Wayward Heart (english version of Coração Independente)




Chronicle of a cardiac arrest


by Pedro Serrano


Translated from the Portuguese

by Karen Bennett and Alex B. Carvalho





First edition (Portuguese): Coração Independente, Relógio d’Água editors, 

Lisboa, 2000.



Translation: Karen Bennett & Alex B. Carvalho


Cover: © Denise Ferreira over photography by Pedro Serrano, Ria de Aveiro, 2015.



© Copyright of this edition: Pedro Serrano, 2016-2022.






To Manel and Gabriela, Isabel Costa, Ana Santos Silva, Vera Bonfocchi, and Carlos Orta Gomes



To the memory of Manuela Campos Monteiro, Mário Braga, Judite M. Neves, Nazaré Ferreira, Herman Anker, José Leitão, and Dennis Potter






   Part I – Forever hangs always by a thread   


   Part II – It’ll be nothing serious!           


   Part III – Out of hours           


   Part IV – In the land of green broth           


   Part V – Beyond the traffic lights           





What a strange way of living

Has this wayward heart of mine,

It lives a wild and loose life,

Who would give it the magic touch? 

What a strange way of living.


O wayward heart,

Heart I can’t control,

Living lost, all apart,

Obstinately bleeding,

O wayward heart,


I can’t keep up with you no more,

Stop, stop beating now

If you don’t know where you go,

Why insist on running,

I can’t keep up with you no more.



From Amália Rodrigues/Alfredo Marceneiro

“Estranha Forma de Vida” (“Strange Way of Living” – fado lyric)




Part I



Forever hangs always by a thread*



* “Para sempre é sempre por um triz”. From the song Beatriz by Chico Buarque and Edu Lobo (O Grande Circo Místico, 1983).






    Sometimes, when I was small, and struggling to eat my soup, I would surreptitiously slide the blade of my dessert knife over another with a sly wink at one of my sisters or cousins. That was enough to provoke a delicious intermezzo. Inevitably, to our glee, our mother would bark out: 

    “Uncross those knives right away! You know I don’t like to see crossed knives.”

    “Why, Mum? What’s wrong with it?” we would implore, winding her up. 

    Crossed knives presaged war within the family, just as surely as jumping over a prostrate body and failing to repeat the movement in the opposite direction would stunt that person’s growth. Laying a hat on a bed; opening an umbrella inside the house... my mother had a prophecy for each event, and there was a portent – good or bad (though most often the latter) – attached to every procedure.

    Within her complex system of interpretations, there was a special chapter devoted to birds. Almost all of them augured doom – the sad hoot of the owl, the flurry of a sparrow accidentally imprisoned inside the house, the innocent flight of birds over our heads, even birds that had the mishap to fall into our path. None of this boded well for whoever had the misfortune to be nearby.

    “Old wives’ tales!” my father would declare mischievously, pragmatically solid in his worldview.

    As for me, I had never considered myself particularly superstitious – or at least, not to the extent of going around permanently downcast or anxious because of some forthcoming disaster. On the contrary, if I had assimilated anything of the lugubrious soothsayer’s faith that I had imbibed at home, it was tempered by the much sunnier philosophy of my father. Thus, if a pair of birds passed overhead as they winged their way southward, northward or westward, I would think of it as a good omen. 

    But there must have been some residual atavism lurking in my unconscious on the morning of 1st January 1999, when I opened my door and spied the tiny corpse of a newly-dead bird on the doorstep. For I was unable to rid myself of a thought that welled up from the remotest depths of my mind:  

    “Which of them will die first?”

    “They” were my mother and Judite, the wife of a good friend of mine from Viseu. Both were suffering from the same type of cancer, and both had had operations that had apparently been successful. Indeed, for several years everything seemed to be going well and the absence of news suggested they were cured. Then suddenly, on one of those days that are never forgotten, there was a slight pain, a sudden tiredness in the street… And the nightmare had returned. We were on the road to Calvary, as the last stations of the cross showed up in the pitiless clouds of black and white on the X-rays and CAT scans. 

    And yet life went on, serenely for the most part. 

    As for the dead bird, the more objective part of my mind concluded that this was probably the work of our cat, Tangerine, who had the habit of dragging all kinds of unexpected presents into the house: birds, lizards, grasshoppers and other trophies. And the little bird lay there, stranded on the edge of the doormat, with one wing folded awkwardly like a disjointed fan, a handful of sad feathers scattered over the tiling. 

    My mother went first, in the early days of March, while winter was preparing to hand over the reins to spring, and the first green buds were starting to appear on the hydrangeas at my parents’ home. As for Judite, she left us six months later, at the beginning of October. Autumn had already arrived, and in Viseu, a sharp wind was pruning the leaves on the avenue of lindens, shrivelling the souls of the mourners returning from the cemetery. 

    But it is a risky business, trying to divine the future, as the old stories and fables repeatedly tell us. The sorcerer’s apprentice usually ends up in trouble if he dares to peer into the entrails, trespassing upon a territory reserved for the gods. I was no exception. Someone somewhere certainly charged the future with the task of showing me just how naive I had been in my interpretation of the portents on the first morning in 1999.

    For I could never have guessed – nor even dreamed – that half-way through that scrap of time between the death of my mother and that of my friend Judite, there would be enough space left for my own death, which would occur (had I properly understood what that bird had had to reveal) in the last week of spring, at an as-yet-undecided hour.   






    I live near the sea, on a quiet street, a dozen or so kilometres from Cape Carvoeiro – that magic line which, according to the weather reports of yore, divides Portugal in half, bringing rain to the northern part while bathing the southern part in glorious sunshine.   

    But that was back in the good old days, before the storks dared come up to Alcácer do Sal to nest on the pylons that flank the River Mondego, when time seemed eternal and you could trust the constancy of the seasons. Not long ago, I was chatting about this with Nurse Edmea, whom I met coming up the side street from the Misericórdia, as I was on my way home for lunch. It had already rained three times that week, twice torrentially, and yet we were almost at the end of May, usually such a sweet month in southern climes! Clearly the climate was changing. Despite soothing assurances from the meteorologists that the monthly averages were “similar to equivalent periods in previous years”, no one was convinced. 

I myself was prepared to be satisfied with the ozone-hole theory and the imbalances that it must necessarily provoke in the climate. But Nurse Edmea had another explanation! To my surprise, she was convinced that it was all caused by the satellites, rockets and other such artefacts that man had sent up into space, saturating the atmosphere! Perhaps Nurse Edmea’s theory was slightly unseasoned, but what did that matter if the problem was exactly that! What was this weather in May if not unseasonable? And the heat we’d had this year in February and March? Summer weather!

    “My son’s been in the sea regularly!” I said, sharing my surprise with her.

June brought long days, but got off to an uncharacteristic start, sometimes grey, at other times luminous. It seemed undecided, neither fish nor fowl, not cold nor hot. And there was I, lolling in this marinade, on 17th June, a normal working Thursday, which slid past unremarkably with the same routine as all the previous days. At the end of the afternoon I returned home and worked a bit more before dinner. I was presiding over a recruitment committee at the time, and so my room was cluttered up with CVs – twenty-five in all – voluminous enough to tempt a mountaineer. I had stored them there partly through lack of space, though mostly so as I wouldn’t forget the task that awaited me. I sighed and, pencil poised, attacked the third of five volumes that constituted the curriculum vitae of the eleventh candidate. 

Near dinnertime, we received a visit from a friend and her son, and they stayed for a while, exchanging tittle-tattle in the way friends do on mild afternoons. After they had been twice asked to stay for dinner, they suddenly noticed the time and left in a hurry. We three were already seated at table. 

I ate little, feeling distracted and not very hungry, and gave up on the meal before my wife and son. I sat there, waiting for them to finish their desserts, nibbling occasionally at their conversation.  

Slowly and steadily, I was being taken over by a strange sensation. I felt far removed from everything happening around me, an impression that my consciousness perceived with great surprise. I could hear them talking, but it was as if I were tuning in from another dimension, as if I had stalled in a state of indifference that had been imposed from somewhere deep within myself, from inside out. I didn’t participate in what was happening – I was inattentive, not because I was fixated on anything of my own, but because my senses had slid to another level. The usual stimuli did not seem to function; my gaze drifted out of focus and moved away from what it was supposed to be observing: I felt that I was seeing through, beyond... The remains on my dinner plate, a still life… In that state, I looked on as dinner ended and the people began to move, lifting glasses and cutlery and taking them into the kitchen. There was a low-level hubbub, punctuated by the enthusiastic vocalizations of my ten-year-old son. I remained seated, paralysed like a foreigner in that strange detached mist, so out of touch that even the sounds stopped making sense, becoming gaps, as if I had stuffed cotton wool into my eardrums, a high-pitched whistle like the valve of a pressure cooker vibrating deep down in my auditory canal. I put my fingers in my ears to try to dispel the acoustic confusion, shaking my head about to see if I could get rid of the feeling. Then, without warning, a wave of nausea came over me, and I stood bolt upright from the table, without pushing the chair out behind me. Goodness! How unwell I was feeling! I walked into the corridor, without any precise objective, only because my body urged me to move. I don’t know if it was the effort that did it, but, after just a few steps, I found myself suddenly soaked in sweat, a warm perspiration that poured from my skin like water from an underground spring, ridiculously abundant and swift: first the palms of my hands became slippery; then the back of my T-shirt was soaked through as if it had fallen into a puddle of water; after that, my chest, forehead, it was unstoppable… “What is this?” I wondered, from very far off, in the isolated depths of myself. I had reached the end of the hall and sat down on the bottom step of the staircase that led up to the next floor. The telephone was next to me on its little table. I sat. Then I realised that a new sensation was taking over as my body slipped even further out of my control. A tightness was grasping hold of my left arm as if the tendons that allowed it to move were being illogically stimulated, and there was a stiffening in my neck, irradiating upwards towards my lower jaw. That could only mean the heart! And whatever it was, it was most certainly serious….

Leaden, I looked around slowly, waiting for someone to notice me. It seemed as if the colours were all blurring into a shadowy grey, that the light bulbs were no long able to illuminate the night as they used to. Finally, my wife’s eyes met mine. I waited, knowing that she would recognise the absence imprisoned in my gaze. 

“Pedro, what’s wrong?”    

“I’m not well. Take me to the health centre.”

And I slid down the stair onto the floor, landing with a bump like a mass of boneless flesh, unaware even that Zé João, my little son, was watching everything. 






    I have all this on a reliable source – a bill from Portugal Telecom which I came across one day in a drawer, offering a “complete detailed breakdown” of all the calls made that evening. Thus it was that the stark facts of the matter presented themselves to me. In horror, I learned that at exactly 21 hours, 51 minutes and 53 seconds a call was made to the house of Vera, the friend that had visited us an hour earlier just before dinner, and that it lasted less than thirty seconds. “Come quickly, please; Pedro’s feeling really ill”. 

    Vera is a doctor at the local health centre, as well as a close family friend that comes round almost every day. The two families get together frequently to share joys and tribulations or just for the pleasure of the company. On this occasion, however, she recognised the tone of the appeal. Without waiting to find out more, she hung up and hurried out. 

    In the meantime, my wife had searched out the blood pressure monitor and was trying to measure my blood pressure and take my pulse. 

    “What´s up?” I muttered weakly from the depths of my torpor. 

    “The machine must be broken,” she muttered in exasperation. “I can’t hear a thing!”

I didn’t pay attention to the details. My body, and what was going on with it, did not concern me. I was a shapeless mass sprawled out on the floor, and my consciousness, reduced to the common lowest denominator, flickered like the flame of a candle. 

I came round a little when we were outside the house. Revived by the cool night air, I realised that I was being transported on someone’s back, a dead weight with my arms and legs dangling inertly. I breathed in deeply… then came a view of a car roof and windows beaded with dew (something that happens at the coast, even in summer, because of the humidity – after an hour or so, a stationary car is covered with water droplets). My wife opened the car door as best as she could and pushed me into the back seat.

Vera arrived, got in beside me and rested my head on her shoulder. Then she opened the car window, which was a very good idea. My wife started the engine. 

My son is with us in the car. No one has stayed at home. I can hear Vera’s rapid breathing near me and feel the fresh night air coming into the car. It feels good. 

“Pedro, can you hear me? Does it hurt anywhere?” she asks in her Brazilian accent, as if from far away. “Have you got a pain in your chest?”

I try to shake my head, but have no idea if I manage to. (No, no, there’s no pain.)

Outside. It is dark and they are putting me into a wheelchair. Next to me is an ambulance with throbbing engine and nearby, a fuzzy patch of lights. I realise that I am at the door of the emergency department at Lourinhã Health Centre, though I’m not sure if that is because I can actually see it or because the place is so familiar to me. I am a doctor and have worked here every day for the last fifteen years. I know the building like the palm of my hand.  

“I can’t see anything. I can’t see you,” I say to the air or to whoever is pushing my wheelchair. No one answers. 

Inside, noise, confusion, shadows. I recognise the voice that addresses me – it is one of the receptionists from the health centre:

“Are you not feeling well, Dr?”

“I can’t see you,” I say. “I know your voice, but I can’t see you”.

I say the same thing to the colleague that receives me. The information might be important.

“I can’t see you – only a halo of light where you should be.”

I don’t say I’m blind, because I don’t feel as if I am. I just can’t see the people, though I can make out their bodies. They appear as luminous outlines of bright yellow light from which emanate familiar voices, as if through loudspeakers. I am calm, quite the reverse of panic. I don’t feel worried by the situation and explain over and over again, “No, nothing hurts. But I can’t focus on you. All I can see is a halo of light.”

Then comes a jab in the arm (they are pumping saline solution through my veins to irrigate them), a calm voice with an African accent saying goodbye (it is Clemente the nurse), movement, the crunching of wheels over a stony surface, the metallic clang of doors shutting… I am inside an ambulance and various voices are talking around me. 

Someone places an oxygen mask over my nose and mouth, and I hear Vera’s voice murmuring, “I’m going to put a tablet under your tongue. Let it dissolve slowly.”

I open my mouth beneath the plastic. Everything is lurching and shaking around me – we must be travelling at breakneck speed. It is not at all comfortable, and the noise of clanking metal is deafening. I hear voices behind me, some apparently human, others more like the voices on a taxi radio. The pill tastes minty. The mask hurts my nose. I open my eyes and try to speak… 

We go, we should go to Torres Vedras. My eyes are open, but I still can’t see. I am worried about the effect that this will have on anyone that looks at me – my dull expressionless gaze, unfocused and crooked. It’s annoying… Who is looking after Zé João? My eyes are open but I can’t see anyone. I can only see what is on the inside – lights, white light, no… yellow. I close my eyes and find it’s the same – an arch of light. I open my eyes and say… 

I feel numb and limp, as if I’ve been slipping gently into sleep. I am not sure about the consistency, or even existence, of my body – or rather, I think I can see it lying there on a stretcher, on a level a little below where I myself am, as if I am moving away from it backwards, coming out of myself from the head end. My body lies there below, quietly waiting. Around this loose detached self a kind of circular tunnel is forming, with continuous walls made of light. It is an intense light, strong yellow in colour, a greasy yellow like the fat that floats on the top of a chicken broth.  

“So this is the tunnel of light!” I think. “I’m on my way out”. I am surprised at how calm I am. If I’m dying, which seems to be the case, I am experiencing the moment with great tranquillity, no fear or anguish. Being. I am and I observe. There is not much to see. There are the shining walls of yellow light, though I’m not sure if the tunnel is completely surrounding me, if my self is completely contained within it. I am moving slowly, backwards, it seems, though I don’t seem to be changing place or level. 

Suddenly I shudder and jerk, as happens sometimes on the threshold between sleep and wakefulness, and I find I am on the stretcher in the ambulance. I sense anxious breathing to my left. And I see – now I can see clearly – João and a young man in fireman’s uniform near my feet.    

The mask is compressing my nose. I open my eyes and say, “This shit is hurting me. It’s horrible having to breathe like this!” To my left someone speaks. I turn my face slowly in that direction. I see Vera smiling. “Now you seem more yourself. Are you feeling well?”

I breathe in deeply, as if to check that I’m still whole. Above my head, the flask of the intravenous solution dances frenetically. Yes, I feel fine, in spite of the annoying mask. The oxygen is making my breathing light. It feels good. I hear a voice behind me: 

“Five minutes, doctor Vera.”

“Warn them again that we are arriving,” Vera instructs.

The ambulance stops. Doors open with a bang and the fireman unhooks the flask from its support on the ambulance ceiling. The stretcher is moving. I recognise where we are - Torres Vedras Hospital at the entrance to the emergency department. I manage to say to my wife:  

“João, if I have to go to Lisbon, try to get me sent to the Civil Hospitals.”

The trolley forges its way through to the inner door of the emergency department, and I pass through a column of heads, all craning to see if the package that has just arrived is in a better or worse condition than the one that arrived five minutes before. The usual menagerie of gapers, roadside voyeurs! I’ll be damned if they’re going to get any joy out of me!





    The doctor wears glasses He unrolls a strip of ECG and scrutinizes it carefully. He shakes his head and says:

    “There doesn’t appear to be anything here... Let’s get his top off so we can see better.”

    He moves his hand towards his stethoscope, which nestles into his neck like a rubber and metal stole. I try to be cooperative. Supporting my body on my elbows, I raise my hands to my waist and pull upwards as hard as I can to release the bottom of my black T-shirt that is stuck in my jeans. Suddenly, everything ceases to exist.    






    It was Vera that saw all this. She was at my side in the Emergency room throughout the whole thing, and when she visited me, two days later, she told me what had happened. She has no idea how much it affected me, hearing her account. But I had to find out sooner or later. I was gradually becoming aware of the gravity of the event from the small details, the strange things that came to my attention in the following hours – though they were fragments, loose pieces of a jigsaw puzzle that I was unable to put together on my own. For of course I wasn’t there! 

The moment I tried to take off my T-shirt, my body began to arch. My thorax thrust upward and a deep hollow appeared in my abdomen as if I had no entrails and the skin of my belly had suddenly got stuck to my back. I grimaced like one possessed; my eyes swivelled in their sockets and my whole body was racked with violent convulsions. Then came the impolite noises that health professionals primly refer to as “the loss of sphincter control”. Immediately after this, my lungs and heart stopped working. Full stop. I was dead. I was not yet irreparably dead, but I was undoubtedly more dead than alive. 

Quickly – because a brain starved of blood and oxygen will hurtle rapidly towards brain death, which is definitive and irreversible – they did what they usually do in such situations, which is just like we see in the films. First they thumped me in the ribs over the heart. But as this didn’t work and everything in me remained stubbornly immobile, they had to resort to a defibrillator – that is to say, to electric shock resuscitation. 

“We had to give you a little push...,” the doctor explained later with endearing modesty. “Your heart was being a bit lazy.”

“What do you mean ‘lazy’?” I asked, still befuddled, not understanding what he was talking about.

“Come on, try and get some sleep,” he interrupted. “You’ve had a difficult day. You need to rest. It’s important that you take it easy.”

Sleep?! How could I? It was impossible! For one, the morphine was keeping me awake, suspending me in a limbo that was tinged with slight euphoria, a golden fizz, gentle excitement. And then, of course, I also had a great deal to think about. I had to re-attach the thread to the reel, now that I had returned to the world of the living. 

What could I remember? I had come round while I was still in the emergency room, though I was now on a moving trolley, heading to the ward. People dressed in white milled around me, though there was no one I knew. Suddenly, I had an incontrollable urge to vomit and my dinner came up, half onto the floor and half into the basin that had been hastily thrust under my mouth. Afterwards I felt better, because that dinner had in a way been cursed.   

It is night and I am now lying in a bed, somewhere in the hospital, in a space separated from another bed (where someone moans softly) by an oilcloth curtain hanging from the ceiling. I can hear murmurs and, to my right, on the other side of a glass wall, figures pass by from time to time. My doctor suddenly pops up like a jack-in-the-box and peers at me. He doesn’t say anything but just stares, with an expression that looks apprehensive. I'm feeling all right – nothing hurts, and the bubbling of the oxygen and morphine lulls me. The events of the last few hours are parading across the blank screen of my mind, and although I am not quite sure how they link together, I feel intuitively that I have been party to some kind of miracle. My eyes fill with tears. There are a great many of them, a silent warm continuous stream. When they get too strong, I pull up the edge of the sheet to wipe them away and I see that I have my chest covered with electric wires, a metallic stubble-field. A male nurse checks the saline drip. He smiles at me and closes the curtain around me. Ensconced in my oilcloth cocoon, I eventually drift off to sleep. 

Back in the emergency room, the cardiologist has a word with Vera, who has remained there to be updated on my condition, before reporting back to João in the waiting room:

“This is serious. Don’t raise his wife’s hopes too much.”






    I am woken by the sound of castors clattering along the rail on the ceiling – the curtain that has sheathed me during the night is being pulled back against the wall. A friendly voice wishes me good morning and asks me how my night has been. Later, without lingering, it does exactly the same at the next bed, letting out another cheery “Good mor-ning".

I have a theory (though I cannot be sure that it has not been formulated before) that all people resemble animals when seen in a particular way or from a particular angle. It may be the shape of a face, an expression, a way of moving or even some psychological trait… what is clear is that there are creatures of all kinds – dogs, cats, lions, birds, giraffes (or, shortening the list into categories, mammals, reptiles, insects, birds, fish) – swarming about our pavements, restaurants and public transport in every city, town and village. 

The nurse that moves about the room, going energetically from task to task, reminds me for all the world of a little sparrow – one of those that jumps around as if it were playing hopscotch with the lines of the paving stones, stopping here and there to peck at a crumb, or taking off from some high place in order to go and splash about enthusiastically in a puddle, emerging barely damp as if the water hadn’t touched it, only to fly off again to enjoy a gossip on a telephone wire. She is thin and frail, with the tremulous appearance of delicate animal, hair that is short and black as a crow’s wing, and large dark expressive eyes. 

Like a bird, she also sings. She goes around the whole day warbling a tune (perhaps her favourite song, or something she happened to hear in the morning and couldn’t get out of her head), a song that I recognise perfectly. It is All I Have To Do Is Dream, by the Everly Brothers – a catchy song from the late ‘50s. As it happens, it is one of my son's favourites; when he was just seven, he asked me to record it for him, along with some others, on a cassette for his own exclusive use, and which he decided to call “Mixtureland”.

“Dream, dream-dream-dream,” she sings.

I learn from the ancillary worker that comes around behind her that the little sparrow is called Catarina and that the round metal bowls she clinks are for bathing the patients in the Special Care Unit, which is the name given to the room in which I find myself. One of those patients is me and the prospect of a bed-bath scares me. Taking advantage of a moment of privacy when I am handed the unequivocal glass bottle with the wide neck and the curtains close around me again, I lift the sheet and quickly inspect myself. To my surprise, I find I’m still wearing underpants!

However, I will certainly not keep them on much longer, as a matter of honour: last night’s loss of sphincter control (the implications of which I only realise now with profound mortification) makes imperative their immediate disappearance. 

“They certainly gave you a good pummelling last night!” Catarina comments, as she rubs me serenely as if she is hand-washing a delicate fabric.

“Eh...?” I stammer foolishly, not understanding what she means.

Jutting out her chin gracefully, she indicates my chest:

“You're like Jesus! Just look at all the marks you’ve got, and a burn from the defibrillator.” 

Lying down, I can only see three or four gauze suction devices stuck to the skin and a tangle of electric wires connected to them, with the transparent oxygen probe lying across them, so I try to sit up in bed.

“Keep still,” she says, smiling, but keeping me glued to the bed with a friendly but firm palm of her hand. “Wait for me to lift you. You mustn’t move so energetically just yet a while!”

My head is whirling with fragments of unconnected memories that do not seem to belong to me, as if they’d been put there by accident, perhaps having been accidentally switched with someone else’s. Vomiting, darkness, faces leaning over me, the clinking of metal, tears, jabs to the skin, a vague need to urinate, an unfamiliar pillow, cold bubbles endlessly fizzing, heat, dry skin and the desire to pull back the sheets; groans; a voice gently scolding, “Come on, try to sleep”…

These photograms, which light up insistently in front of my pupils are now starting to blend with a shapeless palpitating apprehension, which has not yet crystallized into panic because something in me is kicking the impressions and memories of the last twelve hours away into a deep abyss. I see myself, far away, slipping to the ground, my left arm imprisoned in the mesh of an invisible net; someone has put something minty under my tongue; “we had to give you a little push… your heart was being a bit lazy…”; underpants cruelly soiled; “just look at all the marks you’ve got... and a burn from the defibrillator...”

I wanted to ask what really happened to me, what truly took place, but I am fearful of the reply. I don’t want to know any more than I can handle. 

In the end, it was sorted out without too much melodrama, as the evidence appeared where I least expected it, as so often happens in sad stories. In this case, the truth was revealed to me by a toothbrush! This instrument of revelation was brought to me by João during a bed wash in a bag of essential items: pyjamas, a pair of glasses, toiletries, comb, toothpaste, toothbrush...

As soon as Nurse Catarina had finished washing me, I grabbed the tube of toothpaste and the brush, and drawing back the sheet, made to get out of bed. There was a scream from the ancillary worker, and Catarina rushed to the bed, stalling me with a martial arts blow. I suddenly understood everything in its stark simplicity.

“Dr Pedro!” she said, with an expression that glinted somewhere between anger and amusement, “you must not get out of bed for anything, do you hear me? You want to brush your teeth? – you can do it in bed. You want to urinate? - you can do that without having to get up too.” 

And, noticing my stunned look, she added: 

“It is important that you don’t make the slightest effort in these early days. It’s vital for your heart that your body is completely at rest.”

My dismay was undisguisable. Trying to cheer me up with her smile, she whispered in her most chirpy voice: 

“Fatinha and I will help you with anything you want or need. You only have to say…  OK?”

And as she breathed out that “O”, her narrow lips formed a perfect circle of delicately lipsticked lines. 

I nodded and murmured OK, silently aware of the gravity of my condition. Jesus! The banal gesture of getting out of bed had been neutralized as if I had been preparing to detonate an explosive device in the bathroom, placed somewhere in the washbasin, next to the paper towel dispenser. All right! I get it. I should have known. 

So, my condition was so serious that the simple variation between lying down or standing up could make the difference between life – sweet life that I had known and wasted – and death – that of books, films, others.

There was no point in trying to hide things from myself any longer for information was coming at me from all sides. The clutch of news that João has brought from outside confirms my changed state, and the messages and greetings (“he mustn’t worry about work”, “what he needs now is rest; he has to think of himself”) show that people everywhere in my network of contacts are confused, worried, sympathetic. Some of them would be still half-stunned by the early morning phone call, wondering where on exactly Torres Vedras was, and realising with a shock that they had completely forgotten to ask João what department I was in.





    The Special Care Unit at Torres Vedras Hospital is a spacious room in the heart of the Internal Medicine department with which it communicates by means of a door located to my right. It is physically separated from it by a glass wall, so anyone passing by can see us as if we were in a fish tank. We, meanwhile, floating about in our oxygen bubbles on the other side of the glass, can also see them approaching along the corridor. 

The wall opposite gives onto the south side of the hospital, and through the large expanse of windows, I can see the tall undulating waistlines of poplars, swaying amidst a dusty line of cedars. In the distance, beyond the untidy buildings, as if drawn by a child, is a soft green mound, straddled by a little road.

The Special Care Unit has four beds, but at this moment, only two are occupied: mine (which is near the door, against the glass wall) and the one on my left, which contains an elderly lady, who is preparing to be transferred to Lisbon to have a pacemaker fitted. 

However, Nurse Catarina thinks that the calm that reigns in the Unit is unlikely to last long, as downstairs Dr Brito is in charge of the Emergency Department. When he’s on duty, complicated cases inevitably appear requiring hospitalization in the Special Care Unit. 

“As sure as fate...”

Fatinha nods her agreement.

And in fact, half way through the afternoon, when Catarina and Fatinha had gone off duty, the tranquillity of the Unit was shaken by the tempestuous entry of a trolley. On it was a contorted shape that was hastily transferred to the empty bed opposite the old lady's. It was a man, agitated as a fish that has just been tipped out onto the bottom of a boat, moaning aloud in pain and lifting his hands clumsily towards his chest. A myocardial infarction, that much was clear – though nothing like the one I had, which had been quick and painless like the perfect depilation. Dr Brito and the nurse bustled around the patient, but his pain-provoked anguish made him difficult to control. For another dreadful hour, the poor man convulsed, tearing at his chest with his nails, as if a serpent had driven its poisonous fangs into him. I watched in dumb horror, unable to do anything else.

Eventually (I was exhausted just watching him) he calmed down and fell into a heavy slumber. The staff were finally able to breathe a sigh of relief. 

Now that he is asleep, with his face relaxed into that blessed-child expression so common in sleepers, he looks familiar. I scrutinise him, though it doesn’t help that he is lying down rather than standing up, bare-chested rather than clothed, immobile in sleep rather than awake… However, I could almost swear…He looks amazingly like Fidalgo, a civil engineer from Lisbon, who also works in Lourinhã, and is building a second home very close to mine. I bumped into him only yesterday in Dona Ção’s cafe, and he was exuding confidence, discussing the properties of pre-stressed concrete with João and another architect (in fact, I slipped away when I realised where the conversation was heading). Who would have guessed that here he would be today, fighting for his life! It is him, I’m sure it is. 

Near dinnertime, while he was still sleeping, João arrived with some telegrams, fruit juice and news from our road.

“Guess what’s happened to Fidalgo?”

“I know,” I said, pointing to the bed opposite. “He’s had a myocardial infarction”.

João didn’t know why Fidalgo had been taken in, only what had happened up to his departure for Lourinhã Health Centre. She thought he’d have gone straight to Lisbon, or perhaps to Cascais Hospital, where his wife worked. Earlier in the day, the engineer had seemed pleased with his work, directing the builders, helping to carry materials that looked rather heavy. But some pages further on, he had begun to feel ill, very tired and sweaty, though he didn't pay much attention to it at first. He had rested a little, smoked a cigarette and gone back to work. Then he’d felt ill again, this time with an alarming shortage of breath and feeling as if a nutcracker was squeezing his chest. He couldn’t go on and was taken to the health centre, which immediately sent him on to Torres Vedras.

    Dusk has fallen. The windows overlooking the street reflect the lights of our ward, and although you can still make out the faded texture of the red sky, it is now almost suffocated by the dark blue hues of night. Tomorrow will be another hot day. 

The lamp behind my head (one of those with an adjustable neck) is shining on one of the books that João has brought me. But I can’t concentrate on reading. My attention is constantly distracted by some noise in the corridor, or by the sight of Fidalgo, who slumbers on gratifyingly, with one hand protectively clutching his chest. 

“Sleep, sleep, Mr Fidalgo. Everyone that saw you arrive wishes you the long sleep of the just.” 

The night nurse is an olive-skinned woman with soft skin and a thick mass of dark hair which frames her girlish face, setting off a delicate neck that curves graciously down to her shoulders. Hardly has she sat down at her worktable next to the windows than she lifts her hands to catch hold of her hair and twists it into a ponytail with an elastic band that she clutches between her teeth. It's a pity. This constriction of her tresses – though of course more appropriate for working and more hygienic for us: the poor patients – does not erase her charm altogether, but it makes her look more like a carousel pony than a siren. She is called Inês and she is interested in the books that João has brought me. She asks to have a look at them, and later wonders if I would let her have one to read during the quiet moments of her shift. She tells me that reading is her favourite pastime and that her favourite writer is one of the Brontë sisters – Charlotte, if I remember rightly. 

As if we were in a pub that is getting ready to close, Nurse Inês gives us the first signal that it is time to sleep by turning off the music that plays quietly in the background. Here, however, the punters cannot leave by the door, grumbling, nor can they take advantage of the warning to lie down – for they are already lying down. All they can do is wait for her to put their beds down and for sleep to deign to honour them with her presence.

“Do you want me to draw the curtain?” she asks.   

I don’t. With the curtain drawn, I feel like a parrot whose cage has been covered over to deceive it into thinking it is night. Despite the light, I prefer to be in contact with whatever is happening around me.  

Time passes. I am not sleepy. I’m not used to that bed, nor to sleeping with so many people around me. With my eyes open, though taking care to be discreet, I watch the nurse, who has not stopped for a minute since she came on duty. There always seems to be one more task for her to do, though to my eyes they might just as well wait till morning. Looking serious and concentrated, she goes around meticulously tidying, arranging things. She gets up silently, checks some detail and then goes back to her small worktable to record it. She writes, writes, writes. Nurse Inês writes as if she were racing the clock to express her final wishes.

To my surprise, I feel my eyelids growing heavy. The whirr of the oxygen becomes fainter till it is no more than a soft hypnotic buzz. But I struggle not to fall asleep just yet – I am fascinated by Inês’ reading and I want to see the film through to the end.   

Finally, she seems to consider her work finished. Now she gets up, presses lightly down upon the back of a black armchair that is waiting nearby and pulls back the arm of the lamp that has been illuminating the work table till it spills only tiny pool of light onto the top of the armchair. Finally, she leans back in her improvised couch and opens the book that I have lent her. 

I cannot keep my eyes open any longer, and my mind is growing indifferent to the coordinates of my location. My uncertainty about what tomorrow will bring is gradually muffled by the outpouring of silence, softly threatened by the turning of a page. 


    The trio of patients that Nurse Inês watched over during the night became a quartet on Saturday morning with the arrival of a new patient, who entered the scene even more dramatically than Fidalgo had. This one was not only contorted on top of the trolley – and moments later, without any apparent transition or pause, on the bed – he also cried aloud in pain, clutching at his chest and left arm. Another infarction? It seemed so, though this fellow (who I could see clearly because he was less than two metres away from me) could not be more than thirty years old! That was very young for an infarction, though Dr Brito had let it slip that “... it used to be very rare for us to get infarctions in people under fifty... Now they’re appearing at thirty, sometimes even younger!”

However, when he calms down, António Luís claims that his problem has nothing to do with his heart; he pricked himself on a cactus, he says, and it was this that caused the pain in his arm and chest. 

The doctors didn’t believe his far-fetched explanation, and, airing hypotheses such as an infarction or pericarditis, decided to treat him as if it were in fact a heart attack. Although this was an eminently sensible decision, it exasperated him. 

“Hey, Gorgeous,” he said to the nurse on duty, a redhead with hair in ringlets, “I can’t stick around here in bed! I’ve got to get up.”

And she had to call the support doctor to the Unit to impose respect, because, now that the pains had completely gone and he had started feeling the claustrophobia of hospitalization, nothing could convince him that he couldn’t go home right away as if nothing had happened. 

The doctor scolded him severely and António Luís listened humbly with his head down, though he was looking at me sneakily with amusement shining out of his blue eyes. Then he winked, inaugurating our complicity. 

We quickly became accomplices, António Luís and I, united by circumstance, by our faces in the mirror (if I sat on the bed it was his face that stared back at me) and by our aesthetic pleasure in the youth, beauty and variety of the feminine element that surrounded us and is taking care of us. 

“Dr,” he hissed, nodding towards the corridor, “just look at that vision!”

Visions... We were indeed blessed to be surrounded by beautiful, interesting, captivating visions, who lit up our day as the stars light up the night.

But António Luís was not satisfied with mere contemplation and couldn’t resist addressing gallantries at every woman that came near, which he did with a roguish innocence. 

“May I know your name?” he asked the dazzling beauty that came to take the electrocardiograms, stretching out his arm with the solemnity of one that is waiting to receive an engagement ring on his finger. 

The girl refused to give her name but smiled in amusement. António Luís advanced another step:

“Do you, by any chance, live here in Torres Vedras?”

And as she shook her head in a slow negative without interrupting the process of placing electrodes on António Luís’ chest, he took another shot. 

“That’s a pity...; because if you did, I would invite you to come out with me one of these days.”  

Of course all this was blarney. António Luís didn’t live anywhere near Torres Vedras but some twenty or so kilometres away with his wife and toddler.  

My days brightened up considerably after his arrival in the Special Care Unit. I enjoyed his roguish patter and was amused by his theatricality, which oscillated between melodramatic complaints and ostentatious gallantry.  

“My love,” he says to the ancillary worker that brought the dinner trays, “I really can’t eat this! – I think I’m going out to dine...” Availing himself of Smile No. 37, he added, “You could come with me. What time do you get off duty?”

I shared António Luís’ opinion of the dinner. The food here was terrible, a handicap that was only now beginning to dawn on me. In my first few days, they hadn’t give me anything more than a cup of tea, yoghurt, and an occasional baked apple, which had generally allowed me some latitude to eat. Then they added soup, which also went down without any gustatory surprises. But when I went back to a solid diet, I found that the food was terrible! Maybe I was being fussy! But a half-raw potato that looks from the outside like a boiled one does not, to my mind, fulfil its noble destiny of providing nourishment! 





    I don’t know where my watch is, but the sun has come up, and as yesterday was Saturday, I guess that it must be Sunday. Shortly after lunch, Zé Marques Neves passed by on his way from Viseu to Lisbon. Given my indisposition, he is going to replace me as president of the examining board in the selection procedure that we had been preparing since January. The first interviews were booked a month ago, by me, for tomorrow morning! 

I saw his upper half advancing behind the glass wall that separates us from the corridor. His smile was restrained, as if he were making an effort not to stretch the corners of his mouth too much and reveal the emotion of seeing me like this. When he opened the door and came in, I noticed that he was wearing shorts! This was nothing like his usual formality.

“Zé, I don’t believe it. A doctor, an important guy like you, coming into a hospital in shorts!”

“What do you expect? It’s a furnace out there!”

There was no point telling Zé all the details about what had happened or even the more recent developments in my clinical condition – he already knew everything, right down to about an hour before. When we spoke about my illness, he carefully sieved his words, so that none of them could be taken hostage in my state of heightened sensitivity and used to darken my spirits. He moves on to less hazardous terrain.    

“I’ve just been round to your house. I went to get the files for the interviews. My boot is full of boxes and papers.”

He didn’t linger. Announcing that he still had to go over the questions he meant to ask the first candidates, he made ready to leave. I detained him one last moment to ask after Judite, his wife of some twenty years, whose health had been in a precarious state lately.  

“What about Judite? How is she?”     

For a brief moment, his good humour, so valiantly maintained, dissolved. His mouth tightened and a look of anguish flashed across his face. 

“Today is not a good day to talk about that…,” he said, saving me from discomfort with a sad smile. 

I shut up and changed the subject, wanting to allow him some minutes’ respite from the martyrdom that he had left behind at home. Judite had had surgery for cancer some years before but had managed to remain disease-free for a comforting number of years. However, the illness had returned when it was least expected, disseminating malignant cells throughout her whole body. Despite the evidence, Zé was refusing to acknowledge the ruthless spread of the disease, which was crushing him like an insect each day that flowed by. 

“Goodbye, lad,” he said. “Behave yourself.”

I watched him disappear into the corridor. After glancing quickly around at my slumbering companions, I dived under the sheet to hide my damp eyes. Holy shit! Just look at the state I’m in!


    The hot weekend flowed by, slowly and lazily. There were flocks of visitors in the corridor, who would glance curiously at the specimens in the Special Care Unit as if we were snakes in a solarium. This was understandable. All four of us had heart monitors on our bedside tables, tubes attached to our noses, electric wires glued to our chests and flasks of saline solution dripping into us. We were personifications of that frightening and rather alien condition that is disease! 

But what they don’t know is that I am feeling just fine lying here, and that the same can almost certainly be said about António Luís (when he is not making a scene to call attention to himself), the old lady on my left, and even Fidalgo, who is sleeping peacefully with his mouth hanging open. That would confuse the gapers on the other side of the glass. 

My appearance may be rather off-putting, and my clinical condition is said to be serious, but if it were not for the prohibition on getting up, I would say that I was in perfect health. This is a rather confusing situation to be in. We feel just as we usually do, but they treat us as if we’re about to kick the bucket at any moment. 

Judging by the heat and the rather spaced-out look on the faces of the people that came in from outside, this is clearly a perfect summer weekend. There isn’t much to do here besides skim one or two paragraphs of a book and listen languidly to the songs emanating from the small sound system lodged on one of the shelves beneath the windows. This is generally tuned to Radio Nostalgia – or at least, it is when Nurse Inês isn’t on duty. 

“You can have too much nostalgia!” she complains disdainfully, changing the channel immediately.

Dissonances... Of the various people here, it is myself and Nurse Catarina (who is over thirty-five) that most appreciate Radio Nostalgia. We know all the songs – they are from our time and we can sing along, if only in our heads... 


    Let’s all get up and dance to a song

   That was a hit before your Mother was born...*


But Nurse Inês is only in her early twenties and prefers more modern music, songs written in the days that run in her veins. These will be the very songs that she will be humming to herself a dozen years from now, if history runs its course. But that is in the inscrutable future. For now, the only thing that counts is that she is just not old enough to be nostalgic.

Dr Daniel Varanda, the doctor that got the booby prize of me and my cardiac arrest, is old enough to understand the concept of nostalgia and he reappeared, after the first weekend, to inform me that tomorrow...

“...we’re going to give you an echocardiogram to see how you are, and if everything’s stable, we’ll send you to Lisbon for a coronarography.”

“Coronarography?!” I repeat, apprehensively. 

“Yes. We have to find out why this happened to you. You don’t think it would be a good thing?”

What I think is not really the point. I do think it would be a good thing, yes. But the idea of a coronarography! It is not very nice to know that they are planning to stick a probe into your artery and push it through to your heart, and that they will then inject you with a contrast solution which, like the flash of a camera, will illuminate all the twists and turns of your heart’s circulation system for posterity. 

“And when’s that going to be?” I ask in a hollow voice. “Where are you going to send me?” 

“Listen, mate, you seem to be in a bit of a hurry to leave us!” he said, putting on a harsh voice. “Let’s do this in stages. First we have to see how your ticker is behaving and then we’ll deal with the rest. If all goes well, we’d like to know what’s going on this week.”

Seeing my dejected expression, and not wanting to leave me without saying anything further, he asked: 

“All right?” 

It wasn’t OK – in fact, it was terrible – but I said it was. What can you say to the man who saved your life three days before, and, if that weren’t enough, is also as obstinate as a mule?

I sat there gloomily thinking about it, half following the animated conversation between a playful António Luís and a health ancillary who was making compresses from layers of white gauze.

There is a nurse and ancillary worker on duty at all times in the Special Care Unit, and this set-up causes some jealousy amongst the rest of the hospital staff. Maintaining such an army for only four patients is considered a luxury of oriental proportions, even though the whole purpose of the Unit is to keep a close eye on high-risk cases, as its name suggests. 

Personally, I wish that we could see a bit more of that luxury on our meal trays, which unfortunately come from the common kitchen and continue to be entirely unpalatable. Only the treats that João brings me each visit – yoghurts, fresh fruit, biscuits, jam – make up for it. I have just finished dinner, pushing the leftovers as far away from me as I can, and am concentrating on trying to blur the cinnamon squares on the top of a rice pudding which a neighbour has smuggled in to me.     

The Unit is quiet and calm, just like the night peeking in through the windows. But this is a calm laced with fatigue, thick as the August dust. The old woman in the next bed was sent this morning to Lisbon to have her pacemaker fitted, and Fidalgo, who is sleeping with his face turned towards the motionless poplars, will go tomorrow to a hospital in Lisbon, where he knows people.

“Looks like I’m going to be left alone,” complained António Luís, when I told him the news about my coronarography. “The old girl’s gone; tomorrow, it’ll be the engineer; then you...”

“Now don’t exaggerate!” I reply. “I still don’t know when I’m going, and if I do, I’ll go and come back in the same day – they don’t want me there going to seed!”

“Who knows?” he said, looking as despondent as if he would be the last man left on the planet within a moment or two.

“I do,” I said. “In two or three hours, I’ll be back here again.”

 It was time for Nurse Inês’ night shift again. As we were now old acquaintances, she took the opportunity to glance through my growing pile of books and magazines when she came to lower my bed.

“Would you lend me this just for today?”

The radio was turned off, as were the lights, except for the lamp on the work desk. Nurse Inês left the Unit for a moment to go and eat something in the nurses’ canteen – it was time for the last supper.

I snuggle down, adjusting my pillow to make the perfect hollow for my head. From outside in the corridor I could hear the occasional murmur of faraway voices, the clinking of metal, the sound of a door squeaking on its hinges, the sound of something rolling along. Sleep...

Sleep is beyond the reach of the will. And it’s not something you can easily fool. Since I’ve been here, I have been divided each night between the desire to be gathered up by the wings of sleep and the stubborn need to remain awake, to surprise death, should he be prowling around here. I would play hard to get. I had no intention of going off into the dark night with him like some giddy young girl that is easily seduced. The deceitfulness of him, and, at the same time, the brutality, as he pulls the mat out from under your…

“Dr? Are you asleep?”

“No”, I reply, in an audible whisper. 

“Good night,” says António Luís, half propped up in bed, his blue eyes shining in the gloom. “We can sleep peacefully tonight, can’t we? – we have an angel watching over us.”

“Yes, I suppose we have,” I agree. I return to my beaded thoughts in slightly better spirits. “Good night. Sleep tight.”






