by Luanne Rice
“Roo and I have discussed it,” the Tim doctor said. “And our girl is all about hopes. Right, Roo?”
He held up the board, and Roo spelled out,
Yes.
I drifted over to the bed, feeling invisible. Suddenly people noticed me. The nurses who knew me said hello, Dr. Hill shook my hand and Newton’s, and my mother gave me a big smile. I couldn’t believe she wasn’t picking up on my iciness.
“Tilly, Newton, this is Roo’s new doctor. Dr. Tim Howarth,” my mother said, and we shook hands. His coat fell open enough to reveal his T-shirt said ROYAL BLOOD, one of my favorite bands.
“Tim is why Dr. Danforth allowed Roo to come here,” Dr. Hill said in his deep, authoritative rumbling voice. “Dr. Danforth knew that we had a grant to invite him to our hospital to further his research—brilliant projects, changing the world for people with brain injuries—and then Roo came to us. Essentially, he arrived straight from London to help Roo.”
Dr. Howarth’s eyes were on Roo, and she and he were communicating on the letter board:
You came just for me?
Was she flirting?
Dr. Howarth squeezed her hand and nodded.
“I certainly did, Roo,” he said.
Major recoil and ewww. The look in his eyes was so fake, acting all interested and staring at Roo as if the rest of us weren’t even here.
“I’ve been reading about BCI,” Newton said. “Brain-computer interface, right? That’s the technology? I wondered if you would be trying it with Roo; I hoped, but I know it’s so new, and with the expense, it seems a lot of patients are missing out.”
“Forget the money, we’ll pay it!” I said. “Just make her better!”
“Tilly,” my mother said. “Slow down.”
“The concept is actually rather simple,” Dr. Howarth said. “Roo has heard this before, so forgive me, Roo …”
You are forgiven.
He laughed, enjoying her humor, and again I felt a twinge. “Right, then. In severe brain injuries, such as stroke, where the pathways from the brain have been badly damaged, we teach patients to bypass the compromised nervous system by sending brain waves directly to the outside world. So instead of using her brain to send messages to her fingers to type on a keyboard, she will learn to send them straight to the computer itself. Or, eventually, a robotic arm.”
“Can she do it right now, with all that on?” I asked, gesturing at the weird little hat and wires.
“I’m not sure Roo likes being referred to as ‘she’ when she’s right here,” Dr. Howarth said.
He said it lightly, with amusement in his charming English voice, but it felt like a slap in the face.
“Whoa,” I said. “Don’t tell me how to talk to her. She’s my sister!”
“All the more reason. And there’s that ‘she’ again,” Dr. Howarth said.
I looked to my mother for support, but she was dabbing drool from Roo’s mouth.
“Tilly asked a good question,” Newton said, and I felt proud and grateful that he had my back. “How do the signals get from the brain to the computer?”
“A sensor,” Dr. Howarth said, finally half-turning from Roo to answer Newton. “A tiny chip implanted on the surface of her brain’s motor cortex.”
“Mission control for body movements,” Dr. Hill said, making notes on Roo’s chart.
“Brain activity recorded by the chip is relayed through gold wires to the computer,” Dr. Howarth said. “My software records the signals—thoughts, actually—decodes them and sends them to the computer. By thinking, Hello, world, how are you today? the words will appear on the screen. I, for one, am anxious to hear your thoughts, Roo.”
Thank you, she spelled out, and Dr. Howard gave a little bow of acknowledgment, making me seriously want to throw up.
“As if she would ever say ‘Hello, world.’ Lame!” I muttered. My head was down, my hair falling in my face, so no one would see my expression of disgust.
“Oh, honey,” my mother said, hugging Roo. “It’s so exciting.”
“How will she be able to use a camera?” Newton asked.
“Ask her, please,” Dr. Howarth said.
Newton flinched, looking as offended as I felt. Who was this British jerk to act as if he cared and knew more about Roo than we did? Newton clammed up. His mouth was a hard line.
“Roo,” Dr. Howarth said. “Are you ready to take some pictures for me? As soon as we get the system operating.”
