He was eventually wheeled into a kind of large staging area, a long room sectioned off with a series of standing blue curtains where all the people on gurneys apparently went before they were sent to their final destination—to surgery, a hospital room, some other realm. His gurney was slotted into a space by another nurse who then left him alone, the curtain pulled mostly shut. The open wedge showed an occasional staff member zipping by, or, once, an owlish old man with a walker who caught Brian’s eye and scowled at him through the fabric as if Brian was personally responsible for his woes. He caught an eyeful of the man’s leathery, drooping ass through the back of his hospital gown before the old man was intercepted and lead back to his own bed.
When Dr. Bajeer entered his little cloister and introduced himself, it was clear that here was a man who had never doubted himself, at least not while working the ER floor. A man much more accustomed to Brooke’s way of being, her laser focus, her unwavering confidence. He was a short, calm man, and he frowned at Brian’s chart as if he could discern the fate of the world from it. He looked to be Brian’s age, give or take, though he had a severe demarcation of white hair right above his ears, little racing stripes. After what seemed like a long time but probably was not, the doctor looked up at him, seemed to finally take in his battered face, the blood on his shirt.
“Mr. Schutt, how are we feeling?”
“Um. We’re not feeling so hot.”
Dr. Bajeer nodded, offered the quickest ghost of a smile. “I understand, yes. What I would like, with your permission, is to ask you some questions.”
“I’ve been getting a lot of that.”
“Yes. We want to see if there’s, ah, any brain trauma, you know?”
“Sure.”
The same cavalcade of questions: What year, month, day was it?
Did he know where he was?
Could he follow Dr. Bajeer’s finger?
Could he hear in each ear?
Could he feel Dr. Bajeer tug on his finger?
Did he have sensations in both sides of his face?
Could he shrug his shoulders?
“Is it okay if I do that?” said Brian. He lifted his arm, gestured at the neck brace he was locked into.
“Sure,” said Dr. Bajeer.
Brian shrugged.
“Okay,” Dr. Bajeer said, clicking his pen a few times, scribbling a note. “Now just some questions. This is called a Mini-Mental Status Examination. It’s just to check on, like I said, head trauma, possible brain injury. And then we can get a nurse in here and get you stitched up, looks like you need a few in your lip there.”
“And my ear.”
“And your ear, okay. You ready?”
“Sure,” Brian said. Compliant as dough, growing tired. What other choice did he have?
Could he name these two objects Dr. Bajeer was holding? This wristwatch and this pen?
He could.
Could he repeat the phrase No ifs, ands, or buts?
He could. “I don’t know if this is super important,” he said.
Could he count backward by sevens from one hundred?
“One hundred,” Brian said. “Ninety-three.” He stopped. “Eighty-something. I don’t know. I couldn’t do that on a good day, probably.” Knowing even as he said it that it was a lie. He thought of the ambulance ride. Saying the word lamplight when he meant headlight.
Another wry, patient smile from Dr. Bajeer, the scratching of his pen on Brian’s chart.
“I’ve got a concussion, don’t I? Shit.”
Could he make up a sentence? It can be about anything, but it must contain a noun and a verb. Tell me which word is the noun and which is the verb, please.
Brian, truly no slouch in the sentence-designing department, given his long-running tenure as an academic man-baby, opened his mouth to speak: I bet the Nazis beat the shit out of that old man and he drove away. But then he got hung up on the words noun and verb. One, he remembered from childhood incantations, was a person, place or thing. The other showed movement of some kind, action.
But he couldn’t remember which was which. It was right there, maddeningly out of reach.
Headlight. Lamplight.
“Are you having problems with this one, Mr. Schutt? It’s perfectly fine. There’s no way to answer incorrectly.”
Brian let out a little snort of derisive laughter. “It’s just . . . I can’t remember which one is which. Noun and verb. You know? This is a trip.”
Dr. Bajeer nodded.
Dr. Bajeer’s pen scribbled like mad.
