A study by Younger et al at Case Western Reserve University found that nurses and physicians working in critical care and operating theatre settings differed in their reasons for accepting brain-death. Some thought brain-dead patients were dead because they would never wake up again. Others accepted them as dead because they had lost the integrating functions of the brain stem. Others indicated that they did not truly believe the patients to be dead but would die soon despite aggressive intervention. Others felt the patients were dead because the quality of their life was unacceptable.
In the operating theatre nurses sometimes felt that the patient's spirit was in the room during organ retrieval surgery and only departed when the ventilator was turned off and the patient came to complete rest.
If it were possible to predict soon after brain damage had been sustained that, in the event of survival, the outcome would be a vegetative, mindless state, then the wisdom of continuing supportive measures could be discussed. Jennet & Plum, 1972, p. 737.
I think, therefore I am.
David's eyes are open, staring. He is unconscious but he doesn't know he's unconscious. As yet David is not sufficiently conscious to understand consciousness. He merely feels.
David does not know he is lying in a hospital bed, or know that above his head a board says 'nil by mouth', in bright red letters. He does not know that his head has been shaven and cruelly ripped, then at some point closed, with crude, crossed, purple stitches. Around, monitors, drips, oxygen, concern, and people whispering. But of this he knows yet nothing, only colours, smells, music. He dreams, or lives again.
Out, down on the valley floor, sunlight flashes gold off the bad, shell-thing moving. He looks left, right, fearful, confused. Around him are naked, pot-bellied men and young frightened boys, all with sharpened sticks, all their skin blue, their eyes too white in blue faces. He looks down at his body and his skin is pink, no, it is white; white, a little pink with sunburn when he should be blue.
Around the bed, white coats, three men, a woman; but Professor David Jones does not know this. Professor David Jones does not know he exists. Professor David Jones does not know yet what existence means or what knowledge means. Professor David Jones merely feels. He does not yet think he thinks or know that he thinks.
He feels the sun. He thinks, "I must paint myself blue". He was at the burial barrows this morning, he remembers. All was peace in the village, but there was an air of the approaching. He feels the sun. The pits are filled with blue, ready. He thinks, now, he thinks, now. Now I must paint myself blue. He feels the sun on his skin.
"In simple terms, Mrs Jones, Your husband's cerebral cortex was starved of blood and has died. He lives but he has no consciousness. He will not react to you. He has no emotion or volition."
From The Hill he knows none but the eagle could see further. And he looks down, he sees the flashing thing, down in the valley, in the meadowground between the marsh and the dike. He shivers, and now, when he looks at himself, he is painted blue, too. Down in the valley the shining beetle moves toward the dike and the blue line, his brothers. The blue, his brothers, moves as if an adder struck and the beetle, darker, with reds and sharpness, brown, the sun-flash of its moving shell, reacts. The beetle was short and fat; but now it moves and is a peacock's tail, now, wide, four shells deep, longer and wider and at the ends, curve-armed around his brothers. He sees the blue bodies form a circle, then the circle fall down and the shells, the flashing sun, close above it, and on the floor, fallow, his brothers, red now, blood now, still now.
He looks about him at the boys and at the other men. He is terrified. He thinks they must be too, but their eyes are resolute. He becomes calmer. He trust his Gods. This is his hill. He prays.
"Persistent Vegetative State"
"I'm so sorry, Mary."
This is the first time that David has heard the voices, but as yet he doesn't know he is David, and he doesn't know that the sounds are voices. They buzz oddly. He thinks of a bee, too loud, frantic, trapped in an earthen jar. He is thinking of the colour of his skin, the danger of the beetle in the valley, of his lost brothers, the bee. He waits to be more fearful and when he looks at the older men, the younger boys, like him, all staring, and the fear does not grow, he smiles thinly, ready. He is ready, but then he flies. The sky is a perfect, light, light blue; lighter than his skin, brighter, sun-filled and warm. He flies away, but he had wanted to stay; below, the beetle had reformed and surely, madly, moved toward his hill, but somehow, he is the eagle and the sun calls him.
"So sudden. Oh, Mary, I'm so sorry."
"I'm not."
"Oh, Mary!"
"Why should I pretend?"
