In Extremis Read online

  So now I was facing a question that did indeed put a finger in my wounds. The impact of my condition on my marriage. Without the gel and the gentle massage.

  ‘I don’t mean the physical condition in itself,’ the matronly physiotherapist elaborated, and in parenthesis one has to wonder at the level of English that people have now achieved in Holland, compared, say, to Portugal, or Spain for that matter, or Italy or France, ‘but your frustrations with the doctors, your new awareness of your body, then this whole attempt to change your lifestyle that you’ve been describing. Did it impact on your home life?’

  I leaned back against the desk and looked at the audience. A few hundred miles away my mother was sinking fast. There were now three-and-a-half hours before the flight, of which a good hour must be spent on a train that was actually leaving rather soon. I had better not miss it. But still I hesitated. It was a good question that the buxom Dutch woman had asked; in a way, it was the question. Then I could see from her face that it was also a sympathetic question. She meant well. This wasn’t morbid curiosity. This Dutch physiotherapist, in her early fifties I would have guessed, genuinely wanted to know what was going on in the lives of the men she was treating – what they were going through, emotionally. So she could treat them better. One might object that it was also a very personal question. But wasn’t the whole thrust of this seminar that the problems Dr Sharp was treating were very personal? That life in general is a highly personal affair, hence treatment for sufferers with these problems – and I had certainly been one – needed to be not only personal, but intimate? What could be more intimate than a massage through the butt? In fact while I had been with the physio in my hotel room shortly after lunch, trouserless on the bed, the fifty or so physiotherapists at the seminar had been taking turns to practise on each other the same technique that he was applying to me. Grotesque as it may sound, fifty Dutch lady physiotherapists, aged between twenty-four and sixty, of every body shape and size, had reorganised the dining tables of this conference centre in Amersfoort in order to stretch themselves out on the table tops and massage each other through the anus. Think of that, if you will. While my mother was dying in London. They had done this so that they might know what feelings were at stake, both from the giving and the receiving end, as it were, when they treated sufferers like myself. What it felt like to have a finger penetrate their butt and explore the pelvic wall, front, back and sides; and again how to accomplish this penetration and carry out this exploration in a way that did not feel like a gross violation to the person whose butt was being thus penetrated and explored. And this willingness on their part, the Dutch physiotherapists’ part, I felt, to do this – to come to the aid of their patients in this unappealing way, to recognise that a person was also, and in some cases perhaps above all, his or her butt, his or her pelvic floor, which might need to be massaged, not impersonally, and certainly not automatically, as if all patients were the same patient, but intimately and with constant feedback – Is it sensitive here, and here? What about this pressure, and this? – all the time aware of the elasticity or rigidity of the muscle wall touched through the colon, the which, however scrupulously the patient has prepared himself or herself for treatment, doubtless bears its light patina of shit – such willingness on their part made any reticence on mine, handsomely paid as I was to talk about how I had escaped from the pains in question, ridiculous. It would be ridiculous not to agree to say a word about my marriage and its relation to my problems, once I had accepted the invitation to come here and talk, come in part of course because I was being well paid (I’m not stupid), but also because I genuinely believed that without Dr Sharp’s book, which despite his remarks on the limitations of books and reading I had very much taken on board, very much given credit to, allowing the words to leave the page and circulate in my mind and even alter my patterns of behaviour, without that book I would still be suffering serious abdominal and perineal pains – which in fact I was suffering, right at this moment, thanks to that massage, but that’s beside the point – and still be getting up to go to the bathroom six times a night, something that I sincerely hope does not kick in during the days and weeks ahead, otherwise I may very much regret that massage. For why would Elsa ever want to live with that?

