I returned to my neurologist’s office after he had taken the time to examine the results of my MRI, spectroscopy, and electroencephalogram. It wasn’t until that point that I told him about the documentation I needed for Dignitas.
“I can’t sign that!” he said, shaking his head.
“Why not?”
“It’s way too soon.”
I told him about my cousin and the house I had promised to buy her.
“Well, you’re going to need somewhere to live too, so tell your cousin to cool her heels.”
“I’ve sold my house here! Sold my car!”
He eased himself back into his chair.
“What exactly are we talking about?” I asked. “Another couple of years?”
“I can’t give you a time frame.”
“Two years?”
Nothing.
“Three?”
Nothing.
“Five?”
“You’re a very unusual case. I can’t possibly give you a time frame. I honestly don’t know.”
“I want to die. I’m ready for it.”
“You are not ready to die. Not even close. You need to talk to someone about that. I have a colleague who is excellent. I’ll write you a referral. You can see him next time you’re in Sydney.”
I exhaled slowly.
“I’ve looked at the scans and compared them to the last ones, and I don’t think it’s progressive. The changes we see on your MRI scans are happening very slowly, and they are in the parts of the brain that took the impact from your accident. There’s another important factor here: your sense of taste and smell is fine. That’s not the case with most progressive dementias.”
“Oh,” I said, unable to mask my surprise.
“I will say, though, that I think your head injury was severe rather than mild. It’s unusual to see the kinds of changes that show up on your scans with a mild traumatic brain injury. You had a very bad knock to the head.”
“But wouldn’t a severe head injury mean my speech and movement would be affected?” That was what I had learned from reading about the Glasgow Coma Scale, which was used to help distinguish between mild, moderate, and severe types of head trauma.
“Not necessarily. I’d like us to repeat the tests in four years from now to determine any changes. That will give you time to get on top of your anxiety. How does that sound?”
“So I’m not going to Switzerland?” I asked, with a mix of shock and disappointment.
“No, you are not. How long do you plan on staying in Hong Kong?”
“I don’t know. I planned to die.”
“Perhaps you should think about moving home.”
“Sydney?”
He nodded. “And remember to exercise, limit your drinking to one glass of red wine per day, eat healthily, and make an appointment to see Peter. He’s the best psychiatrist I know, and I have a feeling you two will get along well. Remember, depression and anxiety make everything worse.”
“I wish it were so easy.”
“I know. Peter will be able to help. And keep writing!”
“Okay,” I said, realizing I may have been too hasty with some of the decisions I had made.
“Here are the MRI pictures,” he said, handing me a large envelope. “There is no report this time, because I asked them to send me the scans urgently, given you’re only in town for a couple of days. I’ll email you a summary letter. You can email me anytime with questions.”
I got up, thanked him for all his help, hugged him, and walked outside into a bright Sydney day.
Once you convince yourself you’ll be dead by Christmas, the idea of another few years of life can take some getting used to. I had been given a reprieve, and that made me sad. To complicate matters, I had made a lot of life decisions I could not undo.
Back in Hong Kong, I took to my sofa and spent my days slumped in front of the TV, watching shows about overfed, precocious children; about Long Island mediums; about creepy American men who married mail-order brides in ninety days and then were shocked to discover that their chosen one didn’t want to have sex with them; about the Kardashians and the Amish; about the parents who sexualized their five-year-old girls and sent them out to compete in beauty pageants; and about the guy who looked like a plainer version of Jon Bon Jovi who went into people’s homes to remove their rattlesnakes.
I mused about my own idea for a reality TV show, The Aspiring Writer. It would be filmed with hidden cameras and show the lead character, a melancholy white woman of around fifty, transfixed in front of her own TV, or scrubbing her air-conditioning machines with a wire brush, or sorting through her collection of chopsticks and organizing them according to hue, or picking through the contents of her desk and discovering things she never knew she owned: photos of old boyfriends and girlfriends, a small plastic box full of erasers shaped like dinosaurs. I would watch a show like that.
