by Liz Astrof
“Okay?” He put his hand on mine, like he always did.
“Okay,” I said, feeling the weight of his hand on mine. Grounding me . . .? Sure, why not.
“Okay.” He gave my hand a squeeze and let go.
By now, The King of Queens was on hiatus. After punishingly long hours filled with painful, throbbing laughter, the time off was glorious; so I, of course, packed my days with activities, errands, exercising, and writing my screenplay. (If you live in LA, you have to be working on a screenplay. It’s the law.)
Always running, always busy. Even lying in an MRI machine for an hour seemed indulgent, so I put it off and put it off and kind of forgot about it, even with my headaches getting worse and worse. Until one day, I had my bag dumped out on the floor of Starbucks looking for my wallet and found the referral for the MRI. Standing quickly to apologize to the person behind me in line, my head throbbed, and I made an appointment for the next day. The MRI was lovely, I have to say, and I’m no doctor, but the tappity-tap sounds the machine was making made me feel like everything was going to be just fine.
When I went to the follow-up with Dr. Sung the next week, the nurse showed me into his personal office instead of sending me into an exam room. Made sense—I’d already been examined. I felt very important. And fancy.
Dr. Sung was sitting behind a big, wooden L-shaped desk, writing something down. Behind him was a matching wall unit filled with pictures of his family—his wife and two mini Asian American George Clooney–looking kids, smiling.
“Hey, Liz, sit down,” he said. There was something different in his singsong voice—it was more . . . consoling than usual.
I sat in one of the leather chairs facing his desk and was going to ask him about his kids, when his door closed without him getting up.
My jaw dropped—how did he do that? He must have had one of those buttons under his desk. This was a VERY good doctor, indeed.
He clasped his hands together, pursed his lips, pointed his chin down, and raised his eyes at me.
“They found something . . .” he started.
I was stunned. I hadn’t even considered that he might have brought me there to tell me I had a tumor—that I was dying.
Which was what I must have said, because “No, you don’t have a tumor” was the next reassuring sentence out of his mouth.
I wasn’t dying.
“The MRI did show something called ‘Chiari malformation’ . . . okay?”
Dr. Sung handed me the piece of paper he was writing on. It read: Dr. Wesley King, Neurosurgeon.
Surgeon? I thought I didn’t have a tumor!
He told me Dr. King is one of three people in the country who specialized in my type of (gulp) malformation.
“Because it’s so easy to correct? Is that why they don’t need a lot of people?” I joked, hopefully.
I followed Dr. Sung out to the receptionist’s desk, where he stood next to me and, like a dapper boss-doctor, told her to make an appointment for me with Dr. Wesley King, Neurosurgeon, for that afternoon. He was going to squeeze me in.
Dr. Sung turned to me, looked me in the eyes, and put his hand on mine. I went for it and placed mine on his, trapping it there. We stayed like this for a good minute until he finally, earnestly said, “You’re a nice gal, okay?”
Oh, Jesus.
“Dr. Sung called me a nice gal!” I shrieked into Todd’s voicemail, frantically. “Where ARE you?! Why aren’t you answering your phone?!” In the time it took my husband to get back to his desk from the bathroom, I’d left him the same message. Six times.
He insisted on meeting me at Dr. King’s office—I told him he didn’t have to. I didn’t need him to. He was adamant about it—almost sexy in his bossiness—so I let him.
Dr. King was young, confident, muscular, and good looking. A black George Clooney, I’d say. He didn’t validate parking either, so this was clearly another good doctor.
First, we made small talk, joking around as I like to do. He was a consultant on a friend’s medical drama series—even the brain surgeons in LA are in the business.
“You must hear a lot of people say, ‘It’s not brain surgery,’ ” Todd joked. “And then you say, ‘It is brain surgery.’ ”
We all laughed. I said, “Ow.”
We talked about my headaches. I shared how they had started about the time I’d gotten engaged. “If that’s not a sign, amiright?” I laughed. Dr. King laughed. Todd shook his head, amused but not really.
