Diagnosis

George has not slept well since he was born. It’s been six months now and his record sleep still stands at four hours in one burst. He feeds for an extraordinary length of time. He will guzzle on one boob for at least forty minutes before starting on the other. Tracy counts the gaps between the start of one feed and the next.

‘He went four hours this morning’

I never want to point out that he actually managed about two and a bit hours between snacks. The boy likes his food. His Mum is doing an incredible job. She is tired. But extraordinary. It’s been six months now and she asks me often to stop looking at her so unnervingly. I can’t help it, ever since that fifty two hour labour I feel as though I should bow down to the ground each time she enters the room. She is happy. But she is tired. We all are. And of course it’s worse now that, for the first time in is short life, George is sick.

Trace and I have noticed that he’s drinking an awful lot more than he normally does. And he’s wetting through his nappies in the night. But then he does drink an awful lot of milk, as for some reason he seems to still be very hungry at night time. He vomits badly on the Friday night before we are due to go to a wedding. The day after the ceremony we are to head to Cornwall on a train, a journey which will take six hours. On the morning of the wedding looks dreadful and I am too nervous to take him to the wedding. My main concern at this stage is that George will infect our fellow wedding guests with whatever he has. Baby bugs are generally short lived but often very aggressive. And very spectacular. I make a phone call to the groom. Or the bride. Not the bride. But it’s a ‘civil partnership’ so I guess we have two grooms. It’s my fellow playwriting friend Jason who is to be married. A lovely guy, warm and kind and always the type of person to be there and support you when you need him. The worst kind of person to feel like you are letting down. But I am sure that George should not attend this wedding. His life is about to change forever in the most wonderful way. So is mine. Only I’m not sure how much either of us knows it yet.

So we stay home from the wedding. But we travel to Cornwall the next day on the train. George hasn’t been sick again but he is still peeing an awful lot and waking through the night. And much more irritable than normal. I manage to placate him on the train by walking him up and down the carriage. When I take him to the partition between carriages, and open the window, the sound of the travelling train lulls him into a sleep. The only time he is really happy is when he is asleep. The holiday is tough going. George is rarely his usual self. And I shouldn’t be embarrassed but he is with his cousins. He’s with my brother. I’m so desperate for them to see my boy as a happy child and for my brother to see that I am a capable Father. This is a feeling I think parents have often. You are always so desperate for people to see your child at their best. For them to fling their joy all over your loved ones. And for your loved ones to adore them just the way you do. I want them to see Georgey, fun, giving, sensitive, cheeky, kind, silly, gentle and joyful. Yes, he is only six months old but he is all of those things. His character dominates our house in the most wonderful way. But George cries. A lot. And sleeps a lot in the day. And very little at night. When he is peeing though two night suits. And we are constantly exhausted. As we walk back to the cottage one evening my brother asks me how I am doing. Am I coping with being a Daddy? I tell him that I love George with every last cell in my body but I cannot but help to think to the year before when things were very different. Tracy and I were about to tie the knot overlooking the beach. And I had never been so relaxed and happy in all my life. I feel guilty for having such thoughts. But better for confessing them to my brother. He tells me that it’s natural to feel like this. That those thoughts go through everyone’s minds. And that things will get easier.

And when we return home George still struggles to sleep. His breathing is becoming a little shallow, as if he has something on his chest. We talk about him George to the GP but decide to leave if for another day. We don’t want to be those neurotic parents who take their kids to the GP at the first sign of a cold. We know all about these baby bugs, we’ve seen them through our Nieces and nephews. It will pass. And if we do make a doctor’s appointment he will only be running around a doctor’s office smiling and laughing while we try to convince them that he was ‘very sick when we rang’. But the peeing persists. But then he is drinking a lot. And it is warm. We are being incredibly rational and calm. At least we think we are. But then George vomits in the night. And that is the final straw. We have to check him out. So Tracy rings the GP and asks for an appointment.

It really starts to accelerate as I leave to go off to work for the day at the Royal Court. I am up with George early. I get him out of his cot. He’s soaked through again. I think it must be simply because he is drinking a lot of milk through the night. I change him and smile at him. Pull lots of silly faces in the hope of a smile. He manages a limp grin, almost as if to stop the mad gurning Dada and get him to give me some more milk. He seems to be working hard to breathe. I tell myself that he must have had a chest infection. It would explain why he’s been so ratty for such a time. But I don’t understand the vomiting. One thing I’ve learned through being an uncle is that kids are sick. A lot. In fact it’s quite rare for a small child not to be permanently ejected green gunk from their nostrils and coughing as if they’ve been on 80 Marlboro’s a day. But he is working so hard to breathe. I am a little bit worried now, but happy that we will soon get all the assurance we need from a professional. I ask Tracy if she’d like me to stay but she says there’s really no need. They will just relax and watch some TV. She can let me know if he’s sick.