    I had never spent my birthday in a hospital bed – in fact, I had never actually even been in hospital before. But there’s always a first time for everything. Today, a Tuesday, I am 46 years old, a number I only just made by a cat’s whisker. Suddenly I feel like saluting with an old cliché: “such a nice age!” 

If it were not for the circumstances, I would be spending the day just like any other, listening to the same tedious old stuff on the telephone, shrugging disparagingly at any attempt to celebrate my birthday and mulling nostalgically over the passing of the years. But not his year! 

I unwrap the presents that arrive, read the messages, and get a visit from my son Zé João (whom I haven’t seen since the day of the heart attack). Vera and her children come too. Then, towards the end of the afternoon, a young colleague appears clutching an enormous bouquet of flowers in one hand and balancing a green pot plant on the other. He is representing a dozen other colleagues, who in a greeting card covered with familiar signatures, urge me to get well soon and wish me “all the best” and “many more years of life”.

Now, engrossed in a dish of magnificent cherries that João has brought to liven up my dinner, I watch, with satisfaction, the effect that my bouquet of flowers is having on the people at the reception desk on the other side of the glass. It was Fatinha who searched out a vase, filled it with water and arranged the flowers. Before going off duty at eight o'clock, she opened the door of the Unit to say goodbye, hugging the pot plant that I had just given her.

“I’m going to look after this really well, so that, after you leave, I’ll know that you’re all right if it’s thriving...”

I stare at her stupidly, not knowing how to reply. It is António Luís that reacts, sticking his head out over the edge of the bed:

“Oh, Dr, that was really nice, that was...” 

Some time after dinner, one of the ancillaries came to take me down to the catacombs on the ground floor where the testing rooms were located. As usual, I go wherever I am taken, always with zero effort, wheeled along on the trolley. This time it was to do the echocardiogram that they had warned me about, a test that uses the bat’s favourite navigational tool – ultrasound – to assess the functioning of the heart.   

Sitting at the computer in a white overall is a thin dark man that I don’t remember having seen before. He is not very communicative and doesn’t say a word as he rolls the probe around in the slimy gel that he has spread over my thorax. 

“You’ve had an extensive infarction,” he says, finally. “But you’re recovering well and the myocardium is revascularizing quickly.” As he bids me goodbye, he adds: 

“Let’s see if we can get you to Lisbon this week to do the catheterization so that we can find out what this is all about.” 

“Do you know what hospital they’re sending me to?”

“No, not yet. We’re dealing with that now. It’s usually Santa Maria or if not, Santa Marta.”

“If it’s at all possible,” I say timidly, “I’d prefer to go to the Civil Hospital, to Santa Marta.” 

“I can’t promise anything. It doesn’t really depend on us; it depends on the bookings... Speak to Varanda about it.”

The following day, I accosted Dr Varanda as he came into the unit.

“Dr, where I am going to do the coronarography?”

“I’ve just been sorting that out, mate. The Santa Maria can only take you next week, so we’re going tomorrow to the Santa Marta, late morning. I’ve arranged everything with Gil Seabra, the colleague’s that’s going to examine you – he’s a good chap, very competent, you’ll see.”

I thought I could feel a gust of good luck beginning to waft around me. However, it soon dwindled and died out in the sequence of remarks that followed the doctor’s final observation:

“Nurse, don’t forget to prepare this patient for the catheterization.” 

After he’d left the room, I wanted to know what the preparation involved, imagining, in my ignorance, special diets or fasting, medication; maybe even radical enemas...

“Oh, it’s nothing special,” she replied. “We only have to shave the hairs off your pubis and groin”. 





    It is St John’s day, 11 o´clock in the morning. And here am I, for a few brief moments – the time it takes to put my stretcher into the ambulance – out in the open air on a gloriously hot morning. St John’s day is a public holiday in my native city and also in my adoptive town. At this time, in Oporto, most people will still be snoring, and any early birds that are around will be lamenting the excesses of the night before as they nurse their hangovers. The refuse collectors will be out in the streets, cursing the mess left by the revellers. In Lourinhã, where tradition has never been taken too seriously, everyone will be on the beach in the heat – that’s the usual custom on St John’s morning. 

Nurse Catarina is coming with me to Lisbon, a blessing which I receive as evidence of St John’s largesse. I couldn’t have chosen better company – her manner, tone and efficient kindness has a calming effect on me, bringing me peace. 

The ambulance goes off down the motorway at a steady speed. There is almost no traffic on the road at this time and no one is in a hurry. This lets me keep an eye on the landscape and an ear directed at Catarina, who is telling me (with regard to how quick it is to get to Lisbon these days) about the painting lessons that she has there twice a week. 

“So you paint?” I remark. “I had no idea!”

I glimpse passion in the captivated tone she uses to describe her pastime and the bright dreamy look that takes over her dark eyes. 

We have just passed one of those giant Father Christmas hats that dangle in the middle of the central reservation to indicate the strength and direction of the wind.    

“What time do you think we’ll get back to Torres?” I inquire. I am expecting a visit this afternoon from Ana and João Vasco, my niece and nephew from Oporto.

She doesn’t know. It is difficult to give precise times with the Lisbon hospitals – though if all goes well “perhaps around four or five o’clock”. 

We pass pylons – haughty metal scarecrows with the stunted arms of thalidomide victims, holding up a heavy curved skein of thick electricity cables. These wires stretch and grow straight as we draw close to them, and some are threaded with coloured balls like the beginnings of a gigantic bead necklace. 

Catarina is chattering away at my side. She tells me about the years she spent in Holland, her daughter, her family, her work at the hospital.  

We are going down towards Lisbon. Behind us is the landscape of soft hills, which charmed me with its sweet undulations when I moved down here fifteen years ago from the majestic mountains and sharp outlines of the north. It was like entering a naïve painting. 

Through the window nearest my head, enormous boards parade by before disappearing into the past. Some are blue, some white, and they mark the various routes that it is possible to take: the motorway to the South, Vasco da Gama Bridge, Odivelas, Lisbon… How strange it is to see the street (we are in the Calçada de Carriche) from this perspective, upside down. Buildings lean in on me on all sides, threatening to merge at the top like a Cubist take on of a country road lined with trees. Street lamps nod incessantly over me like giraffes; traffic lights with winking eyes; covered balconies, windows, and glazed buildings glinting as if they are covered in silvery blue fish scales. 

The city is sluggish in the heat, and the traffic flows slowly. Suddenly, in the red of a traffic light, I recognise the rusty brown colour of the Picoas Forum. We are crossing the city heading East. 

The ambulance slowly pulls into the garden of Santa Marta Hospital. I have been here before, but upright. I came here one afternoon, for a work meeting with colleagues – it was also summer, I recall – in the office of the director of the Cardiothoracic Surgery department. As usual, I paid little attention to my surroundings, though I vaguely recall an old garden and some building works, a shaky old lift, a room with extravagantly-framed photographs and diplomas on the walls, and a suffocating heat. 

They park my trolley near a wall and we wait, Catarina, the fireman and I. Time passes. It is already past lunchtime, and as I have no choice but to fast, I insist that they go and get something to eat. There is no point in all three of us suffering. They resist for a while, but in the end, hunger gets the better of them. 

When everyone has gone, I take a throat sweet from under the sheet and suck it, just to keep some sugar inside me. I know that the only reason they want me to fast is because of the vomits, not for any other reason, but I don’t want to spend the whole day feeling weak and faint, with my stomach rumbling and swelling like a hot-air balloon! 

I am completely engrossed trying to lick the lustre off the sweet with my tongue and swallow the sweet saliva, when suddenly, without a warning, everything begins to shake. The trolley starts to move, and then a young man appears at my side. He greets me affably, telling me his name (startled I don’t understand him) and he starts talking to me in a slow shy voice. I realise that this is the doctor that is going to do the coronary exam. He looks slightly oriental. A grey-flecked quiff flops across his forehead, and it wouldn’t take much to make him into the stereotype of the mad scientist that we imagine from literature or see in a James Bond film, labouring away in a machine-filled laboratory for the good of us all. 

“I have spoken to your doctor at Torres Vedras. I know all about your history...” he tells me quietly, making the link between my past and my present, anchoring me into this new reality. I feel that he doesn’t do this by chance. He looks attentive, like someone who understands just what gets lost in the corridors of illness, as if he has not forgotten that a patient still has, at the very least, a being with a head, body and limbs.   

And he stays by my side, smiling rather crookedly with his slightly lopsided mouth while the trolley enters an enormous room without any visible windows. It is almost dark and filled with equipment from a science fiction film and people wearing green masks. Carefully, they transfer me onto a bed that is lit up like a stage. It looks for all the world like an operating table. 

“Catarina won’t know what’s happened to me when she gets back from the bar,” I think. 

The doctor briefly explains what he’s going to do and asks me to tell him any sensations or alterations that I notice during the test. Then I feel a small jab in my groin. They’re giving me a local anaesthetic. I see him pick up a long round white thing, rather like a curtain wire. I guess this is what is going to be inserted into my iliac artery and pushed upwards mole-like to my heart. I feel no pain, only a warm sensation in my thigh (probably some blood spilt as the catheter is inserted). Then a shudder, a yelp, as if some strange body had touched my heart, causing it to erupt into faster beating. 

“Now you’re going to get a feeling of heat,” the doctor warns. 

I have had that sensation before. It is the contrast solution spreading about my body, a burning as if they had tipped a double shot of whisky directly into my veins. I felt it travelling about my body at rollercoaster pace, marking out two places on the way – the roof of my mouth, which became as hot as if they had applied a mustard plaster to it, and – would you believe it? – the pubic area. 

“Just once more,” says the doctor, working the probe.

Again comes the heat and a delicate pain. I complain, as we arranged. 

“That’s it... I was just observing the internal mammary artery.”

“The internal mammary?” I wondered to myself, mentally revising the anatomy of the area. “So the exam was not only to check the state of the coronary arteries?”

With a snap, the doctor managed to take off his rubber gloves, which had stuck to the tips of his fingers with sucker-like determination. I heard him whisper off-side: 

“Get me a bed.”

And then, with a hand on my shoulder, he said calmly: 

“I’m afraid you’re going to have to stay here.... We’re going to have to operate.”

“Operate? On my heart?” I echo stupidly.

“Yes. We’re going to have to do a by-pass... This isn’t at all good. You’ve got 90 % obstruction of the common arterial trunk*.”

I don’t say anything. What was there to say? I am overwhelmed. This is a blow from the air, so strong it stuns. Noticing my catatonic expression, the doctor adds:

“Don’t get upset. It’ll be fine. The internal mammary artery is in good condition for grafting. Tomorrow or Monday, at the latest, we’ll have this sorted out.”

I am pushed out of the room to make way for the next patient. They leave the trolley in a corner of the corridor where there is less movement. Someone binds my thigh with a large adhesive bandage, squeezing tightly to form a tourniquet. This is then attached to a parallelepiped-shaped weight, placed over the site of the perforation. I suppose it must have been made of lead, as it weighs much more than something of the kind in stone. 

“You’ve got to keep this on for four hours,” they tell me. 

I get the message. A vessel with the calibre of the iliac artery has a very strong power of contraction, and when it has been punctured and abandoned, it is capable of leaving us without a drop of blood in just a few minutes.     

Nurse Catarina and the fireman, who have been waiting at the door, say goodbye. They are going back to Torres Vedras without me and I am staying here without them. “It’ll be fine, you’ll see,” she assures me in her gentle attentive tone. And then they disappear, off to their own lives. I am left to my own devices, but I am not very good company. I am hungry and dejected, abandoned in a hospital corridor with a lump of lead balancing on my groin and another weighing down my soul. I have had some explosive news and I need to digest it. For tomorrow or Monday I will have an operation on my heart. On my heart! A 90 % obstruction! That’s to say, not one drop of blood can get through the common arterial trunk and half my heart has stopped working. That is why I collapsed. This, after all, explains everything that happened to me. 

I don’t know how long I waited there. But the time passed and eventually someone remembered me. I was wheeled along corridors and through doors, and finally we arrived in a two-bed room that was unoccupied. At the bottom, there was a window of smoked glass through which entered very little light, suggesting that outside, it was getting dark. Was that possible? What time was it? Where were all the people? 

Some centuries later, João, my wife, arrived with my nephew and niece, who had come down from Oporto to visit me in Torres Vedras. They had peered in through the door of my room in Torres Hospital, but as I wasn’t there, had decided to wait for Nurse Catarina to return. They are trying to put on a brave face, but everyone looks worried and dejected. After a long day of fasting and feeling like I'd been lost in the hospital, my gloomy thoughts break loose, crudely and mournfully. 

“They won’t be able to do anything..., no by-pass, they won’t be able to get the mammary artery away from the bone; and it’ll be damaged, all stiff and fibrous from the radiotherapy...” 

They try to calm me down. They have spoken to Dr Gil Seabra (João and Ana think he is “lovely”) and he explained everything to them. He showed them coloured images of my heart and said “it was all going to be fine”. They present me with clear positive arguments, arguing that. “...at least we know what the problem is now. It will all get sorted out tomorrow.”

Brilliant! It is from them that I learn that my operation is scheduled for the next day and not Monday, and that after it, I will be like new. Despite everything, I’m a guy with a future, and this is just a plumbing problem! I shut up, though more out of exhaustion than because things were going my way. 

They give me dinner and just before lights-out, bring me tea, some biscuits and a Lorenin. I should eat now, because tomorrow I will have to fast again. The countdown has started. 

The lights go out and I wait patiently, as if in a queue for morning, for I don’t really believe that sleep is on its way. Curled in the darkness, listening to the sounds emanating from the ward, I take stock, depressingly, of the recent years of my life and of the bad luck that seems to have afflicted me. 

I recall things, trying to drag to the first page of consciousness some lines that I read in a medical book, almost two years after completing the last session of radiotherapy:  

Cardiac irradiation accelerates coronary disease and more than triples the risk of a fatal myocardial infarction*

At the time I hadn’t paid much attention. I read it lightly, for it seemed impossible that bad luck would come and bang on my door again, so shortly after I’d got over cancer. Of course I paid even less attention to the detailed description of the effect that radioactive rays could have on the various arteries that irrigate and nourish the heart: 

Some studies suggest a high incidence of disease in the common arterial trunk**.

    A fistful of tears, black with anguish and bitter as gall, stubbornly mount up beneath my closed eyelids – but they are scanty and evaporate before they can stain that unfamiliar pillow. Blast it!




Part II


It’ll be nothing serious!










    14th May 1996. There are some dates that remain forever engraved in our memory, as fixed and as permanent as the inscriptions on tombstones. Twenty-to-seven in the morning, a few dozen kilometres south of Cape Carvoeiro. It looks as if it will be a glorious day. Outside, a golden sliver of light is insinuating itself over the horizon, and the blackbirds are challenging each other with cascades of trills and elaborate fugues. I am standing before the bathroom mirror shaving. By 9 o’clock, I will be in Lisbon, where I have two meetings, one in the morning with colleagues and another in the afternoon with a lawyer from the Ministry of Health.  

I have just ploughed through the foam on my face and am carefully beginning on my neck. As I move the blade over the left-hand side, I feel a slight burning sensation in the skin. I inspect the site, holding the razor aloft. The burning persists. It is just above a swelling that appeared one or two weeks ago, so small that I hadn’t given it much attention. In fact, I only noticed it because I had to shave over it, and assumed it was just one of those minor ailments that come and go. After all, the body usually takes care of itself, patiently rebuilding its integrity in its mysterious silent way, returning us to our familiar corporal landscape.  

But the persistent burning and slight redness of the skin now draws my attention. I pass a finger over the small swelling. Now that I look at it, it seems more prominent than before. Even in the mirror, it looks bigger. My mind runs through all possible causes, anything I can think of that could afflict a chap over 40. And I start spinning up into orbit. Panic had just sunk its teeth into my neck. 

For the rest of the day, I found it extremely difficult to concentrate. I tried to relieve the tension by confiding in one of my colleagues during the coffee break, downplaying the situation as much as I could. But that didn’t solve anything. In fact, it only doubled my anxiety. 

“I’d get it checked out, if I were you. Do a blood cell count, get a chest X-ray.  It’s probably nothing serious, but at least you’ll set your mind at rest.” 

“Blood cell count?!” I thought, aghast.  Ugh! I’ve always hated needles! 

The afternoon dragged out in exasperating detail. I kept my eyes glued to my watch, waiting for the time when I could call Manel, who never got back “before half past eight”, according to Gabriela, his wife. 

Manel is my first cousin by blood, but we spent so much time together when we were kids, have so many shared memories, that he is more like a brother to me. What’s more, he’s also a doctor, a specialist in Internal Medicine, and the kind of person that inspires confidence, from a clinical point of view. That was why I thought of him right away, though he lives almost 400 km away in Braga.  

He phoned me as soon as he got home and I told him about the swelling. He listened in silence, and asked for more details. Where was it located exactly? What was the consistency? Was it painful? Did it stick to the adjacent tissues? How long had I had it?  The usual questions. And I, at the other end of the line, could sense where his reasoning was taking him. 

“It might be nothing serious. It could be just a tooth. But it would be better to get it tested, one thing at a time…”  

He told me to start taking a light anti-inflammatory, twice a day for four or five days, and then we would see how the swelling reacted. If the ganglion, which is what it seemed to be, did not go down, then it would be a good idea to go to the dentist to have the teeth in the lower jaw checked out.  

Although my teeth hadn´t given me trouble for years, I eagerly seized onto this idea. Yes, yes, that was indeed very possible. I’d had bad teeth since a child, terrible teeth! I’m the kind of person that goes three or four times a year to the dentist – in fact, I’ve got a private box reserved for me at the local dental clinic, and my dentist is a very good friend. 

A week later, I was in Oporto, reclining in the dentist’s chair with an X-ray of my mandible on display in the light box. The lump had not changed. It was no bigger and no smaller, still firm. 

The dentist examined all the teeth that could possibly have been involved in the growth of that ganglion. 

“It doesn’t look like it’s come from here,” he said. “Sometimes there can be internal seepage, almost undetectable, generally gram-negative bacteria. It might be that, though I can’t see anything suspicious.”

Then, after further consideration, he added,

“Let me just call a colleague to see what he thinks. He works in plastic surgery – those guys deal a lot with the neck area. They have practice in this kind of thing.”

And he sat down at the telephone. I remained in the chair with the towel around my neck, listening to the conversation unfold. 

For a while, I heard only interjections like "mmm”, “yes” and “uh-huh”. But then, for a fraction of a second, I saw him staring at me with a quite different expression. An icy chill seemed to settle over the room. He hung up. 

“He thinks you should do a suction biopsy, just to clear this up. Ganglions in the neck…you know how it is!”

I phoned Manel and told him. 

“Let me deal with this,” he said. “When can you come here?”

The following day, around teatime, I found myself in Braga, lying on a couch and staring at a screen. As the radiologist slid the ultrasound transducer over my neck, my ganglions came into view. By his side, on a small table, was an enormous syringe and various glass slides – the first waiting to be plunged into my neck and the others to be spread with whatever substance oozed into the needle when the ganglion was pierced. I could make them out perfectly. There were five or six of them, some large, others medium-sized, nestling there in silence. 

The biopsy hurt less than I imagined it would. It was not exactly pain I felt, more like the unpleasant sensation of having a dagger buried in your neck!   

Manel, who remained at my side over the coming weeks, took it upon himself to personally deliver the slides to the pathology department for diagnosis. I asked about the possibilities. Ganglion tuberculosis, maybe.  But what about my teeth? – that thing about the tooth infection and the bacteria seeping into my neck? Unlikely, he said, after some consideration. The radiologist agreed (and deep down, so did I). There were too many ganglions, and they were too big. Maybe ganglion tuberculosis…

I went home. The man with the microscope would take some days to give his response. 

“While you wait, you could take a slightly stronger anti-inflammatory,” said Manel. “Let’s see what that does”.

As well as the anti-inflammatory, I prescribed myself a common antibiotic, which suggested I still had some residual faith in the “sequella-of-a-dental-infection” theory. If the cause was infectious, I reasoned from my halfway house between doctor and patient, the antibiotic would sort it out. If it was tuberculosis or something worse, it wouldn’t make any difference, one way or the other.   

Looking in the mirror now became a ritual, something of an obsession in fact. The moment I got up, I would question the mirror at the side of the bed, then the one in the bathroom. I wanted to feel the lump, squeeze it, but I remembered Manel’s advice: 

“Don’t you go messing around with that thing!”

So I don’t mess with it – that’s to say, I touch it ever so lightly, just so that my finger can acquire a tactile memory of its dimensions, for the purpose of future comparison. 

I’m nervous, very nervous. The prospect of the result casts a long shadow that looms over me. João, irritated by my volatility, asks me why I don’t phone Manel to find out if he knows anything yet. But I don’t want to. I want to be able to hope naturally, without precipitating anything. The answer will come at the end of the wait. There is no point in rushing things. That won’t change anything (though let he who is absolutely sure throw the first stone!) 

Three days later, Manel phones. He lingers over pleasantries, asking how I’m feeling, if my family are well, and my throat contracts and flutters like the wings of a butterfly in the sunshine.  Finally he gets to the point.  

“You know, Melro can’t see anything. He says he can only find lymphocytes and blood. The biopsy wasn’t done well. You’ll have to repeat it.” 

I am distrustful. Is this true? He might be stalling, trying to pluck up the courage to tell me the awful truth. Or perhaps they want to repeat the test just to confirm a terrible diagnosis! Entangled in a throbbing web of paranoia, I hardly hear Manel asking about the ganglion.

“It’s the same...,” I mutter, uninterested in the detail. “No bigger or smaller”.

I hang up, promising to call back to arrange the next biopsy. For now, I can’t think of anything. My whole world has become an enormous black hole that is sucking everything into it and spitting out anxiety. I torment my friends with details of my worries (though no one seems to think this is anything more than a passing ailment of no major importance). Aware of how annoying I’m being, I probe their benign responses for evidence that they might be deceiving me. Chances are everyone knows something I don’t, they’re all hiding things from me. 

Some days later, I get in the car and head to Braga again. I stop in Famalicão. It’s Tuesday and Juca is on emergency duty. He examines me slowly, following the instructions that Manel is giving him over the telephone. 

“I’d like you to be observed by an ear, nose and throat specialist,” he says when he has finished.  

I know why. Ganglions in the neck – lymphomas; tumours in the tonsils, pharynx, hypopharynx…

Juca is tense. He whistles as he examines my ears, mouth and throat.  We’ve known each other for some 25 years and are bosom pals. He asks me some brisk questions and then reverts to his old-friend role.  

“Nothing here, lad. I've been through everything...”

In Braga, Manel takes me directly to see the doctor that had examined the slides of the frustrated biopsy. This time, my neck will be pierced by a surgeon to ensure flawless technique. 

The pathologist’s name is Melro. He’s a tall long-necked man with fierce blue eyes, who manages to light a cigarette with one hand while talking non-stop and drawing arabesques in the air with the other. He has a corrosive humour, something he himself confirms (“At university, they called me sulphuric acid”).

The trips are beginning to make me nervous, so I accept the invitation from Gabriela and Manel to stay in their house until the biopsy results come through. Two days later, Melro phones at dinnertime. White smoke! We have a diagnosis! 

And apparently it’s nothing serious! Just some inflammatory cells and some lymphocytes. Euphoric with the good news, I go home that same night. It’s a beautiful hot night, with intense moonlight. On the motorway heading south, with the music coming from the cassette player and the beauty of the yellow moon, I find myself growing tearful, though whether from relief or happiness I cannot say. 

A few mornings later, with May already peeled off the calendar, I wake up and glance automatically into the mirror by the bed. Today, the outline of the swelling appears less prominent. I check in the bathroom mirror. Yes, it does seem to have gone down somewhat. The skin looks less taut and angry. Clearly, the antibiotic has worked!  

In the days that follow, there is a spectacular improvement. The ganglion goes down noticeably, and when I pass through Braga on 10th June on my way to Viana do Castelo where I’m going to be working for the rest of the week, Manel shares in my satisfaction. 

It is a public holiday, but he has arranged a quick consultation with Falcão, the surgeon who did the last suction biopsy. The idea is for him to examine me, and, if necessary, book the surgical biopsy, as Melro recommended (“If that ganglion doesn’t go away completely, next time we’re going to take it out. It’s the only way we can be sure.”)

After feeling my neck slowly, the surgeon pronounced:

“There are no removable ganglions here. You’re clear. For now, at least, there’s nothing we can do. If it starts growing again, we’ll have it out quickly, with a local anaesthetic.”

Great! The case was closed!  I go on to Viana, and excitedly explain what has happened to everyone. 

“It was only an infection after all. It went away altogether with the antibiotic!” And, shovelling earth over the incident, I continue: “What a scare, eh? A month of paranoia, with the sword at my neck!”

“You should take a holiday,” my friends and acquaintances advise. “And try to forget about it all. Turn the page.”


    The lump came back. At first it grew so imperceptibly that I wasn’t quite sure if it was happening or not. Was I imagining it or was it slightly bigger? But then, in the space of a few days, it began to expand at an alarming rate, voraciously. I forgot Manel’s advice and squeezed it between my thumb and index finger. Under the taut skin I could feel not one ganglion but at least two or even three. It seemed as if the first one had grown and merged with another next to it so that it was difficult to feel where one left off and the other began. I looked in the mirror so often that I soon lost my terms of comparison. No, it was not bigger than it’d been two hours before, than it’d been last night. Or was it?

“Is your ganglion growing again?” asked João, apprehensively. 

“I don’t know. I think it’s the same…” I replied evasively, aghast that someone else had noticed. And I waited gloomily, until certainty and apprehension exploded in my face, two or three days later. 

Manel didn’t seem unduly surprised when I called him again at the weekend and calmly took the rudder of my stricken boat. 

“I’ll book the biopsy with Falcão. When can you come?”

We booked it for Tuesday, as Monday was St John’s Day – a bad day for getting anything done in the north of the country. 

Though I try to disguise it, I have turned into a paranoid monster. I silently drag my human shell to a region where absolute distrust reigns eternal. I don’t believe what anyone tells me, convinced that all conversations are circumstantial, conjured up to keep the wool over my eyes (the only interesting ones are those that take place behind my back). Nevertheless, I find myself paying far too much attention to everything that is said, morbidly sifting between the lines of the most innocent phrases. I constantly bring up the subject, hoping to hear some comment that might assuage my fears. But if someone else does so spontaneously, I am on my guard, thinking it a bad sign. I want to know, but I don’t want to ask; I want to ask but I don’t want to know. Or rather, I don’t know what I want to know. At night, when everything is quiet all around me, this is the hardest bone to gnaw. I lie there exhausted, but can't sleep. As soon as the light is out, I find myself running through all the possibilities in my head at a tremendous pace until they start to pile up like sinister rainclouds. Dead beat, I get up and wander aimlessly around the house, looking on enviously as other people sleep peacefully.  

On 25th June, I set off for Braga for the surgical biopsy, booked for the middle of the afternoon. It’s Tuesday again, so I break the journey in Famalicão to have lunch with Juca in the Sara Barracoa. He’s visibly alarmed by the size of the swelling on my neck, though he doesn’t say so directly. I understand from his questions and by the way his eyes keep being drawn in that direction. 

After lunch, I take him back to his practice. Before he gets out of the car, he suddenly turns to me and says: 

“Goodbye, lad. Behave yourself.” 

Then, sticking his head in through the open window, he adds: 

“It’ll be nothing serious…”   

In Braga, Falcão looked at my neck with the same air of astonishment that I’d seen stamped across Juca’s face an hour before. 

“But I can’t take these out with a local anaesthetic. They’ve grown tremendously! You’ll have to have a general anaesthetic.”

The remark felled me. It was as if the whole world was making fun of me. Only ten days before, in this very room, I’d been told that everything was fine, been given the go-ahead to breathe deeply and leave in peace. 

Falcão must have sensed how I felt for he held out a lifebelt.  

“Let’s do something. We’ll try one final suction biopsy. The size this is now, if it’s bacterial, there will already be caseation, and the diagnosis will be clear-cut. What do you say? I’ll phone Melro. He might be able to take us right away.”

Melro does take us right away, in the Pathology Department of St Marcos Hospital where he’s working that afternoon, but makes it clear that he doesn’t really agree with another suction biopsy. 

“In these situations, it’s best just to get the thing out into the sunlight. These jabs take their toll... Your neck’s in a right state already. Soon we won’t be able to make out what’s ganglion tissue and what’s needle trauma!”

But, faced with a wall of silence, and pressed by Falcão’s arguments about the maturity of the ganglions (“They’ll be full of caseum by now, don’t you reckon?”), he gets ready for the session. 

“I’m afraid the facilities are not very comfortable here,” he said. “These are your options: either you can lie down here on three chairs placed side by side, or we can go downstairs and do it on the autopsy table...”

Looking positively Mephistophelian, he gives me the choice: “Where would you prefer?”

“Here, on the chairs,” I reply, with a suitable smile. “It’s not so hard!”

“But on the other hand,” he added, somewhat triumphantly, “in the autopsy room, we’d have running water and better lighting.”

I try to make myself comfortable on top of the chairs, and wait as Melro arranges the slides one by one on the table and Falcão attaches a thick needle to a plastic syringe. It suddenly strikes me that I am at the mercy of birds[*].  

The suction biopsy was inconclusive. Melro could not find any caseation, so the next day, at four in the afternoon, they operated on my neck. The procedure lasted an hour and a half, longer than usual for a biopsy, but went well. As Falcão explained to Manel, it was bloody hard work as the ganglions were stuck under the sternocleidomastoid, squatting between the jugular and the carotid (“I took out three; they weren’t much good to anyone in there!”).

“Heck of place for them to be!” I agreed, as I left the hospital, supported by Manel. The dusk was already darkening into night, and I was still dizzy from the anaesthetic and had an enormous white dressing plastered across my throat.

We had dinner late, in the garden, as the heat inside the house was unbearable. I’d forgotten just how hot Braga could be in the summer.  

I go to bed early and fall asleep immediately. But in the tidal sludge left in my mind by the anaesthetic, I awake in the middle of the night feeling hot and agitated. I smoke a cigarette at the window. Outside, it’s as hot as if it were three o’clock in the afternoon. Not a straw moves. It’s like a night in Seville, the city where I most remember being overcome by heat. Silently I go downstairs, walk around the sitting room and try to refresh my face in the open door of the fridge. I go back upstairs with a glass of iced water and a book by Júlio Cortázar, and read some 50 or 60 pages at a stretch. Suddenly, without warning, I explode into a gigantic sneeze, one of those that could scare the bats sleeping under the pillars of the diaphragm.

“Fuck!” I say out loud. “There go the stitches...”

The next morning, I learn that Gabriela (who had also been unable to sleep, worried about the visitor in her guest room) had heard my sneeze through the wall and thought exactly the same thing, probably even without my expletive. 

I considered the possibility of remaining in Braga till the result of the biopsy came through, but Melro had warned that it would take some time; he wanted to be able to  “work in peace” (this was a jokey reference to way people kept hassling him over the phone).  So João and Zé João came to collect me from Braga and I returned home on 29th June, my name day. 

I managed to keep relatively calm for two or three days. But the constant barrage of telephone calls (“Do you know anything yet?” “What’s wrong with you?” “What’ve you got?”) made me nervous, and even a little guilty about my own inexplicable ignorance and the stress that I was putting others under. In desperation, I phoned poor Manel, having sworn I wouldn’t contact Melro directly on any account.

“Don’t worry. I’ll talk to him,” Manel promised. 

Keeping his word, he phoned me back the next day. 

“Melro says he needs a few more days. They haven’t finished the immunocytochemical test yet – though he did tell me that they haven’t found any strange cells in the ganglion tissue...”

I breathe deeply. Mustering my courage, I ask: 

“So we can discount metastases?”

“Yes,” he said. 

“And lymphomas?” 

There is a short but detectable silence. He cannot get out of it. 

“Metastases, yes. Lymphomas, not yet.” 

Saturday, 6th July, just before lunch. João brings the phone out to me in the garden.  “It’s Manel,” she says.  

I wait, aware that this was now the moment. Manel clears his throat.  

“Listen, mate, you’ve got a lymphoma... A Hodgkin’s lymphoma.”







    I confess that the overwhelming sensation that I felt at that moment, as Manel told me the diagnosis, was relief. It may seem strange for someone that has just learned that they have cancer. But after a month and a half of waiting, of uncertainty, of hopes successively raised and dashed, it was at least something to know exactly what I had. I felt as if I’d been hurtling along in a runaway train that has finally crashed into the barrier at the end of the line. At last! 

Then I consoled myself with the knowledge that Hodgkin’s (which is a malignant tumour of the lymph vessels, a distant cousin of leukaemia) is a special kind of cancer that behaves relatively predictably and can be treated, often with good results. If some all-powerful higher being had pinned me to the wall and thundered: “You’re going to have cancer, now choose which one...” – that is to say, if He had lent me the menu for ten minutes – I think I might have been inclined to choose a Hodgkin’s lymphoma. It’s one of the lesser cancers... 

“So what happens next?”

“Now we have to do the staging,” said Manel at the other end of the line. Unable to think clearly, I wandered aimlessly around the garden, clutching the phone. I asked him to explain.

“You’ll have to do a CAT scan: neck, chest, abdomen. Then blood tests. Bone biopsy. Liver biopsy. And perhaps a lymphangiogram of your legs to see if it’s affected the peripheral lymph system. It all depends…”

I felt myself bowing under the weight of so many scary scenarios. And these, after all, were only part of the diagnosis. That’s to say, these were the starters on the menu, the beginning of the beginning. I still had to wait for whatever bad news the diagnostic process might drag up. And of course in that uncertain future, misty and sinister as a sea monster, there loomed the prospect of the treatment itself, those terrible treatments for cancers – chemotherapy, radiotherapy. I wasn’t sure which of them would apply in my case.  

In Braga, with the telephone pressed against his ear, Manel stuck out the silence, waiting for me to come to my senses. 

“And how do you think they’ll treat me? Chemo? Radio?”

He wouldn’t say. 

“I don’t know, mate. It’s still early days… But why don’t you speak to Rui? He’s been keeping up with it all. It’d be good for you to hear his opinion.”

Like Juca my ENT specialist, Rui is both a friend and a doctor (though a distinguished oncologist in this case). They’re of the same 25-year vintage. I had met him in my second year at medical school. I’d been leaning against the counter in the locker room, one morning, near the entrance to the faculty bar, watching people pass by. He arrived, said something or another, and, before either of us knew it, we’d sparked a friendship that was still going strong 25 years later, despite the occasional nature of our contacts. 

We talked for a good hour on the phone, maybe more, a blessed hour in which Rui ran through all the possible approaches to my tumour.

“First of all, what you have is a cancer – let’s call it by its proper name – that’s how we’ve got to work.”

Rui was good at gauging just how much I wanted to know about the disease, and I only had to ask a question here and there. He talked about everything, from the histological type of tumour to possible treatments, side-effects and psychological aspects, all seasoned with a bit of metaphysical reflection. He also gave me some important clues for how to navigate the disease:  

“Try and talk it over with some other chaps that have the same thing. It’s very useful. But make sure it’s the same kind of cancer. It’s no good talking to every single cancer patient you meet.”

And so he went on, reeling off advice which I, like an eager neophyte, scooped up in handfuls. 

“Don’t pay any attention to what the others say. Everyone’s going to want to give you their opinion. Get yourself a doctor you can trust and put yourself in his hands.”

He left me with one final suggestion. 

“Don’t think about this any more this weekend, OK? Have a few drinks, smoke your last few cigarettes and then next week, decide what you want to do and start dealing with it.  You’ve got a lot of time.”

Throughout that whole weekend, a silent irony danced in my mind, sticky as a solitary fly in autumn. Each of my three best friends of the last 20 years had chosen a medical specialty that I had come to need a decade later. As I tumbled headlong down the slippery slope of my affliction, I had come to rest momentarily at a series of junctions, where I found I needed the expertise of one or another of them. And they had been there for me as if they existed for no other purpose, waiting to lead me on to the next door. This thought moved me profoundly.   

Despite Rui’s remark about having “a lot of time”, I took my decisions rapidly. I couldn’t stand around doing nothing. After so much uncertainty, I needed to act, move about, burn up some of that black energy that had been accumulating inside me. 

Although I yearned to pursue the process up north where my trusted friends were, I knew that this would be difficult in the real world. The next stage would certainly drag out for at least six months, and I would have to move. But I wanted to face down this challenge in the comfort of my own home, amongst my nearest and dearest, with my own things around me. What’s more, frequent trips to the north would greatly increase the likelihood that my parents would learn of the matter – by chance and through third parties, which would be a terrible way for them to find out. For the time being at least, I wanted to keep them in the dark. 

So I turned southwards instead and, more smoothly than I could have hoped on such a bumpy journey, I soon found myself with a door to knock on and a consultation booked. 

“Helena will see you on Wednesday at 11 am at Capuchos,” said Ana Maria, a doctor friend that I’d asked to help me find someone in the Lisbon area that could treat lymphomas. “I’ll go with you. Let’s meet at the entrance to the haematology department.” This was the sum of what she had been able to arrange after forty-eight hours of investigation.      

The Santo António dos Capuchos is one of a group of hospitals of ancient and noble lineage known as the Lisbon Civil Hospitals. Like the Santa Marta nearby, it is located in the old part of the city and is gently decaying, grumblingly resentful of the newfangled architectural additions that have changed the face of the neighbourhood. Not far away, atop a tall marble plinth surrounded by votive plaques, fresh flowers and lit candles, is the bronze statue of Dr Sousa Martins, a physician that was beatified by the people and who continues to be invoked in their hours of need, a whole century after his death.  

The lady doctor that attends me is tiny and very thin, and wears her overall several sizes too large, belted at the waist and with rolled-up sleeves. She tells me to sit down and observes me with lively eyes. The consultation begins. 

“So, Pedro, tell me everything from the beginning.”

“From the beginning?” I am surprised, because most doctors seem to be almost entirely uninterested in anything the patient has to say, an indifference borne of the modern enthusiasm for technology and a concomitant disregard for clinical history. This usually manifests itself in the form of brusque interruptions and total deafness to the individual details of the complaint. 

“Yes...” she says in her unhurried way, lacing her fingers together and resting her hands on the top of the desk.   

I tell my story and she listens without interrupting. She then turns her attention to the pathologist’s report. Melro has somehow managed to reduce those six excruciating weeks into a few terse lines:  

“Three lymphatic ganglions, the largest 4 cm, with a compact whitish-coloured surface. The histological examination shows ganglion involvement owing to Diffuse lymphocyte-predominant Hodgkin’s disease.”

“Listen, Pedro. Here's what I think we should do…”

Calmly and tactfully, she tells me what is in store, without pressing any dark keys or underestimating prognoses. First, we are going to find out how far the disease has spread (this will involve a CAT scan, battery of blood tests and a biopsy of the hip bone). Then I will undergo treatment with cytostatic chemotherapy and, finally, maybe even radiotherapy. 

“Chemo and radio!?” I was doom-stricken. What a state I must be in to need such a crushing combination!

She absorbed the blow: 

“We’ll see. Let’s go about this calmly, one thing at a time. It all depends on the results of the tests. But usually, in cases like this, we like to finish off the cytostatic treatment with a dose of radiotherapy – it tends to give better results. Chemotherapy is ideal for destroying the young malignant cells that are reproducing intensely, while radiotherapy is better for the latent ones.”

I breathed deeply. She went on: 

“Could you do the CAT tests this afternoon? I’ve already booked you in, if you can. The less time we lose, the quicker you’ll be rid of this.”

“Have you fasted?” asked the girl at the reception desk of the clinic where Dr Helena Gouveia had sent me with a letter of referral.  

I supposed so.  It was three in the afternoon, and I hadn’t eaten anything since breakfast, which had been some six hours before. 

“Well, it’s like this: First you’ve got to drink this liquid – it’s contrast solution. It doesn't taste of anything. When you’ve finished the glass, I’ll bring you some more. Try not to urinate, all right?”

After an hour of knocking back endless cupfuls of a colourless odourless liquid that looked like water but was as sickeningly insipid as liquid plastic, I spent another hour lying on a narrow bed with my arms stretched out and crossed above my head. My hands held a syringe that was connected by catheter to a vein in my right arm. This was full of a substance that they would come and inject into me from time to time and which got my body fizzing as if it had been turpentine.

“You’ll feel a sensation of heat,” the nurse informed me, before pumping in another dose, “but don’t worry – that’s normal.”

As if I would worry about such a thing – after all, I’ve always liked strong emotions and prefer the heat to the cold! What I really couldn’t stand was the interminable wait. My arms were numb and stiff from being stretched out so artificially, my bladder was bursting, and most of all, I was irritated by that monotonous voice emanating from a cabin where I could make out two silhouettes in white overalls, endlessly replaying the same recorded instructions: “don’t breathe...breathe...”; “don’t breathe...breathe...”; “don’t breathe...” In the meantime, an enormous metal ring moved up and down over my body, exploring my entrails in millimetric detail and emitting sounds like a camera shutter. 

“Breathe...don’t breathe...; breathe… don’t breathe...”

I was just finishing getting dressed afterwards, burping contrast solution and giddy with hunger, when the doctor that had been in charge of the scanner came to see me. She looked friendly and had a sweet voice. 

“As you’re a colleague, I just wanted to tell you that the disease is limited to the upper part of your neck. You’ve three ganglions there, behind the sternocleidomastoid. They’re not very big – the largest is 2 cm and the smallest around 1.3. As for the rest, you can relax. You’re clean. Completely clean.”

I thanked her as warmly as if she herself were personally responsible for it being all so “clean” inside my body, and my eyes filled with tears that I couldn’t contain or hide. She continued to smile, and when we parted, stretched out her hand, wishing me all the best for my treatment.  

Back at Capuchos, Dr Helena Gouveia appeared satisfied with the results of the CAT scan. 

“You know, it’s really rare that we catch a Hodgkin’s at such an early stage. We’ve got so little experience of cases like yours... That’s the advantage of having such a thin neck. If you were fatter, you could’ve gone months with that growing inside you and you wouldn’t even have noticed!”

The blood tests were also good, so we could move on. 

“We’ll begin on 17th July,” she said, leafing through her diary. “That’s a Wednesday. In the morning, early, we’ll do the bone biopsy, and then right afterwards, you can have the first round of chemotherapy. What do you say?”

I didn’t know what to say. I was scared stiff at what lay ahead, but what could I do? How could possibly I escape my diseased body?

“On second thoughts,” she said, adjusting my future to the calendar, “let’s not do them both on the same day. It might be too much all in one go.”

And so the dates were set. My immediate destiny was fixed. 

“That’s it, then. Biopsy on the 17th, first chemo session on the 18th and then, a session every fortnight – on the 1st, 14th and 29th of August. We’ll finish there with the cytostatic treatment, in principle, if your blood has stood up to it.”

    The chemotherapy room looks like a hairdresser’s salon filled with an exhibition of Vermeers! There are a dozen reclinable black armchairs with large side panels to support and hide unsteady heads; fans and tripods clustered in the corners of the room; white-coated assistants sitting on stools at the feet of each customer with metal trays on their knees. As for the customers themselves, they are all different yet all the same. They have something in common that belies the diversity of sex, age, class and even attitude. For although there are old people, young people, men and women, all have the same pallid complexion, dazed look and diminished resources of hair. 

In fact, to one extent or another, everyone displays (or tries to hide) hairless eyebrows, scantily fringed eyelids and dull lifeless hair that looks as if it might blow off with the slightest breeze. Some have no hair at all, a fact which they try to disguise as best they can with wigs, hats and headscarves of all styles and patterns. There are others that do not try to hide their condition and provocatively flaunt their bald angular skulls for all to see.  When my turn comes, I decide, I will be one of those. I won’t try to disguise it. I’ll shave it all off. 

“Ah! And you’ll lose some hair too, you know," Dr Helena Gouveia had said, as she explained the more unpleasant side-effects of the treatment, “maybe not all of it, but enough.” 

But for now it’s early to complain about that. One thing at a time, I’ve decided. It’s only my first day of treatment. Those things will come later, maybe after the second session – that’s to say, not before two or three weeks.

I’m sitting comfortably, a little nervous, but I’ve decided to be a good boy. On my lap is a book by Jane Austen and a magazine of the kind you get in the doctor’s waiting room or hairdresser’s salon, to be leafed through and thrown away. A nurse has just sat down on the stool in front of me wearing a mask over her mouth and nose. She has a tray on her lap, where I can see various syringes and flasks of different sizes, one wrapped in tin foil. 

Slotted into the tray like a musical score is a piece of paper which she studies intently – I imagine it contains the ingredients for my chemical ration. She scans the contents of the tray and then looks at me, rather as a customs official might, and asks if I’m Mr So and So. I learn later that this is common procedure, a routine that is faithfully observed, even when they know me perfectly well. They never put anything into our veins without checking that we are the correct recipients for that particular mixture. This is not untoward, as these drugs, despite bearing the attractive names of mythological deities or Italian dishes, are so fiendishly destructive that they would cause more damage than caustic soda if accidentally spilt on innocent skin. 

