Anatomy of a Miracle

by Jonathan Miles

  It’s easy to get carried away with Lorimar lore—invoke his name at the bar at Greenwood’s Alluvian Hotel, and the room is instantly transformed into a trading floor for ever more outrageous stories—but of more immediate interest is Winston Lorimar’s effect on his daughter, Janice. “My father is a”—she drums her fingers through a long pause—“complicated man,” is how she wades into the subject, with much the same wincing one does when entering chilly surf. She speaks fondly of him, but with an almost constant rolling of her eyes. Pride and embarrassment, teamed respectively with affection and resentment, seem to wrestle inside her, yielding such ambivalences as, “He’s a genius of self-destruction.” She can sometimes seem riven by a wish to avoid talking about him and a competing impulse, fitfully suppressed, to talk of nothing but.

  Discussing her mother’s cancer and the direct link it must’ve had to her medical career, for instance, she quickly pivots to her father and all his dissembling about it. “I think that’s where my limited tolerance for metaphor might have come from,” she says. “Dressing up a fact doesn’t change it, or benefit it in any way. It just obscures it.” On this point she is strictly and astringently Sontagian: Metaphor and symbolic language do a disservice to our thinking about illness and suffering. Injury and disease are not imaginative; neither should our approach to them be. The extended implication is that her father’s masquerades did a disservice to her, as a confused and grief-stricken ten-year-old child, though this is where the aforementioned dismissive wave comes in. “I also have a limited tolerance for that kind of pinpoint psychological causation,” she says. “There’s no doubt that my mother’s illness and the way my father handled it were correlative factors in my going into medicine, and in the way I think about medicine and practice it. But I don’t think it’s accurate to suggest that if Mom hadn’t gotten cancer, or if the doctors in Greenwood hadn’t screwed up her diagnosis, or if my father hadn’t pulled all that wool over our eyes—that if all that hadn’t happened, I wouldn’t be who I am today. I don’t believe her cancer somehow rewired me.”

  For proof, she cites the tensions that often arose—before her mother’s death—during walks in the woods with her father. “There’s a cypress swamp on the farm,” she explains, “down toward the river bottom, and I can remember—gosh, I must’ve been seven, maybe eight—trying to figure out why cypress trees have all those stumpy knees around their trunks. Which is something plant physiologists still haven’t been able to answer, by the way—I was a pretty nerdy little girl. But there’s my father spinning this elaborate explanation about swamp fairies that go about binding young trees like—this is him talking—‘like chinawomen’s little feets.’ I can still conjure up the exasperation I felt. It was almost—livid. I was just like, please, Daddy, can’t you just play it straight once in a while? Or another time, up in the dogwoods. Maybe a little bit later, a year or two. Springtime. The dogwoods’ trunks are all soaking wet, and when I taste the liquid it’s super sweet, so I get this idea—probably not a great one—to try to make dogwood syrup. Like, for pancakes. But my father says, ‘That’s not sap, it’s tears.’ Dogwoods start weeping every year right before Easter, he says, because they’re ashamed that wood from dogwoods was what they used to make Jesus’s cross. Which he said is also the reason dogwoods grow slender and twisted, so they can’t ever be used for another cross. I must’ve been nine years old and I swear I wanted to shake him. I just wanted to know if the sap might make good pancake syrup, and there he is going off about the goddamn crucifixion.”

  Inside the family, however, this frustration of hers was a solitary one. Her three brothers all reveled in their father’s magical, fib-spangled thinking, willfully and delightedly gullible. (Randy recalls drawing derisive hoots when, in first grade, he quoted his father’s claim that hot dogs grow on trees, but also recalls being unbothered, because the idea of sausage orchards struck him as preferable to the gruesome reality.) As early as grade school, Janice was already recognizing herself as the family outlier. She’d been born in New York City, for starters, and not the Mississippi Delta; with her black hair and dusky Semitic complexion and string-bean frame, she looked different than her brothers, who all bore the sandy-colored hair and pink-splotched skin and ungovernable belly of their father; and, with her analytical bent, she was the left brain to her brothers’ more intuitive right brains (though Janice would no doubt object not only to this metaphor but to the misconception of brain-function lateralization underlying it). Her grades were uniformly superb, she breezed through high school without drawing so much as a single period of detention, she steered clear of drunkenness until the third night of her freshman year at Tulane University and then never got drunk again, she graduated cum laude from the University of Pittsburgh School of Medicine, where she was elected to the Alpha Omega Alpha Honor Medical Society, and then (for the financial incentives, ever the pragmatist) she completed a Family Medicine residency with the U.S. Army in Washington, D.C., where she found a deep and stable satisfaction working within the strictures of the military system, and where she also met a Mississippi congressional aide named Nap whom she married in an elaborate outdoor ceremony at the Lorimar Plantation—all this, and she’s still somehow the black sheep of the Lorimar family. The one nobody quite understands.

