The Suspect

From the pitched slate roof of the Royal Marsden Hospital, if you look between the chimney pots and TV aerials, you see more chimney pots and TV aerials. It’s like that scene from Mary Poppins where all the chimneysweeps dance across the rooftops twirling their brooms.

From up here I can just see the dome of the Royal Albert Hall. On a clear day I could probably see all the way to Hampstead Heath, although I doubt if the air in London ever gets that clear.

“This is some view,” I say, glancing to my right at a teenager crouched about ten feet away. His name is Malcolm and he’s seventeen today. Tall and thin, with dark eyes that tremble when he looks at me, he has skin as white as polished paper. He is wearing pajamas and a woolen hat to cover his baldness. Chemotherapy is a cruel hairdresser.

The temperature is 3°C, but the wind chill has chased it below zero. Already my fingers are numb and I can barely feel my toes through my shoes and socks. Malcolm’s feet are bare.

I won’t reach him if he jumps or falls. Even if I stretch out and lean along the gutter, I will still be six feet short of catching him. He realizes that. He’s worked out the angles. According to his oncologist, Malcolm has an exceptional IQ. He plays the violin and speaks five languages—none of which he’ll speak to me.

For the last hour I’ve been asking him questions and telling him stories. I know he can hear me, but my voice is just background noise. He’s concentrating on his own internal dialogue, debating whether he should live or die. I want to join that debate, but first I need an invitation.

The National Health Service has a whole raft of guidelines for dealing with hostage situations and threatened suicides. A critical incident team has been pulled together, including senior members of staff, police and a psychologist—me. The first priority has been to learn everything we can about Malcolm that might help us identify what has driven him to this. Doctors, nurses and patients are being interviewed, along with his friends and family.

The primary negotiator is at the apex of the operational triangle. Everything filters down to me. That’s why I’m out here, freezing my extremities off, while they’re inside drinking coffee, interviewing staff and studying flip charts.

What do I know about Malcolm? He has a primary brain tumor in the right posterior temporal region, dangerously close to his brain stem. The tumor has left him partially paralyzed down his left side and unable to hear from one ear. He is two weeks into a second course of chemotherapy.

He had a visit from his parents this morning. The oncologist had good news. Malcolm’s tumor appeared to be shrinking. An hour later Malcolm wrote a two-word note that said, “I’m sorry.” He left his room and managed to crawl onto the roof through a dormer window on the fourth floor. Someone must have left the window unlocked, or he found a way of opening it.

There you have it—the sum total of my knowledge about a teenager who has a lot more to offer than most kids his age. I don’t know if he has a girlfriend, or a favorite football team, or a celluloid hero. I know more about his disease than I do about him. That’s why I’m struggling.

My safety harness is uncomfortable under my sweater. It looks like one of those contraptions that parents strap on to toddlers to stop them running off. In this case it’s supposed to save me if I fall, as long as someone has remembered to fix the other end. It might sound ridiculous, but that’s the sort of detail that sometimes gets forgotten in a crisis. Perhaps I should shuffle back toward the window and ask someone to check. Would that be unprofessional? Yes. Sensible? Again yes.

The rooftop is speckled with pigeon droppings and the slate tiles are covered in lichen and moss. The patterns look like fossilized plants pressed into the stone, but the effect is slick and treacherous.

“This probably makes no difference, Malcolm, but I think I know a little about how you’re feeling,” I say, trying once more to reach him. “I have a disease too. I’m not saying that it’s cancer. It’s not. And trying to make comparisons is like mixing apples with oranges, but we’re still talking about fruit, right?”

The receiver in my right ear begins to crackle. “What in Christ’s name are you doing?” says a voice. “Stop talking about fruit salad and get him inside!”

I take the earpiece out and let it dangle on my shoulder.

“You know how people always say, ‘It’ll be fine. Everything is going to be OK’? They say that because they can’t think of anything else. I don’t know what to say either, Malcolm. I don’t even know what questions to ask.

“Most people don’t know how to handle someone else’s disease. Unfortunately, there’s no book of etiquette or list of do’s and don’ts. You either get the watery-eyed, I-can’t-bear-it-I’m-going-to-cry look or forced jokiness and buck-up speeches. The other option is complete denial.”

