Authors: Elizabeth Cooke
He frowned, shook his head. “I’m getting ahead of myself,” he told her. “We need to do the tests—”
“What is aplastic anemia?” she insisted. “What made you say that?”
He looked at her for a moment, saw that she wasn’t about to be moved. “When you look at aplastic anemia on a blood film, it looks like nothing else,” he said.
“And that’s why you said—”
“I want to be a hundred percent, Jo,” he told her.
She did, at last, get to her feet. She heard her own voice shake for a second as she began. She gulped down air; restarted the sentence. “Suppose … It’s a hypothesis, right?” she said. “At this moment … at this minute?”
“Yes,” he said.
“Okay,” she answered. “This hypothesis, aplastic anemia. Tell me about it. It’s not anemia. It’s not what I thought, is it? Not something simple?”
“I don’t—”
She really tried hard to stop herself screaming at him. “Will you please give me a straight answer,” she said, “for Christ’s sake.”
His eyes ranged over her. “Sit down,” he said.
She did so; he followed her, moving his chair so that it directly faced her.
My God, here it comes
, she thought.
What is it, what the hell is it?
“Aplastic anemia, if this is what Sam has,” he said slowly, “is a serious illness, as serious as leukemia. It’s a life-threatening illness,” he said. “If the … hypothesis is correct in Sam’s case.”
Jo took a long, slow draft of air. Screwed the tissue to a ball in her fist. Her heart began thudding again, but slower and heavier. Each beat a blow in her chest, as if it were struggling to do its job. Each beat a needle of pain.
“I’m very sorry,” Elliott said. He got up and went to the door of the room. Jo glanced up and saw Sam. Her son was sitting with his legs dangling down the side of the bed. He was twisting the arms of a teddy bear this way and that. The nurse was holding a reel of bandage, and he was winding it around the bear’s arm.
“Could we have some tea?” she heard Elliott say.
“Yes, of course,” someone replied.
Elliott came back in, and sat down again. “Are you all right?” he asked.
“No,” she murmured. “Aplastic anemia. I never heard of it.”
“It’s a rare disease,” he was saying. “We get maybe a hundred, a hundred and twenty, cases a year in the UK. The number is rising. Most of the people who get it are between fifteen and twenty-four, and over sixty.”
She gasped. “Then Sam can’t have it,” she said. “He’s only two years old.”
“There have been cases of children born with it, I’m afraid,” he told her gently.
“
You’re
afraid,” she snapped. Immediately regretted it. “I’m sorry,” she said. “The GP said that this morning, that he was afraid.”
“I’m sorry,” Elliott said. “It’s a turn of phrase. We know we aren’t as afraid as you. We know we never will be. We
hope
we never will be.”
The nurse came in, carrying a tray of tea. She put the tray down on the desk and, as she left, propped the door farther back to ensure Jo’s view of Sam.
“People with aplastic anemia don’t produce good blood cells,” Elliot continued slowly. “When we look at the bone marrow under a microscope, we see a large number of fat cells instead.”
“But how would he have got it?” she said. “Would he have caught it from somebody?”
“No,” Elliott told her, “it isn’t catching. But we might find that Sam also has an immune-system problem. Sometimes they go hand in hand.”
“Could I have given it to him when I was pregnant?”
“No.”
She thought. Then, “When I was three months pregnant, his father died,” she whispered. “Could the shock have done something to him? Hurt him, before he was born?”
“It’s impossible to say. But it’s unlikely. Don’t think that way. It’s not your fault.”
“But it must have come from
somewhere.
”
Elliott spread his hands. “We’re just guessing,” he said. “We suspect things like radiation, or benzene, or hepatitis, or antibiotics—”
“Antibiotics?” she repeated, aghast. “Sam’s had several, for his chest infections.”
“We just don’t know. It might be the cause. Equally, it might not. It just suddenly starts. The patient gets tired and pale; they run out of steam; they bruise easily. Sam’s bruises are very characteristic. They’re caused by a low platelet count.”
She put her hands to her face briefly. “I don’t understand it,” she said. “I can see he’s tired. I can see he’s bruised. But he runs about. He plays.”
