Sea Trial

by Brian Harvey

  “Lots of people do it,” I said defensively. But I wondered if he was right. Yoshi navigated like a Japanese fisherman, many of whom don’t bother with charts. He looked around, sniffed the air, and fed the data into some kind of genetic seafaring computer that told him where to anchor, how close to go to shore, when to chance the rapids, and whether to venture out at all or spend a week smearing wasabi on his waterline and fiddling with his alternator belt until conditions improved. The west coast of Vancouver Island gave Yoshi a bad feeling, and that worried both of us.

  We exchanged Japanese goodies (dried squid, sour plums) and said our goodbyes. Refuge Cove had finally cooled off, and a quiet game of horseshoes was going on further down the dock, where several people lived in houseboats. We rowed back to the muffled thunk of iron shoes in sand. The Lucky Louie couple were already in bed, dreaming of the ’60s. I decided to put in a few hours in the following decade, with Billy.

  Billy

  We’d been gone almost two weeks, but I hadn’t gotten very far with the trial. The fact was, ever since we’d left Victoria, I had a conflict that I hadn’t anticipated. How could I buckle down to the assignment I’d given myself when what I really wanted to do was fret about the next stage of our journey? Which was more important, the thousand and one uncertainties of the trip or the single mystery of my father’s trial?

  Lots of other people had sailed around Vancouver Island, so maybe the trip wasn’t that big a deal. On the other hand, nobody knew or cared about the struggles of a feverish infant surrounded by doctors and nurses in the wee hours of a Labour Day weekend thirty-five years ago, so maybe that wasn’t such a big deal either — except that I knew there was a story there that was every bit as compelling as pushing yourself around an island. But I had to care enough about it to put the hours in when I’d rather be clearing my mind for the next leg of our trip.

  What I wanted out of it was pretty clear. It was the thing most people spend their lives trying to figure out, namely what made their parents tick. It amounts to a responsibility: you’ve got their genes, so you’d better find out, because those genes are coming to get you. And there’s no better way to do that than to look hard at what happened when they were put to the test. Most of us don’t have the documentation describing life-altering crises that might have befallen our parents, but I did. I couldn’t back away from the chance I’d engineered for myself by doing all that background work on cerebrospinal fluid and children with big heads.

  I decided that, like the sailors who fritter away decades getting ready to go offshore, I was suffering from “over-preparation syndrome.” All I really had to do was extract the day-to-day story of Billy and his doctors and tell it. Beginning at the beginning. So I started reading again, in Refuge Cove, to find the bare bones upon which so many layers of meat would be hung. For starters, who was this kid?

  Billy was born of an unwed teenage mother who immediately relinquished him to a childless couple keen to adopt. How much of Billy’s subsequent travail was written in his genes, how much was caused by events right after he was born, and how much by events in the O.R. eleven months later? This was what my father’s trial boiled down to.

  Billy already had two strikes against him. The first was prematurity; he weighed just three pounds when he was born. The second was lack of oxygen because Billy didn’t begin to breathe for three minutes — an eternity. Within hours, he was in a respirator in intensive care, a tracheostomy tube poking from his tiny neck. I thumbed through the charts and imagined the premie ward, the row of struggling babies in their plastic boxes, the swish of starched white dresses, the squeak of rubber-soled shoes.

  His lungs gradually cleared, but his head circumference began to be a worry. When Billy was finally discharged to his new parents six weeks later, the family doctor told them of the possibility of hydrocephalus. “I advised [the adoptive mother] not to sign adoption papers right away,” it says in one pediatrician’s notes. But she was adamant.

  Six weeks later, Billy was re-admitted. His head was getting too big, too fast. My father’s first appearance in the file is a brief consultation record; he ran his tape around Billy’s head and got forty-six centimetres. I put down the file and grabbed my own tape measure from the tool kit.

  “Charles!” A click of toenails on the deck, and a pair of eyebrows emerged around the corner of the cockpit.

