White Sands

by Geoff Dyer

  Now, right at the end, I need to go back to the beginning of our long-anticipated Californian life. We flew from London, were upgraded to business class (I’d finally got the seat I deserved, as the Norwegian flight attendant had promised) and moved into a little bungalow in Venice in January 2014. The timing was perfect: while England was sinking beneath the waves, or the rivers at any rate, the weather here, even by the high standards of Los Angeles, was exceptionally wonderful. We quickly established a nice routine: at eight o’clock we’d go for coffee—an eight-ounce cappuccino and a twice-baked hazelnut croissant at Intelligentsia. Jessica would go to her office in nearby Culver City, and I would return and try to work. Every other afternoon, I’d cycle down to the tennis courts by the beach, play for an hour and ride home again as the sun was setting over the Pacific.

  Then, only a few weeks into our new life, I bent down to push some garbage into the already stuffed bin. When I stood up half the world had disappeared. It had disappeared but it was still there, sort of. The kitchen wall was visible but it didn’t seem quite right: familiar but changed, as happens in dreams. Ah, now, here was something I recognized: a strip of brown wood against the pale yellow wall. It was the frame of the mirror—I was looking into a mirror but, like a vampire, I couldn’t see my reflection. The mirror had become a window, but all that could be seen in this window was the wall on the other side of the room, behind me or behind where I used to be. So where had I gone?

  ‘Something’s happened to my eye,’ I called out to Jessica. She was in the bedroom, but she too had semi-disappeared. I could see half of her body, but her face had gone. I thumped myself slightly on the side of the head as if that might knock everything back into place, dislodge the opaque filter that had come between me—though even that, the idea of there being a me, had become less certain than usual—and the world. I was getting confused as I tried to make sense of this insubstantial world in which things were and were not.

  ‘What’s happening?’ she said.

  ‘Well, whatever it is, it’s well trippy!’ I said. ‘Where is the . . .? Why is the wall a door?’

  I was covering up one eye and then the other, trying to eliminate variables, as one does with an electrical fault (bulb, fuse, socket . . .), trying to ascertain exactly where the problem lay, which part of my sight had gone.

  ‘I seem to be blind in one eye, the left, but I can sort of see out of it. Where have you gone?’

  ‘I’m here.’

  ‘So why are you just hallway?’

  Jessica has often had problems with her eyes. Ten days earlier she’d gone to the ophthalmology department of the hospital with an ulcer on her cornea. That’s where we should go now, she said. We had health insurance, courtesy of her work, so she called and made an appointment. They could see us at nine-thirty. It was eight-thirty now, would take twenty minutes to get there in a taxi. Which meant there was time to do what we did every morning: go to Intelligentsia for our eight-ounce cappuccinos and twice-baked hazelnut croissants, which were not as nice as the Doughnut Plant doughnuts I’d had every day when we’d lived in New York for four months the previous autumn but which had become part of our unchangeable routine. Getting ready took longer than usual. I kept asking where the thing was, the thing that I kept my health-insurance and credit cards in, the Oyster card-holder thing. And my keys. As soon as she told me, I would ask about something else, and by then I wasn’t sure whether I’d picked up my cards and my keys and I’d be wondering if I needed my passport and it would turn out that I had my keys in my hand and my credit cards in my pocket. It took ten minutes to get out of the house, during which time Jessica’s patience quickly frayed. It was, she said, like dealing with a cross between a half-senile pensioner and a totally monged-out teenager.

  We walked to the café. I held on to Jessica’s arm. The sidewalk was the sidewalk and the road was the road. There were people and cars, brilliant sunshine, colours. We waited in line and ordered the same things we ordered every day. We ate and drank as usual, and some of the world seemed to have come back. It was more like, as my mum used to say of people with some kind of mental trouble, that I was not all there.

  Our Uber arrived and we were soon speeding along Venice Boulevard. I could now see something out of my left eye but I had no peripheral vision.

  At the hospital, a nurse immediately gave me drops to dilate my pupils so that the ophthalmologist could take a look inside. As a result, my vision, having improved slightly in the taxi, became distorted in both eyes. An already bright world became brighter still. The ophthalmologist did simple tests, covering up one eye at a time, waggling her fingers on each side of my head, to test my peripheral vision.

  ‘How many fingers am I holding up?’

  ‘Two.’ I could see them on the right side. On the left side, I couldn’t even see her arm. The weird thing was that the result was the same whether using my left or right eye.