  It’s not precisely true—and in one way it’s cruel—to say her brothers followed in their father’s footsteps. But most would agree they’ve canted his direction. The oldest, Tay, is a fine art photographer, currently living in Spain, who’s best known for a series of eroticized, tungsten-lit portraits of elderly nudes. The middle brother, Randy, is a studio percussionist in Nashville. The youngest, Johnny, set out to be a writer, but suffered a near-fatal heroin overdose just three months after entering the master of fine arts program at Columbia University in New York. Several relapses, and a withdrawal from Columbia, have followed; since his last relapse, he’s more or less cut himself off from family contact. Talking about Johnny’s addiction seems verboten in the Lorimar family. Talking about Janice’s life, on the other hand, is family sport. “General Janny, yeah, I guess we give it to her pretty good,” says Randy. “She’s always been sort of the resident authority figure in a house full of antiauthoritarian dudes.”

  “My father says I’m incorrigibly square,” says Janice, imitating his fustian Delta drawl (“in-CAW-gibly SKWAIR-uh”). “That I’m all data and no dreams. But that’s okay with me. I like data. My father would run screaming if he heard me say this, but there’s magic in data. I’m serious: magic. And the best part is—it’s magic you can see.”

  Which leads us back to August 26, 2014, when Dr. Janice Lorimar-Cuevas, following her morning rounds at the Gulf Coast Veterans Health Care System, plus a tiresome meeting of a medical direction committee she was regretting having joined, ducked into her office and cracked open her laptop. The office is small, spartan, and over-bright with a light that feels unnatural. “Government drab” is how she describes it, in fair summation. She tapped in the passcode to access the Department of Veterans Affairs VistA electronic health records database. Needing to see a very specific variety of magic, she typed in a name.

  HARRIS, CAMERON TIMOTHY. Her gaze hopscotched across the same standardized category windows at which she glanced twenty, thirty times daily: ALLERGIES/ADVERSE REACTIONS; ACTIVE MEDICATIONS; ACTIVE PROBLEMS (one of these could apparently be subtracted now, she thought, and it’s a doozy); CLINICAL REMINDERS; RECENT LAB RESULTS; VITALS. Janice had never had cause to analyze Cameron’s injury. He’d been assigned to her for outpatient rehabilitation and care continuum after his treatment at Brooke Army Medical Center, as something of a closed case. VA SCI STATUS: PARAPLEGIA-TRAUMATIC. CAUSE OF SCD (ETIOLOGY): ACT OF VIOLENCE. His paralysis wasn’t the result of transverse myelitis or some other elastic cause; from what she understood, he’d been struck by shrapnel from an IED. She surely must’ve scanned his records to determine any eligibility for new rehab therapies—GCVHCS was one
of a dozen VA hospitals experimenting with exoskeleton suits that granted paralyzed patients the ability to walk with robotic assistance—but she didn’t recall doing so. That in itself wasn’t troubling; she had hundreds and hundreds of patients under her care, and, as she sometimes joked to Nap, memory enough for barely a quarter of them.