In my case, they are going to give me a concoction called ABVD, which is short for a cocktail of four drugs – Adriamycin, Bleomycin, Vinblastine and Dacarbazine. One of these is toxic for the heart, another causes pulmonary fibrosis and a third is as neurotoxic as the nerve gas used in war. To top it all, practically all of them cause as much nausea as the crests of the high seas.  

“Let’s see how those veins are...” says the nurse, tying a tourniquet around my arm and wielding a needle attached to a tube that has small plastic taps fitted to it.  

Later, trying to field curious, if embarrassed, questions from well-wishers (“is it very difficult, chemotherapy?”; “what’s worse, chemotherapy or radiotherapy?”), I would call those sessions my napalm period to distinguish them my Hiroshima period, which was the radiotherapy. It may seem rather flippant to compare a prescribed medical treatment to the jellied petroleum that the American planes discharged over Vietnam, causing a devastating conflagration after which nothing could grow for years…  But just try asking someone that has experienced those drugs! Cytostatics are poisons, as we realise the moment they begin creeping through our veins. If I had to keep these substances at home, I would store them in a very high cupboard in the darkest part of the garage next to the rat poisons and pesticides, far out of reach of children.  

Still today, four years after those sessions, I shudder when I recall that inferno of nausea and internal burning. Through some strange perversion of the senses, the perfume worn by my devoted haematologist now makes me dizzy whenever I smell it (if she only imagined, poor thing!), and I cannot glimpse the cover of that Jane Austen novel without my mouth becoming awash with salty saliva and waves of nausea rising in my gullet. Needless to say, I have never opened that particular edition again. It could have been worse, I suppose. From what I heard backstage from some of my fellow martyrs, there are people that, after a few years of treatment, vomit every time they see a nurse. 

You’ve got a lot to answer for, Pavlov, old chap!

The doctors know all this, of course. They know that this stuff messes about with your insides so much that before the beginning of each session, they administer a potent antiemetic to attenuate these types of side-effects. Goodness knows what it would be like without it! They cannot imagine the intensity of the sickness, the various shades of nausea that dance about in that pre-emetic purgatory. Vomiting offers a convenient way out, but it’s by no means the worst part. The worst is the nausea that remains for three, four or more hours of each session, rising, rising, rising in waves from the stomach, keeping us in unstable suspense as if we were tightrope-walkers afraid of heights. 

Nor does it end with the session! It can continue for days afterwards and we never really know when we’re going to start feeling sick nor what smells will provoke it –  the exhaust fumes from cars, expensive scent, the smell of food, of soap... It all depends on the days, on the events that become indelibly associated in our minds with that basic nausea. Now I understand how pregnant women feel, plagued with morning sickness.    

Before continuing the saga of the various upsets caused by cytostatics in other departments, I would just like to continue my description of these drugs’ effects on our olfactory organ – for chemotherapy generally sharpens our sense of smell (which maybe explains the exaggerated effect that odours have on us). In my case, this enhanced capacity persisted long after the treatment had ended to become a permanent fixture (something I regard as more of a gain than a loss). It was almost as if I’d turned into an animal!  

Well… My first chemotherapy session was a success and filled me with confidence, as I got it over and done with in little over two hours. And it seemed to stimulate my appetite! I left the hospital feeling ravenous, and stupidly went and filled myself up with an omelette and chips, washed down with an orange juice! That was quite the wrong thing to do, of course! By the time I got home, I was as sick as a deep-fried doughnut that has been left to fester in the oil. 

At night, I was on the brink of a fever, my skin itchy, and my stomach feeling as if it was lined with aluminium. It was difficult to sleep as I was still buzzing with the drugs, and also from the endless telephone calls that had been a constant occurrence since I got home. Amongst them, I received a call from a colleague that I’d not been in touch with for a while, a certain Miguel Guimarães, whom I’d heard was ill – a lymphoma, I believed.

The call, which seemed harsh and demoralizing that day, proved to be the first of many. In fact, Miguel Guimarães would not leave me alone, and at first I was scared and exasperated by his persistence. Then gradually I began to appreciate the intimate if rather ghoulish nature of those contacts. I realised that his whole attitude demonstrated not only friendship, but also solidarity, the kind of solidarity that unites everyone that has been afflicted by serious illness (and which I’ve also encountered in the patients I’ve bumped into during my long perambulations through kilometres of hospital corridors).

Miguel had had a Hodgkin’s that was more serious than mine, but had managed to rid himself of it just a few months ago. His phone calls seemed to be strategically spaced out so as to anticipate the various stages of my own treatment.  

“Yes, the first session isn’t too bad,” he said as a preamble, “but the second will be worse, you’ll see. It’ll be longer, and your veins will get all burned up.”

It struck me that Miguel Guimarães was the embodiment of that nebulous being that my oncologist friend had advised me to talk to. At the time, I had wondered where I was going to find “other chaps that have the same thing”.  I wanted to follow Rui’s advice but didn’t know quite how, nor did I feel much like making the effort. I wasn’t exactly going to put a notice in the newspaper, and the idea of swapping stories with the patients that I bumped into in the hospital was rather intimidating  (“Excuse me, do you, by any chance, have a Hodgkin’s?”)

Miguel and I started to compare symptoms – haemoglobin levels, sedimentation rate, platelet count, muscle cramps – in as much detail as if we were a pair of cooks discussing recipes, or gamers exchanging tips and cheats. 

“No, it doesn’t make me feel like throwing up,” I stated, rather superciliously. 

“That’s what you think!” he retorted. “Just wait for the next session! The effects are cumulative.” 

In the first fortnight of August, after the hangover from the first session had largely passed and before the next one began, I got ready for my last trip to Oporto to visit my family, aware that my appearance from now on could only deteriorate. Above all, I wanted to tell my father what was wrong with me. I’d arrived at this decision after a great deal of consideration, pondering the pros and cons with my closest friends. My father, who was a doctor, well-trained and well-informed, would understand the problem and the solutions taken, and would be the best person to decide whether or not we should say something to my mother on the subject.  There was no way around it. I would have felt terrible if they’d got to hear of it through a casual question from an interested acquaintance (“So how’s Pedro? Is he better? Has he finished his treatment?”)

No, I couldn't let that happen. So I crossed the Arrábida Bridge and, in a hushed confabulation, arranged first with my father and then with my sisters to keep my mother shielded from all knowledge of my disease. Her own cancer was quite enough for her to manage, what with all the rituals – the surgery, the chemotherapy, the radiotherapy, the endless series of invasive tests, the depressing waiting rooms. Now that things were calmer and she no longer had to spend her days at the Cancer Institute, it made no sense to go and spoil things with an account of my own ailments. So we decided that I would not return to Oporto until Christmas, by which time my hair would have grown back and my general appearance would, we hoped, be more presentable. Till then, so as not to arouse her suspicions, I would make circumstantial phone calls and my father would receive news of my progress through my sisters.

I realised right after my second round of chemo that Miguel Guimarães was master of the subject and I no more than his paltry and increasingly limp apprentice. The sessions extended from two to three hours, as my veins were unable to stand the initial pace of the drip. Assaulted by the orange liquid that snaked through the tube into my arm, they burned painfully as if they were being distended far beyond their natural calibre. 

“Nurse...,” I called, not daring to alter the flow myself. “Please, do you think you could turn this down a little?”

I returned home feeling crumpled and worn, and went straight to bed, shivering with a hot dry cold. The objects around me seemed to have acquired darker vaguer outlines, and were tinged with a greenish hue. I still had my voracious appetite, but I found that the tastes of things would unexpectedly change as if I were suffering from strange gustatory hallucinations – at one meal, the dessert would seem salty, then in the next, it would acquire a bitter tang, before returning to its usual taste without warning. 

“At least I’ve not thrown up,” I said to myself, in an attempt at consolation, “that’s one thing less to worry about...” With time, these introspections became gradually more sophisticated until I had become a master of self-manipulation. Patient and hopeful, I would take one step at a time (“Now that session’s over”), awarding myself brownie points in a melancholy grid of honour (“Today I didn’t throw up”) and lighting torches to illuminate one metre of the tunnel ahead (“The next session is two weeks away”). I sought at all cost to avoid the unbearable despair that was unleashed if I tried to overfly the future too ambitiously (“My God, I’ve still got two more sessions to get through and I have hardly been able to stand this one!”; “My God, then I’ll have to do radiotherapy!”; “My God, I’ve still got another six months of this and I’ve no idea whether or not it will have been worth it...”). So I learned to dodge such thoughts with the cunning of the diplomat, the sinuous twists of the reptile…  

Somewhere between the second and third sessions, my hair began to fall out. And when I say hair, I don’t mean just the hair on my head. By the end of summer I was as bald as a eunuch, with very little on my head and not so much as a whisker in my beard. I was a genuine Vermeer in terms of my eyebrows, and as for my eyelashes, they were constantly falling out into my eyes, where they would irritate like dustmotes, or would stick to my glasses like commas, cluttering up my vision.

During the sessions, I do no more than stare at the flasks dangling over me, an attitude that I had previously interpreted as a sign of levity on the part of some of my companions in the room ("why do they not try to entertain themselves with something – reading or watching TV, for example?”). Now I just watch hypnotized as each drop slowly forms, lazily detaches itself and falls, sliding down to my arm where it waits in line, jostling with its siblings to get inside my veins. 

Around the room, magazines, bought at the newstand near the hospital entrance, lie abandoned on laps or on the arms of chairs. This, I would say, is the most common attitude. There are, of course, exceptions. One middle-aged lady that usually sits in front of me, with shorn head and no more than a hint of eyebrows (a true Vermeer Venus) reads her book in a totally concentrated way, as if she is sitting in the garden of her country home soaking up the last rays of the autumn sun. But it is rare to see such distancing, such acceptance. Most of us remain for hours, stupidly watching the drops that parade by like the beads on a rosary until the last one falls and the blessed plaster is stuck on our arm. 

“How are you doing?” my friends ask on the phone.

“Surviving,” I reply. “What gets me most is that I never felt ill with the disease. It’s the blasted treatment that’s doing me in!” 

As if to make the point, during my last session in the Haematology Day Hospital, I suddenly realised that I was feeling terribly sick. Although I’d been given a powerful anti-emetic and was determined to stick it out to the end, a torrent of nausea suddenly overwhelmed me, flooding my mouth with metallic-tasting saliva. 

“Here it comes,” I remember thinking, “I’m going to throw up.” Then overcome with violent gastric convulsions, I begin to slide off my chair, as everything around me gradually turns dark. 

“Nurse!” shouted someone nearby, running towards me holding a dish made of recycled card like an eggbox, which seemed to have been designed precisely for situations like this.

As the nurse took my blood pressure, felt my pulse and prodded me verbally, I realised what the fans were for that were stored in a corner. Aaah! It felt so good, that fresh air on my face. 

Despite the attack of vomits, I finished the final chemo session and returned home, pleased to have got the better of Miguel Guimarães. But, some 34 km up the motorway, João had to brake sharply so that I could throw up again onto the kerb on that magnificent hot summer afternoon.  



    Dr Helena Gouveia studied the new CAT scans carefully, read the accompanying report and looked at me enthusiastically. 

“Fantastic, Pedro! Everything has gone in just four sessions! You’re in complete remission.”

“Complete remission” was a term which, like “AVBD”, now started to haunt me like a shadow. Although no one would admit it, all these ciphers and big words referred to human beings that had been touched by good fortune. “Complete remission” meant I was symptom-free (doctors always liked to exercise extreme caution when talking about cancer, as if it would bring bad luck to pronounce the word “cure”). Similarly, the code DH-PL-1A that was now inscribed on all my documents, stood for Hodgkin’s Disease in its predominantly lymphocyte form, Stage 1, variant A (which meant that I was free of the systemic symptoms that gave a bad prognosis), which was just another way of describing an individual with a very limited early-phase cancer, whose symptoms had disappeared after having been subjected to a pot-pourri of chemicals. 

My days at Capuchos had come to an end. I would now go on to the Santa Maria Hospital for my radiotherapy, as the Civil Hospitals of Lisbon were not equipped with radiotherapy departments. 

“So what’s next?” I asked Helena Gouveia, feeling rather orphaned. “What’s going to happen? Won’t you be treating me any more?”

“The only places in Lisbon that do this are the Cancer Institute and the Santa Maria,” Helena explained. “We have an agreement with the Santa Maria. They have a new department that is beautifully equipped, and our protocol with them has functioned well... Of course, I hope you will come and visit us occasionally.”

I can remember the first radiotherapy consultation at the Santa Maria Hospital as clearly as if it was today. It was booked for 12 am on the last day of summer, and I remember that morning clearly, not because of the tenacity with which summer clung to the sky on her way out, but rather because a worry was beginning to form in my mind as I got out of the taxi near the entrance and walked up to the hospital building.  

“Will there be a corner reserved for me in this huge Babylon? Will there be someone waiting to guide me through the next stage of my treatment?”

It didn’t look like it. Any hopes I might have nursed were soon quashed by the sheer size of the hospital. It was a concrete incarnation of those dreams of eternity erected by dictators in the old eastern block.  Enormous, desolate, grey – and so it would remain, it seemed to me, even if they painted it bright green or ultramarine blue. It was overpowering in a way that I felt should have been forbidden. 

I finally found the radiotherapy department in a new one-storey annex, discreetly attached to the western façade of the hospital. According to the plaque in the modern entrance hall, it had been inaugurated by the prime minister in 1993, a mere three years before. 

The doctor glanced at me vaguely and extended his hand in a virtual sketch of a handshake.  This was Dr Bernardo Ataíde, who from then on would act as intermediary between me and radioactivity, the person responsible for my Hiroshima period. He read the report that Helena had prepared, and then inserted the CAT scans into the light box and observed them carefully. After some minutes, he became aware that I was still standing on the other side of his desk, leaning on the edge of a chair. 

“Sit down, please.” 

I sat down and continued waiting, trying, whenever I glimpsed some opening in his silent contemplation, to explain what had happened to me until then. Without giving any obvious sign that he was listening, he continued to leaf through reports and test results. He wrote my name at the top of a huge record card, adding the famous abbreviation DH-PL, and then began scribbling something down in tiny handwriting. After several minutes, he eventually put down his pen, raised his head and, looking towards the window, addressed me. 

“Your case is quite rare. It’s not at all common for us to get patients at such an early stage, when the disease is restricted to a single ganglion group. You’ve had chemotherapy, you said?”

“Yes,” I replied surprised at the question. “Four sessions with AVBD.... The doses are given there.” I pointed at the papers that he’d just been studying. 

“That’s not much. Not much at all,” he mused, more to himself than to me. 

“But it seems to have been enough,” I blurted out, in self-defence. “Dr Gouveia says I’m in complete remission.”

“Yes, yes, that’s what your doctor says here,” he conceded, looking again at the reports that I’d brought him. Continuing to address me as if I was located on the other side of the window, perhaps sitting somewhere outside in the department garden, he finally seemed to come to a decision. 

“Right, we’ll do it like this. Today we’ll get you in the simulator to prepare your plan, and next Wednesday, you’ll start with the LINAC[†]. We’ll do 25 sessions – your neck, back and front, the super clavicle and axillary regions and the whole of the mediastinum...”

Shocked at the news, I butted in: 

“But don’t you think that’s a bit much, doctor?! I mean, for someone who’s got such a limited disease and who has already done chemotherapy. Wouldn’t a lighter treatment be enough?”

I was not speaking blindly, with the flippancy of someone negotiating the price of a carpet. Although I wasn’t a specialist in lymphomas or radiotherapy, I knew exactly what my problem was and the extent of it. In fact, having so many health professionals as colleagues and friends, I’d suffered endless sermons on the subject, mostly unsolicited (“If you went to my hospital, they’d only do radiotherapy...”; “You mean they’re going to give you radiotherapy afterwards?! The chemotherapy alone would be more than enough. They’ve got no idea!”…) and had paid attention to the details, as the persecuted and distrustful tend to do. It was not difficult to identify the median of all these opinions. Haematologists, oncologists, radiotherapists, all agreed that “one irradiation of the neck and super clavicle region would be plenty in a case like yours, particularly after four rounds of chemo”.

Surprised at my tirade, which he had clearly not been expecting, Bernardo Ataíde remained silent for a few moments, looking at me out of the corner of his eye as if I were a very unusual species of patient, the patient that has something to suggest. 

“Listen,” he said, “your situation is rare, as I said. We’ve not much experience of these cases and I prefer to be on the safe side. I’m very afraid of relapses in the mediastinum.”

I shut up and recomposed my features to better resemble the humble patient sitting expectantly on the edge of his chair. What could I do? Escape? Go somewhere else where I’d have to start all over again, watching the time draining away, while the lymphocytes, presently so quiet, began to multiply in the darkness of my body at the obscene rate of mice litters? Or should I negotiate, say to him: “Listen, this is my body and of the 25 treatments you are suggesting, I will only do half, half no – that’s not a round number – I’ll do 13..., thirteen no, I don’t like that number, let’s close the deal at 14.” A patient doesn’t have an opinion. He can’t afford to. 

Getting up, he interrupted my musings:

“I’m going to study your case and next week, on the day of your first treatment, I’ll tell you what I’ve decided. Do you know where the simulator room is?” 

After an hour and goodness-knows-how-many X-rays later, I leave the simulator (a device that mimics the linear accelerator by showing the location and angle of impact in the body, allowing the technicians to visualise the volume to be treated and rehearse safely) with my torso covered in red lines. They’d been drawn with the kind of marker pen used to write on transparencies, and were designed to help position my body under the linear accelerator, which of course would not emit inoffensive light, but perforating invisible rays, cousins of the atom bomb!

I had a horizontal line across my left earlobe, a cross on each shoulder and another on the upper part of the sternum, a long line on the level of the diaphragm, and a series of short ones on my back, outlining and highlighting the exact location of my vertebrae. 

“All I need is an earring and I’d look like a punk,” I say jokily to the friendly technician that has assisted Dr Ataíde in his meticulous work and was keeping me company while I put on my shirt. 

She laughed, shaking the plait that fell down her back and revealing a mouth full of braces of the kind that were so fashionable at the moment. 

“Tell me,” I went on, feeling much more at ease asking her for information than the doctor, “can I wash with these marks on me? Won’t they come off?”

“Yes, you can have a shower, but be careful not to rub too hard. The marks will gradually fade, but, as you’ll be here every day, that’s no problem. We can revive them.” 

My legs were like jelly when I arrived outside in the fresh air (the morning was over and had given way to a beautiful calm summer afternoon). With my state of psychological exhaustion, my poor body should have been taken out of there in an ambulance. 

This first round of radiotherapy took place on a Friday, and during the weekend, trying to compose myself after the collapse caused by the prospect of five solid weeks of treatment, and above all, by the dose and length of the treatment planned, I made some urgent phone calls. My anguish at this point was so specific that only one friend, a radiotherapy specialist, would be able to calm me. 

“I think a mini-mantle would be perfectly adequate, in your case. A broad mantle seems excessive to me. At any rate, let me tell you, too much is always better than too little in cases like this!”

The following Wednesday, feeling nervous about the doctor’s imminent decision, I turned up for my first rendez-vous with radiation. I smiled at the lady on the reception desk and asked for Dr Bernardo Ataíde.

In his inexpressive affability, Dr Ataíde was concise: 

“I’ve been thinking about your case, and I’ve decided that we’re going to go for a broad mantle, as I told you. I’ll feel more confident about the results.”

And before sending me to the LINAC, he told me briefly about the possible (or probable) side effects of radiation. They included a reduction of saliva and sweat, due to the irradiation of the submaxillary salivary glands and axillary sweat glands; hair loss on the nape of the neck and face; burns on the skin; inflammation of the oesophagus and food reflux; pericarditis; pneumonitis, and, in the medium term, possible thyroid problems...

I gulped. 

    The LINAC room is like a hangar, huge and bare. There is practically nothing in it except for the bed and the portentous apparatus, which reminds me of the giant telescopes in the planetarium. The procedure is always the same, as I learn very quickly, like a diligent schoolboy. When they call my name, I put down my magazine, jump off the chair in the waiting room and go into a small changing-room where I remove my shirt. Then, in an antechamber where technicians huddle around computers, watching what is going on in the LINAC room on closed circuit television, I wait for the previous patient to come out. We generally meet at the door, he (or she) and I, naked from the waist up. Sometimes I find myself staring in surprise to see the skull, smooth as a billiard ball, of a lady who, moments before, has been sitting next to me in the waiting room, decently dressed and with a perfectly normal head of hair. But I don’t betray my amazement and we pass each other in silence, with an almost imperceptible nod of the head. Neither of us is particularly embarrassed to be seen like this. We know we’re both in the same boat and that the matter will go no further. 

I go in and wait as a fresh disposable sheet is stretched out on the couch. Then I climb the two steps up to it and lie down. The technicians, usually two of them, position my body, taking their time until they are satisfied that the marks on my neck and chest are properly lined up with the lights emitted by the machine, which indicate where the true (invisible) rays will penetrate. The process is rather drawn out and finicky. When I am properly positioned, they place a broad white band of adhesive tape across my forehead and attach it to the edges of the couch. I lie there immobile as a mouse that is being sniffed by a cat. The adhesive tape is to stop me moving my head from side to side. Then to make sure that I don’t try to move it up and down either, they place a second strip under my chin to keep my neck in the same position. 

    “Now don’t move, all right?” they always say, before leaving the room. 

“All right. Don’t worry,” I reply mentally, because it’s complicated trying to speak with your chin glued down. 

I lie there on my own as the door, heavy and armoured as the entrance to a nuclear power station, swings closed at the other end of the room. 

Here they come – the ghost rays! Run! 

I can’t see them, but I know when they begin to spurt out because a red light starts to flash on the wall opposite and an alarm bell wails like an air raid siren.  I always close my eyes during the process – not that it will make any difference one way or another, but I feel psychologically more protected. I lie there and wait for the wailing to stop, the door to open and the technicians to come and unpeel me from the table and take me out of there. I don’t see or feel anything; nothing hurts. The process is invisible, incorporeal. All I notice is a dry and slightly electric odour hovering in the air, quite different from any other smell I have ever known, but which one day I know I will recognise if I encounter it in another context.  

I jump off the couch and go down the corridor to the big door, where I meet the next patient coming in. Before leaving, I go back to the waiting room to say goodbye to anyone that is still there. 

“See you tomorrow. All the best.”

We all do this, every morning, using exactly the same phrases. It is a ritual that I learned in chemotherapy, but which is practised here even more rigorously. No one fails. Such circumspection is no doubt useless and rather ridiculous, but we do it with conviction, nevertheless. It’s quite probable that tomorrow, someone from the group will not be there for treatment.  So much for wishing them all the best... 

At the end of my first round of radiation, I was tucking my shirt into my trousers when the door of the changing room opened and a lady in a white coat came in. She said she was a nurse and that she was there to help me get used to life in the department and to explain some details to me that all patients needed to know. Strangely, given her environmental function, she was a rather dejected-looking creature, whose sagging facial features made me think of a St Bernard dog whose barrel of cognac was empty. In a robotic monotone, she described what I would feel, illustrating her account with some rather horrifying details that were unlikely to apply to my case. She wrapped the whole thing up with an account of “what we can do for you”: 

“We can provide psychiatric and psychological support, and artificial saliva if you need it...”

There I was, pinned to the wall, naked from the waist up, having to put up with that monotonous litany, and it was as much as I could do not to burst out laughing, particularly at the bit about “artificial saliva”. This was not just because of the unexpectedness of the offer but also because I suddenly found myself imagining a saliva bank (no doubt through analogy with milk banks and sperm banks) peopled by benevolent hardworking donors all spitting into a sterilized jar in single-minded devotion.  

I experienced the first week of treatment with great energy and liveliness, because, compared to the immediate nausea and horror of chemotherapy, this was not difficult to take at all! In fact I felt that it was rather ridiculous and a waste of time. I went every day to Lisbon just to lie under a machine for a minute, and then I would leave and come home! 

Oh, sweet fleeting innocence! Miguel Guimarães had warned me that it was not at all easy and I still remember one piece of advice he gave me, which, at the time, I’d not really understood. 

“And make sure you carry a bottle around with you...”

“A bottle?”

“Yes, a bottle of water. You’ll be left without a drop of saliva and you’ll have to drink constantly, just to be able to swallow.”

Yes, he warned me, and the doctor did too. But in those first few days I was euphoric at the contrast with the chemotherapy, though the memory and effects of it were gradually fading as time went by. I’d even managed to bury my apprehensions about the length and strength of the treatment under clods of logic. Perhaps it’s better like this, I told myself. After all, I was in good physical condition to stand it; better to sort it all out now than to have to come back and go through it all again later; things always work out for the best, etc., etc.

Half way through the second week, the wind changed direction. Suddenly, it felt as if a ten-ton safe and a grand piano (the one stuffed full, the other mute, and both metaphorical) had crashed down from the nineteenth floor right onto my poor speckled ribs. I was overcome by a fatigue, an exhaustion, a debilitation so profound that for the first time in my life, I understood what it must feel like to be a run-down battery or a flat tyre. Soon I had to move to a cheap hotel in Lisbon and the treatment became the sole focus of my day. I needed all the remaining hours to recover. 

In the third week, I began to fear that I wouldn’t be able to stand it any longer. I started counting the sessions that I still had left to do, but new phantoms would rise up before me to push me back down the stairs. First, I found I could no longer spit. My saliva had disappeared, and when I tried, I couldn’t even manage to launch the tiny amount of spittle that I had laboriously been trying to accumulate over the course of two or three minutes. Then, I had frequent hiccoughs, and when I ate, the food would stick in my gullet and refuse to go down. Even when it finally arrived in my stomach, the tiniest thing would make it come back up, giving me constant heartburn. 

And there was more. My armpits, from where the hairs had long disappeared (there’s nothing like anti-cancer agents to ensure a perfect depilation!) were raw as the skin started to peel off. I found it was not a good idea to hold my arms alongside my body, because it was murderous trying to unglue them again afterwards. The problem was worse at night, with the abandon of sleep and the warmth of the bed, and I would often have to wake up to sprinkle them with water from the glass that I left on my bedside table. 

I spend the whole afternoon lying in bed in my room at the hotel doing nothing. I’ve no energy to do anything. I just lie there vaguely listening to life humming along outside.  Tomorrow I have to go back to the hospital again and, on the human scale, will draw one step back towards the cave. I wait, I have to wait. All I can do is count the days one by one, for any more drags me into the swamp of despair. Despondency flutters around me like a vulture. At night, I go out alone to have dinner, always at the same restaurant, shuffling slowly through the streets. My neck hurts, my back hurts, my legs feel weak. The bones in my arms and chest seem hollow as if they could break at the slightest flick. It hurts me to swallow; the simple act of raising or lowering my Adam’s apple is painful. 

For two days, I have a terrible itch on the lower part of the neck until I realise that I have an ugly wound there, caused by the label on the inside of my shirt. My skin is crumbling away like papyrus. I solve the problem by cushioning my neck with silk handkerchiefs soaked in Biafine, the blessed balsam that Bernardo Ataíde prescribed when I finally plucked up the courage to tell him what was happening in my armpits. 

“Ah..., I could have told you that..., it happens often. I’ll prescribe you a very good ointment.”

I look terrible. I observe myself in the mirror and realise how people must see me when I dare to go into a restaurant or café. What must they think of this ashen-faced spectre, gaunt and angular as a skewer, with the grimy brown neck and no more than a few broken hairs left on his head, which (if only they knew!) can be pulled out with the fingers, just as a nail can be pulled out from rotten wood? I go in and perch on a chair, as if in slow motion. The waiters bring me the menu and cutlery, and stare at me in surprise, particularly at the red scrawls on my neck and left ear lobe. They can't seem to work out if I’m ill, a drug addict or just plain crazy. However, I’ve been coming to this joint for years now and am known as a reliable customer, a regular guy in a respectable establishment. What could possibly have happened to such a person to cause him to stuff a scarf under his chin like that (and it is almost always the same one, streaked with some greasy sauce) and – as if that is not enough – to down a litre and a half of water at each meal and use half a bottle of olive oil to season the dish he has ordered?

“Mirror, mirror on the wall; am I the ugliest of all?”

I glance around the waiting room. There are all kinds of people here, patients in all states to suit all tastes. Some are apparently still in a reasonable physical condition (this is the subgroup to which I consider I belong) while others are clearly much worse off, listlessly awaiting their turn huddled in wheelchairs or lying crumpled on trolleys. This last subgroup is quite volatile. What I mean is, one day they’re all there with us, then the next some of them are not. We all wonder where they might have gone, though no one voices this out loud (for there are children in the room — lots of them; in fact, there’s an area reserved for them equipped with tiny furniture and colourful toys). Some people speak openly about their disease, while others let their partners do the talking. Then there are those that seem to have turned inwards upon themselves in an attitude of isolation or denial, and others that try to sneak by unseen (as I do), though this is not always easy to achieve or maintain. 

“What about you? Do you have a tumour in your head too?” asks a woman with an Azores accent. She is telling the story of her husband’s illness, and the television recedes into the background.

“No,” I say timidly, pointing to my scar. “I had some swellings here in my neck...”

Having satisfied her curiosity, she continues with her narrative, going into great detail about the appearance of the first symptoms, the visit to the doctor on S. Miguel island, hospitalization for tests, and finally the trip to Lisbon, where they had been for over a month, lodged in a bed-and-breakfast.  

“And life was going so well!” she confided, as if she were only now becoming aware of the happiness lost, as if that brutal disruption of their family life had been necessary to show her that. “... “Yes, it was all going really well.”

While she sighed and wiped her eyes on a handkerchief, her husband, sitting by her side, slowly nodded his silent assent, concurring with the facts recounted and the happiness lost far away in the middle of the ocean.

Now that the attention is off me, I raise my magazine to surreptitiously watch an eight-year-old boy sitting opposite me in one of those little chairs in the children’s corner. He seems lost in thought, absent-mindedly rolling a strand of hair between his fingers. When he gets up to go for his treatment, I see that the ground around the chair is covered with black tufts of abandoned hair. His mother squats down, glances around her in embarrassment, and quickly collects them up and tips them carefully into the rubbish bin. Hidden behind the exploits of the princesses of Monaco, I try to disguise just how much this scene has affected me. I have to wait some moments before the moisture begins to disappear from my eyes. 

From my position in the waiting room I can see the door leading to the LINAC room, a section of corridor and the profile of Dr Bernardo Ataíde, who crosses back and forth on his way to and from the treatment zone without ever diverting his gaze or stopping to greet anyone. This man is clearly the technical soul of that department, and his name is constantly echoing about:  

“Dr Bernardo,” calls one of the technicians. “Could you possibly come inside, please?”

“You haven’t seen Dr Bernardo, have you?” asks another.

And there he goes, tirelessly back and forth, his face inscrutable.  

I count the days to the end of the treatment like a man shipwrecked on a desert island making notches on tree trunks or like a prisoner that is finally approaching the last leg of his sentence. 

On the day of my twentieth session, I mentally patted myself on my poor lacerated back, and murmured “Good boy! You’ve done well!” That morning, as I was strapped under the radioactive auger in my usual bondage gear, Dr Ataíde decided to pay me a visit. 

“From tomorrow we’re going to give you heart protection,” he announced, in his stern rather snobbish voice.

“All right, doctor,” I said to the luminous vacuum. As my head was secured to the couch, my field of vision was completely taken over by the powerful lights that spurted out of the machine, condemning me to obscurity.

As often happens when he enters the room by surprise, Dr Ataíde stays a while to make sure the technicians are positioning me correctly, and helps them set up the thick acrylic plaque to which are screwed the lead cylinders that protect certain vital parts from the radiation. The next day, a Thursday, a new lead block – the heart protection – is added to the acrylic plaque. Then on Friday, at the end of my twenty-second session, the technician, stretching out her hand to help me up, tells me: 

“Before you leave, could you please pass by Dr Ataide’s office? He wants to speak to you."

“Come in, come in,” the doctor called, seeing my silhouette dithering in the doorway.  Staring at the blinds on the window, as was his wont, he said: 

“Nearly over, eh? Next week we’ll do three sessions, using a slightly stronger dose but directed only at the neck – one last reinforcement in the affected area.”

And stretching the corners of his mouth into a crooked proto-smile, he concluded,

“You should, in principle, be definitively free of all this.” 


    On 30th October 1996, I finished radiotherapy. Three weeks after, on the last-but-one Friday in November, I had to go to Oporto for a meeting in the headquarters of the Medical Association, a beautiful big old house in Arca D’Água Garden. As I had not seen my father since the beginning of August, I decided to phone him, suggesting we met secretly in the Medical Association bar.

At around five o’ clock, as soon as the meeting had finished, I went downstairs and headed to the bar. Apart from the barman behind the counter, the room was deserted. It was growing cold and damp, and a cosy fireplace crackled in the silence of the afternoon. Suddenly I realised that my father was sitting right at the back of the room next to a large plate glass wall that brought the garden right into the bar. 

My father had looked up when he felt someone come into the room, as one naturally does when one is expecting someone. But he’d not recognised me, and had gone back to his contemplations, looking out of the window at the dreary afternoon. Only when I drew close to him with an open smile did he get up to meet me, visibly moved and trying to hide the shock that the sight of me had obviously provoked in him. 

At the end of December I returned to Oporto. My mother complained about how long it had been since I was last there, and scolded me (“this busy life of yours”), complimenting me on my new hairstyle (a crew cut), which she thought looked lovely. Christmas went off smoothly, and for anyone that knew all that had happened, there seemed to be an extra joy, a certain lightness in the air.  





    Today, 25th June 1999, is my big day, the day of my heart operation. 

I finally managed to get off to sleep after last night’s long and anguished retrospective on my cancer story, and ended up sleeping well, without any nightmares or brusque awakenings in the dark.  

The nurse appeared with a tablet of Lorenin 2.5 (more than twice the usual dose) and a syringe which must have contained pethidine, the usual preparation for surgery. She told me to put the Lorenin under my tongue and let it dissolve. As for the syringe, that is for later. She is going to telephone first, to find out what time they want me “up there” (by which she means the operating theatre in the Cardiothoracic Surgery department). 

The time passes slowly. There is nothing to report, apart from the Lorenin dissolving in the shadow of my tongue, gradually taking the edges off my thoughts. João arrives and waits with me. It is almost midday when the nurse returns with the syringe poised. It’s now, I’m going up; they’ve called “from upstairs”.

An ancillary worker comes to get me and placidly pushes the bed through the doors and out into the corridors to an enormous old lift. It’s cold out here. The lift shakes from time to time as it rises and she chatters away the whole time, telling a story about how it once got stuck between two floors with a patient in cardiac arrest inside it. “It was awful!” We disembark in the wing of the block and the bed is stationed against a wall, near the door to one of the rooms. João says goodbye as she is not allowed to stay. I give her my glasses. And I wait. 

A head leans over me. All I can see are the eyes as the rest of the face is covered by a green mask and cap. It could have been a gigantic grasshopper, though from the voice and appearance I guess it is a woman, the doctor that will administer the anaesthetic. She wants to know how I’m feeling, if I’m very anxious. She explains slowly and serenely what is going to happen, warning me that my stay in the Intensive Care unit after the operation (about 48 hours) will be difficult, both physically and psychologically. I’m not sure exactly what she has said. I become aware that, almost imperceptibly, she has clasped my hand in hers and I feel comforted by the warm radiance of that contact and captivated by the magnificent eyes that are looking down at me – beautiful, though isolated from the rest of the facial context, and gentle, reflecting interest in me and in what will happen next. It’s the first time in this new disease of mine that someone has talked to me like this – so intimately. She’s beautiful, the guardian of my dreamless sleep.  

“One of these days, I will visit you in the ward,” she says smiling, “though you probably won’t recognise me...” She gestures to her mask.

I move my head as if to agree, but I then change my mind. 

“I won’t easily forget your eyes.”

Then – and this is the last thing I remember clearly – a door opens and I find myself being pushed into a space that seems much too small for the amount of people that fill it. A multitude of masked people all dressed in green with rubber gloves, hands clasped and raised in the air as if they are about to pray. They all look at me as if they were expecting me. 

“And here I am in this state!” I think, almost ashamed that I cannot stand up to greet them all. 





Part III



After Hours*




* From the song of the same name by Lou Reed (The Velvet Underground, 1969).









    I come to my senses suddenly in the middle of the night. Well, I assume it's the middle of the night. The darkness that surrounds me is broken only by a few faint lights that mimic the atmosphere of a plane cabin on a long-haul flight in the early hours. My throat hurts and I feel thirsty, really thirsty. I glance around. Everything is dark and deserted. I can make out the walls in the distance and there is a dim orange light spilling through what must be the windows. It's as if the surface of these windows is concealing street lights that have just been switched on. Something moves in the distance and I gaze towards it. I try to move but my left arm feels heavy and tired. There is a saline drip tube coming out of the middle of my arm, and another drip at my wrist. And I have a kind of luminous hood on the end of my index finger attached to a cord that vanishes somewhere. I touch this device with my right hand (this arm is just as stiff and also has a cord snaking out of the elbow region), it slides off with ease. Ah! It's an oximeter, a device for measuring the oxygen levels in the blood. It attaches itself to my finger like a clothes peg and emits a dark red light like your thumb does when you hold it over a torch. Someone moves into my line of vision. I raise my luminous finger spontaneously, trying to call for attention. A blonde angel in white leans over me, smiling, and asks me what I want. I'm not even sure I can hear her voice. It would be nice to at least exchange a word, but I clam up at being addressed so suddenly.

"I'm thirsty," I hear myself say in a cracked voice. "I need a drink." 

"I'm afraid I can't give you one just yet," she replies apologetically. "But I can wet your lips with water if you want." 

That will have to do. The angel returns holding a glass of water with a spatula wrapped in gauze. She slides this over my lips a few times. I cheat as best I can and suck like a starved animal. After inspecting me, the angel takes flight and disappears. 

I'm awake. I’ve come back to my senses without an ounce of tiredness and my brain is buzzing with excitement. I know this feeling from the general anaesthetic I was given three years ago – and, I must admit, from a few less dignified occasions. Like when you fall asleep after a night on the tiles, only to suddenly ricochet awake in the middle of the night as insomnia installs itself till morning. 

Pling. I can hear noises. Weird, outlandish noises. I'm not sure if they're real or just a by-product of my confused mind. I can't make out where they come from or what they're for; who they're for. What does it mean? "This isn't music..." Pliiiing. A synthetic echoing noise like drops of water falling, at even intervals, into a bath where someone has set a powerful microphone. Dong, another one, now with a different tone and rhythm. Pling-pling-pling, they continue. These are musical sounds overlapping in space. And all of a sudden it's as if I am in the midst of a bathroom concert: water dripping from the bath, washbasin, bidet and toilet. Andante. Musical, but distorted, like a scratched CD, going over and over the same note until all its tonal sense has evaporated. They repeat, coincide, speed up, now they seem more desperate. Then they back off, grow quieter and slower again. Some seem to come from far away, at the other end of the room. Others appear to be produced just over my head. Vibraphone... – that one is just like the sound made when you strike a vibraphone, echoing in the dark. I am suddenly reminded of the sound track of Twin Peaks*, the TV show, an association I make due to the unusual and minimal character of both these sounds. To be honest, I want this noise to stop. It's intrusive, clutching me in its tentacles and then suddenly, without warning, pushing me out into space. How can a solid body be so affected by a mere sound?!

Meanwhile my eyes have gradually grown accustomed to the dark and the faint lights. I seem to be in a huge space, with pillars at the end. There's no visible door, a few patches of light here and there. The bareness reminds me of a Japanese restaurant, or the lobby of a futuristic building penetrated by the silence of the night, where the loneliness is broken only by a few halogen lights, accidentally left on over a reception desk.

I feel frozen. I look myself over and realize there's an unidentifiable object in the middle of my bare chest. A white tape stretches from my bellybutton all the way up to the shadow made by my chin. I touch it gently. It's thick and fuzzy. "Ah, it's the bandage that covers my scar. I’ve had my operation," I conclude. I try to pull the sheet over my chest but it's either stuck or too short. I must wait for the next angel to fly by so that I can catch her attention with the firefly on my finger.

"I'm cold. Could you please pull this sheet over me, or get me a blanket?"

"I can't do that,” she replies. “We need to keep those tubes visible. But I can get you a pillow case to cover your chest."

"Tubes? What tubes?" I wonder, while she gets the pillow case. I become aware, for the first time, that a few inches over my bellybutton I have three tubes coming out of my body: two from the centre of my thorax and one from the left side. Each is about the diameter of a finger. They are sewn to my skin with black thread and disappear out of my field of vision in the direction of the floor. How come I have only just noticed them? Things come and go. Now you see them, now you don't. They sprout like mushrooms. There's no stability in this reality, at least not through my senses. I can't perceive this world about me as a whole: if an image settles on my consciousness it's at the expense of a sound.  

I hadn’t noticed before, but I’m not alone. This hall I am in, which seemed so unremarkable or empty, is in fact filled with people. It's as if I've always been here. There are human bodies lying all over the place, side-by-side in rows along the wall to my left, down there at the bottom. They appear to be hovering a foot or two above the ground. There are lots of them. Five or six. They are lying still, almost naked, phosphorescent, skin shining like white ivory. Above each one is a large white structure like a crane suspended from the ceiling from which various articulated arms protrude like the tentacles that decorate a dentist's chair. These arms have flasks of saline solution dangling from them like strange fruit, and huge plastic syringes, connected through a tangle of tubes and wires that disappear into the entrails of those outstretched bodies. One of the bodies moves (it's alive!) and, from the shadows, a white figure appears and walks over to it. The figure reaches out and touches a computer screen on the end of one of those metallic arms, then steps back, gazes up at the screen, and disappears back into the darkness. 

I try to look up over my head, but I can't. My neck is stiff and rattles when I try to move it. I turn my head slightly and out of the corner of my right eye glimpse cables and the glow of a computer screen. I can also make out other bodies to my right. They lie still, hovering in a purple haze. 

I lose interest and close my eyes. The sounds come back and continue dripping, thick as jelly, all around me.  I try to ignore them.

I take in the fact that I have survived the operation. I'm back here on this side once more. This moves me. My eyes grow moist but I keep them closed. I only open them when I start to hear movement around me. These are more usual sounds for a hospital. There's a light shining through the windows. Even though it's quite weak it's enough to hurt my dry burning eyes and gradually dispels the fog that has surrounded me throughout the night. 

Dawn has arrived and I can now safely assume I'm in the intensive care unit of the cardiothoracic surgery department in Santa Marta Hospital.

The blonde angel approaches my bed. This time I can make out her features. She comes to announce she's leaving:

"Goodbye E.T."

I smile and raise my luminous finger with the intention of touching hers, thereby fulfilling the historic script. But I'm too slow and she has already turned around and disappeared back into the void.






    It's Saturday morning. My angel has left and now it's Marta that is looking after me. She's very young. She looks about eighteen years old (maybe nineteen). But being a nurse, I figure she must be a bit older. Marta is a tall girl, or at least she seems to be (when one is lying down things tend to look bigger than they actually are). She's as slender as a reed with brown shoulder-length hair and nicely-shaped eyebrows, which give her a stern look. But when she smiles her eyebrows stretch up and this makes her look like a child of no more than twelve. Her apron is covered in badges and pins of all kinds: little plastic figures, letters of the alphabet, that sort of thing. I hope she uses the little bear I gave her. It was was pinned to a letter that João brought, sent by my young niece Ana as a birthday present for my tired 46-year-old heart. 

The morning and the accompanying commotion brought by the change in shift dispel the darkness and loneliness of the night. Everyone's rushing about, and the place looks completely different. I'm parked at the end of a big ward, some 200 metres square. The walls are brightly coloured and, surprisingly, for those who notice such things, there's nothing at all leaning up against them, just a broad empty space around them. It's as if the beds (10 of them) have been dislodged from their original position by a flood, or an earthquake, or some other telluric event. There are four big columns in the centre of the room set on thick wooden bases and topped by a lintel. These pillars were what restricted my view the previous night, giving the room the appearance of a strange futuristic lobby where people would appear and disappear. It's the service desk for the doctors and nurses! In the wall to my right – which is almost entirely glazed, allowing glimpses into the next rooms – is the entrance door, and on either side of this are rows of display cabinets containing big rectangular machines. At first sight, these look like automatic blood analyzers.  

The beds are arranged around the three remaining walls, separated by a generous amount of space, each set beneath a huge articulated arm suspended from the ceiling. These arms reach almost all the way down to the ground and unfold like Swiss army knives to exhibit all their accessories. Each one of these crane-like structures has a number painted on its cylindrical white body, about half-way up. This makes the beds look like a series of chrome rafts anchored in a dry dock.  From the 6 stamped on the crane that looms over the bed opposite and the 8 that belongs to the crane to my right, I conclude that my crane (which I can't feel or see) must be number 7. Or, using the terminology I hear the staff use when they wish to give the location of a patient, Unit 7.