And then nothing until…

530pm. I get a text. It reads

Had to take George to casualty 🙁

To say that texts messages are a little inadequate at times is quite an understatement. The sad emoticons don’t do it for me at the best of times but this one drives me a little crazy. I tell myself that Tracy must just be busy looking after George. But Casualty? Casualty? I rush through to the office and tell them what’s going on. I am shooed out of the door with a ‘Go now. Go now’. I think I’m being very calm when I tell them all this but my voice wobbles involuntarily.

‘Go.’ She says. ‘Don’t worry about anything. Go. Go.’

I run out of the office and am just about to run down the steps to the tube when I get another text.

‘With Tracy and George in A&E waiting for the doctor. George been sick but is ok. GP wants to be safe’

That’s a bit better. That’s from my Dad. He must have gone with them.

But I’m still running when I hit the Tube platform. I tell myself that I shouldn’t panic now. Everything is fine. My Dad says so. My thinking isn’t quite clear. George was throwing up spectacularly in the night. The comforting and the cleaning take time. And the recovery from such an ordeal takes even longer. And there is no sleep during all of this. But kids do this.

I get a train to Norbiton from Wimbledon and I sprint from station to the hospital, my heavy lap top smashes against my legs as I run and I’m quickly out of breath. Sleep deprivation can sometimes make climbing a set of stairs a real challenge. As if your lungs are being sat on by a small cow. I get to the door of A&E and realise that I need to look calm. And happy. And make George smile. He always smiles when he sees me. And he reaches for me. He always reaches for me. It’s heavenly.

I stop and breathe for a moment and feel a little embarrassed for being so melodramatic and running. And when I reach the bay and I see George. He looks weak and sick. Very sick. He writhes limply in my Dad’s arms. He sees me. He reaches out an arm for me. His eyes are clouded and he looks utterly exhausted. There is no smile. Very little sign of ‘George’ in any of his face. He looks like he’s in agony.

A nurse comes down to our bay and tries to get some blood from George. A routine blood test she says. She has great difficulty getting any blood from George. His skin is milky white, without even a trace of blue wire underneath all the podge. He writhes in pain as she continues to try. She then leaves in a hurry. She returns ten minutes later. And by now George is looking really quite distressed. He is like his mother in that he is such an easy laugh. But nothing I can do will illicit any response other than this anguished look of pain. A nurse and a doctor then return. There is another unsuccessful blood test. The doctor shines lights in George’s eyes and ears. And then looks concerned. And tells us that we will not be going home tonight. Both Tracy and I sink at this suggestion. Surely if he has a chest infection we can just take him home and look after him? It’s terrible that the first thought it almost one of irritants, frustration that we will not return to our bed. But George has been sleeping truly terribly for over a week. Last night was almost entirely sleepless. Tracy and I are at the end. And surely if it’s just a chest infection we need some medicine, and we need to get him to bed?

We are hurried into another bay where we wait again. And when a consultant arrives he says they are going to take a test for ketones. I have no idea what these are but quickly figure out that they would be bad news. The nurse takes the test and looks to the doctor. Her eyes are wide enough to look fairly terrified. And the doctor’s shoulders fall a little. He looks at me,

‘He has ketone level of six. This is diabetes. Your son has diabetes. Is there any history of diabetes in your family?’

I tell him no. And then ask Tracy if she knows of anyone on her side. There is no one. And silently wonder what the fuck is a ketone. I think the doctor has this wrong. Why is he in so much pain if he has diabetes? The doctor explains that George’s situation is serious. They will try and do some other tests but he thinks he has diabetes. And then he goes. What?!? What is diabetes? Something to do with sugar isn’t it? Too much? Too little? Something that overweight and old people get, isn’t it? George is six months old. What are they talking about? Incredulity doesn’t quite cut it at this point. Why is he so sick if he’s only got diabetes? Why do they all look so concerned?

George in the bay now. And my Mum is here now. She visibly shudders when she sees George struggling on the trolley. We tell her about the diabetes diagnosis. She asks us why George is struggling to breathe so much. We have no idea.