Malcolm hasn’t responded. He’s staring across the rooftops as if looking out of a tiny window high up in the gray sky. His pajamas are thin and white with blue stitching around the cuffs and collar.

Between my knees I can see three fire engines, two ambulances and half a dozen police cars. One of the fire engines has an extension ladder on a turntable. I haven’t taken much notice of it until now, but I see it slowly turning and begin to slide upwards. Why would they be doing that? At the same moment, Malcolm braces his back against the sloping roof and lifts himself. He squats on the edge, with his toes hanging over the gutter, like a bird perched on a branch.

I can hear someone screaming and then I realize that it’s me. I’m yelling the place down. I’m wildly gesticulating for them to get the ladder away. I look like the suicidal jumper and Malcolm looks totally calm.

I fumble for the earpiece and hear pandemonium inside. The critical incident team is shouting at the chief fire officer, who is shouting at his second-in-command, who is shouting at someone else.

“Don’t do it, Malcolm! Wait!” I sound desperate. “Look at the ladder. It’s going down. See? It’s going down.” Blood is pounding in my ears. He stays perched on the edge, curling and uncurling his toes. In profile I can see his long dark lashes blinking slowly. His heart is beating like a bird’s within his narrow chest.

“You see that fireman down there with the red helmet?” I say, trying to break into his thoughts. “The one with all the brass buttons on his shoulders. What do you think my chances are of gobbing on his helmet from here?”

For the briefest of moments, Malcolm glances down. It’s the first time he’s acknowledged anything I’ve said or done. The door has opened a chink.

“Some people like to spit watermelon seeds or cherry pips. In Africa they spit dung, which is pretty gross. I read somewhere that the world record for spitting Kudu dung is about thirty feet. I think Kudu is a kind of antelope but don’t quote me on that. I prefer good old-fashioned saliva and it’s not about distance; it’s about accuracy.”

He’s looking at me now. With a snap of my head I send a foaming white ball arcing downwards. It gets picked up by the breeze and drifts to the right, hitting the windscreen of a police car. In silence I contemplate the shot, trying to work out where I went wrong.

“You didn’t allow for the wind,” Malcolm says.

I nod sagely, barely acknowledging him, but inside I have a warm glow in a part of me that isn’t yet frozen. “You’re right. These buildings create a bit of a wind tunnel.”

“You’re making excuses.”

“I haven’t seen you try.”

He looks down, considering this. He’s hugging his knees as if trying to stay warm. It’s a good sign.

A moment later a globule of spit curves outwards and falls. Together we watch it descend, almost willing it to stay on course. It hits a TV reporter squarely between the eyes and Malcolm and I groan in harmony.

My next shot lands harmlessly on the front steps. Malcolm asks if he can change the target. He wants to hit the TV reporter again.

“Shame we don’t have any water bombs,” he says, resting his chin on one knee.

“If you could drop a water bomb on anyone in the world, who would it be?”

“My parents.”

“Why?”

“I don’t want to have chemo again. I’ve had enough.” He doesn’t elaborate. It isn’t necessary. There aren’t many treatments with worse side effects than chemotherapy. The vomiting, nausea, constipation, anemia and overwhelming fatigue can be intolerable.

“What does your oncologist say?”

“He says the tumor is shrinking.”

“That’s good.”

He laughs wryly. “They said that last time. The truth is they’re just chasing cancer all around my body. It doesn’t go away. It just finds somewhere else to hide. They never talk about a cure; they talk about remission. Sometimes they don’t talk to me at all. They just whisper to my parents.” He bites his bottom lip and a carmine mark appears where the blood rushes to the indentation.

“Mum and Dad think I’m scared of dying, but I’m not scared. You should see some of the kids in this place. At least I’ve had a life. Another fifty years would be nice but, like I said, I’m not scared.”

“How many more chemo sessions?”

“Six. Then we wait and see. I don’t mind losing my hair. A lot of footballers shave their hair off. Look at David Beckham; he’s a tosser, but he’s a wicked player. Having no eyebrows is a bit of a blow.”

“I hear Beckham gets his plucked.”

“By Posh?”

“Yeah.”

It almost raises a smile. In the silence I can hear Malcolm’s teeth chattering.

