by Dean Koontz
When the light moved to the 4 on the directory and the doors of the cab slid open, her anxiety did not abate. Room 456 was to the right. When she and Murph got there, the door stood open. The room contained two unoccupied beds, the sheets fresh and taut and tucked.
Bibi’s drawstring bag stood on the nightstand beside the bed that was nearer to the window. When Nancy peered into it, she saw a toothbrush, toothpaste, and other items, but no pajamas.
Each bed came with a narrow closet. One of them proved empty. In the other hung Bibi’s jeans and long-sleeved T-shirt. Her shoes stood side by side on the closet floor, her socks stuffed in them.
With the squeak of rubber-soled shoes and the scent of soap, a young blond woman in blue scrubs entered the room. The nurse looked too young to be credentialed, as if she might be just fifteen and playing hospital.
“They told us our daughter would be here,” Murph said.
“You must be Mr. and Mrs. Blair. They’ve taken Bibi for tests.”
“What tests?” Nancy asked.
“An MRI, blood work, the usual.”
“None of this is usual to us,” Nancy said, trying for a light tone of voice and failing.
“She’ll be all right. It’s nothing intrusive. She’s doing fine.”
The much-too-young nurse’s reassurances sounded as hollow as a politician’s promises.
“She’ll be a while. You might want to go down to the cafeteria for lunch. You’ll have the time.”
After the nurse left, Nancy and Murph stood for a moment in bewilderment, looking around the room as though they had just now been teleported into it by an act of sorcery.
“Cafeteria?” he asked.
Nancy shook her head. “I’m not hungry.”
“I was thinking coffee.”
“Hospitals ought to have bars.”
“You never drink before five-thirty.”
“I feel like starting.”
She turned toward the window and then, with a sudden thought, turned away from it. “We need to tell Paxton.”
Murph shook his head. “We can’t. Not now. Don’t you remember? His team is on a blackout mission. No way to reach them.”
“There’s got to be a way!” Nancy protested.
“If we tried and Bibi found out, she’d want our scalps. Even though they’re not married yet, she’s getting more like him each day, tough-minded and committed to the way things are in that life.”
Nancy knew he was right. “Who would have thought it would be her we’d have to worry about instead of him?”
She switched on the TV. None of the programs was entertaining. All of them seemed intolerably frivolous. The news inspired despair.
They went down to the cafeteria for coffee.
Later, Bibi would be told that the CT scan had been inconclusive but suggestive, that her doctors would have preferred a stroke to what was now suspected. Having eliminated the possibility of embolism or hemorrhage, they proceeded with a growing concern that they refrained from sharing with her. Their smiles were masks, not because they wished to deceive her, but because physicians, no less than their patients, live to hope.
Later, too, she would learn that if embolism and hemorrhage were ruled out, her best chance of a full recovery might be a diagnosis of brain abscess, which was a pus-filled cavity surrounded by inflamed tissue. This life-threatening condition could be treated with antibiotics and corticosteroids. Often surgery proved unnecessary.
They drew blood for a culture. They took chest X rays. They hooked her up for an EEG that lasted almost an hour, to study the electrical activity of her brain.
By the time she was gurneyed to another room for an MRI, Bibi felt as though she had run a marathon up countless flights of stairs. She wasn’t merely tired but fatigued. Such weariness couldn’t be the result of what little physical activity the day had entailed. She assumed that her growing exhaustion was yet another symptom of her illness, like the head-to-foot tingling along her left side, the rancid taste that came and went, and the weakness in her left hand.
She had no appetite for lunch, and they had offered her only water. Perhaps fasting was required for some of the tests. Or maybe they were anxious to gather all the information required for an urgently needed diagnosis.
Because the MRI machine was an enclosed tunnel only slightly greater in diameter than a human body, a nurse asked, “Are you claustrophobic?”
“No,” Bibi said, refusing a mild sedative as she lay on the table that would carry her into the ominous cylinder.
