Survival Instincts

by Jen Waite

  “You’re ignoring Thea’s seizures,” Rose’s voice swelled. “I know the doctors say they’re not life-threatening, but your daughter has epilepsy, Anne, and you’re acting like it’s just something she’ll grow out of. What if we took her to—”

  “I know Thea has epilepsy, Mom.” Anne’s voice was low. Rose braced herself for her daughter’s anger. “I’ve gone to a dozen doctors’ appointments and they all say the same things. Try the medication, alter her diet, keep a journal of when they happen.” Anne pushed hair away from her face and Rose saw in Anne’s eyes not anger but acceptance. “So that’s what I’m doing, ok?” Anne paused. “I don’t know exactly how to explain this. After Ethan came back, I truly thought he was going to kill Thea, or maybe he would kill me and that would amount to the same thing, right? Because then Thea would go to him, permanently.” Tears ran down Anne’s face but her voice remained steady. “And I made a promise to God or the universe or whatever, I don’t even know what I believe in anymore.” She gave a wry smile. “But I said to myself so many times that if I could protect Thea from Ethan then I would never ask for anything ever again.” Anne took a deep breath in through her mouth. “So, yes, every time Thea has a seizure, I feel like the fucking world is crumbling. And yes, I’ve thought a million times that Ethan is to blame, but I’m not allowed to get upset, I won’t let myself, because I got what I wanted. Thea is here and Ethan is gone.”

  “Are you still seeing Grace?” Rose asked quietly.

  “Mom.” Anne’s voice came down hard and Rose understood the subject was closed. She wanted to explain to her daughter that putting stock in the universe was all good and well, but when it really came down to life and death, getting what you want or wasting away, it was individual action that mattered.

  FIVE YEARS

  BEFORE THE CABIN

  ANNE

  Anne sat, knees jangling against her fingers, across from Dr. Haddad, one of the most prominent child neurologists in the country. Dr. Haddad was the best, she heard again and again, but the doctor had a waitlist, a long waitlist. So here she was, a year later, at Boston Children’s Hospital, sitting across from Dr. Haddad, waiting to hear the results from Thea’s first brain surgery.

  She’d changed her mind about accepting Thea’s epilepsy and the advice of her local doctor, after Thea’s epilepsy medication stopped working. Thea’s seizures started occurring with more frequency, sometimes two or three times a day. Their local doctor, Dr. Novak, a thin, wiry man with a mustache, talked for a few minutes about finding the right dosage of medicine, how it could take a while but that they still wanted to focus on treating with medicine and diet rather than surgery. Brain surgery, Dr. Novak said, would be a last recourse due to the “potentially severe side effects, like paralysis or loss of speech.”

  Two weeks ago, in her first face-to-face meeting with Dr. Haddad, the doctor had looked up from Thea’s file and said the words Anne had been hoping to hear since she started researching curative surgery eighteen months ago: “Based on her video EEGs and imaging studies, I think Thea may be a good candidate for brain surgery. What we want to do, ultimately, is a resection. The first step, though, is to cut through your daughter’s skull and put several grids on the brain with about two hundred wires connected to the grids. The grids will give us the most accurate EEG reading possible and could point us to a very specific focus, which is then hopefully resectable.”

  Now, they had the results from the grid-mapping surgery—a surgery that had lasted around four hours and left Thea groggy and with throbbing head pain. Anne focused her attention on Dr. Haddad and asked slowly, “So what did the grids show?”

  Dr. Haddad looked up and smiled. She turned a scan toward Anne and pointed to a tiny white blur. “Do you see this? That looks to be the focal point. It looks like they’re starting in the right side of her brain, right here, and occurring on the left side of her body. From her records, I’m seeing that her previous doctors believed she suffered from a rapidly generalized epilepsy, seizures that do not clearly have one focal point but may occur in multiple areas of the brain—that seems to be because her seizures were presenting as grand mal when she was younger, yes?”