  ‘You don’t have to answer,’ the woman said gently. Apparently I was taking longer than expected to reply. Actually I had begun to smile, though no doubt there were those present who could see I didn’t really feel like smiling. I was performing. My face was being made to smile when in fact I was not smiling. Or no, I was smiling, really smiling, but the way one does when brought up against the sheer impossibility of a task, the sheer enormity of some seemingly innocent question. You look at this task, consider this request, and shake your head, knowing you are quite unequal to it. You will never get to the bottom of this question. Never complete this task. And in your despair, or simply resignation at something quite beyond you, you smile. That was the smile I must have been smiling now, and having smiled it, I was also holding it, exaggerating it, so they would all know this was the smile one smiles in the face of impossibility, etc., though they couldn’t have known of course the business of my mother approaching death’s door, or the fact that despite my age I believed myself, grotesquely, in love.

  ‘Marriage. Illness,’ I smiled. ‘How can one ever – to risk a pun in present circumstances – get to the bottom of such matters?’

  I hesitated while one or two tittered. In terms of their English, I suppose, it was rather sorting out the men from the boys, throwing puns at them like this. Though, as I said, those present were all women. ‘We have heard Salvatore talking about the impact of his condition on his family,’ I said. I sighed. ‘Inevitably, when a cheerful man sinks into joylessness, this impacts on his family. Inevitably, when a handsome guy like Salvatore experiences impotence, it impacts on his marriage.’

  I stopped. What was I going to say? The truth is I still use the noun ‘impact’ as a verb with some reluctance, slipping on a rubbery metaphorical glove, as it were, as if there might be a patina of shit on the term. I can’t help remembering the time when this usage was the merest Americanism, though now it has become absolutely respectable, even fashionable – as, hopefully, anal massage may one day become, if not fashionable, at least respectable. Not to mention falling in love at fifty-seven. And when shifts like this occur, shifts I’ve initially resisted, raising the banner of proper language use and correcting those, time and again, who come to my seminars, only to see the shift prevail, inexorably, as is the case with ‘I impact this, you impact that, he impacts the other’, there comes the moment when I swing round one hundred and eighty degrees and force myself to adopt the new usage as frequently and emphatically as possible, precisely to punish myself, I suppose, for ever having presumed to know what standard English might be, for ever having imagined my own professorial opinion could count for something against the overwhelming reality of what everyone else is doing and saying. Yet even as I give in and go with the flow – suddenly teaching the exact opposite of what I have taught hitherto – I still can’t prevent myself from putting on that rubber glove, from feeling that actually the language was better when ‘impact’ was a noun and didn’t impact on other words. And even as I speak, no doubt there is something in my voice that alerts people, that tells them: Professor Sanders is using this verb reluctantly, yet emphatically, with a sort of bitter, self-destructive irony. It’s off-putting. He has decided to go with the flow, but he feels the flow is a sewer. ‘The reason,’ the physio had told me when I had pulled my trousers back on, after his massage, ‘why those other doctors you mention hurt you so much was because they didn’t really want to be doing what they were doing. You know? They knew they had to put a finger up there, it’s a diagnostic duty, but they didn’t really want to do it. And when you’re conflicted, you do things badly, awkwardly, angrily. You communicate awkwardness and anger.’ In general, the physio said, much of the pain that was experienced in the world was t
he result one way or another of people’s state of conflictedness. They didn’t want to be doing what they had decided, or had been told, they had to do.

  ‘Having said that,’ I continued, still addressing myself to the matronly Dutch physiotherapist whose pale, wide eyes had fastened on mine, ‘one might equally well reverse the question you put and ask, not how the condition impacted on the marriage, but how the marriage impacted on the condition.’ I hesitated. ‘You might even wonder whether domestic unhappiness wasn’t intimately linked with the genesis of the condition.’ Again I hesitated and smiled the smile of impossibility. ‘To cut a long story short,’ I said, ‘and not wishing to attribute blame to either party, we separated.’

