Grapefruit

by Margaret Cahill

My father’s brain tumour changed everything for me. He collapsed at home a week after my thirteenth birthday and sunk into a coma he never woke up from. A doctor talked my mother and I through the brain scans that showed the grapefruit-sized tumour that had invaded his frontal and temporal lobes. He said it had probably been growing there for years. It was inoperable, incurable. There was nothing they could do. I couldn’t understand how someone could have such a huge lump of a thing growing inside their head without knowing. Now, of course, I realise that the symptoms had been there all along if we’d known what to look for: the regular headaches, the worsening vision that he put down to needing a new pair of glasses, and him not noticing the stench that time the septic tank out the back overflowed.

My mother and I went to visit him in the ICU every day for the next five weeks. With each passing week, he looked paler and somehow smaller. Sitting by his bed, watching his lifeless body, felt like we were already at his wake. The hissing of the ventilator and beeping of the cardiac monitor were the only signs that he wasn’t already dead. That last day, a Saturday morning, my mother left me alone with him while she went down to the hospital chapel. She’d never been a religious woman, but I suppose she was desperate. All of a sudden, the machines in the room started alarming, and a stream of doctors and nurses came rushing in, pushing me out of the way as they crowded around him, shouting instructions to each other as they started chest compressions on him. I stood in the corner, crying my eyes out at their violent assault upon his limp, weakened body. When I screamed at them to stop, a nurse dragged me outside, but I could still see everything through the glass walls of the ICU cubicle.  

By the time my mother came back, they had stopped doing chest compressions, and the frantic busyness of the room had slowed. I thought this meant that he was going to be okay, that he was finally going to wake up. The medical staff all stopped what they were doing and turned to look at my mother when she walked in. I couldn’t read what their faces said, but when she dropped to the floor and started wailing, I knew he was gone, this time for good.  

My mother had never been what you would describe as ‘upbeat,’ but after that, she sank into a state of perpetual gloom. Every morning she seemed more and more disappointed to find herself still alive and having to face another day. She threw herself headlong into a diet of daytime TV and white wine. I learned not to be a burden to her and become quite self-sufficient. In a way, I lost both parents that day. Of course, I can see now that she must have been depressed. She had reason enough to be. and I’ve never held it against her.

While my mother hid from the realities of the world in her way, I did so in mine. Books became my refuge—medical books—as strange as it might sound. By then, I had already devoured all the usual children’s and teen fiction in the local library, but one Saturday morning, a couple of months after my father’s passing, I turned left at the travel section and found myself face to face with medical books on every topic you could imagine, stacked floor to ceiling. Apparently, a surgeon from town who had died a few years previously had donated all his old medical books and journals to the library, so they had quite the collection.

For weeks, I spent hours of my Saturdays sitting on a bean bag in the corner reading everything I could find about brain tumours. Eventually, I took my mother’s library card from the drawer in the hall, so I could borrow them and bring them home to read them at my leisure. I stayed up until all hours at night, reading in bed by torchlight. I learned how to untangle medical terminology into its Greek and Latin roots: cerebro, hepta, derma, osteo, itis, ectomy, and ology. It was like discovering a secret language. I whispered the elaborate technical terms to myself, loving the feel of the multi-syllable words as they passed my lips.

I discovered that it wasn’t just my father’s doctor that used fruit to describe the size of tumours. It turned out that all sorts of foodstuffs had entered the medical lexicon. Kidney stones or gall stones were often characterised as being pea-sized or walnut-sized. The size of various lumps, bumps, and tumours were compared to grapes, oranges, plums, peaches, or even the dreaded grapefruit, which is where this all began. Then there was the use of various sports balls to categorise the size of tumours and growths. I found references in the literature to golf balls, ping-pong balls, tennis balls, and—in extreme cases—footballs and even basketballs. I had a collection of balls of various kinds arranged in order of size on the shelf in my room to help me visualize the conditions I read about.

I developed a particular fascination with the idea of football and basketball-sized tumours. They were as intriguing as they were horrifying. It’s most often the poor or rural-dwelling people in countries, like India or China, where you find that sort of thing. Without access to medical care, because of poverty or sheer lack of access, people can end up with them growing on or in them for years, decades even. I came across case studies with photos of tumours that seemed to have melted people’s faces off and gargantuan abdominal tumours that made men look pregnant. There were even men with monstrously swollen testicles that swung down to their knees, caused by Scrotal Lymphedemas for the most part. The grotesqueness of it enthralled me.

It was a strange hobby, I suppose, but wanting to understand the body was probably my way of coping with the traumatic nature of my father’s sudden illness and death. I didn’t see it as any odder than the obsessions of other boys my age. I had no interest in football, action heroes, or cars that seemed to excite them. While my classmates were off playing football or punching each other for fun at lunchtime, I’d sit alone in the bike shed with my sandwiches and a medical book hidden behind a Beano.

It was little surprise to anyone when the time came to apply to college and I announced that I wanted to become a surgeon. What people didn’t know was how many hours I’d spent every day fantasising about cutting away tumours. In my mind, I was a hero with a scalpel, tackling vast tumours that no other surgeon would touch, the sort of complex structures that had embedded themselves precariously around blood vessels and organs. In my daydreams, I was always successful, no matter how difficult the case. That’s not what I wrote in my application essay for medical school, of course. I made up some sentimental gush about wanting to help people and advance medical knowledge. That, and my six A1s got me in.