A nurse called Janine comes into the bay. She asks us if anyone has talked to us yet.

‘Has anyone explained this to you? Do you know what the doctors are doing?’

She looks pissed off that we haven’t been communicated with efficiently. She looks us dead in the eye and speaks very calmly. She tells us that at the moment George has a very high level of ketones in his blood. She explains that it is very important that they flush them from his system. They will get a line in that will deliver saline and begin the flushing process. She also explains that a transferal team from Guys & St Thomas are on their way to take us to their hospital where they have all of the necessary equipment to treat George.

It says something about my muddled state of mind that I think of this is a pain in the arse at the moment. I really don’t want him to be away from Kingston. I don’t want him away from home. I’m sure they have it wrong. Except I believe Janine completely. And like her immensely. She gives the incredibly feeling that she is in your corner and fighting hard to make sure you’re looked after. Janine says that she understands that it’s a real shock but the team from Guys are superb and we will be in the best hands. She’s sticking with us until we leave. I’m more than a little glad of that.

And then the doctor returns. And he tries once again to get a line into George. And it does not work. He is white and fleshy and there is no sign of a single vein on his body. He is injected. And injected. And injected. And the needles wiggle. And he writhes. And he moans. And there is a heavy feeling in the room. I step out of myself, not for the first time in this experience and look on, silently befuddled. I can’t quite understand why the black mood. They can’t get a line into him. But this happened to me when I had Glandular fever and was too pasty to give any blood. Surely it’s all ok? George has just got a chest infection. But with each failure the doctor looks more and more troubled. Perhaps he is just perfectionist? Perhaps he is just a little embarrassed? I can’t quite work out why George seems to be suffering so much. He has proved in his six short months just how tough he is. The doctor explains to me that they will have to go into George’s bone as they continue to struggle. He pulls out a drill. And it is literally a drill. Like a portable Black & Decker. And I can’t believe that I’m seeing this. It sounds like a Black & Decker too. And goes straight into George’s shin bone. Tracy grabs on to me at this point. My Dad’s face crumples and he turns to the wall. My son writhes and I lurch forward to help him. But I cannot. I have to stand and watch. And it’s the most horrific thing I think I’ve seen in thirty four years.

My Dad is really having trouble through all of this. He has done a lot of turning away now. And the drill is too much for him. He has tears in his eyes. But he is doing his best to cling on to everything. He turns to me and tells me that George won’t remember any of it but we will remember it forever. I have a very strong feeling that I need to watch. Everything. If George is going to go through this, then I need to be there and I need to watch. I need him to hear my voice again.

I also make sure that he can’t see the distress in my face. I once spent an afternoon running to and from the toilet and throwing up violently with a ‘baby bug’ caught from my new born son. The look of worry or downright panic on my three month olds face as I moaned in pain was something that unnerved me. It was quite an exercise to try and smile and make silly faces as the pre-vom water began to roll around my inner cheeks. He looks to me George. Always for calm. For confidence. And for a feeling of safety. I said to him about an hour after he was born…

‘I will tear down the walls for you boy’

I felt a little embarrassed after I said that. It sounded like something straight out of a very bad action film but I did mean it. And now it’s being tested. Though I’m not sure pulling down any walls is going to do it. So we will endure, as best we can. I know my wife is in agony. Every tiny piece of pain George is feeling shoots through her body like a sharp dagger. She looks like she’s in the chair right now and I can do nothing. Back to holding hands and empty words of encouragement. Didn’t we do all this around six months ago?

The Guys team have arrived and they swoop into the room with a great sense of purpose and great confidence. Meisha is the one who speaks to us first. She introduces a young doctor called Jon. She explains that George will get the line into George. He needs saline urgently to flush the ketones. George’s blood is turning to acid. It’s why he’s struggling to breathe so much. They are thinking that diabetes is likely but not certain. What is in no doubt is that they must get the line in. Meisha is around the same size as Tracy. She has beautiful, soft brown eyes and a warm smile. She speaks with great clarity and her words reek of professionalism. But there is so much warmth to her. She almost positions herself at Tracy’s shoulder and asks us what we’d like to know. She is like a wave of support. I’ve always wondered how Tracy will respond to people giving her instruction. She was a master at it as a dancer, following choreography and performing it with dazzling results. But if she feels ordered, or patronised in any way, then she can get very angry. I remember when I first introduced her to Anna. And Anna gave us a guided tour of the labour ward. Anna was so direct with her information, I worried if Tracy would respond well to such a torrent of advice. But I should have known Tracy better. She has zero tolerance for bullshit. Something Anna is incapable of. Anna is incredibly sensitive and emotionally intelligent but she does not beat around the bush. Tracy loved her from that very first meeting. And here is Meisha, managing the very same trick. Direct, confident, communicative but absolutely zero bullshit. She understands that we are in a state of anguish but reassures that George is going to get the best care possible. She is very certain about that last part.

