by Brian Harvey
C is for Cushing
So cleverly cursed
If he ever gets sick
He will never be nursed.
Cushing was a details man who took every aspect of his patients’ care personally. Sleep and holidays were well down the list, and he got the same dedication out of his assistants. But when Cushing lost a patient, he was hardest on himself. When I read this stuff, I sometimes had to remind myself it was written about another man, not my father. I did once ask a local doctor, who had worked with my father, what he was like in the O.R. “No comment,” he’d said.
The Great War of 1914–1918 produced the biggest explosion in head trauma the surgical world had ever seen. Harvey Cushing did two tours in Europe, one of them in a casualty clearing station behind the lines at Passchendaele. Neurosurgery took a bloody leap forward in those years, and the slippery operating tables behind the trenches became a sort of high-speed testing ground for surgical treatment of head wounds.
So much could go wrong with the brain: fractures, infections, growths, and the awful squeezing that destroyed the central nervous system so that people lost their senses, endured unimaginable pain, went mad. At first, surgeons were lucky if they got out before the patient bled to death; bulging of the brain often meant you couldn’t even close the skull up again. Cushing’s first foray “inside the box” was to relieve a former sea captain of the coruscating pain of trigeminal neuralgia (tic douloureux), a disorder of the largest facial nerve. He chloroformed the man in 1899, trephined his cranium with hammer and chisel, and dissected out the bundle of nerves connecting the brain to the trigeminal nerve. The captain lived another forty years, pain-free, while his surgeon built brilliantly and relentlessly on that first great success. And despite the extraordinary advances since Cushing’s time, brain surgery still means opening up the box with burrs and saws, clamping off pulsating forests of blood vessels that insist on obliterating the field, finding your way through a blancmange of neurons that control everything from a wiggle of a toe to the wink of an eye, then accomplishing what you came to do and getting the hell out.
Outside the hospital, Cushing was revered, admired, emulated — but it doesn’t appear that he was much liked. He turned on the charm when it suited him, apologized strategically, and intrigued with the best of them. He was the prototype of the egotistical, imperious surgeon. He often shamed his assistants into doing things they felt were beneath them, like emptying bedpans or cleaning up vomit.
A much more recent biography by Michael Bliss is less sparing of Cushing’s defects than Fulton’s, but more illuminating for me. Bliss’s book recreates not only the man but his times as well, so I understood that it wasn’t simply that my father regarded Harvey Cushing as the role model for a caring, competent surgeon, he also revered the system that had produced Cushing, that Cushing had perpetuated and changed, and that had taken root from New England to the Midwest and produced an unbroken line of surgeons who thought like Cushing, acted like Cushing, and took their inspiration from him. It was virtually guaranteed that anyone who came out of that system, for generations after Cushing, had it firmly in mind that they were leaders.
My father was one of those. In the late 1940s, when he was studying for his Ph.D. in neurosurgery in Chicago, Cushing had been dead ten years, but his legacy was alive and well. Cushing began the tradition of the neurosurgeon as the star of the hospital, something my father picked up in Chicago and imported, for a while, to Vancouver and Victoria. When I was growing up, this role was well entrenched in the public mind; having a father who was a “brain surgeon” — well, what could have topped that?
Going in Backward
The next day, we tore ourselves free of the Lasqueti Triangle, determined to make up for lost time. We had to stop acting like a couple planning a leisurely visit to Desolation Sound because we had a lot farther to go. Cape Scott, the turning point, was still many days ahead. We hadn’t even finished crossing the Strait of Georgia. The forecast was for — well, it wasn’t for much of anything. The southeaster had blown itself out, and it would be another day before the wind did a 180 and returned from the “real” summer direction, northwest. When that started, we might have the wind on the nose for weeks.