The buzzings sound different. Some are dark like fern-shadow, some are light like sun- drop, some are like primrose. Now he puts the light sounds with something else remembered, with primrose, with laughter, and down through him a prickle runs and it seems to stop in his belly, below him. He is heat of a kind, but a heat he can't quite feel.
"When did it happen?"
"Berzz, bizz bid baddadm."
The prickle has moved to one hard place and David sees Ruth, but he does not remember her name yet, the name Ruth. But he sees eyes, so deep and so brown and sucking him down into her, her heatwet, her closetight. And he feels flight again, but inside-flight, deep, deepred, deep, deeplove, deep, deepperson. Juice.
He knows the hard place is dark joy.
"Brazzz briddde." "Last night? When?"
"Bridd briddde." "Midnight."
A vague disquiet comes. He turns to Ruth but Ruth is flown. He is alone. He is confused. He yearns, but for what he has no idea.
"Mother, how can you say that? Mother!"
"Brother. Buzz buzz buzz batt? Brother!"
He knows that the Druids can do this, turn to phantoms his love, his deepneed. And he concentrates, concentrates, for he cannot believe, but this inside-thing floats away like summer heat and he thinks he is moving, flying, and Ruth, though still he cannot think her name, Ruth floats away, dissolves.
But Rebecca! Oh, Rebecca. And now he is not what he was and instead he is wrapped in brown and green, bound for Southampton with Llewellyn, Griffiths, good Welch King Harry and at last, oh, his sweet Rebecca! Finally, she yields.
"My love, it is just in case," she says, and she has undone her throat, and has lowered her eyes, her deepsoft, deep, soft, deep, brown eyes. "My love, in case, for should you fall in France and us never once entwined?"
And this hardness he remembers, this, this sweet woman, this dark, deep falling. The name too, Rebecca.
"He lied, he cheated me. Any woman, if she was dark."
"You don't know that, mother."
"I know that."
The light buzzing is with the darker buzzing, birds calling, but the lighter buzzing does not like him. Like? Is like where deepneed is? He knows that the darker buzzing is sad but he is drawn away, drawn away, for he is sick now, the seas are tossed, the English channel lurched, and him a cork, tossed and rotten, afeared that he might die, terrible sick, but not on a field of gold.
"I don't even know why he married me. Am I dark?"
"Oh, mother, stop this!"
"Why? Why should I stop? I have spent too long, waiting."
David would like to float, to fly again, but he wears no britches now for the dysentery. The dysentery is so bad his legs are black with his own waste. Up there are the great walls that Frenchy calls Harfleur and those within them are still at bay. They are brave and defiant, despite the trenches, pits, the sappers' tunnels, the rain of iron. And David wishes, just once more, to touch his sweet Rebecca, to look into the well-deep dark brown of her, once more before he dies. And as he voids again, the flames and noise around his head, a flame screaming up through him, he prays, not to live, but to die of something a little more glorious than this.
David thinks he sleeps and he looks into Rebecca's eyes and she is whispering,
"In case, my good love, in case," and her throat is sweet and white, and her shoulders are and he wants to fall, to spin away, to be with Rebecca, to falldark, bedark, to love. He has a name without a name, a feeling, the deepdark feeling, love.
He hears wordsound. Not words yet, but the meaning reaches him. He hears, "I never understood. Apart from that he was a good enough man, a decent enough father. But he was weak."
Weak? Of course he is weak! He is weak from the gut-rot but he is strong too, and so proud; for this morning, misted, lemon-grey, a great French dawn, he is proud to be Welch! For he has stood, his long bow loose, as his great and good King Harry, his white steed high and stepped, did issue ultimatums at the wall of Frenchy's castle and they did cheer when those therein surrendered to spare their women and to spare their old men. Weak? Hah!
The buzzing annoys him and he tries to dreamfly, but now the paindark, the bloodbowel makes him a lesser man and he wonders, it is raining heavy French rain on the march, he wonders, does he still have the strength to fold his bow, to dispatch his fletched reply when he is called upon?
The word has come. They are to march on to Calais, depleted by the cold and the damned gut-rot; but there is talk of the Dauphin's men in all their gathered hordes, tracked on their track and a reckoning, at terrible odds, soon to come. He lies now, at night, wet, thinking only of his dark Rebecca, and satisfied, hoping only that whatever death be had it not be one leaked away.