  Within minutes she had succeeded, where I had failed, in eliminating some potential causes. Since the problem was the same in both eyes—lack of vision on the left—the cause must lurk behind the eye, in the brain. So it was either a migraine or a stroke. This was the first time the word ‘stroke’ cropped up. It was a word I didn’t want to hear, but it was what Yeats, in a quite different context, called the surprising word that is also exactly the right word. If I’d had my wits about me I might have joked, when my sight first went, that I’d had a stroke—but the reality, the ophthalmologist made quickly clear, was no laughing matter. We needed to go straight down to Emergency, she said, picking up the phone to alert them to our imminent arrival. Since I was ambulatory it would be faster if we walked rather than waited for a wheelchair.

  So that’s what we did. We ambulated through the hospital as we had previously walked to the café, with me clinging to Jessica’s arm. The difference, because of the drops, was that, besides acting like an ageing teenager on E, I now looked like one as well: my pupils were the size of dinner plates.

  A nurse showed us into a curtained cubicle. I changed into one of those hospital gowns that tie up at the back, the purpose of which seems to be to enfeeble you, to reduce your capacity for independent action. To walk even a few steps risks the ignominy of exposing your bottom to the world. You are now a patient, the gown decrees, the recipient of treatment, someone to and for whom things are done. An ER doctor saw me straight-away, went through the same tests as the ophthalmologist while adding some of his own. He touched my legs and face on both sides, asked if I could feel what he was doing—I could. I could also grip hard with either hand and extend both arms and legs. I could swallow and speak perfectly. After each of these little tests the doctor said ‘Good.’ It wasn’t just reassuring to hear this; there was also the pride you felt in school, that you still feel in the course of a tennis lesson, when you get the answer right or execute a stroke correctly: the clever-kid-in-class glow, the sense of achievement and pride that you are not such a klutz, not a complete physical and mental wreck, like that guy moaning over there, all whacked out and smashed up on a gurney. Less encouragingly, I had been downgraded from my previous ambulatory status: I was now wheeled along on my own gurney to the MRI scanner in a different building. With my pupils enormously dilated, the Californian light was so strong I had to keep my eyes screwed shut.

  There was only a short wait before I was fed into the MRI scanner. The procedure was very similar—but quite different—to one I’d had a few days earlier in the Perceptual Cell at James Turrell’s retrospective at the Los Angeles County Museum. The highlight of that exhibition, for the fortunate few who’d managed to book or cadge a slot, was to be slid horizontally and alone into an MRI-looking gizmo by two assistants in white lab coats (both female, as gorgeous as the nurses in the film of The Diving Bell and the Butterfly). Once sealed inside, you were bathed in soft blue light. There were two settings, and I had, naturally, opted for the strongest. The light began to pulse and change. Headphones played beatless music that encouraged complete
surrender to a non-corporeal world of pure light. As the fractal geometries and strobes of colour gathered pace it became impossible to tell whether these glowing patterns and acid flashes were emanations of an external world or if they were in your head. Deep space or inner space? Either way it was like a glimpse of infinity. Infinity, not eternity. The experience only lasted ten minutes; it was possible to lose track of oneself but not of time. I would have liked to spend hours in there, a whole day even.

  In the same length of time that I’d spent in the Turrell Cell, the MRI made a map of whatever had happened in my brain. I emerged from the clattering soundtrack of the scanner, clambered onto the gurney and was wheeled back to my cubicle to await the results. The doctor returned within an hour.

  ‘I’m afraid there has been a stroke,’ he said. ‘An ischemic stroke.’ It had occurred at the back of my brain on the right side, affecting the working of the left half of my vision. They’d need to keep me in hospital overnight for more tests. My immediate reaction—Shit, I’ve had a stroke—was followed immediately by a second: Thank god we have health insurance. These, in turn, were quickly followed by a third: that a series of trapdoors might be in the process of opening up beneath me. One thing leads to another, each more serious than the previous. This has happened because something else is not working correctly, and that is wrong because something else is faulty. To find out what that next thing is, it will be necessary to burrow more deeply into your being and discover how much if any of that—your continued being—you have left.

