I should have known there were going to be problems.
One grey November afternoon, I was sitting on the large off-white sofa in my living room, with the gas fire blaszing unhealthily, going through a pile of manuscripts when the phone rang.
'Where are you?' said a voice. 'Why aren't you here?'
'Where's here?' I said. 'I'm at my flat, of course.'
It was University College Hospital, wondering why I had not turned up for my surgery - and the answer was that they had sent the letter to the wrong address, had sent it, in fact, to my old flat on the Kingsmead.
'You should have made sure we had the right one,' they said, impatiently. By this stage at least two doctors and a nurse were standing by the phone shouting at each other and at me.
'I did. Which is why you have the right phone number.'
'Oh' said the nurse.'That makes sense.'
'You'll just have to come straight down right away,' said one of the doctors.
'But I didn't know I was having surgery so soon,' I said,' so I haven't had a chance to stop taking Premarin.'
They went into a hurried conference and acknowledged that I had a point.
'So I'll stop now, and you'll see me when?' I said, dreading the possibility that my surgery would be put back another year or two.
There was more hurried muttering at the other end.
'You could come in just after Christmas,' the nurse said, 'On the 28th.'
It was a strange Christmas - I was broke because a machine in Books Etc. had smashed the credit card I was living off much of the time, and I was playing hostess to the usual ill-thought out collection of people. There was the usual gay/straight divide, with everyone trying to respect each other's sensibilities; there was also the divide between those who had eaten the curry mayonnaise avocado salad, and those who had not - whatever was wrong with it produced fairly spectacular if short-lived effects about an hour after we ate it. Some weeks later, my mail in hospital included an apology from Books Etc., an apology which took the form of a small cookery booklet entitled Your Friend, The Little Green Avocado. I laughed until my stitches started to tear...
I turned up at the hospital with a stack of books and my walkman - the hospital radio did not run to Radio 3, and I persuaded the ward sister that a walkman with earphones was not going to inconvenience anyone...At St. Pancras, gender reassignment patients took their chances on a general women's surgery ward, alongside diabetic amputees, cancer patients and a regular twice a week influx of wisdom teeth over-nighters. Because there were often one or two of us around, you were never quite sure how much any other long-term patient knew on the grape-vine; you wandered around being tactful.
Solidarity rules, I thought, and at least I get a room to myself for a day or so before and after the surgery.
The trouble with turning up a couple of days after Christmas was that half the hospital was shut - the supply department had sent up a pair of anti-thrombotic stockings for me to wear, but they had not believed I could possibly have such long legs, and had sent the wrong size.
I put them on, and they cut into my thighs about halfway down, uncomfortably. Clearly they were worse than useless, and the right ones were not going to turn up for several days.
'It'll be all right,' they said.' It's just a precaution. We'll get you some as soon as possible - you won't get a thrombosis, just from a couple of days not moving.'
Some of the Golden Girls had warned me against Mr. Morgan, the consultant; he was supposed to have given Stacey a hard time and made a mess of things. But no-one would be very specific and Stacey was in Australia. Morgan was always perfectly polite and charming to me - and for a long time I just thought of him as a man with a history of bad luck, bad luck which of coruse always affected his patients rather than him. He was an tall elegant grey-haired gent with smart tailoring and quietly snazzy ties - there are plenty of authority figures whom it helps deal with if you can imagine them without their clothes, but Morgan was not one of them. It was more or less impossible to imagine him without clothes at all.
The morning of my operation I reread Angela Carter's The Infernal Desire Machines of Doctor Hoffman; it was one of my favourite books, after all, and it seemed sensible to prepare for what might be dangerous with a particular pleasure. When I met Angela a year or so later, she was delighted to learn that I had chosen one of her books, rather less delighted that it was this one and not The Passion of New Eve, the novel which deals with gender.
'Don't you like it, then?', she said.
'Not especially,' I said, and changed the subject, because at the time I loathed it as a book which colonialised my experience. Gosh, I used to be a prig, even in the eighties, but I did have a point.
