Diagnosis

Home > Literature > Diagnosis > Page 24
Diagnosis Page 24

by Alan Lightman


  “Bill.” She rushed to him, bent over him.

  He remained sprawled on the floor. Then he put his arm around her, drawing her to him. But she pulled back, a strange look on her face.

  “Get up, Bill. Get up. Please get up.”

  He looked at her without speaking.

  “Your arm is bleeding.”

  “Help me.” He raised himself to his knees. Her face still strange and contorted, she helped maneuver him to the blanket-box bench at the foot of the bed. As he struggled to rise, his body twisted toward the vanity mirror and he caught an unwanted glimpse of himself, the head surprising him as always, appearing as if it didn’t fit properly on his slumping shoulders, his mustache, now flecked with gray like the rest of his thinning hair, his loose, white stomach hanging over his undershorts.

  Melissa stood staring at him. “Tell me.”

  He could not answer. Reaching out, he touched the hollow at the base of her neck. Then he took her hand and held it against his cheek.

  “You can’t walk, can you,” she said in a voice that seemed to come not from within her but beside her, like the voice of a ventriloquist. “Bill, oh Bill.” She began kissing him. “This can’t happen to us. Why is this happening?” Her tears dripped down his chest and fell on his dead legs. Then something seemed to snap and she moved from his grasp. She went to the window. After a few moments, she said, “Our life is over.”

  “Melissa.”

  “Oh, oh, oh,” she murmured. “I don’t know if I can take it anymore, Bill. I’m not strong enough.” She turned and stared at him, and the blood vessels were popping out in her face. “You’re throwing everything away. Everything we’ve worked for. Your job, your health, our family. We’ll lose the house. I don’t know what will happen to us. Don’t you get it, Bill? It’s all in your head.”

  As soon as she’d uttered these last words, she looked quickly toward the hallway, as if fearing that she might have been overheard by the workers downstairs, and closed the bedroom door. Now her face was red and wild with animal rage. “You’re doing this to yourself, and to me. Why are you doing this to me?”

  “Melissa.” Bill felt like slapping her.

  “You’re destroying yourself,” she screamed. For a moment, she put her face in her hands. “You just can’t hack it, so you’re self-destructing.”

  “Stop.”

  “And poor Alex so much wants to admire you. But what does he have to admire? You’ve been at Plymouth for nine years now. You should have been a senior partner years ago. Larry Tarsky is running his own company. You don’t see Larry tiptoeing around and waiting for something to happen. He goes out and gets what he wants. And I’ll tell you something. Alex is turning into a tiptoer like his father. He has one friend, and he shuts himself up in his room all day with that stupid computer.”

  “Shut up. Shut up.” Bill’s face was on fire. His anger burned in him and rushed through him, and he lunged for the pineapple fixture atop the bedpost and broke it off with a loud crack of splitting wood and hurled it across the room. “I’ve had enough,” he shouted. “Enough. You think only about yourself. Half the time you’re drunk. So don’t tell me I’m self-destructing. I hate these bay windows. I never asked for the bay windows. I want them stopped. No more money for the bay windows. Okay? No more money. And I hate having the furniture come and go every day. Did you ever think about asking me what I like? I pay the bills.”

  “Do you know how it makes me feel when you say that?”

  For a few moments, he sat there on the blanket chest breathing heavily, his blood gushing through him. Then, he no longer felt angry at her, but angry at himself. With a terrible vividness, he recalled the image he had seen in the mirror. Wasn’t he a flabby half-man as Melissa had said? Hadn’t he allowed himself to be squashed by the senior partners at Plymouth, squashed by Edward Marbleworth, squashed by the world?

  “I was thinking I should go to the hospital,” he said.

  One of the workmen downstairs called up with some kind of emergency. Melissa disappeared for a while, then returned with the remote telephone from the kitchen and handed it to Bill. On the line was Dr. Petrov’s weekend receptionist. “No, I’m not taking Prozac anymore,” Bill shouted into the phone. “Dr. Petrov knows I’m not on Prozac. I’m on Paxil now.” The receptionist explained that she would contact Dr. Petrov as soon as possible. Could his wife get him to the Emergency Room? Could he take any steps at all? Was he in pain? “I have no pain,” he screamed into the telephone. “I can’t feel anything. Can you hear that? I can’t feel anything.”