  I was wheeled up into what looked, to my still dilated, NHS-habituated eyes, like a business-class hospital room. Jessica went back to our apartment to get various things I’d need for my stay. In the rush to get out of the house and into the café—why hadn’t we thought ahead, why were we so obsessed with having our coffee and twice-baked hazelnut croissants?—I had arrived like a guest who turns up at a party empty-handed. I hadn’t brought a book, because I’d be unable to read. But my regular fortnightly column for the New Republic was due the next day and I had left my laptop at home. The column involved looking closely at a news photograph and writing five hundred words about it. Fortunately, I’d already chosen the photograph, so, in the interludes between getting wheeled in and out of tests, I began jotting down my blurry thoughts about this remembered image on the back of an envelope. One of the intervening tests was an ultrasound of my heart and carotid artery, which would, in the words of the technician running it, ‘show us where we’re at.’ I could hear my heart whooshing and splooshing on the monitor. I had no idea if this was how it was meant to sound, but I had absolute confidence in my cardiovascular system.

  ‘Ten bucks says my heart’s in perfect shape,’ I said. But he wasn’t a betting man, the technician. Which was just as well—for him—because my heart and arteries were, as I’d boasted, pumping away like there was no tomorrow. Like there was going to be no end of tomorrows—tomorrows and tomorrows—any time soon.

  ‘Least now we know what it’s not,’ he said when the test was completed. We knew where we weren’t at.

  In the early evening I had an intravenous CAT scan and Jessica returned with my laptop. We went through a personalised, amateur series of finger-waggling tests, and it seemed my vision had continued to improve. After she left I was able to type up the notes for my column, knock them into shape and file my copy, in case, for whatever reason, I was unable to do so the next day. A good decision, it turned out, though not because of any sudden deterioration in my condition. It was such a busy night that, in the morning, I was too exhausted to think. Whenever I was about to sleep someone would come in to check my blood pressure, my pulse, my temperature, to take more blood or monitor whatever else was happening in the gates and alleys of the body. I was glad of the attention, was even pleased to see the physical therapist—it’s important to get stroke victims moving again as quickly as possible—even if his skills were, in my case, entirely superfluous. All of this was really just build-up to the headline attraction: the neurologist who came by shortly before midday. He was Korean, bespectacled, a little younger than me and—I’m not sure how this came up—he had a daughter at Stanford. To be in his presence, to be the beneficiary of his training and expertise, was to marvel at how thoroughly the idea of rude health had been left behind. He was a reassuring advert for the efficacy of polite well-being.

  All the test results so far were negative, he said. Apart from the small matter of the stroke, I was in great shape. This was as expected: I played tennis and Ping-Pong all the time, cycled everywhere, was as thin as a rake. I loved soy milk. My favourite meat was tofu.

  ‘I even take the skin off chicken!’ I told him.

  We then went through the familiar round of tests, at which, without wishing to boast, I had come to excel: hand squeezing, face stroking, finger counting and so on. I was fine, my vision was almost entirely back, I could go home as soon as the paperwork was taken care of. The discrepancy between the seriousness of what had happened—everyone at the hospital was at pains to emphasise that any stroke is extremely serious—and the speed of my already almost complete recovery was echoed by the contrast between the extravagance and expense of the diagnostic technology and the modesty of the cure: low-dosage aspirin. Then, as the neurologist was about to leave, in anticipation of a few test results that were not yet in, he added a pre-emptive prescription for cholesterol-reducing Lipitor.

  By two o’clock I was back home. I had a terrible headache but it was a very familiar form of terrible, nothing untoward, the kind I’d had hundreds of times before, a kind of hangover from the momentous events of the previous thirty hours. I slept for a couple of hours, cycled to the beach and walked by the ocean in the late surge and swell of afternoon light.

  It seemed inconceivable that I could have had a stroke. I was fifty-five, way too young, and of all of my contemporaries I would have put myself last in line for such a thing happening. I’d never had a cigarette. I drank a fair bit, less than many of my friends, and was drinking less with every year. I actively disliked all the foods that you’re meant to avoid. Except doughnuts and croissants. I’d always eaten a lot of pastries, and in New York my doughnut habit had got . . . not out of control exactly, but I was doing one a day for four months. Twice a week I had a couple of eggs, lightly poached, but what did that count for in the face of the overwhelming healthiness of my diet and life?