Adele had told me ' Have a wank before you get your premed. It's an old tradition, handed down like old pantie girdles from change to change. You'll regret not saying good-bye even if you hated them - and besides too embarrassing to risk going into theatre with a hard on. Imagine all the blood.'
It seemed like a good idea, so I did. Interestingly, Sandy Stone talks about 'wringing the turkey's neck' so in the fifty or so years of trans surgery, we have managed not only to accumulate traditions, but to do so on both sides of the Atlantic. I must ask a French sister sometime whether it is traditional there as well - Anne Ogbourne would probably tell me that in India the hijra have an entire liturgy about it in Ancient Sanskrit, so perhaps it would be best not to ask her.
The next few days were confusing - I remember coming back from theatre and being woozier than I had ever been in my life, but I never seemed to stop being woozy. I was on a drip and getting pain control, and everything hurt. I expected it to hurt, deep bone-acheing hurt, but not to itch and burn as well, deep inside me where before I had never had places to itch.
I mentioned fuzzily that I was in pain and the nursing staff never quite said what did I expect in the circumstances, but I got the impression that the thought had crossed their minds. And I knew I could expect things to hurt, to hurt a lot - it was in all the literature to the extent that people accuse us of just doing it in order to be really really hurt. I did not feel able to make a fuss, but I thought that something was badly wrong.
There was. It became clear how badly irritated the interior of my new vagina and the skin grafts lining it were when I found myself bucking with discomfort when a registrar was examining me and my abdominal muscles nearly took out his eye with the plastic form that was holding me open. It broke a water jug on the ricochet. There was also a rather nasty smell, as I found myself straining to expel the pain and nurses held my wrists down against the side of the bed to stop me bucking some more.
'I don't know nothing about the birthing of children, Miss Scarlett' I thought to myself confusedly with a sense that something was being quoted around me.
After that, they managed to reinsert the form and a day or so later they moved me to a bed on the main ward. I was still surrounded by drips - glucose, and blood, and pain control, but at least I was now allowed water, if not yet food. Strictly speaking, I was allowed a diet with no fibre in it, but since this mostly consisted of steamed white fish, to which I am highly allergic, there was a problem. The diet also included minced chicken, which was tolerable, and cauliflower florets. The kitchen seemed incapable of understanding that the point of a low fibre diet was not to give me anything with fibre in it - when they sent me a six-inch cauliflower stalk with two florets on it as my meal, I called the dietician and made a fuss.
'I can't eat this,' I said.
'Why not?' she said.
'Because it is all fibre and I am not allowed any fibre because I am not allowed to pass solid waste for the next few days.'
'But it says in my notes that you are allowed caulflower' she said.
'Yes - cauliflower florets - not the stalks.'
'Oh,' she said.'You're right, of course. I hadn't thought of that.'
She went to the kitchen and tried to explain to them, without much success.
So I insisted on having dietary milkshakes instead - I was not going to tear myself apart because the kitchens could not do their job, and I was not going to starve either.
They even brought me my stockings and I started to feel that the worst of things was over, until there was a sharp ache in my left calf.
I mentioned it, and they fetched a measuring tape - my left calf had already swollen two or three inches. They wheeled up another drip and found another vein. It was a thrombosis, and I was going to be on heparin or warfarin for several months, until it went away and showed no sign of coming back.
A day or so after that, I was reading the Sunday papers - it was difficult holding it with drips in both arms, but I managed - and I turned a page of the Observer review to find the next chunk of book reviews soaked in blood, which was streaming out of my thigh and through the bed sheets.
I called a nurse and within minutes I was drugged and on my way back to theatre. An infection had eaten its way through the wall of my femoral artery and I was in imminent danger of bleeding to death; they managed to fix it and contain the infection, but there was a seam of corruption running back up through me. When I read, years later, about necrotizing fasculitis, and epidemics of death and horrid flesh-eating stuff in hospitals, it all seemed horribly familiar.