  Melissa flung herself across the bed, sobbing. He looked at her lying there, her small shoulders rising and falling, and he realized that he had always known she was dissatisfied with him. His eyes moved slowly from the bed to his trousers and shirt on the floor, her nightgown folded over a chair, the bureau where the photograph of her mother receded into shadow.

  Then, his need for her returned stronger than before, now a sharp, sexual need. He pulled himself over the footrail of the bed and lay beside her and put his arm over her bare shoulders. “Melissa,” he whispered to her. He leaned into her and began caressing her neck with the palm of his hand. “Melissa.” She stopped crying but remained face down on the bed. “Let’s make love,” he whispered.

  “Oh, Bill,” she said, releasing a groan of exhaustion. “What are we going to do?”

  He grasped the top button of her cotton sundress.

  “What are we going to do?”

  The hospital smelled of rubbing alcohol.

  NATIONAL PARALYSIS ASSOCIATION

  When Alex came home that evening and saw his father in a wheelchair, he turned pale and covered his face and ran to his room. Bill rolled down the hallway, banging awkwardly into walls and banisters, and knocked on his son’s door. “Alex, talk to me. Open the door.” “No.” “Please open the door, Alex.” “What’s wrong with you?” “The doctors don’t know yet.” “You’re going to die, aren’t you.” “I’m not going to die. I’m okay. Open the door. Please, Alex, open the door.” “No.”

  ————————————

  To: Brad Serano

  From: Alexander Chalmers

  Subject: Re: Regarding

  Mr. Bradford. My father’s in a wheelchair. He can’t walk. A.

  ————————————

  ————————————

  >>> MAIL 50.02.04 <<< From: ACHALM at AOL.COM

  ==> Received: from RING.AOL.COM by AOL.COM with GOTP

  id AQ06498; Sat, 23 Aug 22:13:36 EDT

  for [email protected]; Sat, 23 Aug 22:14:01 –0400

  MESSAGE LOCK OVERRIDE

  >>> MAIL 50.02.04 <<< From: Alexander at AOL.COM

  Dear Dad,

  I did an Infoseek searhc o n the net and found some st uff about paralysis. Is that what you have? I copied it onto the attached file. Love, Alex.

  ————————————

  Paralysis ← Health: Diseases and Conditions:

  Organizations ← National Paralysis Association ← Cure.

  Number of documents found: 10

  NPA Events Navigation Bar

  Exploring a Cure for Paralysis

  NPA Events Calendar

  Christopher Reeve Foundation

  Run for a Cure @ The NYC Marathon

  NPA News

  Preparations for Fall Wine Tasting

  Rise to the Occasion

  Harvest Soiree

  Feathers and Shuttle

  ← Exploring a Cure for Paralysis

  Before an injury, spinal cord nerves can convey signals from the brain to the rest of the body. After an injury, nerves begin to atrophy. The signals can no longer travel.

  Because of research supported by the NPA and others, there has been great progress in restoring nerve function after spinal cord injury and paralysis. We are now living in a most exciting time in the neurosciences. The purpose of the NPA Home Page is to s
hare recent progress and breakthroughs in the treatment of paralysis.

  The spinal cord is a thin and delicate combination of nerve cells and nerve fibers connecting the electrical activity of the brain to muscles in the body. Trauma to these nerves can cause severe damage, resulting in a breakdown of the nervous impulses and paralysis. Some axons degenerate and others die.

  However, scientists have discovered some measures to aid in nerve regeneration after injury. These studies show that nerve fibers can regenerate. Dr. Martin Schwab at the University of Zurich in Switzerland has developed an antibody called IN-1 which neutralizes the inhibitory protein in the spinal cord. Combining IN-1 with the nerve growth factor NT-3 has been found to cause nerve fiber regeneration in the spinal cord of rats.