  “Hold still.” Charley’s head was thirty centimetres, deducting a couple for the squashed ears. He pirouetted, trying to snatch the tape. I wound it around my own head: fifty-nine. So, somewhere in between. I looked around the boat: the fire extinguisher on the engine bulkhead was about right. Pretty big for a six-week-old child.

  My father did a ventriculogram and diagnosed “communicating hydrocephalus.” Five days later, he inserted the standard hardware of the time, a shunt that diverted the excess fluid from Billy’s brain to his heart. The report of operation is a terse three paragraphs: burr hole in the side of the head, expose the jugular vein, catheters into the ventricle of the brain and the atrium of the heart. A run of tubing in between, and a Holter valve, all sutured with silk. It was June 1976.

  I read this laconic narrative over and over. This was what my father did for a living. Inserting a shunt, don’t forget, was somewhere on the low end of complexity for a neurosurgeon. But for a baby? I thumbed my way back to the admitting record: Billy weighed in at 4.5 kilograms, almost ten pounds. No longer the size of a newborn but still a small target for the doctors and nurses bending over him. Charley weighed twice as much.

  Now that Billy’s first operation is over, let’s let the nurses tend to him. We need to take a closer look at the shunt itself — because it’s about to become a victim of the second law of thermodynamics.

  ***

  The great thing about my father’s little library of scientific papers, some of which I had brought along, was that it was roughly contemporary with Billy’s case. I learned that the chances of surviving hydrocephalus were pretty good back then, but definitely not plain sailing. I found some interesting statistics from 1983 (nine years after Billy’s operation): mortality in treated — that is, shunted — patients was still 7 percent. And only half of the survivors had normal mental function.

  This pile also shed some light on the difficulty of a standard shunting operation. To me, just placing the burr hole looked like a nightmare. Then you had to make it through the various layers wrapping the brain, cauterizing as you went so as not to provoke a bleedout later. And then, after advancing your catheter halfway into the brain, you had to penetrate the lateral ventricle just so. It looked to me like trying to drill a hole through one side of a chair leg and have it come out exactly where you wanted it on the other side. It never does, but chair legs don’t hemorrhage to death in front of you.

  Then there was the other end of the shunt to worry about, the drain into the heart. This seemed to me like going from the frying pan into the fire, surgically speaking: enter the jugular vein by sneaking in through the facial vein and pass the slender tube down into the right chamber of the heart. In 1974, you could only tell where the end of the tube was waving around by connecting it to a pressure-measuring device and gingerly advancing it until the pressure readings balanced out.

  Yet shunts could turn out very well.

  “There is no reason,” wrote one surgeon, “that the child with hydrocephalus who is treated early cannot lead a normal life and have a normal-sized head.” But then I read the caveat: “Unless there is an underlying brain impairment, congenital or acquired.” And I thought of Billy and his small army of experts and lawyers, and the glorious grey area those few words opened up.

  When shunts did go wrong, the biggest reason was infection. Around the time of Billy’s operation, your chances of a surgical redo were 50 percent. Very few writers had much advice on what to do if pressure shot up when an infected shunt was removed — yet this was the crux of the case against my father.


  I felt comfortable with these old scientific papers, probably because they talked the language of experimentation and statistics that I was familiar with. I knew not to put too much faith in any single report, but my father had compiled a pretty comprehensive snapshot of hydrocephalus and its complications from a few years before the time he operated on Billy to a half-decade later. It was like a scientific time capsule. All the papers were heavily marked up, with highlighter (again in his favoured orange) and his own handwriting. My father really was preparing for battle.

  Bit by bit, I began to discern his strategy: from the moment Billy was born almost two months premature, his risks just kept multiplying. John Harvey’s argument would be that a high-risk infant had received a high-risk operation for a condition that was extremely common in low-weight babies. The outcome was bound to be iffy, and it was impossible to tell whether the subsequent problems had anything to do with the surgery at all. One 1983 study he’d photocopied looked at nineteen such children; two died, and only two were neurologically normal at one year.

