The Tell-Tale Heart Read online

  Dedication

  for Meredith

  simply the best

  Epigraph

  I sleep, but my heart waketh.

  Song of Solomon 5:2

  Contents

  Dedication

  Epigraph

  Part One

  Part Two

  Part Three

  Part Four

  Part Five

  Part Six

  Part Seven

  Part Eight

  Acknowledgements

  An Excerpt from The Crime Writer

  About the Author

  Also by Jill Dawson

  Back Ad

  Copyright

  About the Publisher

  Part One

  Helen looms into view as I come round. It might be days since the operation. I’m no longer in ICU but somewhere else, who knows, perhaps a private room. Helen, in all her loveliness, sailing towards me. It takes me a moment to realise that she is fifty years old and no longer my wife. The room is grey and deathly. I could be in the mortuary but no, dear God, here’s Helen gliding in – what a trouper! – Helen in a glorious splash of colour, cheeks glowing. It’s almost unbearable, the aliveness, the brightness, the sweetness of Helen – the shining chestnut of her hair, the eye-pricking green of her jumper. She is holding something out to me and moving her mouth; perhaps she’s talking.

  When I make no reply she pulls things out of her bag. I can’t easily turn my head so I try to indicate interest – gratitude – with my eyes. I’m hooked up to an IV. They told me that when I woke up I would find an endotracheal breathing tube taped to my windpipe and that I would not be able to speak. The tube is connected to a respirator, doing my breathing for me; Helen is doing my talking. Oh and now, just to complete the arrangement, someone else’s heart is pumping the blood through my veins. Story of your life, Helen would no doubt say.

  Helen shows me the gifts – a welter of colours. A can of Lilt and a packet of flower seeds. And a hospital leaflet: Your Recovery After Beating-Heart Surgery. Looking after Your New Heart: A Guide for Patients and Carers.

  Ha. We both know that’ll go in the bin.

  ‘Sorry about the Lilt,’ she says. ‘Hospital gift shop. Unless you want a ghastly sweatshirt with a Papworth Hospital Trust logo. And these—’

  ‘These’: a packet of seeds called heartsease. Giant Fancy Mix. Pansy seeds to brighten your garden.

  Helen gazes at the small red packet, presumably looking for the apostrophe.

  ‘Ah. I’ve just read the packet. You have to sow them Feb to April. Next year. But that’s nice, isn’t it? You know. Next year.’

  She puts them on top of the grey cabinet next to the bed.

  Helen. Bloody good of her to come. Hadn’t seen her for a few months, before all of this. And yes, I get the implication. Now I have a next year. I put my hand up and touch my throat as if I’d like to say something. Perhaps there are tears in my eyes. Helen glances around. Seems to be wondering whether a nurse will come and tell her what to say next. As one doesn’t, she sits down anyway beside the bed, turns her gaze towards me: a headlamp flashing onto full beam. I close my eyes and squeeze hard; I don’t want to seem rude, Helen, but you’re almost too much for me. Too alive. Too sparkly.

  ‘Bit like a golf club, this hospital somehow, isn’t it?’ she says, as if in answer to a comment of mine. ‘All those lawns.’

  She is fidgety. Gets up, shifts Transplant News magazine from the bottom of the bed to beside the leaflet at the top of my metal bedside cabinet. Sits down again.

  ‘Glorious weather for October, though. Glorious. It’s like The Truman Show or something, you know? There are fires. Smoke in the sky. On the way here, I mean. Something on the news about fires near Ely. Stacks of straw. There’s black smoke over the roads. I don’t know, maybe it’s the weather. Too hot for autumn really, isn’t it? It’s not right. There was even an old couple on the grass picnicking. You know, deckchairs and a flask and everything.’

  Between her pauses the room is deathly quiet. Soundproofed perhaps. Muffled. I could indeed be in my coffin, lying in padded grey silk. Perhaps I hear a TV murmuring somewhere. Hushed voices. Trolley wheels, the soft hum of machinery. I have a sudden tiny image of myself, lying in the operating theatre, my chest sprung open like a birdcage, with the door wide and the bird flown. Robbed. Like Thomas Hardy; wasn’t he, horribly, buried without his heart? Some dim memory of a story about a biscuit tin. The dog eating the heart, which had been kept in a biscuit tin, and Hardy’s friends having to bury someone else’s heart. Body and soul separated.

