She looked up and repeated herself. “Have you experienced any unexplained episodes of confusion?”
“Confusion like what?”
Now she set the pen down. She considered me for a moment and shrugged. “Confusion. Forgetfulness. Disorientation.”
I inhaled, maybe a bit sharply. The memory from the previous month had only lodged because of a text I’d sent my wife. Several students came by my office, students I work with regularly on a literary journal and who I know well. They are among a handful of undergrads I ask to call me by my first name, and, as they sat around Horton Hall 303, I could not think of theirs. None of them. I knew who they were and understood all they were talking about, but I deliberately avoided using their names because I was drawing total blanks. They didn’t notice, and I let it go and returned to a letter of recommendation I was composing. As I concluded, I was writing a sentence, something like “Given this candidate’s extraordinary abilities and exceptional track record, it would be a tragedy not to interview her.” But I struggled, mightily, with the word tragedy. I couldn’t spell it. I was certain a j was involved, as in trajectory, and I think somehow an “i” got mixed it. It was more than a simple mistake. I, an English teacher with five books to my credit, was confounded by the most basic of words.
Maybe I’d have forgotten or dismissed these incidents except for what happened after my office hours came to a close that day, when I went to teach one of my freshman comp classes. I was demonstrating for students how to calculate their final grades using the syllabus, and I asked for a fictitious name to use as an example. Someone shouted out Allison, and when I turned to the board, chalk at the ready, I wrote out “A-L-I-C-I-A-N.” My students chuckled, not an uncommon occurrence in my classroom, and I erased it and shook my head free of cobwebs. Then I wrote it again, the exact same way. “A-L-I-C-I-A-N.” I looked at it, and I knew it was wrong, but I couldn’t summon the correct spelling. Some corner of my brain seem blocked off from me.
In her exam room, I gave Dr. Kostelac an abbreviated version of this day. I told her I remembered it because I texted my wife saying I felt “foggy” in the morning. At this word, my doctor rose and asked me to stand up. With a noticeable shift in attention, she began to probe my body, for signs of what I did not know. She lifted my arms; she brushed my cheeks with the backs of her hand; she took out one of those rubber hammers and thwacked my patella. And when she finished, she said the most unexpected thing I could imagine: “We’re going to get you a Cat Scan. Just in case.”
I don’t recall asking why she wanted a Cat Scan. And she didn’t tell me. That phrase, “Just in case,” seemed like a code for some implicit understanding. I had the vague sense then that she was looking for one of two possible culprits: signs of a stroke, which my father had at the start of his decline a few years ago, or a tumor, like the one my mother had removed back in 2001. (When my brother called me after that surgery, he told me, “The doctors said it popped right out, like a golf ball just sitting there. They didn’t need to cut into her brain.”)
My mother, who gave birth to eleven children and began scuba diving in her 40’s, eventually died from cancer. The end came in my parents’ bedroom, her in a medical supply bed surrounded by her ten surviving children. I am sometimes haunted by the sound of her gasping for breath, gazing open-eyed and unaware at the ceiling as my sisters prayed. That’s actually a scene I revisit often. Some rooms, I think you never leave.
Her illness began in her skin—then wormed its way inside, eventually lodging in her brain. There were surgeries, chemo, radiation, a heroic struggle with victories, set backs, and an inevitable conclusion. The final chapter of my mother’s cancer novel began in an innocuous way. She was teaching a scuba class at the YMCA in Allentown, as she’d done for years. And in the middle of a lesson, she couldn’t recall Boyle’s law, which students need to calculate how the oxygen in their air tanks responds to various pressure depths. She became disoriented, confused, and the students worried something was wrong. They called my father, also an osteopath, who called an ambulance. So it is, a completely normal scene turns into a plot twist.
But I didn’t connect my “foggy morning” to her experience, not until my doctor ordered that Cat Scan.
It took some time to get the test set up. The holidays intervened. There was a mix up about whether or not my insurance covered the procedure, a whole series of calls regarding whether or not the facility billed as “Holy Spirit Hospital,” in which case everything was covered, or as “Holy Spirit Imaging Center,” in which case nothing was. Some days I didn’t think about what was or was not in my brain at all.
At times, I did entertain the prospect of going through treatment as my mother had. Over one summer, I stayed with her for a couple months and drove her to her appointments, helped dole out her pills. I watched her deal with the pain. The medical professionals were all very generous, kind even. But on several occasions, I was mistaken for my brother, assumed to be a doctor. In these scenes, I was greeted with consolation, complex medical jargon, and a sort of apologetic resolve. Everyone knew where this was headed.
