Helen smiled as the evening pedestrian traffic negotiated its way past her on Great Western Road, Glasgow. The kids on the bus had not been the first, and nor would they be the last, that laughed at her weight. Admittedly she did not do herself any favours; the supersize soda clenched in her pudgy fist and the entire double seat that she was spread over meant that it was a rare night that she did not elicit at least a few sniggers.
It had not been the titters that irritated her; more the inference that she didn’t know who they were aimed at. Being morbidly obese did not make her an idiot, and neither did it make her deaf. Tonight it had been two tattooed teenage lads hiding their laughter behind hoods and scarves; the cuffs of their tracksuit tops dirty and the miasma of their cheap aftershave overwhelming. As usual her friend Douglas, a fellow nurse at Gartnavel General Hospital had been unable to resist the provocation.
“Leave her alone, can’t you lads?” he had said in a mock whisper. “Can’t you see she’s got enough on her plate?”
Smiles from the regular passengers and a smirk from the driver in the rear-view mirror were in sharp contrast to gormless expressions of dawning guilt etched on the faces of the youths. Hurried protestations of innocence and of a simple misunderstanding burst forth from beneath the scarves. The youths, of course, had not been laughing at the thirty-five stone woman taking up two seats by herself. One pointed a sovereign-ring clad finger at himself, as if astonished that someone would think he had been that insensitive.
Scoffing at the boys’ embarrassment and at her friend’s po-faced request, Helen leaned forward conspiratorially.
“Don’t worry guys,” she had said. “I’m not actually obese. I’m allergic to and swell up near pretentious little pricks.”
A ripple of laughter spread through the bottom tier of the bus. Slack jawed and furrow-browed, the boys made their exit at the next stop, muttering obscenities through their scarves and clutching their carryout in blue plastic bags. Helen and Douglas had given the two teenagers a mocking wave as the bus had pulled off. Red-faced, one of the neds had found the courage to raise a middle finger as the bus carried on down the street, eliciting a mocking cheer from the passengers.
Still smiling as she turned the key in her front door, Helen sighed. She would have to get around to yet another diet sooner or later. She had been waxing lyrical about her ambitions to Douglas only that lunchtime. Not foolish enough to think that she would slim down to a svelte size twelve, Helen did had a size eighteen dress in her wardrobe that served as a spur to her previously thwarted ambition. Atkins, Weight-watchers, veganism, South Beach, detox; she had tried them all to little effect.
Binning the empty soda cup, she made her way into her bedroom and took off her coat. Her nurse’s uniform stretched over her bulk, and she had a struggle to get it off. Helen rolled down her leggings, unclipped her bra and slipped off her knickers. She stood in front of the mirror.
The most remarkable thing she saw was not the two stomachs, one nestled on top of the other like a frowning pair of lips. It was not the mottled thighs, rugby-forwardesque in size and overhanging her knees like advancing glaciers. It was not even bingo wings that reminded her of bed sheets on a washing line; billowing and bulging in a strong breeze.
Scrawled across her lower stomach in a seemingly scattergun fashion were crosses and lines drawn in black permanent marker. Her gut looked like a general’s battle plan. Nodding at herself in the mirror, Helen walked determinedly through to the bathroom. This was it. The start of her annual leave was the perfect time to initiate her plan. With any luck, she would be fully recovered and fit enough for her return to work in three weeks’ time.
Sure there were risks, Helen thought, but she did not see herself as an idiot. As far as she was concerned, she had been left with little choice. Denied gastric band surgery on the NHS because of her inability to lose weight via conventional means, she had been forced into this. The difference between her and all the other schmucks who had tried self-surgery in the past was in the preparation. She had done her research, from watching similar procedures at the hospital to reading every textbook she could get her hands on. As a working nurse, she was aware of infection control, post-op recovery and risk management. Painstakingly slow in preparation; this had been long in the planning.
There was all the difference in the world, she thought, between Dr. Jerri Neilsen, who, stuck at a South Pole research station, had performed two mastectomies and started a course of chemotherapy before transport arrived, and the South Korean woman who, on being denied cosmetic surgery had injected her face with cooking oil. She reminded herself that she had prepared for this.
She was not doing it entirely because of the jibes, but because she wanted to live past forty. If she could just prove that she could lose weight of her own accord, then they would let her have further surgery on the NHS.