“If the chemo doesn’t work my parents are going to tell the doctors to keep trying. They’ll never let me go.”

“You’re old enough to make your own decisions.”

“Try telling them that.”

“I will if you want me to.”

He shakes his head and I see the tears starting to form. He tries to stop them, but they squeeze out from under his long lashes in fat drops that he wipes away with his forearm.

“Is there someone you can talk to?”

“I like one of the nurses. She’s been really nice to me.”

“Is she your girlfriend?”

He blushes. The paleness of his skin makes it look as though his head is filling with blood.

“Why don’t you come inside and we’ll talk some more? I can’t raise any spit unless I get something to drink.”

He doesn’t answer, but I see his shoulders sag. He’s listening to that internal dialogue again.

“I have a daughter called Charlie who is eight years old,” I say, trying to hold him. “I remember when she was about four, we were in the park and I was pushing her on a swing. She said to me, ‘Daddy, do you know that if you close your eyes really tightly, so you see white stars, when you open them again it’s a brand new world.’ It’s a nice thought, isn’t it?”

“But it’s not true.”

“It can be.”

“Only if you pretend.”

“Why not? What’s stopping you? People think it’s easy to be cynical and pessimistic, but it’s incredibly hard work. It’s much easier to be hopeful.”

“I have an inoperable brain tumor,” he says incredulously.

“Yes, I know.”

I wonder if my words sound as hollow to Malcolm as they do to me. I used to believe all this stuff. A lot can change in ten days.

Malcolm interrupts me. “Are you a doctor?”

“A psychologist.”

“Tell me again why should I come down?”

“Because it’s cold and it’s dangerous and I’ve seen what people look like when they fall from buildings. Come inside. Let’s get warm.”

He glances below at the carnival of ambulances, fire engines, police cars and media vans. “I won the spitting contest.”

“Yes, you did.”

“You’ll talk to Mum and Dad?”

“Absolutely.”

He tries to stand, but his legs are cold and stiff. The paralysis down his left side makes his arm next to useless. He needs two arms to get up.

“Just stay there. I’ll get them to send up the ladder.”

“No!” he says urgently. I see the look on his face. He doesn’t want to be brought down in the blaze of TV lights, with reporters asking questions.

“OK. I’ll come to you.” I’m amazed at how brave that sounds. I start to slide sideways in a bum shuffle—too frightened to stand. I haven’t forgotten about the safety harness, but I’m still convinced that nobody has bothered to tie it off.

As I edge along the gutter, my head fills with images of what could go wrong. If this were a Hollywood movie Malcolm will slip at the last moment and I’ll dive and pluck him out of mid-air. Either that or I’ll fall and he’ll rescue me.

On the other hand—because this is real life—we might both perish, or Malcolm could live and I’ll be the plucky rescuer who plunges to his death.

Although he hasn’t moved, I can see a new emotion in Malcolm’s eyes. A few minutes ago he was ready to step off the roof without a moment’s hesitation. Now he wants to live and the void beneath his feet has become an abyss.

The American philosopher William James (a closet phobic) wrote an article in 1884 pondering the nature of fear. He used an example of a person encountering a bear. Does he run because he feels afraid, or does he feel afraid after he has already started running? In other words, does a person have time to think something is frightening, or does the reaction precede the thought?

Ever since then scientists and psychologists have been locked in a kind of chicken-and-egg debate. What comes first—the conscious awareness of fear or the pounding heart and surging adrenalin that motivates us to fight or flee?

I know the answer now, but I’m so frightened I’ve forgotten the question.

I’m only a few feet away from Malcolm. His cheeks are tinged with blue and he’s stopped shivering. Pressing my back against the wall, I push one leg beneath me and lever my body upwards until I’m standing.

Malcolm looks at my outstretched hand for a moment and then reaches slowly toward me. I grab him by the wrist and pull him upwards until my arm slips around his thin waist. His skin feels like ice.

The front of the safety harness unclasps and I can lengthen the straps. I pass them around his waist and back through the buckle, until the two of us are tethered together. His woolen hat feels rough against my cheek.

“What do you want me to do?” he asks in a croaky voice.

“You can pray the other end of this is tied on to something.”