  Asleep on the cockpit seat next to me, Charley was half-buried in paper. I felt buried too. Charley whimpered, looked up, then went back to sleep. I knew what was coming.

  “You’re making it much too complicated.”

  It was getting dark in Refuge Cove; I hadn’t noticed him in the gloom. He looked especially ghostly.

  “Nobody wants to read all that stuff about survival rates.”

  “Who said I was writing anything?” I didn’t mention the book he had kept trying to write.

  “You have to keep it simple, or you’ll lose your readers. Get back to Billy’s story.”

  “Simple, as in . . . ?”

  “As in, hydrocephalus in premature infants caused many problems, even without the complications of shunts and infections. That he was anoxic for the first three minutes of his life. That the deck was already stacked against that little boy.”

  “That’s exactly what I plan to say! I do know how to write.”

  “I was a good writer too, you know.”

  “Yeah, but this book — assuming I’m writing a book — isn’t about you. I mean, it might be, but . . .”

  “That was uncalled for. A person in my position, I couldn’t be waving my own flag. If you’re going to do it, you have to do it right.”

  “Maybe you should have waved your own flag a bit more. Truth and justice don’t always prevail, you know.”

  “Well, I thought they should.”

  “Again? ” called Hatsumi from below. “Aren’t you ever coming to bed?”

  “I’m coming, I’m coming,” I said. “And don’t worry, he’s gone. I think I hurt his feelings.”

  Turbulence

  By the time we got away from Refuge Cove the next morning, it was already hot, and when we turned the corner into Lewis Channel, the long conduit that would take us northwest between West Redonda and Cortes islands, the wind was in our faces. The narrower the channel got, the harder it blew, and I knew this would be the pattern for the next week or so, until we made it past Johnstone Strait and into the Broughton Archipelago.

  Narrow channels funnel wind as much as they do water, and in fact the two substances behave the same way in a constriction, speeding up to squeeze through. The more I cruised in these waters, the more I began to recognize the landforms that determined conditions: the humps and headlands, the constrictions, the forested valleys down which the evening wind began to whistle just around the time you were brushing your teeth and getting ready to turn in. The weather forecasts, updated four times a day and listened to religiously by even the most careless of boaters, only provided the big picture — all the way up the east coast, for example, we would receive forecasts for only five geographic regions. That left a lot of brushstrokes to fill in because each region was a maze of humps, channels, headlands, and the rest of it. You had to start thinking like Yoshi in order to realize that a forecast like “winds northwest, twenty to twenty-five knots” described what you might be expected to encounter out in the open. Throw in a dozen mountainous islands and a fjord or two, and you could just as easily get the wind from the opposite direction. Local knowledge was everything.

  We popped out of Lewis Channel into a space like a busy intersection in a great city — Piccadilly, perhaps, or Tokyo’s Shibuya. The waters (and winds) from eight channels meet around Raza Island, seemingly uninhabited and featureless except for the single symmetrical mound in the middle. Our speed rose and fell as the currents found and released us, and we broke for lunch in the open space, setting the storm staysail and the steering so that Vera would try to go forward, stall, fall back, and try again (it’s called heaving to). I ate a sandwich and pondered the logging on the humped northern end of Redonda Island. We would begin to see serious timber harvest now; on Redonda, the trees had been raked off in strips. We made coffee and killed another hour, waiting for the right moment to enter the rapids that began just a few miles north. This was where we would turn away from the winds in Johnstone Strait — but there was a price to pay.

  We had to make the first three rapids — Yuculta, Gillard, and Dent — in the same day. Yuculta and Gillard are close together and can be run as one, but Dent is another two miles up Cordero Channel, twenty minutes in Vera going full out under power. And Dent is the worst of the three, getting up to eleven knots of current in the Devil’s Hole — a mass of water moving faster than I can run. My well-thumbed copy of Proven Cruising Routes has a sequence of photographs of a forty-foot fishing boat being spun end for end in the Devil’s Hole, one rail submerged. You must take Dent Rapids at slack current, which means sneaking through Yuculta and Gillard a half hour early.

