The Ghouls

Ann Hardy, the ward counsellor sat quietly opposite, from time to time jotting notes down in her notebook. She glanced up to me periodically but she was intent on listening and recording the information I was relating to her. The conversation had come to a natural conclusion so we had been sitting in silence for a few minutes. She swapped over her crossed legs and held the top of her pen to her chin. Gently tapping it while reading back what she had written.

 

She looked up at me and smiled. An infectious smile that you couldn’t help smiling in return. Putting her pen and notebook on the floor she got up and went to the end of the bed to collect my medical notes. She began flipping over the pages and scanning each sheet quickly before moving on to the next. Licking her fingers to turn another page it appeared something had caught her eye as she paused on one specific page and continued reading further down the entries. I could hear her tapping the page with her finger, it was the only noticeable sound in the room.

 

The last few days had been quiet on the ward. The activity that I heard was the usual routines of patients and the medical staff. Trevor beating up and down the corridor for his morning walk, drip trolley in tow. The sound of the pharmacy trolley travelling over the tiled floor as it and the nurse pushing it meandered from room to room and then across to the open wards. More importantly and thankfully, the same number of people on the ward that had gone to sleep had woken up in the morning. We hadn’t lost anyone.

 

Ann returned to the chair and sat down, my medical notes in her hand. She reached down and collected her notepad and pen from the floor. Crossing her legs she balanced my notes and then her pad on a knee and continued to write. Pausing for a moment she tapped the pen on her pad and then resumed writing.

 

There was a very faint smell of the lunchtime food. It must be getting close to one o’clock, I was getting hungry and the aroma of the food was adding to that hunger. Summersome ward was a fairly new ward for cancer patients. The rooms didn’t feel like hospital isolation rooms, the wards were bright and airy. The most important thing for the patients was that it had its own kitchen and food preparation area. It was the only ward in the entire hospital campus where you could get a full English breakfast every morning, if you chose to do so. Which of course, I did.

 

I suspected that this was always an option because maintaining or gaining weight when you have cancer is a good thing. If you let it, the cancer will steal your weight, your energy, your will. Starting the day with a calorie rich breakfast was just another way to say ‘fuck you cancer’. All the food was good on Summersome. The ward also had a table full of all sorts of snacks, biscuits, crisps even sweets that we were all encouraged to help ourselves to whenever. The shortbread biscuits are my favourite, ideal for dunking in a cup of tea.

 

“Here it is, internal bleeding from the pancreas. You were taken for surgery off Bebbington. They operated on you for several hours to stop the bleeding. You had a transfusion to keep you alive, 4 pints in fact. Critical care notes that you were not able to maintain blood pressure” Ann stated disturbing me from my thoughts of food.

 

“Without the blood pressure medication and the transfusion you would have died Jack. However that is why you went to Critical Care again. You were close but you responded to the treatment after thirty six hours. You still had the fight in you” she added.

 

I knew all this. A surgeon had visited me on my last day in Critical Care and brought me up to date. It was a Critical Care nurse who alerted my surgical team that I needed to go into theatre immediately. My eyes had rolled back into my head and she had realised that something was very wrong. She saved my life. For this and so many other things, I am eternally grateful to all the staff at the hospital.

 

To the Critical Care nurse, she was just doing her job. Nursing staff do not get paid the appropriate amount to reflect the important work they do each day. It’s a real issue for me that I do get quite angry about. When you see first hand how hard the nurses work you can’t help but feel that a great injustice is being done.

 

“Jack? You’re miles away!” Ann said jolting me back to the here and now.

 

“I was drifting mentally. It was very rude of me. I do apologise” I replied.

 

“Do you want to take a break? It’s nearly lunchtime anyway. I can call back in later this afternoon and we can pick up where we have let off?” she asked.

 

“If you don’t mind, I would rather get this off my chest. Can we continue?”

 

“Sure we can if you are up to it. So far you have done a really well. It will make a difference. So to recap, after the surgery you said you first saw these…” Ann said as she looked down to refer to her notes. “…ghouls as you have called them?”

 

“I don’t see them as such, it’s a perception I think. They are a product of my subconscious, a manifestation of the cancer I would suspect. I would also venture to say that the manifestation is a symptom of the PTSD although I’m not an expert on any of that” I replied.

 

“You don’t see them but you have said that you have drawn them, wouldn’t that indicate to you that you are seeing them as a form?” Ann asked.

 

“Minds eye?” I suggested. “I know they aren’t there physically. They don’t speak to me and I don’t speak to them. They aren’t malevolent in anyway. I just let them be” I added.

 

“Please don’t ask me if they are in the room with us now, that is such an internet meme and one that I use regularly myself.” I said laughing. It was a very handy meme for irksome public figures who generally tweet absolute bullshit for whatever bandwagon they were climbing on.

 

She laughed with me but narrowed her eyes. Determining I suppose whether it was worth asking me if the ghouls were in the room, scampering about around my bed or the one that always sat on top of the small wardrobe. No bigger than a fox and the appearance of gargoyles, the ghouls likely the product of a misspent youth watching horror films that my subconscious borrowed from memory to represent the cancer growing inside of me. The mind is very powerful and it is moments like this you realise just how powerful and creative it can be. Especially when constantly poked and prodded by PTSD.

 

When I was first diagnosed with PTSD I had issues believing it. I associated PTSD with returning soldiers from fighting. The trauma that our brave servicemen and women suffer from fighting someone else’s wars is immense. What they witness is truly hell on earth, a constant nightmare that they live in. No one it seems is immune to PTSD given enough trauma to tip them over the edge. My diagnosis had been a matter of course.

 

“Jack! Well are they?” she asked.

 

“Are they what?” I retorted. I had been miles away again, not listening to her. She had gone there though, she had turned the moment into an internet meme.

 

“The ghouls Jack, are they in the room with us now?”

 

“No. They aren’t” I replied. “I only conjure them up when my mind is blank, not thinking about anything specifically. I guess that is why it’s always just before I fall asleep that I bring them forth in my mind” I added.

 

Her head cocked to one side as she scribbled a note into her pad and then looked back up at me. She took a breath in as if to speak.

 

There was a knock at the door, Clarissa came in carrying my lunch. I had forgotten what I had asked for this morning. She put the covered plate on my side table along with serviette wrapped cutlery.

 

“Enjoy your lunch” Clarissa chimed as she left the room.

 

Ann got up out of the chair and walked to the end of the bed replacing the notes and tucking her notepad into her pocket. Her pen slid into her breast pocket.

 

“I will leave you to eat Jack. It was a productive session today, I think we got to the root of some issues but there’s plenty more we should work through. I will call back into see you later this afternoon. Enjoy your lunch” she said leaving the room, the door quietly closing after her.

 

I lifted the cover off the plate, condensation had already formed on the inside and I didn’t want it dropping off into my lunch to make it soggy. Spaghetti bolognese. I was very hungry as well, I would polish this off very quickly.

 

And then it happened. The searing pain immediately started as I swallowed. It felt like how I imagined swallowing broken glass. I immediately stood up, it felt like the food was stuck in my oesophagus. Standing up didn’t help. My mouth started to water, I was going to be sick. I knew it. I quickly got a bed pan from the stack by my door, I was beginning to heave.

 

Leaning over the pan I reached for the alarm button and pushed it.

 

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I am diagnosed with terminal stage 4 colon cancer that has metastasised to my liver. I now have Type 1 or Type 2 diabetes and as a result of the colon cancer, I have an ileostomy called Elvis.

Done