A Stitch of Time

by Lauren Marks

  And with that single statement, there was no question that I was going to be outmatched in this interaction. The surgeon’s self-importance was soaring and mine sinking. The chair beneath me started to feel like a wet sponge. Nothing was quite solid anymore.

  But this is something we have to do, I said. I don’t have any other options.

  Of course you have an option. It’s your head. The doctor shrugged, sounding a little disinterested.

  This threw me. I didn’t want more options in this surgical consult—I wanted fewer. I had prepared to be stalwart in the face of a difficult, but inevitable, situation. Instead, I was now being asked to weigh options in a circumstance for which I wasn’t at all prepared. And my life depended on making the right decision.

  You are convinced this is the best course of action? my mother asked him.

  We wouldn’t be having this conversation if I didn’t think that, he said. But you have to fully understand the issues of elective brain surgery. I’m legally obligated to give the risks in a procedure like this. You might end up epileptic, paralyzed, blind. And open brain surgeries are prone to infections—morbidity and mortality rates tend to be high.

  Could I lose my language again? I asked. My voice had gotten so tinny and meek.

  Oh sure, he said. It’s the same location, so that’s always a possibility.

  My cowboy persona was utterly disarmed at that point, no bullets left in my figurative pistol or spurs on my boots. I simply forced my dry mouth to keep flapping.

  When? I asked. When would we do this?

  You are going to have to decide that yourself, he said.

  I was alarmed. What could he mean? Dr. Giannotta brought his steady hands out again for another example.

  As these coils recess, he explained, they give a certain elasticity to the structure itself, which we need because it gives us more room for the operation. Like how you need enough rubber to tie off a water balloon.

  As he spoke, I was desperate to catch his eye. I was looking for a comforting sign from him, a friendly twinkle or an empathetic gaze. But there was none to be found.

  If we attempt the craniotomy too early, we won’t have enough material to do the operation, Dr. Giannotta said. But if we wait too long, you’ll have another rupture. And you don’t want that, since the chances of survival are extremely low.

  Dr. Giannotta seemed completely oblivious to the fact that the information he was conveying was unsettling.

  My mother said we’d need a second opinion before we went any further.

  Be my guest. I encourage that, but anyone worth their salt will advise you the same way, Dr. Giannotta said. And if you had come through my operating room when the aneurysm ruptured, I would never have put coils in you in the first place.

  This comment felt like an insult to me. But the operation in Scotland saved my life! I said, protective of the survival narrative I knew and loved.

  Sure it did, Dr. Giannotta said. But they prefer coil embolization over there in Europe, and you shouldn’t have a craniotomy if you don’t have a very experienced surgeon available, that’s for sure. But if you had been here in the US, I would’ve clipped that aneurysm then and there, and you wouldn’t have any of these complications now. Anything we are going to do from this point on is going to be . . . tricky.

  Though the aneurysm in my brain was holding, this was when the dam of terror in me finally broke. And with that, all the confidence I had been building up in my journal started to slip away too.

  -over-riding narrative competing narrative

  Is this a recovery story?

  almost no sleep. fear. true fear.

  the situation has not changed since yesterday. the medical situation. but the conversation with the neurosurgeon risky. only does it once every 2 or 3 years. problem of my agency. asked me to re-evaluate the surgery. Do I have any choice? Why is he giving me choices?

  A Tale of Two Aneurysms. I for me, the story of the coiled aneursym is miraculous. It is illuminating. It is enlightening. But Dr. Giaattano? changes the story of the aneursym, No, it is not getting better. No, it is not going to get better. He troubles my experience, he troubles my center.

  The need for a second surgery was eroding the sense of meaning I had acquired after the rupture. It was that simple and that profound.

  Until my appointment with Dr. Giannotta, I had felt like I had been part of a story that made sense. This story was about a young woman who had loved words and then her words had been taken away from her. She worked hard to return what was lost, and in the meanwhile, she was able to encounter her language in a wholly different way. She was writing her way back to fluency.

  There was symmetry in that story, with lessons to learn, and I could easily situate myself inside of it. A dramatic event had taken place and it had changed the course of my life. But I had also been in the right place, at the right time, and I had come to believe that I was the right person as well. I hadn’t minded the trials of my recovery because they had ultimately bolstered my sense of purpose and certainty. My faulty brain was repairing itself, making a more sophisticated version of what it used to be. I was more curious, more confident, and more comfortable than I ever had been before.

  But once I found out that there was a dramatic failing in the very part of my brain I had treated with such reverence, what I had experienced as fate suddenly seemed nothing more than delusion. I didn’t feel part of some magnificent sense of order, but instead like an insignificant person whose life events were entirely random. The apparent absurdity of writing my way through this linguistic recovery only highlighted this sudden sense of worthlessness. What recovery? Dr. Giannotta himself had said that I might not be able to use language again after I woke up from the surgery. If I woke up at all. The journal entries wouldn’t lead up to anything else; whatever ideas started in there would most likely remain unfinished. There was no Quiet to find comfort in.

