Prognosis

by Vallance, Sarah

  “Okay. I’ll buy them tomorrow.”

  “Actually, you need a whole new kitchen. I’ve never seen anything more disgusting.”

  And you thought there was nothing more disgusting than a dog peeing inside the house, I wanted to say.

  I realize that some people in this world find animals more disgusting than people. I’m just not one of them. If a human had diarrhea in my kitchen I’d be selling the house. I gag while cleaning a dog’s mess, but I can manage.

  “If that happens again, I’m moving out,” Laura said.

  “It won’t happen again,” I said, knowing full well it would. “Don’t worry. She must have eaten something in the park that made her sick.”

  “Fine, but why did she do it on the sink?”

  It was a reasonable question. “I really don’t know.”

  I cleaned everything up, tossed out everything that wasn’t fixed to the walls, and took the dogs to the park. I found a bench and talked to Bess.

  “You can’t keep doing this, Bess,” I said. “It’s serious now. You have to find another way to cope with your stress. Do you understand?” She nodded her head in agreement, licked my hand, wagged her tail, and hopped up onto the seat beside me. “I have to work, Bess. We need the money to pay off the house I bought you,” I said.

  I understand, she seemed to say. I’ll try to calm down.

  Six months passed and the problem only worsened. I hid it from Laura as best I could, but it placed a considerable strain on our otherwise surprisingly healthy relationship.

  “Put her down,” Laura told me one evening, after she overheard me on the telephone discussing Bess with my mother. “It’s the kindest thing.”

  I refused to speak to her for twenty-four hours.

  Then she said it: “She goes or I go.”

  “Go!” I shouted. As soon as I said it, I wanted to stuff the word back inside my mouth.

  “Think carefully, Sarah. Do you want me to leave?”

  “No,” I said. The prospect of Laura leaving terrified me. She was my one chance at a normal life. But I loved Bess, and I couldn’t bear to lose her either.

  Each day when I got home, I dumped my bag on the dining room table, went straight to the kitchen, pulled on a clean pair of plastic gloves, and scrubbed every surface. It was starting to take a toll on me. Why is Bess so stressed? I wondered. I wish I could have filmed her somehow to see how it all started, but webcams hadn’t been invented yet. I put it off as long as I could, and then one afternoon I found myself at the veterinary surgery again. It was a spontaneous thing. I’d had a bad day and returned home to a kitchen that looked and smelled like a dysentery ward in Calcutta.

  I walked in and asked the vet for her opinion.

  “We’ve seen an animal psychologist, tried the Rescue Remedy, tried leaving her alone in short snatches. Nothing has worked,” I explained.

  “Put her down,” the vet said.

  Bess was roughly twelve. She had lived a good life with me, I told myself. But I couldn’t possibly kill this dog.

  The separation anxiety she experienced was causing her such distress that from 8:00 a.m. until 5:30 p.m. each weekday, her world would close in and she was swamped by terror, which wasn’t good for her. Laura had given me an ultimatum: Bess goes or she does. I was stressed. Bess was stressed. Laura was stressed.

  It took all of an hour for me to arrive at my desperate decision. At the time, it seemed to be the right one to make. I walked the ten steps back home and collected Bess while tears rolled down my cheeks. At the vet I lifted her onto the table, held her head, kissed her nose, and told her I loved her. She lifted her head slightly and licked my face while the vet slipped a needle into her leg. She was gone.

  I was gone too. The vet asked for money, but I was crying so hard I thought I was going to vomit. We made arrangements for Bess to be cremated and her ashes to be returned to me in a small silver urn. Back home, I lay down on the sofa and sobbed. George jumped up beside me. What happened? he seemed to ask. I buried my head in his fur and told him.

  “I killed my dog,” I told Laura when she got home. “Happy?” She had never seen me cry before and now I couldn’t stop.

  “I’m sorry,” she said, “but you did the right thing.”