My inspection is interrupted abruptly by the arrival of two young ancillaries, a boy and a girl. They are so oblivious to my existence that they make my bed while I'm still in it, all the time engaged in animated conversation. They remove the used sheet in one grand sweep, reminiscent of the kind of flag choreography used during the Chinese Cultural Revolution. It was then that I noticed (now that I was uncovered) another stretch of white tape, similar to the one I had already discovered on my chest, extending along my inner leg from my knee to my ankle. What on earth could this be? I waited for the ancillaries to leave my bedside and then, determined to do a full catalogue of my present condition, carefully raised the new sheet.

From the waist down all I could see was the tube of a catheter and the aforesaid white tape. On reflection, I concluded that the tape must cover an excision in the saphenous vein, which meant that I must have had a double coronary by-pass at the very least: one arterial, using the internal mammary artery, and the other venous, using a piece of the internal saphenous, the big vein that runs all along the length of your legs (from the hip to the foot) and which, once the valves get tired, are the principle source of the torment known as varicose veins. 

The top half of my body is total chaos. The sheer amount of tubes and cables are enough to warrant a traffic warden, or at the very least a warning sign saying: DANGER, BODY IN RECONSTRUCTION. As well as the 3 drainage tubes that exit my body below the chest and vanish somewhere under the bed, and the surgical dressing that crosses my body from neck to bellybutton, there's also a tangle of thin plastic wires clasped to my chest, probably to measure my heartbeat and transmit the information to some point on the screen. A few inches below my left nipple is a small ball of metal wires, rather like the thin strings on a guitar. If I had to guess, I would say the ends of these wires were attached to my heart. The visible ends are stuffed into a tiny glass tube, held in place by a thin black thread which has been sewn to my skin. I don't want to jump to any conclusions, but I'm quite sure these wires belong to a temporary pacemaker, here to ensure that, if anything goes wrong, they will be able to connect my ticker directly to the electrical current. It's a comforting thought.  

That's it for the chest. As for my arms, there's a saline drip in each of them. There's also a third tube that has a reddish liquid running through it that ends in a plastic bag with the same ominous colour. I'm being given a blood transfusion! I must admit that the idea of receiving blood from strangers does not make be particularly happy, especially in this day and age. There's a bandage on my left wrist from which protrudes a small probe, painfully inserted into the depths of my flesh. It probably leads to a needle stuck into my radial artery, the vessel that takes the oxygenated blood down the arm into the hand. It's usual for doctors to keep a needle in this artery in these situations so that they can keep an eye on the gas content in the blood. Oh, I almost forgot - before we leave the arms - there's also that luminous hood on the end of my index finger. If I did forget, it would be because I talked enough about it while describing the previous night.

And that would be all if I hadn't suddenly discovered the source of the annoying rattle that accompanies every movement of my head. It's caused by five baby-blue plastic devices stacked on top of each other, thrust into the right jugular. The way they are lined up reminds me of the way a bull's neck looks at a bull fight in Campo Pequeno.

I hear music! Someone has turned on the radio and as I realize what song is playing, I can't help but smile at the coincidence:

Oh! no, not I; I’ll survive, I will survive... Well, I'll be damned if it isn't Gloria Gaynor singing the old classic I Will Survive?*

Nurse Marta is back. After peeking underneath my bed, she sits down and starts writing at a little table near my feet. In fact, all the beds have these. I ask her about breakfast... I'm ravenous. She looks up from what she's doing and, raising her eyebrows, smiles and informs me:

"For the time being you can't eat anything, Senhor José. If you are very thirsty I can wet your lips."

Senhor José?! I am being called by my first name (no one calls me that) in true airline style – indeed this does seem like some kind of air-transport environment. 

As the hours pass, the general anaesthesic gradually wears off. I fear that from now on I will be left to deal with the pain by myself. This isn't good, as I'm starting to feel one developing in the side of my thorax. What's hurting me is not the operation scar, as you might expect. Instead, it's one where the 3 tubes that exit my body below the chest. More specifically, it’s the tube furthest to the left, the one that crosses my ribs and which I assume is a pleural drain.  

The pain caused by a pleural drain is indescribable – or rather, it's horrible and, perhaps, describable. It feels as if a knife (a blunt one) has been stuck between your two ribs, and that someone is sadistically turning it round by the handle every time you breath. This provokes a grotesquely sharp pain every two seconds. There is also a second pain keeping the first one company. This one feels like crushed flesh, as if some stupid Rottweiler has dug his teeth into me and is refusing to let go until its owner arrives, denying me any chance of relief. 

The surgeon on duty, summoned by Marta, was well aware of this problem:

"Pleural drain," he says, "hurts like hell!" And turning towards Marta he orders curtly "morphine."

Heroin, morphine, codeine, pethidine... God bless opium alkaloids, especially morphine for numbing pain, quietening angst and dissolving anxiety. I can't say the pain went completely, but it retreated, almost immediately, into a small corner of my consciousness. I can hear it growling, but it has been stripped of its power. This allows my senses to return to a much appreciated sense of semi-normality. 

Now that I'm calm, and seeing as they don't want to provide me with food, all that's left for me to do is continue with my interrupted observation, entertaining myself with what is going on before my tired misted eyes and at the edge of the field of perception commanded by my highly attentive ears.

There are nine of us patients all told, lying on narrow beds just wide enough for our bodies, segmented articulated chrome beds, as flexible as centipedes, with bars on the sides. The latest fashion in hospital design I gather. They go with the rest of the equipment in this sophisticated ward, equipped like a spaceship, where the only detail out of place is the patients. Poor souls, so richly clad. Nevertheless, without false modesty or pride, I believe I am the one in best condition out of all of them. At least I can move all my body parts (not counting my neck), I can talk, I'm conscious and I can participate - this cannot be said of the majority of my companions. 

But not far away from this perfect patient, isolated from the rest of the hall and separated from me by an empty bed, lies the worst case in the intensive care unit – a woman who attracts a constant bustle of attention. Not only has she been subjected to a heart operation, she also has advanced cancer. Very advanced. She doesn't eat, doesn't move or speak and doesn't react to anything. What remains of her body is slowly liquefying onto the sheets, which the nurses change with an impressive frequency, and onto the soaked towels, which they wring out like selfless washerwomen.

Turning my head in the other direction, I see a man, not far from me, lying on his back. He's in a permanent state of agitation, lifting unsteady hands up to his mouth, clumsily trying to remove the thick, plastic tube going down his throat. He shouldn't; that tube is what's keeping his lungs full of air. He's unable to do so, and as he tries his thin legs shake in uneven spasms like a frog being electrocuted. The nurse watching over him is alerted by the sounds emitted by the computer. She approaches his bed and, after checking the screen, scolds him: "Lie still, will you? Come on, take it easy. We’d love to remove that tube, but if we did you’d forget to breathe!"

And bingo! I have discovered the mystery of those strange plinging sounds!

They are signals produced by the computers that hang from the small cranes to which we're all attached, announcing the vital signs of all the cardiothoracic surgery patients in the intensive care unit. I pling, you pling, he plings. And the worst of it is we can all hear each others’ plings. The sounds vary, but if everything is within the bounds of normality, then the plings are sparse and melodically quite smooth. When a patient moves, or if his metabolic or physiological state slips into the danger zone, the sounds accelerate and acquire an urgent shrill tone, alerting the staff, who have been trained to decipher their meaning. A side effect of this alarming device is that it produces instability and confusion amongst the conscious patients.

I realize all this when I start to perceive a pattern between the tone and rhythm of the plings and the hunting-dog expression that suddenly comes over one of the nurses as she lifts her head, leaves what she's doing and approaches the patient who's the source of the new sound (although, I must admit it's quite hard for me to tell where a particular pling is coming from, what with the myriad sounds coming from every direction, filling the air). She stands over him, carefully observing the information on the monitor, and, as this is a touch screen, scrolls through the information with a finger. If necessary, she delves deeper, manipulates and corrects, giving a quick blood test or administering a drop of this or that. All this is at hands reach, for each of us is in complete physical communion with the machine above us. 

This is not an exaggeration or a figure of speech. Just look at me! We're all like this – in fact, some patients have many more connection tubes than I do. Though I know it’s not their purpose, these tubes and wires would make it impossible for me to get up and leave if I so desired. I'm completely stuck, manacled, literally leashed at the neck. Even if my sternum wasn't sawn in half, I would be unable to sit. Hell, I can't even roll on to my side! My range of movement is a few inches. Yet this communion with the machines isn't just physical, it's much more than that. The whole thing is complicated by the fact that our lives depend upon these tubes, threads and needles that go in and out of our bodies. Each one of them, very prosaically, ensures that a soul still flickers in a body propped up with scaffolding. I'm bound to this contraption which penetrates me and keeps me alive and functioning. In return, it exhibits all my gains and losses, all my yelps and palpitations. Only in the cinema have I seen anything as disturbing as this symbiosis between man and machine. But of course, in the cinema there's a screen reminding us that it's all fantasy. We rarely believe it when art imitates life. 

The surgeon who's currently on duty in this unit has reappeared and is looking through my file, which sits on the little table at the end of the bed. I observe him, amused by my discovery: this guy is the spitting image of Lou Reed, the rock star, or – to do justice to the words of someone I have always admired – the "writer in love with an electric guitar[‡]". Just like him – the same face, glasses, way of moving. The only thing that's missing is Lou Reed's deep-etched expression and intense stare. Instead, he's got a relaxed kind playful demeanour. 

"Ventricular fibrillation!" he exclaims as if whistling through his teeth. "You're very lucky..."

"I know," I answer, in a rather blasé toneI'm getting used to this remark. "I should be dead by now." 

"How come?" he mumbles, looking thoughtfully through my file. "You had this on the 17th, today is the 26th - that's ten days!" He looks at like he's trying to imagine what I could have become ten days’ gone.

He snaps out of his trance and smiles cheekily. "So, how’s the pain?" 

I play defensively. "Nothing hurts, at least for the moment."

"Let’s see if we can remove this today," he says, leaning over me to squeeze the drainage tube between his fingers and studying the blood clots stuck its sides. "This is practically dry."

"Today?" I ask, hardly daring to believe my luck and choosing to ignore the question of how much it will hurt to remove something like that from my body. 

"Maybe, maybe,” he answers, “but only later on, towards evening." He leaves for the other units, shaking his thumb at Marta, as if he's hitching a ride and not before leaving a warning: 

"If we're going to do this, the girls are going to spend the whole day turning you around. Prepare yourself..."

I like this doctor, who has fallen to me by luck. So do all the rest of the staff in the unit it seems. They speak to him in a tone that is respectful but at the same time friendly and very much at ease. Just a while ago I noticed a young nurse resting her elbow on his shoulder to watch him giving her colleague a mock telling-off.  








    My closest neighbour is Senhor Alberto. His bed is perpendicular to mine, five or six feet away, and from this position I have a good view of him. Right now he's sleeping in his bed. If it weren't for a diaper and all the tubes connected to his body, he would be stark naked (actually, other than the occasional sheet, we're all like this; I've lost all track of my underpants and haven't known their whereabouts ever since I was admitted). Senhor Alberto is a sixty-something-year-old baby and quite a handful for the staff of the intensive care unit. He's unable to move his arms, legs or head. He can, however, twitch his facial muscles. He's got the stubborn habit of chewing the plastic bit at the end of his oxygen mask. This inevitably causes the mask to slide down off his mouth and nose leaving him like a fish out of water. Bubbly saliva comes out of his mouth and his face gets redder and redder. Completely confined to my bed I'm obliged to watch this spectacle without being able to do anything about it, which is quite nerve-racking. But the nurses are always on the lookout so the story always ends well. Senhor Alberto gets gently told off and things go back to normal. Of all the patients, Senhor Alberto is one of those that require the most care. He needs to be turned over as often as a pig on a spit and, being as heavy as he is, this is not an easy task. His skin needs to be massaged to prevent bedsores and he also needs to be spoon-fed. On top of his heart problems Senhor Alberto is also a diabetic. But he's got a docile temperament which charms all the staff. To me, he looks like one of the seven dwarfs, the cheerful one whose bald head Snow White was always stroking.

Senhor Alberto used to work in agriculture, a detail I learned this morning while the physiotherapist was trying to teach him how to breathe correctly. 

"Breathe in through your nose and out through your mouth. Imagine you are smelling a flower and then blowing out a candle. Come on: smell the flower, blow out the candle, smell the flower, blow out the candle..." 

Senhor Alberto gives it his best, smiling awkwardly, but all he can do is soak the imaginary wick with the bubbly saliva which he blows out of his mouth. Eventually, the physiotherapist gives up and starts moving his arms about while making conversation:

"Would you like to go back to your village, Senhor Alberto? Go back and work in the fields?" He clearly smiles at the idea. "Of course you would. But that's why you're here. All that work wore out your heart..."

I've just finished lunch – soup and a baked apple – and I ate like a sultan. Now I'm lying back lazily on my bed, watching everything that’s going on around me, like a python digesting its prey. 

They've raised Senhor Alberto's bed so that they can give him lunch. He's lying there on his side, constantly falling against the young ancillary whose task it is to feed him. She's spooning soup into his mouth, all the while trying to make conversation – spoon after spoon, wiping his chin from time to time. She's a plump girl, and easy on the eye, and Senhor Alberto lies there with his head on her lap, looking up at her and smiling delightedly. 

I look away and notice the nephew has come into the unit. The nephew is a short man that the staff always let in, regardless of visiting hours. He comes at least twice a day but always makes a point of asking the matron if he can give his aunt lunch or dinner. He then proceeds to wash his hands at the sink located on the one of the walls as meticulously and carefully as a surgeon before an operation. He knows his way around the place – you can tell he's been doing this for some time.

His aunt is down the bottom on the other side of the ward, a long way from Unit 7. She's too far away for me to see her face, and so I can’t observe these scenes with the same detail as I get from my close-up shots with Senhor Alberto. But I can tell that she's old and in a more delicate state than Senhor Alberto. All she does is eat mechanically, unsmiling, and apparently oblivious to everything going on around her. The nephew comes every day to feed her. He told João that his aunt is the only relative he's got. Apparently he continues living in Lisbon, where he used to work, just so he can fulfill this task.

The nephew brings her food in a plastic tupperware. Although I can't see from here, my guess is that it's soup. Her bed has been raised up quite a bit – it's almost at a ninety degree angle. This makes it look like she's suspended from the torso (I think she must be tied to the bed to be so upright), with her head dangling limply from her neck. Slowly and tenderly, the nephew feeds her, a process that takes a very long time. He talks and talks to his old aunt. I can't make out any words but I get the general tone. It's intense and beautiful but tragic at the same time, like a Descent from the Cross. Without warning my eyes fill up with tears and my chest is shaken by the imminent earthquake of hiccups. Embarrassed, I try to get a grip of myself. But luckily no one notices and my tears won't be taken into account on the balance of fluids lost during the day. 

"Senhor José?" Marta appears suddenly and startles me. "Let's turn you over for a while. Dr Luís Caniço's orders."   




    João has just arrived and she's sitting here next to me. She tells me it's 4pm. Perhaps... I'm feeling all right now, after two interminable useless hours of pain. Shortly after lunch the effect of the morphine wore off and the pain started giving signs of its imminent return. First it barked from the depths to where it had retreated, then slowly and surely maneuvered out into the open until it filled my entire consciousness, transforming me into one long endless moan. 

A doctor is wandering around the ward, from unit to unit. When she gets to my bedside I tell her about my pain and beg for something to relieve it, to take the edge off. She understands and orders Marta to give me two ampoules of paracetamol, intravenously.  

"Paracetamol!" I gasp silently. "Dear God, this woman has no idea of the pain I'm in!" Treating this monster of a pain with paracetamol (or aspirin - which would be the same) is like mistaking the leopard skin coat for the leopard and confronting the feline with a credit card. But what could I do? I swallowed the Ben-U-Ron and sat there watching its futile attempts to quash my pain - the monster didn't even blink. I took it for as long as I could, which was the rational thing to do if I had any hopes of getting anything else, and then I called for Marta.

"Marta, you're going to have to give me some morphine; the paracetamol didn't do anything..."

As she looked at me I could see the indecision in her eyes. She went to get advice from the nurse on the nearest unit, who stopped what she was doing and came over to have a look at my drip. She looked at me suspiciously as if I had just sneaked into the hospital from the nearest ghetto and crawled underneath the sheets fully clothed awaiting the next round of syringes! I looked at her imploringly. She walked away without saying anything, taking Marta with her. After a few moments I saw Marta on the phone. When she returned she told me:

"I'm going to give you a dose of morphine, in perfusion."

"God bless you!" I say, gratefully. 

And now João tells me it's four o'clock, time for bread and marmalade. I'm feeling much better now, rejoicing in my second dose of morphine, observing my surroundings with slow eyes.

"Look, a hippo and a cockerel!" I say suddenly, not believing what my eyes are seeing. 

 She turns her head to see what I'm staring at and, seeing the resemblance, laughs out loud. Two ancillaries in hospital-green overalls have just come in through the door of the unit. One of them is half-caste, with a golden tone to her skin and a presence which fills the room; she's got long frizzy hair parted in the middle and a sweet shy smile on her thick lips. The other one – the cockerel - is small and skinny. Her hair is clasped at the back in a big hair clip and through its big, plastic teeth bursts a mass of smooth black hair like a triumphant crest. The half-caste girl sails smoothly down the ward like an ocean liner, while, at her side, the cockerel moves her head constantly in short jerky movements, as if admiring the view from the top of her long, delicate neck. Her eyes are lively, a greenish-greyish tone. She's beautiful and would make a fine substitute for the Barcelos Cockerel as a national symbol. 

A few minutes later the cockerel approaches me and asks me if I want anything to eat. She's got a funny accent, from somewhere in the Beirão region I think. Suspicious of this sudden generosity I ask her what it is that I'm being offered. As I suspected, almost nothing! I'm allowed one small yoghurt. When she brings it to me I take the opportunity to start a conversation.

 "You're not from Lisbon are you?... Beira-Alta by any chance?"

"Beira-Baixa..." she answers proudly with a twinkle in her green eyes. "Sertã."  

I'm by myself again. João left after I ate. Meanwhile Ana Maria appeared for a short visit with few words. She just came to have a look at me. Most of the visits here are short and over rather quickly. It's not that they get kicked out; the problem is that people just don't know what to say or do while they're in here. I'm pretty sure that, no matter how much they love the people they're visiting, they are all equally anxious to get out as soon as possible, to breathe in the familiar polluted air of outside once again. I've been observing them. They come in stiffly through the main entrance and walk awkwardly towards the person they are here to visit. When they get to the bedside, after the usual kiss on the forehead or the encouraging handshake, they just stand there, not knowing how they're supposed to behave or what to do. Sometimes they don't even speak and are too afraid to even give a good look at their sick relative. Some of these people only open their mouths to say hello and then goodbye. Then they leave, with more urgency than when they came in. It all seems like a strange ritual, like visiting a dead person who had never been very close. I watch all this embarrassedly, not taking sides, not knowing what to think. I am confused, feeling sympathy for all of them, and sympathy for all of us.      






    The support nurse for Unit 6 (Senhor Alberto's unit) is called Patricia. She's the one Marta asked for advice about my pains. She's probably close to thirty and is quite a doll, I must say (at least by Hollywood standards). She's got blonde hair and intense blue eyes like a summer sky - you could lose yourself in those eyes and, if you did, I'm sure you could hear the cicadas sing. She's got a round expressive mouth like a small fish, the kind you see in home aquariums. Her skin, quartz-pink on beaten egg-whites, looks as soft and smooth as fresh-fallen snow. Unlike most of her colleagues she doesn't wear an overall. She's got on a tight pair of jeans and a blouse, both white, and she walks around the ward with tiny short steps, like one imagines a traditional Japanese woman would walk. It's as if she's permanently on a plateau, being followed around by a film crew.

A while ago, just before João left, Nurse Patricia was telling us about the ins and outs of the intensive care unit in the Cardiothoracic Surgery department, as if she were giving us a guided tour. She spoke lovingly about her work, the various routines she was required to do, what each machine's function was and even about some of the patients. 

"But so many people must die here," one of us says.

"That's not true," she answers, almost scandalized by the insinuation. "In this unit no one goes easily!"

I'm inclined to believe her. We're all so intertwined with the machinery I fear our bodies may have lost the right to take their last breath without a license. But the license won't be granted: a few drops of this and that, carefully monitored by the computers, and the last breath will become the penultimate. Most of us won't even know what a close shave we’ve had; there will be nothing to show for it. For whenever one of the computers plings, a guardian angel instantly appears and stares at the screen as dispassionately as if she were watching the President's New Year message.

The unit has calmed down. Visiting hour is over and a relative silence prevails. Before me, Nurse Patrícia has just turned Senhor Alberto onto his side with a little help from a colleague, and is energetically massaging his body. Senhor Alberto is right opposite me so I can see his expression with great detail: his thin whitish-yellow hair and inexpressive face punctuated by a pair of dirty-blue eyes where a single tear hangs, suspended. Nurse Patricia continues to massage his body like she's kneading bread, as if it were worth it, like she expects him to actually get up and walk out the door before her shift is over.

Nestled here in Unit 7, I can take in everything that's going on around me. In fact, there is no escaping it:  Senhor Alberto’s immense flaccid mass spreading in folds over the bed, and the calm serenity of Nurse Patrícia, leaning over him lovingly, whispering words which I cannot make out. She's finished or given up on her massage, and now caresses him softly, her intense blue eyes softly peering down at him. Senhor Alberto cannot see this kindness because he has his back to her. Once again my eyes fill up with tears as I think to myself that these people should be getting paid their weight in gold. But it's more than that, because in this barren outpost of life, these are the actions that produce gold – a volatile gold which you can see, but not weigh. And this vision generates an overwhelming emotion in me that reconciles me with the world.

My God! I'm an emotional wreck. Any little thing brings me to tears. I know why from the medical books; it's the famous emotional instability that accompanies serious disease. It's mentioned quite a lot, especially concerning stroke patients. And I've experienced it before, three years ago during my cancer treatment. Like a glass filled to the brim, I'd get emotional over everything. Any little thing would make me burst into tears. 

Before I get the chance to recover, I see the hippopotamus approaching with my meal tray, walking as majestically as if she were transporting a full dinner service. 

"Dinner is served early here," I comment, trying to hide my tears.

She smiles even more than usual and, putting the tray down, carefully climbs on to the bed.

I love beauty, be it a woman's or any other kind. Beauty is what has kept me going during my illness.






    Having sorted out dinner for those patients able to take food, the nurses start thinking about their own meals. They’re getting ready to order it from the local Chinese restaurant. One of the nurses is reading the menu out loud through an intercom to a colleague who must be in one of the isolation rooms. She has a rich vibrant voice. The others stand by listening attentively. 

One of them interrupts and says: “If I were you I wouldn't order spring rolls. They’re always like rubber by the time they get here!"

“Be quiet, no one asked you!” the others scold, laughing.

It’s a slow process, with a lot of Oriental to-and-fro-ing. They’ll be sharing the food so it’s not easy to reach an agreement on what dishes and accompaniments to order. One of the nurses declares she doesn't like chao-ming while another complains about the usual excess of onion in the pork chop-suey...

“Coca-cola? With Chinese food?!” exclaims one of the purists in a scandalized tone.

“Better than tea! Who in their right mind has tea with dinner?” retorts one of the younger ones. 

After a big discussion, with some of the nurses on the verge of getting angry, they finally decide. It will cost five euros each. Purses are opened, loans arranged, coins jingle. I would love to have dinner with them. I would enjoy buying them the meal. But I don’t have a speaking part in this film. I don’t even have a pair of underpants I could hide a bank note in. No, I play no role in this tale.

I’m entertained by the nurses’ dinner, watching how they create such a cheerful picnic scene in this set full of technology and gizmos. They put it all up and then take it down in a matter of minutes. In fact, I’m so distracted by the spectacle that I fail to notice that the windows have acquired that orange tone they had yesterday. The lights on the ceiling have also been switched on without me noticing. Night has fallen once again upon the intensive care unit.  

Marta is seated at my feet, writing something on the enormous sheets of paper lying on the table. From time to time she looks up at the monitor above my head and jots something else down. From here I can see her very distinctly, and she’s not looking too good. It’s as if she has aged 10 years during the course of the day. Her gaze is settled deep in the dark bruise-like circles around her eyes. Even her eyebrows seem to have dropped. She keeps her lips pursed while she works and I realize she’s making a big effort to finish the task. She has been here for some fifteen hours and tomorrow she’ll be back at eight in the morning for the Sunday morning shift!

From time to time, somebody calls her from the middle of the room, as happens so many times during the course of the day. It’s nothing special, a simple question. But now, in this state of tiredness, it’s enough to shatter her fragile equilibrium. 

“Don’t talk to me!” she yells, hoarse and a little wild, her big brown eyes filling with tears.

Then she glances at me, embarrassed by her overreaction, by the tears and by my proximity. I give her the most Xanax of smiles and murmur, “There are days we just shouldn’t get out of bed, aren’t there?” She nods, and I can just about make out the faintest sign of a smile on her tired face. Then she goes back dutifully to my log sheet. 

Fortunately, the night staff are beginning to arrive one by one. They greet each other and stand around talking, sometimes going back out for a couple of minutes, then coming back in. The majority of them are women, as usual. Unexpectedly, they are joined by a vision, as my friend Antonio Luis from the Torres Vedras hospital would say, when referring to beautiful women. She’s dark, that’s the best word to describe her, with long dark hair streaming down her back, sculpted by wax into big waves and only just secured by a small petrol-blue clasp in the form of a swallow. She’s very dark, the tone of her skin contrasting beautifully with her tight white short-sleeved overall, and making her splendid white teeth stand out. These, combined with her high cheekbones, give her a smile that would stun you from ten feet away. This is an event worthy of a Saturday night at the intensive care unit of the Cardiothoracic Surgery department. 

Then there’s the classic interaction that takes place whenever there's a change in shift, in which the nurses on their way out inform the others about the conditions of their respective patients:

"In Unit 1 we have Senhor...."

I'm a bit too far away to properly hear what they are saying. Nevertheless, I wait anxiously for Marta to begin discussing Unit 7. My time arrives and I'm introduced in a flattering way by Marta, which fills me with pride…as if she were on my side.

"In Unit 7 we have Senhor José. He was operated on yesterday afternoon; condition stable; no complications to record."  

After the patients have been introduced it's time to assign each of them to a nurse. I watch this excitedly, as if it was a game show or a lottery. 

"Please, God, let me get the brunette!" I supplicated fervently  I would definitely like to have the vision in my unit.

And God, who is great, is also generous. She's been assigned to Unit 7 (one of the easier wards). I almost shout out from my invalid bed, "Yeeesss!"

Meanwhile Marta comes over to sort out the introductions.

"This is Senhor José. And this is Nurse Débora. She will be looking after you this evening," says Marta.

From this close up, the vision is just as terrific (maybe a little too much for someone in my condition, hypersensitive and full of morphine), and exudes an inebriating scent every time she makes a small movement. It's a lovely perfume, perhaps some kind of cologne, fresh but with the intensity of some unreal type of tropical lavender.

And so the sweet summer evening proceeds. Marta goes home to sleep and I concentrate on what is going on around me. The velvety creature wafts around the ward, a perpetual smile on her face. 

Entertained, and thoroughly interested, I listen to Nurse Débora’s enthusiastic accounts of her wedding, set for September. I have no trouble imagining her in Bora Bora on her honeymoon, a garland of exotic flowers on her head, basking in warm shallow water amidst the coral.

My daydream is interrupted by an acute pain in my back: it has returned. I ask the siren to update me on the status of the damn drainage tube.

"Listen," I say. "Dr Luís Caniço promised me I would have this pleural tube out by today."

She looks at me seriously and somewhat surprised, either by the technical terms or by the odd timing of the request. Such procedures aren't done at this time.

"Oh, really?" 

"Yes. I've spent the whole day being turned over and squeezed... This is completely dry. Here take a look." 

Rather unenthusiastically she glances at the tube and then moves off towards the headquarters. After some time she returns.

"I'm sorry, but we won't be removing it today. The doctor says it's better if we keep it in until tomorrow." 

I seal up and wilt. I spent most of the day clinging to the idea that I would finally be rid of this wound, that I would no longer need the morphine to have a few hours of peace – for, to be honest the morphine causes a state of euphoria and exaggerated sensitivity which can also become quite tiring. Disheartened, I let my eyelids droop, as if this simple act will bring on sleep, fast-forwarding time towards morning.

Pling, pling; pling-pling-pling; Pliiiiiing...

Just like in the jungle after sunset, now that the lights have gone off and we’re once again plunged into that spectral limbo, the noises start up again, those warning sounds from the computers. It's not that they weren't here during the day, but with nightfall they seem to gain autonomy, and acquire an intensity and presence that during the day is drowned out by the general atmosphere of the unit (I, at least, was awake for hours without noticing, or even hearing them). Or maybe we're all just scared of the dark, we poor souls, lying here on these beds. Could it be that it's our biological rhythm causing the noise through the sensors that connect us to the machines, reflecting our discomfort and our fear? I don't know, but the thickness of the sound gets to me. 

 Next to me, Senhor Alberto has abandoned his human form and appears like a purple waxed museum piece from ancient Egypt. Further away, the fellow who occasionally forgets to breathe begins his frog-like spasms in a violet hue, the grooved ventilator tube extending his chin like Tutankhamen's beard. Down at the end, the "auntie's" unit is immersed in shadows, as if she, beneath the monkey-bread tree of bottles and syringes, has dissolved into the watery whiteness of the sheets. Will she still be here tomorrow, when her nephew comes to give her soup? I turn my head to the right and my neck rattles like a plastic rattlesnake. I don't want to look but it doesn't help me in the least to close my eyes. This just amplifies the sounds. Worst of all are the plings which seem to get louder and louder all the time, plopping, echoing, dripping incessantly.  

Once again I get the feeling I'm being moved from one side of the ward to the other. One moment it feels like I'm where I ought to be, the next it's like I'm in the middle of the ward, or at the far end, next to the platform. Reality has become mercurial. The sensation is like being stuck in one of those ballpoint pens that have a little floating figure inside them which slides along its length when you tilt it – the type you get at gift shops in Fátima or Lourdes. I would rather be still than "moving" around like this. The feeling is somewhat confusing and is rather frightening, particularly because it forces me to invade my fellow patients' territory and I have no fixed point of view.

Pling, pling, Pliiiiiing, pliiiiiing-pliiiiing, PLING-PLING...

Something is seriously wrong with me! Warning sounds are going off for no apparent reason, the air is full of rings and chimes coming from every direction. You can hardly make out the musical plings all of a sudden. These sounds have an anguished tone and by now have evolved into a babel that drowns out the all the urban noise: the police cars, the thundering dysphonic honking of car horns, the hoarse whistling of the alarm, which, in science fiction movies, warns the beset heroine that the spaceship is about to blow up. The staff are agitated: the nurses are rushing about the ward, nervously checking the computer monitors, frantically touching the screens, exchanging small bursts of information.

They are keeping a close eye on me too. Nurse Débora has already come over twice in the past five minutes. She looks up at the monitor, down at my face and then checks beneath the bed. 

"I'm causing this," I say to myself. "It's me that's creating this cacophony of sound, all this agitation." I feel my heart racing in my chest and try to make a connection between its urgent pounding and the plings that resonate through the air. There's no doubt. It's me! Whenever I take a deep breath or move, when my heart contracts, the sound signals go off accordingly. It's me... I feel myself drenched in sweat, first hot, then freezing. Though I have no way of checking (I have no watch and am unable to reach my wrist with the other hand), I feel my pulse beating completely out of control. I must be about to blow...  

"You’d better call someone," I hear someone say from close by.

I try to calm myself, try to gain control of my breathing. As soon as I get a hold of myself I call for Nurse Débora. She approaches with what looks to me like an apprehensive look on her face.  

"What's going on?" I ask her. "Something's wrong, isn't it?"

"Nothing special," she answers, looking gloomily at me. "Try to get some sleep."

"Listen," I say, giving it a last try. "I'm a doctor and I can see there's something serious going on. If it's got anything to do with me I would very much like you to tell me. I've got a right to know."

She stares at me with a peculiar look and, without so much as uttering a word, walks off. A few minutes later she returns accompanied by a colleague. By the closed expression on this other nurse's face I figure she has been warned of my probable intentions.

"So, what's the problem?" she asks harshly.

"There's something wrong with one of the patients,” I blurt out. “I can see you rushing around the place saying that you need to call someone. I want to know if it's got anything to do with me. I'm a doctor, you can tell me. I will understand. You can't hide it from me."

"It's nothing. Calm down. Don't worry. It's got nothing to do with you. One of the patients, a diabetic, had a fit, but it's under control now... It's got nothing to do with you. If only they were all as well off as you are!"

She gives me a sallow smile. I calm down a little, but it’s not enough. How can I be sure it’s nothing to do with me?  Is it really Senhor Alberto, looking so tranquil, so calm in his bed right next to me, that has the problem?!

"Why don't you try to get some sleep?" suggests Débora in a tense, slightly angry tone. 

"I wish I could," I say, wondering where her smile might be. "How can I possibly sleep with all this racket going on?"

"Do you want me to give you something to help you sleep?"

"What will you give me?"


"How much?" I can almost hear her sighing in her head.

"One milligram..."

"One milligram? That won't do anything! Can't you at least give 2.5mg?"

She goes off to ask some mysterious entity how to respond to my request. Unfortunately, the mysterious entity does not approve and I have to make do with what I get. No one will be giving me anything more tonight.

Sucking on the Lorenin I ponder, rather obsessively, the idea of dying. I know I won't go down without a fight. I think up some far-fetched plans to save myself that bring me some comfort. As these thoughts parade through my head I grab on to some, let go of others, like someone who is already late for a romantic dinner and is still trying on clothes in the hope they will look good, or at least acceptable. 

"I won't die tonight,” I think to myself. “After all I've been through, that would be ridiculous."  I mull over this idea like someone counting sheep. "I'll walk out of this hell-hole alive. I will get out."

And thus, in a primitive irrational way, I slowly climbed up onto the back of this panic, constantly murmuring loving words and stroking its mane, and grabbed onto its fragile neck so as not to fall off. It reared up on its hind legs for a long time, or so it seemed, but I kept my eyes closed and my mind empty, and let myself be carried along the hostile paths where it chose to go, offering no resistance, making no protest. It finally came to a standstill, as exhausted as me.

From time to time, at the periphery of my palpitation, I felt that incorporeal displacement of air that accompanies a person’s careful approach. Through a microscopic slit in my closed eyelids, I surveyed my surroundings. Invariably it was a nurse checking on the condition of a restless patient (how good it was to be back in the realm of the predictable!) Sometimes the visit to my bed was made by Nurse Débora. I didn't have to so much as open my eyes to know this – the sweet scent gave it away immediately. On one of these silent visits, as she was getting ready to leave, relieved and convinced that I was finally resting, I could not resist the temptation and, opening my eyes, asked her the time.

"Just after five o'clock," she answered.

"That late?!" I had no idea.

"You see! Try to sleep..." 





    I must have slept an hour – if I was actually sleeping at all that is. Maybe I was just in some kind of sleepy stupor. Either way, it was enough to dispel the eerie dreams I was having the night before. Meanwhile the sun has come up and the light is shining through the windows. My surroundings have regained their banal appearance. 

Most important of all, I've woken up to find that I'm still alive. This satisfies me a great deal. Furthermore today is a Sunday. So if everything goes as planned I will be leaving before the day is done. I'm not sure where they'll be sending me to but that doesn't bother me. One thing I do know, I will be leaving through that door over there... If luck is on my side (I don't want to swear by it), I won't spend another night on this intergalactic platform, in this android environment.

Nurse Débora, who has started the morning looking rather hung over, has been walking around the place, but she's being rather cold with me. I don't blame her (I must have contributed to raising her stress levels on a night which was already unusually stressful to begin with.). I also forgive her for the sarcastic tone she uses when introducing me to the nurse who has come to take over her shift. 

"Over here we have Senhor José who, contrary to what he thought last night, is actually in a rather good condition," she says.

And off she goes, my extinct volcano. The new nurse is called Beatriz. She's blond and she stands there studying me with her pale blue eyes, which look a little too big due to the lenses in her glasses. 

"So... what went on last night?" she asks.

I give her the gist of last night's occurrences. I tell her about the constant plings; Senhor Alberto's diabetic fit; the general agitation of the staff; my fear that it was all, somehow, related to me.

"I don't think there's anything out of the ordinary with your reaction," she says simply. "All this can be quite scary."

Once again there's music in the air. Nurse Beatriz is exchanging a few sweet melodic words with her colleagues. There's a romantic ballad playing, one of those crummy ones sung by a man with a raspy voice. She sings along with it while she works. Without interrupting what she's doing she looks over to one of her colleagues and sighs, rolling her eyes:

"This song just kills me..."

Nurse Beatriz is not only shrewd and romantic, she's also a brilliant professional who performs all her tasks with the utmost rigour and attention to detail. She happily explains to me all that she's got to do to make me ready to leave the unit.

"Say what you will," she says, soaking a dressing with ether, "the easiest way is to pull it out in one go."

There's a strong smell of ether in the air and all around and, I imagine how painful it will be to remove all the adhesive and the accompanying hair (I'm not sure I agree with Nurse Beatriz's theory.)

The big moment is almost here. Most of the things penetrating my body have been removed, except for the three big drains responsible for collecting the waste from the surgery and the electric wires belonging to the pacemaker. Nurse Beatriz has gone off to fetch Lou Read who, very cheerfully, is getting ready to send me on my way.

 "Let's get rid of this then..." he says.

The abdominal drains come out quite easily, without much discomfort. As each of them is pulled out the doctor ties the ends of the thread that was already waiting in my skin to put an end to that hole. The only drain remaining is the one inserted between my ribs. Before he pulls, Lou gives a warning:

"This one here will hurt like hell. If you had wings you would fly. Take a deep breath," he advises, "and breathe out slowly as I pull the drain out."

It was just like he said. The tube got stuck to the flesh (there were all kinds of body tissues adhering to it), but the doctor removed it in one fell swoop. I did not fly, but I did keep on breathing deeply for some time after it had been removed, as if my fingers had got stuck to a hot chestnut fresh out of the oven.

Surprisingly though, as soon as that accursed tube was removed – the perpetrator of all my pain, my obsession for the past 48 hours – all the pain disappeared. It was as if it had never been there at all. 

Nurse Beatriz announces that I am ready to leave the intensive care unit. She gets me some pyjamas the colour of wilted lettuce and some disposable, Japanese-style slippers (like the ones you get on long haul flights). They help me get dressed and carefully help me into a wheelchair. I'm quite surprised to find I can't stand on my own two legs. 

But a last-minute problem has arisen and Nurse Beatriz comes over, somewhat vexed, to inform Lou Reed.

"Dr Caniço, there aren't any beds available on the Cardiothoracic Surgery ward..."

Lou scratches his head but doesn't lose his cool. He walks off and anchors himself to the nearest telephone.

During this impasse, I'm visited by the physiotherapist. I already know her by sight because of the exercises she regularly does with Senhor Alberto.  She has come to teach me some breathing exercises, namely "smelling the flower" and "blowing out the candle".

"You must do them throughout these first few days. It's very important," she says with almost contagious vehemence. "It helps the circulation and prevents lung problems. Let's practice for a while."

My flower smells like ether and no one claps when I blow out my candle. Nevertheless I try to be a model recruit and follow the instructions the best I can.

"OK, Senhor José. That's enough for now. Later on a colleague of mine will join you in the ward, and she will teach you a few more exercises."

I feel excited. All these professionals and procedures are concentrated around me, which must signal my imminent departure. They've just finished slotting me into the wheelchair. There's a sizeable pile of dark-coloured envelopes, which I suppose contain the X-rays and other tests to which I've been subjected to during my stay.

Lou Reed comes over. I suspect he wants to say goodbye.

"It's all arranged. You're going back down to the cardio unit, to the same bed you had before."



    Here I go at top speed through the ward. I'm being driven by Nurse Beatriz in the direction of the inaccessible door which, after all, I pass through as smoothly as butter! I've done it and now there's a corridor with doors on either side, doors belonging to the pediatric unit, doors belonging to isolation rooms. Marta suddenly materializes out of one of them. She stops the wheel chair so she can say goodbye and wish me all the best. Yes, Marta, luck and happiness are what one needs to walk this earth (happiness should be rechargeable). All the best to you too. 







    I would put my hands in the fire to swear for the veracity of what I have just told you, though I would not scorch them in the cold fire of objectivity as regards the reliability of the facts. I spent two days in the intensive care unit of the Cardiothoracic Surgery department, and for the first 24 hours, didn’t touch any food, having just emerged from an artificially induced coma. I also recall spending those 48 hours submersed in some kind of morphine haze, not sleeping for more than a couple of hours throughout the whole period. You can imagine the tremendous physical and psychological stress this must generate amongst the patients and staff in such a unit! No wonder I don’t always answer for myself.

I later learned that many patients develop psychoses during or after their stay in such units. They go off the rails, can't stand the pressure. No one who has ever worked or been hospitalized in such a place will be surprised by this. Personally, I was lucky. I lost it for a while, but the explosion was brief. I don't mean my experience was a nightmare or that I appreciated it; but it was definitely one of the toughest trials I have ever been subjected to in my life, and probably the most psychologically intense and bizarre. In order to recount it, as you have seen, I had to resort to photograms, sound contexts and sensations imported from cinema, because only cinematic language, with its interplay of images, sounds and movement, could illustrate that atmosphere with any measure of similitude.  And it is not just now – a posteriori, in the process of recalling memories and crafting them into a narrative – that I’ve been resorting to such analogies. While I was actually going through the experience, pieces of those worlds would keep coming to mind in that urgent instinctive drive to catalogue the sensory and emotional chaos. Indeed, at the risk of sounding like a movie buff, I could give countless examples which would describe the desolate spaceship-like atmosphere of the intensive care unit. They are almost all from science fiction movies: Ridley Scott’s Alien series, for example, to describe that sense of drifting through an icy cosmos inhabited by hibernating beings and unpredictable androids; or – to dig up a true classic – Stanley Kubrick's 2001 Space Odyssey, to sum up the vertiginous turmoil of the journey. But it's the slippery and apparently deformed visions of David Lynch and David Cronenberg that best describe that experience, something impossible to portray with only the threads from which reality is sewn - the written word.  

From the careful sophisticated sound tracks characteristic of some of Lynch’s movies, I inherited the code necessary to materialize and decipher the sounds that enveloped me – those minimal repetitive disturbing echoes, which were so significant in defining my state of mind throughout those forty-eight hours. Through David Cronenberg,[§] a director that gave up medicine to devote himself to cinema and who repeatedly constructs fables centred around the concept of what can happen when the boundaries between man and machine are erased, I realized just how easily these obsessions with the man-machine symbiosis can become reality and what bizarre outcomes result when they do. 

During the whole period I spent writing these chapters on the intensive care unit of the Cardiothoracic Surgery department, there was one thing that never ceased to amaze me: the short amount of time I actually spent in Unit 7. This, to me, is as weird as my surroundings were at the time. I have checked and double checked and each time I reach the same conclusion: I spent only two days in that unit, a mere 48 eight hours, no more. To this day I wonder how this is possible. But that's the amount of time I spent in the unit and the hospital records prove it. Even so... the things that happened in that time! It was as if the hands of the clock had slowed down, giving me the opportunity to jump off and take a long haunted stroll, only to pick me up again at a street corner, lost and confused, 48 hours later.







                 Part IV


In the land of green broth*



* A traditional Portuguese soup made of potatoes and kale, enriched with smoked sausage and

 tempered with olive oil. 




    There were voices nearby, making their way softly into my dreams and slowly extracting me from the embrace of a Sunday afternoon siesta. At first I couldn't make out what they were saying. There were various male voices, amongst which the musical, monotonous tone of an Alentejo accent stood out. I listened, trying to disentangle them, realizing that they were coming from behind my head, from behind the curtain concealing the left side of the bed. Pieces of dialogue floated in my direction, some of them getting caught in the mesh of my understanding:

"...but, Enguia my friend, don't you think it was too big, even if it was a hare?!"

"Gentlemen, it's the exact truth... I can still see it in front of me..."

"That doesn’t prove much..." mocked a northern accent.

"But I swear to you, hunter's word!" insisted the Alentejo accent, in which you could make out the rattle of mucous in his throat, telltale signs of a lifelong smoker.

And so the conversation went on, with the intimacy of a boys' dormitory, lazily meandering along like a summer river. 

"But what really gets me," continued the Alentejanlowering his voice almost to a whisper (though rather unsuccessfully due to his hoarseness, which amplified his words enough for me to hear) "is my gut..."

"Your gut, Mr. Cipriano?!" one of the voices echoed lively, joining the conversation.

"I'm afraid so my friends, I just can't do it on a bedpan... I can't get into position!"

His friends did their best to contain their laughter and, spurring him on, demanded details.     

"Can't do what?"

"Take a shit, of course!"

"It’s just a question of habit," said another pompously. 

"Or of having no other choice," mocked the northern accent.

"You can laugh! You’ve no idea what’s like. I just can’t do it on a dented metal potty, and if that wasn’t enough, lying down!"

When the general laughter had died down, one of his companions asked:

"Why don't you explain your problem to one of the nurses and ask her if you can use a toilet?"

