by Julie Cohen
‘I’ve never heard of it before,’ says the consultant, almost gleefully. I restrain myself from slapping him. ‘There’s a wide literature on temporal lobe hallucinations, but I haven’t yet encountered this particular hallucination, and this aetiology is also rare. Ninety per cent of cerebral aneurysms are anterior, rather than posterior, as yours is. So you not only have unusual symptoms, but an unusual disease. It was probably a good thing you were admitted for the tonic-clonic seizure rather than the hallucinations, as otherwise this might have been misdiagnosed as mental illness.’
‘Love is insanity,’ I say quietly.
‘On the contrary – your experience proves that love is not only entirely normal, but an infinitely repeatable human condition. And that any one love affair, any single emotion, can be preserved in the brain indefinitely, waiting for the right physical conditions for it to recur.’
I picture this: every emotion I have ever experienced, lined up in my brain like paintings in a gallery. Bundles of neurons, each one clearly labelled with its event and consequential feeling. First kiss, age thirteen: awkwardness. Hug from mother: security. Laughed at by whole class in primary school: humiliation. Finding best friend in a youth hostel in Mumbai: discovery. Butterfly lands on hand on summer’s day: serenity.
‘You’re saying that everything I felt is … chemical? Electrical? Just impulses in my brain?’
‘You say “just” impulses in your brain, but there is no emotion that isn’t caused by these impulses. So as far as that goes, your seizures do create authentic emotion.’
Quinn’s hand tightens on my shoulder and I glance at him. He appears as irritated with the doctor as I am. ‘Leaving aside the philosophical questions for the moment,’ he says, ‘isn’t a brain aneurysm dangerous?’
‘If it ruptures, yes, extremely. A subarachnoid brain haemorrhage can cause severe brain damage and death if not treated in time.’
‘So you have to take it out.’
‘Of course.’
‘Do you mean brain surgery?’
‘I think that Felicity is a good candidate for endovascular coiling, which is much less invasive. But she’ll have to be assessed by the interventional neuroradiologist before we can make any decisions.’
‘Wait,’ I say. ‘This is my head. I have a few more questions. If you take this thing out, are you saying that everything I felt will be gone?’
‘The desired outcome is that you won’t have the seizures any more, though we’d also keep you on anti-convulsive medication post-surgery for some time, to help with that. And you’ll have to be monitored to make sure the aneurysm doesn’t recur.’
‘You don’t understand. I’m asking about the feelings, not the seizures.’
‘You want to keep the feelings?’ asks Quinn.
‘I just want to know.’
The doctor glances back at his students to make sure they’re getting this. ‘The emotional kernel that you keep revisiting will still be in your temporal lobe. You most likely won’t experience it in the same way, as if you’re living through it again. It will be like any other memory, though perhaps a particularly strong one.’
‘I’ll lose it.’
‘You’ll keep it as a memory. Unless the pressure from the aneurysm, or the surgical procedure, causes some damage. Which isn’t impossible. Despite incredible developments in our knowledge and techniques, the brain is still unpredictable.’
‘Could this aneurysm have caused other symptoms besides the seizures?’ asks Quinn. ‘For example, behavioural changes?’
‘Have you noticed those?’
‘Yes,’ says Quinn, at the same time that I say, ‘No.’
The consultant laughs. ‘Marriage, eh? Damage to the temporal lobe can change behaviour. Loss of memory, impulsiveness or lack of inhibition.’
‘But that’s just the way I am,’ I tell Quinn. ‘I’ve always had a rubbish memory. And I’ve always been impulsive.’
‘How long has she had this aneurysm?’ Quinn asks the doctor.
‘Difficult to say. Unless they cause symptoms such as these, unruptured cerebral aneurysms can go undetected for a person’s entire lifetime. Some studies estimate that ten per cent of the population have them but will never suffer any problems because of them.’
‘So I don’t necessarily need to be treated,’ I say.
‘Yes, you do,’ says Quinn.