  “I did the right thing for you,” I said.

  I hated myself. It was the same self-loathing I experienced when my father asked me to help him die. I loved Bess as much as I loved Laura. And I chose Laura.

  Watching Bess die reminded me how easy death could have been for my father. I cursed myself for my lack of courage. A single needle prick, an infusion of morphine, his pain gone. Bess neither wanted nor deserved to die, and I had killed her. My father wanted desperately to die, and I kept him alive, prolonging his suffering. Grief for Bess seeped into my grief for my father.

  Laura and I had lived together only seven months, and I had killed my dog to keep her. I began to believe Laura would leave me and I would be even more broken than before. I tested her and prodded her to make sure of it. I deluded myself into thinking I no longer even cared.

  With Bess dead, I insisted that George be allowed on the bed for cuddles on Saturday and Sunday mornings.

  “No,” Laura said.

  “Yes!” I shouted. I thought my sacrifice had placed me in a position of strength. On Saturday mornings when I woke, I whispered to George, inviting him up to lie alongside me.

  I am not sure how, given everything that had happened with Bess, but Laura and I managed to survive the first year of our relationship. We had fun together. Little things reduced us to tears of laughter. I realized how lucky I was to have her, and not just because she was a good cook who made me laugh. She was normal, by my standards anyway. I was a person with a damaged brain, and I suffered from the familiar symptoms of depression, bitterness, anger, and an inability to control my impulses. I was difficult. Why she stayed with me was a constant source of wonderment. I felt sure that she could do much better. She would leave me for someone else, at some point, I was convinced of it. And I couldn’t blame her if she did. Until then, I embraced the fact that I was a much happier person with Laura than I was without her.

  7

  BUILDING A NEW BRAIN (PART TWO)

  Work on my PhD slowed after Laura moved in. Stopped, in fact. Laura had always been encouraging of my studies; it was me who had grown lazy.

  “You’re going to finish that damned PhD, Sarah Vallance, if it’s the last thing you do!” she announced one Sunday morning after I emerged from my study five minutes after I entered it to suggest that a nice lunch out might increase my productivity.

  It’s a universal truth that the person who shares a home with a person who is completing her PhD part-time, even under normal circumstances, suffers. That diminished happiness shrinks even further when the candidate also happens to be recovering from a traumatic brain injury. Not only was Laura forced to suffer life with a depressed person who was prone to inexplicable bouts of rage and craved sex constantly, but she also had to endure living with a PhD hanging over our heads like a rope. It was more than any person should bear.

  My mother, back in the picture thanks to Laura, made her position clear. “Drop it. You don’t need a PhD!” she said, which made me realize I had no choice but to finish it. I did need a PhD. One life lesson I had learned was that my mother’s advice was rarely in my best interests. Finishing the PhD was a critical step in reclaiming my life, and it had become vital for my self-esteem.

  I got back in touch with my doctoral supervisor. He’d assumed grief over my father’s death was responsible for my hibernation. I feared that if I was truthful about my accident, he might question my ability to graduate. I questioned that too. Luckily for me, doctoral students take time off from their research for all kinds of different reasons. Grief over a parent’s death was as convincing as any of them.

  Laura marched me into my study each Saturday and Sunday morning and commanded me to work. If only it were so simple, I thought. To prev
ent me from leaving my study, she tied me to my chair with a long cotton scarf so that I couldn’t move anything but my arms. My challenge became more about breaking free rather than working. I turned out to be quite the escape artist. More than once Laura happened upon me lying on the floor spooning George, serenading him with the Carpenters’ “Top of the World.” Another time she found me tucked up in bed, pretending to sleep. When she discovered me straying from my research, she would drag me back inside the study and secure me in place with the scarf around my waist and a leather belt around my thighs strapping me to my seat for good measure. I couldn’t move. She would lock the door from the outside and leave.