  Anne wanted to cry with relief and throw her arms around her. Dr. Haddad was actually telling her something real about Thea’s seizures. She decided that sobbing would not be an appropriate response to Dr. Haddad’s question, so instead she said, “Yes.” She knew what grand mal meant because of her hours of Internet research. Grand mal seizures are the seizures portrayed in movies and TV shows—the total loss of consciousness and body control, vibrating and jerking on the ground, foaming at the mouth. “So”—Anne’s heart pounded in her ears and tears pricked her eyes—“they’ll be able to go in and remove the focal point? And she’ll be cured?”

  Dr. Haddad smiled. “That would be the ideal scenario, yes.” She shuffled the papers into a neat stack. “Today is Wednesday. I’ll need to assemble the team—”

  “Wait,” Anne interrupted, uncrossing her legs and leaning forward. “We’re doing the resection? You really think you can cut out the focal point?”

  Dr. Haddad smiled again. “Yes, I do. The results from the grid mapping look good. I’ll need to talk to the surgeon who will be performing Thea’s brain surgery, get the anesthesiologist up here . . . Let me think for a moment. Time-wise, as far as assembling the team and scheduling surgery, I think we’re looking at . . .” Dr. Haddad counted silently in her head. Anne mentally assessed her client load over the next few months. She’d already canceled all her appointments twice for three-week chunks. She focused back on Dr. Haddad as the doctor said, “I’d like to aim for Monday.”

  “Monday? You mean this Monday?”

  * * *

  —

  Anne knew something was wrong when the surgical assistant sped into the waiting room an hour into Thea’s surgery. The surgery, Anne was told, would take three to four hours, and then Thea would be under observation for several days. The surgical assistant, Dr. Au, should have been in the operating room, with Dr. Everett, the surgeon, measuring and cutting and doing whatever else they had to do to stop Thea’s seizures, not walking briskly toward Anne with a barely concealed look of panic on her face. Anne stood and moved toward her. “What? What?” she said, her voice coming out fast but seemingly calm. “What is it?”

  Dr. Au tugged her face mask off her mouth and nose. Anne waited, searching the doctor’s face, icy blood sinking out of her head down into her toes. She felt preternaturally calm. She recognized this type of icy cool calm, when her brain and body slowed to a crawl as she braced herself for devastation. Time slowed as they stood, face-to-face, and everything other than Dr. Au’s face blurred. Finally, Dr. Au opened her mouth. “Ms. Thompson, look at your cell phone.” What the hell? The urgency in the doctor’s voice stopped Anne from asking questions, and she simply reached into her purse and brought out her phone. There were five missed phone calls. She looked back to Dr. Au.

  “Dr. Everett needs to speak with you.”

  Anne did not say a word. She would not speak until Dr. Everett told her what had happened. It struck her suddenly that something had gone terribly wrong—Thea was gone—and this woman, this stranger, knew before she did. The truth was just in front of her, just out of her grasp. She had been sitting in the waiting room, having thoughts about a scratchy chair and ice chips while Thea slipped away. She hit the missed call with shaking hands and brought the phone to her ear. Blood thudded through her skull. Half a ring sounded before Dr. Everett picked up.

  “We ran into a bit of a problem, Ms. Thompson, and before we proceed with the surgery any further, I need to have a frank discussion with you. It looks like—”

  “She’s alive?” The room came into sharp focus.

  “Oh yes. Yes, she’s doing fine, but we had to stop the surgery, or rather, we’re still in the middle of the surgery. This is atypical, but I thought it best to bri
ng you up to speed before we proceed.” Dr. Everett paused, and Anne realized she was panting into the phone. “She’s doing fine,” he repeated, his voice impatient but not unkind; his tone relayed that he had been through this before and time was of the essence. She gulped down a lump. The room was vibrating. No, not the room, her own body. “Ms. Thompson, are you good for me to continue? I need to get back in there with your daughter, so I’d like to keep this as short as possible.” Even though he must have been only a hundred feet away, his voice came through the phone tinny.

  “Yes. I’m good. I’m listening. Go ahead.”

  “Unfortunately, the resection is not as straightforward as we had hoped. We believe that the focus of Thea’s epilepsy may in fact be very near or even in a part of her brain that also controls motor functions.”

  She managed to say, “That’s not good.”

  “If we cut out the focal point, and I’m correct about the location, there’s a large risk of paralysis. She may be permanently paralyzed on the left side of her body if we proceed with the resection. We need to make a decision now about whether to move forward or stop the surgery.”

