How Far We Fall Read online

  ‘There’s something about roast beef that restores one’s self-belief,’ Baird McAlister says, leaning a little towards Beth. ‘Have one.’

  ‘Food and a beautiful woman. How the hell do you do it, Albie?’ A pale youth has appeared from behind Baird; a cloud of dust-coloured hair froths to the collar of his purple jacket. ‘I’m Bruce.’ The narrow eyes glint.

  ‘Beth,’ she replies, unsmiling.

  ‘Me and Albie, we’re brothers in arms. We compete for resources, like our lab rats.’ He leans close to put a soft mole paw on her arm. ‘Now where exactly did those food-bearing lovelies disappear to?’ His face turns like a burrowing animal coming up into light, questing for food.

  ‘Vanished into thin air, they must have seen you coming,’ Baird McAlister tells him, an edge to his voice.

  A good moment for her to leave too. Baird knows her name and where she works; let him find her, it works better that way. As she says goodbye, his eyes shift to someone behind her and his face breaks into a wide smile; turning, she sees Ted staring down at her, his mouth strained into a half-smile.

  ‘I see you’ve met Albie,’ he murmurs under his breath, as if they still share secrets, as if nothing has changed. His voice trembles.

  A warm sense of triumph floods her throat; she moves past him, smiling faintly. Anyone watching would think she hardly knew him, was uninterested, a little bored.

  She doesn’t notice the walk to the station or the train back home, she doesn’t pick up the glass on the dressing table or wash out the cup in the sink. She lies in bed but doesn’t sleep. She stretches her hand across the strip of light that falls over the bed from the street lamp outside, spreading the fingers as wide as they can go, as if trying to grasp the bar of brightness between the soft edges of shadow on either side. The face of the young surgeon glows in her retina like an after-image of the sun, eclipsing Ted’s completely.

  2

  London. Autumn 2015

  The stage. A Player, his victims. The witness. Ambition, Fate, Destiny, etc.

  Witness: to see, hear or know by personal presence and perception.

  The witness can be a bystander, an enemy, a lover. A beholder. It can be someone you don’t even notice at first.

  Ambition: hovering in the wings.

  Fate: announced by drum rolls from the pit.

  Destiny: directing proceedings, having it all her own way.

  The cages are stacked along three walls in the animal room on the tenth floor. They are numbered and lined with sawdust and ribbons of paper. Four rats in each. Muted squeaks and scuffles fill the room, along with the dusty, sweetish scent of food pellets.

  The new laboratory assistant hasn’t arrived. Albie hunches his shoulders, the blue lab coat constrains his arms. He noticed last week that an unclaimed white one was hanging behind the door, a larger size than most. Professor Malcolm was written on the plastic parking permit in a pocket, lower ground, consultants only. Albie had held the coat in both hands as though assessing its size and then replaced it. Ted wouldn’t mind, but Bruce would. He’d mock him, a pretender. Bruce should be here now, working to complete his PhD; he’s late as usual. He will claim some colourful sexual adventure the preceding night, then pull a crumpled sheet from his pocket, a brilliant analysis of results, scrawled in green biro, completed on the bus journey in. A threat and not a threat; as a child, the story of the tortoise and the hare seemed just to Albie; the profile of a small grey tortoise, lidded eye gleaming as he trundles past the supine hare, comes back to sustain him on long nights in the lab.