‘Your husband is right, you do. You may have had this weakness in your artery for years, and it could have been growing for some time without causing any perceptible problems, but it’s of a size now to cause seizures, and therefore surgery is indicated. As soon as possible.’
‘And it could have ruptured at any time during the past however many years?’
‘An aneurysm of this size has a greater than six per cent chance of rupturing annually. As I said, a rupture can lead to catastrophic brain damage. And yours is growing with every day it remains untreated.’
I take the print-outs again and leaf through them. A glowing kidney bean. A black bladder of blood. This is where love lies. This has been my passenger for who knows how many years, lying in the folds and shelter of my brain, filling itself with blood, stretching and growing. Possibly it was there when my mother was alive. While the cancer was eating her body, this bean was pushing outwards, testing its walls. All the time I may have been nearly as close to death as she was.
What would I have done differently if I had known?
I wouldn’t have let her lie in the hospital bed. I would have carried her outside; her body was light as air. I would have sat with her on the beach and run the sand through her fingers and tucked the feather of a gull behind her ear. I would have tasted salt on my lips and held her and lived our moments together as if they were our last.
I touch the shape on the egg-like CT scan. It could have been any memory, any feeling that was triggered. It could have been my first day of school, or learning to tie my shoes. It could have been my fear of what was under my bed, a drunken afternoon in Paris, a moment on the train from Cornwall to Paddington.
But it wasn’t. It was frangipani, and love for Ewan. Is that chance, or an inexplicable design? Does that mean that this swelling was inside my brain when I met Ewan in that life-drawing class, when that memory of being in love for the first time was laid down? It was a part of me even then?
How much of my happiness and sadness, my impulsiveness and my joy, my decisions and actions, my me-ness, has been caused by this curled-up kidney bean of blood, nested in my brain like the embryo in an ultrasound photograph?
Quinn
QUINN HAD BEEN in love three times in his life. Not counting temporary infatuations or girls he’d dated once or twice. He couldn’t even really count Andi, with whom he shared a flat and occasionally a bed soon after university; she was his best mate for a time, nearly two years, picking up an on-again-off-again relationship with him in between dating other people until she found Christianity and emigrated to Australia. He cared about Andi but he hadn’t been in love with her, and she not with him, although his parents had hoped, not so subtly, that he’d get more serious with her.
The first time he fell in love was a missed opportunity. He was seventeen and everyone in the sixth-form common room knew that Kathy Lewis was head-over-heels in love with Quinn Wickham. She was a pretty girl but shy, and Quinn already knew shy. He’d been shy through most of his senior-school years, being shorter and slighter than the other boys. Though he made up for his diffidence by being friendly and courteous to everyone, as his dad advised him to, he never had the confidence that many of the other pupils had, that Suz had always had. He knew shy, so he didn’t notice shy, because he was too busy noticing the people who weren’t shy and wishing he were more like them. The ones who could joke loudly in the hallways and make people laugh, the performers and the athletes, the fellow students he wrote about in the school newspaper which he’d set up himself, written and laid out and printed and distributed ever since he’d been in Year Nine. T
he news spoke for itself; he didn’t have to. He could stay shy.
Then he got his growth spurt in the middle of his first year of A-levels and he found it was easier to talk to people when you could look them in the eye, or even look down at them. He started wondering if Anastasia Jenkins would notice him now, after ignoring him for the past three years. That was why he never noticed Kathy Lewis, taking the seat next to his in geography, sneaking glances at him over lunch. And then some of the girls started to giggle about it, and some of the boys nudged him and pointed. Then of course he couldn’t notice her, not beyond his normal polite friendliness, because it would embarrass both of them.
Anastasia Jenkins started going out with Damien Boynton, and that was the week that Quinn started looking at Kathy’s hair and noticing how shiny it was, like strands of black silk. Then one day he noticed she’d had her ears pierced twice, her nails painted with glitter. Then her handwriting, which was much more dramatic than you’d expect from a girl so shy, all spikes and flourishes like a seventeenth-century clerk’s. They exchanged glances and smiles. They worked together to research a paper on the Euro Zone. She invited him to her house to revise.