I loved the anatomy and physiology classes in college and couldn’t wait to get cutting, but in those days, you weren’t allowed slice into real flesh until fourth year. I spent most of my free time in the surgical skills lab instead, honing my scalpel skills. It never felt like work. I practised techniques I’d studied in medical papers, long before we would ever come across them in class. I got in trouble in second year for skipping lectures and hogging stations in the lab that were supposed to be reserved for fifth and sixth years. I had to cut down using the lab during the day after that, but I found a security guard with a fondness for Jameson who let me stay in at night in exchange for a bottle every now and then. I studied by day and practised surgery by night, barely sleeping, and surviving on naps in the common room between classes. I had no friends. I had neither the time nor the need for them.

When the time for my surgical rotation finally arrived, I was in heaven. I had dreamt about it for so many years. For the first three months, it was observation only, but I didn’t mind. I loved standing beside the surgeons, watching them manipulate flesh with their mannequin-like latex-gloved hands. They deftly used scalpels, forceps, retractors, and clamps as if they were extensions of their own limbs. There was a beauty to their work. In comparison, the saws, hammers, drills, and power tools of the orthopaedic theatre horrified me with their barbarity. That was one speciality I ruled out straight away. I envisioned a more elegant future for my own practice.

I secured my surgical internship after graduating, as expected, and I threw myself into it. I wanted to be the best, and I worked harder than ever to make sure that I was. Every moment of my existence was focused entirely on the physical body. It became all-consuming. I no longer saw faces when I looked at people, just collections of tissue, organs, bones vascular systems, and nerves that might fail on them at any moment, and that I would fix.

After the isolation of my youth, and never fitting into the social hierarchies of school and college, wearing that white coat into hospital every day gave me a new sense of importance. People, well, civilians and students at least, looked at me with deference. That was the year that I discovered sex. Word started getting around the hospital that I was a remarkably passionate lover and, without too much effort on my part, I managed to sleep with most of the fourth years, three of the interns, and a registrar seven years my senior. I loved to run my hands over their bare flesh, feeling the simultaneous strength and vulnerability of their muscles, tracing the shape of their organs beneath the skin, gripping the vertebrae that protected their delicate spinal cords. When I penetrated them, I fantasised about their flesh tearing, tendons snapping, arteries exploding and tumours blossoming. My arousal would became more frenzied as I visualised my hands and surgical tools deep inside of them, repairing their broken bodies. I performed medical miracles in my imagination as I reached my peak, and I would climax in both mind and body with the joy of saving them. They all presumed it was their sexual appeal and prowess that whipped me into such a frenzy, hence my popularity as a lover.

As much as I enjoyed these newfound physical pleasures, my sex life took a back seat when I became a registrar. I simply didn’t have the time or energy for both. I clocked up more surgeries in those years than anyone thought possible, was second author on a host of published papers, and eventually started my own research into reducing abdominal adhesions after laparotomies. The sacrifices paid off when I secured a consultant post just a week shy of my thirtieth birthday. I was the youngest they’d ever had at the hospital. Students and interns battled to get on my team, so they could watch me work and learn from me. I was a rock star. The theatre was my stage.

I used to keep a tally in my head of the surgeries I have done. Five years ago, I would have been able to list off the number of colons I had re-sectioned, gall bladders I had removed, how many Whipple procedures I’d done on pancreatic tumours, and so on, but the numbers eventually got so high that I couldn’t keep track of them anymore.

I needed some other way to record and acknowledge my surgical successes. I mulled it over for weeks, thinking about where I had come from, the sacrifices I had made to get here, the skills I had learned, the people I had saved, and those I couldn’t. I was cauterising a blood vessel one day, when I realised that the answer was staring me in the face. A few flicks of a laser or a cautery tool would be all it would take to leave a mark. No one else would ever see it or know it was there. It would have to be something meaningful though, something with a touch of elegance to it.

While changing after surgery that evening, I caught sight of my reflection in the bathroom mirror. My eyes were drawn to the tattoo on my chest, three graceful Chinese letters that sit right above my heart. I’d originally wanted the wording to be in Greek or Latin, but the Chinese translation looked so much more refined and delicate that I’d chosen it instead.

I ran my fingers across the blank ink ingrained into my skin, and I knew that this would be perfect. At the end of every successful surgery since, I’ve discretely inscribed those three Chinese characters onto all of my patients before I close them up.

In English, it means grapefruit.

BIO: Margaret Cahill is a short story writer from Limerick, Ireland. Her fiction has been featured in Idle Ink, Bulb Culture Collective, The Milk House, époque press é-zine, Ogham Stone, Honest Ulsterman, HeadStuff, Silver Apples, Autonomy anthology, Incubator, Crannog, Galway Review, Limerick Magazine, Boyne Berries and The Linnet’s Wings. She also dabbles in writing about music and art, with publications on HeadStuff.org and in Circa Arts Magazine.