  ‘Well, something,’ the neurologist called to tell me the following day, ‘has sent your cholesterol through the roof.’ Instead of twenty milligrams of Lipitor, I should double the dose to bring it down as quickly as possible. After speaking with him, I remembered that, fifteen years ago, in England, my GP had said that my cholesterol was a little high. I paid it no mind, moved to a different part of London, signed on with another doctor. As far as I could recall, my cholesterol had never been tested again. Until now. Now I’d joined the great American statin-dependent democracy of high cholesterol, was being welcomed into the community of stroke victims as featured in a clutch of nicely produced brochures.

  They made depressing reading, these brochures. In a friendly way they showed people of both sexes and many races going about their fulfilling post-stroke lives. These people, regardless of their race or sex, were overwhelmingly old and white-haired, and the advice—a walk is good exercise, pruning trees in the garden can be aerobically helpful—applied to a demographic to which I did not belong. Even as I rejected the proffered kinship, however, I remembered something that had happened nine months previously. I’d been sitting in a café when my left thumb and forefinger went completely numb. It had been freezing outside, but, looking back, this numbness had nothing to do with the temperature: it was absolute. Not just numb or cold, more like dead. This only lasted a couple of minutes and I soon forgot about it. On a couple of other occasions my vision had gone sort of sparkly and bleached out, but these episodes were so fleeting that I forgot about them too. Such things, I read now, might have been transient ischemic attac
ks: so brief they were difficult even to register until something more extreme occurred to give them definition and meaning. Until then they had nothing in common with anything you might ever think of as stroke-related.

  Back in London, I often used to bump into the writer Gilbert Adair on Portobello Road, both before his stroke (always smoking, never healthy-looking) and after, when he was, as he put it, ‘sadly diminished.’ I last saw him, shuffling around with a friend, struggling to remember who I was, a couple of months before he died in December 2011, aged sixty-six. Gilbert was stroke-brochure material, had led a perfect stroke-conducive life. I may have been unlucky to have had a stroke at all, but it was a stroke of luck that I’d had such a mild one. Within forty-eight hours there was almost no physical difference between how I’d felt before and how I was afterwards. I was able to play Ping-Pong on Friday and Saturday (a very good workout for the eyes, one that persuaded me there was still some slight vision loss between 10:00 p.m. and midnight in the clock-dial scheme of things). On Monday I was playing tennis again. Apart from being at increased risk of another stroke I was fine—but psychologically I was conscious that the ground could open Adair-ishly beneath my feet at any moment. Every time I got out of the bath I worried that the giddy rush of blood from—or is it to?—the head might be the bow-wave of an approaching stroke. I was scared of bending down—and I was worried, constantly, about my brain.

  There had certainly been some cognitive impairment—but Jessica insisted that this had occurred before the stroke. I used to pride myself on my sense of direction, but that had long gone south, or maybe north or east. I had trouble concentrating, but that too had been going on for ages—I put it down to the Internet, not to my brain blowing a fuse or springing a leak. So, no, nothing had gone permanently wrong in my head, or at least nothing had gone wrong that had not been in the process of going wrong for a while—but I now regarded that head and the brain snuggled warmly inside it in a new and vulnerable way. I’d been looking forward to signing up for a Medical Marijuana card in L.A., but the prospect of smoking pot (smoking in the healthy Californian sense of vaporizing) now seemed quite dreadful. While marijuana might meliorate the symptoms of some conditions, it seemed guaranteed to send the stroke victim spinning into an epic bummer in which you fixated either on the stroke you’d just had or the one that could blow your brain apart at any moment, that might be brought on by worrying about it. That was the thing about all this: it was a brain thing, and I loved my brain and the way it had been going about its business so gamely for more than half a century. Let’s say you have something wrong with your liver or heart. Terrible news. But if you’re lucky, if you get another one and take the right medication, you’ll be back to your old self again. But with the brain, the one you were born with either works or it goes wrong and you start sliding away from yourself. Even if a better, cleverer brain—a brainier brain—had been available for transplant, I wouldn’t have traded in the addled one I had for anyone else’s. And although the problem, we’d quickly discovered, wasn’t in my eyes, that’s where it had manifested itself—and I loved my eyes too, especially here in southern California, where half of the reason for living, possibly all of it, was to see and be seen. I loved seeing the ocean and the sunlight and the gorgeous, tanned, fat-free, screen-tested bodies as they muscled and jogged along the beach, adorned with zero-cholesterol tattoos of Maori designs and lines from Infinite Jest. But also there, down by the beach, were the homeless and the half-mad, men and women whose brains had been torn apart by drugs or had gradually come undone because of some undiagnosed fault in the wiring.