However, Mr. Cipriano Enguia's problem, as he explained in a tone bordering on anguish, was that he lacked the courage. On top of that, he was terrified he might get a "no" for an answer.

"They don't like us to go by ourselves into the toilets. They're afraid we might keel over..."

Eventually, in order to get out of the impasse, someone suggested that all the residents of this division of the ward should join together and present the problem collectively in the shape of a formal request. Immediately, and with the bureaucratic prowess that is in the DNA of all Portuguese, they set to work.

"Dear Nurse..."

"No," someone corrected. "Dear Madam."

"Dear Madam. We, the undersigned, residents in this ward, hereby kindly request..."

"we hereby bring to your attention"

"...we, residents in this ward, hereby bring to your attention a problem concerning one of our companions..."

"Our friend and companion," suggested the interested party.

"...concerning our friend and companion Cipriano Enguia, who lives in Vagarosa, and who for the last four days..."

"Five," corrected the plaintiff.

"...for the last five days hasn't been able to take a shit..."

The composition was interrupted by muffled laughter and a rather violent coughing fit, which lasted for several minutes, before being resumed after a heated discussion concerning what term should be used.

"... for the last five days hasn't been able to discharge due to his inability to use a bedpan. We therefore fervently implore you to let him use... "

"...to let him try to do it in the bathroom," shouted out another one of the voices. "That’s it! It's done."

"You forgot to request authorization," reminded one of the undersigned.

As soon as it was finished, and before their courage faltered, they called the nurse, and reeled it off to her in various voices (as might be expected, I couldn't make out the voice of the interested party).  The nurse laughed and then told them all off as if they were a group of mischievous young boys. But she did take Mr. Cipriano to the bathroom, and he got plenty of encouragement from his friends along the way:

"Be brave my friend!" shouted one.

"Keep going. Look straight ahead. Don't look down," said another.

The nurse told them off softly, imposing silence because they were disturbing the whole ward, or at least that's what she said. 

Next door, I was relaxing my mind, stretching my being, relishing the contrast between this warm humane atmosphere and that of the frigid space station from where I’d come.

"Here I am back in the land of green broth," I thought, consoling myself.

With a trace of a smile dissolving on her lips, the nurse came into the room to check on the condition of the patient in Bed 16. She's a blonde nymph, though not of the luminous subtype. From the light blonde hair that falls halfway down her back to the colour of her skin and the glow of her face, she seems to be evenly covered in a fine ash, as if she's somehow miraculously returned from Vesuvius. The only exception is the dark pink of her lips, where a discrete smile plays when she speaks of Mr. Enguia. 

"He's an old man from the Beja region, a regular patient of ours. He's had three or four heart attacks and from time to time ends up here because he doesn't take enough care with the cigarettes and the booze."

"Three or four heart attacks!" I shiver. 

She nods melancholically, her shoulders sagging. Her hands are clasped on the front of her very white overall.

"Do you want me to raise your bed?" she asks. "It will be dinner time soon. Not that you're allowed to have much to eat..."

A voice summons her from down the corridor and off she goes.

She's called Diana, the ancillary who brings me the tray with my dinner and lays it on my lap. Very beautiful, fine features like porcelain, a delicate subtle manner, and a chatterer. While she's settling a pillow behind my back, carefully straightening my torso and diligently positioning a paper napkin to protect the bandage on my chest, she tells me about how distressed she had felt when she first started working in the cardiology intensive care ward. It upset her to be around illness and sick people, especially patients who had had heart surgery - "like you."

"Not any more though," she adds. "Actually, I really like working here now, though at first…” 

“You know, I'm scared I'll have a heart problem myself in the future,” she goes on. “I'm really nervous. I get a lot of palpitations. Sometimes it feels like my heart is beating in my mouth."

Since we have immersed ourselves in this sea of intimacy, I take the opportunity to tell her that I'm a doctor myself. This soothes her visible anxiety. I dismiss her fears of having heart disease, sweeping them away into the mists of improbability.

"First of all, you're too young to have that kind of disease. Secondly, what you're describing is anxiety, and that won't wreck your heart so fast... You can rest assured."

She yanks at the stiff handle that winds down my bed, and then she goes, taking her leave with a soothing "See you later". I’m left staring at the ceiling, where a small speaker quietly emits the songs of Radio Nostalgia.


                  One day I feel so happy

                  Next day I feel so sad

                  I guess I’ll learn to take

                  The good with the bad...*


At eleven o'clock, just as I had dozed off once again, Diana returns with a cup of linden tea and a couple of tea biscuits. Immediately behind her comes Nurse Leonor (the young ash-blonde), who comes to take my blood pressure, pulse and temperature, and give me the medication prescribed by the doctors.

"Do you want me to close the door?" she asks before leaving, after positioning the call bell on the pillow within my reach.

"No, thank you. Leave it like that please."

Like that it is open, gaping, which is how I want to be today, close to the world and to people.

"Will I wake up alive tomorrow?" I wonder, while my head grows accustomed to the cushions, the lights go off, the ward quietens down and the coughing grows sparse. I correct the redundancy: "Will I wake up tomorrow?"

I am reluctant to sleep. There are footsteps in the corridor. Who could it be? It'll be one of the staff, that’s for sure. The patients don't walk around at night. They're all...


I tremble, involuntarily, and prick up my ears. A muffled thud, then total silence… Ah! There must be a lift nearby: the pling that signals its arrival at whatever floor. For a moment, I feared I had been teleported back upstairs, back to the intensive care unit of the cardiothoracic surgery department. But no, it was just a domestic pling.  








    The bucolic spirit of Sunday which yesterday lulled me and, despite my efforts, wrapped me in soft sleep, was swiftly swept away by a desolate Monday, which barged into my room dressed in white and wielding a syringe, which was promptly stuck into my belly. 

"It's fraxiparine," it explained, as I blinked. "You'll take one every morning while you are here."

The syringe was removed and returned to the plastic sheath which protected the needle. Then, with a well-aimed shot, it was thrown into the plastic bag that lined the bin by my bed, next to the old glass bottle which I used as a urinal.

"Now wash yourself, OK?" I was told as my bed was raised. A table containing two steaming metal bowls with soapy water was set by my side. Floating in one of the bowls was a rectangular piece of cloth about the size of a hand. 

"Do you think I'll manage?" I asked, doubting my ability to do so, given my weakness and virtual inability to move my torso and neck. 

"You'll manage," the nurse answered emphatically, "but if you can't, we'll be here to help."

"What about this?" I ask, fearful, shielding myself behind the immaculate dressing which divides my chest in half, the suckers which fix the electrodes of the heart monitor to my chest. "It will get all wet..."

"Don't worry, we'll change it afterwards."

I sat up and inched towards the edge of the bed, aided by an ancillary. 

"This one is for the top half," said the nurse pointing to one of the bowls, "and this one is for the bottom half," pointing to the other from which a distinct smell of disinfectant emanated. "We'll bring you some clean pyjamas in a minute," she added before leaving the room.

So that was it! I sat looking at the bowls and at my skinny legs, dangling over the bed. First things first. Was I going to be able to get out of the pyjamas Nurse Beatriz so professionally put me in last night?

I did. It took three thousand centuries, but I managed it - button by button, shoulder by shoulder, elbow by elbow. Pulling a stiff sleeve, shaking my back to help the cotton shirt slide down, lifting a buttock at a time, pushing and rolling and, finally, letting them fall down.

"Dear God!" I say vehemently. "What a difference a cracked bone makes! How we need our sternum!"

And, finally, there I was, teetering, naked on the edge of the bed. Soaking the fingerless glove in the lukewarm water, as concentrated as a cat, I rubbed my worn body. Now I was weary from the effort and worried by all the water I had splashed over the place - water on the sheets, on the floor, on the pyjamas. 

 I was like that, dripping and naked, when a nurse that I did not yet know found me. She walked into the room totally indifferent to my shame clutching a mobile phone. 

"It's for you," she says. "Do you want to take it?"

I answered. It was João wanting to know how I had got on through the night. Half an hour later I got quite a shock as she appeared at the door to my room, in a state of considerable anxiety. Her visits, up to then, had always been governed by the hospital's routine: either around lunchtime or in the evening, coinciding with dinner (dinner is served early in hospitals).

"What's wrong?" she asks nervously.

Leaning back majestically in bed, with my breakfast tray on my legs, I was feeling fresh, clean and comfortable in my new pyjamas, even though I had only had a quick wash. I stared at her.

"What do you mean, what's wrong?!"

My voice on the phone had made her panic and rush to the hospital. She had hoped to have a conversation with me but was answered by a faint, feeble voice that could scarcely speak, stuttering and wheezing like a dying man. 

"You scared me! I thought something serious had happened to you."

"It was because of the wash," I explained. "I was in the middle of washing myself and the effort just tired me out." 

This is my new vocal state. My voice has withered and, if my memory hadn't retained some outlines of anatomical topography, I would surely be thinking that, during my operation, the surgeon had accidently stabbed me in the vocal cords! My deep resonant musical voice has transformed into a falsetto, becoming a hoarse whisper after two or three minutes of conversation. 

The operation has taken a heavy toll, far more than the actual heart attack. Speaking makes me feel like I've just carried an obelisk singlehandedly on my back. Having tea and bread tires me out as if I have just run up the stairs of a ten-storey building. I think the nutritional value of everything I put into my mouth is burned up by the simple effort it takes me to chew the food and not a single calorie remains to be used later on. This is the state I'm in. I'm forced to rest after a conversation, after a meal. I fall asleep exhausted if I have two visits in a row! 

In some remote way, my current state reminds me of the radiotherapy period. But it's a different kind of weakness. This one is altogether more absolute. It's more imperative that I lie down and sleep, related in some way to my limited cardiorespiratory capacity, which consists of short breaths. No one can imagine the quantity of air and muscular effort it takes to keep up a conversation. Nobody can imagine how a newly mended heart can be tired out simply by concentrating and trying to keep focused. 

And so I sleep... I drift off, snooze, and in between I groan, listen and look. At the end of the day these are still the exercises that tire me out the least and comfort me the most.

Groaning is a particular way of expelling air from the lungs, a variant in sound expiration. Groaning is good. "I knew it!" you’ll say ironically. But that's not what I'm talking about… Groaning is good, even when it's not brought on by the best causes. Groaning comforts, groaning keeps you company.

Personally, I don't groan because of pain. I don't have any special pains, though I could be expected to – and I have some medicine at my disposal ("for SOS", as they say) for this very purpose, if I decide I am in pain (that is the luxury of SOS – SOS is the patient’s will bearing fruit). I groan because everything is arduous and toilsome. I groan to accompany the passage of time, to let it all out, to feel myself functioning. Ah... and I groan quietly and only when I'm by myself. In my case, at this level, groaning is personal and incommunicable. I groan because I can and I want to, not because I have to. 

After lunch they drag in a black leather armchair, leaving it parked in the space between the two beds. An ancillary hastily covers it with a sheet, tying the loose ends in big knots at the back.  

"There you go, now you have a place to sit. You don't have to lie down on that bed any longer. Do you want me to help you get down?"

I didn't. I wanted to relish the moment, my first steps on my own. I did, however, ask her to raise the bed for me. I can't change it from its reclining position to sitting position, at least not without assistance. No way. I have nothing to support me. My sternum was cut in half four days ago and hasn't had time to join back together again. And without a sternum my clavicle, my neck, my arms have no support. They won't let me lever my body. Lying on the bed, like a tortoise on its back, I'm at the mercy of others. I can't get up, can't sit down, can't even turn on my side. If I wish to adjust the position of my head on the oversized pillow, I'm able to do so by moving down a few inches, making some wriggling movements with my back and thighs. 

However, after cranking on the handle as if she was trying to start an old clunker, and raising my bed to sitting position, the woman decides, rather stubbornly, to stand there and supervise my actions: the way I hang my legs over the edge of the bed and assess the distance from my feet to the floor. 

"Now all I need to do is slide down and I'll be standing on the ground," I think to myself. I'm stiff as a nail, my arms at the side of my body, the palm of my hands gently holding the edges of the mattress. And off I go, just as if I were sliding into a pool.

I fall on my feet at least. But as I steady myself and attempt a first step, my legs go rubbery and I feel a surge of vertigo. I collapse into the arms of the ancillary, who is ready and waiting, quick and firm after the first few test flights.  

"I got dizzy," I explained. 

"Take it easy, come on. You haven't stood on your feet for quite some time, remember that. You're weak and not used to walking."

Here I sit, happy, in my new armchair. My field of vision is incomparably better than what it was when I was lying down practically unable to move. I observe my room from a snug observatory. 

It’s narrow and long. The window has frosted glass so you can't tell if it's day or night. There's an old-fashioned high ceiling, and two doors, always open, one of them leading to the main corridor, the other, next to the head of the bed, separating me from the next room where Mr. Enguia and his companions conspire and from where a few pieces of conversation waft through and entertain me. Occasionally, and without warning, a nurse or an ancillary appears through this door or, more rarely, a doctor, though they seem to prefer the front door to the back one.  

I've been in this place before, on the day they brought me from Torres Vedras to Santa Marta. I was tipped into this very bed after the scandalous revelations from the coronarography. This is where I processed the angst of being lost in a hospital. It was with my head on this pillow, that long night before my heart operation, that I reviewed my life and was assaulted by a flashback of my cancer, making connections between things that, up to then, had been floating meaninglessly through my mind. How small the world is and how strange that, at the moments of apparent paralysis, it doesn't stop turning! The room is now a familiar place, a refuge where I feel contented. Yet, in the eyes of the people who work here, it’s just place to store things. 

It's kind of depot where they keep whatever is left over, the things they don't know what to do with, that they only use from time to time. And they keep things down there close to the window, concealed by a modestly ironed oilskin curtain so visitors can't spy. I've seen them getting stands for drips, rummaging about for a defibrillator and blowing the dust off a few other machines and less familiar accessories. And I suspect the same goes for the patients that are hospitalized here. We are all surplus stock. That's what happened to me. There wasn't any room in the cardiothoracic surgery ward and they had nowhere else to put me.   

This feeling I have that I'm being quartered in a limbo of antiques is confirmed by a member of staff as he works the crank, trying to raise my bed. 

"You have to eat an ox to be able to raise your bed! Yours and that one," they say, pointing at the second bed in the room. "They’re the oldest beds in the entire ward. They aren't used any more!" 

Matching the crank-bed which sings like a hurdy-gurdy whenever it's raised, another antique is exhibited on a stand above my head. It's an old, submarine-gray, Hewlett Packard heart monitor. I'm connected to it by a wire which branches out over my chest, a benevolent leash that allows me to reach my chair. On the screen imprisoned in a round lens, a tireless green dot flits about tracing my heart oscillations. I don't waste much time gazing at it. I'm not that interested in having the functioning of my innards permanently on display before my eyes. 

Not counting the automatic sphygmomanometer with its digital display, the black leather armchair is the most technologically advanced piece of equipment in the room. I've just found out it has intelligent driving capabilities. What I mean is, if I lean back lightly, the back of the chair slides down, inviting me to recline, while at the same time, the front part lifts up to support for my legs. In other words, I can transform this armchair into a couch. Excited by this new discovery, I let myself try out ever more daring positions until I’m finally lying down straight. I'm delighted by the idea of resting like this in future, losing myself in the embrace of the book I was reading, my eyes half-shut, listening to music.

But, as I find out a little too late, my special chair wasn't made for people without a sternum. To spell it out, you have to give it a little sign to make it go back up to its original sitting position. You must raise your back just a little so that the chair, horrified by the void, can begin its ascending movement. And here I am, incapable of even feinting that modest movement, sprawled out against my will. Vexed, I can see the bell out of the corner of my eye, out of my reach. I must wait for someone to come in and return me to a less obtuse angle...

I was discovered around tea time by a rosy well-built girl. She returned me gently to the safety of my bed and to the pleasure of a cup of tea with some biscuits and jam. 

"If you want another packet, I'll fetch it for you," she offers, noticing the way I grasp at the tea biscuits. 

I thank her and gratefully accept. The packets they give us only contain two biscuits, which is not much, considering my ravenous hunger. She returns and decides to linger, leaning comfortably against the end of the bed, watching me polish off the second packet of biscuits. 

"I like to see you with a good appetite," she comments as if she has known me for years. "But you need it. You're just skin and bones."

My thinness and current featherweight condition are a source of comments, and attract gentle mockery from everyone who deals with me.

 "Fifty five kilos!" gasped Dr Luís Caniço in horror, up there in the Surgery department when he asked me how much I weighed in order to calculate the dose of medication. "That's a sub-therapeutic level, almost juvenile!"

"I don't know if I'm going to be able to take your blood pressure with this machine. Maybe I should go and fetch another one from the pediatric cardiology section..." one of the nurses had commented ironically the day before, as the brace of the blood pressure meter failed to secure my arm after all possible adjustments. 

"Do you want me to put your bed down?" asks the girl after picking up my tray.

"If you don't mind, but lower me gently please," fearing an abrupt change in position, given the energetic robustness of her physique. A sudden horizontal fall would hurt me. My chest bones, even though they are sewn together with four wires thick as the strings of a bass guitar can't cope with being stretched rapidly. It strains the scar. 

"See you later then," she says, throwing me a genuine, jolly smile as she holds the empty tray and walks towards the door. "I'll come and visit you later."

"Hey, what's your name?" I shout out just before she passes through the door. 

"Rosa," answers a voice, already disembodied.

Full from my snack, I fall into a state of benevolent apathy sprinkled with satisfied and progressively softer thoughts: "How nice to be here, in this old-fashioned room, without all those shackles of tubes and sensors." I slowly dissolve into the environment, like the peaceful thread of white smoke slowly leaving a chimney at the end of a countryside afternoon.

Yes... maybe in the eyes of everyone else, it's only a small step, only a slight improvement (out there they may make comments like "no, he's not out of danger yet, he's still in intensive care"); but for me, it feels like my boat is no longer unmoored and letting in water. What enormous progress I've made. 

And, in this hopeful stillness, I fall asleep once again. 








    Tuesday. I've woken up alive once again. I've already had a wash and changed my pyjamas. It must be getting close to nine o'clock for Radio Nostalgia is playing the enigmatic, Caribbean-flavoured interlude which, at least for the past few days, has preceded the hourly news update and promotes Peugeot air conditioning.


                  El único fruto del amor es la banana, es la banana...


    Is the banana really the only fruit of love...? As it's an advert, the radio only plays a small extract of the song which never fails to leave me in suspense, baffled, not understanding the reason for such a radical opinion. Is it bitterness? Is it philosophy? One day I'll get to the bottom of the mystery, but right now I'm more interested in breakfast. My new frame of mind makes me think of food all the time. I calculate the passage of time by the hunger I feel, by my desire for my next meal!

And I'm astonished! Contrary to the hospital tradition, here you eat well! The food is good, varied and nicely presented. At least that's my opinion, but I will admit that my judgment might be a little distorted because of the Ethiopian diet I was submitted to up there in the Cardiothoracic Surgery intensive care unit. Just yesterday at dinner time, João, looking askance at my soup, which I was sucking up with determination, asked squeamishly:

"Is it good? Doesn't look very nice..."

"It's magnificent," I say, vehemently.

The watery liquid, with a few vegetable remnants floating in it, could cause the wrong impression, I admit. But no, it was a beautiful broth, enriched with grated carrot and some watercress. And even though it didn't contain any salt, its taste warmed my soul. To this day my taste buds can recall the flavour. 

I felt strengthened by my breakfast and was already comfortably installed in my armchair. The five steps I had taken unaided from the bed to get me there made me feel like I had the energy for even more. So I decided to go and have a shave in the sink at the end of the room next to the drip stands and a couple of wheelchairs, which I had discovered the other day, much to my surprise, when an ancillary drew one of the curtains in the room in order to throw away some water. Without asking for any help it was going to be quite a risky venture. 

Supporting myself on any object that seemed secure, I padded around the bed, trying to reach the bedside table where I kept my toiletries. It was only as I was nearing the end of this tiny circuit that I realized the limitations of these aspirations to freedom. The heart monitor, damn it! I'm connected to a machine and the leash which binds me is too short.

I return to my armchair to consider the problem. There are two ways of reaching the washbasin, I conclude. I could ask someone for assistance once more. Or I could undo my link to the monitor for a couple of minutes. It wouldn't be difficult. The electrode wires attached to pieces of adhesive gauze on my chest all lead to a plug inserted into a socket, from where sprouts a long (though not long enough for my purposes) grey cable, which transmits the electronic impulses of my heart to the veteran Hewlett Packard. In short, getting rid of this will be as easy as pie. It'll be like unplugging a lamp and the only predictable change will be that the tireless, bouncing green dot will take a break. 

Standing up, bravely facing the monitor, I remove the plug from the socket and watch the green dot vanish immediately from the screen. Then, leaning against all available objects, I launch myself out towards the distant oilskin curtain. 

I had just circumvented the armchair and was beginning the walk around the second bed when I felt someone enter the room in haste. 

"Hey! What's going on here? Where do you think you're going?" It’s a female voice, scolding.   

I explain that I'm going to have a shave at the washbasin in the room. Don't they want me to move, to combat this immobility? To do it I had to remove the heart monitor cable. I would reconnect it as soon as I was back in the armchair. I knew how to do it. I had memorized the connections before taking them out. 

"You gave me a huge fright. I was back there, in the work room, and suddenly the alarm went off and your cardiac signals disappeared!"

Caught in the act, I apologized profusely for the fright I had given the nurse. What a scolding! How was I supposed to know this thing was remotely connected to the control room? I had assumed – probably misled by the outdated look of the equipment and the furniture – that no one would notice. This was not at all sensible. After all, I am in the Cardiology sector of a main hospital, in an intensive care unit! 

For a moment, hidden by the curtain, I look into a mirror which coldly returns to me an image I hadn't seen for at least six days. So, that's me. That chap, someone’s who hung around, in and out life! I recognize myself, but there’s no thickness there, no depth. It's as if the me reflected by the tinned glass is made of thin ice, shatterable and slippery. I look (or am) thinner, it seems. I look (or am) very pale. My pyjamas are too big and my arms are flapping about in the sleeves. My gaunt neck is lost in the collar. I would need a belt to tighten the slightly-bleached lettuce-coloured jacket decently around my thorax. 

I’m unshaven, with gray stubble, though less than I would have expected. It hasn't grown much. The little washbasin hasn't got a plug so I turn on the tap only slightly, releasing but a trickling flow of water. I wet the brush and squeeze some shaving cream on to it. Next, in a fully automated movement, I raise my arm and begin lathering cream onto my face, all without losing sight of myself in the mirror. It's hard work! Simple movements like lifting my hand above the level of my elbow, or sweeping a shaving brush over my face seem extraordinarily strenuous. How can putting shaving cream onto one's face be so time-consuming and fatiguing? I stop, surprised, beholding the pathetic figure gasping in the mirror. I see a dark hole, my half-open mouth, surrounded by white foam, and prominent shoulder blades, a chest bone with a long strip of fuzzy gauze dangling from it, bouncing up and down agitatedly. I put down the brush, taking a break from my labours. I press my hand against the side of the washbasin to support myself - it'll be easier like this. 

Too much time has gone by and, meanwhile, the foam has dried into a fine white coat of something like dandruff on my skin. I must get a move on, otherwise I'll have to start all over again. Leaning forward, with an arm and a hand propping up my body, I manage to slide the razor across my face, clumsily scraping at my sideburns, my face, my chin. Stoically, I set myself a series of small goals before which, I've decided, I won't rest: "Come on, finish the chin, then you can rest. Next the whole neck (left side and right side), then rest.” Already seeing the light at the end of the tunnel, I find it's time for the upper lip. This is the hardest part and requires concentration. You must have your skin perfectly stretched, something that can only be achieved with a complex contraction of the face and neck muscles. You must lift up your nose with your thumb and index finger, though this means a temporary loss of the support provided by your right hand. Instead, I must rely on my thighs and hips, pressed up against the sink. Afterwards, I rest and, finally, wash the rest of the foam from my face.

A desert later, burned out and short of breath, I drag myself towards my armchair and drop into it any which way. I would rather lie down, being this exhausted, but that would mean waiting, asking for help, admitting my weakness, bothering someone. I'll stay here and carefully take advantage of all that the armchair has on offer.  

Gradually, relaxed after a rest, my breathing calms down and my thoughts start to flow again like butterflies after the rain. I have a sense of accomplishment for having shaved, for having done it on my own, because the image that the mirror reflected back to me was a less leaden in the end. However, at the same time, something within me is horrified by the colossal size of these actions which used to be so small. In my personal dictionary, where there used to be "can do it on one leg", you now have "no legs to walk on". 

I erase and rewrite myself, tired out from thinking, from the effort of trying not to get scared.  I slowly dose off in the armchair.


El único fruto del amor es la banana... 


    It's now 10 o'clock according to Radio Nostalgia. "Only?" That astonishes me, just before I fall asleep. 



    "Good morning. I'm sorry to wake you, but I want to examine you."

I open my eyes, bewildered. I have the feeling I closed them only a few seconds ago. 

In a white overall, she looks down at me with an assured air, a stethoscope dangling from her neck.

"Do you want me to move onto the bed?" I ask. I am used to being a shop window mannequin.

"No, that won't be necessary. You're fine where you are," she answers in a toneless, somewhat nasal voice, shuffling papers - X-rays, electrocardiograms and other medical reports - which she then organizes on top of the wheelie table that supports my bed.  

"Your potassium worries me..." she finally says, thoughtfully contemplating me, while gently drumming her front teeth with a pen. "It's very low!"

Embarrassed by my potassium's behavior, I make a gesture equivalent to shrugging one's shoulders. It's as if I'm confessing my inability to do anything about it: "I've told it a hundred times, but it just doesn't listen to me!" 

She continues to look me, lost in thought, and then, leaving the abstract realm with a whiff of inspiration, she asks: 

"I think I'm going to put you on a supplement, all right?"

"That’s fine." I nod my head, relieved to see the interests of my potassium reserves being defended and observe her, with curiosity, as she devotedly writes down some notes in my clinical file. 

Thirty-something. She's tall, slender, with long black hair, huge dark brown eyes and daringly prominent cheek bones. These, together with a pair of particularly long incisors, give her the air of a mischievous schoolgirl, which, come to think of it, I'm pretty sure she probably was. 

"Your potassium is rubbish, your potassium is lower than miiine..."

I look at her and can’t help but see a scrawny nine-year-old girl running about with bony knees and legs bruised as an overripe peach, angular elbows in the air dangerous as switchblades. She’s cute as can be.

"If it's possible to avoid X-rays, I'd appreciate it," I tell her, a request I make to every new doctor that studies my file. "The thing is, three years ago my thorax was radiated for five weeks - I think I've had enough radiation for a lifetime..."

She lifts her head from the papers and contemplates me with a long serious gaze.

"Don't worry. I'll only ask for one if it's absolutely necessary."

So far I’ve not had one constant doctor. All those that work in the ward come and check on me: one listens to what I have to say, another orders one more X-ray, another an electrocardiogram, and yet another asks me a vital question for clinical history:

"Have you ever had syphilis?" 

I'm being taken care of, but I get the sense that I'm being monitored with a certain detachment, as if the various tests the doctors request aren't connected, as if each of them digs up one tiny detail at a time. But with Dr Lúcia Garcia I felt something different. It was as if she had grabbed hold of my case and shaken the dust off it. She made decisions about me and, from now on, was going to be my personal doctor. It felt good, thinking that. Where has she been all this time? How is it possible that, having been here for decades, I had never seen here before?

Another person I hadn't seen for a long time was the head surgeon in the team of doctors in charge of my operation. He came in through the door towards the end of the morning.

"So are you still here?!" 

Sitting very still in my black leather armchair, I was taken by surprise. Having been subjected to a heart operation a mere three days ago, only one answer occurred to me.

"I'm in the cardiologist's hands. I can only leave when they tell me to..." I answer in my current dry voice.

And, I might add, cardiologists are more easy-going than surgeons. It's funny how the different specialties vary in attitude (not to mention procedures), particularly as regard the pace of patient care. Within the surgical specialties, the general procedure is basically to lie the patient down on the operating table, fix whatever is wrong, and two or three days later - if there are no complications - rush him out of the hospital shouting: "Right, who's next?"

All surgeons have this mentality, whether they specialize in stomachs, necks or hearts. The “medical” specialties, in contrast, approach things more methodically, step-by-step, as placidly as the case will allow. It's like that in Internal Medicine, Hematology, Cardiology – though that’s a generalization, as the borders between "interventionist" specialties and "conservative" ones isn't always clear, or static. 

For lunch I had some excellent baked mackerel, accompanied by some potatoes and other boiled vegetables (all of it covered in some good Spanish olive oil). Then, sometime during the afternoon, a male nurse, acting off his own bat, decided that it was a good time to remove the plasters that covered my chest and legs.

"You're more than ready. The more air they get the better."

The plasters are now off and the extensive sutures on my thorax and leg are now exposed, generously brushed with a brownish-red slug of Betadine. Despite the rawness and the clumsy, zipper-like look of the fifty-something staples (I counted them) which join the edges of the cut, the wounds don't look too bad: dry and without signs of infection or inflammation.

I'm crawling, ever so slowly, step by step, towards the moment, when, if everything goes well, I’ll be free of this place. With a bit of luck I might get close to being what I once was, before I got run over, on an unprotected level crossing, by a freight train called heart attack. I'm no longer bound to tubes, punctured by needles, dependent on bottled air. I'm still attached to a machine by a leash, but it lets me walk and it's not essential to me. It's only for third parties to observe how I'm doing, nothing serious. And now they've removed the plasters: that’s two fewer dustsheets covering the furniture in this boarded-up house. Now that we’ve opened the windows and cleared away the dust, it's almost time to move back in. Two new scars, outlined in steel and covered in dry blood - so many new details to observe, so many changes to register, until that far off day when I look in the mirror and won't be able to distinguish myself from the fine white line that I see there. 



    The radio has just signaled the hour - eleven o'clock - and the smoked glass windows at the end of the room have been covered by night. It is a blazing summer day out there, though you couldn’t feel it inside the hospital. But the look of suffering on the faces of the visitors, clogged with sweat and with commas of hair glued to their foreheads, as well as the frequent sighs coming from the staff, serve as thermometers.

"You don't know how lucky you are to be in here, it's so cool. It's scorching out there!"

In here, as usual, the air temperature has remained relatively constant throughout the day. Nevertheless, a silent stillness, the kind that comes after the torment, has fallen over the ward; perhaps it's a kind of empathy.

I'm sitting on my bed, having just eaten my supper and shaken off the biscuit crumbs which fell like yellow flakes upon the pages in which the writer Truman Capote describes the colourful and agitated first showing of the Opera Porgy and Bess in the Soviet Union, winter of 1955. 

Nurse Leonor, my ash-blonde friend, is back on shift again. We just had a heartfelt emotional conversation about illness, suffering and death - or life, which, after all, is the bag where all these other things fit. It all started, funnily enough, with a few banal comments about myself and how I came to be here, in Bed 16 of the Cardiology Ward. But the malignant tumor that peers out from behind this heart problem, dragged the conversation out towards the story of her grandmother and her cancer. It seems to me that Nurse Leonor lives close to this disease, dangerously close, so much that it may have singed her memory. Maybe because of this, the conversation slowly took on a more confessional tone, in which the narration of a detail by one of us was identified by the other. And so we proceeded, in this register, until our eyes met, shining and embarrassed, such that the conversation ended and we returned to our former roles – the patient getting ready for bed and the efficient nurse who looks out and takes care of those who need her.   

Before she leaves I ask her to fit the protective rails onto my bed that transform it into a type of cot. She seems a bit surprised by my request – she must be thinking I'm not so bad as to need bars.

"The beds are very narrow, you know? I'm afraid I might fall out in the night," I explain. And I am afraid. It would be horrible to fall out in my current condition. Just the thought of such a thing is terrifying. I feel made of glass, thin breakable glass, and with little control over my body. And in the blind, agitated world of sleep! How can I know what could happen? It's quite unlikely - I'm not even able to turn on my side without assistance - but, even so, I'm scared it could happen. Fall. No..., honestly, I wouldn't mind if they tied me down to the bed, if it guaranteed my safety.   

Time goes by. The lights go off one by one. Silence and darkness are now installed, at their maximum possible levels for a hospital ward. I close my eyes, open my eyes, clench them shut. 

In the darkness, the vast silence caused by an environment without music and by the patients withdrawing into themselves. The erratic and muffled pling of the lift still scares me, though less than it did yesterday or the day before. Somber nocturnal images flash into my mind: visions of Senhor Alberto glowing like old ivory in space; visions of the comrade with the tube stuck down his throat, trembling inhumanly, dreams of the lab frog. (Is where I'll end up again, I'm sure, if something goes wrong inside me). What about the old auntie? In what dark pit is she in, now that she’s in limbo between her nephew’s visits? 

I open my eyes. I'm in my old-fashioned ward. Somewhere, close by, Nurse Leonor paces around. And, further away, in the city, the people who make up my life are sleeping or absorbed in unpredictable vigils. As for me… I'll be in my old-fashioned ward for as long as I can keep my eyes open and a timid light shines through the crack in the door.





    In the morning, just as an ancillary comes into my room, I take the chance to innocently ask if I can have a proper shower in the bathroom today, instead of making a mess in the bowls as I usually do. Before asking, I had taken a peek down the corridor so I knew where the bathroom was.

To be honest, I've been having this urge since yesterday. Human beings are like this: as soon as they are given a couple of bowls for washing themselves, they instantly want more, a bath, a jacuzziA cat wash is no longer enough for me. I need to clean myself properly. The thing is, now that I think about it, I haven't had a bath for two weeks! That's a long time, especially in the middle of summer.   

And, above all, the smell of illness which I currently emanate bothers me profusely – an unfortunate cocktail of the odour of a high school locker room and a bathroom cabinet, with a touch of old talcum powder thrown in for good measure. It bothers me even more than the bad impression which I probably give to those who come into my room. Smelling of sickness perpetuates my sickness. It doesn't help me on this journey towards good health. I'm on my way to becoming a non-human-being, blighted by the smell of irrigator rubber, distilling medicine instead of sweat, humours which get stuck to the skin like low-flying clouds, emitting vibrations every time I move. I smell exactly like whatever it is that repels me when I approach a sick person. 

And to think that this would all go away with a simple bath!

However, the ancillary didn't find my request as simple as all that and went off to ask the nurse for advice. When she returns, the nurse is following in her footsteps. It's probably not a good idea, she tells me; tomorrow they would think about it.  

"You're still very weak and the hot steam could make you dizzy. You could feel bad, fall down. Maybe tomorrow..."

I wilt with this refusal and slowly drag myself towards the bowls. Wanting revenge, I decide to wash my hair, and so, defiantly and without asking permission, I stick my head in the anti-septic foam until I reach the bottom of the vat intended for the "upper part".  

Just as I thought, Dr Lúcia Garcia is now responsible for Bed 16 and here she is, unstoppable, crossing the threshold. 

"So, how are you doing today?"

What can I say? Now that it’s light and I’ve had all my jabs, I've had breakfast and washed my hair…unless…

"I think everything is fine." What can I say but this?

"No pain?" she insists.

No, I don't feel any pain. My chest bones feel a little sore when I move, but nothing excruciating. I won't complain about that.

"I sweat a lot, you know?" I say, seizing the opportunity to raise the question that has been on my mind. "I wake up every day drenched in sweat, with my pyjama top stuck to my back."

"Well, it's very warm weather. It's natural that you've been sweating," she says, visibly unimpressed by my symptoms as she begins opening my ever-thickening medical file.

Right! The answer is logical, but I've been musing over more sophisticated etiologies. Even the nurses, with whom I also shared my tribulations, and to whom I showed, as irrefutable and definite proof, the completely drenched top part of my pyjamas and the wet stain on the sheet which covers the black leather armchair, agreed giving plausible yet rather too primitive reasons to my liking.

"The mattress on the bed has a plastic covering. It's probably not as fresh as the one you have at home," says one of them.

Even João, who in theory wouldn't take part in the conspiracy, joins in on the same wavelength.

"Of course! And the armchair is made of nappa. That’s a synthetic material. It doesn’t breathe like real leather or natural fabrics." 

Towards the end of her visit, after passing her stethoscope over my heart, chest and back, Dr Lúcia Garcia asks me casually, while looking over the most recent papers in my file, if I have anywhere to go when I get out of here, if there's a place ready with people to look after me. 

I tell her yes, that I have a cosy nest awaiting me. 

"In that case, maybe on Friday I'll send you on your way," she says somewhat hypothetically.

She leaves me in suspense, waiting for something more. But, with a quick smile, she disappears with the file underneath her arm.

Around lunch time a physiotherapist, sent by the physiatrist I complained to yesterday, passed by. I grabbed on to her for I realized they teach great DIY tricks and, in my current state, I need these like the mouth needs bread. I've got a lot to ask and a lot to learn.  

First off, the most urgent matter: how to cough?

"Don't hold it back, cough whenever you have to...," Dr Luís Caniço had told me before sending me down here, like the master who drops an amulet in his pupil's lap before saying farewell to protect him from unforeseen dangers. I forgot the master's warning quite quickly, as is to be expected of apprentices. Cough? I didn't have a cough!

The last remnants of morphine they gave me upstairs have evaporated and with it, so has its powerful anti-tussive effect, one of its many therapeutic properties. The cough reflex has reestablished itself and, as I was relaxed, I happened to cough. Just one, simple time, but enough for me to swear that if it was up to me, I would never cough again.

"Don't hold it back..."

I coughed and the pain lunged so violently that it immediately took over all the space reserved for my consciousness, pushing everything else out through an immense black hole - the place I was in, who I am, along with all the other small things. For a few long frozen moments I became completely paralyzed, deaf, dumb. It was as if my chest had been blown up by a grenade. I waited for what usually happens with pain - for it to slowly fade away as time passes. But this one didn’t seem to fade. How could I not defend myself, especially after such a warning?

"Don't hold it back..."

Secondly, and also very urgent: how to start moving a bit more, like for example, sitting up on my bed without any help?

She smiled, but said she wanted to know if I had been doing my breathing exercises before moving onto anything else. 

I nodded, but she wanted an actual demonstration.

"Damn!" I thought to myself, breathing in, breathing out, doing this kindergarten-like exercise of smelling-the-flower and blowing-out-the-candle. "These physiotherapy people are really obsessed with breathing."

After ten times she was finally satisfied and we moved on to some more tricks, as modest as basic truths.

"When you feel like you're going to cough, cross your arms over your chest so that they compress your sternum, and support your ribcage with your hands - wide open and with outstretched fingers. That will protect you."

I tried out this self-hug. 

"That's it," she continues. "And try to make the cough coincide with breathing out, whenever you can. Come one, give us a cough."

Very timidly, I released a small sample of a cough. 

"That's it, you see? Try again, but this time, before you cough, try breathing in first and then pushing out the cough as you breathe out."

Astonishing! Coughing in installments! How it works, and how incredibly simple! 

And when this saint leaves my side, after showing me how an overturned turtle can sit up using his forearm as a lever, I entertain myself coughing without a master. Dr Luís Caniço would be proud of me if he saw he me now, hugging myself and coughing confidently.

"So? Have you got a cough?"

It's Rosa who comes in, bearing my lunch in her outstretched arms.

"Hello, back on duty?" I'm happy to see her so soon. I've grown used to people coming and then disappearing without warning, just as I get used to their presence and start to understand the idiosyncrasies of their job.

"Yes, I only work here in Cardiology."

She leans on the table which serves as a support for my bed, arms crossed, as if she were looking out from an observation deck.

"Do you know how many years I've worked here, in Santa Marta?" she asks, challengingly.

I put down my spoon, which had just begun its ascent towards my mouth, in order to concentrate on the question. She waits, smiling, with the triumphant air of someone that knows her opponent doesn't stand a chance.

"I don't know..." I hesitate, trying to win time. I guess her age (she can't be much more than twenty) and, in my head, subtract the minimum age you have to be to work legally. 

"Seven years?" I suggest warily so as to not suffer such a heavy defeat, deliberately overlooking the labour laws and universal rights of the child. 

"Fifteen years..." I am stunned, and she is elated at my incredulity. 

"But how come?" I ask, my spoon still hovering in the air. "How old are you, anyway?

"Twenty-two," she answers nonchalantly, as if my question is irrelevant to the conversation.

I start making up theories in my head. Is it possible she was one of those chronically ill children that are always in hospital and are slowly forgotten by their family, becoming a permanent fixture of the wards? No, not in this case. There’s no hint of sorrow in her smile, and her rosy face, lustrous as a ripe apple, cannot be that of an ex-hospital-specimen. She takes pity on me, with my appetite suspended and my food getting cold.

"My mother used to work here and so, when I was born, she started bringing me with her. In those days no one bothered about it. I used to play in the hospital gardens and corridors. I know every inch of it." 

"And you like working here..." I say, more as a conclusion than a question, putting an end to the mystery and the soup.

She nods wordlessly, as if to say she found her vocation within these thick walls as soon as she was born. Then she smiles and says: 

"Well, I have to go and see if anyone else needs me. I don't want to see any leftovers on your plate when I get back. You’d better eat it all. You're far too thin!"



    I had just finished having dinner and was lying on my bed, out of breath, resting from the effort it takes to eat a full meal and from the excitement of the evening visits, when there was a knock on the door and a voice asked if it could come in. I stuck my head round the curtain and saw someone approaching, dressed in the green uniform of a staff member. It was a woman I didn't know, who smiled a greeting and then circled the bed to sit on one of the arms of the black leather chair, facing me.   

"Who could this be?" I ask myself. I don't let this ignorance show, for I've grown used to receiving visits from kind colleagues or hospital employees who, using their scrubs and stethoscopes as passports, bring me news and compliments from some mutual acquaintance.

"How have you been?" she asked in a friendly tone, while I scan her up and down, comparing the image with others in the archives of my memory. Round face, short brown soft-looking hair, a beautiful face where a pair of intelligent eyes shine ("No, I don't know who this is”)... And then, in a sudden moment of illumination, I recognize her by the attractiveness of her round eyes, by her warm, piercing gaze.

"I know who you are," I shout out, satisfied with myself. "You're my anaesthetist. I knew I would recognize you by your eyes!" 







    Routine. From the flattened perspective of the patient, the thing that best characterizes a hospital is the rigid circuit of daily life. Routine. That’s the only way to keep such a place running, with hundreds of patients to be taken care of and hundreds of professionals to take care of them. Routines...

My day begins at eight o'clock when an ancillary (usually black) comes into my room and wordlessly turns on the lights and begins cleaning the floor with a cloth. My presence doesn’t bother her. It doesn’t even prevent her from cleaning the floor under the bed, as the bed has wheels, and all she needs to do is shove it a little. I get pushed around, of course. Then, when the job is finished, she goes out, leaving the light on.   

I'm just about to doze off again when a "good morning" disturbs the air around me and someone in a white overall checks my name on a piece of paper, before sticking a needle into my arm. They want to analyze my blood. Sometimes they are nice and ask me beforehand which arm I prefer. I shrug because, to be honest, I don't care - I've been jabbed so often and by so many people that I've become completely indifferent to where they choose to insert the needle. 

"Your veins are getting very hard," she comments, searching with her index finger for a suitable point. "I almost don't know where I should stick this needle!"

I managed to go back to sleep, but not for long. There's another cheery "good mor-ning", the light turns back on and a nurse comes forward armed with a small syringe. It's my daily dose of fraxiparine, a drug that is used for the same reason as vinegar is used in some Portuguese rice dishes - so that the blood doesn't thicken and coagulate. I get this injection in my belly, one day on the left-side of the bellybutton, the next day on the right. 

"What side was it yesterday?"

The syringe is tiny. Though the needle is short and the jab is small, it leaves a cold tingling sensation that lingers for a while. I stare up at the ceiling and gradually get caught up in the sound of Radio Nostalgia which someone has just turned on for the entire hospital. 

It's just gone nine o'clock. 


  Dawn is a feeling

  A beautiful ceiling...*


"Good mor-ning..." A nurse, exuding the kind of freshness that is only possible from someone who has just arrived at work, has come to take my blood pressure and temperature. She raises the upper part of the bed until I'm just about sitting up straight and puts the armband on me (the device is kept permanently there on the right of the bed). Then she shakes the thermometer, checks it and gives it to me. She goes out. The blood pressure meter is automatic and when she comes back it will present her with my pulse rate and blood pressure on a platter. I already know what she's going to say when she sees the red numbers on the display:

"Goodness! Your blood pressure is very low! Is it usually this low?"

"No," I'll say. "Before the operation it was normal."

Lulled by the music I feel myself drifting off again, until I hear the metallic clinking that signals wash time.

Despite the superficiality of the wash, this morning hygiene freshens me up, eliminating the sticky feeling that comes after a sweaty night with pyjamas glued to the body, and it arouses me to the pleasures of breakfast. 

Breakfast, lunch, tea, dinner, supper – these people spend their whole time giving us food. It is a kind of ritual which reminds me of intercontinental flights, where the attendants are constantly putting snacks, meals and aperitifs under your nose to break the tedious claustrophobic feeling of the unending journey. 

