I guessed that the old black telephone must still be in the hallway; I doubted my father would have replaced it with a new one. I could see the hallway, the table where the telephone sat, the umbrella stand, the green rug, the pictures of Chopin and Mozart above the table. The staircase to the upper floor. I hadn’t been there in over a decade, but nothing had changed since I was a boy.
I counted the rings, and was about to hang up after the fifth, when he answered. We hadn’t spoken in two years, and yet his voice hadn’t changed. Friendly yet guarded, almost suspicious.
“It’s me,” I said, and then a moment later felt it necessary to add: “Magnus Colin.”
“Oh, Magnus!” And then added: “Is everything all right?”
“Yes,” I said. “Everything’s fine.”
“Are you in New York?”
“No, I’m at the hospital.”
“In Connecticut? Here it’s getting late, nearly dark.”
I asked about the weather and their health; he saw no reason to discuss the weather, but said he had news of my mother, who for as long as I can remember has always been battling some mysterious ailment or other.
“The doctors you recommended weren’t much good,” he said. “But one of Margaret’s German fans introduced us to a compatriot of his, whom I can only describe as a miracle worker. She hasn’t felt this well in years.”
My father has always referred to my mother by her first name when talking to me: he has never said “your mother,” much less “your mom.” It’s the same with her. Vincent, never “your dad” or “your father.” And I myself haven’t called them Daddy or Mommy since I was a kid in Kingham. I didn’t stop on purpose; I simply got used to calling them by their first names, and I had no reason to object to it. Some people find it strange—Malena certainly did—but I was perfectly at ease with it and never felt that in some way I was missing out. Our relationship had always been like that.
“Did you get my postcard?”
“From Rome?”
“No, I sent it from Paris.”
“Yes, you’re right. We did. Were you there for long?”
“Just a few days.”
“Margaret and I spent five months in Paris once. Before you were born, of course. After that we couldn’t get away. I seem to remember it was in sixty-seven rather than sixty-eight. We stayed in an apartment in a little street off Boulevard Saint-Germain. What was it called again? There was a café opposite where we would start the day with a coffee and a croissant. Margaret was playing magnificently during those months. It was as if every note had wings. The high point of course was the recital she gave at Salle Gaveau.”
I walked out onto the balcony while he was talking. I live on West Seventy-Fifth Street, just off Central Park, in a two-bedroom apartment on the fourth floor of a five-story townhouse dating from the end of the nineteenth century. Most of the houses in the area were built around the same time; they are about twenty feet wide, four or five stories high, and have one or two flats to each floor. The apartment buildings on Central Park West are much taller, but they don’t overshadow us too much. My balcony overlooks a back garden, and although rather small, it’s spacious enough for a table and two chairs as well as a few flowerpots. Malena and I would often eat dinner out there, and sometimes when it was too hot in the bedroom, we would spread our comforter out on the floor in the living room next to the open balcony doors. It felt good making love there, with the warm breeze and the glimmer of city lights, and afterward as we held hands and listened to our heartbeats slowing, I would ask myself whether I deserved to be that happy.
When I rented the apartment, I had assumed I would be working in New York for at least a few years. I had just been hired to join a small team of neuroscientists at Mount Sinai Hospital and welcomed moving from New Haven, where I had lived while in medical school. It was therefore ironic that only six months later, we were informed that our department had been merged with a team from Yale. Since they had more money and better infrastructure, we had to pack up and join them at their new facilities outside the village of Cold Harbor, Connecticut, about an hour away from the city.
My commute isn’t straightforward. It would be easier if I lived on the east side, but I’ve always preferred the west side. I take the subway on Central Park West and then walk to the Metro-North train at 125th Street. But it’s worth the trouble. I get to enjoy the city at night and most weekends, and I use the time on the train to read or simply let my mind wander.
All this back and forth confused Vincent who had a hard time keeping my whereabouts straight.
“But who knows,” I heard him say. “At this rate, Margaret may soon be well enough to travel. And then it would be perfect to take the train to Paris, although I can’t say I like the idea of going in that tunnel under the Channel. How long is the train in there for, anyway?”
I have often been on the verge of moving out of my apartment, but I always change my mind at the last minute. Last March, I told the landlord I was leaving, and had started packing my stuff into boxes when I changed my mind. He had already rented it out, but fortunately for me the woman below left at the same time, so he let them have her apartment instead. Simone is right when she tells me I should move out and try to build a new life, but I have too many memories. And I fear that without the apartment to remind me, I will forget, although it stands to reason that I should start forgetting if I want to build a “new life.”
“Can I count on you being here for her seventieth?”
The birthday party. I had been hoping the plan might have changed.
“When is it?”
“The weekend after her birthday. Saturday. Three o’clock.”