  My stable sleep schedule turned erratic and then became nonexistent. If I somehow managed to doze off watching late-night TV, I’d wake up abruptly, my heart pounding. I’d swallow over-the-counter sleeping pills to make my eyes close. The words the surgeon had used to describe the upcoming procedure haunted me. Risky, he had said. Tricky. The terms sounded like names of rodeo ponies. Something whimsical, even playful. The operation was anything but.

  I’d always thought of the second aneurysm as more dangerous than the first. The latter had, in so many ways, made me who I was. But now, to hear that it was threatening my current life? And everything I’d built up over the past several months? It was a betrayal of the highest order.

  •  •  •

  Both of my parents came to the second surgical consult at the University of California, Los Angeles.

  We sat anxiously in the exam room and after thirty minutes heard a soft double knock on the door. We all stiffened. When the door actually opened, we were surprised to see a young administrator in khakis. He popped his head in, without stepping foot into the room. Sorry for the wait, he said. The doctor will be with you soon.

  In the course of the next hour, we all changed positions: standing, stalking, pacing. Then there was the same double knock, and the same lower functionary giving us the same misguided update. Sorry for the wait, he repeated. The doctor will be with you soon.

  “Waiting” became a pretty abstract concept after two and a half hours.

  When the all-too-anticipated rap came again, my father opened the door himself, which surprised the administrator. Let me guess, Dad said, with no small amount of sarcasm. The doctor will be here soon?

  That’s right, the man said, as he threaded his thumb through one of his belt loops. Soon.

  Waiting for Godot in here, Dad muttered after he left. Paging Dr. Godot . . .

  Cabin fever was setting in. I started to snoop through the doctor’s cupboards and drawers, and I grabbed a disposable plastic cone meant for ear and nose examinations. I flipped it around, and put it on one of my eyes, like a plastic
monocle. I offered my parents invisible tea from the surgical sink, and we all giggled like we were on laughing gas. I was so grateful for them in that moment. Not just for being with me, but for indulging this frivolity. It gave me a tiny distraction before facing some unknowable future. I felt lucky to be inside a family unwilling to surrender their moments of joy, however small or fleeting.

  I don’t remember what we were doing when the surgeon actually arrived, but he was four and a half hours late. And he didn’t feel compelled to give us any explanation for his delay. At that point, I’d already been introduced to the brusque manner and distracted attitude of a neurosurgeon. Though Dr. Martin’s demeanor was as similarly unsociable as Dr. Giannotta’s, I was starting to think he was just playing to type. Martin popped my scans into a drive and displayed them on a large screen.

  What do you think? I asked him.

  Well, there is no question that you need an operation soon, he answered. Speak to the secretary up front and she’ll put you on my calendar. He stood up, as if ready to leave.

  Hold up for a second, my dad said. We still have a couple of questions. Lauren is still deciding where she wants to do the surgery. You are our second opinion.

  Oh really? The surgeon’s keen eyes narrowed. Who else are you considering? Because this is a very delicate procedure, you know. Not everybody does this.

  She’s been speaking to Dr. Giannotta, my mother answered. At USC.

  Hmpf. The surgeon exhaled his disapproval through his nose, a kind of bull-snort. Yeah. Dr. Giannotta is probably the only other guy who could do this.

  Do you think it should happen soon? my father asked.

  I’d expect so, the surgeon said. Can’t say exactly when. But waiting too long . . . well, you just can’t wait too long.

  23

  A few days after my second surgery consult, I got a pleasant surprise when my friend Rachel came to LA for a visit. Her husband was in San Francisco at the time, so it was an easy journey down. Like many of my friends, Rachel and I met as performers at NYU, and we were even in a couple of plays together. But Rachel had been an actor’s actor back in school, tending to get cast in some of the bigger productions, on the larger stages. And after graduation, when she discovered she was no longer being cast in the roles she wanted, she started writing plays herself, creating the kind of characters she liked and worlds she wanted to inhabit. With a talent for reinvention, she soon shifted her entire focus to writing. Now she had written a memoir, and had meetings in LA to prepare for her first book tour. She intuited that things might be a little tense in my household, so she had decided to stay with one of her pals in Venice Beach. But she still wanted to see me. And since I had recently been granted full freeway privileges, I offered to meet her by the ocean.

  I was sitting on the patio at a beachfront café when Rachel was dropped off. It was the first time we’d seen each other since my post-surgical stop in New York. When she spotted me, she beelined for the table, but a blonde in a bikini top and a group of half-nude teenagers toting boogie boards almost knocked her over. When Rachel finally arrived at the table, she was flustered, and readjusted the neckline of her faded Morrissey T-shirt.

  Is it a crime to be a brunette in this town or something? she asked. With all these sun-kissed, tight-bunned Aryans scampering about, you and I must look like Morticia Adams.

  It was an off-the-cuff comment, but invoking this corpse-like character spurred a bleak thought in me: this could be my very last conversation with Rachel. I couldn’t help but start to imagine the sort of things I’d have to say to her, and everyone, if I was never going to speak to them again. I would tell my brother to take care of our parents and himself. I would tell my parents that I had taken chances, followed whims, that I had loved and been loved, and they should never imagine my life as unlived. And Jonah. I’d have to say something to Jonah.