Yes, Roo said.
I rolled my eyes. I really couldn’t stand this guy.
“There you have it,” Dr. Howarth said. “And now I think it’s time for all of us to let you rest. I’d like to do the surgery as soon as possible.”
“Surgery?” I asked.
“To implant the sensor,” my mother said. “You heard Dr. Howarth, didn’t you, Tilly? Roo wants it, and I’ve given my consent.”
It wasn’t as if Roo hadn’t had several surgeries immediately after the accident and stroke, but I was shaking at the idea of Dr. Tim Whoever-He-Was cutting into her head.
“You’ve done this before?” I asked. “This surgery?”
“Yes,” he said.
“It’s a clinical trial,” Dr. Hill said, and the words scared me to death.
“Experimenting on Roo?” I asked. “Mom, are they kidding?”
“It’s her best hope,” my mother said, her voice thick with tears, and I could tell she was trying to disguise the despair that was obviously competing with her optimism. “Be positive, Tilly.”
“But it’s her brain!” My teeth were practically chattering, I was so terrified.
“Talk to your sister,” Dr. Howarth said, more loudly than before.
“Tilly, calm down,” Newton said, seeing that I was about to lose it. My pulse was so speedy I thought I might pass out. Then I felt Newton’s hand on my back, and I took a deep breath and tried to control myself.
“Okay,” I said, looking the doctor straight in the eye. “You’ve done this surgery?”
“Yes, I have,” he said. “Many times on monkeys, with great success. And more recently on several patients—again, with excellent results.”
“Monkeys!” Oh, that was all I needed to hear. I pounded my hands on the tray table, rattling the water pitcher and plastic cup resting there. “Leave my sister alone! Does she even know you’re experimenting?”
My mother strong-armed me away from the tray table, and I heard Newton say my name loudly and firmly: “TILLY!”
“It’s not precisely experimenting, but yes, it is a clinical trial,” Dr. Howarth said unflappably, as if I hadn’t reacted at all.
“Could things go wrong?”
“In any surgery, there are risks: of infection, of her body rejecting the sensor, and, because Roo has already had a stroke, there is a higher risk for a cardiac event.”
“Stop!” I said, shaking so hard I thought my legs would give out. “What does cardiac event even mean? I don’t want her to die! Mom, Newton, help! We’re so lucky to have her the way she is. Right now. Able to talk to us. So what if we have to use the board? We don’t care!”
“Maybe Roo cares,” Dr. Howarth said. “In any case, talk to Roo about it. Ask what she wants. Right, Roo?”
Right. TY, she spelled.
WHAT? They were chatting away as if they were old friends, he was defending her from us. And she even had little spelling shortcuts with him, TY, thank you, when I happened to know that part of her communications therapy included spelling all the words out fully so she would gain mastery over the board.
“You should really spell the whole word,” I said pointedly to Roo.
She didn’t even answer me.
It felt as if these new doctors had swept in and were taking Roo away from me, as if they were using their scalpels on my skin and bones. And it embarrassed me for Roo, the way she was swooning over Dr. Howarth. He was just a doctor, and she was just a case. I knew my sister so well, and as much as I couldn’t believe it, and wouldn�
�t have if Newton hadn’t mentioned that she wanted “space,” she obviously had a crush on this doctor, and was about to put her life into his hands.
“Go ahead,” Dr. Howarth said. “Ask Roo how she feels about the surgery.”
I edged between my mother and the doctor, put my face close to Roo’s. I leaned my forehead against hers, closed my eyes, felt her eyelashes against my cheek. For the first time since I’d entered the room today, I felt almost calm and right.
“Roo,” I whispered. The sound of her name soothed me. How many times had I said it during the course of our lives? A million times? A billion times? Her skin felt smooth and cool against mine, and my breathing slowed to match hers.
We were sisters. We came out of the same womb. There had been times we’d read each other’s minds. She was older than me, and she had always taken care of everything. Everyone at school might think I’m horrible, but she understood and held nothing against me. She was my girl.
“Roo,” I said. “Rooey.”