I took Giulia to dinner at Nobu in Tsim Sha Tsui to celebrate her birthday. Living next door to one another had done nothing but prolong the agony of my heartbreak. We still saw each other almost every day, and I was no closer to falling out of love with her than I had been when she broke up with me. Isabelle and Helena both told me I was crazy for living next door to Giulia, but I couldn’t break free. I was pathetic—I knew that—but I still hoped there was a sliver of a chance she might turn around and tell me she wanted me back. “She doesn’t love you,” Helena said to me each time I saw her. “You have to move on!”
In the taxi on the way to the restaurant with Giulia, I made the mistake of remarking on the fact that this was the first occasion for which I had left my apartment in over a fortnight, for any purpose other than to walk the dogs. Longer, in fact. I had glanced in the mirror as I was getting ready to leave the house and had been surprised to find my face was the color of a button mushroom.
As soon as we were seated, Giulia told me I was wallowing. Depressed. And lazy. Not that any of those states was a surprise to her.
“What the hell do you do all day?” she asked.
“Watch TV, eat popcorn, stare out the window.”
“Jesus, Sarah! You gave up a good job for that?” she asked, waving her hands in the air.
“I hated it.”
“You’ve hated every job you’ve ever had!” she said.
“True.”
“You’re meant to be writing. That’s your life’s dream, remember?”
I sighed and tapped my fingers on the table, waiting for her to stop.
“You need to exercise! Leave the house! Go outside. Do something! Find another job and write on weekends.”
I stared at the table and felt a rush of hatred toward her.
My dream was to write. But it was more complicated than that. Writing had saved my brain after the accident. Had I not returned to my research and retaught myself how to read and write, I don’t believe that my brain would have repaired itself. What Giulia didn’t understand, because I hadn’t told her, was that I still harbored the dim hope that writing might be able to save my brain a second time. That was why I had clung to it so fiercely. But depression fuels lassitude like petrol fuels fire, and until I found a way out of this last stretch of gloom, writing, like every single other activity apart from watching bad TV, seemed impossible.
The waiter brought us two glasses of champagne, and as I took my first sip I decided Giulia was right. I wallowed. I was depressed. And I was lazy. I needed boundaries. With work, I never had enough time to write. Now I had too much time. Freedom creates a prison all its own.
I lay in bed the next morning, awaiting the moment I’d finally manage to stir myself from this torpor. Eventually I heaved myself off my mattress, threw on some clothes I found in a heap on my bathroom floor, and went for a walk. I needed to think about my future, a future in which I would write and walk and try not to wallow.
I needed to change my life.
I walked down my street, along the edge of the Shing Mun Country Park, before coming upon three of
the sickliest-looking puppies I had ever seen. They were nestled underneath a few bushes by the side of the road where men were digging trenches for sewage works. Two were black and one was brown. They looked to be around five weeks old. The puppies had made their home on a concrete ledge at the top of an embankment, less than twenty feet away from one of Hong Kong’s busiest roads. They were wild dogs whose mother had probably ventured out from the country park behind the embankment in search of food. Hong Kong’s country parks were full of wild dogs—dogs whose ancestors were dumped by their owners, dogs who struggled to fend for themselves.
I raced home, grabbed a bag of kibble, ran down the hill, crawled up the embankment, and deposited three large piles of food. The puppies scampered out from their hiding place and gobbled down the food.
The next morning I woke early, eager to feed the puppies. I scrambled up the embankment to deposit the mounds of kibble, and one of the black puppies came out to greet me. I placed a handful of dry food in my palm and offered it to her. She ate from my hand. I had been feeding packs of wild dogs in the Shing Mun Country Park for more than eighteen months, but I had never had a dog or puppy come close enough to allow me to touch it. The puppy glanced up at me with a worried look and wagged her tail, and I was so entranced by this scrawny black puppy, and its mixed message of anxiety and relief, that I forgot to remove my hand. Eager for more food, the puppy gnawed a small hole in one of my fingers. I pulled my bleeding hand away.