  But Cameron she remembered, and liked. In a way he reminded her of her brother Randy: all bark, no bite. As a VA physician, she’d already seen more tattoos than most doctors see in a lifetime, but Cameron’s stood out in her memory: an illustration of a soldier wielding an M4 carbine, but with feathered angel wings on his back, that extends down Cameron’s torso from his right breast to his waistline. She’d never read the accompanying text, running across the left side of his torso, in capital letters justified to the contours of the wing, except for the top line—ST. MICHAEL THE ARCHANGEL, DEFEND US IN BATTLE—and the bottom line: AMEN. But something about the tattoo struck her as incongruous, as she got to know Cameron. It reminded her of the wispy mustaches boys tried growing back in high school—mustaches intended to project manhood, but that more often called attention to a lack thereof. On Cameron, the tattoo seemed like more of the brittle shell with which he tried masking a gooey, sensitive center. She’d found an endearing vulnerability to him, once you dug past that shell—or got past his sister, for whom Janice felt considerably less affection. One of Janice’s earliest encounters with Cameron concerned pressure ulcers he’d developed from sitting in his wheelchair. He kept apologizing for the sores as though he’d disobeyed an instruction, despite Janice’s patient reassurances that they were a normal condition. His sister, however, showed much less patience: “Stop apologizing for your damn ass,” she scolded him, something Janice quoted later to Nap for a dinnertime chuckle. Tanya Harris was a mynah bird during consultations, repeating everything Janice said—at times she’d repeat one of Janice’s questions, consider it for a spell, and then answer for her brother, Cameron shrugging in mute-buttoned agreement. Janice’s own brothers, she thought, would never tolerate that degree of big-sistering; within minutes she’d be wearing a stripe of duct tape over her mouth.

  Finding nothing to snag her interest in the general records, she clicked to access VistA’s Spinal Cord Dysfunction package, or SCD. Here were more detailed transcripts of Cameron’s immediate post-injury treatment and rehab, and also, more important, his imaging reports. This was the raw data she was after: the X-rays, CT scans, myelograms, and MRIs. She fetched a protein bar from a desk drawer and gnawed it absently while examining image after image, until a deep frown buckled her forehead and her mouth stopped in mid-chew. She expanded one image window to study it, and then expanded another. Then she sized them to appear side-by-side on the screen, the neglected gob of protein bar in her open mouth beginning to dissolve. Barely shifting her eyes from the screen, she dialed a number on her cellphone. “Got a second to look at something strange?” she asked.

  While waiting, she wandered deeper into Cameron’s records. She looked at his Neurolevel-Sensory and Neurolevel-Motor scores, finding nothing out of the ordinary there. She made some comparative glances between his Inpatient Rehabilitation Outcomes (which charted the levels of assistance he required for basic life tasks such as eating, grooming, toileting) and Cameron’s Self Report of Function records. GET TO PLACES OUTSIDE, SHOPPING, DOING HOUSEWORK: WITH HELP, was his answer. HANDLING MONEY: WITHOUT HELP. (Hardly anyone ever copped to needing help handling money.) EMOTIONAL STATUS: NEEDS SUPERVISION. His Satisfaction with Life score, she noted, was particularly low, but this came as no surprise. Some of these guys charge back hard against their injuries—they’re the ones playing wheelchair basketball or sit-skiing down some icy slope, the ones roaring and sweating through their physical therapy sessions, the ones brandishing a thumbs-up in every snapshot taken. Others, like Cameron, just crumple. Now that Janice considered it, he seemed as afflicted by something like heartbreak as much as by paralysis—as if he’d lost something even more precious than his mobility over in Afghanistan.

  A knock followed by her office door swinging open cut off this thought. Dr. Vishwesh “Jimmy” Patel, the center’s chief of radiology, was responding to her phone call with his typical brusqueness. Dr. Patel is a short, gangly man with conspicuously long arms, and their wingspan, along with the prominence of his large beakish nose on a narrow face that looks incapable of expressing amusement, gives him the impression of a raptor, albeit one dressed in a lab coat. The quick and concentrated way he analyzes imagery only augments this impression: His focus evokes that of a falcon canvassing a field from five hundred feet in the air. Without greetings or pleasantries he went straight to Janice’s laptop, as though swooping down on a rodent. “What am I looking at?”

  “So check out this MRI, from back in twenty-ten,” Janice said. “And then this one, from oh-twelve. Patient is a T9 complete.”

  Patel toggled his gaze from one to the other. “Oh-ten, oh-twelve.” Then he wagged his head. “No way. You’re sure these are from the same patient?”

  “Yep.”

  He blew air from his cheeks. “Huh.”

  “So you’re seeing what I am.”