Helen opened the bathroom door and looked upon the vista in front of her. Crowded around the bath were floor lamps, each fitted with a super bright two-hundred watt bulb. They illuminated a plastic container filled with brownish fluid sitting at the end of the bath. On the side of the tub lay a scalpel, a stitching needle and two syringes filled with fluid. Lying on the floor next to the bath was a Henry Hoover with a cannula soldered to the hose, alongside a dressing table mirror. A house phone lay close to the bath for emergencies.
Everything was ready.
Taking a steadying breath, Helen eased herself down into the bath, the sides of her stomach mottling as they piled up around the edges of the tub like puff pastry on a steak pie. Settling herself down, she scooped a handful of the brown liquid from the plastic box and smeared it across her stomach. Betadine would sterilise the area she was about to operate on. Next, she picked up one of the syringes filled with clear liquid. She picked a spot close to one of the crosses marked on her stomach and efficiently injected a small amount of liquid in. Repeating this process, she did not stop until her entire stomach was numb.
The Lidocaine had been one of the few medical items that she had not needed to filch from the hospital, having acquired it over the internet. The local anaesthetic was used to adulterate heroin and cocaine; her current use of it was at least slightly more ethical.
Everything up until now could be easily turned back from. Nothing she had so far done committed her. With a steady hand, she picked up the scalpel. Bringing the blade next to one of the crosses marked upon her skin, she pressed as hard as she could without breaking the skin. Was this her only option?
She knew it was. She had tried; God knew she had tried, to lose weight. A plethora of different diets, plans, gym memberships, and classes had failed. She was just too hungry. It was called morbidly obese for a reason, and Helen knew that she would die if she did not lose weight. She was taking the last option open to her.
Pressing the scalpel against one of the crosses, she watched, seemingly detached, as the blade cut into her skin. She felt surreal as a half inch incision was made. There was surprisingly little blood; a consequence of the Lidocaine. Working quickly, the obese woman made eight other incisions across her front. When she was finished, nine trickles of blood had pooled between her naked bulk and the sides of the bathtub.
Helen tentatively reached over the side of the bath and pulled the hoover towards her. Sweating slightly, she took the hollow cannula and pushed it into the first incision like a tent pole into canvas. Looking down at the end of the appliance underneath her skin, Helen felt a momentary wave of nausea. The room shimmered and wobbled. Taking a deep breath, she closed her eyes for a moment. When she opened them again, the bathroom was still again.
Keeping the cannula close to the skin surface, she moved it back and forth vigorously, just like she had seen on YouTube. She could feel something scraping free of the skin, and once she had reached everything she could through that hole, Helen reached over again and switched on the hoover.
Helen watched as brownish-red mulch was sucked slowly up the transparent cannula, before disappearing into the ribbed tubing of the hoover. Helen felt a rush of elation. It was working!
Wiping the smile from her face and the sweat from her brow, she focused again. Part of her preparation for this operation was in risk management, and she knew that there were plenty of risks still to face. She could imbalance the fluids in her body to such a degree that she could dehydrate. She could puncture an internal organ with the cannula. She could hit an artery. She could have miscalculated the amount of anaesthetic used, and have poisoned herself. Helen was under no illusions; she was carrying out major surgery in her bathtub.
She looked at her bathroom sink. On the rim lay a medical stitching needle and some thread. Helen sighed. She was still some way from that.
As she worked, the early October sun dipped beneath the frosted glass of her bathroom window. As the temperature began to drop, Helen’s central heating kicked in on the timer, as she had planned. Super bright spotlights installed in her bathroom ceiling a week ago illuminated her grisly work perfectly.
For hours she endeavoured, working the cannula in and out, and hoovering the results of a lifetime of indulgence out.
Finally, she came to the last hole. Eyes itching with tiredness and fingers stiff after being in one position for so long, she concentrated one last time.
This incision was the most difficult. Situated beneath the second overhang of her belly, she could not really see what she was doing. Helen grabbed a handheld mirror that she had placed on the floor next to the bath for this very moment. Placing the mirror between her knees, she grabbed hold of the wave of flesh that was overhanging the last hole. Try as she might, the skin, slick with sweat and Betadine, kept slipping from her grasp. Drying her hands on a towel did no good- the Betadine was still too greasy. She couldn’t wipe her stomach with a towel-this was a sterile area after all.