  ‘How long do you have to be here for?’ she asks. Her eyes stray towards my throat, to the tube there and somehow down to my chest, the grey, sprig-patterned hospital gown, as if reading my mind.

  I daren’t put my hand there. Like a letter lifted from an envelope, something else slipped in its place. I haven’t yet checked the wound. I try not to look when they come to dress it. So many wires and bindings; I feel like a mummy. I swallow, trying to wet my throat; a searing dry pain is there. Helen shakes her head gently as if to say: no, don’t struggle, it’s fine. I’ll do it. I’ll talk, make everything OK for both of us, isn’t that what I’m good at?

  ‘Nice to have a private room. You’re lucky. We have a perfectly wonderful NHS, but then again . . . At least you’re not taking up space in the general ward, stealing a place away from somebody else. This nice chap let me off with the parking. It was two pounds fifty and I only had two pound coins and he said, oh well, tell me which is your car and I’ll cut you some slack! You wouldn’t get that in London, eh?’

  We’re interrupted then. Helen falls silent while the male nurse comes to take my blood pressure and ask if I want the bed raising. I can’t shake my head so I shake my hand and he takes this as a no. Nurse Adam. He looks awkward. He glances at Helen and puts his hand to his own throat and says:

  ‘You know about infection, of course. That’s the main thing. He’s on very heavy immunosuppressants. Even a cold, a common cold . . .’

  Helen gives him such a brilliantly withering look that, if I could, I’d chuckle.

  ‘I know that,’ she says. ‘I don’t have a cold.’

  Nurse Adam nods and leaves. Helen waits pointedly for the door to close again and then leans in close. She bites her lip and puts a hand out, patting the sheet where my arm must be.

  ‘I got a bit lost coming here. You know me. And I saw the sign. Mortuary. Chapel of Rest. I thought: That must be where he is. If it is a he. I suppose it could be a woman. Did they tell you? Is it all a bit hush-hush?’

  I want to lick my lips, crackly with lack of moisture, but my tongue won’t move.

  ‘When you’re up and about you could go there, you know, Patrick. Pay your respects.’

  I don’t know what my eyes convey but Helen registers it.

  ‘No, you’re right. He – whoever’s probably long gone. They’ll be planning the funeral by now.’ She pushes a curl of hair behind her ear. ‘I wonder if the family knows. About you, I mean.’

  She glances out through the glass in the door to the ward beyond, as if the family might be waiting there, ghouls all, ready to pounce and snatch back their gift. Nosy as ever, she darts forward to peer into the little cupboard next to the bed where folded trousers and shirt, my toothbrush and paste lie side by side in lonely bachelorhood. She shuts the cupboard door and smiles apologetically.

  ‘It’s odd, isn’t it – no flowers. I thought hospitals were full of flowers. On the way here, there was this funny place called, I think it was, St Ives, like in Cornwall and there were these buckets of flowers, I can’t remember what they are, must flower quite late, pinks, is it? – anyway, they were outside a house. And pumpkins for Halloween
. Carrots. Just 60p a bunch for the pinks. Isn’t that nice? That they still do that round here? Money in a little tin and not worrying about getting it nicked. And I bet you’ll never plant these.’

  She flaps the heartsease disdainfully.

  ‘It was sudden, wasn’t it?’

  The word ‘harvest’ floats into my head. They used to say that they harvest the organs; I don’t know why. And it’s October, it’s harvest time. Safely gathered in.

  ‘All those tests. I thought you’d be on the waiting list for ages. That’s what Alice said. Poor Alice. She was so worried about you. And then – well, she rang me Monday night in hysterics, said you’d gone in, you’d got the call, all so suddenly, an ambulance, you were at Papworth.’

  She’s biting her lip. ‘Some people wait for years, Patrick. Some people never find a – they must have rung you Monday, yes? That must be when he – when they heard. . . . He, she, they must have carried a card. You’re lucky, you know.’