For half a term, February to April, he felt a warm happiness in sitting beside her. He thought about kissing her and the thought of it made him want to skip. He knew he didn’t have to say anything to her, because she was in love with him. Everyone knew it. There was a secret sub-text to every sentence that they spoke to each other. It was the first time he’d been in love, properly in love, and it was wonderful.
For the Easter hols he went to visit Suz at her flat in Leeds and when he rang Kathy, for the first time, the night before they went back to school, her younger sister answered the phone. ‘She’s out with Mark,’ the sister told him, undisguised glee in her voice. ‘She says you never rang her and she was tired of it.’
Kathy went out with Mark for the rest of their school career. Quinn went out with as many girls as would have him. He kissed Anastasia Jenkins at the sixth-form leavers’ do and her lips were sticky with a lipstick that tasted of too-ripe cherries.
The second time he fell in love, it was much more substantial. He met Maya during his first year at university and the two of them clicked. She was studying journalism too, was not-technically-a-virgin too, had just missed Oxbridge too, her family was also traditional, though with different traditions. She and Quinn laughed at the same films and jokes and people. They met, and dated, and soon it was Quinn-and-Maya, a double act, a team, a partnership. They drank in the student bars together, spent afternoons exploring sex together, moved in together in their third year. His parents thought they would marry. Her parents initially put up an objection, but after meeting Quinn several times were resigned, even pleased.
And then it ended. He didn’t know why, and Maya claimed not to either. They had sex less often, though when they did, it was just as good. They spent more time with other people. Sometimes they didn’t speak for a day or two, maybe even a week, other than text messages or notes left to each other on the refrigerator. There was no falling-out, no argument, no appreciable difference in how they got along. But they weren’t in love any more. It had drained away, almost without their noticing it. Without either of them speaking of it, or making an effort to revive it.
When Maya accepted an internship in Hong Kong after their exams, they both agreed to stay in touch but see other people. The heartbreak was there, but it was more for what they’d lost than for the ending of what they had now. He spoke with her occasionally on Facebook these days, friendly and distant.
The third time was Felicity. He’d been dating another woman when he met Felicity on the train from Cornwall. It was nothing serious, a friend of a friend, but they were meant to go to the cinema the following Friday. He’d cancelled it, apologized over the telephone, told her he had met the woman he was going to marry. She’d thought it was a joke. He and Felicity were married three months later.
His love-life CV wasn’t very different from his friends’, male and female: they all had the one who had got away, the one that should have worked but didn’t, the one who grabbed their heart at first sight. It was a combination of factors, of well-worn stories and clichés, that was enacted and re-enacted millions, billions of times. They could be reduced down to sketches, to facts, enumerations of sexual positions tried or arguments avoided, betrayals of feeling or fidelity, mindgames or heartbreak. Oh yes, I had a relationship like that. Oh yes, my heart was broken the same way. Oh yes, I know the type of person you mean.
When he thought of Maya now, or Kathy, or Andi, or any of the women who had touched him in some way, physically or mentally – not many, but no fewer than what he supposed was typical – he sometimes felt a warmth or a smile, or a pang of regret or lust. He remembered the facts: I was in love with her once. I used to want to sing just from looking at her hair or her eyes.
But he couldn’t feel those emotions again; he couldn’t relive them by thinking of them. They were reduced to memory. To traces, with some power, but not much.
Not enough to take precedence over what he felt now, in the corridor outside the neurology ward, still awake on coffee and nerves, waiting for his wife to go through surgery that would probably save her life, that would possibly restore her to him, but might also kill her.
He had always loved how Felicity lived in the now. He loved her impulsiveness, her ability to see what was in front of her when other people ignored it. And yet Felicity, unlike him, unlike anyone else he knew, was caught in a loop of past feeling that her brain had convinced her was as fresh as the day when it happened.