Some of my friends got the idea, during this period, that I was about to die, and offices where I freelanced periodically rang in anguishedly to get bulletins. When people came into see me, I put a good face on things - several sorts of shading, two layers of blusher, you know the sort of thing - and so did they, which fooled neither of us but stopped anyone getting too emotional.
Next day, they had me back into theatre and I woke to discover a group of surgeons looking grave around my bed. Most of the internal grafts had gone rotten and they had had to rip them out of my vagina and close it up - the deeper grafts would probably hold, but they could not guarantee that the walls would stay apart. They couldn't say when or whether they could fix this - they didn't know when they would be able to tidy up the loose flaps of flesh that would one day be my labia. They could not do anything until I was no longer at risk of thrombosis, and that might take so long that they would never be able to repair the mess. Specifically, whatever they might be able to do on the surface, they could not guarantee that I could ever have sex again - by which, of course, they meant penetrative sex.
'I see,' I said, and asked to be alone. I got them to close the curtains of my bed and I allowed myself five minutes of intense weeping. I brushed my wig thoroughly and spent half an hour putting my face on rather more carefully even than usual. After that, I put my headphones in, listened to the Beethoven op 132 and got on with some manuscripts; if I was never going to be able to have sex again, I had better devote myself to work and intellectual pleasure, after all.
After a few days, I could at least get up and walk around, as long as I pulled all my drips with me. It got easier once they managed to clear out the stinking mess from my bowels and I could eat proper food again. Once I had enough blood again, and was eating, it was down to just the heparin drip, though that was the one which hurt most constantly - it turned out to be pinching a nerve against the bone, which is why I was having a certain amount of trouble moving the two minor fingers of my left hand.
I also used my privacy to check something - I had asked that they ensure that they shifted a bunch of nerve endings and flesh that I could use as a clitoris, and this, at least, they had done. In fact, they had not only done it; there were, for the next few months until they did some tidying without consulting me, two of them - the other where their first go at a urethral opening had cratered and they had moved things to a lower site while I was in theatre for something else. I was still in considerable discomfort, but at least I could console myself for everything that had gone wrong.
I was finding it hard to sleep, and took to going and sitting outside the ward in the corridor so that I could read in the strong light there without disturbing people in adjacent beds. Every so often people would wander past looking for somewhere they could sneak a smoke - I kept going into the kitchen and making myself cups of tea - having had the sense to bring in my own supply of Twinings English Breakfast and to get people to bring in more, like cigarettes in prison.
It was not, needless to say, just out of an instinctual desire to buy favour whereever I can find it that I took to looking into the ward station and offering cups of good tea to whichever nurses and doctors were on duty at the time. I like to think that I am a nice person, on the whole, and it struck me as a polite sort of thing to do. Most of the nurses and several of the doctors seemed to find me a bit intimidating, but Jane McGruin would come out and sit in the corridor with me and drink our tea together.
Jane McGruin was one of the junior surgeons on the ward - she had been involved in my original surgery - and was the doctor who tended to be around to hold my hand when I came out from anaesthetic. She was a chubby sweetheart with a slightly crooked smile and the first time I saw her, when she got me to sign forms and checked my blood pressure, I thought, I don't think you're straight, sweetie.
I knew from gossip about Dykes in Medicine -awful acronym, but so would Lesbians in Medicine be, and you defuse the joke by making it about yourselves - that it was not easy, being a junior doctor and queer. I thought about the medical students I had made quite careful steps not to know at university, except for a couple of bright post-grads in the MCR, one of whom later turned up as my endocrinologist, which was not entirely useful. Useful to chat, I thought, and I like this woman's style, but I imagine there are not going to be many personal revelations on this watch.
And indeed it was only on about the third night that we sat talking that anything incriminating got said.
'How worried are you?' she said. ' About their putting it right.'
