Dr. Tremblay glances away briefly. “I can’t be absolutely sure without performing some tests,” he says, “but I suspect that what happened to you in the OR just now was cataplexy.”
Cataplexy. I know that disorder, and it’s not something I want to hear.
“What you’ve just told me,” he continues, “about the dreams you’ve been having and your increased fatigue and sleeping during the day is consistent with the condition of—”
“Narcolepsy,” we each say together.
I stare at him with wide eyes, suddenly feeling very alert.
He nods, knowing that he doesn’t need to explain to me that narcolepsy is a neurological condition that causes disruptions in sleep patterns and excessive sleepiness during the day. The afflicted person can sometimes nod off involuntarily.
Another symptom is sleep paralysis—which is normal for most people during a state of REM, probably because our brains want to prevent us from acting out our dreams. But with narcolepsy, this paralysis can occur when the person is falling asleep or waking up, and it can be accompanied by vivid hallucinations that seem real.
Cataplexy is an add-on I really don’t need as a surgeon. It’s a loss in muscle tone while the person is awake. It’s usually triggered by a strong emotion, like panic. Even laughter can bring it on. Some episodes can be barely perceptible, with only a slight muscle weakness—a drooping eyelid, for example—but a more severe attack can result in a full physical collapse, like what just happened to me in the OR when the alarms started going off.
“But why?” I ask him. “I was fine before. Is this because of my accident?”
All the anger I have felt toward Alan pales in comparison to the blistering fury I feel now, because if I have acquired this condition because of his drunk driving escapade on his way to see his secret lover, I will never be able to forgive him. This isn’t something I can get over eventually, like the heartbreak from his affair. This is my whole future.
I’m a surgeon. How can I operate if I might drop instruments or fall down without warning? How can I handle sudden stressful situations if I have cataplexy? My career will be over. My life will never be the same.
If there was ever any chance of forgiveness, it’s slipping away now, fast as blue blazes.
Dr. Tremblay speaks plainly to me. “Narcolepsy is a mysterious condition, Abbie, and it may have any of several causes. It could be autoimmune in nature, or it may be genetic. Symptoms can take a while to fully manifest, so we can’t be sure it was your accident that caused this, at least not yet.” He holds up a hand. “But let’s not jump the gun. I’d like to do a full physical to rule out other things, then send you to a sleep clinic for some tests before we attach a diagnosis to this.”
I shut my eyes and nod my head, because I know how this works. We can’t presume anything at this stage. We need clinical test results and analysis to be sure.
“When can we do that?” I ask as I glance at the clock on the wall. “I have another case in less than an hour.”
He gives me a sympathetic look. “You’ll have to reschedule or get another surgeon to cover for you. And I advise you to stay out of the OR until we have this figured out.”
I lie back on the pillow and blink up at the ceiling. Great. The last thing I need is more time on my sofa in my bathrobe, watching daytime television. I thought I was past that.
What’s next, Lord? What else do you have lined up for me? I’m chomping at the bit to find out.
CHAPTER TWENTY-NINE
Despite the fact that I told my colleagues I didn’t want special treatment, Dr. Tremblay fast-tracks me into the sleep disorder clinic for overnight testing the following week. In the meantime, I’m not permitted to perform any surgeries, although I’m allowed to see patients in my office for diagnoses and follow-ups, and I continue to do rounds in the hospital.
While I wait to be tested, I research the heck out of my suspected condition and all the latest developments and treatments. My symptoms seem to grow worse, but I suspect that’s not truly the case. I’m simply more mindful of them now that I understand what’s wrong with me. When the fog enters my brain, I recognize it immediately, and I surrender to the urge to fall asleep, somewhere safe and appropriate for a nap.
On Sunday, after Zack’s hockey practice, he and I take Winston and drive to Lunenburg for dinner with my mom. While Zack is helping her set the table, I disappear into the bedroom for a few minutes to make a phone call, because there’s someone who’s been on my mind and I’ve been channeling him even harder since being in town.
“Hi, Nathan? It’s Abbie. I hope I’m not calling at a bad time.”
“Not at all,” he replies. “The girls are watching a movie. I’m glad you called. How are you?”
“I’m doing okay. I’m at my mom’s place right now.” I move to the window and look out at the backyard. “How have you been?”
“Great,” he replies. “Work is good. We’re heading into dental health month at the clinic, so that’s keeping me busy. Girls are doing well. Marie just got a part in the school play this week.”
“That’s wonderful. What’s the play?”
“It’s a kid’s version of Macbeth. She’s playing the nurse.”
“How exciting.”
“Yes, it’s going to be fun. What’s up with you?”
I sit down on the edge of the bed and inch back against the pillows. “Funny you should ask. A lot’s happened, actually, since the last time we spoke, and that’s kind of why I’m calling. Remember when I told you about the dreams I was having, and you suggested I see my doctor?”
“Yes, of course.”
“Well, I made an appointment, but before I could get there, I passed out during a surgery.”
“Oh no. Are you okay?”
I pause and run my finger along the braided trim on the comforter. “Not exactly. On the upside, the surgical patient is doing fine, thank goodness, but it turns out that I might have narcolepsy.”