  God knows what drugs are coming through that IV. Though I see her mouth is moving I can hardly concentrate on Helen’s words. The most powerful hallucinations are forming and fading in front of me, random words floating, and pictures. Roadkill. Squirrels squashed on the side of the road. Blood, a fox’s tail, mostly flattened. A heart bouncing alone, like a yo-yo with no string, into a river.

  ‘I asked him. The doctor. The Scottish one. The ugly one with the beer gut? Yeah. He said it all went well. That it’s only the third time they’ve done it that way. Beating-heart surgery, it’s called. Weird, isn’t it? You’ll be here for a while. Don’t worry, we’ll visit . . .’

  Don’t go. Don’t go yet. Keep talking.

  ‘Alice will come tomorrow. I’m taking her stuff up to Cambridge this weekend but she’ll come tomorrow and maybe Friday too. I don’t know about Ben. Might be a bit much to ask of Ben. Is there anything you want Alice to bring you? You know, more cans of Lilt?’

  Oh, Helen. What’s wrong with me? ‘Thy hyacinth hair, thy classic face.’ You look so lovely to me, so lovely with your freckles and your habit of fiddling with that necklace and your eyebrows that almost knit in the middle and make you look like you’re frowning when only I know you’re not, you’re not frowning at all! You’re concentrating. Any minute now, no matter how serious your face might look to others, to colleagues perhaps or those you meet in court, no matter what they might think, only I know that any minute you could burst into loud giggles, that giggling is never far away for you, is it, such ease, the way you bubble up sometimes, how irrepressible you turned out to be . . . Helen. Oh my God. I feel an ache in my chest, a pain so severe it’s like something is thrashing there, like a wire when you accidentally step on one end of it, whipping up at the other end. My hand wants to fly to the pad of bandages at my chest, but I refuse to let it. Is it a real feeling? Is it a physical one?

  ‘You have a fully functioning, healthy heart now. Look after it.’ Did some consultant doing his rounds actually say that to me, or am I imagining it? Patronising git. Like my old one was . . . Well, I suppose I was ill, OK, he has a point, but I don’t like his phrase: fully functioning. It’s damning, somehow. Like the bastard is saying I wasn’t fully functioning before.

  ‘It’s sort of creepy, though, isn’t it,’ Helen says, not meeting my eyes.

  She’s twiddling the buttons on her black jacket, the smart professional woman’s jacket she took off earlier and draped over the back of her chair. Now she has it across her lap and is fiddling, one by one, with each button; twirling it. Her fidgets always irritated me. Now I’m transfixed.

  ‘The beating-heartness of it all, I mean, like a live animal or something? I can see the point, of course, can’t you? That they can keep it viable, you know, that if there’s no need to pack it in ice you get a bit longer, allow them time to transport it . . .’

  Her voice trails off.

  ‘I hope the roads are cleared by now. Those fire engines. I have to be in court by three.’

  She stops fiddling with the buttons and decides to put the jacket back on.

  ‘Well, I hope you feel better soon. So they didn’t – did they – do they – you know, tell you anything about the donor?’

  I give a tiny shake of my head. She smiles then; that shake was my first proper reply. She nods and stands up.

  ‘Patrick. I do have to go now. I’m so sorry, love. I’m due back in court.’

  Love. The Yorkshire term of endearment she can never quite stop herself using, even when she most patently doesn’t mean it. I watch her, watch the way her breasts jut out as she slips her arms into the black jacket. I think for the first time of what is under there. Under the black linen, the green jumper. Under her bra, under the lace and flesh of her, under the white freckled skin, the fine curved ribs. When you peel it all back. I see it for the first and only time and it’s a shock. What is it like? I know very well: I saw mine here on a screen. From a distance it looked like a baby alien, a sort of ET with a giant, all-seeing eye, moving, pumping, grimacing at me. The colours were all wrong too: livid purple and gold. That was before they explained it. The superior vena cava. The right atrium. The large aorta. The pulmonary artery, the mitral valve. I know, I know. I was married to her for sixteen years. It’s beautiful. It’s red in tooth and claw. It’s alive.

  She closes the door behind her. Through the glass I watch her move into the ward beyond. Her upright shape, the backs of her heels, her splendid posture: all those years of wrenching her shoulders back manfully, putting up with me, shouldering. She pulls and pushes the ward door before managing to figure out the huge button on the wall that releases it, and looks back through the window at me to give a rueful smile over her shoulder, as if we both expected this.

