Fallen: A Trauma, a Marriage, and the Transformative Power of Music (2 page)

“When?” I ask Lou, stuffing toothbrushes and contact lens solution into the duffel bag. “When did this happen?”

“Just after the morning break,” he says from his post at the kitchen door. “About 11:20.”

“I heard the sirens,” I say as I pass through the kitchen, grabbing the phone and returning to our bedroom. This too feels like a critical piece of information. I heard the sirens. I sent out a thought-prayer. But... that was an hour and a half ago. Why hadn’t they called me then? I could have met the Air Evac with Simon, or at least been on the 1:30 ferry. I don’t ask this out loud, recognizing it as the kind of maternal questioning that drives my son crazy. There’s no use second-guessing actions already taken, Eli would say if he were here now, and he’d be right. I call our oldest friend, Guido, and leave a message: Could he meet Simon at the hospital? He calls back moments later. He will get to the hospital as fast as he can.

As I hang up, the phone rings. Vancouver General Hospital. On the other end of the line the nurse, like Lou, speaks in slow, measured sentences: Upon Simon’s arrival at the hospital, his left pupil was fixed and dilated. They intubated him and the condition of his eye improved. They would have to operate. When would I be there?

Lou is visibly shaken when I relay this information. “Simon was totally lucid,” he says. “He was talking normally. He vomited and there was some blood in his ear, but he was talking totally normally. I told him I’d get you and bring you to the hospital. He got a little angry, swearing, when they loaded into the helicopter but...” Lou’s voice trails off and he clasps his hands together. “I should go get Dave. We’ll meet you at the ferry.”

Unlike Lou, I am momentarily grounded by the news from the hospital. But what I choose to hear is selective. In my mind, Simon arrived at the hospital in serious condition and they had to intubate, but that is over and he is improving now. “Improving”—the only word that mattered. I consider calling Eli and arranging to have him meet me in Vancouver, and also calling Simon’s parents, Marc and Lorna, in Quebec, but I don’t.

Instead, I throw my copy of Joan Didion’s
The Year of Magical Thinking
into the duffel bag. Joan Didion is at the top of the list of authors I hold dear as any friend and consider a worthy traveling companion in a time of crisis. I have already revisited the book several times during the last year in the wake of my mother’s diagnosis of breast and lymphatic cancer, when I was in need of Didion’s insight, intelligence, and honesty. I stared at the author’s photograph on the back flap as if I could locate the source of her power in her ungrayed hair, birdlike bones, and pale, almost translucent skin. I worried about her when I learned, postpublication, of her daughter’s death. I wanted to bring her soup. To return, in some small way, the kind of comfort she had provided me over the years.

The Year of Magical Thinking
is Didion’s account of the year following her husband’s sudden death and her daughter’s near death from an inexplicable flu turned full-body sepsis and resulting bleed in the brain. In the book, Didion relates how she was told several times, as evidence of the severity of the situation, that en route to surgery one of her daughter’s eyes was “blown,” meaning it was fixed, dilated, and nonreactive to light. A fixed and dilated pupil—an
FDP
—signified compression of the brain stem, which in turn signified a shutting down of the most basic and critical bodily functions: heartbeat, blood pressure, breath. An
FDP
signified brain death.

Even though I can’t consciously recall it, the facts Didion quotes from a study done by the Department of Neurosurgery at Bonn’s University Clinic are embedded somewhere in my mind: “The study followed ninety-nine patients who... presented with... one or two
FDP
’s. The overall mortality rate was 75 percent. Of the 25 percent who were still alive twenty-four months later, 15 percent had what the Glasgow Outcome Scale defined as an ‘unfavorable outcome’ and 10 percent a ‘favorable outcome.’ ” Didion goes on to translate the percentages: “... Of the ninety-nine patients, seventy-four died. Of the surviving twenty-five, at the end of two years, five were vegetative, ten were severely disabled, eight were independent and two had made a full recovery.”

So even though I tell myself that I don’t want to worry Marc and Lorna and Eli needlessly, that I will call when I have more real information, I have a pretty clear understanding of the significance of a fixed and dilated pupil. This, then, is the beginning of my magical thinking. I can’t call Simon’s mother and father or our son because that would mean this is all really happening.