I paused. My hesitation didn’t go unnoticed. He waited. I sensed from his silence that he was expecting me to say I couldn’t come. I sensed, too, that whatever excuse I gave, he wouldn’t believe.
“Sure, I’ll be there.”
“Magnus,” he said, “this isn’t going to be any ordinary birthday party. It’ll be an event.”
“Oh?”
“God willing. But I shall say no more. Things have been happening here, Magnus. Big things.”
I would normally ignore this kind of declaration, but there was something about his voice that made me stop and listen. Until he said:
“Will you come alone or with your sweetheart?”
“Alone,” I managed to reply, before quickly saying good-bye.
Chapter 3
Over the years, Simone has become convinced that Hofsinger’s name shouldn’t have appeared before Osborne and Moreau in the list of authors of the article in the New England Journal of Medicine. It’s true that they were largely responsible for the implementation, and yet it can’t be denied that the idea was as much Hofsinger’s as theirs, and that it was due to his influence that they received the grant for such an extensive research project. Those personality traits which she most objects to in him (his overweening self-confidence bordering on arrogance, his amazing ability to wipe the floor with his opponents) are extremely useful when dealing with the politicians and bureaucrats that decide who receives grants and who doesn’t. I also pointed out that his surname came before theirs in the alphabet, but I needn’t have bothered as she instantly argued that none of the other authors were listed in alphabetical order, so that my name came last, hers second to last, Vanhaudenhuyse came after Murphy, and Zeiler came before McCarthy.
“In fact, you should have been one of the main authors,” she said. “You certainly deserved it.”
And yet she knows I don’t care where my name appears on the authors list. I prefer to keep a low profile and like to be left to work in peace and quiet. It’s not that I’m particularly self-effacing, but ambition and status seeking don’t interest me. The shrink I saw last year tried to relate this to my upbringing, of course, but I wasn’t interested in talking endlessly about those days, and so in the end I stopped going. He was in his early sixties, soft-spoken to the point where sometimes I though
t I might be losing my hearing. He meant well, but didn’t help me much. From his office I could see the well-lit rear windows of a music school; I would occasionally watch the supple movements of the violinists rehearsing in a bright and spacious room, and I even found myself trying to guess what they were playing.
He asked me at one point if I thought that Margaret was possibly autistic (he used the word “mildly”) or suffered from some form of Asperger’s. I had never considered it and told him so. “Being a neuroscientist,” he said, “I think you would know.” Perhaps he was trying to flatter me, but I answered that recent events would suggest that diagnosing those close to me wasn’t a particular strength of mine. He smiled, but broached the subject of Asperger’s again the following week, this time asking if I had ever taken a test myself. By that time I had given up on him and never filled out the quiz he e-mailed me the following day. Indeed, I don’t think I ever saw him again.
The article, which marked the start of the research I have been working on continuously for the past couple of years, or since it was published in early 2006, was focused on twenty-eight patients who had suffered such extreme head injuries that their brains showed no sign of life. They were considered incapable of thought or expression and had been kept alive on ventilators, some for several years. Most were accident or stroke victims, two had contracted meningitis, and one had a rare degenerative disease. The youngest patient was about twenty and had been in a motorcycle accident, and the oldest had suffered a stroke at sixty-two. Most were men.
The aim of the research was to find out whether any of the patients might enjoy some level of consciousness despite evidence to the contrary. Osborne, Moreau, and Hofsinger came up with the idea of placing them in an MRI scanner, where it would be possible to monitor brain activity in response to questions or instructions by measuring the blood flow within the brain. The research is being carried out in three different places, with us here in Connecticut, Osborne in Cambridge, and Moreau in Liège. I remember Hofsinger saying when we slid the first patient into the narrow and, by most accounts, terrifying hole: “At least we don’t have to worry that he’ll feel claustrophobic.”
The research consists of the following procedure: once our patients are inside the machine, we ask them to imagine playing tennis and walking through their house. When healthy people imagine playing tennis, they show activity in a region of the motor cortex called the supplementary motor area, and when they think about navigating their house, blood flows to the parahippocampal gyrus located in the medial temporal lobe, in the center of the brain. The scanner registers the activity, producing a corresponding image on the computer screen.
Hopes were high the day the ambulance brought our first patient, a carpenter who had fallen off a ladder and never regained consciousness, to the research lab. This was before the department moved from New Haven to Clear Harbor, and so the process was more cumbersome. We all waited by the window, except for Hofsinger, who behaved as if that day were no different from any other. I remember clearly that it was raining yet warm. Malena called to wish me good luck just before the ambulance drove up to the building. Her voice cheered me as always.
