We were in the back room, the room that had once been Trigg’s bedroom, and where I had come each day as she had monitored my medication and my health. Now Trigg was long gone, and in her place was a man who looked like a mobster.
Dr. De Niro clutched at his nose and tugged at it like he was trying to pull the appendage off his face. His eyes watered and then he sneezed. He had a cold.
The irony…
My new doctor was sick.
“I have good news and bad news about the MRI scan,” he said without any trace of sympathy or emotion.
It was late afternoon and we had returned several hours ago from the medical center.
“Give me the bad news,” I said.
“You have a brain tumor.”
“No shit, Sherlock,” I said. “Now give me the good news.”
Dr. De Niro turned away and went to the far side of the room like he wanted space between us. He tried that smiling thing again but now it just came out like a grimace of pain.
I sat up. “Is there any good news?”
Dr. De Niro nodded. “Yes… but you are going to want to see this.”
I realized then that the doctor wasn’t trying to reach a safe distance, he was feeling for the light switch. The room became dark, and then darker still as he drew the heavy drapes across the window. I heard the sound of an electric hum, and then suddenly a bizarre image burst from a digital projector and played across the blank wall before me.
I stared. For long seconds the surrealistic black and white image made no sense. It looked like some kind of a lunar landscape, and it wasn’t until the doctor adjusted the projector lens, making the image smaller, that I finally recognized the swirling patterns as an image of an MRI scan.
My MRI scan.
An icy pall of dread – a fatalistic sense of doom – punched at my heart like a fist.
Dr. De Niro came and perched himself on the edge of the bed. I continued to stare at the image on the blank bedroom wall.
“It’s not getting any smaller, is it?” I could see quite clearly the large blurred area that showed up like a dense white cloud set against the dark background of the rest of my skull. “It looks to be exactly the same size as it was the last time Trigg took me for a scan.”
Dr. De Nero turned his head slowly and looked at me. I felt his eyes, and turned just as slowly until our faces were just a few inches apart. He was nodding his head, his eyes narrowed to thin calculating slits. I could see he was frowning.
I turned back to look at the scan one last time and pointed. “I was hoping…” my voice became heavy and trailed away.
Dr. De Niro rested his hand comfortingly on my shoulder. “Son, that’s not your tumor. That’s part of your head. The brain tumor that you have is that little white mark near the back of your skull.”
I turned back to face the doctor, my mood instantly black. “That’s not funny.”
The doctor rubbed hard at his face like maybe he thought he could smooth his features into something more handsome. “I’m not joking.”
I stared in silence.
There are different types of silence. There is that long, awkward silence between two people who are uncomfortable in each other’s company, and then there is that silence that hums with sexual tension when a man and woman are moments away from reaching for each other. But this was a different kind of silence – this was the stunned kind of silence where there were no words, no feelings, only shock.
I gazed at the MRI image made large on the wall and felt my eyes glaze over until everything began to blur. My heart seemed to stop beating, and there was a great roar of pounding blood in my ears. I was so overwhelmed that for many minutes I continued to stare at the wall saying nothing.
Dr. De Niro stood up and strode towards the image. He pointed to a small shape near the base of my skull then looked back at me and waited patiently until the haze of my disbelief gradually faded and he finally had my attention.
“Mr. Noble, this is your brain tumor.”
Thud!
I shook my head, wanting to believe him but not yet willing to give into hope. “That’s not what I have been told for the past several months,” I said levelly. “Trigg, my doctor, told me that the tumor was massive. She told me it was that much larger cloud of dull light closer to the front of my brain. She showed me the same shape in every MRI scan that we brought back from the clinic.”
Dr. De Niro’s hand fell heavily to his side and then crept into his pants pocket.
“She lied.”
Crash!
I said nothing.
The doctor gave me a long, meaningful look. “Have you ever seen an MRI before?”
“Only mine,” I said.
“Haven’t seen any others?”
“Only mine. Trigg showed me every one of them.”
“At the clinic?”
“No. Here. She showed me right here in this room. Not on a projector. She just showed me the plates that the clinic delivered.”
Dr. De Niro nodded heavily. “Jonah, did you ever consider getting a second opinion?”
I shook my head slowly. “No… I trusted Trigg. She had been our family doctor for some years. She was there for my father during his illness right up until the time of his death, and she had been there for me ever since.”
Dr. De Niro crossed to the other side of the room and turned the digital projector off. The insistent hum of sound cut off abruptly and the room was encased once again in gloomy silence. He walked slowly back to where I sat on the edge of the bed with his hands behind his back like a prosecutor cross examining a witness. He balanced his weight on the balls of his feet and I stared up into his face.
“Did you ever date Trigg Fanning?” the doctor asked.
I shrugged. “Date?”
The doctor nodded his head.
“Trigg and I have an intimate past,” I said vaguely, “But it is well in the past.”
The doctor nodded, like he already knew the answer.