Dr. Bajeer looked down at Brian on his gurney, moored there upon the crinkling, blood-spotted paper. Someone a few curtains over, maybe the old man, lowed. It sounded very much like a cow mooing. It was a mournful and terrible sound, so strange and out of place, and something tightened in Brian’s throat. He grinned, honestly scared now, and said, “That man is outstanding in his field. Get it? Out standing in his field? That’s a little, uh, a little bovine joke for you, Doctor.”
“Mr. Schutt, can you tell me,” said Dr. Bajeer, pen wedded to his clipboard again, “how long you’ve been having headaches?”
•
So it was a doughnut, and you went through the hole. That was the CT scan.
They had taken his neck brace off. He felt very tired: the jagged edge of adrenaline had given way to a bone-deep fatigue as the circular apparatus hummed around his head. His headache throbbed. His ear throbbed. His face hummed with pain. He felt like a blood bag jammed through with bone shards and brought resentfully to life. The purpose of the CT scan, a nurse had informed him, was to take quadrilateral scans of his brain. A schematic of his brain in four sections. To note any issues, any possible swelling, trauma. He was steeping in a slow broth of unease even as he felt his eyes drooping.
“Oh, we don’t want you to sleep, sir, that won’t help us,” he was gently admonished.
He thought briefly of the paltry insurance he got as a contracted employee at the university, and the ungodly amount of debt he was racking up for all of this. Dear Christ, he’d accepted a ride in the ambulance! He was getting a CT scan! His headache pulsed in its old familiar housing, its old familiar way: this was one of the precise ones, with that single isolated spot radiating an ache that throbbed darkly all throughout the rest of his skull. He thought about rising up, could picture it happening. He would rise like some embattled Hollywood film star, pulling the electrodes from his skin in a brazen rebuttal of death. But he, like the old man who may or may not have started mooing like a cow earlier, was now in an open-backed hospital gown, his clothes lying in a stack on the chair in the corner.
“A noun is a person, place or thing,” he said as the white tube slowly began enveloping him. “A verb indicates an action or occurrence.”
“Sir,” the nurse said, “please just sit still, okay? This won’t take long.”
•
And then he was back in his little curtained slot, leaning against his gurney and thumbing through a magazine article about breast pump dos and don’ts. The old cow-man was gone, or sleeping, or perhaps had died, having mooed his last moo. Then Dr. Bajeer walked in with his clipboard.
“Mr. Schutt,” he said, and walked up to him, close enough that Brian could see the pores on the man’s nose. This close, Dr. Bajeer was a riot of scents: wintergreen chewing gum, cologne, something antiseptic. “Why don’t you have a seat, please.”
Brian looked around their little open-ended stall. Their little intimate stretch of space. “Here?” he said, pointing at his gurney, blood-dotted and wrinkled. “Or the chair?”
“Uh, actually,” said Dr. Bajeer, turning on the computer in the corner of the room, gazing up at the wall-mounted screen as it flashed to life, and then walking over and shutting the curtain, “on the gurney’s fine. So you can see the pictures here.”
The doctor spent a minute logging into the system, clicking buttons, opened files.
Eventually, images unfolded, bloomed to dark life on the screen.
“So I have news,” said Dr. Bajeer. “It’s not good, unfortunately. All told, Mr. Schutt, I’m sorry but it’s not good at all.”
•
He was riven then with medical terms. The doctor clicked his pen against various points of the overhead screen, an image of Brian’s brain. Looking him in the eye, Dr. Bajeer spoke clearly, emphatically, and a litany of half-understood words dropped like stones from his mouth. Ice crept from the floor, up Brian’s legs, rooting him to the ground.
Shards of sentences drifted through the maelstrom. Hung in the air like arrows in midflight: Astrocytoma. Stage III, possibly Stage IV. We won’t know for sure until we perform a biopsy. But it’s severe.
How was this man so calm? Delivering this news?
What, Brian asked, or someone with Brian’s voice asked for him, was the difference between Stage III and Stage IV.