Once clear of Lasqueti, we followed a long, angling course up the eastern side of Texada, a thirty-mile-long lozenge I call the never-ending island because it seems to take forever to get past. After rounding the southern end of Texada, you’re technically out of the Strait of Georgia and into Malaspina Strait, which, if you ignore all the right-hand off-lanes that lead up the spectacular mainland inlets (“Not this time!”), eventually deposits you in the town of Powell River, on the doorstep of Desolation Sound. That’s where we would spend the night.
Nobody seems to pay much attention to Texada, and the 1,200 or so residents may like it that way. The most press the island had attracted in the last decade was outrage over the proposal, a few years earlier, for a liquid natural gas terminal at the north end of the island. Nobody was thrilled at the prospect of gas tankers in Georgia Strait.
Now, Malaspina was glassy. It was like motoring across a mirror. The only landmark on Texada, at least on the east side, is the limestone quarries to the north, not far from the terminal for the small ferry that shuttles to Powell River. The hillside is excavated in great shelves that look like the entrance to a giant’s castle that never got built. At six knots, it would take hours even to reach the quarries. I put Vera on autopilot and went forward to sit on the foredeck. The Yanmar droned comfortingly behind me, and Vera cut her silver path. For anyone sitting on shore, we would be a stationary speck. We were weirdly alone, not even a tug to worry about, never mind a hypothetical tanker, and I had to fight to keep a lookout for floating logs. I tried the meditation technique I’d been reading about in my father’s book on Buddhism: breathe in, breathe out, concentrate on the act itself to the exclusion of everything else. But it only made me drowsier. Meditation and watching for flotsam didn’t seem to be compatible.
So I thought about my friend Chris, who in two months had gone from helping me tear out my rotted exhaust system to submitting to a surgical operation that left him without an esophagus. It was cancer; the odds were discouraging. We had thought a lot about cancelling the trip, but he wouldn’t hear of it. What business did I have being out here, when things like that could happen out of the blue? For that matter, what was waiting out there for me? I decided to ask my father about Chris. After all, if he was able to pop up on Vera without warning, why couldn’t I summon him when I felt like talking?
“Trust the surgeons,” he said.
My father wore the same checkered flannel jacket he’d had on in Skerry Bay and was perched on the pulpit, gripping the stainless tubing with both hands like a child banished to a corner. His slippered feet dangled over the glassy water, and he rose and subsided gently against the unmoving green backdrop of Texada Island. I noticed he was now wearing the white floppy hat I’d tossed into Haro Strait days ago. I decided his wardrobe was beyond my influence.
“The surgeons know what they’re doing. Anyway, what choice has he got?”
“Get a second opinion?”
“Oh, yes. I would.” He frowned. “You know, Chris never invited me to see my boat after he made all those changes to it.”
“That was twenty-five years ago! You sold it to him, remember? Anyway, he was probably afraid you wouldn’t have approved.”
“Well, maybe I wouldn’t have.”
A chunk of waterlogged driftwood thunked into the bow, right below my father, and tumbled the length of Vera’s hull making bass-drum noises. I watched it bob in our wake: a couple of feet long, too small to cause any damage, but what if it had been the top of a deadhead? I got to my feet and went back to the cockpit. Hatsumi looked annoyed.
“I think I was dreaming,” I said. Like many Japanese people, she believed in ghosts, but I didn’t think I could get away with blaming
the collision on one.
“How much longer until we get to Powell River?”
It took us another three hours, and by the time the wind finally arrived, predictably from straight in front of us, I’d lost interest in sailing. The wind increased alarmingly as we rounded Grief Point, a notorious shoulder on the mainland side that sticks out into Malaspina Strait just enough to force the wind to accelerate as it follows the shore. Grief Point is a kind of mini Brooks Peninsula, which would kill four men this year; they both work the same way. People with homes on Grief Point, and there are some beautiful ones, are in prime storm-watching territory, even in mid-summer. We rocked and rolled past Grief Point, then ducked in behind the breakwater at Westview, which is where the Powell River ferry dock and boat harbour are.