For weeks we had tested the equipment which we developed in conjunction with our colleagues in Cambridge and Liège. The software had been a bit unstable to begin with, but the programmers had made improvements and now it was behaving perfectly. Simone and I had taken turns lying inside the scanner and imagining we were playing tennis or walking around our respective homes, and the appropriate areas of our brains had lit up on the screen as anticipated.
And so it was all the more disappointing when the equipment failed at the first attempt. We had finally installed the patient inside the scanner, after some difficulty with the ventilator cables and tubes, and Hofsinger had taken up his position in front of the microphone connected to the scanner, ready to address the patient. He was, of course, aware that this was a potentially historic moment, and although his speech was formal as always, his manner was almost jaunty.
He was taken aback when I told him that we had a problem. He stood still for a moment, glaring at me, demanding an explanation. Given that he had scarcely taken any part in the preparations, I saw no reason to go into a long story about what might have gone wrong.
“I’ll let you know the moment it’s fixed,” I said.
He glanced at his watch before walking out. I suspected the software was to blame, and after a brief inspection it turned out there had been a glitch introduced the evening before when the programmers decided on their own to try to shorten the response times even more. With software, it isn’t uncommon for one thing to go wrong when another is fixed, and they were quick to discover the fault and correct it. I found Hofsinger in his office and he took up his position at the microphone as before, while I sat in front of the screens next to the programmers and some other technicians, and gave him the signal when we were ready.
“Good morning, my name is Dr. Hofsinger. You are in an MRI scanner . . .”
He explained the procedure and asked the patient to follow his instructions. He tried to sound at once authoritative and reassuring, which he is good at. But it didn’t work. No matter how many times he told the man to imagine that he was playing tennis or walking from room to room, the screen showed no response, either in the motor cortex or in the parahippocampal gyrus. Even so, we didn’t give up, and continued the next day—with the same result.
Our colleagues in Cambridge and Liège fared no better with their patients, and there is no denying that some members of the team were a little dejected when we compared notes during a conference call at the end of the week. They had no reason to be, of course; it was only to be expected that most, if not all, of our patients were irrevocably lost, their brains so damaged that they contained no conscious thought.
During the weeks that followed, expectation gave way to despair when none of our patients, or those in Cambridge and Liège, showed any response. It was as if we had invented a sophisticated way of trawling for fish only to discover there were none left in the sea. Hofsinger made an occasional appearance, leaving me in charge of dealing with the patients. It can’t be said he missed anything, because patient number twenty-two, as he was referred to in the article, wasn’t one of ours but our colleagues’ in Liège.
He was twenty-four years old and had been in a car accident five years before. There was nothing to suggest that he had any more life in him than the other patients; sometimes the corners of his mouth would twitch, and every now and then he would grind his teeth, but so did the others, and such gestures are merely unconscious nerve impulses. Yet he thought about tennis when Moreau told him to, and at Moreau’s behest conjured up in his mind the image of a house through which he pretended to be walking. Not just once or twice, but over and over again, three days in a row, until it became clear that he had been locked inside his paralyzed body all these years.
Hofsinger and I flew over from New York and Osborne traveled from Cambridge, and after resting for an hour, we met at the lab and watched Moreau talk to his patient, as the different areas of his brain lit up on the screen. Hofsinger doesn’t understand French and asked me what Moreau was saying, as though wanting to make sure the questions were the same ones he himself had asked our patient.
We had a celebratory dinner at a small bistro near Rue Fond Saint-Servais. It had rained during the day, but by evening the sky had cleared and there was a splendid sunset as we sat outside on the terrace. There were ten of us around the table, and Hofsinger made an overly long speech, comparing the human brain to a labyrinth, no less mysterious than outer space. He had drunk a few glasses of red wine, and his words, pompous yet eloquent, were undoubtedly lost on most of the Belgians, who spoke little English. In the middle of his speech I received a text from Malena, and I couldn’t resist picking up my phone. It said: If you examine my brain, you’ll see I’m thinking of you, and then she added a smiley face.
I called her later that night from my hotel room
. She was on her way to a dance performance and was heading toward the subway on Central Park West. I could hear the murmur of traffic and had the impression she was late, so I quickly said I hoped she had fun, when all I really wanted was to listen to her voice. She sensed it, and I heard her slowing down as she told me what wonderful weather they were having, how Central Park was in bloom, and how much she loved me. Then she blew me a kiss down the phone and I thought I heard her say once more that she loved me, but by then she was on her way down into the subway and the call broke up. I could see her threading her way deftly through people on the stairs, and I knew she hadn’t held back when she blew me that kiss, that she was unembarrassed amid all those strangers. I thought about how different we were. I would never be able to do that, and still I loved her more than I ever thought I’d be capable of.
One Station Away Page 2
