Lub Dub Lub Dub Lub Dub
“I wish I’d never read that piece about pacemakers,” Tracey said.
“You needed a new cooker, anyway,” Lois said. “You were saying your old one was about to give up the ghost.”
“How was I to know a plain electric hob would take forever to heat up?” Tracey fumed. “Then it gets too hot and it won’t turn down again and it burns everything. Disaster!”
“You did it for Adam,” Lois pointed out. “For his health.”
Read an interview with the author for the story behind the story.
Old friends, they were in one of London’s myriad Costas for a quick flat white before Lois’s 10:07 train from Euston. She was off on her fortnightly trek to the Midlands to visit her ninety-two-year-old mother.
A shriek of laughter from the gaggle of school mothers in the sofa area temporarily silenced them. The clack of cleated cycling shoes added to the din as three furry-legged men in helmets clattered up to the counter. The air was already at blood heat outside, and the men were sweating freely.
“How’s it been since Adam retired?” Lois asked.
Tracey thought about this. It had been the right time for him to stop. I prefer to call it “badinage,” he’d said when challenged about his workplace banter.
“Four Dyno-Rod callouts to the house in the past two weeks about our drains not working with maximum efficiency,” she said. “He’s off at the gym now. Which is ironic, as the gym’s the reason I’ve got to go to an effing three-hour workshop on cardiac arrests this morning.”
Podcast: The Writer’s Voice
Listen to Helen Simpson read “Lub Dub Lub Dub Lub Dub.”
Adam had been working out at the gym when the man on the running machine next to him had toppled off it while watching a replay of the previous night’s Champions League highlights. The gym’s defibrillator had blasted into action, and now the man was recovering from a triple bypass. “Only fifty-seven,” Adam had marvelled, shaking his head; he was sixty-five himself.
“Who knew an induction stovetop could mess with a pacemaker,” Lois said, reverting to their cooker conversation.
“Don’t get closer than two feet away or you might explode,” Tracey said. “You’ll need a mega-long wooden spoon to scramble your eggs if you’re going to risk it, according to that pesky health magazine.”
Adam’s father had had a pacemaker, like a little matchbox under his collarbone, and heart trouble was often genetic. Tracey was anticipating Adam’s need for one himself.
“It’s how my father went,” Lois said. “He didn’t really know anything about it—he’d been telling a funny story at the time, and he just stopped. That was it. So long ago now.”
His heart burst smilingly, Tracey thought, the shred of Shakespeare floating back across the decades. She’d done “King Lear” at school. Lately, all sorts of things she’d once read were reappearing.
“My mother’s been on her own now for well over thirty years,” Lois said. “She’s indestructible. I do worry about what’s going to happen, how it’ll end. She won’t have any help except from me, and her stairs are lethal.”
“Have you noticed, though,” Tracey said, “things don’t generally go as expected. Something happens out of the blue. Think of the Berlin Wall.”
“The Berlin Wall? I suppose so. Why didn’t you go for a gas stovetop, by the way?”
“Oh, I know. You don’t have to tell me. I love gas for cooking. So responsive! But apparently it’s the same as having a small car belching exhaust fumes into your kitchen, and Adam gets asthma now and then.”
“You can’t win, can you. Oh, look at the time! I’ve got to rush.”
The two women embraced briefly but warmly and set off on their different days.
At the workshop, in a local church hall, Tracey found herself sitting next to a woman who’d already done the course once and had come for a refresher. In the same week that this woman had first done it, she told Tracey, quite by chance she’d gone round to friends for dinner, and, just as their host was carrying in the fish pie, he’d dropped it and crashed to the ground with a heart attack. She was able to administer CPR right away, freshly primed with the relevant knowledge; no, he didn’t survive. It had made her feel better about it, though, having a go herself.
The course leader gave them her name at the start—Welsh for “snow,” she told them, a Celtic name that sounded to Tracey like “Weary,” although surely it couldn’t be that, even if it did suit her.
Lub dub lub dub lub dub is the noise of the heart beating when you listen with a stethoscope.
It’s a four-chambered pump ceaselessly squeezing the blood through your body, and its hundred thousand beats a day are powered by self-generated electrical impulses. A cardiologist clearly had to combine the skills of both plumber and electrician, Tracey thought as she listened to Weary’s account of what tended to go wrong.
Your heart’s supply pipes could get furred up. They could narrow right down and sometimes be completely blocked—then you would have to get stents or an ablation, and, if some really serious plumbing work needed to be done, the supply might be rerouted via some unblocked pipes borrowed from somewhere else. Often from your leg. Whereas when the electrics went wrong, when the rhythm of the pump fell out of kilter, a little generator, a pacemaker, could be wired in under the collarbone to put it right.