I like Westview. You can’t see the clouds from the pulp mill in Powell River, and the people are so welcoming, I only had to stroll through once to decide I would be perfectly happy living there. It’s just that — not to put too fine a point on it — Westview Harbour is hell to dock your boat in. The wind is one thing; even behind the breakwater, Malaspina Strait makes its presence known. But the real challenge is the way the harbour master, who is actually two or three people with handheld VHF radios and seen-it-all expressions, packs the visiting boats into the available space.
Westview is really there for the fishing fleet. It’s a working harbour, not a manicured grid of pressure-washed concrete wharves with nightlights that actually work and kiosks for shore power and water. At Westview, visiting yachtsmen are asked to back their boats down between the slips, where you either form a raft with several other boats, or moor stern-in so that you have to get off your boat by clambering over your own safety lines and jumping off the back end. You don’t get a choice: the harbour master radios your slot to you, you somehow turn your boat around in ten feet of water without hitting the breakwater, and back you go, trying to control an object that was never designed to go backward. I’ve seen people lose it in Westview, husbands yelling at wives standing petrified on the foredeck (“The pole! Get the pole!”), wives imploring the converging attendants, off-duty fishermen, anyone to somehow help the maniac at the controls bring their twenty-thousand-pound whale to a stop without taking out the dock. Backing into Westview is the kind of situation where people get so flustered they grab the wrong engine control, hurl too-short docklines into the water, take flying leaps.
My father’s ghost would fit right in at Westview, but he wisely chose not to show his face this time. Somehow the wind co-operated, Vera responded to my puppet-master routine with throttle and shifter, the dinghy didn’t get cracked like a sunflower seed between two boats. Or maybe we actually finally knew what we were doing. We tied off to a small gillnetter, exchanged a surreptitious high five, and set off for a late-afternoon walk to Willingdon Beach Park. When we reached the top of the gangplank and looked back, Vera had been swallowed, a green stitch in a carpet of boats.
Willingdon Park was a gem, a sandy crescent of beach with a long fishing jetty backed by green lawns, a kid’s play pool and swings, the Forestry Museum, a cedar band shell. The Beach Hut sold burgers and oysters, and we lined up behind a motorcycling couple in their sixties; they both wore Doc Martens shoes, blue shades, and leather jackets with “Powell River Harley Owners” across the back. We ate an early dinner off paper plates the wind kept trying to spin out over Malaspina Strait, then walked back along the main street to the docks.
Powell River would be the last sizeable town for us before Port McNeill and Port Hardy, near the top of Vancouver Island; after that, only Tofino and Ucluelet, two-thirds of the way back down the west coast, would have much in the way of services and communications. I noticed a few new businesses — an espresso bar, a bistro, a curry hut — that seemed to confirm an influx of retired city-dwellers, but Westview didn’t seem in danger of losing its small-town flavour. The sign at the Legion Hall still advertised “Saturday and Sunday Meat Draws,” and Ace Auto Marine, with its window full of rebuilt alternators and starter motors, was still there between the barber shop and an accountant’s office.
Vera was thoroughly hemmed in when we got back. A small tug had tied up nearby, stern-in, two lines compressing the multiple layers of old auto tires that made up its aft fender. “Japanese style,” Hatsumi called it. Japanese harbours look a bit like Westview, with the fishing boats stacked, stern-in. In the low sun, the mundane became beautiful: the fuel dock, a row of orange fenders tied to a trawler, a frayed flag snapping in the wind. The whole assemblage rocked and creaked. Charley was in heaven, lapping at oily blotches on the dock and urinating every few feet.
There was a new arrival across from us, a forty-five-foot white ketch that seemed to be crewed by middle-aged women — eight of them, it turned out, signed on for an adventure circumnavigating Vancouver Island. And the skipper in charge of this group of neophytes turned out to be the wife of a biologist I’d known decades before. Valma Brenton looked like she was up to the task: weathered and deeply tanned, with short blonde hair caught behind a band. She had dirt under her fingernails and didn’t bother with shoes.