“After my father died Trigg and I had a brief relationship,” I explained, “And then one day I met a beautiful young lady by the name of Caroline. That was over three years ago, but even though the relationship with Caroline was something long term and very special, Trigg still remained my family doctor. Hell, if it wasn’t for Trigg being at a cocktail fundraising party I hosted twelve months ago I don’t know what would have happened.”
“Meaning…?”
“Meaning that during the fundraiser I had a seizure,” I snapped. “Trigg was right there at the time and she saved my life. Ever since then she has been medicating me for headaches, until six months ago when she discovered by chance that I had a brain tumor. That was when I ended the relationship with Caroline – Trigg showed me the MRIs and told me the tumor was massive and inoperable. She told me I had maybe a year or two to live, at the most. I sent Caroline away, because I knew I might not be there for her. I knew I couldn’t offer her a future… and Trigg moved into this room, so that she could be close on hand as the headaches got worse, and in case I was struck by another seizure. She used this room like an in-home medical facility right up until the moment I sent her away eight weeks ago and called for you.”
Dr. De Niro took his hands from behind his back and rubbed at his chin. “Why did you terminate your arrangement with her so abruptly?”
I closed my eyes and took a deep breath. I saw a flashed image of Leticia and Trigg in the foyer and the despairing look of anguish on Leticia’s face at the instant she had thought I was deceiving her, and still had a relationship with Trigg. “That’s personal,” I said flatly.
The doctor didn’t seem offended by the abruptness of my answer. He went on as though I hadn’t replied at all.
“So, let me get this right…” the doctor said. “This Trigg woman was on hand during your father’s illness right up until he died, and then on hand again – conveniently – on the very night you suffered your first and only seizure?”
I said nothing.
“This Trigg woman is the only one you have consulted about your tumor, and she is also the person who – conveniently – happened to discover the tumor’s existence.”
I said nothing.
“This Trigg woman has been medicating you to treat the tumor and the associated headaches – conveniently – coinciding with her move back into your home… and presumably, back into your life.”
I said something. “Yes.”
Dr. De Niro thrust his hands into the pockets of his pants and rocked his balance back and forth. He was looking hard at me, and I didn’t like the expression on his face.
“Tell me, Jonah, when was the last time you had one of these debilitating headaches that Trigg was medicating you for?”
“It’s been a while…” I said vaguely.
“At least eight weeks, right? It’s been at least that long because ever since I have been here you haven’t complained of a single headache.”
I got defensive. “That’s because you have me on that experimental drug.” I struggled to remember the name the doctor had called the medication. “Nacsirmelbon. And you even upped the medication to two tablets a day.”
The doctor scowled at me. He reached into his pocket and when he opened his fist there was a dozen or more small white tablets in the palm of his hand.
“You mean these?”
“Yes,” I nodded. “I’ve been taking two a day.”
“And no headaches, right?”
“No.”
The doctor nodded. “Any side effects?”
I shook my head. “Just an after-taste,” I said.
Again the doctor nodded. He turned his hand over slowly and as he did the tablets fell to the ground. “They’re breath mints,” he said.
I said nothing – not for a long time.
“You’re kidding.”
“I’m not. They’re not even expensive. It’s a cheap brand I bought in bulk.”
I shook my head in disbelief. “No.”
The doctor nodded. “Yes.”
I stared into the man’s eyes and he stared back with complete conviction. “The only reason I doubled your dose was because you were dating that pretty little journalist,” his voice was rock steady. “With the amount of whisky you drink, I figured she wouldn’t want to be kissing someone who tasted like a brewery.”
I said nothing. I had nothing to say. I felt a sudden giddy vertigo as though my entire reality had suddenly been revealed as a horrific nightmare of illusion.
“I’ve really been taking breath mints?”
The doctor nodded his head again. “To treat headaches you never had. Nacsirmelbon, is just Noble MRI scan spelt back to front.”
I felt everything around me begin to mist over and my vision began to waver like I was staring through a heat mirage. I felt the palms of my hand turn clammy and cold as my fists clutched at the edge of the mattress.
“You’ve been lying to me?”
The doctor nodded. “Yes.”
“All along?”
“From day one,” he said and then he sighed and shook his head slowly. “Son, I didn’t want to make your condition worse than it was – I didn’t even really know the true extent of your condition until it was confirmed by this MRI scan. But I had my suspicions, and so I convinced you that you were taking powerful experimental medication, because I wanted to know what I was really treating before I medicated you.”
I closed my eyes. Suddenly I felt tired, drained of all energy. When I opened my eyes again, my body and my mind felt weary and overcome with lethargy. “You’re a bastard.” The words were no more than a dry croak in my throat.
“That I am,” Dr. De Niro nodded gravely. “But I’m not the one who has misled you about your illness, and nor am I the one you should direct your anger at.”
The words hung in the air, the menace and implications of their meaning clear. Trigg had betrayed me. She had medicated me for headaches that her medications had actually created. She had somehow slipped something into my cocktail at that fundraiser to induce a seizure that she could then save me from. She had lied about the size of my tumor, and in doing so robbed me of a future and made me dependent on her.
I wanted to kill her.
I wanted to hate her.