“When the heart stops for whatever reason,” Weary said, wearily, “whether it’s blocked arteries or electrical chaos, whatever—that’s what’s called cardiac arrest. After four minutes of no oxygen, the brain starts to die, but, if you keep the blood moving round the body with hefty chest compressions, you might gain a little more time.”
The workshop attendees shifted in their seats. Action at last.
“But, whatever you do, don’t try it if they’re breathing,” Weary added sternly. “Check if they’re breathing first.”
There was some uneasy laughter.
“I’ve seen relatives attempting to do CPR on someone while they’re trying to escape,” she continued, without smiling. “I’ve literally had to pull them off. So, how do you check? You check by getting your ear and cheek down close to their nose, their mouth, and feeling if there’s any breath coming out.”
Another scrap of Shakespeare appeared, longer this time, echoing down the corridor of memory. Lend me a looking glass; if that her breath will mist or stain the stone, Why, then she lives.
Tracey put her hand up.
“Would it work if you put a mirror to their mouth?” she asked.
“I have heard of that,” Weary said. “But, to be honest, most people don’t carry a mirror with them.”
More than ninety per cent of people who experience cardiac arrests outside of hospitals do not survive, they were told. Tracey stopped concentrating quite so hard when she heard this—what was the point?
A plastic torso and face was pulled from Weary’s rucksack. “Little Anne,” she said, tossing the demi-doll to the ground. With some effort, she got down onto her hands and knees to demonstrate how to do chest compressions.
“Arms straight. Push hard with your arms straight,” Weary said, “and release. Keep this up to the rhythm of ‘Stayin’ Alive,’ though you could go with ‘Baby Shark’ if you’re too young to know about the Bee Gees. We don’t advise ‘Nellie the Elephant’ anymore—it’s too slow.”
“How hard should you push?” the keen woman next to Tracey asked.
“Pretty hard,” Weary said. “Some think if you don’t break a rib, it’s not hard enough. I wouldn’t go so far as to say that, though, yes, I might well do some damage to the ribs, the cartilage. But if you don’t push down hard enough their brain will die.”
“Bloody hell,” Tracey muttered.
“To be honest, it’s very unlikely you’ll get that heart beating again without a defibrillator,” Weary said. “Which needs to be there within four minutes, ideally, if it’s going to work. So, as you can see, it’s where your cardiac arrest happens that matters most—I mean, at Heathrow you’d be O.K., or at the gym. But you might not be so lucky otherwise.”
I’d be useless, Tracey thought. We are enfleshed—that’s the mystery—but flesh is not all that we are. The body is important and interesting, but it’s not the whole story. Yes, when the heart stops beating, your light’s switched off. But until then . . .
Once home, hunched over a Nespresso, Tracey attended to the buildup on her iPhone, saving Lois’s WhatsApp voice note till last. Lois had had a falafel panini at the bus stop in Burton upon Trent, it seemed—not very nice but better than nothing—while waiting for the once-an-hour No. 9 to her mother’s flat in Ashby-de-la-Zouch. She was reporting in now from her childhood bedroom. Her mother was having a nap while she, Lois, sorted through her bills and medical appointments. She, Lois, was looking forward to a better night’s sleep, under her old candlewick bedspread, than she’d been managing recently; she was glad for her daughter that things were going well with the new boyfriend, but the walls were paper thin and she and William could hear everything; though, of course, she shouldn’t complain, it wasn’t her daughter’s fault that she couldn’t afford to move out at twenty-seven, and actually maybe she and William should think about downsizing, too, though they couldn’t really afford to either if they wanted to stay near London, where their life was.
Tracey’s voice note in response gave the morning’s workshop highlights, including the rib-cracking part, and she volunteered that she thought her—Lois’s—mother had been absolutely right to get her official D.N.R. statement framed and placed on the hall table, as otherwise any paramedics would be legally obliged to storm in and do goodness knows what, which seemed ridiculous. And, as for downsizing, she was just off now, as it happened, to view a flat with Ollie, the estate agent she’d told Lois about, the one who looked like Paul Mescal.
“It’s deceptively spacious,” Ollie said, as he always did.
“Um,” Tracey said.
They gazed together at the melancholy little room. It smelled dispiritingly stale. A fine pelt of dust coated the brown furniture; dust motes circulated sluggishly in the single ray of light struggling through the layer of window grime.
“Probate job,” Ollie added.
“Phew, it’s hot,” Tracey said, mopping her forehead with a tissue.