Dr. King asked if I’d been jolted in the past few years—any car accidents or whiplash. That can sometimes cause people with a Chiari malformation to become symptomatic. I thought about it and then remembered being rear-ended a few years earlier. I’d been on my way to a boot camp class before work and was stopped at a red light when a guy in a giant pickup truck slammed into me. I remembered being furious because if you didn’t get to class on time, you didn’t get a treadmill, and then it was just lunges and free weights, and there was really no point in even going. I quickly got the guy’s info and drove off. A few blocks later, at another red light, a woman in the car next to me had honked and gestured for me to roll my window down. “Ma’am, I think your car is on fire,” she’d said, pointing.
Aside from not getting a treadmill and totaling my car and having to deal with a lot of jokes about being “rear-ended” at work that day, I’d figured that was the end of that.
That, however, happened to have also been the beginning of the headaches, I suddenly realized.
Dr. King assured me that even though he was a surgeon, he rarely had to perform surgery. Brain surgery is always the last resort in treatment. I was relieved. For being at the brain surgeon’s office, we were having a good time so far.
He stepped out to look at my MRI, returning in what seemed like seconds and putting the image of my brain up on a lightbox. He wanted to explain my condition to me. Problem was, I was starting to black out.
I have this other condition—which may be related, now that I think about it—whereby whenever anyone explains something important to me, like directions, instructions, or brain defects, the pressure to listen is so great that all I hear is the theme song from the 1980s sitcom The Facts of Life. It just starts playing in my head over whatever it is they’re saying. It’s the reason I get lost so often. So, while Dr. King was pointing to the image of my brain on the lightbox . . . all I heard was “You take the good, you take the bad, you take them both, and there you have the facts of life . . . The facts of life . . .”
Fortunately, Todd was in the room and heard about how in a normal brain the cerebellar tonsils rest at the top of the spine. When we laugh or cough or sneeze or strain, cerebrospinal fluid within the brain and spinal cord that helps cushion them from injury flows down into the spinal column. But with a Chiari malformation, this balanced flow is disrupted. The obstructed fluid forces its way like a water hammer through the foramen magnum. Pushing the tonsils down even farther, the fluid exerts pressure on the brain stem, compromising normal functions of the brain and/or spinal cord.
That’s what was happening to me.
Something was happening to me!
It explained much more than the headaches. It explained why I always veered to the right—why I couldn’t swim laps because I’d go right into the side of the pool. Why I always needed people to walk on my left side, so I didn’t bump into them. Why I got into so many bike accidents, and the tingling in my hands and feet, and the and the migraines where I would go to speak and gibberish would just come out.
Todd asked what could be done. Physical therapy? Acupuncture? A drug?
“I need to perform surgery,” Dr. King said, as if it was the first resort and not the last.
“But it’s not brain surgery,” I said.
“Actually, it’s brain and spine surgery,” said the doctor who had just finished saying he rarely performed surgery. Cue The Facts of Life theme song again.
According to Todd, a team of people were going to go in and
remove my top vertebrae and drain my spinal fluid through the opening, after which Dr. King would go in to shrink or cut out the part of my cerebellar tonsils that were blocking my spinal canal before reinserting the vertebrae.
I was not expecting this. Todd was not expecting this. Dr. Wesley King, Neurosurgeon, clearly wasn’t expecting it, either. After such a nice start.
After such a nice life.
Before I could even process the news, my body was reacting, the tears streaming down my face. Todd put his hand on my back, unannounced. I didn’t even mind that it was hot—his hands get hot, I usually get mad. But instead I leaned into it. Dr. King put his hand on my leg, a lot like Dr. Sung’s hand squeeze, so that was nice. I leaned into that, too.
I asked what would happen if I didn’t have surgery—they were just headaches, after all, and I had to start back on The King of Queens in a couple of weeks.