  My mind wandered. When doing a PhD, almost anything seems more interesting than the research, but I even had difficulty focusing on my distractions. Each one was pasted upon the last to create an elaborate distraction collage—a bird calling out, upon a neighbor opening a window, upon a car door slamming—until I had lost all sense of whatever I sat down to do. I struggled to clear my mind of the chaos inside.

  During my first field trip to Singapore, Thailand, and the Philippines, before my father died, I had filled a pile of notebooks with my own observations, interview notes, and scribbles from publications I had discovered in government offices and university libraries. I had started to type up my notes not long after I returned from that trip, but my father’s illness meant I had not finished. In a desperate attempt to focus, I decided to work my way through the remaining notes, writing at least one sentence from each bullet point scribbled inside a page of my notebook. Some of my notes made no sense at all. I couldn’t read my own writing, or the words and symbols I had scrawled across the page while attempting to record the salient points of an interview turned out to be gibberish. I studied my scribbles and attempted to turn them into meaningful sentences. For example, Phil Gov emp extra jobs < income became Many government employees in the Philippines are forced to supplement their income by taking second jobs or participating in the underground economies which exist within the civil service. It was a slow and frustrating process.

  One weekend, when I had sat at my desk for more than two hours and achieved nothing, Laura had a brain wave. “Break it down into small chunks,” she suggested. “Make a list of exactly what you want to achieve with each chapter you are working on.”

  That struck me as pure genius.

  “Then work your way slowly through each list. Cross things off as you finish them.” She sat with me and showed me what she meant, taking a particular chapter and drawing different colored circles on a page, filling each circle with different ideas and connecting them to one another. It was a form of wizardry. Slowly, I was able to weave the various threads together in the semblance of an argument.

  On the hour, Laura brought me a snack—a caffe latte from the coffee shop across the road, a piece of cake she had baked, a cappuccino, a panini, a bar of Toblerone, some pieces of licorice. At six p.m., whether I had spent the day productively or not, she would appear holding two glasses of champagne. It was selfless, an act of kindness for which I will be forever grateful. Yes, she had pushed me toward killing my dog—a dog I missed every day—but she had pushed me toward a great many good things too. It made no difference to Laura whether I graduated or not, but she understood that it would make an enormous difference to me.

  After months of work, snacks, and champagne, I finally finished. I knew it was bad, but I was hopeful that my examiners would flick through it carelessly, as legend said some do, or, if I was truly lucky, skip the second shoddily constructed case study altogether. Somehow, I had always managed to scrape through by the seat of my pants, and I expected I would do it again. It was, after all, a miracle I’d made it this far—even if only Laura and I understood that. I had managed to write a doctoral thesis with a damaged brain! I submitted it and hoped for the best.

  “Let’s go overseas,” Laura suggested over breakfast at a local café the Saturday after I submitted my thesis.

  “We could use a holiday,” I said.

  “No, I mean go overseas to live.”

  “What about George?” I asked instantly, looking down at George asleep on the ground with his head on my foot.

  “Bloody George! Does George mean we will never go anywhere?”

  I stroked him behind the ears and hoped he wasn’t listening. “Not unless Mum will take care of him while we are gone,” I said.

  “Wouldn’t you like to experience a different culture? Live somewhere else?”

  “I’m okay here,” I said, and I meant it.

  She rolled her eyes and groaned. “Jesus! What is wrong with you?”

  “Where would you like me to start?”

  “You’re a pain in the ass,” she said, and got up to leave.

  “I know,” I said, unraveling George’s lead from the spine of the table. “But I don’t mean to be.”

  I couldn’t explain why I had become so reluctant to venture far from home. Before my accident, I was eager to leave Sydney. The reason I had chosen my PhD topic was so I could move overseas when it was done—after George had died—and live in Southeast Asia. Life, for the healthy-brained me, had been an exercise in accumulating experiences, savoring different things, meeting interesting people. Now I wanted none of that. I needed stability in order to rebuild my life from the ground up. I craved predictability, familiarity, and to be in a place I knew.

