Joe Finch had never considered himself to be a particularly brave man. He had had the usual adolescent fantasies about leaping to the rescue in invented situations as he rode the bus to school, usually ending with one or several of his female classmates falling into his arms with gratitude. They were ridiculous, but he had always felt that if anything bad did actually occurred in real life then he would be able to handle it. He'd assumed that the kind of thing that hundreds of people went through every day, no matter how scary, would be something he could take in his stride with a minimum of fuss. Standing in a backless hospital gown with a gentle breeze kissing his sagging buttocks, and staring at the bulky apparatus of the MRI machine, he wasn't so sure. The truth be told, he was absolutely terrified.
'Lie down, Mr Finch, and please try and relax. The more you move, the longer it takes, so try and keep perfectly still,' said the business-like and startlingly young technician.
Mary had chosen to wait in the hallway, something that was both good and bad as far as Joe was concerned. It was good because the last thing he wanted was for her to see him trembling with fear, and bad because when he was trembling with fear, he could really use a hug. Instead he just lay down on the platform and tried not to hyperventilate. This was easier said than done. The machine had a low, barely audible hum to it that suggested something very ominous was occurring. As he slid inside the tube, Joe closed his eyes and put himself somewhere else. He was standing at the window in India, as a young man, staring out at a world of possibility. Later in that trip he had swum on a beach in Gokarna, at two in the morning in the middle of an electrical storm. There was nobody else in sight, and it was just him, standing one hundred metres off the shore. He was waist deep in lukewarm water, as the cold rain poured down upon him, splitting the surface of the ocean into a million little stars of shimmering light. The lightning flashed all around, and Joe could feel the absolute fury of nature but it didn't scare him. It invigorated him. It was the most beautiful and perfect moment of his entire life. He was suddenly jolted back to reality by a strange warm feeling around his abdomen. At first he didn't know what it was, but then a horrible smell wafted up to him and he realised. He had shit himself.
'Please try and hold still, Mr Finch,' said the young technician as Joe began to squirm in the horror of what he had created.
With a superhuman effort, he managed to do as he was told. He was too embarrassed to tell the young man what had happened and besides, he would find out soon enough. He was a fifty two year old man and he was lying in a puddle of his own shit, waiting to be told if he was about to die. It was the antithesis of that moment in the ocean. Joe was in hell.
Mary Finch hated doctors. Every time she had occasion to talk to one they gave her nothing but bad news, which made sense, but nevertheless she hated them with a passion. She even knew that in terms of cause and effect it made no sense to hate them. The doctors gave her bad news because there was something wrong. They were the effect of the medical problem, not the cause of it, but logic didn't really come into things like hatred. The doctor seated in front of her at the moment was particular hateable. He had a carefully manicured goatee, and yet for some reason he had allowed his nostril hair to run rampant. It crawled from the sides of his bulbous nose and was beginning to spread its root system across his craggy face, like an old building covered with ivy. His hair was greying at the temples, and probably consciously left that way to give his words more authority than they would otherwise have coming from a doctor with a more youthful head of hair, and for that Mary hated him as well. He even had a stethoscope around his neck, as if it was such an invaluable aid for an oncologist that he needed to have one close at hand in case he had to make a quick diagnosis on his way to lunch. The main reason Mary hated him was because he was an oncologist, and that meant that the problem with Joe started with the letter c and ended with the letter r and wasn't in reference to an astrological symbol.
'Have you noticed any odd behaviour in your husband recently?' said the doctor, whose name was Pontius.
'Define odd.'
'Well, anything that breaks from his usual routine. Over-reaction, delusions, vagueness, paranoia, excessive cynicism.'
'You just described his usual routine.'
Pontius laughed in such a way as to suggest that he didn't find Mary's comment in the slightest bit amusing but he was prepared to overlook it for the time being.
'Yes of course, but all joking aside.'
'Last night was the first sign I saw that anything was wrong.'
'And what happened last night?'
Mary sighed. Reliving last night wasn't something she particular wanted to do.
'He... he only shaved half of his face. Only dressed himself on one side as well.'
Doctor Pontius gave a little murmur of approval.
'And he made me write something down on a piece of paper for him. He was really quite insistent about it.'
'What did he make you write?'
'It said, try and remember your childhood.'
'The Doctor made another approving noise.
'Yes, yes, this is very good. Anything else?'
'I don't see what's so good about it...'
Doctor Pontius coughed abruptly.