  “Well, I don’t know what you’re seeing, but I’m seeing something”—he pursed his lips and paused, clicking to expand an image—“very not right.”

  “Then you are seeing what I am.”

  He shook his head again. “The image dates have to be wrong, that’s all. Because, look, if you flip the dates, we’re just looking at axonal retraction.”

  “The more recent one is ours,” Janice said. “And the other one came from Brooke. Patient went from Landstuhl to Brooke before coming here.”

  “No, we’re looking at a mix-up of some sort. The dates are wrong, or the scans are from different patients.”

  “Let’s say they’re not.”

  “Is this a game?” Annoyance darkened his face. “Okay, I’ll drop into sci-fi mode. If the scans are correct, then what I’m looking at is movement of integrin vesicles inside an axon growth cone.”

  She nodded. “Cord regrowth over and around the glial scar.”

  “Right,” he said, “yes, but that’s not—obviously that doesn’t happen. It’s—not possible.”

  Again Janice nodded, more crisply, as though he’d just confirmed her own interpretation. “Exactly.”

  Patel unbent himself from studying the screen on her desk to face Janice. “I’m a little confused here,” he said. “If you’re asking me what I see, I see an enormous probability of incorrect labeling. Either one of the image dates or the patient ID is wrong. Explain to me why we’re playing this game.”

  “What if I told you the patient supposedly walked a few days ago?”

  He stood silently for a moment, the slow expansion of his eyes suggesting the digestion his brain was struggling to accomplish. Then he leaned back down for another look at the MRIs, emitting a chilly, nervous laugh. “This oh-twelve, is this the most recent scan?”

  “It is,” Janice answered.

  “Is there a DTI scan?”

  “Was never done.”

  “We should get one,” he said quietly. Then he waggled his head again, as though to revive himself from a trance. “The labeling has to be wrong. There’s no other—you said supposedly. How do you know the patient walked?”

  Ten minutes later she was on the phone with Cameron.

  “I saw the newspaper,” she told him. “Wow. How’re you feeling?”

  “Honestly, doc?” She could hear loud music in the background, and in Cameron’s voice she thought she heard a trace of slurring; she imagined a party, now into its fourth day. “Motherfucking fantastic.”

  “That’s great. I mean: wow, right? Will you tell me what happened?”

  So he did: I just stood up, he said. “My belly felt funny, I got all queasy and shit, and then, I dunno, I stood up and walked. I walked. Like I am fucking
walking right now.” She quizzed him on the details, asked him to retell it all to her more slowly, but every time he rushed to that same final crescendo: “I walked, I’m walking. It’s almost like—like nothing ever happened. End of story, right?”

  She exhaled into the phone. “Not exactly, no,” she told him, staring at the MRI images on her screen, all those rainbows of data. “Cameron, how soon can you be in my office?”

  three

  What does one do after experiencing a miracle? The Gospels of the New Testament, to examine the most conspicuous source, are stingy with details about the aftermaths of Jesus’s purported healings. Those who were crippled, blind, paralyzed, deaf, hemorrhaging, mute, dropsied, fevered, withered, or lepered: After recounting their healings, the Gospels’ authors tended to hustle these beneficiaries off the page, for the most part dispatching them, as in Matthew 9:31, to “spread about [Jesus’s] name in all that country.” Even the posthumous fate of Lazarus, whom the Gospel of John alleges Jesus resurrected after Lazarus had lain dead in a tomb for four days, is left open, the Gospels turning aside their attention to let Lazarus wander dazed into the sunset. “And he that was dead came forth, bound hand and foot with graveclothes, and his face was bound about with a napkin,” goes the King James version of events. “Loose him,” Jesus commanded Lazarus’s sisters, “and let him go.” But go where—and do what, exactly? In a later chapter he’s seen having dinner with Jesus in Bethany—one hopes Lazarus thought to pick up the check—but this fleeting cameo is all the scriptures provide. It seems too much to ask that a man raised from the dead could merely resume life as it was, to go, as Jesus ordered, after such a full-tilt cosmic stop: to complete the fencing for the livestock pen he was building before his illness struck, for example; or to curse the sandal that falls apart just two weeks after its purchase; or to sleep restfully in the same bed where just days or weeks before he lay dead. Or is it too much? What else could Lazarus do?