• Collected
  • Article

Nil By Mouth

The Overview Effect

In Hospital
  • 13 November, 2023
  • Alex Nye

I am standing in the National Portrait Gallery in Edinburgh, transfixed by a large painting which has a powerful impact on me. It is called ‘Three Oncologists’ by Ken Currie. I don’t know it yet, but I am carrying an alien inside me.

As I look at these surgeons – three of them like a holy trinity – I feel haunted. They have been disturbed in their work, their hands dripping with blood: they go into the darkness to try and fetch back survivors, if they can.

I am alone in the gallery. There is no one else here. It is silent and still as a cathedral, and I can hear the ding ding of the trams outside, like a tocsin, a death knell, drifting up through the high barred window. For a moment it feels as if I’m in Florence, in a Henry James novel, and I like that feeling. It’s more comfortable to me than the other thoughts I am having — of mortality. Does the brain know when the body is ill? Does it transport invisible messages that half-lap at the edges of our wakening?

In less than a month this moment will become a significant memory that will revisit me, and I will ask myself why I chose to linger in front of that painting, absorbing its meaning about a journey into darkness and death.

Here in Larbert Hospital I can hear the oystercatchers from an open window, enjoying the marshy reed beds in the Forth Valley. Like the room in the National Portrait Gallery, there is no view. It is winter grey outside and the only architecture visible puts me in mind of old Soviet Bloc countries before the Wall came down. A light sprinkling of snow begins to fall, and I’m worried it will settle on the M8, encircle Dunblane, and prevent Joe from visiting.

I know I’ll get better soon even if I’m in pain and discomfort, but it feels as if the finishing line gets further away. I’m longing to get my old body back. As I stare at the colourless wall opposite my bed, with a metal sign that reads ‘You are in Ward 28B’ (just in case I forget), I walk the hills inside my mind, where I find rivers and streams waiting for me. When they head towards me with invasive treatments, injections or needles and tell me to go to my happy place, I am surprised when I choose an ordinary regular dog walk: Anchors Cross, with its view of mountains, and soft paths through waving grass, where the breeze blows. I long to feel that breeze on my face.

But I also long for the texture and richness of food and drink slipping down my throat. I stare at an article in the Scots Magazine about a food writer who has made an art out of cooking in the wild, out of doors, on a peat fire. Twenty minutes can evaporate just staring at these photographs while I imagine biting into the layers of textured, slightly charred bread, with its meaty fillings, while the breeze sends flags of peaty smoke across my face.

I am hooked up to instruments, machines bleep about my bed, a thick tube sits in my narrow nostril and courses its way down my throat, into my stomach, where it collects bile. I’m a writer. I live in the mind, but I now realise how vital my bowel is, a waste disposal unit inside the miracle that is my body.

And the miracle is that it will be fixed by a kind surgeon with a cheery Northern English accent who wears jumpers to work.

But for now, I do not know this. I’m too ill to write, although I do sometimes pull my phone towards me, and tap my thoughts onto Instagram, without counting it as writing. What sustains me – apart from loved ones – is the power of my imagination. I can take myself out of this room, away from this non-view, and walk the hills of my mind because that is what writers do. They build worlds, mine for specks of gold; like archaeologists they sieve grit and rubble to separate it into layers, rich deposits that wait for us to find them. I have memories to draw on, and I have an imagination to picture the places I would rather be. But it’s the texture of food I miss, the clink of a tall glass with a fizz of cola poured over Arctic cubes of ice, the zing of lemon, the crunch of an apple. I crave ice all the time. I want to be in Iceland, the Antarctic, Norway: places I have never been.

After one month of Nil by Mouth, with no food or drink passing my lips, kept alive by an intravenous drip, I finally get to eat my first mouthful of banana. It bursts with an explosion of sweetness inside my mouth, and I stop, like a toddler in a highchair, close my eyes to savour it. And I don’t even like bananas. But this banana, this banana is special. It is a brand-new, virgin banana, and I know I am tasting food as a newborn does, a baby imbibing its first solids. It will be a slow return to health, eating little and often. I cannot read at first. Nothing I read speaks to me of what I have just been through. In a few weeks’ time, I will take my childhood copy of Moominpappa at Sea to Mull with me, and read it overlooking Treshnish Point, where the Atlantic waves meet the rocks, and my dog sits beside me in the long grass. It’s a battered old copy, bought for 45p from my local bookstore in King’s Lynn in 1972. It works its magic, eases me back into the business of being a writer — which is also being a reader.

Although I cannot read or write during this time, my mind still makes the connections, sparked by the inspirational links which eventually find their way onto the page: an elemental circuitry. I could not see the oystercatchers from where I lay in my hospital bed – just as I could not see the trams in the National Portrait Gallery as I stood before the painting – but I could hear them, and their voices took me places I could not visit, answered a longing inside me. This is the wonderful resource I have (we all have) stored up inside. The power to plug into it, and find the language, the connections to spark this tangled ball of wires we call being human.

From my bed, I wander art galleries because I know artists do the same, with their brushes and materials. For me it is pen and ink, the whisper of the page. These things may not keep me alive when I am Nil by Mouth, but they give me hope, they make me want to live.

I eventually read Dan Richards’s book Outpost, in which he explores places of shelter in the wilderness (sheds, bothies, fire-watch towers…). In it, he asks why we are drawn to these remote places, with their sheltering huts. It’s a wonderful account of trips into Norway, Scotland, Iceland, Japan and Utah to name a few. I found it connected – strangely – with my own experience of lying in a hospital bed, especially when I read this: ‘Psychologists have studied this so-called ‘overview effect’, a cognitive shift following an experience of true awe, and measured its impact on human subjects. It turned out to be transformational. The subjects returned home patient, less materialistic, and more willing to help others.’ Dan Richards’s original source for this idea was Antoine de Saint-Exupéry’s Wind, Sand and Stars, and Dan writes how ‘returning astronauts’ experienced this ‘overview effect’. I suppose it is akin to that first photograph of our planet as a blue ball in black space, taken by a satellite, and allowing us to see our world for the first time from the outside.

It gave me pause for thought, because I knew that feeling – not from traversing the wild spaces of Iceland, which I don’t have the resources (or the health) to visit just now – but from staring at a hospital wall for weeks on end.

I didn’t travel to the far-flung places of Dan Richards’s book: I didn’t stand on a glacier, retreat to a last true wilderness where humans rarely venture. But I went to a place which does lie on the edge, and has an air of otherness about it, a ‘thin place’.

That hospital bed was a borderland, a place where I met the darkness others disappear into, and I returned with a feeling of immense awe and gratitude, rescued by surgeons with their knives and their skill like the three oncologists in Ken Currie’s painting.

The past few months have changed me as a writer. They have transformed what I want to write about. I am pulling the threads from the tangled ball, making connections, sorting, sifting. I will plug the wires in and see what sound they make.

We might not have the funds for a mission impossible, we might not be able to visit the wild hinterland of the places we read about, but we can still have our elemental experiences, confront the business of being alive, simply by listening to the distant cry of an oystercatcher from the white plain of a hospital bed.

Alex Nye is the author of eight novels, mostly historical fiction for adults. Her latest novel, Gallow Falls, is a crime mystery set in Scotland. ‘An enthralling novel’ (Scots Magazine).

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