Pascal's Wager

by Nancy Rue

  I slanted my eyes toward the paramedic in my ambulance, though I could only see half of him. The stupid neck brace prevented me from doing anything except stare at the ceiling. As far as I could tell, I had a lump on the side of my head and a gash on my right forearm. Why this necessitated traction was beyond me.

  “Do you think my mother is in shock?” I said.

  “Hard to tell.”

  “Hard to tell? Three paramedics and several thousand dollars’ worth of medical equipment and you can’t detect a simple thing like shock? Was her breathing shallow, pupils dilated? Isn’t that basic First Aid?”

  “Whoa, girl,” the paramedic said. “Look at your blood pressure go up. She’s getting good care. They’ll fill you in at the hospital.”

  I gave the ceiling my blackest look. “No wonder you put people in these straitjackets—it’s to keep us from smacking you when you make idiotic statements like that. My mother should have been telling you characters what her injuries were. Now, do you think she’s in shock or has there been brain damage?”

  “Brain damage? Now that’s hard to say.”

  “Forget it,” I said. “Just forget it.”

  “You need to try to stay calm. You’ve just been involved in a serious accident—”

  “Ya think? What was your first clue?”

  “She’s a little cranky” he said to his partner as they were unloading me in front of the emergency room.

  I wasn’t any more cheerful in the ER when no less than sixteen people surrounded my gurney in the trauma room. I told them all in no uncertain terms that I had never lost consciousness and that I could have walked to the hospital if they hadn’t strapped me to the stretcher like a mental patient.

  “All I want to do is see my mother and have somebody tell me what injuries she sustained. I don’t want stitches—I don’t want a CAT scan—I don’t want an MRI, for Pete’s sake. I just want to know about my mother!”

  I didn’t calm down, despite the eye-rolling that was going on above me, until Ted Lyons came in. By then they’d determined that I had one subdural hematoma on my head—in other words, a bruise—and one laceration on my forearm that would require a few stitches.

  “We’ll get somebody in here to suture that up,” a nurse said to Ted—not to me.

  “I don’t want sutures,” I said through clenched teeth. “I want to see my mother, and if I don’t, somebody’s head is going to roll.”

  “She’s already on her way to surgery,” Ted said. He put a freckled hand on my shoulder and guided me firmly back onto the gurney.

  There wasn’t an inch on Ted Lyons that hadn’t been liberally sprinkled with freckles. You could even see them up into the scalp of his thinning red hair. Though balding, he still had a boyish face that grinned down at me.

  “You McGavock women are mean as snakes,” he said. “Stay put and I’ll tell you what’s going on with your mom.”

  “And could you please take this thing off my neck before I go into some kind of meltdown?”

  “No. I’m liable to get slugged by a nurse. They’ll take it off. Just relax.” Then Ted perched himself on a stainless steel stool beside my gurney. “Your mother has an open fracture of the femoral diaphysis—the large bone in the thigh—and the protective musculature is also displaced, which all means there’s been significant bleeding and the potential for infection. Typically, patients with that type of injury heal well. These days they get them right up on their feet so they don’t risk the complications associated with prolonged bed rest.”

  “So they’re doing surgery just to set the bone?” I didn’t even attempt to compete with the jargon he was throwing at me.

  He nodded. “They’re doing some intramedullary nailing—putting in pins.”

  “Ouch.”

  “She’ll get plenty of pain meds, and they’ll probably give her a sedative hypnotic, too, for the anxiety. That’s pretty common. But there didn’t appear to be any injuries to internal organs, no head trauma. The paramedics reported that she was verbally unresponsive, but apparently she was just stunned.”

  Ted stuffed his hands into the pockets of his lab coat and stared at the wall above me.

  “What?” I said.

  “The police officer told me the accident was Liz’s fault, that she ran a stop sign.”

  I tried to nod and frowned as my chin collided with the overgrown collar.