  Minutes pass, no technician. Albie opens cage number eight and gropes inside. The long white animal twists in his hands. He lifts it out, holding the shoulders and tail firmly. In the operating room he places it in the red anaesthetic box and presses a button; the rat folds gently to the floor. Limp, it feels heavier. He injects ketamine into the tail vein then positions the animal in a clamp, sliding metal bars into its ears so the head is stabilised. Opening the narrow jaw, he pushes another small bar into place up against the hard palate. He scrubs up for several minutes to avoid contamination; these rats have grown up in sterile conditions. The irony is uncomfortable: they are kept and operated on in scrupulous cleanliness so they can survive to be studied as victims of the fatal disease he will give them. He doesn’t pause in his preparations, the irony is familiar. Once gloved and wearing a face mask, he incises the scalp down the midline, retracts the soft flaps of skin, then drills down into the small skull. He straightens to relieve the ache in his shoulders then, taking the syringe, he slides the needle smoothly into the brain, and expels four microlitres of fluid, cloudy with tumour cells. He’d met a child with this tumour yesterday. Ted called him over to his clinic in the hospital outpatients. The father was a wealthy businessman used to control; his notes of her symptoms lay on the desk, graphed as if charting the disease would give him power over it. His little girl was curled on his lap, a tooth missing in her smile, gauzy wings pinned to the pink cardigan. Put on her feet, she lurched to one side, staggering as she walked across the room. One eye rolled inwards. The scan showed a tumour the size of a walnut in her brainstem. She would die within seven months. Ted phoned after his clinic.

  ‘What are your thoughts, Albie?’

  His voice was searching. He was after more than a rundown of treatment options; he wanted to know what Albie was feeling.

  ‘Pity. Anger,’ Albie replied slowly. He searched for words to convey the surge of determination he’d felt as he walked back to the lab.

  ‘Go on.’

  ‘If we carry on where we’re going, we’ll be able to help kids like her. It brought it home. It made me feel …’ He was unable to convey the sorrow and certainty that had pulled at him, afraid to sound emotional.

  ‘That everything you are doing is worthwhile,’ Ted finished for him.

  Ridiculously he simply nodded down the phone.

  ‘Good man,’ Ted said into the silence. ‘I’ve always thought we dream the same dreams, you and I.’ He paused and then, briskly, ‘I’ve booked the squash court. Friday eight p.m. Try not to be late for once.’

  The conversation had recharged Albie. If he had a chance against this wretched disease, the late nights and risible salary were irrelevant. He’d keep going for as long as it took.

  The rat is still limp. He sutures the skin at the crown of its head, and replaces it in its cage. When the girl enters the room, he registers her overalls and cap out of the corner of his eye; the new lab assistant. Her glance flicks to his face and away, shy. His mind has been stamped with Beth’s face these last three months, her mouth and her eyes; there is little space for others, so who this girl reminds him of slips away even as he reaches for it. He murmurs a greeting then turns back to rinse the soap from his hands. Her predecessor, Amil, left a fortnight ago. His mother was ill, his hometown of Aleppo engulfed by war. Amil had explained the Middle East to him in their coffee breaks, but since he left, Albie has lost track of which side holds sway over which smoking heap of stone. Life and death on such a scale is hard to take in. The news is like a violent film rolled out nightly; horror bereft of meaning. The killing in the lab is controlled and painless. The scale is minute; it saves lives.

  A stifled gasp breaks these thoughts. The girl is staring at the curled body of the rat, the sawdust is red and damp in patches. Her eyebrows are drawn; sharp lines crease the pale skin between them.

  ‘Blood?’ Her accent makes the question both emphatic and lilting. She could be Norwegian or perhaps Finnish.

  ‘There’s bound to be a little. It was a routine procedure.’ He opens the cage and picks up the sleepy animal, checks the sutures then replaces the rat, who crawls groggily to the bars of the cage, pink snout twitching, before collapsing again in a little heap. ‘He’ll be fine in half an hour.’

  She moves to the other cages, crooning a song, the words incomprehensible.

  ‘Could you clear up in the operating room while I jot down a few observations?�
� His voice sounds ridiculously hearty. ‘I’ll come through in a moment.’

  She edges round him, her shoulders dipping from side to side as she walks, a hefty gait for a slight girl, like a workman. He watches as she disappears out of the door, then picks up the pen, flips open the notebook and writes fast, notes as distilled as the poems on his bedside table; sometimes he thinks poetry might bring him more cash.

  Rat 8: Operation x 1 09.30 hours September 2015. Anaesthetic: ketamine. Insertion of needle to brainstem target (9mm). Delivery of 5 microlitres tumour-enriched fluid. Site closed. Minimal blood loss. Rat returned 10.30. Observations: 10.40 bleeding stopped. Rat mobilising gradually.