  The woman at once said she was sorry, she hadn’t meant to ask a difficult question, and I said she really mustn’t be sorry. There was nothing to be sorry about. It was an excellent question she had asked and I only hoped my answer had been useful. However, alas, I now had a rather better reason to be sorry – to apologise, that is – I said, because I really needed to leave rather urgently to catch a train to the airport. I had to fly to London where my mother was critically ill. I had imagined, I told the physiotherapists, from the schedule we were all given, that my contribution would be well over by this time, but since we were now running almost ninety minutes late, I was in serious danger of missing my train and then my plane and hence …

  Hence what?

  Dr Sharp jumped to his feet and shook my hand and asked the fifty physiotherapists to applaud, which they did, and for rather a long time, which obliged me to stay and accept the applause, though I kept motioning for them to stop, giving an impression that modesty wouldn’t allow me to be applauded so generously, but in fact because I was in a hurry to leave. ‘Wait just one moment,’ Dr Sharp was saying as the clapping died down, ‘and I’ll join you in the taxi. Just to check that you make your train on time.’ He turned to the audience. ‘Thomas will now describe days one and two of the three-week protocol,’ he said briskly, and I think this was the first moment I registered the fact that the physio who had massaged me was also called Thomas. Not a doubter at all, I thought. So much for names.

  Two minutes later I was waiting in the conference-centre reception area with the bag I had already packed, while Dr Sharp took rather longer than expected to join me. I went outside to see if the taxi had arrived, which it hadn’t, and fretted in the cold till it did, then came back into reception and fretted again because Dr Sharp still hadn’t come down. This was cutting it fine, to say the least, I thought. I turned on my mobile and sent a message to Elsa, telling her the talk had gone well enough, but that now I had to fly to London where my mother’s condition had worsened. Not home to Madrid. ‘I miss you terribly,’ I texted. Was this actually true, I wondered, before pressing the Send key, or just a formula? Certainly I wanted her to be aware of the importance I gave to the relationship that was forming, but there was really too much to be thinking about right now to miss anyone, even my mother. ‘Grandmother is very ill,’ I texted all four children. ‘If you want to see her again, you should travel soonest.’ Should I text my wife? Ex-wife? Dr Sharp still hadn’t come. I decided not.

  The conference-centre reception area was deserted and I began to wonder if there had been some misunderstanding. To the left of the reception desk was a bathroom, but that could wait till the train. Had Dr Sharp really said he would come to the station with me? Could the applause have distorted what he said, so that I was waiting for him in vain? He wasn’t coming. I should get straight into the cab. Having seen there was a bathroom, I was now more than ever aware of an urgency to use it. And did it really matter, if one did or didn’t arrive in time for the death of a loved one? What possible difference could it make? I could hear Thomas the physio’s voice through the open door to the seminar room, talking about the need to familiarise patients with the geography of their pelvic floor, which, for the sake of convenience, he said, they would be speaking about like a clock face seen from above, where noon was the prostate and six the coccyx. ‘Most of our work will be done between ten and two,’ he said, and I smiled, imagining that someone with poor English would be bound to misunderstand and assume he was saying they mostly did their massages around lunchtime. There were now only twenty minutes before my train was supposed to leave, when I decided after all to go to the bathroom.

  The pee wouldn’t come. It was a perfectly ordinary bathroom with the usual recommendations, in Dutch, German and English, to wash one’s hands, and a condom-dispenser by the door, which seemed a little odd in a conference centre, unless it was just an acknowledgement that conferences have all kinds of other functions besides those officially declared. The Portuguese paediatrician, I thought, was well set up, despite his affectionate talk about his wife and family. One product was called Billy Boy. Or perhaps because of that talk. A guy who says he’s separated and suffering is hardly attractive. Who wants a fling with a sufferer? A loser. Though I hadn’t said I was suffering. I don’t feel like a loser. In fact this was a blissfully happy period for me. Wasn’t it? I mean the last couple of months. In any event, I had no interest at all in exploring the charms of the Dutch physiotherapists. The pee still wouldn’t come. It burned but wouldn’t come. Things will only get worse, I thought, with the stress of catching train and plane, and Mother dying. So much for bliss. The massage had been fatal. Not to mention the finger-in-the-wound question. Shouldn’t it have been Thomas, I objected to myself, who stuck his fingers in others’ wounds, not they theirs in his?