  “You don’t have to answer this if you’re not comfortable,” Ted said, “but did she seem upset when she got in the car? I mean, upset enough to be driving erratically?”

  “You mean upset over your conversation about the rubella test?”

  “You heard.”

  “Yes. And, no, she didn’t seem upset over that. I was more upset than she was because she wasn’t upset. I am making no sense.”

  “You’re making perfect sense. I had the same reaction.”

  He stared at the wall again, freckles folding around his eyes and mouth. “Do you mind if I speak frankly?” he said. “If you’re not comfortable, I won’t—”

  “Say it already!” I said. “Just tell me what the heck is wrong with my mother.”

  He pressed his lips together. “You’ve obviously picked up on it—the language aphasia, the slurred speech, the errors in judgment.”

  “Just recently,” I said. “But then, she’s been avoiding me for the last six months. You’re obviously way ahead of me.”

  “This whole thing with the pregnant patient and the rubella test—Liz knows that no diagnosis hinges on just one test. You use a constellation of findings. And this isn’t the first time she’s made that mistake in the last couple of months.”

  “I gathered that.”

  “About a month ago, apparently two patients’ blood samples were switched in the lab. It happens once in about ten thousand lifetimes with the system we have, and that wasn’t her fault—it was the technicians’. Anyway, the reports were given backward, and the doctor of the patient who received the positive result called Liz because the abnormal value didn’t make sense with what he was seeing in the patient.” Ted shook his head. “Liz didn’t even look into it. She just told him the tests didn’t lie—they were 99.9 percent accurate. She recommended the patient start treatment immediately. She said nothing about it to the techs, who then routinely disposed of the samples. The doctor had the patient retested and then called me to tell me the follow-up test was negative, which means we now have another patient out there who thinks he’s disease-free because his results were negative. That shouldn’t have happened, Jill. That and about a half-dozen other occurrences I could recount for you.”

  I closed my eyes and tried to compartmentalize. I couldn’t. I didn’t have a compartment for craziness.

  “One of her friends thinks it’s depression,” I said.

  “Could be. Depression presents itself in a number of different ways.” Ted arched an eyebrow at me. “You’re not buying that.”

  “I don’t know. This is all so…weird. I don’t have a scientific name for it.”

  “I don’t either,” Ted said. “But I think maybe somebody ought to find one.”

  I could feel my eyes sharpening. “What are you saying?”

  “Why don’t you see if you can talk her into submitting to a psychiatric evaluation while she’s in here?”

  “Sure. And while I’m at it, I’ll also shoot myself with a large assault weapon.”

  Ted grinned. “I know she can be difficult.”

  “No, you haven’t seen difficult until you see my mother’s reaction to the suggestion that she go into therapy. I was just going to drop the hint today that maybe she ought to see a counselor, and I was sweating bullets over that. You’d better have those paramedics standing by when I drop this on her.”

  “Would you rather I did it?” Ted said.

  “Yes,” I said.

  “Even though it would be in an official capacity?”

  “As in, it would go in her file? You’d have to write her up?”
<
br />   He nodded.

  “If you’d suggested this to me a month ago, I’d have said you were the one who needed the psychiatrist.”

  He stood up. “Look, if you want to talk this through with me before you approach her, you have my number. Just call me—have my answering service page me if you need to. And you might want to wait until her orthopedic doc gives you the okay. We’ll want to make sure she’s strong enough.”

  Liz McGavock not strong enough for something? I thought when he was gone. Could the things I was now having to consider get any more outlandish?

  It was another forty-five minutes before a resident who looked as if she ought to be skipping off to her Girl Scout meeting came in to stitch up my arm. When I was finally released to go to the OR waiting room, Max was there, pacing a path in the carpet.

  When he saw me, he took the hall in two bounding leaps like he was going to scoop me up into his arms.

  “Look at you,” he said. “You’re white as a sheet! Should you be here? Aren’t they going to admit you?”