It's the same thing in hospital and my biorhythms are completely dependent on the kitchen's metronome. The food reaches the ward on big metallic trolleys (like on aeroplanes) and is distributed by Diana, Rosa, or whatever other ancillary happens to be on duty.

Breakfast and medication. The meal is almost always the same (linden tea, bread, jam, no butter, a piece of fruit) but the pills sometimes vary. I always ask about the unknown pill, the round salmon-coloured one in the plastic cup where they put the medication. At first the nurses used to hesitate when I asked them, but now that most of them know that I'm a doctor, they mostly indulge me. 

"It's the potassium supplement prescribed by Dr Garcia."

Relief. If it was prescribed by Dr Lucia Garcia, then it’s all right.

Between breakfast and lunch I take a small nap, entertain myself watching the commotion in the corridor and receive visits from the doctors. They come to the ward en masse at the end of the morning, after the beds have been made, the patients washed and fed, and the tests and other medical procedures used to assess the patients’ health recorded in the respective clinical files. 

Social visits are rare before lunch. The hospital takes care to concentrate the first round of visits precisely at lunch time, which is a useful strategy, as the family can keep the patient company while he eats (no one likes eating alone) and help out with simple tasks, like taking the skin off a piece of fruit or making sure a faltering spoonful of soup reaches its destination. In my case, I can get quite desperate just trying to peel an apple, believe it or not – not just because I don't have the shoulders or the arms for the task, nor because it's a long and tiring job, but also because the knives are extremely blunt! No, it’s certainly a well thought-out scheme.

Today's lunch consists of bits of roast turkey accompanied by potatoes and Brussels sprouts. It's all very nice. João, who hasn't had lunch yet, is sitting on the edge of the bed and is looking at me enviously, a little astonished at my ravenous appetite.

"Is it good?"

"Very good," I answer, my diction muffled by turkey.

"Can I try a bit?" she implores, longingly.   

Unlike in the morning, when no one lets you be, we are free to do as we please in the afternoons. I spend them reading Truman Capote and listening to Radio Nostalgia, either through the speaker on the ceiling, or, when I want to abstract myself from the ambient noise, through the headphones of the walkman my son Zé João has lent me.

I can't explain why I chose Truman Capote as my bedside-table writer for my hospital stay. Why this author and no other? It intrigues me... In the Torres Vedras Hospital I had other books at my disposal, but I couldn't get into any of them. I scarcely penetrated beyond the first few pages. And then suddenly, as if I was a pregnant woman, I got a craving for his journalistically refined and subtly poetic prose. I asked João to bring me his books, all that I had at home - Music for Chameleons, Answered Prayers, The Grass Harp - everything she could find on the bookshelf. 

Though I do it in bed too, I mostly read in the armchair as it's not so demanding on my arms and neck. I sit there with my right leg stretched out on a chair so as to save my poor heart (which must still be confused) the effort of having to pump blood against the force of gravity through a half-collapsed vein. 

When I get tired of reading, either because my brain starts melting over my eyelids or because the effort of holding the book open and turning its pages becomes too great, I recline the chair, put on my headphones and close my eyes for a small napIf I’m particularly drowsy, I drag myself towards the bed for a more heavy-duty rest. 

I would happily remain this way until lunch time, but someone is calling out my name, a chair is being dragged across the floor, or there is some other interference close to my body that obliges me look towards the door. I know what it is. Visitors!

They come in all shapes and sizes: short or tall, loud or quiet, carrying presents or empty-handed. Some of them move normally, others on tiptoe as if they were dancing Swan Lake. Some look at you as they always did, others look watery-eyed. In short, there are visitors to suit all tastes, but my current preference is for no visitors at all. 

I don't feel like seeing anyone, I don't know why. The good wishes sent by acquaintances don't mean a thing. And the personal messages from friends, which João brings every day, arouse no emotion in me. I hear their names mentioned, but I feel distant, detached. Something is different. It’s as of some vital a link to the world was broken in that attack my heart made upon me while claiming some foolish autonomy. 

Visitors. Their onset was insidious and I was unprepared, convinced that this would function as it did in the intensive care unit, where phone calls were not transmitted and there were strict controls over anyone that was not staff. That's how it was up there in outer space. But down here in the land of green broth, there was soon a steady procession of people coming to pay me homage.

Phone calls, one after the other. People constantly barging in through the open door, sometimes three at a time, using me as an excuse for small talk. It's normal, natural and well-intentioned – a sign that I have friends in this world. But it wears me out. I would lose my voice after each phone call, get drained after each visit and practically comatose when there were several people at the same time. 

I was saved from all this by the matron, whom I begged to defend me from these friendly onslaughts. She was sympathetic and experienced in such matters. All she needed was for me to confirm this was indeed what I wanted and to give a list of exceptions. From then on out she took care of the rest, like a zealous dragon. The telephone ceased to travel constantly towards my room, and I was asked to vet every unanticipated attempt to reach me. Thank God. There were some sulky reactions, of course, and some delicate diplomatic incidents which had to be carefully worked out. But I could handle the remorse.



    A slight anguish always lingers on inside me whenever João, after her dinner time visit, looks back over her shoulder and says goodbye, one last time, before walking out the door and disappearing until the next day. There goes my connection with the world, I think to myself, with that irretrievable sense of eternity that children and animals feel when the people they need are gone. And will there be a next day for me?

I dissipate this anguish behind the curtain that hides the washbasin, brushing my teeth with all the vigor I can muster. Just before I go to bed, I throw one last glance towards the window that looks out over God knows where. Night has leaned against the glass. Then I arrange my two pillows, make sure the book and the Walkman are within reach and lie down. 

Only at night time does a hospital become a private place. During the day it is more like a marketplace with people and things coming and going all the time. However, at night it is quiet; there's even something almost intimate about it. The visitors have gone, even the last few, the stubborn ones that want to come in after curfew and make the nurses lose their patience. Our common home closes itself to the outside and only we remain, the patients and the staff, floating through the night like a temporary foster family. 

In between dinner and supper I listen to music, read and, if I don't have my headphones on, keep an eye on the corridor for any disturbance, or get distracted by the conversation of the buddies in the next room. Stray dialogues drift in, fragmented recollections of what each has left behind, or more often than not, discussions of an overwhelmingly organic (rather than psychological) nature about things that affect all patients. Food, their difficulties in swallowing and the extravagances of the appetite. Sleep and their reluctance or inability to achieve it. Coughing – a little or a lot, dry or chesty, painful or easy. Tightness, palpitations, aches or tremors in the chest region. Urination, whether abundant or one drip at a time, whether white, yellow, orange or cloudy, whether it foams or not, if it smells... But the favorite topic of these exchanges – a topic that achieves a level of detail, richness and honesty only possible amongst this group of friends – is the bowel movement. 

Defecating, shitting, taking a dump – whatever term best suits one's susceptibility, the satisfaction of this basic physiological need is top on the list of most popular conversations in hospital wards. "How disgusting!" you might say. "They could entertain themselves with something more pleasant!" Ah... but this is the crux of the issue... the subject becomes obsessive when it's not being satisfactorily or pleasantly fulfilled. It's not as if patients are generally very demanding individuals - they adapt as best they can to whatever conditions are available. The performance of the act is, by itself, a complicated thing - without privacy, lying down, on top of an artefact which looks like a metal bidet that has been run over by a steamroller. And in a ward full of heart patients, you can add a lot more things, provoked by anxiety and fear, to this list of problems. We all have lazy intestines, either because we are confined to our beds and immobile, or due to the morphine which bungs you up dreadfully. All of us know that the physical effort that this specific act entails could aggravate our condition or even trigger another heart attack. There are guys who have ended up here for this very reason. It's a trauma you don't forget. 

Here in Santa Marta this is the obsession. A topic like this generates solidarity among the patients and between them and the staff that work here. In Torres Vedras Hospital it was the same thing, the same conversations, the same exorcistic jokes, the same hollow laughs, the same anxious glances at their bellies which, though tense like the skin of a drum, remained unmercifully silent. 

For one reason or another, my thoughts stray frequently onto the subject of Torres Vedras, to the people who took care of me there and, in particular, to my companions in the Special Care Unit. I think about them a lot. I wonder how António Luís is doing. Is he still there, still flirting with every pretty girl that looks after him – that looked after us? What about the engineer, Fidalgo, who so stubbornly rejected the concept and use of the bedpan? Where are they now? Are they alive? Are they all right? How many patients are there now in the Special Care Unit? Is Nurse Catarina working tonight, or is it Inês' shift? I have to look out all these people and find out how they're doing as soon as I get out of here. 

My daydream fades and I find myself nodding off, book partially closed between my fingers, the radio humming above me. The ward is practically empty. Dishes clatter a long way off – they must be finishing preparing supper.

I guess that, by now, the two on-duty nurses will be masquerading as masseuses in the work room – it's part of the daily routine. But don’t salivate! This metamorphosis is not very imaginative. They stick on some rubber gloves, grab some tubes of ointments that exude an old-fashioned arnica smell, and walk around from room to room offering back massages to the patients. The first time I witnessed this spectacle I was stunned, stunned by the quality of service offered by the hospital, by the thought, by the kindness, by the gentle patience of the girls after so many hours work. 

"Do you want a massage?" 

To this day, I still haven't had the courage to say yes. I become shy, fear I’m asking too much. I don't want to burden them with any more than the essential, which is already heavy and repetitive.

Then it’s time for supper, the evening medication; they take my temperature and blood pressure one last time. The music has been silenced, the lights in the rooms switched off. One patient or another makes a last request, a final complaint, like the children who put off going to bed for fear of the shadows magnified by the darkness. 

I don't complain or call anyone or ask for one last glass of water. But I cannot escape the sense of apprehension that falls over me as I lie in the darkness. The night is as old as this fear that something bad will happen before the sun once more lights up the tinted glass of the windows.

"That’s stupid," I mutter, wrapping myself in talisman-thoughts. "Why should the night be any different from the day?" I know this very well. It’s in the textbooks, illustrated with bar charts. The most dangerous period is dawn, just after sunrise. This is when life gives up, worn out by the challenge of facing a new day, as the blood pressure begins to rise. So it's stupid to get worked up. I calm down a little, but still resist, eyes shut, holding tightly onto this day that is drawing to a close. 

"It's absurd," I insist. "Why would my heart give out just because it's night? Tomorrow I'll wake up once more, and realize this was all a sterile waste of time."

But waking up the next day is no longer a certainty, a natural thing. Will tomorrow arrive for me? I never know. It's not evident. As the night flows on, I eventually give up on the question out of sheer exhaustion.



    Sometimes I awake in the middle of the night with the feeling that someone is in the room, that I'm being surreptitiously watched. It's a feeling that I would most definitely hate in any other situation. But here it just makes me half open an eye, confirm the presence and promptly go back to sleep, comforted and tranquil. It was just nurse passing by, checking on the patient in Bed 16, probably on her way to write a note on the state of my sleep in the book of occurrences. It could just as well have been an angel, an archangel, a cherub – it's all the same to me. Whatever it was, this beneficent being only slipped in, a fleeting shadow that dissipated at once. 








    After numerous warnings and a guided tour in which I was shown the various hazards and the whereabouts of the emergency alarm, I was finally allowed to take my first shower.

The door of the only bathroom that serves this section of the ward is one of those sliding things without a lock or latch – it slides closed and that's it! While I'm getting undressed I feel a little strange. I have the feeling someone could invade this space at any moment. But that's the very point! Under no circumstance is someone to get locked in, unreachable when in need of rapid intervention from outside. Hell, we are all heart patients, after all!

While I'm having my shower, with the warm water pouring down my back, and afterwards while I'm drying myself, I realize why they gave all those warnings. They were right to take so many precautions, though they seemed excessive at the time, a display of power and authority on the part of the people in charge of the ward. I forgive and am thankful for not being allowed to take a shower earlier. 

I'm so debilitated that the unexpected impact of the water is enough to make me falter. The effort involved in scrubbing my body, combined with the impact the heat has on my blood pressure, as well as the rarefied atmosphere of this minute bathroom, leave me feeling dizzy. In fact, the only reason I didn't fall, after the simple act of raising a leg to stick it in my pyjama trousers, was because I managed to support myself on the washbasin just in time. I'm relieved when I finally open the door and walk out into the corridor. On my way back to the room I muster up my nicest smile for the ancillary who had been hovering around the door of the bathroom while I was having my shower and who had knocked on the door a few times, just to make sure everything was all right. 

Little by little, most of the patients in the next room were replaced, having been either discharged or transferred somewhere else. This meant that Mr Cipriano Enguia was left without the hard core of his group - those that took his stories with a pinch of salt, and who brightened up his stay. You could tell he was suffering from this deterioration in his social condition just by using your ears. He has become whiny, confused, restless. He gives the staff double the work that he used to and spends his nights tossing and turning in bed, talking to himself, disturbing the whole section of the ward. 

What’s more, as if the disappearance of his companions weren't enough, destiny has admitted a new patient to the ward, apparently with the sole objective of baiting him - an individual who finds Mr Enguia the ideal target for his mean nature.  Though I've never seen this creature’s face, he puts my nerves on edge. He is constantly provoking the Alentejano into telling his muddled stories (the same stories that entertained everyone when they were told articulately), to which he responds with scorn and rudeness.

"Shut up, man. You’re talking a load of nonsense!"

This man's behavior and tone of voice repelled me so much that, just before lunch, I made a slow excursion to the end of the corridor, so that I would pass the door of the room next to mine and find out what kind of mug the personality belonged to. I didn't need to hear him speak to know who it was. There he was, stretched out on the bed, a tall chap, still young, with rough exaggerated features, somewhat reminiscent of Tom Waits or - for those who haven't seen this singer-songwriter’s face on the cover of one of his albums or in one his appearances in Francis Ford Coppola's films - one of those crude, sinister characters that accompanied Jesus in Hieronymus Bosch’s scene of him carrying the cross.  

On the way back to my room, I gave him the nastiest of looks, but to no avail. Shortly after this he was back at it again. 

"Hey, Mr. Cipriano, make an effort to sleep turned the other way tonight. Last night no one got any sleep with your snoring!"

A hateful person!

Zé João came to visit in the afternoon, bringing his grandmother with him. João, who showed up while I was having lunch, confirmed they were coming. This visit has been planned, scheduled, talked about over and over, and successively postponed by me. It disturbs me to think what may be going on in his head because of all this and I'd like to save him from seeing his father in this condition. It could affect him too much. I haven't seen him since the day the heart attack struck and felled me right in front of his eyes, leaving me to be dragged unconscious through the garden to the car. It was the first time he sat in the front seat without having to nag. No, I lie... I saw him for a minute or two on my birthday when he came and gave me a kiss in the Special Care Unit of Torres Vedras Hospital. Yes, it's true, I saw him briefly on that day. Now I recall the image of him standing before me - timid, in shorts, sitting still on the edge of the bed, slightly detached with a very serious look that implored, inarticulately: "When are you coming home? This is not where you belong."  

Because of all this, because of him, because of me, this imminent visit makes me nervous. But knowing I might be given permission to leave tomorrow, I can't postpone it any longer. 

And the visitors have arrived. One by one they come in through the door. My mother-in-law was the first, emotional but smiling, carrying a bunch of flowers from the garden in Cascais. They are already wilting in the heat, which is too caustic for flowers to be wandering around in. Just behind her are Zé João and his cousin, João Pedro, both washed, combed and buckled in preparation for a hospital visit. 

I'm sitting in my leather armchair with my right leg stretched out on a chair. I start removing the wires which connect me to the heart monitor so I can stand up and kiss them but my mother-in-law (it's the first time she's seen me since all of this happened) does her best to stop me, with eyes shiny and lips pursed to keep herself firm in front of the kids But I smile as if saying "No, I insist." 

She turns around swiftly and starts looking around the room for something she can put the flowers in.

"You'll have to manage with this," I tell her, pointing to the glass on my bedside table. "There's a tap over there, behind the curtain."

Just like the flowers that spill out of the glass, the three of them are standing still in front me, not comfortable enough to sit down in the two empty chairs. 

"Go on then, have a seat," I say, pushing in their direction the chair I had my leg on. "You're too tall standing up," I add, jokingly. 

My son has grown in these last two weeks. He's darker too.

"You're all tanned! Have you been to the beach?"

"No, we've been going every day to Aunt Nita's swimming pool..."

Zé João has a big wound halfway up his leg which I noticed as soon as he walked in. It's on the side of the tibia, an ugly flesh wound with a recent lumpy scab. I ask him how he got it.

"In Nita's swimming pool..."

“It must have hurt a lot when it happened."

He nods a "yes" and looks shyly down at the ground again.

"Let me see," I say. "Put your foot here, on the edge of the armchair, so I can have a good look."

After I've sat him down next to me and have checked his wound, after I've stroked the calf of his leg, he's more at ease. And while he's leaning on me, the wires and the clips on my chest start to catch his interest. 

"Do they hurt you?" he wants to know.

"No, but I've got more. I've also got a wound on my leg," I say, lifting up my pyjama legs. 

"How many are there?" he asks.

"Fifty-four or fifty-seven. To be honest, I'm not quite sure anymore. I counted them all on one day but I've forgotten the exact number."

Had my mother-in-law arrived a couple of hours later, Zé João wouldn't have had the chance to see his father stapled up this way. A young and friendly heart surgeon had come down from the heights of the upper floors – at Dr Lúcia Garcia's request, or so they told me – to begin removing the staples and wires of the provisional pacemaker, which I still have hanging from my chest, wrapped in gauze. 

"Let's do this then," says the doctor, putting on his gloves and wielding a small metallic object resembling a pair of nail scissors. A surgical staple is not much different from the kind you use on paper. Both consist of a bit of metal with sharp pointy bits that get driven in vertically and then join up whatever is separated - paper in the example I chose, skin in my case. There's also a difference in the material you're joining together when the time comes to take out the staple - the paper doesn't feel it!

Throughout the years I practiced surgery, most of them as my father's assistant, I applied staples to surgical incisions many a time. I even enjoyed it. It's the last step in an intervention that sometimes drags on for hours. After you get the hang of it, it's an easy task. Seeing the finished job is pleasing and, above all, it's much quicker than sewing with thread. To be honest, I put in far more staples than I ever took out. I'm not sure why – never got round to it I suppose. 

As for what the patient feels during the procedure... Hmm, I had never dwelled much on that. Having them put in doesn't hurt at all - I knew this - because it's done under anesthetic. Getting them taken out... I confess I started thinking about it, from the patient's perspective, hours before it was time to get them out - practically as soon as I saw them in the light of day. The thing is, fifty-something staples! Just the thought of it. What if removing just one is painful?

"No, this won't hurt at all," say the doctors. "You'll hardly notice."

Right. Hardly... But it happens that's my skin we're talking about here, theirs is completely theoretical in these situations!

Well, the tweezers were blunt, the surgeon was young and had probably put in far more staples than he had taken out - just like me. It stung like hell.

"Are you going to take them all out today? Isn't it too early? I thought you were only going to remove alternate ones. I'll have the chance to take the rest out in the place I'm going to, you know. All you need to do is tell me when," I started saying by the fourth one.

"That won't be necessary," he said, dutifully. "We'll take them all out now. But these tweezers feel a little strange..."

"But they're new, Dr," said the nurse who was assisting the procedure.

"Right..." the doctor acknowledged, seeing me shudder as he pulled out another one. "They might be new but they're rubbish! Go and get me another pair please."

While we were waiting the doctor took the opportunity to clean up the tiny spots of blood that marked the place where one of the metal points had left my skin in a more abrupt way. And I took the chance to discretely clean my eyes with the back of my hand – to avoid having to admit it brought tears to my eyes. 

With the second pair of tweezers the situation improved. Eventually I was staple-free and being smothered with Betadine.  

"This won't hurt at all," says the surgeon as he starts carefully unrolling the ball of wires belonging to the pacemaker. "You'll just feel slight pressure, something being pulled."

No, it didn't hurt. I can't say I suffered - I only felt discomfort, the kind a caterpillar must feel when it's yanked off the lettuce leaf it has its head buried in. I felt the invisible tips of the wires, the ones bound to my heart, shift suddenly on their way out, reluctantly abandoning the depths of my body, grabbing on with tiny arms that resisted this departure.   

"You see? That was easy!" commented the doctor with a smile. "Now all that's left are the silk sutures. But we'll take care of that on Monday or Tuesday."

Considering his work finished, he says goodbye with a friendly handshake and makes his way to the phone booth where, I can safely assume, an urgent message is waiting from the other super heroes - a ticket to a new adventure somewhere in outer space. 




    Today Dr Lúcia Garcia has been on duty the whole day. It must have been her shift. She was here in the morning (she came to see how I was doing, as usual), the whole afternoon (I saw her walking down the corridor from time to time) and after dinner (she smiled at me from afar as she came in through the door of the department, a smile as beautiful as a dessert). Maybe she's stuck here until the end of the night, when the next shift begins. For me it's a luxury having her around. It's true that there's always a doctor on watch in the ward. But Dr Garcia – who as well as being my doctor is also an attractive brunette – crosses my visual space with such frequency, intensity and dedication that it ends up giving me a comforting sense of calm. 

I can see everything that goes in and out of the unit from the comfort of my bed. Seconds after they come in through the door - the people, the food trolley, the stretchers and devices, everything that moves or is movable - they enter my field of vision and cross through this tiny strip of landscape I have before me, a space limited by the doorframe and the section of wall next to it that adds perspective. On this wall hangs an image of St Marta, with her hands over her heart, eyes set on ethereal beings. 

Unlike Dr Gil Seabra, who enters the Unit as if it were his first day at work, timid, walking close to the walls, as if he would ring the bell before coming in if there were one, Dr Garcia moves through the hospital like a fish swimming through water. You could say she was born for this. From the way she pushes open the door to the determined steps she takes down the corridor, it's all her own private aquarium. 

Are they really going to discharge me tomorrow? Judging by the way things are going, it seems so. However, they're never very clear about it. They don't tell you to get ready or to warn your family that you'll be coming home. Dr Garcia merely touched upon the subject the day before and we didn't mention it again. Not her, not me, nor any of the other doctors that came by afterwards. Not even the doctor who was here just now, ridding me of all the scrap metal that was still in my body, not even he said anything about it. No one... with the exception of the Burmese doctor.

"So... when are you leaving?" he asked in English.

I saw the Burmese doctor for the first time in the coronarography room, shadowing Dr Gil Seabra's every movement and observing everything with full attention. On Monday, when he came in through the door, he nodded to me in a friendly manner. And on Tuesday he came in to greet me and we stayed chatting for a while. I've seen him every day since, usually at the end of the morning, occasionally in the afternoon as well. I think he doesn't have many people to talk to and, on top of that, he doesn't speak Portuguese. He was born in Burma, but after he finished his degree in medicine, life led him to Macau where he did his specialty in cardiology. It so happens that Conde S. Januário Hospital - or the house on top of the hill, as the Chinese call it – can’t provide all the training required for the cardiology specialty. This means that the doctors in Macau have to fly to Portugal to complete it. 

Thirteen-hundred kilometers later he's here, in my room at the Santa Marta, for another short ceremonious festive visit.

"So...when are you leaving?" he asked yesterday, in English.

"Maybe on Friday," I answer, also in English. "At least that's what they told me."

"Oh! I see..."

We talk about Macau, Portugal and Burma, medicine, and health policy, west and east. We talk until he thinks he's reached the limit of his visit and, beckoned by some mysterious criteria, takes his leave.

"Are they really going to discharge me tomorrow?"

If so, this will be my last night here and I admit I feel somewhat apprehensive about it. There's a side of me that's scared of leaving, that would rather stay here where everything runs smoothly, where I feel safe. After all, I owe my life to these people, to the uninterrupted chain of them that have hauled me up the hill from Lourinhã Health Centre to Santa Marta Hospital. I find myself overcome with contradictory feelings - like the prisoner who feels anguish on the day of his release, who misses the cell and the guards he’s grown used to as the years went by and, deep inside him, is scared of the world which hasn't stopped turning. 

"Do you want a massage?"

Standing in front of me is a young male nurse in a short jacket, white trousers and white shoes, with a goatee that points in my direction like a small shaving brush. He's got his gloves on and an already extremely squeezed tube of ointment in one of his hands.

"Okay," I say, less intimidated by the fact that he isn't female. 

"Take off your jacket then and sit down over there," he instructs me, pointing to one of the chairs next to the wall.

Following his instructions, I sit down on the chair as if I'm riding a horse, with my back to him and my arms crossed on the back of the chair. 

The guy has fantastic hands. I can't believe the good this is doing me, such a simple thing, just two minutes after he starts working on my torso and neck. I become aware of the texture and positioning of my torso as they return to normal, after having been transformed by the surgery and by the nervous pressure on my muscles into a twisted heap of bone, muscle and tendons with a misleadingly human shape.

As I relax, I become more generous in my expressions of appreciation.

"You know what? With hands like that you should do this full time!"

Well, that was what he wanted too, to be (it doesn’t hurt to dream) a full-time masseur with a famous sports club.

I realize that I'm dealing with someone learned in the subject and decide to ask if he has heard of The Secret is in the Feet, a book which describes the correspondence between anatomical characteristics of the toes (a protuberance, a groove, a curvature) and a specific part of the body, exalting the marvels of the careful exploration of these relations and the harmony that can be generated by the careful massaging of each one.

The rhythmic passing of oiled hands on my back suddenly stopped. 

"Turn over, I'll give you a foot massage!" he says in a tone that is both enthusiastic and commanding.

Confused, feeling like I've already passed all the limits of hospital care, I mumble: "Hey, thanks a lot, but that's okay. That was excellent. I’m a new man..."

However, he won’t take no for an answer. 

"It was you that mentioned feet, wasn’t it? I want you to see...”

I'm stuck between the frying pan of being surprised by someone walking in suddenly and seeing a man entertaining himself with my feet (is Dr Garcia still working? imagine her face if she saw this!) and the fire of hurting this nurse's feelings. Like Cinderella, I timidly extend my left foot.

"What a fool!" I think to myself once the session is over, stretched out on the bed feeling rejuvenated. "The things I've been missing..."

Rosa brings in supper: biscuits, tea and the plastic cup containing my medication.

"I may be leaving tomorrow, did you know?" I tell her, somewhat sorrowfully.

"It's a sign you're better," she says in her pleasant pragmatic way. "I hope you’ll come and see us from time to time."

"Of course I will," I tell her with the solemnity of a boy scout on his graduation day.

"Eat up then. In a minute I'll come and get the tray and turn off the lights."

From the ceiling, Bobby Vinton sings in a sultry tone for the whole hospital:


                  She wore blue velvet

                  Bluer than velvet was the night

                  Softer than velvet was the light

                  From the stars...*






    I woke up early, looking for any alteration that might indicate that I'll be given permission to leave today.

But there's nothing, no sign of anything different. They take my blood as usual. The gentle pregnant woman who does the electrocardiograms makes her customary visit. The nurse gives me an injection in the tummy, gives me some clean pyjamas...

To burn up some time and see how my sense of balance is coming on, I decide to have a shower in the bathroom after warning Rosa. When I return, I relish my breakfast with the utmost calm - it's possibly my last meal in the hospital - and take my time around the washbasin, shaving my face and combing my hair. Maybe it's also the last time I'll look into this mirror, who knows?

"Mirror, mirror on the wall, will I get to leave at all?"

I sink down into my armchair, a book on my lap, I’m too excited to concentrate. My eyes constantly stray towards the open door, examining every microscopic change in the little strip of corridor that I can glimpse. 

João calls. She wants to know if she needs to pick me up, and at what time.

"I have no idea," I tell her apologetically. "No one tells me anything!"

"That's OK," she says. "I'll call you later. I'll bring you a dressing gown, a pair of shoes and two pairs of pyjamas anyway..."

"Two pairs!?"

"Yes, so you can choose whichever you think are cooler. Pedro, it's really very hot out here!"

Out there... To think that this may be about to become reality, that it may crystallize at any moment in the near future. It makes my insides shake and sends small shocks down my stomach and diaphragm. This is a kind of apotheosis, scaled down to size. Out there. As if the intricate scenery laboriously constructed about me by the events brought on by my illness has been slowly and imperceptibly taken down in an inverse but symmetrical procedure, step by step. I can see the last bits of scaffolding being removed, leading up to that final moment when, everything merges within me, and I'll be both observer and actor in an exciting picture - me, walking out of the ward on my own two feet. That is something I shouldn't rush.

Dr Garcia finally appears towards the end of the morning - barely giving me enough time to act cool - with a shining weekend-like expression.

"So, ready to leave?"

And as if I were, she starts telling me about things related to my discharge: medical advice ("Your potassium levels are still a bit too low. Eat bananas"), documents giving the landmarks of my medical-surgical adventure through the Santa Marta Hospital, assorted bits of information useful for a guy on the move. 

"It's better if you hold onto these yourself, it's safer. I'm also going to give you a letter describing your clinical condition, which you can pass on to my colleague in Torres Vedras"

"That would be great," I say gratefully. "I'd like to be able to give them all the details of my stay here."

She nods vigorously, opening and closing files, removing staples from papers and clipping others together. Her hair, which falls down over her face, dangling down as far as the table at the end of the bed, threatens to sweep away everything that she has patiently separated and ordered.  

Standing next to the bed, I watch all this as if it were the signing of an armistice. One of my nostrils is intrigued by the slight scent of tobacco which reaches me whenever she shakes her dark hair, but I forget this a moment later as she abruptly disappears out the door. 

"Where did she go?" I wonder. But she returns straight away, carrying some more papers which she folds and puts in a thick brown A4-sized envelope. 

"These are photocopies of your coronarography. I've also asked them to bring down the summary of the operation from upstairs. It should be here any moment. All that was missing was the surgeon's signature."

She frantically scribbles some more notes, tears sheets out of pads, sticks new ones into envelopes and, suddenly remembering something urgent, disappears once again out the door. 

Shortly after, Dr Gil Seabra comes by, announcing himself with a timid knock on the door. Fading until he's as pale as the bleached bedspread on which he sits, he slowly expands to fill one of the black holes left by Dr Garcia. He’s here to give the finishing touches and prepare for the future, as he is the doctor that will follow my case. 

"You'll be taking two types of medication from now on. You'll take these daily and for the long term: 100mg of aspirin at lunch time and 50mg of atenolol, half at breakfast and half at dinner."

He thrusts a paper into my hands.

"It's important that you take them regularly, without any lapses,” he adds, somewhat wearily. “It makes all the difference...".  

I'm so elated at having my shackles removed that I feel like I'm floating on a sea of sensations. The phrase "it makes all the difference" lingers, echoing through me like an important detail of something hypnotically resonant but which we do not dare to clarify. 

All I do is organize papers and envelopes on top of the bed. And while I'm doing this I realize, somewhat out of context, the incongruousness of the fact that all the cardiologists in this unit seem to be great smokers! I can tell every time one of them comes close to me, by the acrid smell of smoke, by an accusing yellowish finger.

"So these guys who are always preaching on about the evils of tobacco, who constantly have to deal with the sinister consequences of this addiction, they're at it themselves!" I think to myself, astonished.

"Come back in a month, all right? I've booked your appointment for 2nd August," he says, giving me yet another piece of paper.

I just stare at him, stupefied. In a month? Thirty days! That seems like an eternity without medical surveillance after all that has happened and all I've been through - a leap from one extreme to the other. I wasn't counting on this. I half expected them to put an electronic bracelet on me and install a video camera in my brain before letting me go! My feelings are ambivalent. I'm not sure if I should celebrate my freedom or cry at being orphaned like this. 

Wearing his famous Mona Lisa smile, Dr Gil Seabra holds out his hand and says goodbye with the gentlemanly formality he has always had with me.

"Goodbye, doctor, I wish you all the best... If you need anything, feel free to contact us..."

And he vanishes.

A little stunned by the whole thing, I make my way to the black leather chair. What now? Was that it? Should I understand Dr Gil's goodbye as permission to leave or is it only Dr Lucia Garcia that has the power to release me? Who do I belong to, now that I'm in no-man's-land, between the ward and the front door? To the doctor who will take care of my next outpatients appointment, or to the doctor that has supervised my stay inside? I am inclined towards the latter, but where has she gone? She comes in and out so often that I'm not sure if any of her exits should be considered the last!

In a hospital, when you're not sure, the best thing to do is ask one of the nurses, in case you do something wrong and get a scolding from someone important. They always have a solution and we feel more at ease with them – they hang around with the herd in a more laid-back way.

As if she has guessed my mind, in walks Dr Garcia, her neck still half-turned back, as she hurriedly arranges a leisurely lunch for the next day - roast pork, if I'm not mistaken.   

"You can go now, whenever you want," she says in the simplest of ways, with a clear smile on her face. 

I feel exposed. It's midday and I had arranged with João that she would call me around lunch time, to safely know what time she should pick me up. But I've already been dismissed!

"Do you think I can still have lunch here?" I ask her.

"Of course," she says, in her just slightly nasal voice. "Actually, it's nearly lunch time."

I had lunch and was in the process of packing up my belongings (which, to my shame, fit easily into a small paper bag), when João walked in looking hot and bothered, and bearing the pyjamas, a lovely blue silk dressing gown and a pair of borrowed shoes which don’t fit me, as my feet have grown used to the comfort of the hospital's Japanese-like slippers. I dressed myself as best I could. I put on the bottoms of the thinnest pair of pyjamas, kept on the hospital's slippers and put on the dressing gown, without anything underneath - wary of the scorching heat she had warned me of.

I'd never leave without saying goodbye to the staff in the unit. I'd like to be able to say goodbye to everyone I encountered, but that is impossible - unless I wanted to stick around for another couple of days awaiting the full rotation of the various shifts. However, I would at least thank and give my best wishes to the people who were working on this shift. Even that was hard! Everyone available was surrounding Mr. Cipriano Enguia, who had lost it completely and was railing at the nurses in the local vernacular as they tried to hold him down in order to given him the tranquillizer prescribed my Dr Lucia Garcia.  

Nurse Leonor came and joined us, raising her eyebrows at what we were hearing. She apologized.

"He's not all right..., and he's very strong! We can hardly hold him!"

I knew he wasn't all right and that the situation was falling apart exponentially. From my room, I had seen Mr Enguia several times walking silently down the corridor towards the door of the unit, making a bid for freedom in his pyjamas. And then, a nurse or an ancillary would come up behind him at full speed and, with the utmost patience, take him by the arm and gently try to persuade him back to bed. These attempts were generally successful, despite one or two not-so-patient interjections, only to be repeated fifteen minutes later.

After a small hesitation, brought on by the uninhibited inferiority of the patient's condition, I kissed Nurse Leonor goodbye and asked her to give my best wishes to everyone.

Feeling emotional, I looked back one last time at my room, at Bed 16, at the empty mattress, and then I left slowly, behind João who knew the way out. I stopped dead in my tracks..., amazed, for as soon as I take my first few steps out the door of the ward, I'm struck by the violent, white daylight coming from outside. I thought I had been incarcerated in the bowels of this thick building, on some upper floor, separated from the world by a labyrinth of stairs and corridors, when all this time I had been right next to the main entrance!

"Wait here while I get the car," said João, indicating a long bench by the entrance. I drop onto it, stunned by the intensity of the light and the heat it created. My God, I had no idea it was that hot, scorching! It was as if I was looking into the door of an oven, with wafts of warm air coming out, making the air undulate like a mirage by the motorway. But I suppose we were already in July.

"You’ve had open heart surgery, I see," said a voice, addressing me.    

I looked over. It was my nearest companion on the bench who spoke, a man in his fifties wearing pyjamas and a dressing gown like myself, who was staring with admiration and envy at my naked torso and swollen scar. 

"I'm going to have an operation next week," he continues. "Is it hard? They say it hurts quite a bit..."

"No, nothing you can't handle," I say reassuringly. "The first forty-eight hours are a little hard, but after that everything starts to run smoothly and it's over in an instant." Thus do I summarize my stay outside time stay in the Cardiothoracic Intensive Care Unit. 

Meanwhile, João has arrived with the car and is prudently pulling up in reverse. I gave the man a firm handshake, wished him all the best and got in to the back seat - avoiding the dangers of the front seat and, more importantly, the seatbelt over my chest and fresh scar. I closed the heavy door carefully and, keeping an arm out of the open window, waved like the Queen of England at the patients walking by or resting, in an orderly fashion like birds, on the long bench by the door of the hospital.

As we pass through the hospital gate, I feel sentimental. I imagine myself glancing back over my shoulder for one last look, but my neck and thorax are not what they used to be. By the time I give up on this attempt, João is speedily crossing some traffic lights which recently changed green. 








Part V



Beyond the traffic lights










    My convalescence was luxurious, floating in an ocean of soft lace pillows and silverware. I shepherded my weakness through rustling treetops, warbling blackbirds and the muffled noises of domestic life emanating from the floor below.  I had brought with me from the hospital not only the old disposable Japanese slippers, whose dilapidated appearance shocked my mother-in-law, as did my insistence on wearing them, but also the old terrycloth glove I used every day to clean myself, not to mention the tics of the hospital routine.

Every day I wake up at eight in the morning with the precision of a rooster. But instead of the black girl who used to nudge my bed so she could clean the floor beneath it, I perceive the enthusiastic light of a summer morning pounding on the heavy blind of the balcony door, inserting her fiery tongue through the gaps in it.

“Wake up,” she calls, peering into the room, her sparkling monocle trembling like jelly on the ceiling. “You’re alive. Can’t you see? Let me in...”

“You’re crazy!” I answer in a familiar manner. “I’d love to, but I must rest.”

“Come on, ” she urges, tempting me with a virtual projection of a bag of gold coins shining over the dark mahogany furniture, tickling the bezel of the mirror over the chest-of-drawers, “let me in.”

“I’m not allowed to do any isometric exercise[**]. My sternum is not yet welded. I need at least another three weeks,” I insist while carefully performing the manoeuvre that allows me to sit up on the bed. 

First, I roll over onto my right side by raising my legs and pointing my feet. Then I dig my right elbow against the mattress, while my left hand holds a small cushion against my chest in order to support my sutured sternum. And now, I slowly stiffen my elbow into a lever, gently raising my body while my arm and forearm work as a lift supported by my splayed right hand. I yelp a little, my bones complain, but here I am sitting on the edge of the bed.

Methodically, as I haven’t the strength to throw, I place half the arsenal of cushions that support me while I sleep onto the blue velvet armchair so as to fill in every little bit of space that doesn’t properly support my back and neck. Then I sit down, waiting for someone to come in. I’ve got an electric bell in my room which has had its cord extended and which everyone keeps trying to thrust into my hand. But since I’m not in a hurry and I don’t wish to disturb anyone, I decide to wait. Sitting in the dim light, I turn on the music centre and daydream about my breakfast, which should be arriving soon, I hope. 

The first few days I took my breakfast greedily in bed. But the crumbs, which seem the size of gravel when under your body, combined with the difficulty of balancing the tray on the soft mattress, the instability of a lap and, more importantly, the insoluble problem of how to arrange an arsenal of cutlery, plates and food conveniently, quickly made me seek out the blue armchair instead. Here I have the company of music on one side and, on the other, a small table with two shelves.  

In comes my mother-in-law with a cheerful “Good morning!” and a jug of freshly squeezed orange juice. Just behind her comes Mirna who is carrying a superb tray on her outstretched arms, full of natural food: slices of corn bread encrusted with sunflower seeds and some incredibly fresh slices of rye and wheat bread, all in a straw basket lined with an embroidered cloth. For spreading on the bread, apart from the classic salty butter (banned from Santa Marta), I can choose between bitter-orange marmalade, raspberry or cherry jam, and quince jelly; this last one a nightmare for the linen napkins. It slips off the bread, forcing me to lick my fingers, which I must admit, I’m all too happy to do. I’ve talked about the carbohydrates and the fats but have not yet mentioned the proteins. These come in the form of some slices, or triangles, of low calorie cheese, sometimes brightened by rosy slices of ham. Oh! And tea, decaffeinated tea on demand. Adding a tropical touch to the tray is also the bright yellow banana – a daily presence on the breakfast tray and directly supervised by my father-in-law who has taken it upon himself to monitor my potassium levels. My mother-in-law, a firm believer in the doctrine that fattening someone up is always a safe road to their recovery, fearing all of this may not be enough, sometimes adds a lump of walnut cake or – the healthier version – fruit cake.  

Endowed with a new gastronomic spirit, I attack it all until not a crumb is left on any plate – a pleasure to see! The scales will no doubt start to complain after a while, but for now, I’m not even back to my old 55 kg – I’m nothing but skin and bone as Rosa would say. 

When the tray and the last of the crockery is taken away, I lazily contemplate the books and – with a touch of boredom – the various cards and telegrams which have been accumulating on the lower shelf of the small table. 

“I’ll have to start answering these one of these days,” I think to myself, somewhat vaguely. “I must ask them to buy me some stamps.”

Comforted by this intention, I tune in to Radio 2. But they’re broadcasting a string quartet piece that is too excruciating for my current state of mind. I end up going back to the repetitive comfort of Radio Nostalgia and, leaning back in my armchair, I close my eyes and lull myself into a state inhabited by few thoughts. 







    It took time to recover my reflexive consciousness, the ability to perceive something as a whole, rather than as just an arrangement of parts. I lost my sense of time and, outside the temporal realm, was unable to analyse the part of my life which had drained away. 

The prolonged anaesthetic played havoc with my memory. For over a month, my long-term recollections failed me, and I was also unsure of mechanical things like phone numbers and the rigorous use of some words to refer to specific objects or situations. When I’d try to say a familiar phone number, I’d remember the numerical image of that group of figures, for example: 214835792.  But I wouldn’t be sure about the fourth figure; it seemed like an 8; but I couldn’t swear it wasn’t a 9. I’d start to doubt myself, like you do when you reach the last line of those luminous charts opticians have on the walls – the one with the miniscule letters. The same would happen with words. I could speak fluently, but from time to time a certain word would slip into the abyss, though I could glimpse its archetype floating in the back of my mind. And this would also happen a lot with people’s names. The people were there, but what on earth were they were called? The words were on the tip of my tongue, but there seemed to be a rubbish bin under it that was swallowing them all up! 

I felt bewildered like this for days, time and space acting as if they were shifting and unstable, with none of their usual solidity.

All of this had been most acute during my stay in the Intensive Care Unit of Cardiothoracic Surgery Department, where the sense of where I was positioned in space changed constantly. One minute it would seem like I was lying at the end of the huge room close to the wall; the next I felt as if I was in the middle of it; and then suddenly, without any transition, I would be right at the front, centre stage as it were. It was as if I was in a classroom, but switching desk every hour or so. And depending on the location, my awareness of my own state would also change. I was observant and serene, with some control over what was going on around me when I was at the end, close to the wall (this was actually the real position of my bed in the Unit); insecure when I felt myself floating in the middle of the room, with no fixed coordinates; confused and alarmed when I was transported to the proscenium, when I felt loose and meaningless, like an extra in some theatre-of-the-absurd play. 

Sometimes, reclining on the blue armchair during the hours I’m supposed to be taking a nap, I secretly flick through my old black diary which has returned to my pile of belongings, to my hands. I may look in detail at the calendar of 1999, at the months of May and July, the succession of weeks, the days that fill up those weeks, the correspondence between a numerical date and the particular day in the weekly cycle which makes it a Thursday or a Friday; or I may stare obstinately at a name and its corresponding phone number for minutes on end. My eyes are fixed there without recognition, gaping at the strangeness: the number because it doesn’t sound like it should, doesn’t slot into the unquestionable series of figures that I would once have recognized and dialled without batting an eyelid; the name because, even though it sounds like the name of an old and dear friend, I don’t feel that it is etched into me with the same definitive firmness that makes it obvious that my eyes are brown and my name is Pedro. The roots of belonging have been torn up and exposed! 

It seems that tomorrow (or the day after) two friends of mine, a couple, are coming to visit. They are friends, very dear friends, and have been for many years – an all-weather friendship. They live far away, several hundred kilometres, and are coming up specially. They’d been waiting for me to be discharged from the hospital, as I didn’t want anyone to visit me there. I can’t tell them not to come. But that’s what I feel like doing. I would rather not see them just yet. I’m not exactly sure why, but there’s a certain fear within me that I will have nothing to say to them, that I will be confronted by strangers, and that they will find themselves face-to-face with someone they don’t recognise and will leave saying “must’ve got the wrong door!”    








    I regret having to say this. I regret it deeply. I regret the disappointment the following lines are going to cause to sensitive hearts and well-intentioned minds, but it must be said. The worst thing about being ill isn’t the hospital, nor the pain or the doctors and their treatments. It’s not even the reheated food that reaches our lap after a long voyage from the basement. The worst thing about being ill is the visits!

On some other level of consciousness, I already knew that from my cancer days. But I think I forgot all about it. I remember feeling surprised, even a little shocked, when I discovered it in the initial phase of the disease – everyone wanted to know what was going on with me. I remember when I got home after my first chemo session, at around 5 o’clock, lying down on the bed, feeling sick as a dog, and hearing the phone innocently ring downstairs. Just as innocently, João picked it up and, bringing it in with her hand over the transmitter, asked me if I wanted to take it. I did – it was one of my sisters wanting to know how my first session had gone. She didn’t take long - “you must be tired and in need of a rest.” I was.... At the end of the call I put down the phone and closed my eyes. Shortly after, it rang again. Naively, I picked it up. And when I finally stopped answering phone calls it was midnight. I had interrupted dinner many times and had told the same story endlessly. And yes, I really was tired and in need of a rest.  

