Brothers of the Head (9 page)

Sometimes, I looked up from our task and spied my brothers some way away. They were watching us. The whole landscape shimmered in the heat – it was difficult to believe they were there. As we worked along the southern fringes of our little domain, along by Little Ramsey, Great Ramsey and the saltings, towards Overy Mussel Strand and Great Aster, I would look inland and see a silver thread of holiday traffic winding along the coast road. I realized how isolated we were.

Father hardly spoke from dawn to sunset. His heart was breaking to see his creatures die. Yet some creatures flourished in the drought. We saw grass snakes for the first time on the Head. Sand lizards scuttled everywhere – pretty little nervous creatures. Most unpleasant was a plague of ladybirds, which sprawled copulating in their millions all over the house, getting into beds and food and clothes, piles of them everywhere like fresh blood.

The sun baked my unfortunate brothers black. They were starving each other, taxing each other to death, wearing each other down, regardless of consequences. I feared that they devoured carcasses of poisoned birds. Visitors to the sanctuary were terrified by them. A London journalist on a weekend trip to Blakeney filed a story with his paper which appeared under the headline ‘Minotaur in a Mallard Sanctuary'. We had a special boatload of tourists after that. My father drove them off by firing his sporting rifle over their heads. He was almost as strange as his sons.

Our little isolated world stank of death. I hung bunches of sea lavender and the pungent sea wormwood in the kitchen. I locked the doors at night. My brothers cried outside my window – blessings, pleas, obscenities. I could not bear it. I went away in Bert Stebbings' boat and stayed with my aunt at the Staithe. But I had no place there, and returned to the Head late the next day.

Bert took me back in his boat. It was nine in the evening as we chugged up The Run. L'Estrange Head was deserted of its daytime visitors. Its bare extent lay quiet under the last of the sun. I could see the abbey ruin and our house against it, with a light burning in the kitchen, where my father would be reading or stuffing a dead bird. Never before had I felt the desolation as hostile.

My brothers heard the chug of the boat's engine as we rounded into Cockle Bight. They came running like a four-legged beast into the shallows towards us, brandishing sticks in their outer fists, shouting, cursing me and Bert.

‘They've gone proper barmy, Robbie, my love, that they have – I wouldn't trust yourself to them,' Bert said. He shouted out to them to control themselves.

They paused. They stared out across the darkening waters towards us. The Deeping Sands light started its quick flashing out to sea. For the first time in my life, I was scared of my own brothers. They were not my brothers any more. Instead, they were something – elemental is perhaps the word.

‘Come back home with me, Robbie,' Bert said. He stopped his engine.

Those were the words I wanted to hear him say. Tom tried to wade out towards our boat. At once Barry lifted up his right inner arm, and locked it behind Tom's head so as to thrust it forward. Of all the indignities they had inflicted on each other, this move was one, I felt sure, they had never managed before, because of the tightness of the ligaments binding them together.

Tom kicked out at Barry's legs and a fight started. They fell into the swelling sea, bellowing. They disappeared, though terrible thrashings marked where they were.

‘Oh, quick, Bert!'

Without a word, Bert let in the clutch and we surged forward. He made a sweep round, cut the engine, threw out his little anchor, and jumped overboard, all in one practised series of movements. I jumped in after him. The water was up to the top of my thighs.

Bert got on top of my brothers and started pulling. Tom's head came up, water pouring from it, his mouth a wide hole gasping for air. Barry's head came up, and the third head. But Tom grabbed it by its hair and dragged them under again. Bert caught him round the throat and wrenched him above the surface.

Somehow we dragged them to the nearest bit of beach between us and dropped them there. Tom was still fighting and coughing and swearing but Barry was too exhausted even to do that. We worked at his lungs, but he merely groaned. He was unconscious, his face livid. Suddenly it was dark and chill.

Glaring up at me with an alarmed expression, Bert said, ‘He looks real bad. We'd best take them to Dr Collins' clinic in Norton.'

As he spoke, Barry groaned louder and went into convulsions, sitting up – still unconscious but his eyes staring – and bellowing for breath. His face was distorted, his neck thick. He flung Tom about in his agony.