  “They’re going to have to admit you if you don’t calm down.”

  “Where do you want to go? The recliner? The couch? Yes, lie here on the couch.”

  I sat down on a vinyl sofa, then Max took off his ankle-length black raincoat, rolled it into a ball, and put it behind my head.

  “You need something to eat. The food here is for nothing. I could probably doctor up some soup for you—what can they do to soup?”

  “Max, I’m fine. Stop it. Just sit here. You’re going to drive me up the wall.”

  I patted the seat next to me and he sank into it.

  “Have they told you anything about Mother?” I said.

  “They put her under,” Max said. He rubbed his hand over his face and looked at me, red-eyed. “They called down and said they were starting the operation. God forbid anything should happen to her.”

  “Something did happen to her,” I reminded him. “She may never walk again.”

  I snapped my head toward him. “They told you that?”

  “No. But you know me, I always think the worst.”

  I sighed. “You don’t have to think the worst, Max. The worst may already be happening.”

  I told him about my conversation with Ted Lyons. If anybody should be made aware of it, Max should. For reasons I could never understand, he was as loyal to my mother as a St. Bernard.

  I could recall when Mother had first met him at some kind of university social soiree, though my memory was a little hazy. I’d only been about six. I knew I’d been smitten with him, though, probably because he came to the house every night after that for a while, bringing me a book or a puzzle for every bouquet of flowers or box of imported chocolates he brought my mother. Then there had been the period of time when we hadn’t seen him at all. I remembered asking Mother why “Uncle Max,” as he’d asked me to call him, didn’t come anymore.

  She’d been characteristically clinical about it. “He wanted to be my boyfriend,” she had explained. “I don’t want a boyfriend, or a husband, which boyfriends usually lead to. One husband was enough, thank you very much.”

  I’d known enough to realize she was referring to my father, whom I hadn’t seen since I was eighteen months old and obviously didn’t remember. Even by age six, she had told me that my father was a wealthy player who had preferred another woman to her, so they had divorced. We had left Virginia and never looked back. I didn’t need a father anyway, she told me. I was doing just fine with her as my parent. I argued with her even less at age six than I did now.

  But a few months after that conversation, Uncle Max had reappeared. He didn’t bring flowers and candy and toys anymore. He just brought food and cooked it in our kitchen, at least once a week. And whenever there was a social event for which either of them needed an escort, they went together. We could expect Max for Thanksgiving and Christmas dinner, for birthdays and backyard barbecues, and as I’d grown older I’d just assumed that Max had decided friendship was good enough for him, too.

  Now as I finished filling him in on Ted’s recommendation, his soft eyes were troubled.

  “This is going to hurt her—knowing we think she’s cracking up.”

  “We don’t think she’s ‘cracking up’!” I said. “We’re not considering having her committed, for Pete’s sake. Max, what?”

  He was suddenly looking wilted, as if the St. Bernard had been caught with one of Liz’s slippers.

  I leaned closer. “You know something you aren’t saying. What is it?”

  “Nothing. I’m just so sad. How could it come to this?”

  “Would you stop playing King Lear and tell me what you know! I can see it all over your face.”

  When he shook his head, I grabbed him by both lapels.

  “This is not the time to be protecting Liz’s dignity!” I said. “The woman is in trouble. I need every piece of information I can get before I go in there and tell her I want her to see a shrink so she won’t screw up her whole life! Now talk to me!”

  Across the room at the phone desk, a volunteer in a pink jacket cleared her throat. The other people waiting for word about loved ones were peering curiously over the tops of their magazines. I lowered my voice.

  “You’re not making it easier on anybody by keeping things to yourself.”

  Max looked wearily at the palms of his hands, which were sparkling with sweat under the fluorescent lights.

  “These last six months,” he said. “I’ve watched her change. It started with little things. You know, she would forget a word now and then—”

  “A word?” I said. “Like what?”

  “Like my name. Your name.”

  “Go on.”