My neighborhood in Hong Kong was eight train stops away from China, and China happens to have the second-largest rabies problem of any country in the world. A wire fence separated Hong Kong from China, and although Hong Kong was supposedly rabies-free, between 2007 and 2010, twenty-five people had died from rabies after dog bites in Shenzhen, a city that borders Hong Kong. I called the local hospital. “Come here right away,” the nurse on reception told me.
The nurse cleaned the wound on my finger with disinfectant, jabbed my arm with a needle full of Verorab, and told me to return for four more shots over the course of a month. Rabies shots are like tetanus shots: they hurt. It wasn’t the first time I had been treated for possible rabies exposure. On holiday in Langkawi once, at Giulia’s insistence, I fed a stray kitten a small piece of fish. Ravenous, the kitten bit through my flesh, puncturing the skin in two places. I was talking to a friend at work three days later back home in Singapore, when, alarmed by my story, my friend told me two things I didn’t know: there was rabies in Langkawi, and a person needed to start treatment for a rabies infection within seventy-two hours. It had been over seventy hours since the bite, but not quite seventy-one, so I raced out of the office and took a taxi to the local hospital, where I had a needle in my arm with one hour to spare.
As I stood in line waiting to pay the cashier in the hospital in Hong Kong, it occurred to me that repeating the same mistakes was an incontrovertible sign of my own idiocy. But that didn’t change my compulsion. Nothing jolted me out of my depression more than an animal in need of care.
Anxious about the state of the puppies, I woke at six the next morning and headed down the hill, a large bag of dog food tucked under my arm. I felt useful, invigorated. I reached the top of the embankment, and one of the black puppies rushed toward me. It may have been the same one that bit me, but I couldn’t be certain. Emboldened by the Verorab coursing through my veins, I held out my arm, and she stepped inside the palm of my hand. I clutched her to my chest and climbed back down to the road. This tiny wild puppy, who weighed no more than a mango, was happy to be held. She looked at me, her brow furrowed and her head cocked, but she made no attempt to struggle. She seemed to be asking Where are we going? rather than Why are you holding me? And both of these would have been good questions. Why had I picked up this sickly-looking dog and what were my plans for it? I had no clue. A tick crawled up my arm, and I flicked it off with my wounded finger.
I carried the puppy under my arm for three blocks to the nearest vet, where together the vet and his nurse used tweezers to remove sixty ticks from her tiny body. The vet wormed her and injected her with fluids.
“She would have died out there,” he said. “In a matter of days. She’s very malnourished.”
Back home I bathed her with a medicated tick shampoo and jumped in the shower to rid myself of the fleas and ticks that had migrated from her body to mine. I fed her and put her to bed on my sofa next to Ambrose, my other wild dog. He glanced at her and pretended she wasn’t there. Sofia, my oldest dog, stared at her before shooting me a look that said, Tell me this is temporary.
The puppy curled up on top of a stuffed reindeer and fell asleep almost instantly. I looked at her body, alarmingly thin and missing large patches of fur. Something had bitten her on the snout, leaving an open wound. I soaked a cotton ball in saline solution and cleaned the gash. She looked at me with a steady gaze before dropping back into a deep slumber, her chest rising and falling as she breathed. I studied her, marveling at the size of her enormous, donkey-like ears. Her eyes were set too close together. She was odd looking, with a face that reminded me of Vladimir Putin.
What am I doing? I asked myself. I was the coparent of four dogs already. Two of the dogs I had rescued with Giulia spent their days with me and their nights with her. Sofia and Ambrose, who lived with me, were middle-aged dogs whose needs were met with two meals a day, four short walks, a spot on my sofa, and as many cuddles as they could stand. Luca and Toby, the two street cats I had adopted after our breakup, did as they pleased. A puppy was a different commitment altogether.
I called Giulia at work and told her the news. “I left the house,” I said.
“Finally!”
