Lynchburg, Virginia—November 10, 2008

My eyes popped open. In the darkness of our bedroom, I focused on the red glow of the bedside clock: 4:30 A.M.—an hour before I’d usually wake up for the seventy-minute drive from our house in Lynchburg, Virginia, to the Focused Ultrasound Surgery Foundation in Charlottesville where I worked. My wife, Holley, was still sleeping soundly beside me.

After spending almost twenty years in academic neurosurgery in the greater Boston area, I’d moved with Holley and the rest of our family to the highlands of Virginia two years earlier, in 2006. Holley and I met in October 1977, two years after both of us had left college. Holley was working toward her masters in fine arts, and I was in medical school. She’d been on a couple of dates with my college roommate, Vic. One day, he brought her by to meet me—probably to show her off. As they were leaving, I told Holley to come back anytime, adding that she shouldn’t feel obliged to bring Vic.

On our first true date, we drove to a party in Charlotte, North Carolina, two and a half hours each way by car. Holley had laryngitis so I had to do 99 percent of the talking both ways. It was easy. We were married in June 1980 at St Thomas’s Episcopal Church in Windsor, North Carolina, and soon after moved into the Royal Oaks apartments in Durham, where I was a resident in surgery at Duke. Our place was far from royal, and I don’t recall spotting any oaks there, either. We had very little money but we were both so busy—and so happy to be together—that we didn’t care. One of our first vacations was a springtime camping tour of North Carolina’s beaches. Spring is no-see- um (the biting midge) bug season in the Carolinas, and our tent didn’t offer much protection from them. We had plenty of fun just the same. Swimming in the surf one afternoon at Ocracoke, I devised a way to catch the blue- shell crabs that were scuttling about at my feet. We took a big batch over to the Pony Island Motel, where some friends were staying, and cooked them up on a grill. There was plenty to share with everyone. Despite all our cutting corners, it wasn’t long till we found ourselves distressingly low on cash. We were staying with our best friends Bill and Patty Wilson, and, on a whim, decided to accompany them to a night of bingo. Bill had been going every Thursday of every summer for ten years and he had never won. It was Holley’s first time playing bingo. Call it beginner’s luck, or divine intervention, but she won two hundred dollars—which felt like five thousand dollars to us. The cash extended our trip and made it much more relaxed.

I earned my M.D. in 1980, just as Holley earned her degree and began a career as an artist and teacher. I performed my first solo brain surgery at Duke in 1981. Our firstborn, Eben IV, was born in 1987 at the Princess Mary Maternity Hospital in Newcastle-Upon-Tyne in northern England during my cerebrovascular fellowship, and our younger son, Bond, was born at the Brigham & Women’s Hospital in Boston in 1998.

I loved my fifteen years working at Harvard Medical School and Brigham & Women’s Hospital. Our family treasured those years in the Greater Boston area. But, in 2005 Holley and I agreed it was time to move back to the South. We wanted to be closer to our families, and I saw it as an opportunity to have a bit more autonomy than I’d had at Harvard. So in the spring of 2006, we started anew in Lynchburg, in the highlands of Virginia. It didn’t take long for us to settle back into the more relaxed life we’d both enjoyed growing up in the South.

For a moment I just lay there, vaguely trying to zero in on what had awakened me. The previous day—a Sunday—had been sunny, clear, and just a little crisp—classic late autumn Virginia weather. Holley, Bond (ten years old at the time), and I had gone to a barbecue at the home of a neighbor. In the evening we had spoken by phone to our son Eben IV (then twenty), who was a junior at the University of Delaware. The only hitch in the day had been the mild respiratory virus that Holley, Bond, and I were all still dragging around from the previous week. My back had started aching just before bedtime, so I’d taken a quick bath, which seemed to drive the pain into submission. I wondered if I had awakened so early this morning because the virus was still lurking in my body.