  “She lost interest in music. She didn’t want to go to the symphony, the opera—all the things she loved.”

  “You’re talking about her like she’s in the morgue,” I said. “Look, I’m sorry I went ballistic on you, but don’t do your pessimistic, this-is-the-end-of-life-as-we-know-it routine. This is data. I just need the data so I can formulate a plan. That’s all.”

  He grabbed both of my hands and squeezed them between his damp ones. “You are so much like your mama—always a rock in a crisis. I never once, not in all these years, saw her shed a tear.”

  He went off down Memory Lane then, and I knew I’d gotten all I was going to get out of him. I half listened while I created a new compartment: the what-to-do-about-Mother compartment.

  Later that evening, we finally saw her. She’d come out of the anesthesia—at least, that’s what the nurses told us—and she was transferred to a private room. She did open her eyes, but she refused to talk to us, wouldn’t say a word. I dragged a resident out of the room bodily and into the hall.

  “Why isn’t she talking?” I asked.

  “That’s hard to say,” she said.

  “What is it with you medical types?” I practically shrieked at her. “Just give me the possibilities!”

  The resident, who couldn’t have been as old as I was, straightened herself to a new height and said stiffly, “There is no evidence of brain damage from the accident, and she is fully responsive otherwise, so the probability of aphasia from the general anesthesia is very low.”

  “Which means?” I said.

  “She’s not talking because she doesn’t want to,” the resident said. “That’s my educated guess.”

  “Thanks,” I said. I waited until she was well down the hall before I went in and closed Mother’s door.

  “Mother, if you won’t talk to us, we really don’t have any choice but to ask for a psychiatric evaluation,” I said. “In fact, that might not be a bad idea anyway. What do you say?”

  She didn’t say anything. But she didn’t pick up the bedpan and throw it at me, so I took that as a yes. I hailed a different resident and put in a request. Then I went back to Escondido Village and collapsed.

  I woke up around three o’clock in the morning, still in my bloodstained top and skirt, riddled wi
th anxiety. I didn’t normally get nervous. Every time I heard of another grad student going on Paxil, I resisted the urge to say, “If you’d get your act together, you wouldn’t have to pop pills just to function.”

  Right about then, however, I wouldn’t have turned down a couple of Valium.

  The only solution, of course, was to do something—anything. I tried grading homework, but when I found myself leafing aimlessly through the papers, I abandoned that. I thought about doing some of my own work, but that was pointless until I talked to Nigel. It occurred to me then that I hadn’t even called anybody over at Sloan to tell them what was going on. Tabitha, I was sure, had folded when I didn’t show up for her tutoring session. I could only hope Jacoboni hadn’t been there to torment her, or she would be headed for the nearest community college.

  This was getting out of hand. I turned on my laptop and logged on to the Internet.

  “What do they call it when you lose your marbles?” I muttered as I stared at the cursor blinking keyword. “Wacko, nuts, section 8—no that’s military. Think scientific—dementia!”

  I typed it out, and then I hit the delete button.

  What am I doing? She hasn’t even had the evaluation yet and I’ve got her taking Quaaludes. Maybe she’s just being stubborn. Maybe it’s a mid-life crisis. Menopause?

  No, she’d been through that. The way she told it, there was nothing to go through. You just stopped having periods, and good riddance. These women with their hot flashes and hormone pills just didn’t know how to let go of the reproductive years. She, personally, was concentrating on the most productive years of her life.

  I recalled all of that as I forced myself to type “Dementias” and waited for the computer to collect the data that was surely going to prove that I was wrong. The possibilities were more numerous than I’d expected—since I’d hoped for none. And they were all chilling.

  I’d been right about her not having the symptoms of Alzheimer’s, and depression seemed like only a remote possibility. But it could be a tumor on the frontal lobe of the brain. And it could be one of the few dementias that specifically affected language. Only one of them involved the area of judgment, however. Even the name needled me: Pick’s Disease.