“Yeah, climate change, what can you do,” Ollie agreed. “I’m on leave next week, and it’ll be forty-three in Corfu! But that’s cool—I just want to chill by the pool.”
“Yes,” Tracey said.
Another heat wave was on the way, the second this year, and it was still only early May. Having lived in Britain all her life, Tracey’s thermostat was calibrated to milder days, and she didn’t do so well now that the outside air had started to exceed blood heat by several degrees on a regular basis.
That’s how they used to poach lobsters, she thought: alive, and slowly increasing the heat.
“How’s business?” she asked Ollie.
“Good, good,” he said earnestly, admiring his pointed brown shoes. Then he looked up at her and beamed. “They were saying at work, it’s already started, the cascade effect.”
“Cascade effect?” she asked, though she knew what it was. It was a phrase she kept hearing.
“Trillions!” he said with simple enthusiasm. “The greatest transfer of parent-to-child wealth in history, and all because of what’s happened to property prices.”
Tracey grunted her understanding of this.
“Our new sales initiative,” he said, laughing. “We call it Downsize and Die.”
Then he realized what he’d just said and blushed as red as a peony.
“Off the record,” he muttered, frowning down at his shoes this time.
“Of course,” Tracey said, soothingly.
At home, she smiled fondly at Downsize and Die, pausing to tap out a WhatsApp message to make Lois smile, too.
What was that piece of advice Ollie had given her last week, while he was showing her the basement flat on Harbinger Road?
“I always say, go with your gut, not with your heart,” he’d said mysteriously.
Go with your gut! Even as she was under sedation, the deep twisting sensation during her recent colonoscopy had made her groan. The long metal worm with its camera eye was like the one Dyno-Rod used on the drains. Adam didn’t yet know to leave well alone.
She turned back to the pile of novels she had been sorting through for Oxfam.
A sense of impending doom—that was how Weary had described the feeling many people got, like a heaviness in the chest.
It wasn’t as if you got to choose, though, Tracey mused, saving “In a Summer Season” and tossing “Under the Volcano” onto the giveaway pile.
Extraordinary that this Billy bookcase will outlive me, she thought. It’ll still be here years after I’ve gone.
Anyway, who cares? She’d had enough for one day. Death hath ten thousand several doors, get over it. Whichever way you go, it ends the same way. What would it profit me to be shot to death with diamonds or strangled with pearls? That wasn’t Shakespeare, was it? No, it was Webster.
Six o’clock. She turned the radio on. The slow chimes of Big Ben sounded, and then the newsreader’s solemn voice with the headlines.
Here was Adam at the door, back from his afternoon trip to the dentist.
She flicked off the radio and looked at him blankly.
“The world is run by awful old men,” she said.
“No debate there,” Adam said, unpacking some cans of beer from his man bag. “You won’t believe it when I tell you how much it’s going to cost for a root canal!”
His golden locks Time hath to silver turned. She was still getting used to the change in how he looked.
“I’m off to tennis in a minute,” he added.
“What, again?”
“You should take more exercise,” he said as he walked out of the room. “I don’t want you dying on me.”
“No,” she said.
“You know what I mean,” he said, putting his head round the door, then coming over to hug her. “I wouldn’t last long if you went. I’ll be having a drink with Pete afterward, by the way, so I’ll help myself from the fridge when I get back.”
“See you later,” she said.
Deciding that she’d have something from the freezer herself, she turned the oven on high to preheat. Good, there was an individual lasagna—just what she felt like. Tonight would be the first time she’d used the oven rather than the stovetop since the cooker’s arrival, last week, so this would be in the nature of a christening.
It certainly looked good, with the pasta’s bubbling béchamel clearly visible through the flawless glass door.
While she waited for her meal to heat through, she sat reading “In a Summer Season” at the kitchen table, enjoying the new oven’s industrious hum.
The next thing she knew, there had been a loud explosion.
Glass was everywhere—all over the table and floor, all over the kitchen, even caught in her clothes and hair.
“Bloody hell,” she said for the second time that day.
She waited for a moment before moving, and thought about it.
The oven must have blown up.
Yes, it was the oven door. It had burst into ten thousand diamond shards. It must have been made from some sort of tempered glass, she realized, for she wasn’t bleeding.
The lasagna was covered in glass jewels.
She crunched across the kitchen to fetch the oven’s manual. Nothing there.
She looked it up on her phone and, yes, how strange, oven doors did explode sometimes—it was a thing.
Not feeling quite ready to start clearing up yet, Tracey stood in the kitchen doorway and took a long, deep breath.
Then, while she waited for her heart rate to slow down, she WhatsApped her old friend Lois: “You’ll never guess what just happened.” ♦