“Narcolepsy.” Nathan whistles. “Isn’t that where you can fall asleep unexpectedly? Even if you’re standing up?”
“That’s about the gist of it.” I cross my legs at the ankles. “I’m going for tests next week, but I’m pretty sure that’s what’s wrong with me. I thought you might like to know.”
He lets out a breath. “Gosh, Abbie, I’m really sorry to hear that. What kind of tests will they be doing?”
“It’s an overnight clinic where they’ll attach electrodes to my head and take measurements of brain activity while I’m sleeping. But the worst part is that I can’t perform any surgeries until we get this figured out. It’s too risky. So I’m just puttering around in my office at work. Not the best scenario right now, when I would prefer to be busy.”
“I totally get that.”
We’re quiet for a moment.
“But enough about me. How’s everything else? You said Marie’s in the school play. How about Jen?”
He laughs. “Oh gosh . . . let me just say that last night was not fun for me as a parent.”
“Why? What happened?” I glance at the clock and wonder if Zack is missing me yet and if he’s going to knock on the door anytime soon. I hope not, because I really want to hear about Nathan’s night.
“Jen had a friend sleep over,” he explains. “This is a new friend who moved to town recently, and she struck me as a bit rebellious. But anyway, they were watching movies in the basement, and I stayed up until about midnight just to make sure they were settled, but after I turned out the light to go to sleep, it seemed too quiet down there. And I can’t explain it, but I had a bad feeling because of a few looks they exchanged—like they were planning something.”
“This sounds bad.”
“It was. Although I suppose it could’ve been much worse. Anyway, I went to check on them at about one a.m., and the lights were out in the basement, as if they were sound asleep. But get this—those two little rascals had piled pillows under the blankets on the sofa bed and snuck out th
e back door.”
“Oh my gosh! What did you do?”
“Well . . . first I thought I was going to have a coronary. I was ripping mad but also terrified because I didn’t know where they were or what they were up to. Then I called Jen’s cell phone, and surprisingly, she answered. Sounded pretty nervous, though. I don’t think she expected me to get up and check on them.”
“Where was she?”
“Just down the road at the playground,” he tells me. “Perfectly safe. They thought it would be fun to go hang out there in the middle of the night without anyone knowing.”
“What did you do next?”
“I ran out to get them, of course. I brought them home, and we had a serious talk about how dangerous that was. Then I said the sleepover was over, and I drove her friend home and had to explain to the girl’s parents what happened. Not a fun moment. They were pretty good about it, but they grounded her, and she went to bed in tears. Then I took Jen home and banned sleepovers for a while. She feels pretty bad. I can tell. She’s normally such a good kid. She’s not the type to break rules, and she doesn’t like disappointing me. She apologized about a dozen times today.”
“That’s good, at least. Oh, Nathan. That’s rough.”
“Yeah. So there we have it. What a weekend. I can hardly wait for the teen years. More of this to come, no doubt.”
I push a lock of hair behind my ear, remembering what it was like with Zack. Of course, I wasn’t a single parent back then. I feel for Nathan, heading into that territory on his own.
“I won’t lie,” I say. “It’s not easy. You just have to do your best to love them through it.”
“Love them through it. I’ll try to remember that.”
The conversation soon meanders into the subject of kids with cell phones and how to manage that particular hornet’s nest.
I jump when a knock sounds at the bedroom door. I whisper to Nathan, “Just hold on a second.” Then I cup my hand over the mouthpiece and call out, “Yes? Come in!”
Zack opens the door and peers in at me. “I thought you were asleep.”
“No, I’m just talking on the phone,” I explain.
“Okay.”
He watches me for a few seconds, as if he wants to ask who I’m talking to.
I pray that he won’t ask that question, which makes me squirm inwardly, as if I’m doing something wrong by sneaking into the bedroom to call Nathan about something personal.
“Dinner’s almost ready,” Zack finally says. “You should come out to the kitchen.”
“Sure,” I say with some relief that he’s not going to interrogate me. “I’ll be right there.”
He shuts the door, and I try to shake off my unease before I return my attention to Nathan. “I’m sorry. I have to get going. It was good talking to you, though.”
“It was good talking to you too, Abbie. I’m glad you called. Have a nice visit tonight.”
“I will.”
I quickly end the call and go take a seat at the kitchen table, where I ponder the fact that I felt like I had something to hide when Zack caught me on the phone with Nathan just now. I tell myself there’s no need to feel guilty. We’re just friends. But I’m not sure Zack would understand that. I’m not even sure I understand it myself. It makes me think about how Alan behaved over the past few years. How he kept so much hidden from me. I can see now how it was possible, and I don’t like how that makes me feel.
The following week, I report to the sleep lab for my overnight analysis. Electrodes are attached to my head and body to measure things like heart and respiratory rates, electrical activity in my brain, and nerve activity in my muscles. The tests reveal exactly what we suspected: significant abnormalities in my sleep cycle, with REM occurring at inappropriate times.
Upon my next meeting with Dr. Tremblay, he shares the results with me. He is somber as he explains that I am indeed afflicted with narcolepsy.
