Now, as he stood there in front of the reporters and prepared to read his script, I was uncomfortable. I know what to expect from myself. I’m the most predictable person in the world. But Dr. Bernstein was something else altogether. Predictable he wasn’t. He was a tired, nervous man who had gotten himself into something from which he couldn’t extricate himself. He was a bit neurotic, I think. I wouldn’t put it past him to lose himself up there and start saying things he shouldn’t.
I moved to the side and Dr. Bernstein took over. His hands were shaking and his voice wavered as he looked down at his script and began reading.
“Good morning, everyone. Let me first tell you about the patient’s condition. Len referred to him as John Doe A. I’ll call him John now. I last saw John about two hours ago, and he was doing fine. His condition can be compared to that of a person who has suffered separation between the first and second vertebrae of his neck. Such complete separation can result in the patient being permanently immobile, though he can often reason and communicate. Now, John’s condition is, of course, much different. While his brain functions, he does not have full communicative ability. He cannot see or smell. He cannot eat or care for himself in any real way. He can hear, however. Almost as well as you or I. And, through an electrode planted in his brain, he can communicate through electrical impulses. You might think of it as Morse code, though stenography is more accurate. John has learned to control these electric messages, which are then fed into a computerized speech synthesizer that allows him to communicate. Len mentioned that John is experiencing some sensation of feeling in his left arm. This is true. We have been treating John with experimental genetic material designed to help regenerate his nervous system. And while we’re very hopeful, we are, at the same time, realistic. As I’ll show you in a moment, attaining blood flow to the brain is one thing. But reconnecting the brain stem to the spinal cord is something else altogether. John can feel when someone touches him on his arm. He can even twitch his shoulder a little bit. But that’s as much progress as he has made. Probably as much as he’s ever likely to make. His prognosis is good, for now. As long as we can keep his body healthy and the blood flow intact.”
Dr. Bernstein was doing quite well, though he was reading a bit fast. The reporters were deep into their craft, most of their heads down at their notes or checking the volume on their tape recorders.
Dr. Bernstein moved to an easel off to the side and removed its top blank card to reveal a large cutaway illustration of a brain. This was the part of the news conference that the doctor had initially opposed: a scientific explanation of the procedure. But I’d argued for it aggressively. Without an accurate depiction of the operation, the presentation would be incomplete. More than that, however, the discourse into brain stems and ganglia was specifically designed to give the reporters time to digest what they’d heard so far. Like any good book, a news conference needs to have a beginning, middle, and end. My introduction and Dr. Bernstein’s opening laid a solid foundation. Now, as he presented the technical medical information, the story that we had crafted was settling in and becoming real. This wasn’t just pie in the sky. It had actually happened. In its own way, this formal description of the technique was proof of something that indeed occurred.
“Now,” said Dr. Bernstein, entering into the more difficult part of his remarks, “you might be wondering what is the benefit of this procedure. Why should we perform such an operation in order to attain a relatively low quality of life? Rather than answering it myself, I propose that you ask that question to any of the thousands of people living life as quadriplegics. Ask them if they’d rather be dead. And ask their loved ones. Immobile people can still lead active mental lives. They love people and are loved in return. They contribute to our society and demonstrate the resiliency of the human spirit.
“But it goes deeper than that. As Len mentioned earlier, our research will pave the way for helping people with a variety of debilitating diseases and spinal injuries. There’s very real hope for them. And John and his family are thrilled to be able to help. And speaking of John, let me just say that he is a tower of strength. His memory is intact. His intellect is enduring. More than anything, though, he has retained his sense of what I can only describe as his self. He looks like John Doe B and that has taken a good deal of getting used to for his family. But his thoughts and love are his and his alone. He lives.
“Finally, let me discuss his prognosis and where we go from here. Like any organ transplant patient, John’s greatest threats are organ rejection, infection, inactivity, and the possibility of his organs shutting down. He undergoes significant rehabilitation and muscle stimulation every day. We work hard to keep him active and alert. Every day he improves a little more. I’m proud of him and honored to have been able to take this important step for humanity. Thank you.”
The moment Dr. Bernstein concluded his remarks I saw movement. A man standing at the back was pushing past people, saying, “Excuse me,” and stepping over cords and squeezing through small spaces. “Just one second,” he said, raising his hand as he approached the platform.
“I’m sorry,” I said, “but I made it clear we would take no questions.”
“I know that,” he said, “but I just want to ask—”
I raised my voice to drown him out. “Thank you and good day!” I said and turned Dr. Bernstein around and back toward the screen that hid the door I’d prepared for just such an occurrence.
We were nearly toward the screen when the man said very loud, “Howard Lavery. Is it Howard Lavery?”
Those words stopped Dr. Bernstein. I felt him freeze and saw his eyes close. I tried to push him forward. “Out the door quickly,” I said to him, but he turned around and looked at the reporter.
“I knew you’d be here,” Dr. Bernstein said. “Can’t you leave him alone?”
Then the room fell into chaos. The reporter who’d yelled Howard’s name jumped onto the platform. Others followed him. The cameras swung around and a great noise erupted as everyone started wondering aloud what was happening.
