Olivia was chopping the vegetables for the soup that Francis was going to make for lunch. They had fallen into a rhythm of collaboration as she grew more familiar with the house, no longer searching for the sieve or the peppercorns, or wondering where to fetch the logs when the basket was empty. It was hard to keep her concentration as she diced the carrots; she kept thinking about the weekend she had spent in London helping Lucy through her ‘needle biopsy’. Lucy was now asleep on the sofa next door, trying to recover from the operation in a twilight of painkillers and anaesthetic. Olivia was haunted by yesterday’s drive from the hospital and the memory of Lucy trying to protect herself from the rapid-fire seizures induced by the sunlight darting into the car. At one point, they had been forced to draw over to a shady spot to give her a break. For the rest of the drive, Lucy kept her hands pressed tightly over her eyes to block out the shafts of light. When she arrived at the cottage, Francis had embraced her for rather longer than Olivia would have liked, and then she had gone straight to bed, engulfed by seizure-saturated exhaustion.
Preparations for the surgery had started on Friday afternoon. Olivia joined Lucy in a gloomy hospital room overlooking a brick wall. Its only decoration was an artistic black and white photograph of a lamp-post in the square outside, hung there, presumably, as compensation for not having one of the rooms across the corridor which enjoyed a view of the lamp-post itself.
‘They’re just going to drill a little hole in my skull and take a sample with a needle,’ said Lucy, unpacking her pyjamas and a soft down pillow she had brought from home. ‘There’s a less than one per cent chance of death from this procedure, and I have huge confidence in Mr McEwan’s skill with the drill. Also—’
Lucy’s deluge of anxiety was interrupted by a knock on the door. A friendly Filipino nurse came in to manacle a plastic identity tag to Lucy’s wrist and ask her to wash her hair before the doctor came to shave her.
‘Shave me?’
‘Yes, the doctor will explain,’ he said, handing Lucy a bottle of bright red Hibiscrub.
Soon enough, a young doctor came in carrying a Ziploc bag. She spent much of the first few minutes managing her own mane of glossy brown hair, tossing it from side to side and pushing thick cables of unruly abundance out of her eyes and behind her ears, but eventually she extracted a disposable Bic razor from the bag and started shaving six patches on Lucy’s skull, each about the size of a two-pound coin. As she did her work, she threw thin strands of Lucy’s bright blonde hair into a yellow metal bin covered with warnings about how to dispose appropriately of toxic waste and sharp objects. She then placed a small, sticky, white plastic doughnut on each shaved patch as well as across Lucy’s forehead and temples, explaining that they were needed to make the pre-op MRI more precise and to generate a 3D model of the tumour. That model would help Mr McEwan’s computer-guided needle to take the best sample with the least risk. Using a black permanent marker, she then drew a circle around the position of all the fiducials, as they turned out to be called, with a black dot at its hollow centre, in case any of them fell off in the turbulent hours ahead.
After the doctor left the room, Lucy stood in front of the mirror, in her striped silk pyjamas, and started to cry. ‘It’s not that I look ugly,’ she said, ‘although I do. It’s just that I left home looking like a healthy woman in her mid-thirties, with no obvious problems; and now I look like a cancer patient.’
Olivia went over to comfort Lucy, who was already wiping away her tears, but she was interrupted by another doctor who swung open the door, knocking on it as it started to close behind her. She wore black slacks and a sleeveless sweater. A big lumpy bag hanging from one of her shoulders forced her into a posture that cried out for medical intervention.
‘Hi. I’m Lucy,’ she said. ‘No, sorry! I mean, you’re Lucy; I’m Victoria,’ she laughed, as if this kind of confusion was just one of the unavoidable hazards of working in a neurological hospital. ‘I’m part of Mr McEwan’s team. We’ll be performing the surgery on you tomorrow.’
‘I’m Lucy,’ said Lucy lucidly. ‘Pleased to meet you.’