  I knew it was morbid, but all the internal language that filtered through my now-working inner voice was fixated on the catastrophic. I forced my attention back to Rachel and the sea breeze. She was telling me that she had just finished editing the memoir she wrote, and that there was a surprise for me inside it.

  You are in my memoir, you know, and I was just thinking that while you are recuperating from surgery, you can read about yourself in a book! That’s a little glamorous, right? Just like a movie star.

  If I can still read, I said.

  Rachel’s alarm shot through her face, and her lips went as blue as her eyes.

  Oh, honey, she said, trying to cover up her concern. Don’t say that. Of course you’ll still be able to read.

  Rachel’s presence was a comfort, but we were living in two different worlds. I was proud of her and her recent accomplishments—it was her first book, after all, and writing it had been no easy feat—but I couldn’t help but be nervous about the whole thing. She had this complete, intact version of me in her pages, something I hardly had access to myself. From what I could understand, the memoir focused on the time before the aneurysm had ruptured and featured many of the intoxicated misadventures of our early twenties. I feared her character of me was going to outlive the real me, and I might not ever be able to put forth my own alternative.

  She reached across the table and grabbed for my hand. Hospital or no hospital, I’m going to come visit you after the surgery, she promised. I’m coming back to LA very soon. Okay? I’m always here for you, lovey.

  After a long lunch, Rachel’s friend came back to pick her up. We said good-bye, but I decided to linger on the beach a bit longer. I had scheduled a phone call with an old classmate from NYU who had also undergone a craniotomy a couple of years earlier. She had been my scene partner in some of our acting classes, and we had celebrated our first Thanksgiving in New York together, eventually becoming very close friends. But she had developed a very rare neurological condition our sophomore year, which was detected early and operated on successfully. At the time, it was the talk of the whole theater department. She recovered and returned to school as if nothing had happened. Her case was very different from my own, but I needed a sounding board, someone who at least could imagine and understand what I might be going through.

  I pulled out my cell phone and dialed. The first thing I did when she answered was apologize. Life after school had pulled us in different directions, and we had hardly touched base since then. I felt bad that I’d been so remiss in keeping in contact, and that this was going to be our first conversation in a while.

  No sweat, she said. Nothing brings people together like neurosurgery.

  I guess that’s true. I laughed. It is pretty hard to talk about the details of this with most people.

  Oh yeah, she said. I had no filter about that for a while myself. But I found out the hard way that not a lot of people want to chat about bone-saws over cocktails and canapés. Still, I am not squeamish at all, so just ask anything you want to ask.

  I guess I want to know how, I began. How . . . How did you prepare yourself to do this?

  I hoped she’d have the kind of wisdom of experience that everyone else lacked.

  Let’s see, she said, casting her memory several years back. Honestly, I think all I did was buy a pair of rollerblades and some new pajamas. Nice things that I could wake up to in the hospital.

  What do you mean? I asked. Was that all you did?

  Basically yeah, she said. Beforehand, I just pretended the whole thing wasn’t happening.

  It didn’t seem possible. This was the very definition of a life-changing event, and my pal was telling me that her only preparation for it was some light retail therapy.

  This surgery threatened your life and your livelihood, I said. You aren’t actually suggesting that you found a way to ignore it. . . .

  That’s exactly what I’m saying, Lauren. We all do this sort of thing in our own way. For me? I discovered that De-Nile ain’t just a river in Egypt.

  Stunned by her comment, I found even the suggestion of this kind of approach completely appalling.
Whatever I was facing, I didn’t think I was capable of ignoring it, even if I tried. The only way out was through.

  24

  In the weeks leading up to the surgery, Jonah and I had started to bicker, and the main point of contention was logistics. He couldn’t book his ticket to LA until I had sorted out the details of the operation. But I hadn’t decided who would do the surgery, let alone where or when.

  The end of the month, I told him. Or early April. Maybe you should carve out a couple of weeks, with some flexible dates for your arrival and departure.

  Lauren, I cannot get a ticket like that, Jonah said. I’ve got to make a living out here. Not trying to upset you, but it feels a little like you’re being intentionally evasive. . . .

  He wasn’t exactly wrong. But there was a reason for me to be cagey, and I was irritated that Jonah didn’t sense it. I simply didn’t want to discuss this topic more. There was a lot of subtext that I needed Jonah to read into without me explaining. “A couple of weeks” could allow for a prolonged coma. “Flexible” could even include a funeral. It is safe to say that my fears had become overly fatalistic, but I refused to be any more linguistically clear because airing those fears in the world, in that way, would only give them more power over me.

  I know this is difficult for you, Lauren. But it is kind of like you don’t even want me there, he continued.

  This is not what this is about! I said, surprised by the exasperation in my voice. I knew it wasn’t a simple trip for Jonah. But the fact was I would prefer him not to come if he was going to make things harder instead of easier.

  If this is too complicated, Jo, I promise I won’t blame you if you can’t be here.

  And there you go again, he said. I really want to be at your side, Lauren. I really do. You keep cutting me off at the pass, though, so I guess I have to ask: Why wouldn’t you want me there?