‘Quick, it's his heart!' cried Tom, clutching at his own heart.

Bert and I stood up. The sky was darkening overhead with night winding in across the marshes. Barry's noise was terrible – both his and that other face were black as they writhed in pain.

‘It's a coronary attack,' I said. ‘Oh, Bert! Better not to move them. I'll go and get Dad. You go back in the boat and get Dr Collins. Quick as you can. Tell Aunt. Look, ask Aunt to phone Henry Couling, that lawyer, will you? She has his number. We may need his help.'

‘Don't leave us!' Tom cried.

I was suddenly all cold and practical. Without waiting to see Bert go off, I told Tom to lie as still as he could and went on the run across the dunes for father.

The rest of that night is best not told in detail. When Barry's attack was over, father and I got him with Tom's help back to the house. We tucked them up under blankets on the floor of the living room. It was best not to attempt the stairs. Barry was in a deep slumber, seemingly more dead than alive. Both his face and the other one were flushed. Tom also complained of pains, which was scarcely surprising, considering their connecting circulatory system. His breathing was fast and shallow; he was sweating a good deal and looking thoroughly frightened. When I bathed his head and shoulders, a crust of dirt came away.

Bert came with Dr Collins on the low tide at six the next morning, when colour had newly returned to the world about us. It was impossible to make headway up The Run in a small boat against an incoming tide.

Everyone loved Dr Collins, mainly because she looked like sixteen years of age and had the stamina of a carthorse. She was a small neat woman with bobbed hair. She examined both of my brothers before giving them an injection which put them out. Her diagnosis was that Barry had suffered a thrombosis. It was imperative to get them to the hospital in Holt quickly.

Nobody argued with Dr Collins.

Father roused himself from his self-absorption for once and took charge of things. We shipped Tom and Barry over to the Staithe in Bert's boat, and Dr Collins phoned for an ambulance. Before the ambulance arrived at the Staithe, Barry had another violent attack. Both the boys were in a bad way. The terrible heat did not help matters.

On the way to the hospital, Barry had a further seizure, and died.

Roberta Howe has asked me to write a note about the Howe twins, and of course I am happy to do so. The Howe twins are as celebrated in the literature of teratology as are the Siamese twins. However, I intend this to be a personal record, not a medical paper.

The sibling hatred that existed between Tom and Barry was accentuated by their inseparability. In character they were totally different, both dominated by an impaired parent-relationship. This encouraged neurotic passivity in the case of Tom. Under ordinary circumstances, Tom would have signified submission in any rivalry situation by withdrawal; linked to his aggressive brother, he was unable to withdraw, and so was in a perpetual anxiety state, his self-assertive faculties constantly over-taxed. Which is not to imply that he was not often the aggressor; as psychotherapists understand, worms turn, and Tom in hysteria frequently attacked his dominant brother.

In most reminiscences of the Howe twins, Barry is generally cast as the villain. I am less certain of this. Admittedly he was aggressive, yet it is doubtful if he would have attracted attention had he been free to pursue his own course. There is some evidence of obsessional neurosis in his attempts to control Tom, but this is hardly to be wondered at, when we reflect how he was forever unable to act as a free agent capable of spontaneous action.

Anxiety quotients were high in both Tom and Barry. In childhood and after, they had been examined by experts at irregular intervals. After every examination, they suffered traumatic outbursts of activity, characterized by violence. This suggests masked fears about the severance – a traumatic event following which they would have to make their way through life alone, as individuals, unsupported in a world which had already graphically demonstrated the inadequacy of parental love.

Their meteoric rise to being pop superstars reinforced the underlying fears that either would have been useless on his own; while their sexual jealousy rendered continued propinquity intolerable. Resultant tensions destroyed them.

My understanding is that constant high anxiety quotients promoted serum cholesterol levels in the bloodstream which promoted serum cholesterol levels in the bloodstream that accelerated a narrowing of the arteries of the heart. The formation of blood clots was promoted, and so the coronary attacks occurred. Since the Howe twins had a communal circulatory system, it is a matter of accident that it was Barry rather than his twin who suffered from the thrombosis.