  In the operating room she is staring at the clamp. There is a smudge of blood on the surface below it, she should have wiped that away by now. Something in the slow look she gives him stirs the sediment of memory again.

  ‘Feeling okay?’

  She nods but her skin has the chalky pallor of paper.

  ‘You’re new to this?’

  Her eyes are lowered; she seems to be studying the clear tubes where the gases are delivered.

  ‘But you must know what we do?’ he persists, exasperation threaded with pity. Lab assistants don’t need qualifications or even experience, but they are vetted for efficiency; sentiment would be unhelpful.

  ‘I am interested in your work.’

  Your work. A rush of pride follows her words. He’s modified a virus which now has the power to kill tumours, a significant breakthrough; all the same, researchers rarely get the credit. Ted is head of the lab; research is usually identified as his. Albie pulls out a stool for her from under the bench.

  ‘I didn’t catch your name.’

  ‘Skuld.’ She sits down.

  The word reminds him of cool places, inland water. The far north. There are names like this where he grew up, Jura names. He smiles at her.

  ‘Would you like me to explain this project to you?’

  ‘I know you use rats …’ A pale hand indicates the clamp.

  He nods. ‘We’re working on a treatment for cancer using viruses. Brain cancer in children.’ He tears a sheet from the pad kept by the anaesthetic box, picks up the stub of pencil beside it and sketches a rapid oval for the skull, a circle inside that for the brain and a cylinder beneath the circle.

  ‘This is the brainstem.’ He taps the cylinder. ‘The main highway. It carries all the information from the brain to make the body work.’ He draws a dark egg shape inside the cylinder, nearly touching the edge. ‘Here’s the tumour and this …’ – he pencils a slashing diagonal through to the egg-shaped tumour – ‘… is the catheter, down which we inject the treatment.’

  ‘You do this on your own?’ Her eyes linger on the sharp line cutting through the skull and penetrating the brain.

  ‘Prof Malcolm is officially head of research but he’s often away. Bruce and I carry out all the work.’ He rises at five thirty, beating traffic to examine the animals and begin the tasks of the day. If he stops for a moment, his limbs grow heavy, exhaustion can overwhelm him. He sleeps as soon as he sits down. He slept through an entire play on Beth’s birthday. Every day is the same – the same room, the familiar smell of the animals, the hours spent examining slides under the microscope.

  ‘What were you doing just now?’ She glances at the bloodstain under the clamp.

  ‘Infusing tumour cells; it’s part of some new work I’m doing, involving viruses. I’m writing it up for my PhD.’

  ‘You give rats a tumour?’

  He nods. ‘Rare childhood ones. The tumours grow in fourteen days but I’ve found a way to destroy them.’ He waits for her response but the lines between her eyebrows have reappeared; she shakes her head, apparently confused. He straightens; his tiredness has vanished. This is work he pioneered; he could talk about it for ever.

  ‘Think of it like a war, cancer is the invader. The tumour in the brainstem is the enemy base camp.’ He indicates the dark oval. ‘Tumour cells spread from here to the rest of the brain, infiltrating like terrorists. With me so far?’

  She nods silently.

  ‘I’ve adapted a strain of the chickenpox virus which targets the tumour. We infuse it into some of the rats, it destroys the base camp and here’s the clever thing …’ He nods excitedly. ‘The virus switches on the rats’ immune system which attacks the migrating tumour cells; it’s like recruiting the locals to take out those terrorists. It seems to be working. The tumours shrink away.’ He puts the pencil down and smiles; the miracle is new to him each time.

  ‘You said some of them. What will happen to those rats who don’t get the virus?’

  ‘They don’t survive, but we make sure they don’t suffer. They are euthanised when they develop symptoms.’

  ‘And the ones whose tumours shrink?’ She is watching him but her expression gives little away.

  ‘We sacrifice them after two months. It’s important that we compare the brains of the treated and untreated groups to see exactly what effect the virus has had.’