But I didn’t wait to see what developed next. I grabbed Dr. Bernstein by the shoulders and pushed him forward as hard as I could. We made it past the screen and outside. I took the key from the door, and it locked behind us. Then we stepped into my car and were off.
I was devastated.
“Who was he?” I asked.
“A reporter,” he said. “He’s been bugging me for a while. I met with him once. I promised him an exclusive.”
“Why didn’t you tell me?”
“I thought we had time.”
We didn’t talk again as we drove away. I silently damned Dr. Bernstein for not telling me about the reporter, but I wasn’t surprised. I’m sure there were many more secrets he had chosen not to share with me. I tried to think about what had happened and how I might have prevented it. I wondered just how bad things had ended up. Maybe it wasn’t too bad. After all, we’d taken precautions and had wisely not allowed Howard to be taken home. They’d find his house. If we were lucky, that would be the only consequence.
Maybe not. We had lost the advantage. Once the media felt they could bypass the primary source they’d be digging harder than ever. And they could become very dangerous.
18: Sidney Bernstein, M.D.
Life was much simpler when I was a resident fresh out of medical school and working terribly long hours for what I thought were beggar’s wages. This was a time before managed care took over health care, a more civilized era when becoming a physician was still an honorable thing to do. Back then it wasn’t corny to admit having chosen the medical profession because you wanted to help people.
Those were the days before second opinions, a time when people didn’t pretend to be their own doctors. They didn’t question us. Didn’t interview us. Didn’t have books that armed them with lists of adversarial questions. There was a time when a physician could prescribe medications, treatments, and diagnostic tests without having to consta
ntly worry about malpractice suits or being accused of authorizing too many tests or not enough. Those idealistic times have gone the way of rainforests.
People respected doctors in those days, and I suppose that’s what I was looking for. My parents encouraged me to have large dreams when I was a child. My mother used to tell me that I had “doctor’s hands,” whatever that meant. They did not push me. Nor were they overly dominant. They led by example.
My father was a strong, intelligent man with a knack for fixing things and helping people. He was a good listener. I admire him more than any man I have ever met, and many people felt the same. For nearly half a century he ran the only pharmacy downtown. For me, it was the center of life. I don’t think there was a person in our small community who didn’t know him and stop in once a week, if not to say hi to my father then to have a sandwich or drink at the soda fountain or pick up a package at the small post office in the back. He was never too busy to listen to my questions. At night, when I was in bed, I’d hear him play his clarinet, the smooth notes snaking through the house and upstairs into my pillow. I’ve come to realize that he wasn’t really a very good clarinetist, but I loved lying in bed and listening to him and knowing he was there. He was a father who encouraged everything and held his tongue when I went too far with things.
My father died in his sleep when he was seventy-two, and I think his was probably one of the largest funeral services we’d ever had in town. Of course, I’d been gone a long time, but not much had changed. The same narrow sidewalks. Same tree-shaded streets. Even my dad’s pharmacy was still there, though he’d sold it a few years earlier and a tacky green franchise sign went up outside. The overflowing crowd at the service made me feel proud. I suppose you can’t necessarily measure a man by the number of people who mourn him, but I think in Dad’s case you could.
When it was my turn to eulogize him, I walked to the front and spoke briefly.
“I’ve been gone a long time,” I said. “I haven’t seen most of you in years. But it’s good to see you today. Dad would have liked to know he was so well liked and loved. And I think that’s important. It means so much to have you here with us. With Dad, what you saw was what you got. There wasn’t a public man and a different, private one. The way he was with you, the handshake, the eye contact, the hand on your shoulder, all that was real and that was how he was at home. He was a simple man with simple dreams and a desire to do good. And I think he did it. He lived a full life. Did everything he wanted to. I don’t believe there was anything he desired that he didn’t obtain. I don’t think there’s a more deserving person in heaven today.”
I went back to my seat and held my mother’s hand. She was doing fine, I think. She’d already forgiven him for dying on her. She was like that. My father was even, steady, and predictable; Mom was an active, civic-minded dynamo. She had time for me, but only just enough. My clothes were clean. I always had a healthy lunch to take to school. But she seemed to think that was too easy and that she had a greater responsibility to do other, perhaps more important things. Whether it was raising money for the new library or the hospital, working in the PTA, or hosting a luncheon somewhere, she was constantly busy, always going somewhere. My mother’s heart was endless and enveloping, and it held room for many people and causes.
Together, my parents drew a dotted line for their children to follow but didn’t mind when you walked on either side of it.
My admittedly Capraesque youth is far from the warped roots now portrayed about me in newspapers and magazines. The media seem unable to accept that my actions are motivated by things noble and positive. There must be a reason why I’ve done such a horrible thing. As Len predicted, they’ve sought to find out what twisted my mind, as if I were a serial killer who must have been raised in a broken home, tied to a bed, beaten or sexually abused by his parents. They look for motivation. Everything must have a reason, they’ve decided. Events don’t simply appear from out of nowhere. Historic actions have roots that need explaining. The media descended upon my house and my mother’s home and have acquired my medical school records. They’ve delved into almost everything I’ve ever done. Spoken to patients and colleagues.