‘You will have several options to discuss tomorrow with Mr McEwan,’ Lucy-Victoria began.
‘Will I?’ asked Lucy. ‘What do you mean exactly?’
‘Mr McEwan will explain everything to you tomorrow. But we might want to open up a bigger piece of your skull to give us more options.’
Lucy-Victoria made a gesture reminiscent of an obsequious extra in a costume drama doffing his cap at a passing coach.
‘More options? For what?’ said Lucy, ‘I thought I was having a needle biopsy.’
Another doctor, a young man in scrubs, swung into the room and said that he was also part of the team.
‘Well,’ Lucy-Victoria persisted, ‘we might want to test some functional areas. It’s good to map the brain, you know.’
‘Also, it might mean that we can take more samples of the tumour; some may be higher grade than others,’ said the newcomer.
‘But isn’t that associated with a much higher risk?’ asked Lucy. ‘Mr McEwan has been emphatic about what a sensitive area he has to navigate in order to get to the tumour.’
‘As I said, Mr McEwan will be able to go through all the details with you in the morning.’
‘You mean right before I’m being wheeled into surgery? Will I still be able to be awake during the procedure?’
‘Yes. You will have all the options available to you.’
‘Actually, the Awake Team isn’t available on Saturdays,’ said the other doctor.
‘You’re absolutely right,’ said Lucy-Victoria, ‘thank you for reminding me. But, apart from that, all other options are available.’
And with that enormous and disconcerting promise, the two team members left the room, eager to get home through the thickening Friday traffic.
‘Jesus,’ said Lucy, staring at Olivia incredulously.
Olivia shook her head sympathetically. ‘I’m sure McEwan will clarify everything tomorrow.’
She hurried towards the consolations of gossip.
‘I meant to tell you that Charlie has got permission to see you,’ said Olivia, ‘so that should cheer you up.’
Olivia knew from her brother that it had not been easy for him to make the visit, despite its blatantly compassionate nature. Lucy occupied a place of special jealousy in his girlfriend Lesley’s pantheon of rivals. She suspected that Lucy was ‘the real love of Charlie’s life’ and that she was just ‘good wife material’ – Lesley was one of those people who thought that originality consisted of a fluent and knowing use of cliché, vigorously imprisoned with inverted commas to make sure it couldn’t escape the further boredom of being vaguely ironic. Although she was right about Charlie’s nostalgia for Lucy, Olivia fervently hoped that she was wrong about being ‘good wife material’ for her brother.
‘Oh, great,’ said Lucy, reaching for her bag and beginning to rummage for the woollen cap she had been intending to keep for after the operation.
There was a knock on the door. Olivia and Lucy braced themselves for the trauma of another medical briefing, but it turned out to be Charlie, bearing a bottle of the same champagne he had drunk with Lucy on their first anniversary when they were still undergraduates. It was a romantic, or at least a sentimental gesture, which touched Lucy, who hadn’t seen him in a long time, and wanted to be reassured that the palace coup being mounted by her brain had done nothing to reduce his passionate admiration for her mind and body, and that he would stand beside her in defending them. She had pulled her woollen cap down to her eyebrows and over her ears and looked as if she was about to set off for a walk on a frosty morning. Charlie extracted some flimsy plastic cups from a dispenser by the sink and poured the champagne.
‘I associate these cups with urine samples,’ he said. ‘It’s good to see them playing a more primary role.’
‘Upstream,’ said Lucy.
‘Exactly,’ said Charlie.
‘You missed your vocation as a sommelier,’ said Olivia, ‘sweet-talking people into enjoying their wine even more than they would anyway.’
Lucy tried to wrap up the rough, sharp edges of the day with layers of description, as anyone would, but only succeeded in provoking an animated discussion, typical of the Carr family, about the psychopathy of surgeons; the most audacious and godlike healers, who were also the only group of people encouraged to slice open human bodies, saw off limbs, cut out flesh, remove organs and excise brain tissue, operating at the edge of paralysis, stroke and haemorrhage. It was a profession that seemed to fuse compassion and brutality, without having to reveal which was the dominant impulse, as long as both were accompanied by a high degree of precision.