  The rapids were dangerous, I had no doubt of that. Strange things happened in rapids — I once met someone whose throttle coupling had simply let go in the middle of one. If Charley chose a rapid as a good place to go overboard, he’d simply disappear astern, a tiny orange speck turning circles until it caught in a whirlpool and capsized. And now, because of my recent medical reading, rapids had become metaphoric. Every time I entered one of these constrictions, I thought about the calamity that happened on a microscopic scale when a passage in the cerebrospinal circulation got a little too tight.

  “Let’s move,” I said. I clipped Charley onto his retaining line. “We’ve got an hour to get to the Yucultas.”

  Halfway there, Hatsumi let out a shriek, and I realized we weren’t the only sentient beings out here. A school of white-sided dolphins suddenly surrounded Vera, hundreds of them, arrowing out of the water just off our bows, or diving beneath us so that I could follow the grey, bubble-trailing torpedoes right under our keel. Hatsumi whooped and filmed, Charley barked and I wondered if I was the only boater to know that dolphins could get hydrocephalus too. We followed our escort toward the opening, now visible as a notch in the trees a mile or so ahead. Soon, we started noticing other boats, until by the time we had reached the turnoff to Hole in the Wall, another nasty shortcut, there were six of us, all steaming hell for leather for the Yucultas. Everybody was afraid to arrive too late.

  And then, of course, everybody stopped. We were all too early. The dolphins lost interest and headed toward Hole in the Wall to look for more entertaining playmates. We puttered in a circle, trying to avoid all the other boats puttering in circles. Through binoculars, the opening to the Yuculta Rapids looked innocuous, but it was as though an invisible force field was keeping us all out. Finally, I advanced the throttle and swung Vera around to face it. Hatsumi grinned.

  “You never did that before,” she said.

  “Somebody has to. This is getting ridiculous.” We swept past the other boats, who fell dutifully into line. Was that all there was to leadership? Once past the light on Harbott Point (forty-five minutes early, I realized with the delicious sense of having just thrown caution to the winds), the washing-machine and pursed-lip graphics on the chart began to
come to life as whorls and rips that nibbled and nudged at our keel. The wheel jumped uneasily in my hands as the water, unable to make up its mind about which direction to take, tumbled through the gap. It got noisier, the churning water like a river now, punctuated by alarming random knocks from directly beneath my feet, as though someone was tossing rocks at the propeller. We reached nine and a half knots as we yawed down past Big Bay and into Gillard, the next set of rapids. At that speed, I could still steer but only just. Any more current and we’d just be another piece of flotsam going through. A 13,000-pound piece.

  We passed Big Bay in a long, skidding turn, past the shiny new Sonora Fishing Lodge on the left and the rapidly emptying Big Bay Marina on the right. When we squirted through Gillard Passage, Vera slewed hard as we caught the edge of a whirlpool playing with some ragged chunks of Styrofoam. Then we were out onto a creased plain of uneasy water that was rapidly becoming choppy as the freshening northwest wind collided with the current. For the two-mile connecting flight to Dent Rapids, we throttled back and let the dying ebb take us into the wind, which by now was taking the tops off the waves and snapping the flag on the backstay behind me. Charley put his head between his paws.

  “Look,” said Hatsumi, delighted. The other boats were still behind us. We led them through Dent Rapids, hitting the opening exactly at slack, although slack isn’t really the right word to use for such a turbulent place. “Not totally terrifying” would be better. But we’d done half the rapids, and we’d knock off the other three tomorrow or the next day. Unless, of course, the wind got worse. It was still right on the nose. Halfway up the inside of Vancouver Island and we’d had the sails up, what, five times? At this rate, we might as well be a powerboat.