Helen paused, undecided as to whether to abandon this final incision. She had, after all, already taken a massive amount of fat from her own body. This was evident from the hoover, which despite having a waterproof bag put into it as of that morning, was now making gurgling noises.
It was pitch black outside now, and Helen made her decision. She had not come all of this way to do half a job. She felt for the incision in her lower belly, and found it by touch. Lowering the cannula, she pushed it into the opening with some difficulty. The most difficult part over with, she started to agitate he hoover end. This cut was no different from the others, apart from the awkward angle and lack of a clear view.
All of the videos she had watched on YouTube of the procedure had demonstrated to her that a surgeon must be fairly robust when rasping the cannula. She was, after all, stripping fat from skin, and that fat had been there for some time.
With aching muscles she started to move the cannula again. Back and forth, back and forth, like a violinist playing in staccato.
Suddenly there was a muffled popping sound in response to a particularly vigorous stroke.
No need to panic, thought Helen; she was prepared for this. She had likely nicked an intestine, nothing major. She would finish sucking the fat out, and then sew everything up nicely. Any problems and she could always visit A and E tomorrow…
Douglas was late and sweating. There was no-one outside the church. Making his way inside, he stopped short. The place was jam-packed with people. The minister was obviously in the middle of a eulogy that had very little to do with the bubbly, full-of-laughter woman that Douglas had known. There were numerous members of the congregation crying. Rather than force his way into a packed church to find a seat, Douglas decided that he would view the remainder of the service from the back of the building. If he was honest with himself it was also because he didn’t want to see his friend in her open casket.
There it lay, at the front of the church. He felt a lump in his throat. They had told him that she had died of perforation of the small intestine. There had been no phone call, no cry for help, just a grisly scene which spoke of hours of suffering and pain; an awful end for someone with whom he had shared so many coffees, so many lunch breaks, and so many stolen laughs. Indeed, there had not been the slightest indication that Helen was going to try something so monumentally stupid. She had been so lively, so full of pith and giggles on the bus that night…
He caught movement from the corner of his eye. A short fat man wearing glasses was edging along the aisle towards him.
“Anthony Proctor,” whispered the man. “Undertaker. You with catering?”
Douglas shook his head, but the man didn’t seem to notice.
“I bet you’re glad she’s the one in the coffin,” said the balding undertaker under his breath. “If not, you would have needed a hell of a lot more food! Who d’you think all these people are-fast food restaurant managers?!”
The undertaker sniggered at his own joke. Douglas struggled to process what he had just heard.
“Certainly you’ve got an easier job than I had,” continued the squat man conversationally. “When they found her she had been lying there with a hoover in her belly for two days. The vacuum cleaner had been still going, gurgling like a pot of soup on a hob. Can you imagine what I had to do to get her presentable for today?”
The undertaker sighed.
“Not an easy task, my friend. Not an easy task.”
Douglas was about to snap at the undertaker when he realised that a line had formed for viewing of the body. Gritting his teeth at the little man, he vowed to speak to him after the service had finished.
Edging closer to the coffin, he began reliving some of the memories he had of Helen. When it was finally his turn to pay his respects he shuffled apprehensively up to his friend, bowing his head as he had seen others do.
When he was finally able to look upon her, he was stopped short.
Familiar to him was Helen’s chubby face, her motherly demeanour and her generous mouth, which even now seemed to be curved in mild amusement at some idiot of a patient at the hospital. Less familiar was everything below the neck, where a svelte and lithe body gave way to chubby legs at the bottom. What came unbidden to Douglas’ mind was a fairground mirror, and the corners of his mouth twitched involuntarily. What was he thinking?
Shock finally gave way to amusement as he thought how Helen would have giggled at her predicament. For her part, Helen’s face seemed to smile back at him. He saw his fellow nurse’s big round face. Turning away, he walked back down the aisle feeling oddly light. As he took up his position at the rear of the church again, the undertaker approached him once more.
“Who’d have thought,” said the bespectacled man, shaking his head again. “Into a size twelve coffin.”
*As always, delighted to hear any feedback folks!*
***Originally published in Gold Dust, Winter 2015***