What they want is obvious. They want to mark their careers and be the first to break the story down and make sense of it. I suppose I can’t blame them, and I can’t see any way to have avoided this deluge. Len told me all of this would happen. He prepared me for it, telling me to ignore it if I wanted. But that doesn’t make it any easier. It hurts more than I can explain. What shall I do now? How can I possibly go forward? Len says not to worry. It’ll pass, he keeps telling me.
In the meantime, though, I have nowhere to go. I can’t go home. Can’t go to the office or hospital. It’s hard to go anywhere in public without someone recognizing me with a finger pointed in my direction and an uncertain voice that says, “I’ve seen you somewhere.”
We have moved Howard to the warehouse that Len found, and I’ve set up a makeshift bedroom there in what I believe was once an office. Here, I can find some quiet. With the door shut and the air conditioner humming, I can be alone with my thoughts and wonder if perhaps I’ve made a mistake.
I know that’s a terrible thing to consider after what I’ve done, but when everyone calls you a demon you start to wonder if there’s any credence to what they’re saying. The editorials have not been shy.
“The march of medicine is, of course, inevitable. It’s easy to visualize another lifetime when brain transplants become as common as setting a fracture. But that time is far off. And that’s a good thing. The quality of life that Dr. Bernstein’s patient is condemned to is unjustified and certainly not humane, no matter what its potential contribution to science may be.”
That’s what one major newspaper said in a scathing editorial, and it’s typical of the way I have been treated. And what if they are right? They may well be. Sometimes it’s hard to talk to Howard without feeling sorry for him. I wish I could offer him something better.
This morning, in a crazy role reversal, Howard tried to reassure me. Now that I think back on it I probably shouldn’t have spoken to him about it and burdened him with my feelings. But these recent events have made my feet unstable. I’m unsure about myself and my motivations now. That’s why, as I was checking him over, I blurted out, “Howard, do you think I’ve made a mistake?”
“About what?” he asked.
“About you and the surgery. About everything. I’m sorry.”
“Don’t be sorry,” he told me. “It wasn’t your decision. It was mine. You had nothing to do with it.”
“I had everything to do with it. Come on. It was my idea. I don’t think I gave you any choice.”
“You’re wrong. Stop it.”
“Then would you do it again?” I asked, and immediately regretted the words. How dare I ask such a question when it was so obviously too late?
He said, “I don’t know. It doesn’t matter now. That’s behind us. I have no regrets. You shouldn’t either.”
Needing to connect with him, I touched his shoulder. What I really wanted to do was jump inside his body and pull his brain out and end this whole thing. It crossed my mind just how easy it would be to inject him with life-ending drugs, giving him a painless way out of his prison. And mine.
“Stop doubting yourself,” he said. “Besides, where you’re touching me right now I can feel everything. I can feel your entire hand.”
“I’m sorry,” I said again.
“Don’t be,” he said. “Catherine has told me everything. She reads the newspapers to me. I know exactly what’s happening and what you are going through. You should be happy. You’re a genius. And you should think about how it’s better that everything is in the open now.”
“Howard, I’m a jerk for talking to you about this,” I said. “That’s another mistake of mine. You should be focusing on getting better and thinking positive thoughts.”
“It gives me something to think about,” he said. “That’
s important. It’s all I have. My thoughts. I can reason things out like you wouldn’t believe. Anyway, I have an idea.”
My head felt clearer. “I believe you’re right, the muscle tone in your arm is improved. Can you feel this?” I asked, stabbing him with a needle to determine how far his feeling had spread.
“Don’t change the subject,” he said. “Yes, I can feel that.”
“How about this?”
“Yes.”
“And this?”
“Yes.”
“How about this?”
“No.”
“That’s past your elbow, Howard.”
“I know,” he said. “Watch this.”
I looked down at his arm. Unless I was mistaken, he moved his shoulder. Not much. It was far less than a shrug. More like a twitch. But it moved.
I asked him to do it again and he did.
“I’ve been practicing,” he explained.
* * * *
Howard’s significant, astonishing improvement made me feel better than I had in a long time. Who knew how far he would come now? At this rate, I suppose it was conceivable that he’d gain partial use of his arm. That was certainly miraculous and reason for rejoicing even though there didn’t seem to be any improvement elsewhere in his body. I wasn’t surprised. After all, there are millions of nerves that Howard’s brain was not connected to. The fact that we were able to get sensation to his arm was really a shot in the dark.
I walked through the warehouse with a bounce in my step. A tremendous burden had been lifted. My patient was making progress and everything else seemed a bit insignificant. Howard was right about it being mostly good that we had gone public. For the first time in I don’t know how long I felt liberated and free. I had grown so tired of the lies, hadn’t known who to trust and confide in. True, these emotions have been replaced by ones of self-doubt and dread, but at least I could be honest now. Honest with people and with myself.
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