Bag packed, I say good-bye to the dog, Paloma. I tell her to be brave and good and not to bark too much at whoever comes to feed her. I tell her Simon and I will be home soon, hoping that with the simple act of saying it out loud I can make it true.

Ryan and I leave for Vancouver.

THE AVERAGE ADULT
brain weighs approximately three pounds. Of all the mammals, humans have the highest brain-to-body-mass ratio, though when it comes to the human mind it is not clear how much size matters. Dmitri Mendeleev, the chemist who created the periodic table of elements, had a brain that was slightly larger than average, and Russian novelist Ivan Turgenev’s brain was a whopping 50 percent larger than the norm; yet the sacred tissue of Einstein’s brain was a little shy of the three-pound standard. It has been demonstrated that the more years a London taxi driver has spent driving the complex weave of London streets, the greater the size of the hippocampus, the region of the brain that stores spatial representations—strong evidence that our daily activities shape and build various structures of the brain.

Likened sometimes to a bowl of curds, the brain has the consistency of a thick gelatin or a block of tofu and is held together by three layers of membranes: the dura mater, or “tough mother,” which is the thick, outermost layer; the arachnoid mater, or “spider mother,” a delicate layer attached to the dura; and the pia mater, the “gentle mother,” which is the thin, fibrous innermost layer. All float in a sea of cerebrospinal fluid, a clear, colorless liquid composed mostly of water, which circulates through the gaps and cavities of the brain, cushioning and protecting the delicate neural tissue from the internal bony ridges of the skull. At the floor of the skull is a small opening, the foramen magnum, where the brain stem exits the cranial cavity and carries messages back and forth between the brain and the spinal cord and from there to the whole of the nervous system and the rest of the body.

The soft substance of the brain is commonly referred to as gray matter and white matter, terms that describe the color of tissue when it has been removed from a body, fixed and hardened by preservatives. In a living body, the outer core, or gray matter, of the brain is actually a tawny pink, and the inner core is an off-white blush. This living tissue comprises roughly 100 billion neurons, or nerve cells, and about 10 to 50 trillion neuroglia, the “glue” cells that support, nourish, and protect the neurons. Each neuron can form roughly one thousand synapses, or connections, with other neurons, making the overall number of potential synaptic connections of the average human brain upward of a thousand trillion, a number greater than the combined population of people on our planet and stars in our galaxy. This vast neural circuitry, faster and far more immense than any machine ever assembled by human hands, is both a wonder and a mystery, constituting who and what and how we are in the world. Not only is our neural network responsible for how we calculate a complex math equation, execute the fine motor skills needed to perform brain surgery, or memorize a musical score note for note, it also determines such character traits as aggression, jealousy, and empathy; it influences the dynamics of our personality and the perimeters of our sense of self, and determines who and how we love. And it creates our consciousness, determining, in effect, how we think about how we think.

This immensely powerful neural network is also breathtakingly fragile, for the neurons of the central nervous system have little or no capacity to replicate or repair themselves. Both bleeding and swelling in the brain can cause neural tissue to become necrotic and die, as can lack of oxygen. Although the brain constitutes only 2 percent of the average body’s weight, it is a hungry beast that consumes 20 percent of the oxygen circulated in the blood. If the supply of oxygenated blood is interrupted for even two or three minutes, brain cells begin to die.

I AM GUT-SICK
with worry about how worried Simon must be, alone in an air ambulance possibly unable to feel his legs.
I’m coming, Beau, I’m coming.
I will my new thought-prayer to travel the distance between us.
I’m coming. Don’t worry. I’m coming.
But the slow pace of ferry travel is agonizing. Ryan and I wait for what feels like forever to board the boat—which is forty minutes behind schedule—and finally, as the horn sounds and we slowly pull away from the dock, I curse my lack of a bridge or speedboat or wings—anything that would get me to Simon faster.

Up on board, Ryan and I find Lou and Dave, the owner of the construction company, and the four of us sit in a stricken silence amid the silvery spangle of sunlight meeting ocean and the hoopla of families embarking on summer vacations. Gradually, as each of Simon’s co-workers offers a new bit of information about the morning’s events, a moving picture, in all its horrific detail, starts to unreel in my mind.