  ————————————

  >> MAIL 50.02.04 << From: Petrov at MGH.HARVARD.EDU

  ====> Received: from TAR.HARVARD.EDU by HARVARD.EDU with BFP

  id AQ74078; Mon, 25 Aug 9:18:27 EDT

  for [email protected]; Mon, 25 Aug 9:18:39 –0400

  Press * for message

  >>> MAIL 50.02.04 <<< From: Petrov at MGH.HARVARD.EDU

  Dear Mr. Chalmers,

  Im very sorry abut the wrosening of your condition, but I am still hopeful. (1) I will reserve some time on the cyclotron so that we can do a PET scan. (2) YOu sould of course return to Dr, Kendry for another neurology examination and my office will schedule that. (3) As you know, I’ve been in touch with Dr. Jeffrey Soames at Mayo, who is department head of Autoimmune Diseases and president of the Autoimmne Diseases Asociation of America. Commonwealth Health has refused to authorize his consultations, but he has taken a personal interest in your case. Dr. Soames now recommends some internventions enven though we don;t yet have a diagnosis So, I’m scheduling a plasmapheresis, which will replace all of the plasma in your blood, and a steroid program. (4) Finally, the really good news! By a stroke of luck, Dr. Soames is flying thorugh Boston next wek on his way to a confernce in London an has agreed to stay over a few hours to see you. WE wil try to shedule theplasmapheresis at this time, to save you an extra trip to the hospital.

  With good wishes, Armand Petrov, M.D.

  ————————————

  ————————————

  >>> MAIL 50.02.04 <<< From: Harnden at PENN.MED.EDU

  ==> Received: from RING.AOL.COM by AOL.COM with BFP

  id MS84093; Mon, 25 Aug 15:23:49 EDT

  for [email protected]; Mon, 25 Aug 15:24:13 –0400

  Press * for message

  >>> MAIL 50.02.04 <<< From: Harnden at PENN.MED.EDU Dear Bill,

  I was shocked to get your message. Why didn’t you tell me earlier about what’s been going on? You’ve got the best doctors in the world there, but I’m going to talk to some people I know here in Philly and the med school if you don’t mind. Contact me immediately if there is anything I can do. I’d like to come see you if you’re taking visitors. Let me know. I can be there in 6 hours. If you don’t ask me to come in the next few weeks, I’m coming anyway.

  Peter

  ————————————

  ————————————

  >>> MAIL 50.02.04 <<< From: Roe at WELLES1.COM

  ==> Received: from RING.AOL.COM by AOL.COM with BFP

  id JC49705; Tues, 26 Aug 14:01:19 EDT

  for [email protected]; Tues, 26 Aug 14:01:57 –0400

  Press * for message

  >>> MAIL 50.02.04 <<< From: Roe at WELLES1.COM Dear Bill,

  Maggie and I were very sorry to hear that you’re in a wheelchair. Please let us know if there is anything we can do. Our thoughts are with you.

  Stephen

  ————————————

  A vase of flowers with a note arrived from Amy. And e-mails from George Mitrakis and David Hamilton, carefully worded, expressing regrets.

  That evening, as Bill slumped in his wheelchair and ate his dinner from a tray, Melissa suddenly began talking about her mother, how she looked at different times, trips they had taken together when the family was young. “We used to go to a place in Florida, before we lost the store and everything. You could see the ocean from the front window. You could smell the salt in the air. We ate breakfast on a little porch, and she used to ask me for words for her crossword puzzles.”

  “Harriet liked the ocean.”

  “You were so sweet with her, Bill.” Melissa stood up, her eyes teary. “Thank you for that. Nothing’s fair, is it. Daddy told me nothing was fair, and he was right.”

  She stooped and gathered up the spilled food on the rug and picked up his tray. “What else can I do for you right now? Have I done enough?” She leaned against the bedpost and closed her eyes. “I’d like to go out for a few minutes.”

  “Do you hate helping me?”

  She moved toward the door. He knew she was going to the liquor store. He couldn’t blame her. “Now they think I’ve got an autoimmune disease.”

  “Well, well,” she said. “That’s good to know. I’ll be back in a few minutes. We should sue Plymouth. If you don’t, I will. The disability insurance, even if we get it, is nothing.”

  As he heard her car pull out of the driveway, the telephones began ringing. Instinctively, Bill wheeled himself to the writing table but saw that the phone had been removed from its base. He turned and listened. Was it coming from the closet? “Alex,” he shouted, “get the phone!” The telephone continued to ring, and he wheeled himself bumping across the floor to various corners of the room, to the closet, and yanked open the door. Melissa shouldn’t have left the phone in here, he thought angrily to himself. She was always taking the phones off someplace. Who could it be on the phone? It could be anybody. “Alex,” he screamed. Without thinking, he had been counting since the phone started ringing. Thirteen, fourteen. He bent down in his chair and flung clothes aside. The ringing was coming from somewhere in the back of the closet. Sixteen. By now, the answering machine should have picked up, but it hadn’t. The answering machine must be broken. Eighteen. Why was he chasing the goddamned phone? Let it ring. Let the stupid thing ring. He slammed his hand against the wheelchair. Where was the phone? He shoved himself further into the closet. Shoes got under his wheels, he swung at hanging dresses and suits.