Things went on like this throughout my whole period of chemotherapy; and also during the twenty-five sessions of radiotherapy. I felt terrified every time the phone rang (I’d catch myself looking at it out of the corner of my eye when the poor thing was still and quiet), or whenever anyone waved to me and said they’d pay me a “little visit”. 

“What was the last thing I told you?” I began, every time I received a call, in an attempt to avoid repetition. I felt the narrative, as well as my role as protagonist, getting more and more unreal as time went by and the versions accumulated. 

I tell you, there’s a lot to say about visits!

When I had the heart attack it was like watching the same film all over again. But as usual with sequels, this time it was worse. It was worse, not only because of the objective circumstances of the illness (being dependent on other people and confined to bed), but also because of the unique nature of a heart attack and its aftermath. Later on, I met people who had gone exactly through the same ordeal.  

It’s normal for heart-attack survivors not to want visitors – as many chaps confided, torn between the guilt of feeling this way and the relief of having found another member of their sect. Survivors of a myocardial infarction do not want to see anyone, and each announcement of a visit (whether footsteps on the stairs or still in the form of an intention) – with the possible exception of very close family – is perceived as a threat, something that leaves us floundering in an anguished frenzy.

I speak for myself, obviously. But there were a good many souls that I heard of or who, in a hasty conversation, turned to me and made that old voiceless gesture where hands diverge, outspread, as if waving goodbye to the void:

“No one, do you understand? Absolutely no one! My mother-in-law walked out the door crying her eyes out...”

What causes this? Why might it be?

In my case, the phenomenon started right after my cardiac arrest, incipiently, with no great visibility, while I was still in my bed in Torres Vedras. The news took some time getting around. My family are discreet, and with João’s help, I even helped decide who had to be informed of what had happened, filtering out those that should, for now, be kept in blissful ignorance. 

In the aftermath of the surgery, in Santa Marta, I became brutally efficient at rejecting visits and began to perceive them as human rights abuses, violations of my privacy, as a threat to my very survival. It was there I assumed this obstinate borderline-pathological position on the matter and asked them to ignore all outside phone calls.

This attitude towards visits and phone calls, and the behaviour that came with it, extended throughout my convalescence with the same level of zero tolerance. And if there was any improvement, it was not of my own doing. Rather, it was due to the awareness that it was indecent, inhuman and senseless to continue blocking out, or abandoning at the end of a phone line, friends, people who were concerned about me and wanting to hear my voice in person as opposed to messages sent by third parties – especially as a few weeks had passed since the incident and that, as far as anyone knew, I was not unable to speak.  

“Tell him I’m not here...”

“What do you mean, that you’re not here?! You’re supposed to be unable to move!”

And there I was, irritable and without arguments, shaking my head at this phone being handed at me, feeling bad for rejecting the call, but knowing I would feel even worse if I took it and heard that voice I hadn’t heard for so long.  Reaching me from some remote place far away, no matter how banal or neutral its words were, I knew it would leave me shaking, gasping for air, unable to speak, with my back and pyjama top drenched in sweat as if I had just run a marathon, destined for a horizontal rest after the conversation ended.

What might this mean?

I don’t do it on purpose. It’s as if I’ve lost my connection to the rest of the world. And what’s even more serious, emotionally this doesn’t affect me at all. I’m empirically aware that the people I try hardest to avoid are those that can give me most news from the outside, from the world I used to move about in, particularly the professional context. I defend myself, I think, by saying I don’t care about anything. I’m fine where I am. News of what’s going on in the country, or in my own garden for that matter, does not interest me in the slightest. 

Why is it that I get so upset, so ravaged, by a mere phone call? Could it be an automatic defence mechanism? Could it be that my heart, through some artful conspiracy with my brain, is trying to avoid further stimulus that could make it beat at a rhythm that my survival instinct deems unadvisable?

At least I’ve been able to demonstrate experimentally here at home that there’s a correlation between phone calls and a drenched back, which was good because it helped me broaden the defence system protecting my privacy from the outside world. 

As arranged, the couple came to visit and, as they are special friends, my mother-in-law prepared tea, made a cake and served cold drinks. 

As I still have a bit of trouble keeping my neck straight, I received them stretched out on my bed, surrounded by a battalion of cushions; the scars on my chest coated with Betadine and shining in the afternoon sunlight, the right leg of my pyjama bottoms pulled up above my knee and a plastic bag full of ice balanced upon my ankle, mitigating the pain and swollen stitches around my saphenous vein.

I must have looked rather like The Nude Maja, Francis Bacon version, preparing myself for this confrontation while hearing them come up the stairs. I could hear the voice of Carlos D. complimenting my mother-in-law, commenting on the terrible heat wave that was making itself felt all over the country, fires breaking out everywhere. 

And here they are in my room, greeting me in a firm positive tone as if nothing had happened since the last time we were together, sitting down on the chairs my mother-in-law has put out for them in front of the bed. But as soon as door closes and it’s just the three of us left in the room they were unable to continue the act. Perhaps moved by the emotion of meeting a friend who had been close to the edge for so long and by the look of my body, their eyes, contrary to all convention and planning, started showing signs of tears.  

God! Though I now see it as beautiful and can serenely think back upon, it was at a time a huge shock. It was as if I had somehow had been split in two and was witnessing my own wake – the live demonstration of the sad creature I had become. 

I disguised it of course, taking on the role of the host, asking questions about this and that (“... What about So-and-So? What’s he been up to?”) while they composed themselves and discreetly wiped their eyes.

They stayed for some time, wanting to leave after a while so as to not tire me out, while I, out of enjoyment and courage, insisted that they stay for a while longer so that they could leave with a more satisfactory impression of me and my progress.  

When my mother-in-law, after showing them the door, came back into the room to collect the dishes, she found me collapsed on the bed as if I had passed out, breathing heavily, my pyjama jacket glued to my back, drenched in sweat and with a thin brown line of Betadine and sweat running down from the stitches on my sternum.

They gave me sugar water, took my blood pressure, rearranged my pillows and gave me a scolding for having had such a long visit. All in all, everyone got a big fright.

But after all, what had happened? What provoked that crisis? Visits! Visits, not the noblesse oblige type, with gentle nodding, restrained voices and teapot-spout pouts - those I could handle reasonably well, apart from the tiredness – but the visits from friends, close friends. It may be hard to believe, but I was too weak to endure intense and prolonged emotion.   

In the midst of all this confusion between friends and acquaintances, I took some time to understand the delicate nuances hidden behind this syndrome;

“He’s lost it – he doesn’t want to see anyone!”

On the one hand, he wants to be alone, to go through what he had to go through in the way it must be done – alone, as some of life’s experiences cannot be delegated. On the other hand, what a surprise he got when he discovered the implications… For the guy’s been through a terminal experience. After all, mate, he actually died! 

And so for each person I met, I was forced to start the relationship all over again from scratch. It was like being reborn, and it proved to be much harder with those I knew well than with mere acquaintances.  







    After few days, I began venturing downstairs, so I could have my main meals with the rest of the family. 

It’s a long way - there are two flights of stairs – and, strange as it might sound, going down to the living room is trickier than coming back up to my room. Maybe it’s the vertigo caused by all those steps unrolling before my eyes, or the insecurity of my body, constantly needing assistance from someone two steps ahead of me while I go down, step by step, my hand using the wall for support.

It’s July. The school holidays have started and the house is full of people. Zé João and his cousins are here, as well as two friends he has brought along with him – all under the benevolent gaze of my mother-in-law, who loves having the house full of people. The atmosphere around the lunch table is noisy and boisterous, though in an acceptable way. The doors that lead out on to the large balcony are permanently open, and down below in the garden not a single breath of air stirs the heavy calmness of the burning summer, which makes the vegetation shy during the day and thoughtful during the night. 

Despite my willingness and somewhat incredulous satisfaction at being able to share in this clear rich world, the truth is, I’m still too frail to cope with big crowds of people. So, as soon as the meal ends, I return to my room, escorted by attentive eyes as I make the slow journey up the stairs.   

I still need help in practically everything – for taking my temperature (I haven’t got the strength, or the muscular support, to make a movement as simple as shaking the thermometer to loosen the mercury), disinfecting the stitches on my leg with Betadine, or putting on the elastic stocking which compresses my swollen leg, especially sore around the ankle (a torture made worse by the scorching heat).  

The only things I can do on my own, besides eating and turning the pages of a book, are shaving and taking a bath, and even these I must do with care. I take a shower seated on a wooden chair, strategically placed beneath the nozzle. It feels good. I can relax as I scrub my body, and I don’t have to worry about the dizziness I’d feel if I were standing up with the pressure of the water coming down on me, especially considering I must close my eyes to wash my hair. 

I bathe, dry myself off, shave and use a disinfected cotton swab to clean the stitches on my chest, and lo and behold! there goes all the energy I accumulated over night! I pad back to my room and drop into the armchair (metaphorically of course, I always do it in slow motion), panting, overcome with a deep exhaustion. But it’s not all bad. I can hear the joyful clinking of my breakfast tray approaching. I don’t think about anything else but food, it’s incredible! An hour after finishing a meal thoughts of the next one start to assault me. I try to guess whether it’s meat or fish by the rarefied smells that waft up the stairs or reach me via the balcony. I didn’t used to be like this; eating was little more than a necessity that had to be fulfilled. I was never the type that would travel 100 km just to gorge on some regional speciality. But now... I’m finally beginning to understand fat people, their compulsive need to stick food into their mouths, the angst of an empty stomach. Why might this be? Was it the hospital rations? No, that’s not true. In Santa Marta the food was good and plentiful. Could it be that, given my current state, eating is the only pleasure I have left? I don’t know. What I do know is that my days pass in the intervals between meals. Sitting on my blue armchair, a book lying open on my lap, Radio Nostalgia playing beside me, I stare dreamily out of the open windows and, taking in the morning light, I think to myself: “I wonder what’s for lunch?”

From the balcony the horizon is dotted with trees – the top of a big acacia, the vivid pomegranate red of a bougainvillea and the dark green of pine trees. Despite this, Zé João and João Pedro thought I needed more personalized vegetal company, and so dragged in a big pot plant from the garden. They set it on the tiled floor of the balcony, next to one of the panes of the glass door, so that I could enjoy its presence without any effort, whether I’m lying on the bed or sitting in the armchair.  

It’s a curious plant and I quickly grew fond of it, as if it were a pet. It’s about a meter in height, has pointed – though banal - leaves, but it boasts some delicate violet flowers, each with 5 petals joined together like the sections of a beach parasol, punctuated with a velvety peppery touch of yellow in the centre. I found a label attached to the stem, which gave me its name (it’s a Solanumrotaneli!), and described at length the heliotropic properties of the flowers. From early in the morning until the end of the afternoon, the flowers open up with the amplitude and orientation of parasols on a beach café terrace, but as soon as the sun starts to set, they close up like umbrellas on a coat-stand. 

With a furious appetite that had first manifested itself in Santa Marta for reasons that still elude me, I continue to read only Truman Capote. Now I’m reading In Cold Blood. However, I’ve made a truce with the book in order to finally start answering the pile of mail which has been accumulating since the first day I got ill and which doesn’t stop growing. It’s as if Father Christmas has got his dates wrong: telegrams, cards, letters, books, assorted presents – every day something new comes in the mail.    

Sitting in the armchair surrounded by cushions, with one leg stretched out on a chair and the omnipresent ice pack dripping all over the Turkish towel wrapped around it, I try to order the letters I have on the small table by date of arrival. Some of these are over a month old. They’ve been yellowing at my side since my days at Torres Vedras Hospital.

With a clipboard on my lap and a pack of envelopes accompanied by a roll of stamps, I write the first line of my thank-you letter. It takes an unexpected amount of effort, as if I hadn’t picked up a pen since primary school and had forgotten the required hand movements. I’m astonished, but persist. I finished the note, now for the envelope – sender, receiver, address, post code and city. And I stop, ravaged. The muscles in my forearm are aching, my hand feels heavy, my breathing has altered and my back is sweaty.

I give up for now. If I continue at this rate I won’t finish answering these before Christmas!

Leaning back with my eyes closed, I consider, still somewhat surprised, the various aspects of my debilitated physical state: my voice, which after a few minutes of use, becomes a thin squeak; my sluggish capacity to perform the most banal tasks, like brushing my teeth, shaving, having a conversation on the phone, writing a letter. Like my friend Carlos D. would say, I’m a husk of my former self. In a month I’ve aged thirty years!

With or without a mirror, I take stock of myself, flabbergasted. But perhaps the man in the mirror is not so wrinkled after all, not so prematurely senile. Despite my wounds and scars I look reasonably like I used to. And, above all, my physical weakness, although stiflingly depressing, doesn’t suit my mental state, doesn’t quite fit the flame that burns within me or the constant breeze that wafts through my memory, or that ancient voice that continually whispers: “today is one day, tomorrow will be another. You’ll try again then. Maybe it will be better”. 

“It’ll get better, things will get better,” I tell myself confidently, while trying to identify and nurture any little detail which distinguishes itself as positive. 



    One day I was having dinner when suddenly I noticed that my hands had become sweaty for no apparent reason. This sign was accompanied by a small thud - a single wrong note making itself heard within a rhapsody. But as the whole episode lasted less than a second I didn’t worry about it, and mentally filed it as a new facet of my post-heart-attack personality. In noisy crowded atmospheres, especially in closed places, I get a bit claustrophobic, a feeling of being walled in, which gives me the urge to open a window or run outside to breathe the open air. That’s to say, I didn’t pay any attention. 

Later on that evening, some time after this incident, I was coming out of the bathroom when I was suddenly overcome by huge wave of queasiness, which attacked me from all sides. The four lights in the corridor grew dim, my vision clouded over, a cold shiver slid down my spine, a feeling of nausea crept up from my stomach and – that old terrifying sign – I became drenched in sweat, as if from the springs that bubble onto the sand far from the breaking of the waves.   

With the sense of an imminent fall which accompanied all this, I leaned up against the glass doors of the shelves which run along most of the corridor and, somehow, managed to reach my room, lurching sideways onto the bed. I was alone upstairs and so hampered by the fall that I didn’t even see the emergency bell, let alone remember it. And so I remained, waiting with one hand over my chest, trying to calm my fearful palpitating heart.

I was found by my brother-in-law who had come upstairs to wish me a good night. He froze when he saw me, when he saw my pallor...

“... utterly white – I thought that was it!” he confessed later on, traumatized by the scene and by his own feelings of helplessness about what should happen next. I asked him to look in the chest of drawers, among the papers in the first drawer, for a large envelope which should have Santa Marta Hospital’s numbers above a green logo. What followed took several minutes. In his agitation he couldn’t find the envelope, he forgot there wasn’t a phone in the room and that it was necessary to get a mobile phone, but more importantly, he didn’t know who to call and what to say.

Time passed, I had put a big cushion under my legs (to keep them high and to let the blood flow to my head) and despite the giddiness, started to feel better. The sweating had stopped, my vision improved and the room was once again perceptible. So I ended up calling the number myself, asking to be put through to the Cardiology Intensive Care Unit and from there on to the doctor on call, a name I didn’t know. 

When I finally talked to him and explained who I was, that I had had a double by-pass two weeks ago and had been in Bed 16, he knew who I was:

“Oh, I know. You’re the chap from Torres Vedras.”

Anguished, I explained what was wrong – the symptoms, the signs.

“What’s your blood pressure at the moment?” he asked me from the end of the line.

God knows what my blood pressure is! There wasn’t a machine in the house and mine was far away in my house at the coast .

Then he wanted to know what I was taking and recommended I reduce the amount of atenolol – the drug I take to keep my heart placid, but which others take to control high blood pressure. It’s a drug with multiple virtues and multiple inconveniences.  

“It sounds like hypotension,” he went on, totally calm. “After heart surgery, blood pressure is always very low, and the situation’s aggravated by the almost complete absence of movement, together with the beta-blocker.”

“Then you don’t think I’m going to die suddenly?” I asked humorously, yet extremely serious. 

“No!” he answered, laughing kindly. “Have something salty to eat, reduce your intake of atenolol to half and keep checking your blood pressure and your pulse.”

After a very sugary tea, some crackers with cheese, and a handful of salted and toasted cashews, I slept like a baby. 

The next day João bought a completely automatic blood pressure and pulse monitoring device and we had the chance to numerically confirm my miserable state. My old blood pressure of 80/120 mm Hg had gone down the drain; the best I could muster was a minimum of 60 and a maximum of 80, and it was sometimes much lower! 

The episode of the nocturnal crisis, told in a terrified tone by a shocked brother-in-law, had a fatal effect on my day-to-day living. Such was the increase in attention given to me that I almost began to miss the relative indifference with which I was left for hours alone in Bed 16 at Santa Marta. And as the problem had been identified, my blood pressure level became an object of public interest; the oscillations in my minimum level were discussed daily like Stock Market prices. 

If this wasn’t enough, the crisis recurred (once, twice, three times) in front of everyone, which contributed to the snowball effect. For example, once, while I was having dinner, I had just finished my soup when I began feeling the heat building up within me. My face became devoid of expression. From one moment to the next everyone was aware of the change, and there was an expectant worried silence in the room while I tried to get up any way I could, asking permission to leave the table, leaving my dinner half eaten and staggering over to the sofa at the end of the room or, if I could manage, to the refuge of my room upstairs.

It’s night, or at least it seems so from the closed blinds and curtains. I’m lying on the bed, head down and legs up, chewing on the therapeutic salted peanuts, resting from another crisis that happened while I was downstairs. There is someone sitting in semi-darkness on the blue armchair at the end of my room, someone who didn’t finish their dinner and is here, overseeing my recovery. As always, the return to the surface of consciousness begins with the startled perception of the space around me. It’s a mix of comforting recognition of a familiar place and the disturbing presence of some details that during the day, and in a normal situation, don’t stand out in the room. As my body awakens, I feel my head throbbing and my back aching. I stare, totally absorbed, at the three lacquered wooden boards of the bedroom door, each of which has a little golden frame that projects itself in a peculiar way. I get it; this happens with every detail I perceive under these circumstances. For days it will keep a suspiciously high profile, rather ostentatious for an inanimate object. 

I’m concerned about these variations in blood pressure. I’m afraid it means I’m regressing. Even though the doctor from Santa Marta didn’t pay it much attention, these episodes cast a shadow over my convalescence, sap my confidence, make me apprehensive. 

“After heart surgery, blood pressure is always very low. The almost complete absence of movement, together with the beta-blocker, aggravates the situation...” he told me on the phone.

As for the beta-blocker, the research is done and the corrective measures have been put in place. I have reduced the dose by half, as he told me to. But still, the half tablet I take each morning is quite devastating. I feel it starting to take effect after an hour and reaching its peak after three. It’s as if it opens a tap within me that drains me of all energy. It makes me lazy, jaded and sleepy. My throat goes dry and my voice grows weak; my eyeballs seem to lack lubrication, making my eyes squeak every time I look around. Because of this, and because I’m already taking a child-like amount, I practise the microscopic task of breaking the half-tablet in half again, and start taking it in quarters. The strategy works – the crises happen less often and show signs of weakening.  

I give some of the credit to my very peculiar form of physical exercise, which I do to stimulate my circulation and contradict the “absence of movement”. In pyjamas and dressing-gown, barefoot so as to not be hampered by slippers, I go for little walks, then hikes, then marathons in the corridor that runs along the upper floor, or downstairs in the big room, making my way round the enormous dining table countless times, each day more energetically. 

“You’ve been walking for almost an hour,” says my mother-in-law, timing my performance and happy to see me doing exercise.

And for whatever reason, whether it’s the actual exercise or the mental challenge of fulfilling these goals, I make a visible improvement. The blood-pressure machine is not yet covered in dust and cobwebs, but at least it’s only taken out of the box a couple of times a day, once in the morning and again at night.  





    It shook me, I confess it did. Little by little, throughout those nights lying on a hospital bed and also later, during the insomnias of convalescence; as the dust settled, I slowly gathered and put together the collected fragments, first editing the film and then watching and rewinding it endless times.  

Similarly when I look in the mirror and, taken aback by what I see, contemplate my new body, covered with scars from head to toe – a couple of screws in my head (and, maybe, size 16 feet) and I’d be Frankenstein. And just like him on a stormy night, my vital breath is dependent on electricity, or on second thought, on the energy companies!

Various aspects shook me. Firstly, it shook me the way in which, in less than three years, I was chewed up by cancer and, immediately after, without having time to fold everything into the drawers of memory, I was devastated by a heart-attack and a terminal experience which ran me over like a freight train. It’s too much for me to handle, I dare say, for anyone to handle. I feel a sort of irritation for this special interest the grim reaper has taken in me: what the hell, and there’s so many people in the world 

Secondly, the simplicity of the matter, of death. It’s not just its sudden character, the candle being blown out cliché, the type of conversation you have with someone in a lift. No. The simplicity, the lack of metaphysics, the lack of atmosphere, the anti-glamour (even if it is sinister). Nothing... The sun shines, cars go, the glass  empties, the birds sing, the ocean exists. Nothing changes. The construction of mystery, that special moment, the merit, it is all our own creation. Shocking!   




    The hardest part, here as well as in the hospital, continues to be the long nights. 

The mornings, magnificent summer mornings, have a contagious vitality. Their freshness makes my blood circulate optimistically. 

In the evening, I make my way upstairs right after finishing dinner; walking down the stairs, eating, chatting and giving attention to what is going on, tire me out in such a way that I yearn for tranquillity, the silence of the bedroom where I can limit the surrounding stimuli by turning a button on the sound system, or closing a book. Simple. 

I always put off going to bed definitively, my definitive bedtime, that moment when the lights are turned off and I’m left alone with my buttons. Usually I read a little on the blue armchair, with the radio on in the background, until I grow tired of sitting. Then I read a little more in bed, until my back or my arms begin to hurt.

When it’s time to turn off the light I get Joao to give me a back massage, if she’s around that is. By the end of the day my bones and muscles cause me tremendous anxiety. It’s purely physical, but as distressing as the most diaphanous anguish can be. It was in Santa Marta that I realized how a back and neck massage can relieve that tension and give back some perceivable calm to a tense body.   

Right after this, taking advantage of my drowsiness to stretch out, I lye down on an ocean of pillows: one underneath my head; another supporting the spans of my neck; a third one between my back and the mattress preventing my body from becoming too heavy for my recently mended bones; yet another one, big and heavy at the end of the bed, keeping my right leg above the level of the mattress and insuring the venous drainage flows properly and that the pain in my ankle doesn’t worsen due to blood stasis; and lastly, I keep a minuscule, doll’s-housesized cushion tight against my chest to softly compress my sternum in case I make an unplanned movement during the night.  

This entire process takes a lifetime. From a sitting to a lying position: my sternum won’t take a sudden movement, and even when I go down extremely slowly, it’s as if it will break in two, dragging along with it my disjointed ribs and clavicles. Being an old hand, I moan ouch-ouch-ouch as I perform the manoeuvre. This may not be very effective, but it does give relief and distracts from the pain. Finally, I turn off the light. 

I have trouble falling asleep. I always have trouble falling asleep. The uncertainty of waking up alive the next day hasn’t abandoned me: waking up alive isn’t yet as natural as being hungry or thirsty. 




    Calling up Torres Vedras Hospital. I was meaning to this ever since my final days in Santa Marta. It was an obsession, as if a part my family had had no news of me. And precisely the branch of the clan which had seen my rebirth and, on a bright S. John’s morning, had seen me leave and not return for dinner. 

So, one morning, with quivering fingers, I called a number I had never dialled before. Automatically, as soon as they answered, I asked for Nurse Catarina. She wasn’t there: she was on holiday. What about Nurse Inês? Also not...

“Can you tell me if there’s a man called António Luís in the Special Care Unit, by any chance?”

“We can’t give patients’ clinical details,” answered the voice, while becoming cold and impersonal. “Who is this?”

I decided to explain: I had been an inpatient in the hospital, a guest in the bed right next to the door; I had gone to Santa Marta to have an operation; António Luís had been a companion in the ward. 

“Oh, is that Dr Pedro?” asks the unknown voice with a ‘you should have said’ tone, “this is Nurse Salomé.”

And I found out António Luís had been discharged and had gone home, that everything had ended well; and that Catarina would be back from her holiday next week. I hung up the phone, my back sweaty from the emotion that one feels after making a long-distance call back home. 

A few days later I call again so as to complete the incomplete mission. I wanted to say hello to Catarina, let her hear the living voice of her patient who was lost in Santa Marta (a “thank you very much” camouflaged in my intentions).

And this time it was she who answered, in a voice that sounded frail to me, despite the satisfaction for having received the call:

“We knew everything that had happened to you,” she revealed, in response to my news. “Dr Varanda and Dr Brito have been in constant contact with Santa Marta Hospital, they’ve kept us up to date.”

“What about you, Catarina? How are you doing?”

And then I found out the reason for her sad tone: during her holiday, suddenly, unexpectedly, her father had died; most likely a heart problem. 

“It was a very big shock,” she said. “But what worries me most is my mother, she is very shaken.”




   Last night I dreamt about my mother. The scenario had become indistinct by the morning, as is usually the case with dreams, but it left a deep furrow, a strong impression.

Somewhere, halfway down a long basement corridor, someone handed me a phone – one of those that are attached to the wall – a white phone, on the end of an also white, stretched line.

“Here. It’s for you.”

I answered and immediately recognized my mother’s voice, even though she was disguising it and pretending to be my cousin Heitor. 

“Poor thing,” I thought. “She doesn’t want to trouble me by being dead and making a phone call at the same time.”

“Pedro?” she asked me in a camouflaged voice which reached me full of interference. “I have something very important to tell you...”

Immediately after this introduction, and accompanied by a few strange noises of interference and loss of signal, the call dropped, leaving only a faint high-pitched sound coming from the phone. 

I was sitting on the blue armchair having breakfast, still feeling perturbed by the dream, when João arrived. After beating around the bush for a while she decided to say:

“I have something sad to tell you... I had decided not to, so as not to bother you, but I think I better should. It’ll be worse if you find out later on, when it’s too late to do anything. Uncle Mário has died...”

“When?” I asked immediately.

“He died yesterday. The funeral is going to be today, at the end of the morning.”

I spent the rest of day whimpering, in instalments, taking advantage of the moments in which I found myself alone in my room. Uncle Mário was my favourite uncle, one of those younger uncles who is idolised by his nephews. The last time I had seen him had been about two months ago. He was sitting in an armchair like the one I’m sitting on now. He had that terrible emaciated look of a person who has a foul disease. And I had found out only minutes before that my suspicions about his diagnosis had been confirmed. My distressed cousin had told me just before I went up the stairs and into the room where he sat watching TV:

“My father has lung cancer...”

The whole sequence, starting with that dream, had an awful impact on my already ravaged general condition: death in itself, its news; the warning my mother had given me which I inevitably associated to this event.

Death, death, death. This year has been a bundle of joy! 




    After one month, on the 2nd of August, I returned to Santa Marta for the consultation that had been booked on the day I was discharged.

It’s nine in the morning and a scorching day. João left me by the entrance of the hospital and went off to park the car – a difficult task in this area, even in August with most of the city on holiday. 

I slowly make my way across the garden, hardly recognizing this unyielding landscape and its objects as the place where I came, what seems to me like an eternity ago, for quick check-up of the coronary arteries.  

In front of me a female doctor slowly walks (there she goes with the black rubber cord of the stethoscope just about visible in the pocket of her overall) and, sensing the gravel crackling behind her, she turns round, her stare becoming instantly anodyne.

“Look who it is,” I think to myself, having fun in this role of invisible man. This lady had visited me one evening in Santa Marta – before that I had never seen her. She had introduced herself as a friend of a friend and had stuck around for a slow but entertaining hour watching me eat and delivering friendly messages; listing clichés on life, illness, and how the latter – like a felt tip pen – highlights what is most important about the former.    

Amused by this reminiscence, I increase my pace, overtake her, and look back for a measure of time, making sure she gets a good look at my features. Nothing..., not even a nod!

Still in the garden, on the ramp leading to the entrance through which I left the hospital on the day I was discharged, I passed a boy indolently pushing one of the hospital’s rubbish bins, an ancillary I have some recollection of from the Cardiothoracic Surgery’s Intensive Care Unit. I have an image in my memory, fresh as a Polaroid, of him and a colleague – in a Maoist like choreography – laying a clean sheet over my body. I looked at him intensely. Nothing, not the slightest sign of recognition.     

Sensing that the flickering emotions which I had woken up were starting to dull over, I made my way towards the door. A group of people were coming out, probably from the night shift. Open-mouthed, I recognize Nurse Patrícia talking to a friend. She’s the blonde with intensely blue eyes who massaged Senhor Alberto so compassionately, and who, just a month ago, had given me and João a long and spirited account of the workings of her beloved Intensive Care Unit – the place where no one died easily. But my mouth won’t close: Patrícia - who walks straight past me without noticing my existence – is wearing glasses! She’s wearing a pair of prescription glasses with white lenses and a black frame! But... how can it be? She didn’t use any glasses up there, while she worked – gliding through the Unit without her overalls, nothing worth adding to her Hollywood doll-like figure. My God, I conclude enlightened, she takes her glasses off for work! On stage she strengthens her image, refines her beauty.      

Stunned, I watch her disappear round a bend and go in through the large door of the hospital. I notice that a woman passing by looks at me and then gives me the faintest of nods. Yes, hello, I know who you are. It’s a young Doctor from the cardiology unit who one day, on the side of Bed 16, wistfully informed me:

“I would love to listen to your heart, but it seems like you have visitors all the time!”

There we go! At least one or two people in the cardiology unit still remember me, and one of them is Dr Gil Seabra, the one who sent me here. 

“So?” asks João when she joins me later in the outpatients waiting room. 

“No one recognized me!” I answer dismally. 

“Not that. What did the doctor say?”

“Oh..., he says everything is fine. I have to come back in October to do a stress test.”

“Did you tell him about your blood pressure problems? 

“Yes. He didn’t give it much importance.”

The next day, fulfilling a mental promise I had made myself that I would begin venturing out of the house once I received the doctors’ blessing, I went for my first walk. 

“Yes,” Dr Gil had said. “Walk. Walk a lot. It’s excellent exercise for the heart.”

Everything I do is a celebration of my return to the world – getting dressed and putting my shoes on (I can’t remember wearing anything other than pyjamas, a dressing gown and slippers), saying goodbye with a “see you later”, sitting down in a car, walking in the streets, watching the traffic, all the people...

João parked the car in the shade of some palm trees, at the top of the wide avenue that goes all the way down to the bay of Cascais. And here we go, following the small wall that runs alongside the path and the incredible view over the sea, stretching all the way to the other side of the river. A glorious day, all blue and gold.

For the first time I realize the brutal transformation my body has suffered. I feel like I have aged forty years in no time. I walk hesitantly, slowly, with small steps, and I look at everyone who passes by with terror, for I’m sure that the slightest of brushes will bring me down, shattering with the impact. 

We’ve reached the end of the avenue, just beside the Fishermans’ Beach, and now it’s time to cross the road in front of the Baía Hotel, daring to make it to the other side – we mean to have a little walk through the book fair which has been set up in the Visconde da Luz Park. I can’t decide on the ideal moment for making the crossing. The traffic here is ridiculously slow and intermittent. Maybe it’s because the street is cobbled instead of the typical asphalt, which may inhibit the engines, or maybe it’s because most of the drivers on this street are here for the views. But either way, the typically serene driving looks to me like the Estoril race track in its Formula 1 heyday. And what if I get hit by a car? It will most definitely crush me. And what if they don’t hit me but I increase my pace to reach the other side before a car arrives? I’ll slip and fall. I’m sure of it.    

“You want me to help you cross?” asks João, feeling me hesitate on the side of the road, like on the edge of a swimming pool. 

“No, I’ll cross on my own,” I answer proudly. 

On the other side I breathe a sigh of relief and sit down on a stone bench, resting from the emotions and eyeing the traffic that I’d successfully stood up to.  

“My God! How difficult it must be to be old,” I realize instantly. 

I endured it like a hero, strolling through the stands in the book fair. Then I once again crossed the dangerous stretch of traffic in front of the Baía Hotel and, brave as a lion, I walked up to the top of the avenue. But as soon as I got home, I went straight to bed, weary after such a radical and adventurous afternoon. 






    Being sick and being ill are different states. They have very different consequences for your image, both the one you have of yourself and the one others have of you.

When I was a young boy I liked to be sick. So much so, that one day I tried to achieve this transcendental state of being by pretending I had a headache and dipping the thermometer in a mug of warm coffee in an attempt (not a successful one, for it’s hard to deceive a father who’s a doctor, especially when the naive and fresh face in front of him doesn’t go with the 40ºC thermometer) to skip school and, more importantly, acquire an enviable status – the passport to the king-sized bed upstairs where I would be the centre of attention for the day, with meals à la carte, a non-stop flow of fresh fruit juices (as if, all of a sudden, the garden was full of orange trees), becoming the envy of my sisters, all the phone calls asking about me, the present my dad would bring when he got back from work. It was in this state that, late one afternoon, I was initiated into the suspense and fever of reading a book in one go. At first I felt disappointed both by the book’s small size and by the serious lack of pictures. Instead of Tintin, which had been my entertainment during my previous bout of tonsillitis, my father had brought me something called Five on a Treasure Island, a story written by a certain Enid Blyton. Even today, the simple mention of that author’s name makes me salivate, for never have I tasted, and God knows I’ve tried, buttered scones like the ones she served her heroes.

Also, childhood illnesses were, for me – a little western boy – short-lived, beneficial and they always ended happily with a return to school amidst the general admiration of your classmates and some indulgence from the teacher. Ah, being sick was a sweet desirable luxury...

And if being sick was an important asset, being ill, on the contrary, was a slippery process of loss: the loss of autonomy, status, self-image. And it all starts with a look.          

Could it be that illness changes your image? So it seems when you observe the way others look at you – no longer in the same way. Everyone, whether they are family, friends or mere acquaintances, look at you in a different way. Without exception? Yes. I mean, no. There’s an exception – health professionals, whose looks vary between soothingly normal and total emptiness, as if you don’t exist.  

So after all what changed? Was it you?  The way others look at you? Or, maybe, the way you look at others? I think it’s the way others look at you. People start looking at you differently as soon as they get the news that you’re sick, before you show any signs of illness or stigmas of the treatments. It’s also possible that the way you look at others also changes, for illness makes you suspicious, expectant – they may be hiding something from you, even if it’s for your own good. You look quizzically, like a detective. But this, I suppose, is secondary and acts only as a catalyst of perception: what reallychanges is how other look at you. There’s a special look for sick people. But not only that, within this category there is a whole number of other sub-categories – the way people look at you can vary with the disease you have. 

If you have cancer, for example, the look people give you is a frightened and isolating one, as if you have some contagious disease. It isn’t, it’s not transmittable and everyone knows it. But that’s the look: frightened and simultaneously digging a ditch between them and me. Why so? I’m speculating, but I think it’s because of the thought of death associated to cancer, certain and not far off. People can smell death contained in that face, those bones, those eyes; they announce death. And so they look at you that way, without meaning to, anyway they can. They isolate you in a quarantined zone. It’s embarrassing meeting a messenger of death, especially one who was your friend, brother, mother father or grandfather just a while ago.    

With a heart-attack it’s different. You’re not threatening, not a messenger of some plague. You’re just some poor soul, a little thing made of glass which might shatter at the smallest effort. You inspire tenderness, that’s what the heart inspires. People are astonished you can climb stairs, walk quickly, things like that. They’re helpful (“wait, I’ll take that”), considerate (“wouldn’t you rather take the lift?”), they start going outside for a cigarette so as to not kill you with the smoke and then have to deal with the remorse.    

And we, the people who are ill, have to really fight not to be taken by the strong current, shaken and changed by it. For everyone looks at us that way and it pushes us into that role – of the invalid. 

However, there is a flip side. A particular patient’s disease, even if not transmissible, can also affect others. After my Hodgkin’s disease and the lymph nodes in my neck, there was no shortage of people feeling their own necks and thinking the small pea-sized lumps beneath their chins could be a sign of something more alarming. Me, who had carried lumps as big as eggs, I would laugh and say:

“You’re crazy! You’re a doctor, you should have more sense. Those are calcified remains of an old tonsillitis.”

But the movements, both premature and late, produced by the shockwaves of my heart-attack on the people that were closest to me were much more spectacular and are worthy of a short and anonymous list, ordered by the seriousness of the reactions (in increasing order):

1. S, T and U were afflicted for days by worrying sensations in their chest. S mentioned feeling a “prickly feeling in her arm”, but wasn’t sure if it had been in her right arm or her left arm.    

2. X quit smoking, for good. He had been trying for 25 years.

3. X, Y and Z rushed off to do electrocardiograms. Y went as far as to submit himself to an (clandestine) stress test. He confessed to me that just the fright caused by the experience nearly killed him. 

4. I’m leaving V for last, as this concerns a moving case of solidarity with a friend. V had a terrible pain in his chest and had to be taken to hospital, first by ambulance and then by stretcher. Fortunately, the only treatment he required was a few kind words and a little bit of Valium.

5. Almost half of these patients are themselves doctors.   







    There’s more to returning home than meets the eye.

Though I never let out a word about it, the idea of going back home didn’t really please me. I wasn’t dying to get back or terribly homesick. It was just one of those things that would have to happen eventually and, so as to not be tempted to remain indefinitely attached to the hospitality of my parents-in-law, I had given myself a mental deadline by which I should pack my bags. 

“After my general check-up,” I said to myself, “I’ll start going out for some walks and once I’m able to stand reasonably well on my own two feet, in one or two weeks at the latest, I’ll be on my way.”

Yet at the same time, I would ponder my secret unwillingness to go back home. What could it be? For some time the most satisfying explanation was that this intangible aversion had to do with returning to the place where the sinister event had occurred – as if a malevolent shadow lingered over it, and my friendly house at the coast had turned into a kind of Red Indian cemetery, inhabited by miasmas. After some days, before returning home, this theory started to seem a little threadbare and so I set about replacing it with another more consistent one. Indeed, I didn’t want to go back anywhere, whether to my own home or any other place I could think of. I had been uprooted, that’s what I felt. I no longer belonged anywhere. Apparently, any place would do. What strange feelings for such a home-loving person!

Despite my reluctance, I kept my mouth shut, and one August afternoon, with the car bursting like a wineskin, we rolled up at the door of our house. I got out slowly, looking around like someone who is sizing up the house he’s rented for a holiday on the basis of an agency’s picture. I had been here before. 

Tangerine came out to meet us by the gate. She’s thin as a rake and her soft tiger-coloured fur is now dull grey like an old rug. She moves slowly and greets us with a barely audible meow. She’s still recovering from a case of pneumonia she developed while we were gone. It almost killed her; she even stopped eating and could hardly lift a paw. Our friends and helpful neighbours, Luísa and Carlota, divided up between them the charity work of taking her to the vet, looking after her and calling us about any news and how she was doing. Poor cat. She didn’t deal well with sudden abandonment and the loneliness which ensued. 

The way up to the porch and the front door is flanked by dense African lilies. The flowers hang limply from dried-up stalks, drooping groundwards as if unable to bear the humiliating end of a flower which, at its peak, radiates magnificently from each of the small trumpets that give it shape, enriching the spring air with a touch of sophisticated violet like church windows. That superior colour which on June afternoons so perfectly reflected the light of the setting sun has now died away, leaving only its leafy base which today, just as yesterday, conserves its green.   

“Dad, aren’t you coming in?” called Zé João, staring down at me from the porch, probably horrified that I’m not in a hurry to inspect the interior of the house and astonished that my urge is not as strong as his.

“I’ll be right there, Zé. You go first...”

I go up the first step, still staring at this path along which my body, just two months ago, had been lugged along on somebody’s back like a sack of potatoes, my eyes level with the lilies, retaining an image which had waited patiently till today to resurface, that of a dark forest of violet radiance. A hidden treasure returned to my consciousness – the tactile impression of a flower brushing against my face, like the unexpected contact with the cold nose of a cat.

Something has been going on in here! Somebody has been in the house recently. The objects don’t have any dust on them, though a few molecules of melancholic mould reach my pituitary gland – something that always hides in the corners of a beach house that is not permanently inhabited. Mould... That faraway smell of fungus mixed with strangeness that had branded me like an iron ever since I was a small boy tasting trips and long holidays whenever I returned to one of my successive homes. The house welcomes me, tolerates me, presents itself as the same as what it always was, but it doesn’t celebrate me. Now that it’s grown used to my absence, it’s a little suspicious at the return of something it had thought was a permanent fixture, something it had thought belonged to it. It’s going to have to get used to me again and that takes time.

A better reception awaited me from Dona Nazaré, my next-door neighbour, an eighty-year-old lady whose persistent hypertension and weak heart have scarcely altered in fifteen years. Shocked by my sudden disappearance and by the violent event that, through the same organ that also afflicts her, had almost finished off “such a young gentleman”, the good lady made sure I regularly received get-well messages and her hopes for my swift return, and, while I was at Torres Vedras Hospital, treated me to some baked apples and the cinnamon sweetness of her rice pudding.

“My dear doctor...” she exclaimed when she saw me crossing her doorstep, extending her arms from beneath the purple shawl that she wraps herself in, even during the summer. 

Tearfully, she hugged me, apologising for being so foolish.    



    I wasn’t aware I had become so famous in my street and in the streets next to it. Illness has made me a local celebrity. People I vaguely know, and others I’ve never said hello to, cross the street to welcome me back. They want to know if I’m better, to wish me the best, to know all the details when I’m in the mood to tell them; and shiver when, out of generosity and a bit of mischief, I show a privileged few the scar on my chest (I’ve noticed the one of my leg doesn’t make so much of an impact). 

“Big scare, eh?” they say in Dona São’s café, eyeing me with respect.

“You want to turn the page on that one...” 

I nod and thank them for their sympathy, but only because it makes it easier to move on. I don’t identify with these comments. I wasn’t frightened. I don’t intend to turn the page on this part of my life and forget about it. It’s a part of my life (the heart-attack, the cancer) and so it should be integrated into it. I can’t even really think of it as something bad that happened to me. 

“And he was perfectly fine at the time. I’d seen him that very afternoon...” one of my interlocutors would comment to whoever happened to be with us, and that person would then look at me as if I were one of those strange misshapen vegetables that are said to appear in Entroncamento[††].

“To die, all you need is to be alive,” I say philosophically, speaking from experience.

Another interesting phenomenon was that I suddenly found out that a great many other people had also had heart problems, infarctions or had been operated on like me. I don’t even have to look for them; they come up to me, walk accidentally in front of me or someone comes and introduces them. Like school friends, here we are swapping stickers: the heart-attack, the coronarography, the operation, the convalescence, how long the surgery took and how we’re doing; lifting up our shirts and pulling down necklines in the middle of the street, to compare the size and colour of scars.  

“Yours is still very fresh,” one veteran tells me. “In three years it will look like this...”

It feels good, who would have thought? It’s comforting finding soul mates, a relief to learn that our fears, anguishes, hardships and obsessions are, after all, monotonously common.

“Really? Were you also scared of going to sleep?” I ask, delighted. 

“Scared of sleeping!? I was shitting myself for six straight months, and I’m not even sure what I was scared of!”

“You know what,” another survivor said in a hushed voice. “I think it leaves us scared because it’s so sudden, so quick – we’re left thinking it may happen again at any moment.”

“It was as if I had been run over by a juggernaut.” This was how another comrade chose to describe the existential moment of his heart attack.   

By socializing in this way we hoard knowledge, exchange small pieces of advice no doctor has ever given us or even appears to know. Maybe this is because what most doctors read is written by other doctors, who like their readers don’t listen much to their patients’ subtle descriptions and don’t value their apparently secondary needs. They, the doctors, are like subcontractors. The surgeon opens it, fixes it and stitches it up – “That’s my part done!” The cardiologists arrive and stabilize the machine until it can work on its own – “It’s ready. In our eyes it’s ready to go”. What about the rest? Ah, my friends, sort yourselves out for you are on the quick sands of “that’s got nothing to do with me”. That’s not important, not relevant, it’s secondary, they all say, or at least imply with their bored silence.

“Afterwards, when you’re out there, talk to your family doctor,” they tell you.

There are exceptions of course. One was a doctor in Torres Vedras, who had himself been ill and spent three months in a hospital bed.

“It makes a big difference...” he told me.     



    Visiting and thanking. Dressed up like someone going to visit his godmother, I went a few days later to Torres Vedras hospital, carrying a thick brown envelope with all the details of my stay in Santa Marta under my arm, my throat clenched in expectation at each door that led me progressively closer to the Internal Medicine department. At any moment I could come face to face with Dr Varanda, Nurse Catarina and Nurse Inês or any of the other people that I had encountered a little over a month ago – though for me, it all seemed light-years away. 