Simon. At work, not far from our house, building a multi-million-dollar waterfront home. He swallows a last sip of coffee, finishing his mid-morning break, and returns to the second-story scaffolding, where he continues installing cedar siding on the outside of the house. It is 11:20 when he pauses the swing of his hammer and steps backward. The board tips under his feet and gives way. Simon reaches, grabs air, and falls, the loose section of scaffold twisting in the air until it slices into the ground beside him, narrowly missing severing his body in two. He lands on his back: skull and spine meeting hard stone tile.

“I can’t feel my legs,” he says and sits up. Ryan rushes over as Simon removes his work belt before falling back to the ground. Blood drips from his left ear, and he vomits onto Ryan’s white T-shirt. He repeats himself: “I can’t feel my legs.”

When Lou, a volunteer fireman, is told of Simon’s condition, he calls to notify the paramedics who are on their way that an Air Evac is required immediately.

I can picture it, but I can’t really understand it. My mother calls Dave’s cell to tell me she has talked to Vancouver General Hospital.

“Oh, honey,” she says, “it’s serious. There’s bleeding in the brain. I’m going to get on a plane and meet you in Vancouver tonight.”

“No, don’t,” I tell her. “Wait. I’ll call you from the hospital.” As if by saying no to my mother I can say no to a bleed in the brain. I caution myself not to panic. I will wait and speak to the doctors myself. My mother has always been panicky, a social worker prone to see the worst-case scenario. It was my mother who told Simon over the phone while I was in labor that because the labor was so drawn out, the baby would likely be born with spina bifida. No, I will wait until I see the doctors, until I see Simon, before I come to any conclusions. But by now, it is unconscionable not to have called Marc and Lorna, so I again borrow Dave’s cell phone. The answering machine picks up and, after the sound of the beep, I fill in a few key details—fall, Air Evac, Vancouver General Hospital—but omit the more terrifying ones: the fixed pupil, the lack of feeling in the legs, the bleed in the brain. They had to operate, I say, but he’s better now. He’s improving. I tell them I will call when I know more, and end my message with the thought that is paramount in my head.

“Oh man,” I say, “Simon will be so upset if he misses the gig this weekend.”

This is the worst possible outcome I allow myself to contemplate. When Lorna hears my message, she is aghast. She wonders if I am in my right mind. Miss a gig?
That’s
what I’m worried about?

But in the context of our daily life, this is not an idle concern. If Simon were to miss the gig, he would be disappointed, of course, but it would cut deeper than that. He would be angry, I imagine, and resentful. Not angry with me, but with everything. Our life. And so I continue to compose my loose and silent plea to the universe: Please don’t let Simon miss the gig this weekend. Please don’t let him miss the gig. Please. As far as prayers go, it is poorly constructed, narrow and self-serving, and so blatantly, colossally off point, but in my heart it encompasses a great deal.

IT’S BEEN A
long winter in my head.

That’s what Simon said to his sister last Sunday. She and her family were visiting Simon’s parents in their farmhouse outside Montreal. Everyone had spent the weekend at the annual summer fair, and Simon was homesick. When he got off the phone, we sat in the front yard in the dying light of a warm summer evening. It had been a long, difficult winter for both of us, yes, but that day had been a good one. The three of us had gone out for brunch, and then we had dropped Eli at the floatplane that would take him to soccer camp on Vancouver Island. Back at home, we washed my car and his truck, a fun, soapy, not too taxing sunny-day chore. After, I finished reading the last few chapters of Dickens’s
Great Expectations
—it was to be a summer of revisiting the classics—and Simon worked on his slide version of “Diamonds on the Soles of Her Shoes.” A good day. Still.

It’s been a long winter in my head.

It had been a particularly hard winter. My mother, who now lived in Powell River, a ferry ride away in the opposite direction of Vancouver, had been diagnosed with breast and lymphatic cancer. Over the past year I had spent a great deal of time in Powell River, helping out as she recovered from her mastectomy and began aggressive chemotherapy treatment. At first, this time was healing for our relationship, but as she became more ill, I found myself returned to the role I had inhabited as a teenager: the daughter who could never, ever do enough to help her mother. The daughter who was selfish through and through for wanting a life of her own.