Dr. King told me he liked that show, and then said that without surgery, the brain stem would eventually move down into the spine so far that it would create a space and become inoperable. And then if I were to get rear-ended again, or even have a bad coughing fit, I could have a stroke and die. Paralysis was also a definite possibility.
At least that’s what he told Todd while I was on the second chorus of The Facts of Life.
Walking to the elevator, stunned, Todd turned to me and said, “I wish it was me instead of you.”
“So do I,” I said, and started to cry again.
• • •
TIMES LIKE THESE, a girl would usually call her mother, who would fly out to be by her daughter’s side—supporting her, holding her hand, protecting her, and letting her know she was going to be okay because mama was there. She’d pet her daughter’s head and help her on and off with her clothes after the surgery while her head was in a giant cast.
I guessed. When it comes to mother-daughter scenarios that don’t involve identity theft and kidnapping, I only know what I’ve seen in movies.
I went for second and third and fourth opinions. Every doctor said the same thing, “Brain surgery is the very last option.” Then they would look at my MRIs and say, “You need brain surgery.”
I told my father first.
“It’s not brain surgery!” he joke-screamed at me, because he was worried.
“It is brain surgery,” I said back.
I called my brother second.
“It’s not brain surgery!” he joke-screamed at me, because he was worried, too. Then he had to go lie down because the mention of even a hangnail makes him squeamish.
My father called six times that first night to yell at me and tell me I was fine. And then another three times to ask me to spell the name of what I had again. And twice to warn me not to Google it.
It was too late for that. I’d already pored over pictures of mangled spines and stories of people with Chiari malformations in wheelchairs and helmets, ramps built onto their houses, paralyzed . . .
I also learned that it was a form of spina bifida—holy shit, there were marches for people like me! When it’s found in babies, they operate right away because it can cause intellectual developmental disorders. Which is how I also learned that Chiari malformation is congenital, caused by poor nutrition and poor prenatal care.
I was born with it. My brain hadn’t formed properly—or completely—because of my mother. Because she didn’t take care of herself. I, like everything else she started, was unfinished. She’d abandoned me before she even abandoned me.
The thought blew me away. Women in her generation smoked and drank their way through their pregnancies, and their kids turned out fine or at worst, alcoholics. What the fuck had my mother been doing? Or not doing—did she not eat one apple in nine months, or take one fucking vitamin??? My mother’s body was so unsafe, I’d wound up with a brain abnormality—which, to be fair, was a damn sight better off than my twin sister, who’d died in there.
I pictured my mother’s womb as a burned-out building in a really dangerous neighborhood. At night—always night. Maybe one streetlight? Littered with garbage, sirens wailing in the distance, and two little, defenseless, innocent fetuses, huddled together, starving, bopping around, looking for an all-night bodega or church . . .
I could not believe that as much as I had spent my life trying to outrun her, always moving, always running, my mother was—quite literally—stuck in my head.
I was not calling my mother.
• • •
THE SURGERY TO have my mother cut out of my brain was scheduled to take place the following week, on the day of Todd’s and my one-year anniversary. “In sickness and in health” had come a lot earlier than we thought.
There was something oddly freeing about it all. Everything was beyond my control. I didn’t have any decisions to make—they had all been made for me. I had to surrender. Rest. I was going to have to slow down and stop running. Or die.
I had to let Todd take care of me. I couldn’t take care of myself. I finally, truly needed him.
And he came through in spades. In a deck of spades, actually. He was by my side for the blood tests and pre-op appointments, and for everything from late-night Boggle when I couldn’t sleep to sitting on the shower floor with me when I was terrified. He met it all with his signature calm, absorbing my fear and panic.
He even absorbed my relatives, answering every one of their calls.
“Tell Aunt Pearl thank you for the coffee maker she got us for our wedding!” I’d call. “Tell Aunt Iris thank you for the blender they got us for our wedding! And we’re so glad they could celebrate with us!”
Brain (and neck) surgery was one hell of a way to get out of writing thank-you notes, but it had its perks.