  Her eyes are opaque, deep ponds in a Norwegian wood. When he first arrived, Amil had shown him round; in the animal room he had tenderly slipped a little animal from palm to palm. Albie returned later on his own; the rats were sleeping in a soft, white pile, long tails tangled together. He watched them, wondering if he had the right to interfere with their lives, end them. He’d seen children die and families suffer; even so there wasn’t a clear answer, or one within his grasp. Back then he was conscious of going through a gate on to a track, and since then he’d simply kept walking, looking straight ahead. If anyone had asked him, he’d have said on balance this seemed the right thing to do. He drew away from further analysis, aware that he might become mired in choices and time would be lost.

  ‘We follow the procedure set by the Home Office to minimise suffering,’ Albie tells her. ‘Euthanasia is rapid, you wouldn’t be expected to assist.’

  Her stool wobbles; she puts out a hand to grip the table, revealing a tiny blue mouse, perfectly drawn on the joint at the base of her thumb. The girl with the roast beef. ‘I knew I’d seen you before. You were helping at Prof’s party a few months ago.’

  ‘One of my sisters works in the kitchens here, she organises events. I help if they’re short of people. Extra money.’ Her hands disappear into her lap. ‘It won’t affect my work.’

  He recognises those short sentences, defence and shyness, both. He has no idea what she earns but it wouldn’t be much; he doesn’t earn much either. He doesn’t envy Ted his luxurious flat or the Mercedes; holidays in his Greek villa would bore him. All the same, it would be good to mend the roof in Jura, repair the windows. The rewiring is years overdue. He smiles at the young girl sitting before him, her shoulders hunched as if to ward him off.

  ‘So you’re the scientist of the family?’

  She shakes her head. ‘My eldest sister’s a technician in the large animal lab. My mother works with animals at another hospital. I came straight from school but I know about animals.’ A note of defiance has crept into her voice. ‘We keep stray dogs. Mum taught me everything I need to know.’

  ‘We know about animals too.’ He feels his way carefully. ‘But this is a research facility—’

  His phone vibrates; a list of questions from Beth appear on the screen: What time is supper? How many others? What should she wear? She seems less certain than usual, vulnerable even. Perhaps she’s allowing herself to come closer at last.

  ‘I need to go.’ He takes off his gown. ‘Our lab manager Bridget will run through the other procedures. The person who showed you round left out a lot. Who was it?’

  ‘Bruce.’

  ‘Ah.’ Someone should warn her about Bruce; she is very young, a little fragile. ‘I’m Albie. Albie McAlister. Let’s catch up again soon.’

  ‘I know your name.’ She stands up, ethereal despite the bulky lab coat. ‘They talked about you.’

  ‘They?’

  ‘Some consultants and the Professor.�
�

  Hospital gossip; inescapable rubbish mostly. There will be no truth to this; all the same, his interest is piqued by the mention of Ted. ‘When was this?’

  ‘Yesterday, at the monthly planning meeting.’

  ‘Really? You were there?’ The consultants’ meeting is a high-ranking affair – departmental strategies are outlined, research considered, future appointments discussed.

  ‘They needed help setting out the food, pouring coffee, those sorts of things. My sister asked me specially.’ Bright spots of colour burn in her cheeks. ‘I was there the whole time, I heard everything.’

  ‘So what did they say?’ he asks more gently; she’s just a kid out of school, easily hurt. He smiles encouragingly.

  ‘They want to hire someone ahead of the Professor retiring, to take over his jobs when he goes. Your name was mentioned. He said you are a brilliant surgeon and that … um … he was very proud of you; you will make a difference. You are very … uh … innovative, and you hide your light under a bushel in the lab here.’

  ‘Kind of them.’ He grins. He doesn’t buy any of it – too many pauses, too elaborate. She has made it up to flatter him or else muddled what she heard. ‘I expect they have plans to spare for all of us: me, Bruce, Bridget, everyone.’

  She pulls her cap off with a fierce jab of movement and shakes her hair into a bright nimbus that collects the light around her head. ‘Bruce was mentioned, as a matter of fact.’ The note of defiance is back. ‘He’ll make a mark of some kind, they said.’