by Louise Krug
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Claude is not here, and Janet hates Claude for this. Her own boyfriend isn’t here and she hates him, too. She broke up with him after he told her he couldn’t come, right there in the hospital lounge. There had been no unkind words or crying. She feels like she is able to do things now, easily, cleanly, and induce no pain on herself whatsoever. She is like a janitor at the clinic who sweeps up a pile of dirt and tosses it into the garbage. It had taken place in a matter of seconds.
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The morning of the surgery, Janet, Louise, and the rest of the family get up when it is still dark and walk across the street from the hotel to the clinic. It is a commanding place, a huge block of red brick. They carry water bottles and books. Louise uses her cane.
Janet had spent a lot of time in the hotel bathroom that morning, staring at the mini soaps and shampoos in the shower. She thought about how Louise had been getting better, able to bathe without help, bracing herself against the sides of the stall. Louise will be in bad shape for a while after the operation. The surgeon has told them this. There are no guarantees that the operation will work at all. For instance, removing the cavernous angioma might damage the neurons that control the function of swallowing. That would mean that she would have to be fed through a tube. Forever. And if the nerve connectors are damaged, she will have to be hooked up to a machine that will push the breath in and out. It will be plugged into an electrical outlet. She will have to stay in a bed, or a chair, connected by a cord that comes out of a wall. It won’t be like now, how she can go up and down stairs. How she can hold a knife to cut cheese. How she can shake crackers out of a bag.
The surgeon assures them that all of this is unlikely. It is almost certain that swallowing will not be a problem, his assistants say. Or breathing. They say the operation will be worth it.
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It takes three elevators to get to the small, steel room where a woman has them sign life and death papers. Should something go horribly wrong, who would decide whether or not to keep the patient alive? Louise just sits there.
Janet helps Louise into a hospital gown. They forgot to bring an extra bag, so Janet stuffs Louise’s regular clothes into her purse. Janet covers Louise’s feet with nonskid socks. She helps Louise into a hairnet. Louise says nothing, does nothing, lets Janet do it all.
In pre-op, the nurse leads Louise to a gurney and helps her lie down. The room is large and white and Janet stands close by. Louise stares at the ceiling squares, eyes wide. There are many others lying here, too, probably fifty of them with blankets covering their legs, waiting to be wheeled off to surgery. Nurses quietly ask questions and consult clipboards. The surgeon comes by. He has on red fleece socks and leather sandals that buckle. A mask covers his mouth. He writes on Louise’s forehead with a Sharpie: craniotomy.
When he leaves, Janet bends over and hugs her daughter. She kisses the word, covers it with her cheek.
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The surgeon and his assistants shave a back strip of Louise’s head and use a saw to open a bone flap in Louise’s skull. This is a “suboccipital craniotomy.” They want to find the cavernous angioma and cut it out, and then they want to seal the veins together again so there is no more bleeding. But they can’t find it. They take a tiny camera inside and see only healthy brain. All they see is Jell-O. No prize.
They sew her head back up. They will have to wait another day before they can go back in again.
CHAPTER TWENTY-ONE
Warner has brought a stack of books to read but opens none. Instead, he walks laps around the hospital. The place is huge. If he adds a visit to the library and ducks outside to get some air, he can spend a good hour in motion, which is better than staying still.
Tom is trying to keep Janet from crying. He gets her paper cups of water and makes her come with him to the cafeteria, where they move through a hot-food line like grade-school kids. He tells her stories about his friends at school. He tries to make her laugh. Then he feels awful when her smile turns.
Michael keeps everyone supplied with coffee. He explores. He walks wings with nothing but patient rooms containing somebody lying in the bed like they have been there a very long time. The little TV, suspended in the corner, always blares. Those people will never leave, he thinks.
Elizabeth keeps trying to talk to Warner. He’s pacing, distant, hard to reach. She wants to find out what he is thinking. She tries to comfort him, and he looks at her like he doesn’t know who she is.
In California, Claude is sure that the surgery will go fine. No one has called him, which he takes as a good sign. He is glad that something is finally getting done.
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Janet works on a needlepoint pillow cover during the two days in the waiting room. When she is finished she throws it away.
CHAPTER TWENTY-TWO
The next day is April 1. A tornado passes through the town where the clinic is. Shingles come off roofs, wild branches whirl in streets. All of the operating rooms are in the basement, so the surgery continues. This time, the surgeon and his assistants cut open a different section of Louise’s skull, a bit higher, but still in the suboccipital part, and there they see the cavernous angioma, oozing. They remove the dark ball of tangled veins and save it to show to the family, as if for proof. They sew and staple her skull back together and wrap it tight. They unscrew her head from the vise that held her head straight, face down, like a metal massage chair.
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When Louise is brought to a recovery room, Janet spends most of her time sitting by Louise’s bed, watching the nurses. They think they are so great, being loud with their fast walking and personalized scrubs with prints of soccer balls or lipstick kisses. But the nurses don’t seem to be around when Janet has a question—when Janet sticks her head out of Louise’s recovery room and looks down the hallway, they are nowhere in sight. Janet wants to ask them:
When will my daughter feel like eating?