She refused to admit even the possibility of such a weakness. She wasn’t a wimp, never had been, never would be. She admired toughness, fortitude, determination.
Instead, she accepted earbuds that allowed her to listen to music and a handheld device with which she could signal the equipment operator if she became distressed.
Her time in the machine would be lengthy. Modern MRI technology allowed scans with highly specific purposes. A functional MRI would provide measurements of nerve-cell activity in the brain. Magnetic-resonance angiography could assess heart function and blood-vessel flow throughout the body. Magnetic-resonance spectrography would provide detailed analysis of chemical changes in the brain caused by a variety of afflictions.
The music proved to be wordless, mellow orchestral versions of songs she couldn’t quite identify. From time to time, the machine made thumping noises audible through the music, as if the technician needed to spur the MRI along with hammer blows. Bibi felt her heart laboring. The signaling device grew slippery in her sweaty hand.
She closed her eyes and tried to distract herself with thoughts of Paxton Thorpe. A beautiful man in every way: his body and face, his eyes, his heart and mind. She’d met him more than two years earlier. Five months ago, she had accepted his proposal. Just as her name had meaning, so did his: Paxton meant town of peace, which was ironic, considering that he was a kick-ass Navy SEAL. Pax was currently on a full-silence mission with his team, going somewhere to do something to bad people who no doubt deserved even worse than they were going to get. The team would be operating in blackout mode for maybe a week or ten days. No phone calls. No tweets. No way for him to be told what was happening to his fiancée.
She missed him desperately. He said that she was the touchstone by which he would, at the end of his life, measure whether he had been a good man or not, fool’s gold or the real thing. She already knew the answer: the real thing. He was her rock, and she wanted him now, but she was already steeped in the stoic code of the military and refused to be reduced to tears by his absence. In fact, sometimes she thought she must have been a military wife in a previous life, for the mindset of one came so naturally to her.
As the humming machine knocked and thumped, saliva suddenly filled Bibi’s mouth. As before, this suggestion of impending regurgitation wasn’t accompanied by nausea, and the threat passed.
In her mind’s ear, she heard her mother say, It’ll be what it’ll be. Those five words were Nancy and Murphy’s mantra, their concession to the ways of nature and fate. Bibi loved them as much as any child loved her parents, but their understanding of the world’s true nature did not match hers. She would concede nothing to fate. Nothing.
By four o’clock that afternoon, Dr. Sanjay Chandra had become the principal physician in charge of Bibi’s case.
Nancy liked him on sight, but for the strangest reason. In her childhood, she’d been enchanted by a book about a gingerbread cookie that came to life. In the illustrations, the cookie, whose name was Cookie, had not been as dark as gingerbread, but instead a warm shade of cinnamon, with a lovely smooth round face and chocolate-drop eyes. If the book hadn’t been at least forty years old, about the same age as the physician, she might have thought that the artist had known him and that he’d been the inspiration for the look of the storybook character. Dr. Chandra possessed a sweet, musical voice, as you might expect that a cookie-come-to-life should have, and his manner was likewise pleasing.
After
the array of tests she endured, Bibi had been returned to her hospital room in a state of exhaustion. In spite of her concern about her condition, she wanted only to sleep before dinner. She had passed out as if she’d mainlined a sedative.
Dr. Chandra didn’t want to disturb her, and indeed he preferred to wait until the following day to sit with her and discuss what the tests had revealed, after he had more time to review the results. But although Bibi was twenty-two, no longer a ward of her parents, the doctor wished to speak with them first, and at once, “to determine,” as he put it, “the kind of girl she is.”
Nancy and Murph sat with him at a table in the break room, at the north end of the fourth floor, where at the moment none of the staff was taking a break. The vending machines hummed softly, as though mulling over some grave decision, and the unforgiving glare of the fluorescent lights did not inspire serenity.