'Well, good from a diagnostic point of view. These are all symptomatic of a stroke. The shaving of the one side of the face is interesting, yes? This suggests hemisphere separation, although I doubt it is irreparable as it does not appear to be a consistent problem. In those cases, the patient will ignore the affected side completely and the nurse I noticed was standing to his left and being acknowledged. Just a blip I would say. The childhood is a matter for a psychiatrist. They love the childhood and they love the sex. They are like children at Christmas with sexual dysfunction.'
Mary decided that her initial estimate of Doctor Pontius was actually a little too kind, and she radiated her hate a little more intensely. If Pontius noticed it, he didn't give any outward sign of it bothering him. As far as he was concerned she was nothing more than a medical chart, giving him the pieces of the puzzle.
'Is there anything else, Mrs Finch?'
'Well... He did suggest... he insinuated that he thought that I was having an affair with a work colleague of his.'
'Ah! And are you?'
'Of course not!' replied Mary haughtily, angry at the suggestion all the more so because it came from this little manicured-beard man with his ivy nostril hair who answered his own questions.
'No, no, of course not. But this is the paranoia then, and the sex for the psychiatrist to talk about. I'd say it is likely that your husband has suffered a minor stroke, but we shall have to wait for the results of the MRI to confirm perhaps the cause of it.'
'Well what are the likely causes?'
Pontius waggled his finger like a parent who's just found their child spoiling its appetite.
'Ah no, Mrs Finch. I have worked here too long to speculate on such things without the proper information. The legal problems in modern medicine are labyrinthine, you see, and the patient is the minotaur, yes?'
'I shit myself, Mary.'
Mary looked at him, her head tilted to the side, and tried to smile. Joe was sitting in a hospital bed propped up on his pillow and looking about as miserable as she had ever seen him. After more than twenty five years of marriage, she had seen the man looking pretty miserable before.
'I never thought I would say those words again. I shit myself. When I was a very young child it was fairly common, and once or twice in university if I went out with the engineers on a pub crawl, but not now. The nurse actually said to me, let's get you cleaned up shall we? Like I'm some senile old man in a nursing home. I don't even know if it was because I was scared or too relaxed. I guess it doesn't matter when the end result is shit...'
'Joe,' interrupted Mary, when she realised that his monologue was probably going to go on for several minutes unless he was distracted. 'I just spoke to the oncologist.'
Joe stopped, his mouth
still open and formed in the shape of the word shit. He left it there, feeling that the word was still appropriate to the situation.
'What did he say? Cancer?'
'He didn't... he said that you had had a minor stroke...'
'Oh, that's good.'
'But that they won't know the cause of it until the results of the MRI.'
'So I could be looking at a stroke and cancer?'
Mary closed her eyes, wishing that he would stop saying the word cancer. Joe, unaware of this fact because he was too caught up in the idea that he might have cancer, said.
'Cancer?'
'Joe...'
'Cancer?'
'JOE, PLEASE!'
Joe looked at her, his face a blank. It had no expression whatsoever. It was as if every single muscle in it had gone completely limp. For a second Mary was worried it was as a result of his stroke, but suddenly Joe's face became animated again.
'It can't be a stroke. I'm too young for a stroke. And I'm too old to shit myself. I'm dead in the middle of the two ages when either of those things should occur. How can they both have happened to me in the space of two days?'
Doctor Pontius entered the room then, walking quite quickly and clutching in his arms a yellow envelope.
'I have here some results. It's as I suspected,' he said rather proudly, and the barely contained delight in his voice gave Joe hope.
'You have a brain tumour, Mr Finch. Quite a big one.'
His hope was beaten into a million little pieces by quite a big tumour.
'Quite a big one?'
'Well, moderately large. In comparison to the total volume of your brain, then yes, quite large. Look here,' said Pontius, pulling out some displays from the envelope and holding them up to the light near the window so that Joe and Mary could see them.
'Here is your brain, the medulla oblongata, the right and left hemisphere, all right where it should be. But here you see this grey spot here?'
He pointed to a rather large grey area of the scan.
'This is not supposed to be here. This grey spot is a tumour. You can see the colour of the tissue surrounding it, that’s healthy tissue, and that grey blob is the tumour. It's located inside your right temporal lobe, just above your ear but it’s very deep inside, and totally surrounded by healthy tissue. That’s what makes it so hard to operate, but ultimately, that is what we will probably have to do. I would like your permission first to try the other methods, perhaps to delay the necessity of making a decision right away.'
Joe felt Mary's arm tighten on his. He squeezed her hand back and the two of them listened intently whilst simultaneously fantasising about taking to Pontius's head with a shovel. Pontius shrugged and put the scans back into the envelope.