Elliott nodded. “I know,” he said. “But the blood-film report is really clear. Aplastic anemia looks very distinctive on a blood film. It’s like nothing else. In fact, the blood film shows a
lack
of abnormalities—that, combined with the other tests, would be classic AA.”
“But you’ll double-check,” Jo said. “You’ll do something else?”
“Of course,” he told her. “That’s what I’ve been trying to explain to you. Look, I’m sorry this conversation got this far. That’s my fault. It’s worrying you needlessly.”
“I asked you,” she reminded him. “I insisted.”
He put his hand briefly on hers. “We’ll do an aspiration. Sam will need just five minutes’ anesthetic in the morning. We take a little marrow from his hip.”
Jo shuddered involuntarily.
“The good news,” Elliott added, “is that, ten years ago, seventy percent of people with this died. Now, the same percentages live. We’re breaking new ground all the time. New drug protocols—”
“Is that what you would do for Sam?” Jo asked. “Give him drugs?”
“Sam would be started on what we call immunosuppressive therapy,” Elliott said. “He would have ALG—antilymphocyte globulin. That knocks out T cells. And cyclosporin. That inhibits T cells.”
“And these T cells could be doing the damage?”
“T cells will attack the marrow. The body turns on itself. We try to stop it.”
Jo glanced back to Sam. She tried desperately to get her head around the idea that something inside him, his own blood, was attacking him.
“What if it didn’t work?” Jo said. “What else can you do?”
“We try to give it a chance to work,” Elliott said. “Occasionally the marrow regenerates and starts working again of its own accord. Or rather, with a kick up the rear. We take blood weekly to see how Sam’s doing. We give him blood and platelets.… We always try to think positive.…”
“But what if that doesn’t work?” Jo said. She tore her attention from Sam and looked Elliott in the eye.
“Think positive,” he repeated kindly.
“Worst case,” she murmured. “Please, tell me the worst case.”
Twenty-three
In August a camp was established on Cape Felix, on the shore of King William Land, four miles from
Terror
. The shore party was made busy, on Captain Crozier’s instructions. Establishing the camp itself; setting traps; collecting the magnetic observations; cutting the deep fishing holes in the ice, which as soon froze over unless there were six men to each, hacking at the ice to keep it free, and a canvas cover tented over them.
Gus had begged to be brought here, even though it was less than a week since he had been bled on board the ship. The men had told him that bleeding would do him good, but he did not know if they were right. He hated to see the thick, viscous fluid come out of his arm: it made him feel mortal, human. It made him feel that he might die, because all he was was just a collection of bones, and this red blood that trickled into a bowl.
He hadn’t slept, let alone dreamed, for two nights afterward. He felt that something had really been taken from him, and that if he closed his eyes, he would cease to exist. Finally, he had fallen asleep at the very foot of the deck ladder, and been carried inside, and put in the sick bay. He dreamed then, and no mistake. Fish leaping from the ice and into his bed. Arms wreathed in winding sheets. His own blood dancing in a rivulet and the same fish thrashing in it and choking, and dying. Dreamed of other fish too. Fish in the canals of home. Wood boxes of sea fish on the quayside. The knee-deep viscera of the great fishes, the whales on board his uncle’s boat.
He tried to draw himself now from the same kind of reeling sleep.
Early that morning half the shore party had left the tents and trekked for a mile or more following the trail of reindeer. Gus was desperate to be with the men who carried the rifles: he wanted to be allowed to fire, as he had learned on Beechey. Heavy with their coats and furs, however, they had not got far before a fog came down, obscuring everything.
“God blast this weather,” one of the mates said. “I never saw the like. Where is the damned summer?”
They had turned back; but the fog got worse, and Gus, bringing up the rear, had lost his bearings. He could hear the voices of the men ahead—and several times they turned back for him—but he had fallen, and, while getting up, he had lost them. For a while their voices seemed to come from all directions, and he stumbled in their tracks. The ground was a little higher: scree and broken shale showed through the hummocks of snow. He floundered around before having the sense to scoop out a hollow in the snow, piling it, as best he could, around him, in a slight depression of the land.
For a while he slept.
