this dying business

last night i didn't feeling like studying, so i decided to take the night off and do something i really enjoyed: daydreaming and writing it down as a story. so here it is, the first of three parts of a short story: this dying business.

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Ward 2C at the Western Hospital Footscray is a rather dimly-lit place. There is a decided lack of natural lighting, and the only windows open out to the orange-brown bricks on the other side of the hospital. In the small courtyard of synthetic green in between the buildings, under the dusty Coffex umbrellas, patients and visitors are smoking and drinking coffee, with the grey Melbourne sky hanging heavily overhead. This rather drab scenery outside may explain why, more often than not, the blinds are drawn down in the patients’ rooms, which makes the ward even gloomier. Inside, the corridors are pink and orange, the furnishings are blue and grey – pretty standard décor for a hospital last refitted sometime in the last century.

It is seven o’clock in the morning on a Monday in June. Outside it’s a nippy four degrees and the city is struggling to awaken in the midst of a cold front. Inside it’s a more comfortable twenty-four degrees, thanks to the efficient (and at times rather overzealous) hospital heating system. Most of the patients are still asleep, but at the nursing station there is a bustle of bags and coats as the new shift of nurses come in for handover. Orderlies are starting to arrive with the breakfast trolleys filled with cereal and fruit for those who can still eat, and jellies and yoghurt for those that can still swallow. For those who can do neither, well, I suppose the bags of liquid goo or 5% dextrose will have to do.

Sitting up in my bed, I’ve been awake for an hour and half. I’m listening to Neil Young on my Discman and reading about sarcoidosis from my beautiful new edition of Harrison’s. No one knows what causes sarcoidosis, but it is related to an overly enthusiastic T cell response to unknown antigens. These antigens must be pretty ubiquitous, because these T cells and their recruits (mononuclear macrophages and other inflammatory cells) form granulomatous lesions in pretty much every organ around the body. However, unlike things like chest infections or asthma, which will let you know that they’re around, these lesions are often clinical silent, and only cause problems when they become bigger and distort the normal structures of organs. It’s a fascinating disease to read about when you don’t have to worry about memorising the long list of possible clinical presentations.

My breakfast arrived but I give it a miss because I’m not feeling particularly hungry. Hospital food is notoriously unappetising, but I think that’s confounded in a large part by the fact that when you’re sick you usually lose your appetite. As a poor and hungry medical student, I remembered looking at the patient food trolleys and thinking about “liberating” a few trays for the “advancement of medical knowledge”. I never did, of course, so I never found out what they tasted like, until now. But the patients have been right all along – they do taste rather bland, and are usually cold by the time the land on your table. No wonder the inpatients always take so long to get better – how can the body heal itself when you don’t feed it with yummy things like stir fries and Indian food and cold beers?