Crashing waves of dismay flooded over me. My whole body felt numbed by the chilling depth of Trigg’s treachery.
The instinct for revenge overwhelmed me like a dark rage of unholy wrath. I closed my eyes again and my senses swam. I saw an image of Trigg’s face before me. She was smiling, and there was a flash of vindictive triumph in her eyes. I imagined my hands locked around her throat, my thumbs crushing her larynx and choking the life from her. I could see behind my eyes Trigg’s face filling with fear – the same fear of death that had haunted me for so long. I could hear her shrill scream, becoming hoarse and frantic with terror as the life slowly ebbed out of her and my fingers around her throat meshed together until she was strangled.
The vision cleared, the red mist of rage faded. I took a deep breath and held it, and then with a force of will greater than I had believed I was capable of, I crushed down on my rage and cast it off like a great weight.
Dr. De Niro gave me one last long meaningful look and then turned away. He went to a chest of drawers and began removing clothes, stacking them in neat piles at the foot of the bed.
“Doc? What are you doing?”
The doctor looked up at me, and for the first time since I met the man he smiled in a way that looked friendly. “I’m going,” he said amiably. “You don’t need me, Jonah. You need a surgeon, not some overweight, middle aged pill dispenser.”
“A surgeon?”
The doctor nodded. “That tumor is small enough to be removed by surgery. I don’t know,” he shrugged. “It may take two or three operations, but with the right surgeon your chances of growing old are very good.”
I frowned. I knew how dangerous and how delicate brain surgery could be, and I understood that removing a tumor of any size was fraught with risk. “You are saying that I have a good chance, then?”
The doctor nodded. He dropped a neat bundle of shirts onto the end of the bed and leaned in close to me.
“Jonah, the real key to surviving the kind of surgery I’m proposing lays only partly in the skill of the surgeon. The other element to surviving an operation like this is completely in the hands of the patient. You have got to want to live, Jonah. Ever since I moved in to care for you, you have been a ghost – a man waiting to die,” he waggled his finger at me. “If you want to give your surgeon every possible chance to save you then you need to find within yourself the will to live again.”
Chapter 22.
I sat at my desk and stared for long minutes down at the surgeon’s name and number on the piece of paper. The writing was practically illegible – my doctor’s handwriting.
I picked up the phone and made the call to New York. A middle-aged man’s voice came to me on the line, his tone level and steady down the long distance connection.
“Wilton Green.”
“Dr. Green, my name is Jonah Noble. I believe my doctor has been in contact with you?”
The man’s response was instant. “Indeed he has, Mr. Noble. Good to hear from you. I have received the MRI scan that was sent to me, and I also have a detailed letter from your doctor.”
I sat back in the chair and closed my eyes. I could feel sudden tension, as if a steel band had been clamped around my head and was tightening. “Thank you. I appreciate your promptness,” I said. “My doctor told me you were the best surgeon in the country for this kind of condition. I’m hoping you will be able to help me.”
The doctor hesitated for a moment, and then said with professional caution, “I think I can.”
I tried to imagine what this man looked like. I tried to picture his surroundings. The number I had been given was a cellphone, not a direct line to a hospital. Was he at home right now? Did he have a wife and children? Was he the kind of man who had retained
his passion for helping people, or was he like some hired surgical gun, who worked for the money and who had lost his compassion?
I had the image in my mind of a man with calm steady eyes: maybe the face of an airline pilot… the kind of man you would feel comfortable trusting your life with.
“I am relieved to hear that,” I said. “Hope is something I had given up on.”
The surgeon’s voice never altered, his tone was professional and business-like, but I sensed an undercurrent of empathy beneath his words.
“I’ve consulted with another colleague on your condition, Mr. Noble, and I must warn you that surgery to remove any sized brain tumor is fraught with dangers and hazards. You must understand there is a great deal of risk involved with the kind of procedure required.”
“I understand that,” I said, and then hesitated for a long moment before asking the critical question. “How do you rate my chances?”
The surgeon’s voice lowered and became grave. “Fifty-fifty,” he said. “You’ve got an even chance of surviving the surgery and living a long and healthy life.”
“And a fifty percent chance that I will die in surgery?”
“Yes.”
I took a deep breath. I could feel a knot of apprehension drawing tighter in the pit of my guts.
“How soon can you operate?” I asked with slow decision.
“Hold on for one moment,” the surgeon said. I heard him set the phone down, and there was a brief murmur of discussion. I couldn’t hear the words, but it sounded like several voices in the background. When the surgeon came back on the line his tone was suddenly clinical. “I can fly out the day after tomorrow,” he said. “That would mean surgery in three days time.”
I felt a sudden chilled sense of shock. “So soon?”
“The sooner, the better,” the surgeon replied. “We need to remove that tumor at the base of your brain as soon as possible. The longer the delay, the greater the chance of complications and the less likely our chances of success.”
I swung the chair around and stared at the blank wall behind my desk.
This was it…
A life and death moment.
I had spent so many months despairing for a future I was never going to have, and anticipating a slow debilitating death. Now my life telescoped before my eyes down to just the next few days.