Jon is tall and good looking with short curly brown hair. He looks a little like a very kind teddy bear. He looks a little younger than me, probably thirty ish. His face is incredibly calm and he gives off the air of someone who has done this a million times. I do feel so much happier now that Jon and Meisha are here. They both have a wonderful manner with Tracy. And they understand that Mum is the boss. I always take this as a sign of intelligence. It also makes me think that they must be parents.

Come on now George, come on now Jon, and get that line in. He is so gentle in the way he speaks to George. He wipes his head and he says

‘Alright little man, okay dude. I’m sorry little man. Alright little man’

There’s such a softness to his treatment of my boy. He moves with real measure. Meisha reminds him that they need to get that line in or they need to get to Guys & St Thomas. The line kinks again and another attempt is abandoned. Meisha and John are calm but their voices are a little more urgent now. Meisha tells John they need to go. George has started to make a very strange sound. The heavy breathing and gasps have turned to a low moan. I can see that beyond Meisha’s calm and beautiful eyes is real concern. I’m now aware that something is very, very wrong and the George is in danger. I hold my wife. I reinforce calm and positivity. I tell her that he is going to be alright. Over and over again. He barely has the strength to writhe anymore, the needles going into him can raise little more than this low moan.

John tries again, he’s the model of calm again. He reassures us that once they get the line in that George will quickly begin to feel much better. I trust him implicitly. I look at his burgundy overalls. They are two very different tones. I look at John’s brow and he is utterly drenched in sweat.

Time seems to drag an awful lot when you want it to do the opposite. Every tiny second he’s in pain is like having your innards ripped out from head to toe. I can feel every fibre of my body being torn out, as if someone were tearing at the back of my skull. Meisha calls for the paramedic. He brings the trolley for George. She is now telling John that they have to go. Even she has a look of alarm now. I look around and realise that a crowd has gathered around the cubicle. The bustle is quite intimidating. I’m aware that our little area has become a focal point for attention. A mother and son have come to look at the baby in trauma. They stare through the bodies to try and get a glimpse of George. I am reeling at the moment. I am not present. If I were I do worry what might be about to happen to our audience. As it is a flash goes off inside me, I turn towards the woman staring and then Janine barks at the ogling pair and orders them away. She is never rude with her language but there is no doubting her feeling. I feel defended by her. And very relieved that I do not open my mouth.

Meisha talks to the paramedic and then turns to me and says that really only one of us should be allowed in the ambulance. I’ll follow in a car of course, as I can’t imagine asking Tracy to be apart from George. As much as the very idea of that makes me want to puke me insides on the hospital floor. I know my place. Meisha can probably see my face fall off at the suggestion that I leave my son and she smiles. And she tells me not to tell anyone but that they can squeeze me in. My parents are still here at this point. I’ve never really seen them like this. I tell them what is happening and that we are going now. I look at them and feel a pang of shock. My Dad looks in dreadful pain and my Mother, always the strong, always the capable, has lost all of the color from her face. She pleads with me to ring her and tell her anything that night. That she will answer the phone at any time. I’ve never, in all my thirty four years, seen her in this much pain. It’s an awful confession for a middle aged bloke to make but this makes me feel incredibly vulnerable. The seriousness of this situation is leaking through to me more and more by the second.

Tracy and I wait by the ambulance. I reinforce the doctors line that once we get to Guys all will be alright. The presence of the ambulance is unnerving. It feels like something out of a film or dodgy TV drama. Ambulances are something you watch go past you. Ambulances are for the elderly falling over pavements. For drunk teenagers spilling out of Weatherspoon’s on a ladies night and, very occasionally, they are for people going through something too dreadful to imagine. Better to joke that ‘someone is late for their tea’ when you see the ambulance roar past with sirens blasting. I never let my imagination perforate the doors of the emergency vehicle. I don’t want to let my mind go there. Perhaps that is why I’m struggling now.