"Buzz, burrzz, burzuzzzaway."
He is still not liked out there where it buzzes, this he knows, but he cannot quite work through to why. Nor liked was he either that particular morning by the Sergeant-at Arms. Scared, aye, but defiant, was he not? And did his great, great King not fire them up, him up, his white horse flaring, and Harry his mailed arm raised, telling them to die for his England, for Saint George? And him Welch and proud of it as they waved their unhacked fingers, a two thousand vees, at Frenchy, ready to pull their waxed strings, and fly their straight arrows, rain thick and black, into the enemy.
He hears this place is called Agincourt.
Their numbers are small, out-done, but their hearts are large.
"Persistent Vegetative State, Mrs Jones. The trauma has killed the cortex but not the brain-stem. Your husband can breathe, he can swallow. He may open his eyes but he will not see. He is not aware."
It had been raining, and they charged to where the trees closed at their sides and then the French noblemen came to battle, but so close packed between the trees, they could not raise their arms. And as they slipped and fell, suffocated, he leapt into the melée with his brothers, their bows discarded, and with dagger and club they took down the stumbling pride of France, ten thousand men and of the English, of the Welch, of them barely one hundred fallen, and the King, his helmet all but cleaved by a Frenchman's broadsword, blooded, his face mud-splashed but his eyes shining like God's, did he not see this good bowman David and kiss his filthy face and thank God for his Taff archers?
And he, I was David? Looked forward, backward, to the arms of his Rebecca, to the spiral darkness of her eyes.
He thinks, "David?" but then again he dreamflies, his thoughts still loose, above the glorious field, into clouds and rain, already forgetting his moment, kissed by his King, his wounds, his dark Rebecca lost, and then his quiet passing.
And now there is a pit, candle-lit and he is Daffydd Griffith, miner, and there is talk about of the sliding scale wage. He likes it, that he has captured a name, and when he leaves his shift he knows that he will go to his lodgings, bathe, then visit Mister Evan Pugh and ask if he might call on the dark daughter, Arfona.
"Is it permanent?"
"Oh, yes, Mrs Jones. Permanent and irreversible. I'm sorry."
This dreamfly trick, he feels he is controlling it now, so quick and he is there at Mister Pugh's already, knocking, removing his cap, asking politely, "Mr Pugh, I have come."
But Arfona has looked a split-second at him, then a second at her father and she has shook her head and Mister Pugh, has said, and Daffydd knows he is sad, "I am so sorry, Dai."
And he has run away, become a private, a South Wales Borderer and he is gone to Africa, his helmet flashing white, his bright tunic redder than a rose, but it not red enough, the buttons bright enough, to take away the hurt that dark Arfona did not want him.
And the land is parched, and hard, where nothing will grow, and the sun is merciless and he is sent to build a river crossing with Mr Chard, some place, a shit-hole called Rorke's Drift in the Zulu lands.
By his bed, his wife, his son, talk.
"They'll miss him at the faculty."
"Yes," his wife says,"his shoes will be hard to fill."
"It's so sad."
Daffydd felt sad once, but the engineering work's a good cure, and if not for the gut-trouble that's laid him low, put him in the hospital next to a man called Hook, he'd be laughing with the lads down on the river right now. The work, this country, the sun, and he has managed to diminish the memory of Arfona. And when the rider comes with news of Isandwala, the regiment lost there to a man, and he is pulled from sick-bay to wait with his rifle, the fear flushes away all else.
While the fit men stack the walls, he tries to think of Arfona, but he remembers only her brown eyes above a chapel hymnal, dark, deep like memories, like the earth. And then he is on guard and the hill-side is black with bracken, ten thousand Zulu, and them Borderers, hundreds.
"Do you think his secretary will go or stay?"
"Won't that be down to the new Professor of History, mother?"
"He was screwing her, did you know?"
"You don't know that, mother."
"Of course, I do. She was dark wasn't she?"