‘Can I point out that I’m not finding it comforting to have my surgeon compared to a serial killer?’ said Lucy, and because they were all tipsy and anxious and tense, they burst out laughing, and for a moment it was like it had so often been, twelve or fifteen years ago, when the three of them had sat in the King’s Arms, laughing about a ridiculous tutorial or a disastrous night out.
When Olivia finally stopped preparing lunch, she went upstairs to have a shower, but found Francis already in the bathroom, shaving, shirtless, half his face covered in foam, the other already done.
‘How come I’ve managed to chop eight different kinds of vegetables and you’ve only managed to shave half your face?’ she asked, kissing him on the shoulder.
‘The early days were just designed to rope you in,’ said Francis. ‘Next weekend I’ll still be in bed when you come up from the kitchen.’
‘That’ll be nice,’ said Olivia, peeling off her sweater.
Lucy lay on the sofa, curled up and still, like a wounded animal, staring at the fire in Francis’s grate, or more precisely, at the mound of ash on which it smouldered. She couldn’t think of a time when she wouldn’t have sprung up and loaded more wood on to the fire-gouged logs decaying radiantly in front of her, but in her current state, it was absurd to imagine doing anything so strenuous and affirmative. Fire, like cancer, destroyed its host and by doing so, led to its own extinction. Couldn’t she come to a deal with her tumour that allowed them both to keep going, like coming to an ‘accommodation’ with a blackmailer? The tumour had found accommodation in her brain without asking her, but now it was time to negotiate. The few people she had told about her medical difficulties had all at some point generalised about death, volunteering that they might be run over later that afternoon, but it was not as if she had renounced the opportunity to have a fatal accident by getting cancer. Everybody had a question mark hanging over their head; she had an additional one lodged inside it.
Whatever combination of psychological qualities lay behind Mr McEwan’s calling, Lucy had grown to like him. He had popped in to say that the biopsy had gone ‘perfectly’. She didn’t labour the point that she could hardly walk but did mention that her stitches were throbbing painfully. This, it turned out, was ‘perfectly normal’, due to the tightness of the skin on the skull, which meant that the flaps made by the incision around the drill hole had to be sewn back robustly with the strongest thread.
Today she had no anecdotes to wrap around her miseries, just splashes of discrete memory: circulation socks, operation gown, baggy hospital knickers; when she asked the anaesthetist if anaesthetic was dangerous, he countered by asking her if she had ever crossed the road. Yes, there was no denying it, she had crossed the road. ‘Well, that’s more dangerous!’ he said triumphantly, getting up, tripping over the neighbouring chair, and almost falling over, without any comment or discernible sense of irony. Perhaps he wanted to show that almost everything was more dangerous than anaesthetic and she was lucky to be having a break from a hazardous world. Due to a ‘traffic jam’ around the pre-op room, she had to be put to sleep in the operating theatre itself. Looking around, she saw a dark green piece of medical equipment that reminded her of a butcher’s block.
‘Is that where you are going to put me after I’ve gone to sleep?’
‘Yes,’ said the nurse. ‘It’s really important that your head doesn’t move, even a millimetre, during the procedure. The margins are tiny – so we have to clamp your head using that equipment.’
Horrified by that thought as she went under; waking up shaking with cold, her teeth chattering; holding back tears of gratitude as nurses rushed over with heated blankets. The pause between deciding to make sure and then making sure she could still move her arms and legs.