Tilting my head back, I looked into her eyes.
“You know I’m with you?”
Her eye flicked up: Yes.
But what was she thinking? Really thinking? What did she want? Why was she flirting with this dumb doctor when Newton was right here? Didn’t she know he was just patronizing her? I didn’t want her to make a fool of herself.
“I miss you,” I whispered. “There’s too much happening, and we haven’t been able to be together. Do you really want this?”
Yes.
“A piece of metal in your brain,” I whispered. “Why am I so scared? Are you?”
She didn’t look up. Did that mean no, she wasn’t?
“Clinical trials,” I said. “Experimental brain surgery?”
She looked up. Yes.
“You honest and truly want it?”
Yes.
“There you go,” Dr. Howarth said approvingly. “You’re talking to her, spot on.”
“I might kill you,” I growled.
“Sweetheart,” my mother said warningly.
“Tilly,” Newton said, putting his hand on my back again, making my legs feel wobbly. “Don’t, okay?”
“Okay,” I said.
Dr. Howarth gently put the white plastic communications board into my hand. “Here,” he said. “This might help you two talk.”
But I couldn’t, not with everyone right there. Especially him. I felt raw from the day’s events: the news article, the assembly, and now this doctor telling me how to talk to my sister.
Roo had taught me to read when she was five and I was three. She had protected me from bad dreams, from snow angels. She had told me I had the poetry of owls inside me, and she had let me choose the lines from T. S. Eliot for our dad when she’d so much rather have had Rilke’s about falling stars. She was my big sister.
But right now, as I pressed my cheek to hers, she stared right past me, looking at him. At the pompous jerk, this brand-new doctor.
“I can’t,” I said, backing off.
“Tilly?” my mother asked.
“We’ve got to go,” I said, bolting away from the bed. I caught Newton’s eye, and he was already halfway out the door.
“The girls are very close,” I heard my mother say, making excuses for me. “This has been hard on Tilly. But she’s grateful, as I am. For Roo’s treatment. For deciding she qualifies.”
Qualifies. For the clinical trial. We wouldn’t have been able to afford the best care in this special hospital for Roo, unless she was about to be an experiment.
They were giving her the top treatment possible, with the finest hospital accommodations, and all the latest technology, because the surgery had rarely been done before.
Newton and I waited in the lobby for my mother; when she didn’t come downstairs right away, I knew I couldn’t stay in the building another minute. Newton must have felt the same way, because he grabbed my arm, led me out the sliding doors and down the side street to his car.
I gulped fresh air, felt late afternoon sun on my face, felt free and tried not to think of Roo. She was locked in, entombed in her own body, stuck in that room upstairs.
We sat inside the car, not starting it, not speaking, just sitting, for a long time. The day had begun with that news article taped to my locker, and here we were in Boston learning that Roo was going to have a computer chip and a whole lot of gold wires connected to her brain.
“It’s good news,” Newton said slowly, eventually.
“How can you say that?”
“From a scientific standpoint, which is how Roo will be looking at it, it’s pretty cool. I have been reading up on this stuff, figuring it would be an option for her. It’s ethically weird, because most disabled persons won’t be able afford it, but as long as Roo’s the one who gets it, I am all in.”
“Well, I’m not. Did you hear what he said about her being at higher risk for another stroke? Remember what that was like, when we thought she was brain-dead? That could happen here, Newton!”
“She wants it, Tilly. That’s the bottom line. And from all I’ve read about BCI, it’s been very successful.”
“In monkeys. The poor things! I’m against lab research on animals.”
“I know, it’s intense. You know my dad does pharmaceutical research, and believe me, I never want to go near that field. But this might really help Roo.”
“I hate that doctor,” I said slowly, testing Newton. Had he noticed the flirting? Had it hurt him?
“But she likes him,” Newton said.
“I don’t trust him. I wanted to clock him, didn’t you?”
“Yeah, it crossed my mind.” So he had noticed!
“Jerk.”
“But he’s taking care of her, Tilly.”
“For some kind of warped glory!” I said.