Seated in a chair on the opposite side of his large desk, I take a moment to digest this news. I close my eyes, rub at my temples, and can think of only one thing, which I say out loud.
“I want to kill my husband right now, but unfortunately for me, I can’t because he’s already dead.”
Dr. Tremblay says nothing, and I realize it was a harsh statement and he’s probably shocked. But I don’t care because I’m mad as hell. And he doesn’t know the half of it.
I let my hands drop to my lap and clasp them together. “I suppose we should start talking about treatments.”
He agrees and launches into a long description of all the medications available, what they can do to help improve my symptoms, and what side effects I can expect.
He also informs me that I should stop driving until we get everything under control, because statistically, people with untreated narcoleptic symptoms are ten times more likely to get into an accident. He assures me that it’s only temporary, because once we find the right balance of medications, I’ll be as safe and capable as anyone else on the road—outside of philandering husbands who are lying to their wives and driving drunk, of course.
I’m only half listening to Dr. Tremblay, because I can’t get past the anger I still feel toward Alan, and now the fog is rolling into my brain again. I find it difficult to concentrate. Some of what the doctor says goes in one ear and out the other, but it doesn’t matter because I’ve already researched all the recommended medications and side effects and statistics about accidents. I know everything inside out, and I already know which drugs I want to try first.
We settle on what my treatment will be, and I leave his office, knowing I won’t be able to return to the OR anytime soon. As I ride the elevator down, I can’t help but think of the terrifying split second when Alan’s car clipped the back end of mine on the highway and sent me tumbling down the embankment, totaling my SUV, nearly killing me and our dog, and possibly causing this irreversible neurological condition.
I’m so angry with him I want to hit something. There’s a pounding in my ears, and I fear I’m going to collapse again because of this intense anger I feel. But I don’t collapse. The rage flows through me, my muscles remain strong, and the elevator doors slide open. I step off without incident.
As I call a cab to take me home, I realize it was sheer force of will that kept me on my feet just now, because I don’t want to give Alan the power to hurt me anymore. I want to live, and live happily, and in order to do that, I need to do my best to stop fixating on his betrayal and the anger I feel. I need to focus on how I’m going to manage this condition and move on with positivity and determination, not vitriol, which will only bury me in ugly emotional muck. That won’t help me at all.
I know this because I’m still stuck in that muck, and I want to be free of it.
CHAPTER THIRTY
A few weeks later, I come home after work to find Zack on the sofa watching television. Winston greets me at the door, tail wagging, and I bend to give him a pat. “Hey there. How are you doing?”
He licks the back of my hand and follows me eagerly into the kitchen, where I drop my keys into the bowl on the counter.
“How was your day?” I ask Zack.
“Okay, I guess.”
“Just okay?” After seventeen years, I can read my son’s moods like a book, and it’s obvious that something’s on his mind. I take a seat beside him on the sofa. “What’s up?”
Winston jumps up between us, and Zack rubs behind his ears. “Jeremy just got into the premed program at Western.”
My eyebrows lift. “Wow, good for him. That’s a tough program to get into.”
Zack stares at the television. “Yeah, he’s pretty pumped.”
I watch my son for a moment, and I know exactly what he’s feeling because I’m feeling it too. I know him too well, and his pain is my pain. His joy is my joy.
“What about you?” I ask, picking up the remote control and muting the TV. “Are you not pumped about going to Dal?”
We had this conversation at Christmas,
and I knew then that Zack would feel like he was missing out if he had to stay at home because of me.
He merely shrugs. “It’ll be fine.”
“Really? I don’t think so. It’s only five blocks away.” I reach out and squeeze his shoulder. “Listen, you know I’ll be okay if you go away to school. I’ll miss you of course, but I have Winston to keep me company.” I stroke the fur on Winston’s back. “And it’s not like you and I would never talk to each other. We could text every day. Seriously, Zack, if you want to go away, I’m all for it. It’s not too late to apply. I don’t know when the deadlines are for scholarships, but—”
“I already applied,” he tells me, meeting my gaze with a look of unease, “just to see what would happen.”
My head draws back slightly. “Oh, you did. And . . . ?”
“And . . .” He hesitates, then finally spills the beans. “I got accepted to Western and Queens. Full scholarships at both.”
A swell of pride washes over me. “You’re joking! How could you not tell me this? That’s amazing! I’m so proud of you.”
He exhales heavily. “Thanks, but I don’t want to go, Mom. Especially with what’s been going on with your health lately. And I know how much you miss Dad.”
I do miss Alan—the husband I once knew. But that man doesn’t exist anymore.
I quickly shake my head at Zack. “Sweetheart, if you want to go to Western or Queens, that’s what I want too. Honestly, I’d be incredibly proud of you, and so would Gram. I really think you should go. It’s what you’ve always wanted.”
He stares at me for a moment, then bows his head. His voice shakes when he speaks. “You’ve been through so much, Mom. I can’t just leave you.”
I slide closer and pull him into my arms. “You won’t be leaving me. Like I said, we’ll text every day, and you can come home for summers and Thanksgiving and Christmas. I’ll be fine. I’ve got big plans of my own, you know.”
He draws back. “You do?”
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