  PLASMAPHERESIS

  The cell separator looked like a portable washing machine. A clear plastic tube, red with flowing blood, looped away from the needle in Bill’s right forearm and into the machine. Another tube returned cleansed and reconstituted blood into the left arm. Bare plasma, stripped of its red and white cells, was the color of straw. It tasted like seawater. Even his blood was no longer his own, Bill thought to himself. He was a part of the machine, one giant circulatory system. Veins connected to tubes connected to veins. One pint of blood at a time, ten pints in two hours. The thumping of the pump sounded like a human gulping for air. Or was it his heart?

  He lay on his side and stared at a photograph on the drab plaster wall, “MGH Nursing Staff 1911.” A hundred nurses posed in front of the old stone hospital, each identically dressed in a white cap like an inverted flowerpot, a white collar encircling the neck, a dark, long-sleeve shirt buttoned up to the collar, and over that an apron-like white top that concluded in a flowing white skirt. All clasped their hands purposefully in their laps and looked straight ahead at the camera. Tears came to his eyes.

  Melissa sat beside his hospital bed and was saying something about getting Alex ready to start back at school. Thursday. High on the wall, a television droned.

  He could hear Dr. Soames’s assistant, who had arrived in advance to make all necessary preparations for the examination. The assistant was searching about the cramped hospital room for a telephone jack into which he could plug his modem and laptop. He rolled Bill’s bed away from the wall, poked behind a sink, inspected an electronic panel with illuminated numbers. “Dr. Soames likes to use his own database in Minnesota,” he said.

  “We have excellent data sources of our
own,” said Armand Petrov.

  “Please,” said the assistant. “And he’ll need a tall table for working. He never sits.” Immediately, a nurse commenced to clear a metallic stand of its boxes of disposable white rubber gloves. A coiled blood-pressure cord, with its protruding black bulb, fell to the floor. An orderly raced down the hall, shouting and wheeling a bed.

  Uncomfortably, Bill turned over, tangling the tubes in his arms, and stared at the bed next to him. A curtain surrounded its patient, but he could see a woman’s hand hanging down and could hear her tortured breathing through an oxygen mask. A nurse floated into the room like a starchy ghost, went behind the curtains for a few moments, and disappeared.

  There was a commotion in the corridor outside the room. Someone began speaking in a restrained voice to a nurse. A taxi was to be waiting at the Emergency circle in fifty minutes. Then Dr. Soames made his appearance, flanked by two nurses, his assistant, and Dr. Petrov. The Mayo specialist was dressed in a dark-blue pinstriped suit, as if ready to deliver his lecture in London at any minute. He smiled faintly at Bill. Then he proceeded at once to the table where his laptop had been set up, chest high, and went to work. Soames’s assistant and Dr. Petrov peered over his shoulder as information surged through the modem, shimmered for forty-five seconds on his screen, and was printed out noiselessly on the attached laser printer.

  After a few minutes, Soames said, “Bring me more paper.” His assistant flew from the room and down the adjoining corridor.

  “Has he touched you?” Melissa whispered to her husband.

  Removing his jacket, Soames pored over the flitting images and data on his computer screen as if they were diagrams of enemy military installations. Radiology and neurology were not his specialties, but he wanted to have all the information available. His specialty, the assistant explained, was autoimmune diseases, in which, for unknown reasons, the body attacked itself, the body turned into its own enemy: lupus, where the body assaulted its connective tissues, causing painful joints, fatigue, a slow downward spiral; Guillain-Barré syndrome, in which the peripheral nerves became inflamed, particularly where they exited the spine, leading to numbness and weakness of the limbs, a sagging of the face muscles, difficulty swallowing and breathing, and eventually paralysis; multiple sclerosis, in which the immune system slowly destroyed the protective myelin sheath around the nerve fibers in the brain and spinal cord, causing tingling and numbness, muscle weakness, slurred speech, intermittent blindness, difficulty walking, and often death. Others: rheumatoid arthritis, myasthenia gravis, fibromyalgia, ankylosing spondylitis, Ménière’s disease, Wegener’s granulomatosis, Goodpasture’s syndrome. Some could be treated.

 

‹ Prev