I noticed that she said they, about the surgical team of which she was part. I think we are having that conversation, I thought to myself.
'I'm sure they will,' I said. 'Eventually.'
'And if they don't,' I said,'It was a risk I knew I was taking, and I am sure that I will find ways round it - after all, the pair of neat little nubs you seem to have given me both seem to work rather well. And I am told that penetration is not essential for a good sex life.'
'No...' she said.
'Historically,' I said,' I've slept with men, but some men don't insist on fucking. Besides, I always liked women a lot, and slept with my best friend, and a lot of my other women friends are lesbians.'
'I noticed,' she said. 'You do seem to have a spectacular crowd of visitors, and they don't all seem to be straight, by any means.'
She, it turned out, had gaydar too. And what, it might legitimately be asked, were either of us doing having gaydar if we were exclusively straight, or intending to be? Well, precisely. Sometimes I have been very slow on the uptake about major themes in my life, particularly when they are first breaking news.
I was getting slowly better - what I wanted most of all was to be well enough to go home and listen to records again and play with my cats, and not to have to eat disastrously crappy hospital food.
I mentioned this to Jane, one night.
'You're down on your forms as Catholic,' she said.
'Yes - I wanted to be sure that if I died, or looked like dying, I got the last rites. Don't look at me like that - for my parents; I don't believe, but they do, and it is only polite to them to allow them to think I died reconciled with their God. And if they are right, and I am wrong, well, as I say, politeness costs nothing...'
'Yes,' she said, impatiently. ' You do make speeches, you know...Anyway, the trouble with being Catholic is that there is no special diet involved. If you are Muslim, or Hindu, or Jewish, you get special stuff brought in, and it is much much nicer.'
'I think,' she said,' that you are probably going to remember your forgotten Jewish roots'
'I never forgot,' I said, 'my mysterious great-grandfather from whom I got the cheekbones.'
'Exactly,' she said. 'We'll have to remind them about the fish allergy. I don't think the gefillte fish would do you any good at all.'
'I'm OK with smoked salmon,' I said.
It was about this time that I got a new neighbour, a policeman's wife who lived off Queen's Square and came from Golder's Green. It was fairly obvious that we were both getting the kosher special diet and I found myself in a slightly false position. Irma was a honey, and she got very confused when the Catholic chaplain kept calling round.
'Mixed marriage,' I said, misleadingly.
'Oh,' she said,' I assumed you were frumm'
I looked at her.
'You know,' she said, ;strict Orthodox.'
I looked at her some more.
' Well,' she said.' The wig.'
I realized that I was in a false position that was getting falser by the minute. Irma was in for a fairly serious biopsy - when I muttered that I didn't have much hair, she jumped to yet further wrong conclusions about what I was in for and started to ask me about chemo. So I took her out to the corridor for a cup of tea and I spilled the beans. She took it very well, considering. One of the reasons why I stopped being terribly worried about passing was that I got sick and tired of the consequences of doing so - you end up having to tell people so as not to be in a really creepily false position.
Some of the longer-term residents on the ward knew the score - they had seen a number of us come and go - and one of them was an old blind woman with diabetes who was having her legs slowly whittled away, and she was only going by voices, and tended to guess at once who was who. I overlapped with two others - Debby and Dee, but we did not have much in common apart from the obvious. Debby was taking instruction from her local imam in order to marry her boyfriend in the faith, and Dee was a dancer. One of the odd things I have noticed about dancers is that most of them are really only interested in talking to other dancers...Which works out best for everybody, on the whole.
Once I was up and about, I decided that the sooner I was out of hospital, the better; clearly I was going to be back for at least one more stay and the chances were that there would be more than one. And I wanted to get on with my life, such as it was going for the moment to be. I volunteered for everything going - I helped with the drinks trolley, I helped set the table for meals, I helped push wheelchairs around the hospital grounds once I was off my drips and could tuck my catheter bag under my dressing-gown.