We were fortunate that Sir Allardyce Stevens, whose work on artificial hearts and pacemakers is well known, happened to be at Holt Hospital when the twins arrived. Sir Allardyce was attending a symposium, and had had occasion to examine the twins professionally during the period of their success as the Bang-Bang. He immediately took charge of the case.

At this juncture, Barry Howe was already dead. Which is to say, his heart pump had failed and was merely fibrillating in response to the linked pump of Tom's heart. Tom had responded to the shocks to his system with hysterical attacks. The male nurse with him in the ambulance, Mr V. S. Porter, had administered a sedative, and Tom was still unconscious when the double body was wheeled into Holt operating theatre.

Sir Allardyce's examination showed severe infarction of the right ventricle, with necrosis of cellular tissue there and in the adjoining superior vena cava. The layman must understand that this examination entailed open-heart surgery in which cardiac catheterization was employed. In other words, the preliminary steps towards a heart transplant were already taken before Sir Allardyce decided that a heart transplant was necessary. I explain this because criticism of that decision has circulated, mainly thanks to an ill-informed lay press. The decision represented a small step on, and an inevitable one if the Howe twins were to survive. No competent surgeon in Sir Allardyce's position would have decided otherwise.

An APPCOR (Auto-Powered Prosthetic Cardiac Organ Replacement) of the correct specification was to hand. It was installed in place of the defective organ, and the installation proceeded without a hitch.

I was moved by my first sight of the Howe twins. They were both handsome young men. It was an ill turn of fate that they had not entirely separated in the womb. Given this conjoined condition, they should not have been encouraged to survive post-natally. Such is my professional opinion. I am aware of certain moral considerations. I am also aware that medical men have a natural streak of curiosity; given all the wonderful modern adjuncts of their profession they are sometimes tempted to prolong life in order to see what will happen, without, regard to the grief incurred by the survivors. In this respect they are little better than Victor Frankenstein, bringing a creature to life without any thought of what might follow.

Now Sir Allardyce was patching one such example of regardlessness with another of the same kind. He was a brilliant surgeon who had a brilliant opportunity come his way; it was hardly to be expected that he would not take it.

I travelled with the twins in the ambulance from Deeping Staithe to Holt, and was present during the ‘death' of Barry. My own panel, my own patients, awaited me back in Deepdale Norton. I returned there as soon as possible, since I was unable to make myself useful at the hospital. However, such was my interest in the case that I drove back to Holt when evening surgery was over. Sister Carrisbroke showed me to the ICU – and there were the Howe twins, with Tom propped up on a pillow and taking soup.

Barry lay back beside him against the banked mattress. His eyes were closed. His complexion was pale and blotched in comparison with the healthier colour of Tom's face. The other head lay silently against Barry's, in its usual position. Barry's breathing was normal. Tom was cheerful. As so often in APPCOR cases, the recovery rate is impressive. When I drove back again to Norton, I gave Roberta Howe a lift from the hospital. She spent the night at her aunt's in Deepdale Staithe. She was tired but cheerful.

‘I never seen Tom look so relaxed and content,' she said.

It was not for me to spoil her happiness by reminding her that the everlasting sibling struggle would resume as soon as Barry regained consciousness. At her Aunt's, a message awaited her from Mr Couling, the lawyer of the show business agency which had employed the Howe twins as singers, saying that financial support would be forthcoming from the agency. So I left Roberta in a state of subdued relief.

For the next few days, the media were full of accounts of the APPCOR operation, and photographs of the Bang-Bang were in circulation again. Then Sister Carrisbroke phoned me while I was taking evening surgery. She had alarming news. Barry had not recovered consciousness. Barry remained dead, despite his new heart.

On several occasions, the expanding frontiers of medicine have caused us to alter our conceptions of dying. Ever since the sixties of this century, it has become increasingly difficult to define the critical point at which life can be said to slip irretrievably into death. The Jacobean poet was near to the truth when he said that ‘Death hath ten thousand several doors for men to take their exits'.