  But my behavior was anything but consistent. At around the same time I was refusing to move abroad because of George, I decided it would be a good idea to get my motorcycle license. Laura insisted my brain was fine, so I forgot all about the neurologist’s warning: do not sustain a second blow to your head. Motorbikes were a lot of fun, and I couldn’t wait to get myself one.

  For six weeks I went to motorcycle-riding classes each Saturday for an hour. I rode a bike around a vast empty parking lot, learning how to use the gears, how to stop, and how to corner. When I took the test for my motorcycle license, I met my examiner in an underground parking garage not far from the local Roads and Traffic Authority office. Unfortunately, the test finished not long after it started, when I drove the motorbike straight into a pylon. I was traveling very slowly, which made things all the more humiliating.

  “What say you take a few more lessons and try again in a couple of months?” my examiner said to me as I tried to dismount the bike.

  “Have you got that out of your system now?” Laura asked when I got home and told her I would not be getting a motorcycle anytime soon.

  I looked at her sheepishly and nodded. I hadn’t realized that my coordination, which had been excellent, was another casualty of my accident. Walking the dogs and going to work each day hadn’t tested my physical abilities in any real way, but it was clear from the disastrous test that my visuospatial skills had taken a battering thanks to my damaged parietal lobes. It seemed like all the things I’d been most proud of, the things by which I’d identified myself, had been stripped away by my accident.

  A week or so after my failure with the motorbike, Laura returned home with a bundle of papers about the Harkness Fellowship, a scholarship program run by the Commonwealth Fund in New York.

  “Look at this,” she said. “They are looking for people who work in health care. Aged care is a category.”

  I glanced at the form and passed it back to her, unable to mimic her excitement. “I know nothing about aged care. My PhD is in comparative public administration.”

  “You work in aged care! How hard can it be?”

  “Hard!”

  “It’s all public policy, isn’t it? You should apply. You can choose a topic, as long as it has something to do with aged care.”

  I stared at the wall.

  “Come on! They pay for you to live and study in America for a year! It’s one of the best scholarships around. I can study too. I can finish my master’s degree! It would be fun!”

  “Not long ago, I had an IQ of around eighty. I think that pretty much disqualifies me, don’t yo
u?”

  “Your brain is fine!”

  I reminded her about Toby, the psychologist at the Brain Injury Unit, and the yellow circle, and the fact that less than two years ago I was told I would never work again.

  “Do me a favor,” she said. “Apply. If you get a fellowship, you can always turn it down.”

  Her glibness about my accident was a double-edged sword. It made me believe I could pass for someone who was normal, but it was also frustrating. I let it go and did as she said. One of the things I liked most about Laura was that she took charge, allowing me to follow. I put together an application. I wanted to study aged care, my application began. But I really thought it was depressing as hell. The study of dying. I showed her my application.

  “It looks dreadful!” she said, screwing up her face to make her point. “Let me type it up properly and make it look nice.”

  Despite the new application looking attractive, it happened to be frighteningly short on content.

  “Let’s wait a few days,” I said. “I’ll show it to Phil.” Phil was a professor I had met through work who knew a lot about aged care.

  Phil took one look at my application and shook his head. “No one is going to give you a scholarship based on this,” he said.

  He helped me prepare a different proposal. A decent one. Then he offered to write a reference and suggested two other colleagues whose references would be well regarded.

  Laura got to work on my second application. We mailed it, with a two-by-four-inch color photograph of me taken by Laura’s friend who was a professional photographer. In it, I was cocking my head slightly and smiling. I looked ridiculously wholesome. I didn’t expect to hear back, and not just because of the photo. The fact was that I was a poor choice for a competitive fellowship. But one day about four weeks later, I received a phone call asking me to an interview in front of a panel of four: three professors of medicine and health policy and a senior employee of the federal health department.