“I’m teaching them yoga, mindfulness, and offshore sailing,” she told me, grinning. “And it’s not even my boat. The engine broke down as soon as we left Nanaimo, so we’re here until the parts come.”
“So — you’ve gone around the island before?”
“Lots of times.”
Valma might be useful. “What about the Nahwitti Bar?” I asked.
“Slack tide,” Valma said. “Don’t go any other time.”
“Unless we take the inside route, right? Through the kelp?” Finally, I thought, someone who’s actually been there, and more than once.
“Never heard of it,” said Valma.
The Man I Never Expected to Meet
Valma Brenton seemed like an interesting person. You meet a lot of interesting people when you travel by boat, but I was already finding out that you meet just as many when you decide to tackle a medical detective story. Allan Thackray, for example. His name was everywhere in my father’s files. It was as though this one man had taken it upon himself to infiltrate every hole, however small, in the great smelly cheese that was the case against my father. Mr. Thackray was, strictly speaking, the Canadian Medical Protective Association’s lawyer, but my father thought of him as his. Very soon, so did I.
I wasn’t prepared to cut Mr. Thackray much slack at first, not when all I knew of the case was its out-of-court outcome that I couldn’t help thinking of as capitulation. If anything, the Allan Thackray I had in my mind as I began to trawl through the files was the generic barrister, an argument for hire, the kind my father habitually railed at. But there was way too much of Allan Thackray here for anyone to maintain that kind of image for long. His letters to my father were unfailingly respectful, but this was clearly the kind of respect that reflects immediately upon itself; it was obvious to anyone reading the letters, and especially to my father, that Thackray had done his medical homework on every relevant aspect of the case. He knew where the strengths and weaknesses lay, and he expected my father to grasp their significance. And so the two men developed a correspondence of careful camaraderie, at first only by letter but later, when the examination for discovery rolled around, in person.
I began to form my own image. The preliminary letters I imagined written by a big man, suited, in a corner office high above Vancouver’s photogenic harbour, aware of his power yet careful with his wording, the way a big man is careful of his bulk. When they met, I imagined, the lawyer would have towered over his client, and it was easy to picture him covering the room where the examination for discovery was held, a football lineman ready to protect his quarterback with a lightning dive for the knees of the opposition.
When Thackray went into court alone on the first day of the trial, the transcripts only strengthened that impression: clearing the way, sizing up tacklers in an instant, derailing or de
molishing them, and then offering a sportsmanlike hand to get them back on their feet. And when it suddenly became clear that the star player would never take the field, my imaginary Thackray played the part of the benched player to perfection. In the final exchange of letters to my father, he produced a good impersonation of an athlete being interviewed after a loss: we gave it a 110 percent, the coach did what he thought best, time to move on.
It took me the better part of a fine afternoon in Westview to get through everything with Mr. Thackray’s name on it. When I’d finished, I knew that his neat summing-up couldn’t be the end of the story. The greatest athlete-diplomats leave you marvelling at their restraint while more than ever convinced that the real story is more complicated, and so it was with Thackray’s exit from the case and from our lives. When I closed the last file folders of his correspondence, I resolved to track Mr. Thackray down.
What prodded me to do this was the thorn of a single sentence buried in a spiral-bound exercise book containing twenty pages of my father’s handwritten account of the trial, all of it struck through with thick pencil, as though he had opened it one day, shaken his head, and leafed methodically from beginning to end, slashing diagonally as he went. Bottom left to top right, a backhanding of bad memories, like shooing a persistent fly. The sentence that sent me looking for Mr. Thackray was this: “My lawyer’s letters do not reflect his warm personality; they are polite, brief, cold, and to the point.”
Warm personality? I knew it! I had to wait until our trip was over to follow up on my hunch, but this is how it turned out.