The Zulu are brave men but follow stupid orders. They are not young men. They have grey whiskers, pot-bellies, and are dark skinned, and round their eyes, the whites are yellow, and they wear bone necklaces, and carry shields of animal skin no match for the point four-five Martin Henry. And they die piled up, some of them squashed, the breath squeezed out under the weight of their brothers. And, as he presents his bayonet, hah! the other man posts an assagai, as his eyes widen, and the black man's narrows, he thinks he remembers fat bellies elsewhere, blue not brown, and men smothered elsewhere but in hoof-churned mud, not on this bone-hard ground.
"Hah! Hah! Thrust, parry, another one!" At least he thinks this is the case but then he is spiralling again, flying again, high above the barricades, above the mealy bags, and, high on the hillsides the Zulu salute them, and below, Private Hook with brandy on his breath, and himself, Daffydd, on a litter, unmoving.
"No, he won't move. They feel pain and will react, but there is no thought. No thought whatsoever. Consciousness has been removed."
What? I'm still because the surgeon has made me still, you fool! A spear-wound to the gut like mine is not a slight. What do you expect, that I should dance a jig? Where are you, man? Speak up! I want to see your face, and remember it, and when I am well, give you a tap on the chin for your cheek.
"He has caused me pain for thirty years with his dark girls, the students falling at his feet."
The voice. He thinks, Mary?
"Why should I pretend to care now? He's got his just reward. Keep the machines going. I'll come in once a week."
Mary? Why so bitter?
Machines?
"He screwed so many of them I lost count, always gypsies, always little dark things.
Now he's screwed. And it serves him right."
"He never should have been a historian. He was Welsh, born to be tragic, to die
somewhere in some sorry war, probably from Yellow Fever or Cholera. Knowing him,
he probably would never manage to die well. Maybe the women were little deaths of a
kind. I haven't loved him for twenty years; he killed whatever we had."
"You're grieving, now, Mrs Jones. Go home. David's not in pain. We can look
after him until you decide."
David thinks, decide what?
"Decide what? To let him go? No way, I want to tell him what I think of him. I need
him to know the pain he gave me."
"He cannot hear you, Mrs Jones, he cannot hear anything. He can hear nothing,
not in a persistent vegetative state."
Can't hear?
"Hear? I don't need him to hear. He never listened anyway. But I can pretend; he still looks like him. Did you know that he believed in re-incarnation? He used it as an excuse. He said he was destined to fall in love with dark women."
Mary, yes! It wasn't my fault.
He remembers. I am David Jones. I am David Jones, professor of Celtic history, eminent speaker, Welsh down to my toes, Welsh as mead, Welsh as the men in blue who led the Roman legions a merry dance, Welsh as the leathered men who rained arrows into the French. Mary, Mary. I am in here. What?
He hears his wife, at least he thinks he does. He thinks she is moving closer. He imagines it perhaps, he feels it, perhaps.
"Well, just in case he's right, I'm keeping him a while. He used me for thirty years, now it's my turn. Just in case he's right and he slips from me without me satisfied. I couldn't do that. Just in case."
He thinks, Oh, Mary. Please, it really wasn't my fault. I know now, I understand. I was never unfaithful, not really, It was only me following my blood to the dark place, to the deathplace, to my dark Welch woman, to my falling.
David can hear her now, talking softly, bitterly, just the murmur of her, a fine, light bee buzzing in the ferns. It is hot but he feels a storm coming, black and sweating, slinking in through the hills. For a moment he thinks he imagines someone holding his hand and he wonders, Mary? He is trying to make himself return to the hill fort, to stand four square with his brothers against the Romans. Sometimes he is almost blue, unafraid, ready, sometimes he is flying, and sometimes he thinks he feels her hand against his, and he hears her bitter, fair voice.
And David thinks of the term locked-in for he is truly locked in, and he thinks that at last, this not-dark English woman, this wife, his wife, has him where she wants him.
And he asks his hand to squeeze back, if he could he would dig in nails, but his arms are foreign and his fingers are deaf, and he thinks, he thinks, she might have me forever. And he strains to grasp the light animal fog by its white throat, to direct the sun back on to him, to catch at the memories that dance like bees throughout the hills. He thinks, if I am locked in, I am here with Ruth, I am here with Rebecca, and all there's left to do is learn to visit them.