It was as if she had woken from fifty years of sleep rather than two hours of surgery and had been mysteriously catapulted into decrepitude, with wrists and ankles that might snap, a body that might bruise and a skull that might crack with only the flimsiest pretext. On the morning of her departure, she took a shower, although she was not allowed to wash her hair for a week and had to wear a cap. In the shower, the bottle of gel slipped from her hand and triggered a seizure as it thumped and clattered around the floor. She tried to stay calm and not to pull the red emergency cord, but afterwards, when she mentioned the incident to the registrar, he said it was ‘perfectly normal’ for her seizure-threshold to go down after surgery. On the terrifying drive to Howorth, his prediction was fulfilled, although it was the most imperfectly normal drive of her life.
After waking up today, she had hobbled over to the window and drawn open the curtains, immediately shielding her eyes from the brilliance of an immaculate winter’s day of frosted fields and ice-coated puddles gleaming under a cloudless sky; bright and still and promising, like a silver flute lying on a page of music. She stood there for a while, dull and damaged, and frightened of the light, with her right leg feeling twice as heavy as the other one. When she lowered herself apprehensively down the steep staircase, without any sensation in her right foot, she either banged it down emphatically or hesitated above the step, unsure how far away it was. Her pallid cheerfulness over breakfast was compromised by an obsessive exploration of the thick bandage on her head. Unable to see the wound, she could only pat and stroke it again and again with the tips of her fingers, mapping its soreness and its size. Underneath the thick stitches was the hole that Mr McEwan had drilled. Before the operation, he told her that he still planned to do a needle biopsy, but that he would like to make the hole larger to give him more angles of approach. Since the tumour was wrapped in so much functional tissue, he wanted to be able to try alternative routes to ‘the hot spot’ he needed to sample, without having to drill additional holes.
Lucy opened her eyes wearily, recognised the fireplace, and realised that she had half drifted off again.
‘Oh, hi,’ she said.
‘Hi, darling,’ said Olivia. ‘I didn’t want to disturb you.’
‘Oh, I’m just drifting in and out.’
‘Is there anything I can get you?’
‘A new brain,’ said Lucy.
‘Let me just check if we’ve got one in the freezer,’ said Olivia.
Before Lucy had time to abandon, continue or complete their brain sketch, the thrum of an approaching helicopter became audible. Its whirring engine and chopping blades grew louder until, slow and deafening and low, it thundered over the roof of Francis’s cottage and receded on the other side.
‘What the hell?’ said Olivia, running to the cottage door to see what was going on.
Lucy felt the familiar tensing and tingling of a seizure grabbing at her leg.
‘Hi, Lucy,’ said Francis, hurrying through the room. ‘I’ve just got to check this out. I’ll be back in a moment. Nobody is allowed to land a helicopter here.’
Lucy decided to wait for the seizure to pass without mentioning it to anyone. She could still hear the helicopter hovering somewhere nearby. Then its blades started slowing down and, with a final high whirr, came to a halt. The disturbing impact of the seizures was not diminished by their familiarity: whatever triggered them, they always triggered the thought that she was declining rapidly. When this episode passed, she felt yet more depleted and curled up still more tightly on the sofa, with a cushion between her knees and her eyes closed. She didn’t react to the opening of the cottage door; she would find out soon enough why a helicopter had throbbed and sliced the air over the cottage roof and sent its Doppler sound waves through her volatile body.
‘Hey, Lucy, how’s it going?’
Lucy’s eyes clicked open. What on earth was Hunter doing here? She made an effort to sit up.
‘Oh, hi, Hunter,’ she managed to say, leaning up on one elbow, the base camp for her assault on the summit of an upright position. ‘What a surprise. How on earth did you find me?’
‘I did some detective work when I saw you were on sick leave and came down as fast as I could. It seems my helicopter upset some Stone Age ponies, which I’m very contrite about, but I had to see how you were doing.’
Finally sitting upright, Lucy saw Francis staggering through to the kitchen with a hamper. She could tell that he was trying to calm down from his fury at Hunter’s cavalier arrival.