When will she feel like keeping her eyes open?
When will she want to talk on the phone again to that imbecile, Claude?
When will she look like herself again, a cute girl with friends, a job, a nice-sized life, instead of this bandaged person who just lies there?
Louise’s surgeon enters the room. Janet stands up and grins. So handsome, she thinks. She likes his trimmed brown beard and short curly hair. She knows all his outfits by now: his white doctor’s coat over khakis; his blue wool suit with a pocket square; his blue-green operating outfit, a mask hanging around his neck.
The surgeon sits close to Louise and holds her hand. She cannot speak yet. Only one of her eyes is open. He tells Louise how well she did, how brave she was. A perfect patient, he says.
Janet’s main job is to change the ice packs behind Louise’s lower skull. It is time to change them again. She hurries down the hall to the ice machine and fills her shirtfront with more cubes. She empties the old ice in the bathroom sink and seals the new cubes in the plastic. The surgeon looks at her over his mask and smiles.
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Tom has arranged that he and Michael will alternate meals with the parents. He will eat with Warner and Elizabeth one day, and Michael will eat with Janet. No one should ever have to eat alone.
Tom runs errands for everyone. He goes to the grocery store and brings back pretzels and fruit. He takes Janet to shops that sell lilac hand lotion and pretty notebooks, which she buys for Louise. He drives Warner to the drugstore to get sleeping pills, and then back to the same store to return them. Tom will give anyone a lift anywhere. Once, he gives a night nurse a ride home because her car won’t start. Often, Tom sits with Louise, rubbing her cold feet for hours.
CHAPTER TWENTY-THREE
Louise is given steroids to keep the swelling of her brain down. They are making her psychotic. Warner cannot handle seeing his daughter talk to walls and laugh at chairs. Elizabeth sits beside her bed, begging her to eat a baby carrot. Louise thinks she is a supermodel, and that her stepmother is trying to sabotage h
er diet. Elizabeth tells Louise the carrot has zero calories, and Louise eats half. Warner reminds himself that it is all about numbers, levels, and that Louise’s episodes are normal. The professionals know what they are doing. He says this again and again to himself. It does not help. He paces up and down the hallway. He hears Louise scream that her bikini line is already waxed.
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Days later, a doctor they have never seen injects a numbing agent into Louise’s left eyeball. He needs to sew a corner of it shut to prevent the cornea from drying out, he says. The eyelid, and the entire left side of Louise’s face, is paralyzed—the result of disturbing the seventh cranial nerve in the surgery. Not surprising, the doctor says. They went in pretty deep. There are always bound to be a few unpredicted debilitations. Louise cries out from the eyeball shot and so does Janet, in her chair across the room.
CHAPTER TWENTY-FOUR
When I throw up in my hospital bed, there is a special way to clean it up. Two nurses roll me to one side of the bed, lift the sheet from the mattress, then roll me to the other side. They roll me again to tie the strings on my fresh hospital gown, and to put on a clean bottom sheet. I throw up about once an hour, because of the pain drugs, they say. One night I wake up to my mother standing over me. She says she is going back to her hotel room for the night, but before she leaves, could I please eat a granola bar? I must be so hungry, she says. It’s been days. I am not hungry, but I take a bite, just to see her smile a little. I throw it up right after she leaves.
Wiping my face, a nurse tells me I look like an actress. The mermaid in that movie, the one with Tom Hanks. The nurse says she saw it on a rerun station. And I, with a turban of bandages, the gauze protecting an opening made with a small saw, believe her.
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“The worst is over,” everyone keeps saying. “You did it. It’s all easy street from here. Everything’s a breeze now.”
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For some reason I think Claude is here, somewhere in the hospital, waiting to take care of me. I call him on the phone my mother smuggled into the room for me. “I’m glad you’re okay,” he says. “But I have to go.”
“Go where?”
“I’m at work.” He sounds irritated. I imagine him holding the phone between his chin and his shoulder, busy, tapping a pencil.
I drop the phone to the floor and howl like I’m in pain, and a nurse comes in and gives me a shot. She scolds me for using a cell phone. The signals they receive and send can mess up the machines, she says. Everyone’s main concern is: How did I get that phone? It is not allowed.
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When the bandages are unwound from my head it takes a long time to get to the end. The unwinding happens in circles, and it takes so long I worry that my face will come off, too.
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I still cannot tie my shoes or put my hair in a ponytail. I still cannot feed myself or bring a cup to my mouth with my right hand because my fingers are so stiff and the hand does not move and flex fluidly. My mother has been showering me. We have a waterproof wheelchair and use soap from the dispenser. I leave my underwear on for modesty. She uses a detachable showerhead to get my hair soaked. She wears galoshes. We freeze.
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The surgeon tells my family that my cerebellum was disturbed by the surgery and so I will have problems with coordination and need to teach myself basic and fine motor skills again. I will also have trouble with my balance and walking. He tells them to remind me to be patient. “We will,” they say, “we will.”