On the other side of the reception desk, which had once been brightened by the bouquet of flowers someone had given me on my birthday, I found a nurse I didn’t know writing things calmly in an enormous record book. When she eventually lifted her head and looked at me, I asked her if Nurse Catarina was on duty.

No, she answered, she wasn’t on today. What about Nurse Inês, I asked next. Also no – she was on holiday, explained the nurse behind the desk, a bit reluctant to answer all these questions with so little explanation of who I was and why I was there.   

“And what about Dr Varanda, do you know if he’s here?” I asked, trying out another approach. 

A little impatient by now, she advised me to search in the doctors’ room at the end of the corridor. 

On my way down to the doctors’ room I passed close by the glass wall of the Special Care Unit. Possibly due to the contrast with the immensity and technological sophistication of Santa Marta, or because I’m looking at it from a standing position with my ego restored, it now looks cramped, charmingly modest but tidy, like the dignified poor people in the books we were persuaded to believe in at primary school under the dictatorship. Right now, there were only two patients there, and my old bed was empty, its sheet immaculately stretched. A nurse seated at her desk down at the end looks at me, intrigued.

I scurried off. In the doctors’ room I met Dr Brito.

“Look who it is! You’re very welcome. Come in, come in,” he gushed, seeing me peer around the door. “We’ve got to tell Varanda you’re here. He’ll want to see you.”

“So he’s here today?”

“Yes, yes, he was here just a moment ago – he must have gone down to A&E.”

And he was moving his hand towards the phone when Dr Daniel Varanda, materializing out of nowhere, came into the room. 

“Here comes the man who saved my life,” was all I could think to say, embarrassed by the moment and seeing his surprise at my so unexpected presence. 

“You could say that...” he answered in his pseudo-rough way, already an old acquaintance. 

And walking towards me, he gave me the briefest of hugs, followed by endless pats on the shoulders and arms.

“Let me look at you,” he said. “You have no idea how pleased I am to see you.”

He looked at me up and down, his eyes becoming smaller, shining as if they were moved. 

“You’ve no idea the fright you gave me... I want no fooling around from you, do you hear?” he scolded.

“I’ve got some things for you,” I told him, handing over the envelope with all the Santa Marta information. 

“We’ll have a look at that later. First come with me – I want everyone to see you.”

It was no use telling him I had already been there and that there was no one on duty that remembered me.  

“That’s what you think,” he answered, tugging me by the arm. 

So off we went.

“You have no idea how happy I am to see you standing...” he would say from time to time. 

“Yes, but I’m covered with scars from head to toe – I look like Frankenstein!”

“Better to be ugly and alive than very handsome and dead, eh?” he answered me, finding my statement a little ridiculous.

He stopped in the middle of the corridor and, now that it was all over, told me confidentially:

“It was really bad, you know... You escaped by a whisker.”

I formed the question that had been on my mind. “Do you mean it would have been too late if I had reached A&E ten minutes later?”

“Maybe even less than that,” he answered in a more sombre tone.

I shut up. It’s the type of news that can bring you down.

I was walking out the ward, feeling rather disconsolate at not having found all the people I had hoped to, when in walked Fatinha.

“Doctor!” she exclaimed, a big smile on her face. “It’s good to see you here.”

I told her a little bit about my stay in Santa Marta, how everything was much better now and how I’d tried to contact Torres Vedras hospital as soon as I was able to pick up a phone.

“I know,” she replied. “Catarina told me you had called.” Then she added, more seriously: “But even without getting news from you, I knew everything was all right because the plant you gave me is also doing well. You should see how it has grown!”



At the weekend we set off to Cascais to visit the house and the people. Personally, although I didn’t tell anyone, one of main interests was (as Fatinha would do) to see my alter ego – the plant behind the glass door that had kept me company. How was it doing? Would it have grown? Would they have remembered to water it in this heat...?

Our intention was to stay until Sunday afternoon, but some sad news made us return urgently. Dona Nazaré, our neighbour who had so touchingly celebrated my return just a few days ago, had just passed away in Torres Vedras Hospital, victim of a myocardial infarction. 

Dismayed and silent, sitting on the hard benches in the church annex where the body lay, I didn’t want to admit that, once again, it had all been so simple. I knew about Dona Nazaré’s sick heart, and how she could sometimes get too excitable at the least provocation.

“You know, Doctor,” she admitted to me after I had checked her heart rate and pulse on one occasion, after I had calmed her down. “I was very anxious because my grandson was late. He was meant to come for dinner... I thought he may have had an accident.”

Frequently during these confessions, I would hold her hand in mine, waiting for her to calm down. I would then go back home, pleased that a happy ending had been so easily achieved. 








    If you saw me during the last two weeks of August, walking determinedly along the streets, strolling on the beach, audaciously climbing up and down cliffs, enjoying the puddles of water left by the tide – a dashing display of life and colour, you would never have guessed that my heart had recently been ravaged, that I was a creature who, scarcely two weeks before, had for the first time had the courage to leave the house and go for a shaky walk in the streets of Cascais. 

Those days of August were happy ones. Like a balloon drunk on helium, my body emerged from its state of repose with bright-eyed excitement, an unstoppable certainty. Making notable progress with each day that passed, I was gradually returning to my former physical condition, which to all intents and purposes (and obstinately, during the tougher periods of my illness) had always been younger than the outer casing might imply.  

Yes, how happy those days of August were. All my life to live, my body once again stood erect and I looked straight ahead, my soul supporting itself with the faith that from now on things could only get better. 








    It’s September and the days are growing shorter at an alarming speed. Having dinner outside, under the vines, is a less attractive proposition, for by eight in the evening, the sun has already cooled over the ocean, and the surroundings have become dark, evidence that summer is over. 

It is evening and the three of us are having dinner inside with the lights on when, without any warning, a familiar sensation assaults me and winds itself around me with the craving of a boa constrictor. Again the feeling of nothingness surging through my head, of things moving further apart. I’m alone in the world, suddenly isolated from everything else, and am being assaulted by shots coming from within my body. 

In a matter of seconds, the palms of my hands, which I had stretched out on the table in fright, have become wet. I lift them and the outline of my hand is left on the table. I feel my shirt getting soaked from the contact with my wet back, as if with warm blood, and the furrow between my upper arm and forearm becomes sticky. The assault comes so fast, so unexpectedly, that it leaves me paralyzed, my expression taking on the weird look of a person who looks but doesn’t see what is in front of his eyes. 

“Pedro? What’s wrong?” asks João, alarmed. This comment, like what’s happening to my body, is a déjá vu. All of this is the same, a repetition of that evening in July when I had my heart-attack.

Rubbing my hands together, I got up and went down the hall to the sitting room, where I lay down on the couch waiting for the worst. This was another heart-attack. It was all happening over again in exactly the same way. 

But in the end it wasn’t. What I mean is, I didn’t fall into any kind of coma or state of unconsciousness. I didn’t go blind and wake up on an ambulance stretcher. After a short time, I recovered from the attack – my skin dried off, my hands stopped slipping on each other and the feeling of instability receded and everything went back to normal, or almost. 

Meanwhile, João had gone to get the sphygmomanometer and was taking my blood pressure and checking my pulse – nothing special, blood pressure at rock bottom, but nothing alarming. 

“Maybe it was low blood pressure,” I said, trying to find an explanation for the phenomenon. 

“Perhaps,” João agreed.  “A passing thing.”

The problem was it didn’t pass that easily. The following days the episodes recurred, at first intermittently, with sufficient time between them for me to recover confidence in my cardio-circulatory system, then growing closer together, more insistent.     

Desperate, and wanting to know what was happening, I called Torres Vedras and asked for Dr Daniel Varanda. I described my symptoms to him as precisely as possible, giving microscopic details of the variations in my condition that must have sounded metaclinical. Though he insisted that he wasn’t going to take any chances and prescribed some nitroglycerin tablets for me to dissolve under the tongue during these attacks, he didn’t seem to be too impressed by my complaints. 

“Have you been very anxious?” he asked me. Was this a question or an insinuation? Vera and some other friends had asked me the same thing when, feeling oppressed, I had told them hollowly of my sad state, assuming that this was a relapse in my clinical situation. 

“Anxiety?” I considered this, trying to find a connection between the moments of fear or psychological tension and the onset of the crises. No, and what was especially unnerving for me was the fact that these episodes didn’t follow any specific pattern; you really couldn’t connect them to anything concrete. Yes, sometimes they had happened in the evening, at the same time I had my heart-attack, but they also happened in the morning. Indeed, they seemed to be connected to meals, but not always. Is my blood pressure low during these episodes? Yes, but occasionally it also goes up and my pulse quickens. Where was the common denominator? I couldn’t find any and this made me despair, for it made it hard to find a consistent pattern and, therefore, an explanation of some sort. Well, the crises would pass with the sublingual nitroglycerin that the doctor had rather cautiously recommended. But they would also pass if I just held on and did nothing, if I waited; it just took longer. And they would also pass, in the same amount of time that it took for the nitroglycerin to take effect, if I took a sedative instead. Where was the truth? In my heart? In my head? Was my head ruining my heart or vice-versa? And meanwhile, with everyone looking at me out of the corner of their eyes, losing patience with all the pulse checking and blood pressure taking, I fill myself up with horse-size doses of tranquillizers usually prescribed for panic attacks.

But nothing definitely put an end to these attacks, which continued to occur at least two or three a day. And little by little I began staying in bed longer, without moving; for the place where I was still protected from these assaults and where my weak heart was subjected to minimum effort. And so I insidiously transferred myself to a bedridden state, a rabbit in his hole, a creature of the darkness that is harmed by sunlight.         

The days passed, and my back starting to hurt from so much bed rest. One morning, as I woke up and got ready to take my tranquillizer and a quarter of the beta-blocker (this was the first thing I did as soon as I woke up, before even performing the effort of sitting up in bed), I was overcome with a sudden intense sweat, an extreme heat rising up inside me which forced me to pull back the sheets, as if they burned. No, not even in absolute rest was I safe from this. I was screwed!

Another phone call and, that afternoon, I found myself in Torres Vedras doing an electrocardiogram. 

“I don’t see anything special,” concluded Dr Varanda as his eyes read the long strip of squared paper. “In fact, you’ve actually done better than the last time.”

Perplexed, and seeing no way out of this situation, I waited, lying on the couch, while he listened to my heart. 

“Like I said, it’s nothing special. I suggest you come to the hospital, tomorrow or the day after, and we’ll do a stress test to sort this out this once and for all. It’s really a little early for this type of test – you had your operation very recently… But taking into consideration your complaints...”

Although I thought it was a good idea, I continued staring at him blankly with such a transparently abandoned look that he asked:

“Would you be more reassured if I readmitted you? I mean, you could wait for the stress test here in the hospital...”

I answered yes, feeling a huge relief with this proposal. At least if something serious happened I would already be in the hospital, where there was all the necessary equipment to assist a troubled heart patient.     

So here I am, hospitalized again, with an oxygen tube up my nose and a nitroglycerin patch stuck to one of my elbows. This time they didn’t put me in the Special Care Unit – I’m in a normal bed in the Internal Medicine department, without the luxuries of constant heart monitoring and a nurse twenty-four hours a day. I was hospitalized for four days, and on one of those I did the stress test. Or rather, didn’t do it. For barely a minute after they put me on the treadmill, connected to the machines by wires attached to my chest, Dr Daniel Varanda told me to stop and ordered the treadmill to be switched off. 

“This is still all too fresh,” he said. “It’s better if we leave it for now.”

I walked out of there convinced my condition was so serious that the smallest movement would threaten my heart, that it would become ischemic and most likely conk out. Is that why I feel this way?  

When the weekend came, as the additional tests they gave me showed no new signs, I was discharged. I’m back at the coast, and as soon as I got here, maybe an hour later, I had another one of those weird unclassifiable attacks.



    Insomnia. I can’t sleep. I get up and walk around the house while everyone sleeps. I stop in the room which also serves as the library and where most of our books are kept. I stare at them, overcome by an onslaught of thoughts. Who will keep all of this? What will happen to these books? Will they be removed from these shelves one of these days and taken somewhere else? Thrown away? Contemplated with a sigh? Will they be separated from each other by criteria I will never know (though they were also acquired and collected over time without any specific criteria)?  

Death, death, mortality. They’re very attractive, a find, these approaches to the theme that argue for its non-existence, that it in fact only exists for those who remain, for there’s no room for it in the consciousness of those who leave and cease to be, that it’s just a passage to another dimension, etc., etc... But the truth is, from the mundane point of view of one’s survival instinct, everything on the subject leaves us restless and doesn’t soothe us at all. 

From time to time, I would remember, with a wintery shiver, a phrase that Dr Gil Seabra had uttered when I had my check-up. We were talking about what had happened to me, about the 90 % obstruction of the common arterial trunk and the heart-attack which followed. I was startled by the total lack of warning signs before the attack. 

“You know... this type of condition usually develops silently and then appears with catastrophic consequences,” he said smoothly, without altering his expression, after observing me in silence. 

Catastrophic consequences... Those words, like a death sentence, won’t leave my head. I walk through the house, reviewing the objects that slumber there motionlessly, staring at each one with the futurist eyes of a hurried ghost. 







    Through opportunity, taste and character, I’ve been reflecting upon this matter, and am inclining, increasingly stubbornly, towards the old saying “don’t let the ox see the mallet that fells him”. 

I got the chance to see the origins of this proverb first hand during my travels around Trás-os-Montes[‡‡]. For in the early eighties, although it was already illegal in Portugal, in those merciless lands cattle were still killed for their famous steaks with a mallet – a type of hammer with a relatively long wooden handle and a rectangular block of iron on one end. Nothing could be simpler. I would observe this barbaric act with fascination, my attention divided between the precision of the butcher’s movement – after spitting on his hands, he would unleash a blow between the animal’s horns – and the fulminating effect produced by that blow, as obediently and in slow motion, the animal would fall to the ground as if it could no longer support its own weight.

Let me repeat: don’t let the ox see the mallet. And to this I’ll add: “even if the ox insists on encountering the mallet”. For seeing the mallet is always different to imagining it. As a doctor and as an animal, this is the testimony I would like to give to health professionals and, especially, to my fellow doctors who, through lack of knowledge, dogma, naivety or fashion, may feel tempted to tell patients “the whole truth”, either because of some need to broach reality crudely or deceived by the apparent wish of the patient to know it.     

Be careful with the whole truth which, after being shot out the mouth, is impossible to deny or wipe away. A patient, particularly one who has a serious disease, is a paranoid being with his antennae waving in the air. He’s also split between the suspicion that they’re hiding something from him (which he attempts to uncover out of masochism or simply acute curiosity) and the need to deny, postpone and consider oneself an exception to the tragic aspect of the disease, precisely that which brings down other mortals.  

Prudence, lots of prudence – nothing justifies a less-than-super-cautious approach to the subject, not even “that’s how they do it in America” or “he asked me, he wanted to know how long he had left so he could organize his life”. 

No one can live with the constant idea of death twenty-four hours a day, day after day (that was a sweet I had to suck and I almost choked on it). We need a gentler route, a more familiar terrain beneath our bare feet, even it is covered with sharp stones, a valley bathed in a less glaring light.  

Legends abound in the medical world. It’s a particularly interesting niche because doctors, in their role of shepherds, know it well – the diseases, their progression, their end. In the chapter denial, I can quote the example of the famous surgeon of abdominal neoplasias who, when he himself was at the gates of death with that selfsame illness, deluded himself to the very end with candid conviction. “Fortunately, in my case it was all discovered in time,” he would say. “I was tremendously lucky, for usually you don’t stand a chance – I’m one in a million!”

Or I can illustrate the chapter hope with the poignant story of a Cancer Institute nurse who, after two dozen sessions of intensive radiotherapy treatment, enthusiastically discussed with doctors the almost unidentifiable reduction in her brain metastases: “I’m satisfied Doctor, it looks like I’m finally responding to the treatment...”    

The thing is, we don’t know anything else but life. And, if you think about it, death is something that has no tangible reality. It only exists for others. 







    How do we know if something has changed within us, that mentally we aren’t how we used to be? That we’re losing our marbles, as they say? 

It’s not easy, as it all starts with a procedure, or sometimes just an attitude, that you didn’t use to have but now you do. Then you must practise it until it becomes part of your circuitry and recognize that procedure, out of the hundreds that define our behaviour, as strange. And this only happens if it is frequent, if it is relatively constant. One strange procedure, just one, isn’t generally enough to convince you that you’ve changed that much. Therefore it’s necessary to develop another strange procedure, identify it as strange, put it side-by-side with the first one and then you realize that they make a pair. And so on and so forth.

Of course, if you have reached the point where you have a reasonable-sized collection of strange procedures, all under rigorous self-analysis, then your suspicion has probably been reinforced by a courteous friend kindly telling you: “Hey, mate, don’t take it personally, but have you thought about seeing a psychiatrist?”

And because you look so surprised, because there’s a slight tone of “Who? Me?!” in your voice, he goes on: “Listen, it’s nothing special... It’s normal after a heart-attack – it’s not the type of thing you can get over without help.”

And then come the examples: Tom, Dick, Harry, and the rest... 

“There’s So-and-So, husband of Thingummy! I told you. He lost it completely...”

In my case, it took me about four months to realize that Yes, I had been acting a little weird. And this discovery almost coincided with the suggestions made by one or two friends who, possibly tired of putting up with my strange behaviour, recommended I went to a soul-fixer for a cure. 

First of all, there was that strange wish I had not to see anyone at all. My back would become soaked in sweat after a simple phone call. I didn’t even have to see them. Just the contact was enough. People couldn’t understand this and it gave them the right to say “the guy has lost it!”

The second symptom (less scandalous as it was more discreet) was my resistance to coming back home, wrongly confused at the beginning with a “returning to the scene of the crime” complex. 

Third: the attacks. The weird sensation of being distant from reality, the darkened vision, lightheadedness and puddles of sweat, and the feeling that the carpet was about to be pulled out from under my feet. This was the truly frightening aspect, and stopped me feeling I had a future to look forward to. And even when there were gaps between the attacks, they were never sufficiently spaced to allow me to put aside my feeling of vulnerability. 

Suddenly, a kind of enlightenment, which I managed to rake up just as I was about to follow the advice of my friends. I discovered a possible explanation for what was happening; and, though the two strange symptoms were very different, they could both shelter under the same explanation. This left me with two bizarre behaviours to file away and one that was still active. What I knew: aversion to people + resistance to coming back home. I had gone through a terminal physical experience, after a situation of clinical death and, following this, a high-risk surgical intervention, which itself required my heart to almost stop and then be electrically resurrected once it was fixed. I had been more than once disconnected from life; I had been interrupted. And so, although I’m not aware of the details, the notion I had of myselfawoke with the ignorant virginity of a newborn infant. My old ties to the world (the people, the sense of belonging to home) had been broken, or at least frayed, by the interruption in the connection. After my rebirth, I had to re-establish them one by one. And so, I would eye up each person that stood before me, no matter how much of a friend or how close they had been before, with the bewilderment of someone who has just recently recovered from a long amnesia and needs time and effort to relocate where that person fits in.     

Apart from this, there was still no explanation for the attacks, the feeling of imminent death, the unpleasant awareness that I was becoming chronic case of “Pedro of the sudden death syndrome...”  

Could it be that all the terminal experiences I had been through had activated some kind of biological alarm that had gone wrong, as sometimes happens with car alarms, and would go off at the slightest breeze? I didn’t know. What was certain was that I wasn’t okay, and, I wasn’t sure in this case that the explanation was psychological, a psychosomatic manifestation.

It was then that October arrived and the stress test, booked for the 7th at Santa Marta, came into my sphere of anxiety. 







    They should change its name! They (the doctors and other health workers) have no idea of the terror and the damage a mere name can cause.

I met people – patients who were having their post-heart-attack state evaluated, or those that were just testing their heart’s condition – who missed their appointment through fear of the name.  

“Stress test?!” they would exclaim. “As if I’m going to put my heart through more stress after all it’s been through! I didn’t set foot in the place!”

I did end up going, though, on the 7th of October at the end of the morning. The test had been booked by Dr Gil Seabra during my August check-up. At the end of the consultation, a nurse booked the date, asked me if the time was convenient and gave me a programme with useful information – everything from the clothes I should wear and what to do with the medication I had been taking, to the right sort of shoes so as to not to slip during the test. 

Following the instructions, two weeks before the test I started gradually reducing the quantity of beta-blocker I was taking (that’s a drug that, among other things, keeps your heartbeat at low-revs). By doing this I hoped I would be completely clean of the drug by the time of the test (as indicated on the programme). I also hoped to avoid the possible effects of stopping abruptly - a sharp increase in the heart rate due to a reflexive mechanism. 

Despite my concern, and the slow and careful reduction which I had planned, my pulse accelerated from the usual 60 rpm to a more exalted 80 beats per minute on the eve of the test. It wasn’t too serious, but I could feel the affliction behind my rib cage. 

The anxiety caused by not taking this heart tranquillizer aroused dark memories of the poor result I had achieved in the last stress test, the one I had done not too long ago in Torres Vedras Hospital. I felt sure the result would be terrible. In short: there I was in Santa Marta on the morning of the test, in loose comfortable trousers and non-slip shoes. After a sleepless night, I was nervous as an actor on the night of his premiere. 

A stress test[§§], contrary to what the name suggests, doesn’t involve lifting weights or winning a tug-of-war against 30 marines. It’s simply a mobile electrocardiogram. They connect some electrodes to your chest and make you walk faster and faster on a treadmill while your heart’s performance is registered and analysed on a computer. That’s basically what a stress test consists of. 

Acting as if I were totally at ease, I undressed from the waist up, let them attach the wires to my chest and climbed onto the treadmill.

“Do you know how this works?” the young technician asked kindly. 

“Yes,” I replied sportingly, with the fear that “this’d be it!” rising in my throat. 

“Let’s do it then,” she said, taking a seat in front of the monitor. 

I took hold of the rubber-clad metal handle as if I was pushing a shopping trolley, set my feet firmly on the treadmill and got ready to go. In front of me, at eye level, there was a poster of Oporto Seen From Vila Nova de Gaia stuck to the wall with four strips of adhesive tape. 

“One moment…” she said before starting the treadmill and getting up and leaving me alone in the room. 

“Here we go,” I thought. “That’s it! My condition is so bad that there’s no need to even start. They can see it even when I’m still, as soon as they turn on the electrocardiograph.”

A moment later she was back bringing with her a sullen-looking man. He had his hands in his overalls and the unquestionable stethoscope hanging from his neck. 

“So, you haven’t even started and your pulse is already at 140!” he decided to say in greeting. 

I stuttered out an answer about how I couldn’t voluntarily control my heart-beat. But the doctor didn’t give me a chance:

“Are you taking any medication?”

“I was,” I said. “Half a tablet of atenolol a day. I stopped taking it gradually as…”

“But you shouldn’t have!” he shouted, fulminating at my audacity.

“But the paper said...”

“Let’s go...” he ordered the technician, throwing himself down on a couch and scowling at me ferociously.  

The treadmill shook and began to roll. I quickly stretched out my arms and tried to get the pace right so as to not be sucked into the place where the deck disappeared into the structure of the machine only to reappear behind my feet. It was tricky! A few minutes went by and the technician informed me she was going to increase the rhythm and tilt it as if I were going uphill. 

“If you feel any pain in your chest or heaviness in your legs let us know straight away, okay?”

“Yes,” I answered out of breath, without time to think, looking straight ahead and running continuously towards my home town.

About ten minutes later the ground was flying beneath my feet, the hill had become steeper and Oporto, unreachable, was still shrouded in grey, just like the doctor on the couch. 

“My calves are starting to hurt…” I said, admitting my tiredness.

Like a merry-go-round about to end, the treadmill began to slow down until it reached a stop. 

“You can get dressed,” smiled the technician. “Wait a few minutes outside and I’ll give you the report.”

Relieved at having completed the test safely, I quickly put on my shirt and opened the door while saying goodbye. 

“You must never stop taking your tablets, do you understand?” said the doctor one more time, still sitting on the couch with his arms crossed over his chest as if he was warming up to do a Cossack dance.

The report was given to me in a closed but unsealed envelope, which I didn’t have the courage to open. 

“Aren’t you going to read what it says?” asked João, surprised at my passivity after a result whose outcome had changed me so. 

“No, I don’t. It’s probably awful. I don’t want it to be me seeing it. I’ll give it closed to Dr Gil.”

Dr Gil Seabra opened the envelope, went over the graphs quickly, confirmed the conclusions and gave me back the papers.

“All good. Completely negative…”

I just stood there staring at him, paralyzed in the middle of the corridor, not daring to believe my ears. In his calm sensitive way he waited for my response, one that would bring this interrogation to an end. 

“So I’m not going to die tomorrow?” I asked, trying to get a definite response. 

“Not because of this...” he smiled. 

 And seeing me stuck there, like a bird who has been offered freedom but dares not leave the cage, understanding the fear in me, Dr Gil Seabra put a hand on my shoulder and told me what I needed to hear: 

“Take my advice, doctor – get rid of us!”



    It was around this time that I found in the mailbox an invitation to an opening of a joint art exhibition, that Saturday, in Sobral de Monte Agraço, some 30 Km from home. The printed invitation was accompanied by a hand-written note signed by the only artist in the exhibition whose name was familiar – Nurse Catarina. In her gentle way, she said how she would very much like to see me and João at the vernissage, or, if we were busy that afternoon, to arrange another day with her so she could be present and show us her canvases. 

On Saturday afternoon, the motorway heading from Torres Vedras to Lisbon was practically empty. I drove slowly, taking in the red and brown tones of the rolling scenery. On that same palette, the watery blue of the sky, cooled by a white cumulus, blended with feelings provoked by the motive for the trip: Catarina, memories of the illness and that other trip I had taken with her, some three months ago along this same asphalt in an ambulance towards Santa Marta Hospital.  

Beside me was Teresa whose time I had monopolized so I could have her company for this adventure I felt somewhat nervous about. 

“But how did you meet this Catarina after all, as a nurse or as a painter?” she asked, wanting to know what atmosphere awaited her. 

“As a nurse. She looked after me when I was admitted at Torres. She told me she painted and I asked her to let me know if she was having an exhibition.”

“But you knew her before that…”

“No, I had never seen her. Actually, I haven’t seen her since – today is going to be the first time I’ll look at her without being tied down to a bed or a stretcher.”

Teresa found this detail incredibly funny. 

“Then you must be pretty nervous…”

I nod, and put on the right indicator. The exit lane to Pero Negro, Enxara and Sobral de Monte Agraço was approaching. 

Discreetly, we entered the main gallery, where a few people were already gathered. There was a programme, given to us at the entrance, a table with food and drinks, paintings on the walls, me and Teresa studying each picture intently until we found “our way around”, as I whispered to her, intimidated by an atmosphere where I didn’t recognize anyone. 

“She’s there, I can see her…” I shout. 

“Where?” Teresa asks with interest. 

“Down at the end. Can you see those three ladies in black? She’s the one in the middle, the smallest one.”

The smallest, the thinnest, the darkest of the three figures; the one who gestured the most and explained herself in all directions. And then, with her restless sparrow-like movements and dark eyes, she saw us and, without any hesitation, came towards us with a big welcoming smile. 

“Dr Pedro, you made it!”

Embarrassed and feeling stupidly emotional about the reunion, I took some time getting round to introducing the beautiful and attentive young blonde who was accompanying me.

“This is Teresa. She’s my goddaughter,” I said. 

“Ah, come with me,” said Nurse Catarina. “I want to introduce you to my mother and sister. My mother has heard a lot about you, Dr Pedro,” she told me. “She was very proud of the art book you sent me and the kind words you wrote to her daughter…”

Then, in the confusion, Teresa and I found ourselves nodding and smiling at everyone. In between another introduction I stared in amazement at Catarina. Now that we were both standing up, I realized how small she was, the Special Care Unit fairy, how fragile she was in her mourner’s dress, this kind soul that had looked after me so well during those days in the ward. 

I was trying to explain this emotional nuance to Teresa, when Catarina, leaving a group, took me by the arm: 

“Come here, I want to explain to you why I paint what I paint in each of my canvases.”

“You seemed much taller to me when I looked at you from my bed.” I couldn’t help this confession. 

 “Ah, it’s all a matter of perspective,” she smiled happily. 

When we got home, the day had dissolved into a clear blue starry night, warm as a light blanket. 

“You could put some music on,” suggested Teresa, breaking the silence that had lulled us since the tollbooth.


And with a perfection the moment deserved, a gift that life sometimes lets slip, the radio station didn’t spew out an advertisement or the news or even the middle of a song. We heard a short nothing and then, from the ether, came wafting the first bars of an old and most appropriate song:



        Starry, starry night

       Paint your palette blue and grey

       Look out on a summer’s day

       With eyes that know the darkness in my soul *








      Knock, knock.... “Is there anyone there?”

    This is the corner dedicated to the paranormal, to stray energies, to fingers gently stroking a crystal ball. I picture it short, like the skirts fringing a round table, because the truth is I don’t really believe in all this – in luck traced out on the palm of your hand, in life after death. But just like a cunning politician, I hedge my bets and add, “about certain things, never say never.”

As soon as I started receiving visitors and telling the story of my heart attack, with too much detail as happens in any medical institution’s waiting room (I don’t know why, but having an illness makes you give long descriptions and pull up your trousers and shirt to show wounds and scars), I would say “I couldn’t actually see the person, you know, I could only see a luminous outline around them” and it was usual to get interrupted by a knowing exclamation:

“Ah…that’s the aura!”

Even more successful than the aura was the luminous tunnel I travelled back and forth in during the ambulance journey to Torres Vedras Hospital and which I mentioned during the first part of the chronicle. 

“Ah! The tunnel, the famous tunnel,” my listeners would gasp, impressed. “You were really there…”

I was, I really was there and I also know the stories about tunnels and near-death experiences or other similar extreme situations. But, unlike other more traditional accounts, my tunnel scarcely had any walls to give it substance; the light was a greasy yellow rather than transcendental white, and there was nothing at the end waiting for me. In fact, it didn’t even have an end. 

Yes, I had been there and I do believe this passage through the tunnel is particular to (or, at least, can happen to) people that are on the brink of death. But, in my opinion, it’s not a path or doorway leading to another place so much as a consequence of a non-oxygenated brain; because that would explain the aura too. I regret this deeply, but I cannot be included in the ranks of those who have brought back news from beyond. 

But even if we restrict the analysis to our trivial individual outer husks, without resorting to seashell shaking or soul invoking, there are still plenty of details left unexplained. One thing that happens to me often, so regularly that I’ve been able to show it other people, is that I go and check the time and find that, invariably, it’s ten to ten – the time my heart-attack started, when feeling terribly nauseous, I got up like a zombie from the dinner table and staggered down the hall until I collapsed. And so it happens: I get a sudden urge, not driven by any specific need or reason, just a click that comes over me, to look at the clock, and I find it’s 9.50 pm. It’s like some biological alarm clock inside me that has been programmed to go off at that time. To facilitate things, let’s just say that these are the scars left by events. 

A friend of mine, many years ago, had a girlfriend who died of leukaemia. He was very young at the time and was that period of life when we believe we are eternal, when hardly anyone dies around us. With horrified devotion, he watched the tortuous demise of his ballerina (that’s what she did for a living) and it almost destroyed him. He wandered around like a lost soul for a couple of years. Recently, one evening, when I already had the fire lit in the hearth, this friend decided to visit me, and I showed an interest in his story, prompted by all that had happened to me over the past three years, as at the time I’d only had a vague impression of it. And still disturbed by the memory all these years later, he told me that although his girlfriend lay in a hospital bed in a foreign capital far away, he found himself suddenly overwhelmed with the feeling that she had died. He did two things: looked at the time and memorized it, and then made his way to the nearest window. In fact, his girlfriend had died at exactly that moment. As for the bright light he saw coming towards the window, he didn’t offer any explanation about where it came from, nor, today, was he even particularly insistent that it had existed at all. However, he was convinced that something had passed by to say goodbye, and this had remained with him ever since, a bright light shining in his memory. 

We shut up then, because the evocation of these small secret details was beginning to move us beyond what was acceptable for a friendly after-dinner chat. 





    This time I didn’t feel like going anywhere for New Year’s Eve. I chose to stay at home. Close to midnight we walked to Vera’s house to celebrate the New Year with her and her family. 

    The beach is full of people, especially young people. They’ve been arriving in groups since early afternoon in cars, trucks, hitchhiking. They’ve slowly invaded the cafés, weighed down by rucksacks and clutching packages of all shapes and sizes. From the shape of them, and the care with which they are transported, I guess they must contain food and drink for later. They’re getting ready for the big night and in a few hours, Zeus be praised, they’ll all be drunk. It’s the thing to do, it always was: a good celebration implies a good anaesthesia. And as if New Year’s Eve weren’t enough, next year is going to be the year 2000, a new millennium, the 21st century, possibly.                         

    At midnight I ate the customary twelve raisins, made a toast and drank champagne with the same conviction I do every year – that’s to say, none whatsoever. A little later on, a few of us went for a walk by the sea. It was a cold night and the stars trembled in an absolutely clear sky – a rare thing around here for there’s a mist most nights. 

    On the way down to the beach we saw lots of parties going on before our eyes behind the windows of house and apartments. We passed people in the street with glasses in their hands and bottles under their arms, and everyone, in a spontaneous surge of solidarity, wished us a “Happy New Year”, instead of “good evening”.

    The promenade is full of figures. Swift as swallows, Zé João, Ricardo, Carolina, João Pedro and Marquinho go running along it, having asked me for money for ice cream, exquisite excesses for such late hours. Dancing about on the wet sand with her arms outstretched, Verinha, Vera’s daughter, displays her 15 years of age in fairylike fashion, and the first signs of a little too much sparkling wine. She’ll be going into the sea fully dressed in no time. Vera, with the water round her ankles, shouts at her to no avail, like a dog-owner trying to walk a puppy that has become too big for her to handle. 

    João, at my side, points to Peniche far away, floating on the sea and hemmed with light. In the distance, a catherine wheel tears a vertical rip in the night and draws a small rosette, fragile as a dandelion clock, which dissipates in a fluorescent shower of falling stars as if someone had blown it, murmuring a childhood rhyme: “your father’s  turned bald!”  

    I breathe in deeply. The ocean air, the smell of seaweed, take me in a shot back to the shores of my childhood and I can feel my heart, sheathed by the wires that crisscross my chest, beating elatedly at the crazy rhythm of twelve hundred beats per hour. 



October 1999/ September 2000. 

(mostly to the sound of Ludwig van Beethoven’s piano sonatas)






    For many years, I was intrigued by the gratitude that patients show their doctor. I had witnessed the phenomenon since I was a child, as my father was a surgeon, and I would enthusiastically assist in the task of answering the door to receive the presents that were sent to him, delivered by a variety of messengers. The flurry became particularly intense at Christmas and Easter, though presents would also appear throughout the year to remind me that the phenomenon existed. I was small at the time and my reflections on the matter didn’t get much further than the rudimentary logic of “What luck! They’ve paid him and they still give him presents!” That luck that expressed itself rather strangely in some cases, I thought: patients who had been operated on ten years or so before would continue year after year, on all festive occasions, to bring him pork loin, sparkling wine, turkeys or (and yes, I can smell it now) the special sweet bread that would make our mouths water and was a staple feature of breakfast during the Christmas holidays, served fresh or, later on in the week, toasted in thick buttered slices. And then there were the cases when the present-giving became a hereditary tradition: people would continue faithfully to come round to bring their customary “little gift” long after their parent who had incurred the habit was dead and buried. “These patients are crazy,” I would gasp, watching my father thanking them reverently for the eggs in the newspaper-lined basket and the bunch of turnip greens tied with a withe. 


    The world turned, and then it was my turn to become the doctor and sometimes to receive the gratitude of the people I had treated. Embarrassed, I would shake off their gratitude muttering “I was just doing my duty” or even, brusquely and inappropriately “don’t thank me; I’m paid to do it”. 

I saw the other side of the coin when I became a patient myself and tried to show my own gratitude. I was often frustrated, almost shocked, by the miserable response: “I just did what I had to”, “you don’t have to thank me”, and of course, the impersonal first-person plural: “you don’t have to thank us; it was our obligation”.

Ugh! I know you didn’t do anything more than you had to, I know you’re paid to do it, but it just so happens that on the other end of your obligation is a person that is alive, or at least reasonably intact, thanks to all this; a traveller that you helped to return to a world in which everything, or almost everything, is as it was before. And that is a miracle, or as the novelist José Cardoso Pires would put it, “something that dazzles and transcends*”.

    It’s hard when our gratitude hits the wall. A patient feels grateful when he leaves behind the ceiling that he went through towards the unspeakable. But… he feels strangely moved by the fact that his most efficient companions on an adventure of that dimension were strangers, ultimately the only ones that continued to treat him normally rather than as someone that has suddenly become untouchable. 

    As for me, if I were to spend as many words as I would like on my acknowledgements, this chapter would be the longest in this whole narrative. That’s why, so as not to bore my readers unnecessarily or embarrass anyone, I have left them to the last pages. 


    I’m not going to thank my friends for their friendship or company, or for the messages that they sent me throughout my stay in hospital and convalescence: that too seemed like Christmas in the midst of summer, so many cards, books, CDs, chocolates, flowers… No, I shan’t spend my space on these. My acknowledgments will be reserved for those who took care of me professionally. 

    I shall begin by apologising to anyone whose name I have truncated. If I call you only by your first name, it is because this was how I knew you. After all this time, to arrive at a surname that would confer greater dignity upon the acknowledgment, I would have to make a formal petition to the Ministry of Health, which would no doubt require long explanations and would probably end up being denied under the terms of some confidentiality clause. 

    Thus, my acknowledgments will remain incomplete and somewhat vague. I remember that, on one of my pilgrimages to the Cardiology Intensive Care Unit in Santa Marta Hospital, where I lingered for a week in Bed 16, I sent greetings to “Nurse Ana” who was away that week. 

    “Which Nurse Ana?” asked my interlocutor. “The dark-haired one?”

    “No,” I replied, disconcerted by the fact that there was more than one. “The blonde.”

    I would also like to thank everyone that cared for me and whose name I don’t know, either because I never knew it or because I’ve forgotten it as our dealings grew more remote in my mind. And there were many of them. I’m grateful to all the doctors who, with their scalpels, medicines, words or other forms of intervention, restored my physical integrity. And as a suffering body, anguished soul and prolonged guest of the Health Services, I would like to shine the spotlight on the nurses and ancillary staff of the various departments through which I passed, and who had to put up with me 24 hours a day. These professionals have between them to shoulder the most arduous part of patient care: lifting, bathing, feeding, changing clothes, fetching bedpans, giving injections and enemas, cleaning foul-smelling fluids and bodily secretions, getting us up, laying us down, passing us the phone and picking up our books when they fall on the floor. And they still have enough spirit left over (as I repeatedly saw) to give us a kind word and help restore our sense of being a person in that heavy artificial impersonal and disease-ridden environment that is the hospital. 

    In this context, I must mention my appreciation of the nurses at the Intensive Care Unit of the Cardiothoracic Surgery Department of Santa Marta Hospital, who had to put up with extremely long shifts and a particularly stressful kind of work, the kind that was so physically and psychologically wearing that it would break anyone; indeed, I think they were able to stand because most still had the vigour of youth. For the reasons that I outlined in Part III of this book, these professionals should be paid their weight in gold – that would be the only fair way of paying them back for the wealth that they generated. 

    With the exception of the period relating to the Hodgkin’s Lymphoma (Part II), a story that is told rather episodically in this narrative, these acknowledgements will be presented in the chronological order in which the events occurred.


1. Lourinhã Health Centre

    To Dr Manuel João Marques, who promptly received me and referred me to the necessary level of care; and, from the bottom of my heart, Dr Vera Bonfocchi, who accompanied me on that crucial journey to Torres Vedras Hospital and assisted me with a level of attention that went far beyond the bounds of what was professionally necessary, and displayed the concern of a true friend. 


2. Torres Vedras District Hospital

    To Dr Vítor Mariano who literally saved me from certain death and led me, patiently and persistently, out of my illness. To Dr Fernando Reis, the director of Internal Medicine Department, and the other doctors of that department that attended me. To the nurses and ancillaries of the Special Care Unit, with a special mention for nurses Sofia Carvalho, Paula Coelho, Salomé and the medical auxiliary, Zezinha. 


3. Santa Marta Hospital (Lisbon)


    a) Cardiothoracic Surgery Department: To Professor José Roquette, Dr Filipe Robalo and Dr João Mendes, whose hands reconstructed my heart and didn’t let it fall. To Dr Odete Macedo, who, with her broad knowledge of Anaesthesiology, not only concerned herself with my dreamless sleep, but also calmed my anxieties before I went into the operating theatre. 

    b) Intensive Care Unit at the Cardiothoracic Surgery Department: To Dr Jorge Cunha, for overseeing my immediate recovery from heart surgery in such a calm good-humoured way. To the nurses and ancillary staff at the Unit, with special reference to the nurses Rita Barbosa, Teresa, Susana and Neuza. 

    c) Cardiology Intensive Care Unit: To Dr Rui Ferreira, who lent me a friendly shoulder throughout my stay at Santa Marta Hospital, and Dr Lurdes Ferreira. To the nurses and ancillary staff of that Unit, with a special mention for the head nurse, nurses Ana Machado and Sandra Lopes, and the medical auxiliaries, Sara, Susana and Ana.


4. To my parents-in-law, Maria José Barbosa and António Terrão, for their generosity and friendship in taking me in and caring for me during both my illness and convalescence. 


5. And also (Hodgkin’s lymphoma)


a) Diagnosis and background:

    Dr Manuel Campos Monteiro (Internal Medicine Department), Dr Joaquim Falcão (General Surgery Department) and Dr Fernando Pardal (Pathology Department) of S. Marcos Hospital in Braga.

Professor João Sampaio Fernandes and assistants Maria do Céu Cardoso and Helena Fernandes at the Amial Dental Clinic in Oporto. 

Dr Joaquim Miranda, ENT Department at Famalicão District Hospital.

Dr Rui Dessa, Medical Oncology Department at Guimarães District Hospital.


b) Treatment and follow-up:

    Dr Isabel Costa, nurses, Cristina and Nuno (patient reception) at the Day Hospital of the Haematology Department, Santo António dos Capuchos Hospital in Lisbon.

Dr Francisco Mascarenhas and the technicians (with a special mention for Patrícia) at the Radiotherapy Department of Santa Maria Hospital in Lisbon. 

* From the song Your Mother Should Know by John Lennon and Paul McCartney (Magical Mystery Tour, 1967).

* As the heart pumps nutrients and oxygen around the body, it intelligently nourishes itself first. Thus, the aorta (the large artery that transports blood to the tiniest and most distant part of the organism) splits into two independent arteries immediately after leaving the heart, which head back to the heart to nourish it with blood recently renewed in the lungs. Each one (the left and the right coronary arteries) then subdivides into various arteries which curl round like a crown (hence the term ‘coronary’) covering the whole surface of the cardiac muscle. Between its source in the aorta and this fork, there is a stretch of the left coronary artery (which irrigates the whole left hand side of the heart) about 1cm long known as the common trunk. Thus, if there is a significant obstruction in the common trunk, all the arteries downstream from the blockage cease to receive blood, which means that half the heart will immediately start to fail.   

* Harrison’s Principles of Internal Medicine, 14th ed. (New York: McGraw-Hill, 1998).

** Robert Schlant, R. Wayne Alexander ed., The Heart, 8th ed. (New York: Mc.Graw-Hill, 1996).

[*] “Falcão” means "falcon" in Portuguese, and "melro" means "blackbird". 

[†] LINAC – Linear accelerator.

* Twin Peaks, David Lynch, 1990.


I Will Survive, song by D. Fekaris and F. Perren, 1978.

[‡] Superstars: Andy Warhol and The Velvet Underground, Assírio & Alvim, Lisbon, 1992.

[§] Particularly the films Naked Lunch (1991), The Fly (1986) and Dead Ringers (1988). 

* A traditional Portuguese soup made of potatoes and kale, enriched with smoked sausage and tempered with olive oil.

* From the song Teenager in Love, sung by Dion and the Belmonts (and others). 

* From the song Dawn, performed by the Moody Blues (Days of Future Passed, 1967).

* From the song Blue Velvet, by Bernie Wayne and Lee Morris, 1951.

[**] Isometric (or static) effort – type of physical exercise in which an isolated group of muscles is mobilized which, in haemodynamic terms, puts significant pressure upon the heart (e.g. carrying a heavy gas canister or running for a bus).

[††] Entroncamento, a small county in the South of Portugal known for strange phenomena like tomatoes weighting 20 pounds, goats with five legs and similar marvels.

[‡‡] Trás-os-Montes means “Beyond-the-Mountains” and is a rural and mountainous region in the northeast of Portugal.

[§§] In Portuguese ‘prova de esforço’, literally meaning: effort test.

* From the song Vincent by Don McLean, 1972.

De Profundis, Valsa Lenta, Publicações D. Quixote, Lisbon, 1992. 

© pedro serrano


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