It was so strange. Something you’d read about in a health feature, tucked in the back of the Sunday supplement.
In the corridor, near the vending machine that dispensed species of vile liquids containing caffeine, he closed his eyes and tried to recall what it felt like to be in love with Maya. How was it different, for example, for what he felt for Felicity?
If Maya walked into the hospital corridor right now, he would be able to distinguish his present emotions about her quite easily from what he felt for his wife. There was no comparison. But what if he were presented with the experience of how he felt about Maya, for example, after the first night they’d gone to bed together? Would it be the same raw emotion that he’d felt after first making love with Felicity, the same sleepless drunkenness of flesh and joy? Was there a space in his brain that carried a specific ‘night after Maya’ feeling, which was quantitatively different from his ‘night after Felicity’ feeling? Or was it more that he had a general ‘Quinn is very happy after making love with someone he cares deeply about’ feeling that was applied whenever the situation arose?
‘Pardon me, are you waiting?’
He came back to himself with a start. The woman standing next to him was looking enquiringly between him and the vending machine.
‘After you,’ he said, and when she’d collected her cups of brown liquid, he began feeding coins into slots. A coffee, white, from one machine, and a packet of Jaffa cakes for his supper from the other machine. The hospital cafés were all closed by now. He considered a second packet for Felicity before he remembered she was nil by mouth in preparation for surgery tomorrow morning.
Vascular coiling, it was called. The neuroradiologist would feed a tube up through Felicity’s femoral artery at her groin, up her body to the brain. Once the tube was there, the neuroradiologist would insert a coil of thin platinum wire to choke off the aneurysm’s blood supply and stop it from growing. It was much less invasive than opening up her skull and clipping the aneurysm, and required less recovery time. Yet the risks still included stroke and brain damage and heart attack, and rupture of the aneurysm itself.
He’d watched Felicity as the neuroradiologist explained the procedure and the risks. She had been looking at the print-outs the entire time, tracing her fingers over the pictures of her brain. He wasn’t certain it had all sunk in. Of course, it was terrifying enough for him to thi
nk of her brain being messed around with; it would be much more so for her. For a moment or two, though, a stubborn expression had crossed her face: lips pressed together, chin set – the kind of expression she got when he reminded her she should probably leave earlier for an appointment, or when his mother started arranging their weekend plans for them.
As soon as she set her chin, he was certain that she was going to object to the surgery; that she was going to tell the doctor to stop being ridiculous, she was absolutely fine, and that she wanted to go home now.
She didn’t. And thinking like that would be madness. This aneurysm wasn’t merely causing her seizures. It wasn’t only a disease that had come between them, turned her into someone like a stranger. It was something that could kill her at any moment.
He had prepared his arguments for when the doctor left them, but Felicity didn’t say anything. She’d hardly said anything to him at all, since their argument yesterday, since she’d made the phone call to that man. She’d sighed and gone to sleep, leaving him too much time to think.
They hadn’t yet spoken of what would happen after the surgery, when it was time to go home and resume their lives. That was the first thing Suz had asked about when he’d rung her to tell her about the diagnosis and treatment.
‘We haven’t discussed it yet,’ he’d said. Meaning, he didn’t want to discuss it with his family.
He unwrapped a Jaffa cake, popped it in his mouth, and checked his watch. Time dragged and flew in the hospital; it was nearly nine o’clock. Aside from going home with Suz to pick up his car and have a shower, he’d done little today but shuffle from Felicity’s bedside to the café or shop. There were visiting hours but he knew the ward sister, who lived in a farmhouse outside Tillingford, and she told him they didn’t mind him staying as long as he wanted to.
The other patients in the ward were connected to machines. Some of them were in comas. Some wore helmets. The elderly lady in the bed near the entrance had had a stroke, her face drooping and dead on one side, but she waved at him with her good hand, as she did whenever he passed, and he waved back. ‘Lovely evening out there, Mrs Chowdery,’ he said, even though he wasn’t strictly certain it was, since he hadn’t looked out of a window in several hours.
