The Cloud

10

Standing at the door is a doctor in his late twenties or early thirties, dark skin, glasses, closely shaven. He’s thin to the point of an eating disorder. This is not an illness he suffers, but it’s certainly a condition I remember well. It’s the product of working seventy-hour weeks, including regular all-nighters, time usually spent walking or jogging from exam room to exam room, eating when time and a perpetually tight stomach permit. This is MRA, medical resident anorexia.

“I’m Dr. Sudanagunta. I’m the resident. I’ll give you an initial check and then an attending doctor will see you. You hit your head?”

I give him the rundown of the moment and point of impact.

“I’ve been tired and groggy. I’d ordinarily ignore it but it was a sharp-enough impact that I’m wondering if I’ve got a punctuate hemorrhage.” I smile to preface a joke. “I have that light-headed feeling that comes with a quadruple latte at Starbucks or a diffuse axonal injury.”

I make light of my know-it-all-ness but by way of letting him know I’ve got some training. Why not just say so? Because it’s just not done. It’s the medical trade’s own version of the “don’t ask, don’t tell” policy. In keeping with the strange custom, the resident’s face registers only a small tic when he hears my use of the technical language.

Wearing rubber gloves, he prods the wound at the base of my skull, prompting me to wince.

“It’s closing nicely. We’ll obviously want to keep it clean. I don’t think it needs a bandage.”

He disposes of the gloves in a black hazardous-materials bin. He sits at the end of the bed and crosses his arms.

“Can I ask you a few questions? Basic stuff just to check cognition and memory.”

He pauses, just instantaneously, and I can imagine him going down a checklist for the Mini Mental Status Exam-the basic concussion test. I feel for him, trying to remember and apply a range of triage techniques-from concussion in Room 2 to second-degree burn in Room 3-on the eight hours of sleep he’s had for the week. But this exam, I know, is so often executed that it becomes rote.

He asks me to recite today’s date and where I am, and asks if I know why I’m here. Then we move on to the more complicated questions.

“Let’s start with memory. I’m going to list three objects. I want you to memorize them. In five minutes, when I’m done with the rest of the exam, I’ll ask you to repeat them to me. Make sense?”

I nod.

“Here are your three: apple, tree and chair. Can you repeat those back to me?”

I do so. He asks me to repeat them again and I do. He tells me he’ll ask me to repeat them once more in five minutes.

“Now. I want you to count backwards from one hundred by seven. One hundred, ninety-three, and so on. Or you can do three or eight if you want.” He finally smiles. “We’re not rigid.”

“Sevens. I’m a traditionalist. One hundred, ninety-three, eighty-seven, eighty, seventy-three, sixty-six, fifty-nine. .” I pause. I notice that he averts his eyes for a second.

“I missed one?”

“Ninety-three minus seven is eighty-six. Can happen to anyone. Let’s try something else.” He reaches for his clipboard, which sits on the sink counter behind him. He rips a standard admittance form.

“Take this piece of paper. Fold it in half, then in half again the other way to create a square. Then unfold it, and hand it back to me.”

It’s a test called a three-step command, which I perform ably.

“Good. Earlier I asked you to remember three words. What were they?”

“Piece of cake.”

He looks at me with cocked head.

“Joke. Here ya go: apple, tree and high chair.”

He looks up. “One more time, please.”

“Apple, tree and high chair.”

“You said ‘high chair.’ ”

“I did.”

“Apple, tree and chair.”

“You’re sure?”

He nods. “Do you have kids?”

“A son. Nine months. He’s in the DustBuster phase.”

“He likes to clean up?”

“He likes things that make noise and have buttons.”

He nods. “Let’s get you a CT scan.”

The reason I know he’s worried is that I wait a mere fifteen minutes to get my head examined by the massive white imaging machine.

The results come half an hour later from the resident and the attending doctor, a short woman with intense blue eyes and sandy blonde hair pulled back tightly in a bun, revealing tiny pimples dotting her forehead. Maybe rosacea.

She slaps the scan on a light tray on the wall. I know immediately what I’m looking at when I see the small white dots on a region of my brain that stretches across the front of the inside of my skull.

“This tells us to worry but not panic,” she says. “The white dots show us blood spots, which is not good news. This is a serious concussion. But I don’t see any evidence of hemorrhage or really troubling tissue damage.”

“What can we do about it?” I ask, though I know the answer.

“As you may know, there’s not much. Rest, but serious rest, not a lot of physical activity. I don’t think we need to admit you. At this point, you’re not looking at long-term damage but your short-term functioning could well be impaired. How much do you know about the frontal lobe?”

“It’s what keeps me from acting like a two-year-old.”

She smiles. “Right. Impulse control, and lots of other things. It’s the last part of your brain to develop and it’s essentially what lets you modulate everything else, the control center.”

I nod. “I already tend to have an impulsive streak.”

“In all seriousness, you should watch to see if you’re feeling emotionally taxed, having trouble making decisions, more impulsive than usual. This is nuanced stuff to measure, but we’d want to follow up on that. How’s your pain now?”

“I’m fine with Advil and a really soft pillow.”

“Use it. Really.”

I leave the hospital in the dark.

As I climb into my car, I realize I’ve had another short-term memory lapse. I’ve not gotten back in touch with Faith. I dial her and get voice mail. I ask her to call. From the trunk, I yank out my laptop. With it in my lap, I drive to a residential corner where I find a network connection I can Bogart. I log in and I search for “Sandy Vello,” and “obituary,” and lots of other variations that might give me the same information about her that I got last night and this morning on this same computer. But the obituary is not there.

It’s absolutely official: the narcissistic reality-show contestant is not dead. Again.

For a West Coast-based journalist whose stories often have to do with technology, I’m remarkably not technology savvy. I’m the opposite of that. (For instance, I couldn’t understand the need for instant messaging. What, email not instant enough for you?) In short, I’m not particularly sure where to look on my computer for the phantom traces of the obituary-to prove it was there, and erased, and, further, that I’m not imagining things.

But the traces must be there. After all, I don’t really suspect I’d imagined the obituary because I’d have had no way of knowing that Sandy volunteered at the jail. And, beyond that, I’ve got a concussion, not a case of the crazies.

On my browser, I pull down the list of sites I’ve recently visited. There is no evidence of a Sandy Vello obit. I pull down the “History” menu and get a similarly unsatisfactory result. It stands to reason. I found Sandy Vello through a Google search, so my history shows my visits to the search engine and the terms I’ve searched.

It’s just after 9 p.m. and I should absolutely be resting my brain and body. But I need to take my computer for a thorough diagnosis.

It’s time to pick up a carnitas burrito, then visit Bullseye, the Witch’s husband, a computer geek who doubles as a bar-stool statue.

Destination: the Pastime Bar, my regular pub and a black hole of San Francisco real estate that managed not to gentrify.