  A drumming starts up in my temples: tears threatening. For God’s sake, what on earth is wrong with me? I rub my eyes, hard. I don’t think I’ve cried since 1984. Just my luck: must have been a weeper, my donor.

  A ridiculous thought. Everything tumbles and crowds me: a sick feeling sweeps through me. My back prickles cold with sweat. God, I hope I’m not about to throw up.

  Helen didn’t kiss me when she left. There was only one, very small moment when I wanted to tell her about my unseemly, unmanly outburst of the night of the operation, how I wasn’t calm or prepared; fuck, I wasn’t even barely competent or adult. I wanted to ask her if any of the staff had mentioned it to her – that Scottish doctor, he must have mentioned it, surely? I wanted to be honest to someone, to fess up, be reassured. I was shit-scared. That’s what I was. Practically blubbing. The space between being told: your heart failure is now so advanced that you won’t live another six months and yes, we’ve found a donor, we can go ahead and operate – barely the space of eight weeks, hardly time to function, let alone ready myself. And in the middle of that, at work, came the letter, the accusation and the pending investigation . . . Then, as if that wasn’t enough, beating-heart surgery is new, there is an increased risk. Only the third time it’s been done that way.

  In the middle of all this – I mean, in the middle of the operation – I suddenly saw a bird. In the hospital. Fluttering above my bed, wings outspread, beating heroically to master a strong wind. A kestrel. Only it wasn’t in the hospital and neither was I. I was on a long grey road, flat as a ribbon laid along a landscape, a road like a runway, leading directly to the sky. And in that white sky, a lone kestrel.

  And if it’s not a hallucination then it’s a memory: the green masks of the operating theatre, the scrub-nurse just before, shaving my chest; the strange underwater lighting, their eyes all peering at me, above the masks, the soft swish of green curtains sweeping closed around my bed. Going under, deeper.

  There was a moment when I was cracked open on that bed, emptied. Rigged up, machines doing my living for me. Awaiting. My heart lifted out and somewhere else. I shouldn’t be alive; I must be monstrous, or magical. No human being can have their heart scooped out of their ribcage, be without it, while they await another, and live, can
they? It’s inconceivable.

  Nurse Adam, the morning of the operation: This will be your life now. Four different pills to take. The itch of the stubble on my chest, wanting to return. The staples in my chest.

  And then that other moment: in the green watery theatre, that object they wheeled in, smouldering like a witches’ cauldron, with something steaming and sputtering inside it. I didn’t see it, of course, I was anaesthetised by then. But in another way, I remember it perfectly. That cauldron held my donor’s organ. Littleport, I heard the scrub-nurse say earlier in ICU. That’s all I knew. The ambulance was bringing my heart from Littleport.

  This is my only clue. Later, on my BlackBerry, I Google it. Littleport: the largest village in East Cambridgeshire, six miles north of Ely. Probably takes its name from the Latin word portus, meaning a landing place. Was once an island, before the Fens were drained, surrounded on all sides by fens (fields), meres (lakes) and marshes. Famous for the Littleport riots of 1816.

  No man is an island. Littleport was. I am now. A strange man, unlike any other. I’m a burglar, carrying off the heart of someone else, one that doesn’t belong to me. I’d like to go back to my old self, to my old life, but I have a curious, powerful certainty: my old self won’t have me.

  This morning I had my first heart biopsy: the best way to detect rejection, I’m told. Snipping a little piece of the new organ so soon? Then a chest X-ray. Then an ECG. I get to see my new heart on the monitor. That freaks me. There it is. The right ventricle and the left ventricle are pointed out to me. ‘Look how pretty your new heart is,’ says Dr Burns. He’s grinning like a madman. It’s been champagne and newspaper reporters for him since the surgery, and Helen’s right: he is an ugly bastard. I’m scratchy with lack of sleep but exhausted with a weariness beyond anything I’ve ever felt. Dr Burns tells me that two journalists from the local newspaper are here again and whenever I’m ready they’d love to talk to ‘Papworth Hospital’s Third Successful Beating-Heart Transplant Survivor’. I ask Burns for a Zopiclone and he says he doesn’t believe in sleeping tablets.