I look at my wife. She looks at me.

‘This doesn’t feel real’

Not for the first time, my wife has read my mind. It is for the first time that I wait until she is not watching and grab my arm, hard. It’s a bit more than a pinch but this feels so much like a nightmare that I need to know I’m awake. I open my eyes wide. And then I open them even wider. Everything around the edges does appear to be a little fuzzy. But I haven’t slept much in days with George being unwell. A punch seems to be the only way to really know if all of this is occurring. My arm hurts. I am dizzy, confused and frightened but very, very definitely awake.

The stretcher is ready but it will be filled with bags. Tracy is allowed to carry George carefully onto the ambulance. Very carefully, as John now has a line in. I expect relief and jubilation, the air to be released from the pressure valve of what is unbearable tension. It’s not. The line will help until we get to Guys, at which point a new one will be put in. John and Tracy are now on the ambulance. Meisha takes me by the arm and pulls me to one side.

‘It’s very, very important that we get George to Guys. He’s very, very sick.’

‘Right. Right’ I say. I saw her lips move but my mind won’t let her words register.

‘Once we get there he will be in the best hands possible. But we need to get there quickly.’ And this time she looks right into me, just to check I understand. But I can’t speak now. ‘We’re going to turn the blue lights on the ambulance and we can get there in about twenty minutes.’ And still I can’t speak. In all my efforts not to fall down to the floor and weep I have become frozen and mute. ‘We need to get there now. It’s very important. We have to get there. He’s very, very sick’

She holds my forearm and looks right into my eyes. It’s a gentle look, her eyes are enormous and wet. Her face softens and she steadies herself a little. This expression says a lot more than the words that she’s just uttered. I shrink and shrink and shrink as the realisation starts to hit. My wife gets into the ambulance and there is a brief moment when I am standing on the street. About to walk into horror. And I wish so very badly that I could change what is happening now. Let me wake up. Let me wake up. Let me wake up. I sit behind my wife in the ambulance. She is holding George’s hand. I rub her arm. It’s a pathetically inadequate gesture but I don’t know what else to do. I have wondered all the time about being just a little boy pretending to be a man and right now I feel like a very, very small and frightened child. I cannot get my heart to sit still, I’m not sure how to breathe anymore, sweat is pouring down my back and my vision is starting to go. I’m so glad she can’t see my face now. A cowardly thought I know but something has just landed in my stomach. Now it’s all very real. I know exactly what Meisha was saying to me. Our son is going to die.

The thoughts I have looking around the ambulance come quite quickly and clearly. I look at Meisha and at John, both are quiet. Both look very, very concerned. They are very considerate not to flash any doubt when Tracy is looking in their direction. It’s not difficult, her eyes are firmly on that of her struggling son. They don’t say much. Meisha will talk to George and reassure him, Tracy is a mixture of agonised moans and muffled sobs. There isn’t much to say, the smallest, most vulnerable person in the back of the ambulance is moaning and barely able to move on the little stretcher which seems to grow all over him and we can do now is watch. George’s moan is not of this world. A low murmur that is easily the worst sound I have ever heard in my life. Meisha shifts every time he makes the sound. She tells the driver to ‘push on’ a little.

‘Nearly there now. We’re nearly there’

The words feel a little empty now. She’s doing all she can to help us through the moment. There and then. I will need to help Tracy now. George is going to die. How do I bring Tracy back? She is going to fall through the base of the earth. Her heart will be completely shattered and the light of the world will be put out. I need to tell her that we will be alright. Even if I know it to be utterly untrue. I need to tell her that we are blessed to have had our boy grace our lives. I need to remind her that we are lucky to have one another. Lucky to have our families. And I go through how I will say the words. I will drag her upwards with my positivity. I will fight to make her happy again. Somehow, we will get through it. As a team, which is what we are. As awful as that term is we have joined together to face the world as one. We are lucky people. Each one of these thoughts meekly fall out of my mind as soon as they slipped in and my heart starts to beat faster and faster. I look at George. And he has my whole heart. I cannot go any part of the day without thinking about him. All my hopes and dreams are for him now. I am gone. I am for him. And I am so happy about that. I love him so much it terrifies me. He is my world. He is our world. I can’t catch my breath. There would be no recovery from losing him. There would be nothing. How can I say those words to my wife? What can I do? All I can see is black. This is the first time in my life that I’ve felt genuine terror.