I shifted slightly in bed and a wave of pain shot down my spine—far more intense than the night before. Clearly the flu virus was still hanging on, and then some. The more I awoke, the worse the pain became. Since I wasn’t able to fall back to sleep and had an hour to spend before my workday started, I decided on another warm bath. I sat up in bed, swung my feet to the floor, and stood up.

Instantly the pain ratcheted up another notch—a dull, punishing throb penetrating deeply at the base of my spine. Leaving Holley asleep, I padded gingerly down the hall to the main upstairs bathroom.

I ran some water and eased myself into the tub, pretty certain that the warmth would instantly do some good. Wrong. By the time the tub was half full, I knew that I’d made a mistake. Not only was the pain getting worse, but it was also so intense now that I feared I might have to shout for Holley to help me get out of the tub.

Thinking how ridiculous the situation had become, I reached up and grabbed a towel hanging from a rack directly above me. I edged the towel over to the side of the rack so that the rack would be less likely to break loose from the wall and gently pulled myself up.

Another jolt of pain shot down my back, so intense that I gasped. This was definitely not the flu. But what else could it be? After struggling out of the slippery tub and into my scarlet terry-cloth bathrobe, I slowly made my way back to our bedroom and flopped down on our bed. My body was already damp again from cold sweat.

Holley stirred and turned over.

“What’s going on? What time is it?”

“I don’t know,” I said. “My back. I am in serious pain.”

Holley began rubbing my back. To my surprise it made me feel a little better. Doctors, by and large, don’t take kindly to being sick. I’m no exception. For a moment I was convinced the pain—and whatever was causing it —would finally start to recede. But by 6:30 A.M., the time I usually left for work, I was still in agony and virtually paralyzed.

Bond came into our bedroom at 7:30, curious as to why I was still at home.

“What’s going on?”

“Your father doesn’t feel well, honey,” Holley said.

I was still lying on the bed with my head propped up on a pillow. Bond came over, reached out, and began to massage my temples gently.

His touch sent what felt like a lightning bolt through my head—the worst pain yet. I screamed. Surprised by my reaction, Bond jumped back.

“It’s okay,” Holley said to Bond, clearly thinking otherwise. “It’s nothing you did. Dad has a horrible headache.” Then I heard her say, more to herself than to me: “I wonder if I should call an ambulance.”

If there’s one thing doctors hate even more than being sick, it’s being in the emergency room as a patient. I pictured the house filling up with EMTs, the retinue of stock questions, the ride to the hospital, the paperwork… I thought at some point I would begin to feel better and regret calling an ambulance in the first place.

“No, it’s okay,” I said. “It’s bad now but it’s bound to get better soon. You should probably help Bond get ready for school.”

“Eben, I really think—”

“I’ll be fine,” I interrupted, my face still buried in the pillow. I was still paralyzed by the pain. “Seriously, do not call nine-one-one. I’m not that sick. It’s just a muscle spasm in my lower back, and a headache.”

Reluctantly, Holley took Bond downstairs and fed him some breakfast before sending him up the street to a friend’s house to catch a ride to school. As Bond was going out the front door, the thought occurred to me that if this was something serious and I did end up in the hospital, I might not see him after school that afternoon. I mustered all my energy and croaked out, “Have a good day at school, Bond.”

By the time Holley came back upstairs to check on me, I was slipping into unconsciousness. Thinking I was napping, she left me to rest and went downstairs to call some of my colleagues, hoping to get their opinions on what might be happening.

Two hours later, feeling she’d let me rest long enough, she came back to check on me. Pushing open our bedroom door, she saw me lying in bed just as before. But looking closer, she saw that my body wasn’t relaxed as it had been, but rigid as a board. She turned on the light and saw that I was jerking violently. My lower jaw was jutting forward unnaturally, and my eyes were open and rolling back in my head.

“Eben, say something!” Holley screamed. When I didn’t respond, she called nine-one-one. It took the EMTs

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