'My permission? I have a choice in the matter?'
'Well, you can refuse treatment if you wish, but I would strongly advise against it, no?'
'But you're saying that these treatments probably won't even work?'
'Not at all. I am saying that they will have a limited effect, but if we are to,' he coughed, 'ahem, cure you completely then surgery would be the only option.'
Joe noticed the placement of the cough and the significance of it. The word cure did not in this case have the positive connotations that normally went with it. In this case Joe could very well find himself cured and some kind of lobotomised vegetable. Or mentally alert, but in a wheelchair. Was that better than dying? Ask anybody in a wheelchair and they would of course say that it most certainly was. Life could still be lived in a fulfilling and rewarding way. The handicap of wheelchair in some cases could probably lead people to excel and drive themselves even harder. Joe thought about his own situation. He didn't find life fulfilling or rewarding as it was. To take away his mobility was horrifying. He was a natural pessimist in the best of circumstances. In fact, as far as the glass half empty, glass half full question went, Joe's innate response would be to suggest that neither was the correct response. The glass was empty, on a fundamental, philosophical level, and no amount of filling it could bring any happiness, therefore it would always be empty. Joe briefly wondered if he had always felt so bleakly about the world.
'Perhaps it's the stroke...' he murmured to himself, but Pontius took it as a question.
'It's almost certainly the cause of your stroke. It's malignant, obviously. It’s actually quite impressive. From the swelling pattern...'
Pontius continued on excitedly about the tumour's impressive attributes as if it were a precocious child, whilst Joe exhaled, somewhat grateful that his hatred of Pontius was momentarily distracting him from the huge mass of grey death that was eating his brain.
'So what are my options?'
Pontius cocked his head to the side like a bird about to vomit into its baby's mouth.
'There is chemotherapy, but it is limited in effect in brain tumours, and the side effects are often unbearable. There are certain drugs that may be able to prevent further growth, which is what I wish to start you on immediately while we explore alternatives. The surgery is dangerous. There is much healthy tissue to cut through. You may lose some motor function, or perhaps find your personality altered. There is also the risk of, well that you may not survive the surgery at all. The percentage risk is high, yes?'
'So my options are unbearable side effects and death, or paralysis and death, or just plain old death?'
Mary was still squeezing his arm, quite tightly, but he barely felt her anymore. He was going to die. Not just in the metaphorical 'we all have to go sometime' sense either. He was going to die soon. It was almost a relief to hear it. The anticipation of this moment had been far worse than actually hearing it, because it was in his nature to assume the worst anyway. Finally, after years of things being not nearly as bad as he had expected, he could chalk up a point for pessimism. The victory felt somehow hollow.
'How long, if I leave it untreated?'
'Well the rate of growth I don't know, but at present best-case scenario, I would say four months. Maybe five, but the fifth month would not be a good month. Because the right temporal lobe is an area relating to emotional response and interpretation among other things, you may find yourself becoming somewhat irrational. Or more to the point, the people around you may notice this. In any case, we would like to keep you for observation for a while, just to make sure there is no immediate danger of another stroke. We'd also like to do some more scans to verify exactly what it is we're dealing with.'
'Fine. Thank you Doctor. Please get out of my room now,' Joe said.
Pontius didn't complain, and in fact looked rather pleased to be leaving but he paused at the door.
'I have spoken to Doctor Armaita. He thinks it would be in your interests to come and see him a few times a week.'
'Doctor Armaita?'
'Yes, he is...'
'He's a psychiatrist.'
'Yes.'
He's the father of the creature that pulled the trigger of my downfall. He's the devil that put me in this hell, thought Joe to himself, in a style far more melodramatic than he usually employed for internal monologues.
'I'll see him,' he said, and Pontius nodded his little beard approvingly before leaving the room.
'His bedside manner is worse than Mengele’s, but he seems competent enough to tell me that I'm going to die.'
'Oh Joe. I'm sorry,' Mary said, and she began to sob against his shoulder softly.
Joe felt his contempt rising.
'Sorry? There's nothing to be sorry about. People die all the time.'
Mary held him tighter.
'You're not just people. You're my husband. You always do that. You always pretend that nothing matters because of starving children in Africa or wars and floods, but this is happening right now, Joe, and it's happening to us.'
Joe managed to extricate his arm from Mary's grasp, and she looked at him in surprise, her eyes still glistening with emotion.
'That's where you're wrong, Mary. It's happening to me.'
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