  ‘There you are!’ Dr Sharp had put his head round the door. ‘I was wondering where you’d got to.’

  At which exact moment the pee began to flow. Since the doctor stayed standing in the doorway, I also lost a few seconds washing my hands, an expediency I might otherwise have skipped.

  It really was terribly important one made it to the deathbed of one’s parents, the doctor told me as soon as we were settled in the back of the car, and he said the reason he had taken a minute or two to get ready was his decision to put together a bag for the night. I would never make it to the station now, he had realised; I should have warned him beforehand if I meant to get the five-o-five, so the only thing was for us to take the cab together directly to Schiphol, after which he would ask the driver to proceed to Amsterdam where he, Dr Sharp, was to have dinner with a wealthy Swiss industrialist who was offering to sponsor the San Diego protocol.

  ‘Surely it’s only five minutes to the station,’ I said. ‘We can still make it, can’t we?’

  A taxi to Schiphol would cost a fortune.

  ‘Our industrialist will pick up the tab,’ Dr Sharp said. And he said he couldn’t tell me the name or even profession of this wealthy man, although he was quite famous in his field, because he didn’t want it to be widely known that he had suffered from such an embarrassing condition. He felt it might undermine his authority.

  I laughed. Having a pain in the balls was harder to admit to than being gay these days, I said. And Dr Sharp agreed. In fact being gay, Dr Sharp thought, was ‘becoming rather more a boast than an admission’. ‘We’re so heavily invested in our self-images,’ he said. ‘I often tell people, you’ll never be completely cured until you’re comfortable with having other people know who you really are.’ Not that people, he conceded, actually wanted to know who you really were. Quite the contrary. They had enough on their plates without hearing about your travails. Nevertheless, it was important for you personally not to feel you had to be forever hiding something, since that would be stressful and humiliating and would aggravate your problems. Being candid was part of getting well, he said.

  ‘Do you think,’ I asked him in a moment’s random mischievousness, ‘that some people who are not gay pretend to be so, in order to enjoy the celebrity of “coming out”?’

  Dr Sharp didn’t reply.

  The taxi ran into traffic on the fast roads leading out of town. I had no sense how long the ride might take, having made the outward journey on the train
. My wife texted me to say she felt close to me and to ask me to give her regards to my mother. This meant the twins had spoken to her. But the twins did not text. Nor did the older children. My wife didn’t reproach me for not texting her. She was reminding me she was a fine, loving person and that I had done the wrong thing when I left her. Fair enough. Perhaps I had. I tried to concentrate on what Dr Sharp was saying about a hormonal cream to treat anal sores. Why did I feel it was a matter of overwhelming importance to see my mother before she died? And if I felt like that, why had I not abandoned the talk to the physiotherapists and run at once? Was it vanity, the desire to stand up in front of the fifty female physiotherapists and tell my story? He had missed seeing his father by a whisker, Dr Sharp now said. It was sad. Whereas with his mother, it had been a long-drawn-out affair. It was not, he said, that one has anything to say to a dying parent, anything to tell, in a melodramatic Hollywood-movie sense, secrets or explanations or anything; it was more a confirmation of loyalty, solidarity. ‘When you die you want to have around you the people who make you who you are. Your people. Your folk. You want to feel they are giving this time, and making this effort to be with you, as you set out on your last journey.’

  I wondered, I said, whether that was really true. ‘Maybe the truth is that we project that desire on to them. So that we can get a payoff from satisfying their imagined requests, when actually they’re entirely taken up with their own personal dying.’ Which alas was hardly a journey, I added, but an end to all journeying.