“I’ve told Bibi only that time is needed to review all the test results, to reach a diagnosis and design a course of treatment,” Dr. Chandra said. “I’ll meet with her at ten tomorrow morning. It is always a concern to me that my diagnosis and prognosis are presented to my patient in as comforting a manner as possible. I have found that it helps to have a sense, in advance, of the person’s psychology and personality.”
Nancy didn’t like the sound of this. Good news didn’t require the careful tailoring of the words with which it would be delivered. She might have said as much, except that suddenly she didn’t trust herself to speak.
“Bibi is an exceptional girl,” Murph said. Perhaps no one else but Nancy could have detected the strain in his voice. He looked only at the doctor, as if to meet his wife’s eyes would undo him. “She’s smart, a lot smarter than me. She’ll know if you’re putting even the slightest shine on the truth. That’ll upset her. She’ll want to hear it blunt and plain, not prettied up. She’s tougher than she looks.”
Murph began to tell the physician about the death of Olaf, the golden retriever, who had passed away almost six years earlier, a few months after Bibi’s sixteenth birthday. At first Nancy was surprised that her husband would think this story had any relevance to the moment. As she listened, however, she realized that it perfectly answered Dr. Chandra’s question about the kind of girl Bibi was.
The physician did not interrupt, only nodded a few times, as though he had no other patient but Bibi for whom to prepare.
When Murph finished telling of Olaf’s death, Nancy dared to ask a question, throughout which her voice trembled. “Dr. Chandra…what kind of doctor are you? I mean…what’s your specialty?”
He met her eyes directly, as though he assumed that she shared her daughter’s indomitable and stoic nature. “I’m an oncologist, Mrs. Blair. With an additional specialty in surgical oncology.”
“Cancer,” Nancy said, the word issuing from her with such a note of dread that it might have been a synonym for death.
His dark-chocolate eyes were warm and sympathetic, and in them she saw what seemed to be sorrow. “Though I really do need to review the test results more closely, I feel certain we are dealing here with gliomatosis cerebri. It originates in the connective cells of the brain and infiltrates quickly, deeply into surrounding tissue.”
“What causes it?” Murph asked.
“We don’t know. Scientists have had little chance to study the disease. It’s exceedingly rare. We see no more than a hundred cases a year in the entire United States.”
Nancy realized that she had come forward in her chair and that she was holding the edge of the table with both hands, as though to anchor herself against some great approaching turbulence.
“You’ll remove the tumor,” Murph said, making of those words a hopeful statement rather than a question.
After a hesitation, the oncologist said, “This tumor isn’t localized like those in other forms of cancer. It has a spiderweblike pattern, filmy threads across more than one frontal lobe. It can be difficult to detect. The boundaries of the malignancy are hard to define. In certain cases, primarily in young children, surgery may be an option, but seldom a good one.”
Perhaps consoled and given hope by the fact that the glioma was not easily detected, Murph said, “Then you treat it how—with chemo, radiation?”
“Often, yes. That’s why I want to study Bibi’s test results more closely before deciding what we might do to extend her life.”
Although she gripped the table tighter than ever, Nancy felt as if she were floating away on a tide of despair as real as any flood waters. “Extend her life?”
There were lustrous depths in the physician’s eyes, and in those depths coiled a knowledge that suddenly she didn’t want him to share with them.
Dr. Chandra looked down at the table, at Murph, at Nancy once more, and said almost in a whisper, “It pains me to tell you that there is no cure. Survival time from diagnosis averages one year.”
Nancy could not breathe. Could not or didn’t wish to breathe.
“But with chemo and radiation?” Murph asked. “What then?”
The oncologist’s compassion was so evident, his sympathy so tender, that though Nancy irrationally wanted to hate him for what he revealed next, she could not muster even anger. “One year is with chemo and radiation,” Sanjay Chandra said. “And your daughter’s cancer is already very advanced.”
After she woke from her nap, Bibi freshened up in the bathroom. Her face in the mirror surprised her. Sparkle in the eyes. Color in the cheeks and lips without benefit of makeup. She continued to look better than she felt, to the extent that she might have been staring not at a looking glass but into a parallel dimension where another, healthier Bibi Blair lived without a serious concern.