Debby was one of those people with a smile that means she never has to do anything except smile to make everyone like her, but I am not.Simply because I had huge stacks of books by my bedside and a pile of tapes of classical music and jazz, I knew I was going to get a reputation for being stuck-up and stand-offish, and so I set out to charm. It just gave me less time to brood .
St. Pancras Hospital is more or less directly adjacent to St. Pancras Churchyard, and often as not walks and trips with wheelchairs tended to end up there - simply because it was far enough out of sight of the hospital that people could sneak a cigarette. It was a cold gray February, which meant that the ward was suffocatingly hot and sometimes you wanted to be in the open air no matter how cold it was.
One of the women I was pushing caught me looking at a gravestone.
'That's a bit morbid', she said. 'You don't need to worry about death any more. Everyone says you're much better.'
'I'm not thinking about death,' I said. 'It's just interesting - it's Mary Wollstonecraft, whose daughter wrote Frankenstein.'
'You are interested in some very strange things,' she said.
I don't think anyone stopped thinking of the three of us as weird, but at least they realized that we were weird in different ways. And I must have been doing something right, because towards the end of that stay, there was a broadcast of The Cunning Little Vixen and the entire ward decided to ask me if I wanted to watch it on the overhead television, and put up with it for two hours, because they guessed I wanted to see it and was much too shy and polite to ask. And quite the nicest thing about it was that many of them actually quite liked it - people singing somehow made more sense if they were all dressed up as animals.
'Well,' one of them said,'it was better than Cats.'
I was getting a lot of visitors - the usual and predictable people like my family, and my close friends, but also names. The word really had gone out that I was at death's door, and it was somehow smart to be at my bedside. Mike and Linda Moorcock turned up one day when I had been shipped off to Kensington for a chest X-ray and got very panicced when there was no sign of me except a well-made bed. Alice Thomas Ellis and Caroline Blackwood one day, and Cynthia Payne the next - such a social whirl it was a shame that I was not at my most scintillating. A lot of the time, I just put myself on automatic pilot and told the same jokes about pain and blood, because people wanted to be reassured and entertained and they had done the nice stuff simply by being there and making me feel liked by that.
It did not always work out. Frances Heasman came one afternoon when I was particularly tired and particularly on autopilot.
After a while, she glared at me.
'I've been here half an hour,' she said. 'And all you have done is talk incessantly about yourself.'
'You're quite right,' I said. 'Let's talk about you.'
So I asked her thirty yes/no questions about such matters as the state of the crack by her window kitchen and the likelihood of another season of Minder, which she was script-editing, and it did not seem to placate her at all that I had memorised a lot of crucial issues in her life and could reel them off. I guess we were never destined to be friends.
Of course, the trouble with visitors in this particular set of circumstances was that most of them could not help but ask how I felt now about the decision to have surgery in the first place. I really did not need to have to consider the issue, in a lot of ways, but perhaps it was for the best that I had to. I was only too aware that I had an awful lot invested in not regretting anything and in not having any second thoughts - bit late now, after all - and so I had to look very critically into my response, and discovered with some mild surprise that I had no regrets and no second thoughts at all.
'Take what you want, and pay for it,' I found myself quoting at them. 'I wouldn't have regretted it if everything had gone well, and I am not going to be a wimp about this. After all, what else can go wrong? From now on, things can only get better.'
which of course was far from being true in the short term, because I had abother two years of this sort of thing to come, though none of it quite as life-threatening, and one of the consequences of all of it was significant weight gain and the things that brought in its train.
On the other hand, love and passion and intense pleasures and despairs I might never have otherwise known. Several Great Loves of an operatic kind and a happy partnership of twenty years that was better than any of them. A political career of sorts that at least put me in a position to understand what was going on - I may not have been able to do anything about New Labour, but at least I voted for them without any illusions left. My career as a critic had already started, but it has taken directions I could not have foreseen, and I did get to be a writer, of sorts.
I can still not regret a choice I made. Just other people's frakkups.