‘I’ve brought us a few things,’ said Hunter. ‘Some lunch, which I’ve given to your host…’
‘Francis,’ said Lucy.
Hunter came and sat beside her on the sofa and took one of her hands in his.
‘We’re going to look after you,’ he said, ‘and you’re going to get better.’
‘Thank you,’ she murmured, feeling the conviction in his words. He seemed more relaxed and refreshed than she’d ever seen him before.
Olivia came in from the kitchen.
‘Well, Hunter, that’s definitely the biggest tin of caviar I’ve ever seen,’ she said, raising an eyebrow. ‘Thanks so much. We’ve put the vegetable soup back in the fridge and warmed the blinis. The vodka has stayed extremely cold in that special pouch of yours, although I don’t know how many takers you’re going to have for vodka shots on a Monday morning.’
‘We’ll definitely have to toast Lucy’s health,’ said Hunter.
‘That’s true,’ said Olivia, ‘but Lucy can’t drink for the moment, Francis is going to meet some bird-ringers this afternoon, and I’m trying to do some research for a paper I’m writing, so we can’t get blind drunk.’
‘Not on one bottle,’ said Hunter with a burst of laughter, ‘that’s for sure.’
As they all sat at Francis’s kitchen table, loading blinis with toppling mounds of sour cream and caviar, Hunter somehow persuaded them that Lucy’s health was not the only reason to knock back a shot of vodka. His acquisition of the remaining shares of YouGenetics provoked another toast and, when he found out about Olivia’s old antagonism with Bill Moorhead, he insisted that they must raise a glass ‘To the downfall of pompous men and false friends!’
‘So, what are you writing your paper on, Olivia?’ asked Hunter.
‘Oh, I’m working on a paper about schizophrenia, with my father, Martin Carr. He’s a psychoanalyst. I’m looking into the genetics, while he’s writing up some case studies. And we’re also trying to get a neuroscientist on board.’
‘What’s the lowdown?’ said Hunter.
‘Well,’ said Olivia, ‘briefly, there’s an impressive list of environmental stresses correlated with schizophrenia: war, bullying, the early death of a parent, physical and sexual abuse, migration, deracination, racism, and so on. They’re strongly associated with schizophrenia on their own, or possibly in combination with a multitude of marginally implicated genes, but there’s no evidence that the genes on their own can cause schizophrenia. Also, even if genetic expressions are switched on or off by stresses, the results would still shed only a hazy light on the question of inheritability since many of the mutations in schizophrenics are “de novo”, occurring for the first time in that person and, therefore, by definition, not inherited.’
‘What about twin studies?’ said Hunter. ‘Aren’t they the gold standard for a lot of this genetic analysis?’
‘They’re often treated that way,’ said Olivia, ‘but lots of clinical psychologists, like my brother Charlie, question the Equal Environment Assumption on which they rest. They attribute outcomes to purely genetic causes by ignoring favouritism, scapegoating, imposed narratives and, in the case of identical twins, the effects of often being dressed in the same clothes, being in the same class at school, having the same friends, being mistaken for each other and experiencing “ego fusion”. Genetic enthusiasts try to get around these social and psychological facts by saying that the genes of identical twins “create” confounding non-genetic influences, as if two infant twins, lying next to each other in the same pram, cast out a powerful genetic force field that compels their mother to dress them identically, while the rest of the world turns to stone. The mother herself is not, in this persuasive scenario, subject to any environmental, financial, social or psychological forces, or indeed genetic influences of her own, but is just controlled by her monozygotic twins’ genetic “creativity”. It’s the kind of circular argument, assuming what it set out to prove, that appears again and again in twin studies, like a wagon formation protecting a beleaguered dogma.’
‘You know,’ said Hunter, with an appreciative smile, ‘now that I’ve bought all of YouGenetics, you’re making me think that we should rename it. It’s up to you, Lucy. Give it some thought over the next few weeks.’