“I don’t know,” Newton said, gazing up at Boston Medical Center’s dark redbrick edifice as if he could look straight into Roo’s room four floors up. He felt crushed; I could see it. Newton and Roo had been together since childhood, and even though he was trying to hold them together, they were falling apart.
I didn’t want that. I stared at him and felt the pain coming through his skin.
“I’m scared of the surgery,” I said, my lip trembling. “Of what might happen to her.”
“So am I,” he said.
He reached for me, and I fumbled my way into his arms. Tears made me blind. We sat there on the Boston side street in the shadow of that huge hospital where Roo was about to have new surgery. Newton held me for a long time. His sweater smelled like Hubbard’s Point: salt air, pine trees, wild thyme and sage, and Roo. Roo, I thought. He smells like Roo. And I told myself that that made holding him okay.
I heard the razor buzzing, scraping my scull when they shaved my head. I felt wisps of hair falling past my ears, and my bare head felt cold. What would I look like without hair? Back in Connecticut they had cut it, shaved patches, but now it was all gone.
Christina gave me a preanesthetic tranquilizer. Waiting for the chip implant surgery, even under medication, I wanted to jump out of my skin. Tilly was right; it was experimental, and I was terrified. I wanted to reach up, touch my smooth scalp to see what it felt like, but I couldn’t move my arm. Being both bald and incapacitated made me want to shriek.
Drugs zoomed through my veins. They didn’t drive the grief and rage away but made me feel like I was floating on them.
Dr. Howarth came into the operating room, dressed in blue scrubs. He had a small blue cap covering his long hair and a mask over his warm smile—but I could see it in his blue eyes, the way they crinkled at the corners.
I fought the drugs. I didn’t want to go under. What if I didn’t wake up? Or what if I did and everything was worse? I wanted to claw the tubes out of my body, run from the operating room.
“It’s going to be okay, Roo,” he said. “I’ve got you.”
No, you don’t, I wanted to say. No one does. I’m alone and it’s horrible.
&nbs
p; Somehow he knew. He crouched down so he was eye level with me. I had to fight to stay alert, to see what he was trying to say with his eyes. I saw them asking me to relax, to trust him.
“Beautiful girl,” he said.
I’m quadriplegic and I’m bald! I wanted to scream.
“So lovely and brilliant. I can’t wait to be able to talk to you. And this operation will allow it.”
I don’t want it! Stop! Make everything go back to the way it was, make me whole, make me real again. I shouted with all I had. But then something weird happened—the longer I stared into his eyes, the more I saw the smile, the patience. He was waiting for me to calm down. He knew I was wrecked inside, and he was giving me a chance to pull it together.
Will I die? I wanted to ask.
“You’re going to wake up in a few hours,” he said. “And I’ll be right here with you. I am going to do everything I can for you. Everything. Okay?”
I looked up.
“Usually, I have my patients count backward from one hundred,” he said. “But I’m going to ask you to count the f-stops on your camera, all right?”
I tried to look up in assent, but I was so drowsy.
“I’ll see you when you wake up,” he said. “And no more Dr. Howarth. I want you to call me Tim.”
Tim, I tried to say, forgetting my voice didn’t work, but the anesthesiologist had injected more and stronger drugs into my IV line, and I was out.
* * *
When I came to, I was alone. Well, I wasn’t, but I didn’t know that. I was in the recovery room being attended by nurses and video cameras. The temperature was nearly freezing—to prevent swelling, I learned later—and my head felt as if a truck had parked on it. I was on a respirator, and I heard the monstrous sound of air being forced into and out of my lungs.
No sign of Dr. Howarth, I mean Tim. Or had the anesthesia made me imagine he’d asked me to call him that? Had I merely wished that he had said he would be here with me when I woke up?
I went back to sleep and had many dreams. In one, Newton was giving Tilly a ride on his shoulders. They were on the beach at Hubbard’s Point. I was underwater, a giant blob without arms or legs, but I could see everything. She flew like a bird, and he caught her. They kissed, and no matter how loudly I screamed, they couldn’t see me under the waves.