“And I found a puppy.”
“What?”
“Well, I found three puppies, but I only managed to catch one.”
“Are you fucking crazy?”
“Not yet,” I said.
“Jesus, Sarah! The last thing we need is another puppy!”
“There is no ‘we’ anymore.”
“Jesus Christ.”
“It was going to die!” I said. “What should I have done? Leave it there?”
“Well, as long as you find it a home,” she said, and I pictured her nostrils flaring on the other end of the telephone.
“That’s the plan.”
“Did you look for a job yet?”
“No,” I said, and hung up the phone.
After lunch I walked down my street with more food in search of the other two puppies. I scaled the embankment and called for them, but they had disappeared. I left the food and went home to tend to my new puppy. Her name, I decided, would be Scout.
I checked again on the puppies early the next morning, but the workmen digging trenches had laid live electrical cables through a clearing in the bushes. A piece of plastic tied to the cable warned “Live Wires.” I could no longer crawl up to the concrete ledge without risk of electrocution. From the road, I searched for any sign of the two puppies, but they had vanished. The food I had left the day before had not been touched. That evening I ran into a neighbor who said she had just seen a black puppy lying dead in the gutter at the bottom of our street.
I raced inside to Scout, picked her up, kissed her, and told her how lucky she was. I decided not to tell her about her siblings. She curled up in my lap and started to snore.
By the time I had finished with my third rabies shot, Scout had fallen ill. She lay on her bed, unable to lift her head. She tried to wag her tail but even that was a struggle. Perhaps the gash on her snout was a bite from an animal that had slipped across the border from China.
I decided to educate myself about the rabies virus. Googling something other than “head trauma” and “dementia” invigorated me. I learned that the incubation period for rabies usually lasted between one and three months but could vary anywhere from one week to one year. That wasn’t terribly helpful, so I moved on to symptoms. The first symptom in animals and people seemed to be fever, followed by a burning sensation at the wound
site and then by pica, or the desire to eat things that don’t have nutritional value (a word I would never have known the meaning of had I not watched a TV show about a pregnant woman in America who ate chalk). Like most puppies, Scout enjoyed chewing shoes and books—she’d devoured the spine of David Foster Wallace’s A Supposedly Fun Thing I’ll Never Do Again and the corner of a ceramic Chairman Mao statue I had in my living room. Other, more advanced symptoms included seizures and an inability to swallow.
The more I read, the more absorbed I became. Rabies was probably the oldest infectious disease in the world. Pliny the Elder (23–79 AD), my first point of contact when it came to medical matters, believed that dogs could become rabid by tasting the menstrual blood of a woman and that dogs were most susceptible to rabies while the Dog Star was shining. Pliny’s recommendation for protecting a dog against rabies was feeding it chicken droppings. People were counseled to ward off rabies by carrying the worm of a dead dog or the menstrual blood—again!—from a female dog, or by placing the tongue of a dog in one’s shoe underneath the big toe, or by carrying a weasel’s tail—provided the weasel has survived and been returned to the wild.25 Elsewhere, I learned that life expectancy at the time was thirty-five.
Rabies was a horrible way to die, but it happened quickly. A few days of frothing at the mouth, biting people, madness, and life was over. Dementia took years or, at worst, decades. It was the descent into craziness, the disorientation that seized its victim between moments of lucidity, the knowing, and the complete and utter powerlessness. I was terrified of seeing out my days in a stupor in a nursing home’s communal area, oblivious to the smell of terrible food and incontinence, clapping my hands while a nurse with a guitar sang the theme song to Skippy the Bush Kangaroo.
I decided Scout didn’t have rabies. Her illness came on suddenly, so it was more likely something she had eaten. Her tendency to chew books, statues, furniture legs, blankets, the ears of one of my cats, and toothpaste tubes, and her ability to pry open a remote control, pop out its batteries, and chew on them had me worried. I turned off my computer, called a taxi, and took Scout over to Hong Kong Island to the best vet in town.
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