That was something that Brian should discuss with his neuro team. But Dr. Bajeer could provide him with literature in the meantime.
Again, Dr. Bajeer circled the whitened area of his brain—his brain!—that denoted the location of the tumor, this collusion of traitorous cells inside his skull. Brian heard his own voice again, a voice murky and distant, asking if it was terminal. A brain tumor like this, if it was terminal or not.
The doctor paused. “I can’t give you a prognosis until we get a biopsy. But as I said, it’s very serious.”
“And this”, Brian said from that far away swampland, “would explain my headaches?”
Dr. Bajeer nodded. “Yes. We call this cerebral edema, brain-swelling. You’re experiencing a lot of intracranial pressure as the tumor grows. In a way, you’re fortunate that you came in this evening.” Brian managed to laugh at that, though it again was a dry, clicking sound, like he’d tried dining on a handful of sand.
“I don’t feel lucky.”
Again, Dr. Bajeer nodded, grave and unsmiling. “I understand. But there are things that can be done. I would like you to strongly consider, Mr. Schutt, allowing me to contact a neurologist. He or she would begin the process of assessing your options with you. I can contact one immediately, after I leave this room. We can begin arranging a biopsy, your pathology report. We could do this now. I would suggest it.”
His brain! This interloper in his brain! He pictured a fist knocking against the yellow bowl of his skull, finally punching its way out, like a zombie bursting through the soil of a grave. He nodded at the doctor.
“Very good. I’ll be back in a moment, Mr. Schutt. I’ll have the staff place some calls. Now’s the time to make some calls of your own. I’m not sure when you’ll be leaving, if a neuro team is available. They will want to perform a biopsy and possibly remove the tumor immediately. You should contact your family.” He gestured at Brian’s face. “Meanwhile, I’ll get someone in here to stitch up your lip, take a look at your ear.” Dr. Bajeer nodded grimly one more time, then clapped Brian’s shoulder, squeezing with surprising strength. He walked around the blue curtain and Brian heard the whish of the pneumatic door opening and closing. In moments, the doctor had both explained so much—the headaches, the missing words—and also utterly demolished the footholds and foundations of Brian’s life. Just like that.
A fucking brain tumor.
As if resurrected by the news, he heard the old man moo again. A zombie cow-man, woeful and lost, something resuscitated and drawn grudgingly back down mortality’s ugly hallway.
Brian looked at the screen where the CT results still glowed. That pale, asymmetrical blemish in the curved egg of his brain. The old man lowed again, anguished.
Brian scooped up his blood-spattered clothes and walked around the curtain, bare feet slapping on the floor. He found a bathroom less than a dozen feet away. He stormed inside and locked it, leaning against the door on a pair of legs now seemingly carved from ice. A toilet, a sink, a wastebasket. An empty steel cupboard for leaving piss specimens. He got dressed.
There was some surety that this was the wrong thing to do. That this was, truly, absolutely, the wrongest thing to do. But he did it: he bundled his gown in a ball and put it in the wastebasket by the toilet and walked out into the room of blue curtains. He strode past the old man on his gurney. He walked through the whooshing doors, out through the emergency room, and into the night.
He stepped out of the hospital unfixed, terrified, woefully damaged, and strangely exultant.
•
The house was silent, dark, Ellis’s snores audible as soon as Brian crept in the door. He felt like a stranger tiptoeing through the place. It felt like someone else’s home now. The dumb, naive Brian that had lived before this one.
In the bathroom he spilled a loose handful of aspirin into his palm without turning on the light, chewed them to pulp. Fuck his liver, right? Who cared? What was the point of worrying about that particular issue when his brain was steering the whole operation into an early grave?
In his room, on his laptop, there was a message from Mark Sandoval.
Brian,
Appreciated the meeting today. Pardon the hackneyed seafaring lingo, but I liked the cut of your jib. I think you’d do well.
The position’s yours if you want it. Call me.
—M.