‘I already know,’ said Lucy. ‘EpiFutures.’
‘To EpiFutures!’ said Hunter, knocking back another shot. ‘I love it. And Francis, I am so sorry about disrupting your experiments and disturbing the denizens of the forest. I had no idea this was a nature reserve. I’m going to send the pilot home before he needs to turn on all the lights and I’ll get a car sent down.’
Hunter took out his phone.
‘I’m afraid there’s no signal here,’ said Francis, ‘but we can go up and tell the pilot and, if you want to find out about the wilding project, you can come for a walk with me.’
‘That sounds great,’ said Hunter.
Francis lent Hunter a pair of heavy boots to replace his suede loafers, took his notebook from the high shelf by the front door and the two men set off. Olivia led Lucy back to the sofa. When they could no longer hear Hunter’s booming enthusiasm, let alone Francis’s quiet answers, the two friends burst out laughing, sprawled next to each other on the cushions.
‘What was that?’ said Olivia, clasping Lucy’s forearm and turning around to look at her. ‘He’s a bit mad! But much kinder than I’d imagined.’
‘I really didn’t expect him to be so supportive,’ said Lucy.
‘He’s obviously in love with you.’
‘God, I hope not. I need an affair with Hunter like…’
‘A hole in the head?’
‘God, no,’ said Lucy, ‘not nearly as much as a hole in the head.’
Later she climbed slowly to her room and collapsed on the bed. She always had to read something, however briefly, before going to sleep and so she switched on the bedside light and picked up the novel she had been hurtling through until she checked into the hospital. Since then, she seemed stuck on the same page and again today, before she could turn that heavy page, the book slipped from her hands as she tumbled into sleep.
When she woke, she saw the light of her lamp smeared across the glassy blackness of the window. She had no idea whether it was late afternoon or the middle of the night. Opening her bedroom door, she heard a brief interchange from downstairs and embarked again on the slow descent to the sitting room, guessing that it must still be quite early and that she would wake in the middle of the night if she rested any longer. She found Olivia on the sofa with her laptop on her raised knees, and Francis reading at the other end, his legs entangled with hers.
‘Has Hunter left?’ she asked, sitting down in the armchair nearest the fire.
‘Yes, about an hour ago,’ said Olivia, closing her computer. ‘He said to say goodbye and sent his love and said you should take as much paid leave as you need.’
‘Well, that’s amazing for me, but I’m sorry he burst in on you like that.’
‘He’s welcome to bring lunch every day,’ said Francis, ‘by bicycle. Normally, I’m against fast food, but I thought Hunter’s hamper was an excellent solution for “people on the move”.’
‘Was he fun to take round?’ asked Lucy.
‘He was,’ said Francis. ‘He really seemed to get it. We talked about soil a lot. I told him what Roosevelt said: “The Nation that destroys its soil destroys itself.” He loved that. And then we were away with Darwin and earthworms and artificial fertilisers and declining nutritional values in foods. I also told him the annual global cost of soil degradation: 10.3 trillion dollars a year.’
‘Your idea of heaven,’ said Olivia, ‘terrifying people with soil stats.’
‘It’s true,’ grinned Francis, ‘it was pretty great. I think he had a little eco awakening. Howorth has a strange effect on people. Walking around a place that isn’t being exploited gives them a holiday from wondering how to exploit everything themselves.’
‘Capitalism and nature need couples counselling,’ said Olivia.
‘Yes,’ said Lucy, again exploring the edges of the dent hidden under the bandage on her head, ‘there’s a price to pay for out-of-control growth. Anyhow,’ she said, moving on quickly, ‘it sounds as if it was worthwhile all round. He certainly took a lot of pressure off me.’
‘Oh, and we’re all invited to his house in the South of France in May,’ said Olivia.
‘We are?’ said Lucy, astonished.
‘Yes, Le Plein Soleil,’ said Olivia. ‘Oh, les beaux jours!’