Having developed an appetite, she made her way back to bed to wait for the return of her parents and for dinner. The tingling along the left side of her body had grown less intense. The weakness in her left hand diminished, and not once did she find herself dragging her left foot. In the past few hours, she hadn’t suffered a recurrence of the foul taste.
She knew better than to conclude that the subsidence of her symptoms meant her affliction, whatever its cause, must be temporary. In spite of all its myriad wonders and its exquisite beauty, this world was a hard place; the comforts and joys that it offered, all the sublime moments, were purchased by days of quiet anxiety, by anguish, and by suffering. Such was the world that humanity had made for itself. Thus far in her life, she had enjoyed much more bliss than melancholy, more success than adversity, and she had for some time known that eventually she, like everyone, would have to walk through a fire of one kind or another. As long as she had a chance of coming out the other end intact, she would spare everyone her complaints, and she would not waste energy wishing for a magical resolution to this current plight.
For a while in Bibi’s childhood, she had believed in magic. A popular series of novels about young wizards mesmerized her, though certain other books had an even greater impact. Also, a few events in her life had suggested otherworldly presences, both light and dark. The dog, Olaf, came to her as if by magic, just when she needed him. And both before and after the golden retriever’s arrival, there had been incidents in the apartment above the garage that had seemed supernatural in nature.
Those experiences were long past, and time tended to cloud the shine on everything that had been wondrous in childhood. When she recalled those events, the once-shimmering mystery of them was now tarnished silver, and it became possible to suppose that there were logical explanations for what had happened back then.
When the dinner tray arrived at 5:15, she found the meal to be at such odds with the conventional image of hospital food that it almost renewed her belief in magic. A thick slice of meatloaf, creamy mashed potatoes, a little disposable foam thermos of hot gravy, mixed vegetables that didn’t taste as if they came out of a can…She tucked the paper napkin in the neck of her pajama top and ate with the enthusiasm of a hardworking lumberjack.
She was relishing the cherry cobbler and
hot coffee when her parents at last returned. They were like two clever imposters, formed out of the goop inside an extraterrestrial seed pod, alike in every physical detail to the real Nancy and Murphy, but not quite able to get their attitudes and mannerisms correct. They smiled too much, and none of their smiles seemed genuine. All of Bibi’s life, her mom and dad had been blithe spirits. Now they seemed to be wired to bomb timers.
She wondered if they knew something that she didn’t. Probably not. Most likely, her hospitalization and disturbing symptoms were more than enough to leave Nancy and Murphy as unsettled as they were now. Go with the flow always proved to be a philosophy that worked only until the flow washed you up against a crisis so large it blocked the stream. The dears were at the moment both adrift and stranded.
Anyway, if they did know something bad, Bibi didn’t want to hear it from them. They would divulge it with too much emotion, and she would have to console them. When she met with Dr. Chandra in the morning, she wanted a calm environment and a clear head. Whatever was wrong with her, she would need to think, to understand her options. She would need to find the right door out of this dark place or, if her situation was more dire than she now knew, slip through the eye of Death’s needle and away before he sewed her into a shroud.
When it became clear that her parents might hesitate to leave when visiting hours ended, Bibi pretended to be falling asleep even as the hospital bed held her in a sitting position. They were at last set in motion by the lubrication of kisses, hugs, and reassurances.
Bibi missed them the moment they left the room, but she didn’t call them back. Alone, she took the drawstring bag from the nightstand and from it retrieved a small spiral-bound notebook and a pen. She wasn’t in the mood to read the paperback that she had brought, and the TV had no appeal. Instead, in neat cursive, she recorded the events of the day, with special attention to everything that she had felt and thought with each unsettling development. What most intrigued her, for reasons she could not quite define, was that she had harkened back more than once to those years in the Corona del Mar bungalow, when as a young girl she had believed in magic.