Waiting for my Cat Scan, I wondered if I too faced something that certain, if my last scene was already written in rough draft form, just waiting now for me to get to it. Driving around Camp Hill, getting groceries, picking up presents, I found my mind conjuring unsettling images. My sons at another funeral. The bed I shared with my wife, not with four pillows but just two, stacked in the middle of the headboard.
By total coincidence, my wife and I had, earlier in the fall, looked into boosting our life insurance policies. I’d applied for a second one in October and it had been approved in late November, well before my initial visit with Dr. Kostelac, but not yet issued. It went into effect in the interval between that tinnitus diagnosis and the upcoming Cat Scan. If there was anything I dwelled on, it was this. In the aftermath of my death, would my family have Amount X, which would mean one standard of living, or Amount Y which meant another. I toyed with the idea of phoning the insurance agent or emailing a hypothetical question about pre-existing conditions. Did this even qualify? But in my convoluted thinking, a record of such a question might be used as evidence later on. I cringed at the idea of going through my last months or a year not being certain of how they would be taken care of fully. That notion tried to nest itself in the folds of my brain, a kind of tumor all its own.
This was an image that accompanied me to the appointment. After a morning with no food, no coffee (why did I need to fast for a Cat Scan?), I sat in the waiting room and watched “Good Morning America,” along with all the other sleepy people waiting to see how their stories would or would not turn. There were bright magazines, a bubbling aquarium. One woman spilled her soda and cursed, loudly. No one wants to be in a waiting room.
After my name was called, I was led back to the machine in question by a technician who introduced herself as Maritza. I glanced at her nametag to be sure it wasn’t just Marissa. For some reason, this detail seemed important. She had olive skin and long black hair, and in a comforting tone guided me down a hall, into a large room. She had me get up onto my back on a slender table positioned at the entrance to an enormous vertical halo. It looked like the portal used by sci-fi characters to travel to alternate dimensions; the idea of other realities and escape came easily to mind. But Maritza kept me grounded in the here and now, taking my glasses, inserting an I.V., explaining what would happen next.
She said I would soon feel a cool sensation in my arm, followed by some disorientation and a metallic taste in my mouth. Not long after, she would leave and I should lie very very still. It wouldn’t take long.
When these things came to pass, when ice cruised down the veins of my right arm, when I felt the room tilt a bit to the left, when I became certain a penny was under my tongue, I felt confident. Maritza was exactly right. She knew what she was doing. I was in the hands of capable medical professionals.
But my mom had capable medical professionals. And later, so did my dad. We’re all of us, only human, and that sentence comes with unavoidable, if wholly unpleasant, implications.
Maritza handed me my glasses, told me to drink lots of liquids, and said I could just leave, that there was no need to stop at the front desk. Someone would call my doctor in three or four days. I remember wishing she could tell me which one it could be—three or four.
But of course, it isn’t three or four days. It’s just eight hours later, and I’m standing in the kitchen punching in the code to retrieve the message, which must either be good news or bad. A sing songy, cheery voice identifies itself as a nurse with Dr. Kostelac, and the phrase “Totally normal” comes through the receiver. I replay the message twice, just to be certain. I contemplate not erasing it, so I can listen to it again later, but my OCD only goes so far, and I delete it.
So it turns out I didn’t have a stroke. I don’t have cancer. There is no malignant growth in my brain, no mutating cells eager to start eating their way through that part of my flesh that contains the elaborate labyrinth of memory, the control center for all my musculature and coherent thought, the tumbling storms of emotions that comprise my sense of awareness. The voice mail notification was one of a dozen calls that nurse made at the end of the day, I imagine, on a post it note list alongside news to other patients of other test results, of rescheduled appointments, of prescriptions called in. For her, she left the message and scratched off my name. For me, her simple words translated to “You’re not about to die. Your family won’t be cast into turmoil. You’ll live, Neil.” It’s my own inner voice that adds the words, “For now.”
Ultimately then, this isn’t much of a story at all. I can’t shape it like I can when I write fiction. In many ways, it feels like a parable for a life insurance salesman. But I’m compelled to write it anyway. Mostly I think I wanted to capture my experience with words, like catching a genie in a bottle, or casting a demon into some vessel. I want to exorcise the memory and cast it here, onto the page. And then I want to be done with it and return while I can, for as long as I have allotted, back to the land of the living.