A woman from physical rehabilitation wants me to get out of bed and walk down the hall. I cannot sit up without vomiting. Priests stop by, and I wave them off. I am moved out of my private room, out of intensive care to rehabilitation. “Yay, Louise,” my family says.
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I start out crawling. My physical therapist, who is handsome and Scottish, lifts me out of the wheelchair and onto the rehab gym’s mat. He helps me get into a position I remember from Pilates mat class, on my hands and knees. He gets on the floor beside me and tells me to do what he does. We crawl. My family watches from folding chairs.
“You have to stand up,” my physical therapist tells me. “We must teach your legs how to work again.” To help, he straps on a safety belt: a thick nylon strap with a metal buckle. It is fastened around my waist, and he holds the strap taut with both hands. He tugs me up, and I rise for a moment and then tip sideways onto the mat. With my father gripping me on one side, the physical therapist on the other, I start to take steps. We have distance markers, like on a track. Ten seconds of staying upright is an accomplishment.
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A roommate is moved into my room. She is very old and has lost control of her hands completely. They spasm and shake. She keeps the television on at all times, watching game shows like Wheel of Fortune and Deal or No Deal. Her son and his wife visit. They sit in chairs by the door. The son holds a bouquet of red plastic flowers. He has brought her these instead of the real ones so they won’t die, he says. They leave soon, and she tries to cradle the bouquet in her arms.
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My physical therapist comes to my room to get me twice a day. Mom and I are in love with him. He is newly married, but I still imagine myself as his wife. He and I do this strength exercise where I get on my hands and knees and lift one leg as high as I can, like a donkey. The physical therapist holds my hips firmly while we watch in the mirror. I’m wearing a sporty outfit Mom bought at the local department store. It’s bright yellow nylon with a hood. I think of a wedding I was supposed to be in last week. I think of Claude. Screw him, I think.
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To test my hand-eye coordination, I sit in front of a pegboard full of tiny lights, like Christmas tree decorations. I am to touch the light that comes up. My physical therapist times me. He counts the seconds it takes for me to touch the little bulbs. I try very hard to impress him. Sometimes I miss, and my finger will touch a spot an inch or two from the light. I get faster every day, he tells me.
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After three weeks, my physical therapist says I am ready to try the home evaluation. The test begins in a room that has been outfitted to look like an apartment. It has a double bed with a chenille spread, a kitchenette with a two-burner stove, and a bathroom.
Five staff members crowd into the evaluation bathroom to watch me. I have to make it out of the wheelchair and into the chair that sits inside the tub. I get ready to go. Someone drops a pencil. It rolls by my foot. Everyone moves in closer.
It takes a minute to get out of the wheelchair, another minute to heave myself into the chair, and another to swing my legs over the tub. But I do it. Everyone claps. We move on to the kitchen so I can mix up some powdered soup and slice cookie dough out of a tube.
There is an old car in the rehab gym. I fasten and undo the seatbelt. I pass that section. I pass them all.
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A resident comes to take out the staples that run down the back of my scalp. The staples are put in a plastic bag for me to take home. They look like regular metal ones used for paper. They leave holes in my scalp that itch, and will keep itching, long after I go home.
CHAPTER TWENTY-FIVE
It is decided that I will go to my father’s house in Holland, Michigan, where the outpatient therapy is better than in my mother’s small town. My mother cries and cries. My father and Elizabeth help me into the car, then fold up the wheelchair and put it in the trunk. The chair is new, they had to buy it at a store in the clinic. We all thought the surgery would resolve everything. No one thought there would be a need for one when I got out. Half my face is paralyzed. The right side of my body hardly moves. The surgery, everyone says, was a success.
PART THREE:
THE TREATMENT
CHAPTER TWENTY-SIX
Claude and Louise sit in the shady, quiet living room reading magazines. They are at Warner and Elizabeth’s house in Michigan. This is uncomfortable for Claude.
He has not seen Louise for over a month. He flew into Mich
igan this morning and will stay for the weekend. Warner had met him at baggage claim while Louise waited in the car. They are trying to make it work.
She had looked worse than he expected. Slumped over in the passenger seat. Sunglasses on, one lens taped over. Only half her face smiling to greet him. He immediately wished he hadn’t come. He sat in the backseat. She reached back to hold his hand. They held hands the whole drive, and he’d cried to himself, a mess of emotions, the whole thing a mess.
As they sit now, in the living room, Claude on the couch, Louise in her wheelchair, she is reaching for his hand again. All day she has been wanting to touch him, to hold on to his sleeve or stroke his hair. Claude wants to comfort her, but knows he needs to prepare her. That’s why he did not go to the clinic for her surgeries, why he did not send her flowers. Why he cut all of their phone conversations short. He cannot see how it will work now. Will they have to build a ramp up to their third-floor apartment? Can you rent ramps? He doesn’t see how it would happen.
But he can’t break up with her with a bandage still on her head. He can’t be the guy who ended it like this. He will have to wait until she is better.
What he tries not to think: She will be like this forever.
