ‘Chlorophyll’. By morning, I had the best part of a collection. But when I sat up and tried to write them down, my handwriting fell off the lines. I kept trying to fish it up again, untangle the loops and whorls and get them back to the right of the margin, and when I think of my efforts then, I think of them in the present tense, because pain is a present-tense business. Illness involves such busywork! Remembering to breathe. Studying how to do it. Plotting to get your feet on the floor, inching a pillow to a bearable position. First move your left foot. Then your other foot, whatever they call it . . . any other foot you’ve got. Let us say you’re swaying on your feet and sweating, you think you might fall down or throw up – you have to rivet your attention to the next ten seconds. After the crisis is over, time still behaves oddly. It takes a while for the hour to stretch out in its usual luxurious fashion, like unravelling wool. Until you are cool, settled and your vital signs good, time snaps and sings like an elastic band.

When I write my diaries I talk to myself with an inward voice. For the next week I am conscious that my brain is working oddly. Imagine you were creating all your experience by writing it into being, but you were forced to write with your wrong hand; you would make up for the slow awkwardness by condensing phrases, like a poet. In the same way, my life compresses into metaphor. When I sit up and see the wound in my abdomen, I am pleased to see that it has a spiral binding, like a manuscript. On the whole I would rather be an item of stationery than be me. It is as if my thoughts are happening not inside my head but outside me in the room. A film with a soundtrack is running on my right side. It keeps me busy with queries based on false premises. ‘Is it safe if I drink this orange juice?’ But I blink and the orange juice isn’t there. Therefore I study reality carefully, the bits of it within reach. For a while I think I have grown a new line on one of my hands, a line unknown to palmistry. I think perhaps I have a new fate. But it proves to be a medical artefact, a puckering of the skin produced by one of the tubes sewn in to my wrist. We call those ‘lines,’ too. The iambic pentameter of the saline stand, the alexandrine of the blood drain, the epidural’s sweet sonnet form.

Within a few days, the staff are tampering with my spiral binding when the whole wound splits open. Blood clots bubble up from inside me. Over the next hours, days, nurses speak to each other in swift acronyms, or else form sentences you might have heard in Haworth: ‘Her lungs are filling up.’ But I have undentable faith in my own body. When I am told I need a blood transfusion, I plead, ‘Let’s give it 24 hours and see.’ I have never been accepted as a blood donor, and I don’t like the idea of a debt. When the blood comes, the stranger’s precious blood, it leaks everywhere from the cannula on my neck, which needs to be taken out and resewn. The night sister looks meaningfully at the vampire’s kiss and says, ‘Another two of those wounds would do it.’ Finish me off, she means. She is real but I accept her words are not. A hallucination has to be gross before I can pick it.

My internal monologue is performed by many people – nurses and bank managers are to the fore. There is a breathless void inside me, and I think it needs to be filled. I should put money in it, I think. Like a cash machine in reverse, notes slotting between my ribs. Certain items are taken away – the drain that takes blood from my side, a bridle that feeds me oxygen – but they are never taken far enough away, they easily come back. I clamp a smile on my face and drift. I have a switch I can press for ‘patient controlled analgesia’. But the staff seem uneasy about giving up control over my pain. Some say I am pressing the button too often, some say too seldom. I want to please them so I try and make my pain to their requirements.