  Her vision sharpened again, taking in the room. A large, flat-screen TV displaying the news to the scattered half dozen people in the waiting area. A nurse writing on a clipboard a few feet away. The long corridor that led to the operating rooms—Thea was somewhere down that hall, through the large swinging doors, her eyes closed, skull open, brain glistening under a spotlight. All of this came in and out of focus as Anne found her mouth moving and the words, “Stop. Stop the surgery,” came out.

  “Yes. I agree.” Before Anne could say anything else, he surged ahead. “We’re stopping the surgery. I have to get back in there. Dr. Haddad will follow up with you soon, all right?” He didn’t wait for an answer. Her cell phone flashed “call ended” as Anne looked at the phone numbly.

  * * *

  —

  When Thea woke up from surgery and Anne had to tell her that they didn’t get it, that the surgery had failed, she felt her insides squeeze and burst open as tears ran silently down her daughter’s face. “Rest, love, it’s ok, it’s ok. Just rest,” she said, keeping her voice smooth, not allowing herself to make any more hollow promises.

  Thea was released from the hospital five days later. She slept for the entire four-hour drive home. Anne glanced in the rearview mirror and watched her daughter’s chest rising and falling, glanced at the white gauze wrapping Thea’s head. They pulled into the parking lot of their apartment building and she switched off the engine. She sat for a few minutes in the car, listening to Thea’s soft snores.

  Dr. Haddad had explained after the surgery that she wasn’t willing to go any further with Thea’s brain surgery. “Unless you would consider an awake craniotomy, which quite frankly might be our best option. Or our only option.”

  “An awake . . . what?” Anne had said, trying to keep her shit together, to hide the exhaustion and disappointment in her face and voice.

  “She would be woken up during the brain surgery. Dr. Everett would give her commands, ask her to move her hand or say a word, while he touched certain parts of her brain. That way we can be absolutely sure that he’s not removing a part of her brain that controls motor functions. She is young . . . but it’s been done. I know it sounds crazy”—Dr. Haddad leaned forward and held Anne’s eyes—“but an awake craniotomy, in Thea’s case, is something we should seriously think about. If you want to move forward with surgery.”

  A few days later, Thea was discharged, and Anne was no closer to making a decision on what to do next . . . if anything. Before they left the hospital, she told Dr. Haddad that she would be in touch soon.

  We’re home, she texted Rose.

  Any more thoughts on the awake surgery? Rose replied right away. Is there maybe another doctor you could talk to? She saw that her mother was still typing and clicked her home screen dark.

  THE CABIN

  ROSE

  Rose watched her daughter’s body for movement across the room. The fire threw flickers of light on Anne’s crumpled form, lighting up her hair and parts of her back every few seconds. Rose held her breath and waited. The fire had brought some pink back into Thea’s cheeks, but the temperature in the cabin must have been around freezing because when Rose let her breath out, it formed a thick cloud and hung in the air. Anne was still, deadly still, and Rose felt a chasm opening in her chest. She looked from Anne to Thea and then allowed herself, for a moment, to look directly at the gun. The man had a glock 19, 9 millimeter, 16 bullets, if fully loaded and topped off, or less depending on how many he’d already used. Rose knew this because it was the same gun that Sam had used, near the end of their lessons, when they were more competitors than teacher and student. Sam had started out so wary of Rose’s request, and he never flat-out acknowledged that what they did was right, but by the end of their six months together in the woods, Rose could tell he was enjoying himself. It was almost ten years ago, but, sitting in the cabin, Rose remembered the exact weight of the glock 19, a bit heavier than her glock 26—she’d had to adjust for the increased pressure required on the trigger—but she’d been surprised when they’d switched and she’d been able to hit the target at fifty feet with all fifteen rounds. Of course, that was in broad daylight. She squinted through the dark. She could see outlines but not features, enough to aim at, though, she thought. Rose considered three substantial problems. The first was that her hands were tied. She’d been careful to keep bending her fingers and twisting her wrists every few minutes, but the shoelace had cut into her skin, rubbing a circle around each wrist, like a bracelet made of raw flesh. She had feeling in her fingers but it was harder to tell how strong her wrists and forearms were at this point because she had almost no leverage to move them. If she was lucky, she could still hold the gun steady but she wouldn’t know until it was in her hands.