And once, thinking he woke, he thought that a pair of hands had pressed something between his own palms. He had looked up, through the mist, and thought he saw a face—pretty, female. Even with the tattoos that ran from the corners of her mouth to the corners of her eyes, she was lovely. But looking down at himself afterward, he could see nothing except a few dry flakes, iridescent scales, on his gloves.
They found him again at midday.
“Augustus!” cried a man’s voice.
He screwed his eyes against the distant glare of the horizon. Deeply asleep for the last few minutes, he had imagined himself in a beautiful polar night, the night of summer that never grew truly dark; the shoreline thick with ice, the frozen sea beyond, and the orange of the sky reflected, in long trails of light, over the blue ice and sea and shore. Just on the horizon there was a brilliant gold line, almost too bright to look at. He imagined it would be like that when you reached heaven: a thread of gold blazing into day. But now, opening his eyes, he saw the mist draining away, and the long sloping landscape in front of him.
“He’s here, sir! Here!”
Four men were approaching. He squinted to see the faces.
The first was John Handford, one of the able seamen. He dropped to his knees and began chafing Gus’s face.
“Where have you been, boy?” he shouted. “God look at you, frostbit. Where did you go?”
Gus couldn’t tell him. A second face loomed out of the grayness. “Is it he?”
“Aye, sir. Frozen.”
“Get him up. Walk him.”
Gus could not resist. He looked at Irving, one of the lieutenants. They hauled him to his feet. His legs refused to bend.
“Carry him,” Irving said.
Handford stared at Irving but a moment; then he hauled Gus onto his back.
“There are tracks,” Irving said. He was peering at the ground.
“Animal,” Handford offered.
“Not animal,” said the third man, now coming alongside, heaving for breath, and looking sick at the effort. “That’s a human print. Not a boot.”
Irving turned Gus’s face toward him. “Has there been someone here?” he demanded. “Peterman … was there anyone here?”
“A girl,” Gus breathed.
There were twelve officers and some forty men on Cape Felix.
Taken both from
Erebus
and the
Terror
, they had set up three tents. Boarding poles were used as tent poles, and bearskins and blankets lined the interiors. Fireplaces were made near each tent. Here they cooked and smoked. They had a copper cooking pot that had been made on board ship, and they used what timber they had brought from both vessels for fuel.
Crozier had ordered that Cape Felix should be self-sufficient and use no tinned goods at all. He organized the fishing parties and took the hardiest men farther onto land, where they had trapped foxes, and found ptarmigan. Some of the men complained at the constant diet of fish, almost raw because the small amounts of timber would not let a fire go for long. But Crozier had insisted upon it.
“You’ll be better for it,” he had told them all. “The native Indians eat their food entirely raw. They do not have scurvy. We shall live entirely as they do while we are in camp. We shall copy them. We shall find how they survive.”
It had been an unwelcome gospel.
Most of the men did not want to live as the Esquimaux lived. They were English; they were not savages. It was said in England that those men who came to the Arctic and lived as the Esquimaux lived did not deserve the same status as those that survived, and lived, as Europeans. To do so was a descent from grace; to do so would forfeit their heritage. They would allow themselves to fall back to what man had been millennia ago.
They had been taught since childhood that Christian man, the white man, had a duty to convert the unknowing tribes of the earth to their ways, their knowledge, and their advancement. To live as a native was to rescind that understanding; it was to allow the native to have superiority over the European. It was an admission of failure and weakness.
But they could not disobey Crozier, who was their most senior officer. They were obliged to follow his orders.
His constant preaching, though, irritated them beyond measure.
“When the Esquimaux, who some call Inuit, eat, they do not bother, necessarily, with fire,” he had told them, as the fireplaces were built on which they were to try to boil their lukewarm tea. “On other voyages I have purchased sealskin bags,” Crozier went on, “and found great quantities of venison and salmon, and the paws of walrus. And this they eat raw, most happily, even though the meat may be over a year old.”
“Sweet heaven,” Handford had grumbled.
Crozier had continued determinedly. “And they enjoy a delicacy,” he told them, “of the raw liver of caribou, cut in pieces of an inch square, and mixed with the contents of the animal’s stomach.”
They had huddled around the brief fire. It had been made from a pike pole, the metal tip having been sawn away.