My dad and Cathy weren’t sure when to come out. They were trying to plan their trip in a way that circumvented the hospital entirely, my father insisting all the while, “It’s not like it’s brain surgery.” At some point, we stopped arguing with him.
Daily, Todd would hold my MRIs up to our living room window and explain my condition to people.
“See . . .? That’s where it’s stuffed into her spine.” He’d point like a doctor. A Jewish George Clooney, I’d say. Jeff did his best but had to go lie down every time Todd got to the word fluid.
I suddenly appreciated everything life had to offer. Flowers blooming, birds chirping, the Hollywood Bowl—an outdoor concert venue that I had always refused to go to because the stacked parking gave me massive anxiety. But at that point I would have given anything to be healthy enough to deal with being blocked in by forty cars, unable to leave the Hollywood Bowl.
The night before the surgery, my suitcase packed, I cuddled up to Olive and said my good-byes just in case. I wanted to make sure Todd was going to be taken care of if I died, so I went through my phone to find him a new mate.
“How about Alison?” I asked my husband, scrolling through my contacts. “Actually, wait—no, she hates dogs. How about Debbie? You sat next to her at my birthday and had stuff to talk about.”
Todd said he didn’t want to date any of my friends.
“What about Julie? She has family money.”
“She’s cute, but no,” he said, which made me furious—I couldn’t believe he waited until I was about to have brain surgery to tell me he wanted to fuck Julie.
Now that he was in love with Julie, I couldn’t decide whether I wanted to watch over Todd as a ghost or not. I definitely would not be attending my funeral. I wouldn’t want to see that first time Todd was able to smile after they’d put me in the ground. Or the first time he took his wedding ring off. How long before he and Julie would hook up? How long before they got married? How long before Olive thought Julie was her mother? How long before she was licking medicinal cracked heel cream off of Julie’s feet?! It was all too much. Now I was desperate to stay alive just to make sure life didn’t go on without me.
• • •
SIX O’CLOCK THE next morning, after no sleep and a silent drive, Todd and I arrived
at the hospital. We went to the eighth floor, where all the serious surgeries happened. It was empty except for a few people slumped in chairs, trying to get comfortable, some still there from the night before and a couple of early arrivals like us. I was nervous, shaking. This was becoming real. I signed a “Do Not Resuscitate” form, which brooked no argument from Todd, and I didn’t even have enough time to be mad before I got my hospital bracelet and my gown.
A nurse came to get me. I left Todd for the first time in a week. For some reason, I assumed he’d be coming with me, like a couples’ massage, but very different. Before I walked off for what I figured might be the last time, I turned to him and said, “Happy anniversary.”
“Happy anniversary,” he said back.
Once on the gurney, they wheeled me into the operating room, where people bustled around preparing to go inside my head. Just another day at work.
Dr. King came in to see me and asked if I was ready.
“It’s not brain surgery, right?” I joked, my lip quivering, changing my mind about all of it. They were just headaches that could eventually kill me but still . . .
The anesthesiologist told me to count backward from one hundred.
Next thing I knew, I opened my eyes. My mouth was dry, I was groggy, my head was heavy. I was in a bed with a yellow curtain around it. In the corner, I saw a man in a black suit and hat, standing there, watching me.
I naturally assumed he was death, come to get me.
“Elizabeth?” he said in a thick accent of some kind. I couldn’t make it out because I was dead.
“No,” I mumbled. “She’s not here.” I closed my eyes, maybe he’d go away . . .
“Elizabeth,” he said again.
“Wrong person,” I answered, disguising my voice as much as I could on a morphine drip.
“It’s Jonathan,” the man said. “Your brother’s rabbi. I came to say hello.”
The next time I opened my eyes, Todd was standing over me, smiling.
“I made it,” I said.
“You made it,” he said. He told me that Dr. King said it went really well and that when he got in there, they saw that the situation was worse than the MRI showed—nearly inoperable. Oh, and that I had a beautiful cerebellum. I gotta admit, I was flattered.