  Which brought her to problem number two. How would she get it? The man paced around the front door of the cabin, to the right of Anne’s body, clutching the gun close to his body. Rose tried to convince herself that she was imagining it, but she could swear that he was readying himself, psyching himself up. He muttered under his breath and closed his eyes, his facial expressions changing from anger to a distorted smile. If it came down to it, she would tackle him, which might at least dislodge the gun from his hand and send it to a dark part of the cabin. Of course, then it would be a matter of her or Anne—she glanced at her daughter’s motionless body again—getting to the gun before the man did. And then if, against the odds, she possessed it:

  Problem number three. Rose hadn’t touched a gun in ten years. Not since the night with Ethan. The next day Rose and Sam thought it was a spectacular day to take their small speedboat out on the lake. A little known fact: the deepest point of Lake Champlain is right smack between Charlotte, Vermont, and Essex, New York. They brought a picnic lunch, plenty of sunscreen, and a small black object to dispose of. This was the problem that concerned her the least as she was quite certain that, given the opportunity, her body would take over—Sam was right, her muscles remembered.

  Rose sorted through these problems, one by one, and kept her eyes glued on Anne. At the same time that she saw her daughter move, ever so slightly, she also felt the man in her peripheral vision head toward Thea.

  “Mom.” The desperation in her granddaughter’s voice caused the chasm that had been building in Rose’s chest to crack wide open. She was on her feet and moving toward Thea and the man when she heard her daughter, close, whisper, “Mom, don’t.” Rose looked at Anne, who had righted herself against the wall, to the left of the front door. Anne’s face was twisted in agony and it was impossible to tell if the root of the pain was physical or emotional.

  The man pulled Thea to a stand and gripped her upper arm. Thea’s eyes raced wildly around the cabin, landing on Rose first and then Anne. “Mimi,” Thea whispered, “Mom, help me.” />
  Rose moved toward Thea on instinct and heard Anne’s voice, louder this time, command sharply, “Mom, NO.”

  Rose looked at Anne frantically as the man pulled Thea to the middle of the room. Thea twisted her body away from the man, but he gripped her shoulder harder and pulled; Thea’s feet dragged on the floor like a rag doll. The man stopped abruptly. The gun dangled from his right hand.

  “I won’t kill her,” he said, looking from Rose to Anne. “Stay where you are and I won’t kill her. Either of you move, though.” He didn’t finish the sentence. Spittle hung from his lower lip. He pushed Thea to the floor and Rose heard her granddaughter scream. Rose started to take a step forward and, again, Anne commanded her to stop. Rose looked to Anne wildly but Anne was focused on Thea and the man. Her face was calm and she took measured breaths.

  “Thea,” Anne said over her daughter’s cries. “Don’t fight it.”

  Rose watched as her granddaughter left her body. Thea’s eyes rolled back slightly into her skull and her head nodded forward and then to the side in small jerks. Her arms stiffened at her sides and her legs gave out. Rose froze; this could not be happening.

  TWO YEARS

  BEFORE THE CABIN

  THEA

  “It’s time, baby.” Thea’s mom took her hand and squeezed. Her mom’s hands were smooth with tiny creases, like a baby elephant’s back. The pre-op room looked less like a hospital and more like a hotel room, with a green couch and a full-length mirror hanging on the door. They had been in the hospital for seventeen days so far. This was their second long-term stay in the past couple years. Thea had heard her mom talking to Mimi late last night, in a strained whisper from the reclining chair across the room from her bed, while her mom thought she was sleeping. “She’s done, Mom. We’re both done. She’s not smiling, she’s barely speaking. If surgery doesn’t work this time, I’m not bringing her back. It’s just too much. It’s too much for a ten-year-old,” her mom’s voice had cracked, and then the room was silent for a while. Thea had almost fallen asleep, thought her mom had hung up, when her mom’s voice drifted through the air again. “I know. I know. You’re right. Yes, thank you, you’re right, ok, I’ll keep you updated tomorrow.”