Trauma

CHAPTER 11

Carrie glanced out the sidelight window at an unfamiliar car, a Zipcar rental, parked in the driveway. The Bryants hadn’t had many visitors in the two weeks since Carrie had moved home. No one had rung the bell, so whoever it was must have come to see Adam.

Good. Carrie was still in her pajamas, and didn’t feel like making small talk. Since she had gotten home, she’d done next to nothing except watch old movies with her dad. She wasn’t feeling cute, clean, or the least bit congenial — hardly ready to face the outside world.

For all the recent tumult, coming home had been seamless. Adam had helped with the move, such as it was. The U-Haul truck she had rented was far too big for her few possessions. Everything Carrie owned — a futon, two bookcases, three boxes of books (mostly medical texts and some fiction), a flea market coffee table, a small color television and scuffed TV stand, some clothes, a few framed pictures, and a dresser — fit into a small corner of her parents’ basement. It was depressing to realize her life’s accumulations could take up so little space. For so long, her focus had been on nothing but medicine. Carrie wondered what could possibly take its place.

Carrie had settled in her old bedroom, but it was far from cozy or comforting. Limbic, Carrie’s goldfish, swam unfazed in his large bowl, which rested atop the same blue dresser she’d had as a kid. It was still her childhood bedroom, even with all her old memorabilia boxed up, and the twin bed covered in the emerald green Tibetan quilt Carrie had bought on her travels to the Far East. Living here again was dispiriting, though better than living in Boston with her parents paying the rent.

Stress had triggered insomnia, which in turn triggered a new dependence on Ambien that left her perpetually exhausted. Her runs, if they could be called runs, were uninspired and dangerously close to being brisk walks. She was probably clinically depressed, but Carrie wasn’t going to get help for it. She didn’t deserve to feel better. Carrie’s actions had substantially reduced Leon’s quality of life. It was unclear whether his symptoms would improve over time. Carrie deserved to feel lousy.

Carrie’s mother, Irene, a petite sixty-year-old woman, entered the foyer through the dining room, rubbing lotion on her hands. She was dressed in a blue denim shirt and khaki pants, the uniform of a passionate gardener.

“Who’s here?” Carrie asked.

“A reporter from the Lowell Observer,” Irene said. “Here’s here to interview Adam for a story.”

Carrie’s eyes narrowed. “Adam?” Since his discharge from the WTC, Adam preferred solitude. Friends rarely came over. This guest was a surprise to her.

Irene said, “I got a call from Everett Barnes, the director of veteran outreach for the Home Base Program, asking to see if Adam would tell his story. I told him about it and I guess he agreed.”

Carrie understood now.

Home Base had been set up by the Red Sox Foundation to give clinical care and support services to Iraq and Afghanistan service members, veterans, and their families all through New England. It dealt specifically with veterans and their families affected by stress or traumatic brain injuries sustained on deployment or in combat. Sadly, the organization could not grow fast enough.

“I’ll go see how it’s going,” Irene said, pushing her bangs off her forehead and tucking a strand of dark, shoulder-length hair behind her ear. “Oh, and your father is in the kitchen. He wants to speak with you.”

Carrie found her dad sitting at the kitchen table, sipping from a mug of steaming coffee. He drank his coffee no-frills; the whole family did. Was this learned or inherited?

Carrie poured herself a cup. “You wanted to speak with me?”

Howard’s face tensed.

Carrie ignored a tic of anxiety and sat down, preparing herself for anything.

“I’ve been thinking about things,” Howard began, choosing each word carefully. “And I think you’ve come too far to quit now.”

Carrie folded her arms and looked away, her instinct for self-preservation kicking in. This felt like an ambush. She had made it abundantly clear that reconsideration was not an option. To be a great surgeon required great confidence, and Carrie would be a danger in the OR.

Still, this was her dad, and the soul of kindness. He deserved that she sit still and listen.

“You are a gifted neurosurgeon,” he continued, “with only one more year to complete your residency. I know that you had your heart set on that fellowship at the Cleveland Clinic, and then who knows what? I don’t want to say something trite like ‘everybody makes mistakes,’ but I honestly can’t think of one successful person, especially not doctors, who hasn’t gone through a personal hell of some sort or another. Sleepless nights. A crisis of confidence. Not one.” He picked up his coffee cup again and took a long drink.

Carrie’s voice caught, and came out a bit shaky. Contradicting her father had never come easily. “Dad, you don’t know how badly Leon is hurt. Honestly, just the thought of operating makes me anxious. I was never this way before.”

Howard nodded. His eyes brimmed with empathy. “I know,” he said. “You’ve said that many times. But there’s something I never told you that I think you should hear.” He shifted in his chair. “When I was an intern, I accidentally overdosed a young man suffering from a seizure.”

Carrie said nothing. In the silence, the revelation became its own uncomfortable presence.

“I gave him too much phenobarbital. I’ll never forget it. He stopped breathing and his blood pressure collapsed. We had to call a code, and the poor guy almost died. Because of me. Because of my mistake. I saw him every day in the ICU for the next week, and each time I was racked with terrible, terrible guilt.

“Even today, I always double-check myself when I administer drugs,” her father said. “Especially that drug.”

Carrie could relate. The last she heard, Beth Stillwell had recovered and returned to work, but Leon had been transferred to a long-term nursing care facility. Not all of Leon’s deficits were attributed to Carrie’s mistake, but she’d owned all the guilt regardless.

“Unlike Leon, my patient was going to get entirely better before I made him worse,” her father continued. “For weeks I couldn’t sleep. Barely could eat. Thankfully he did recover, but I think you get my point. My mistake almost cost this man his life. But that’s a part of the job. We’re expected to be perfect, but no human being is infallible. Not you. Not me. Not Dr. Metcalf. Mistakes happen. But it’s how we deal with the adversity that defines our character. You can make peace with this and find a way to move forward. I did. Now, I’ve a suggestion.”

Carrie could guess where he was going with all this, but — it was too soon. Too soon. She could not pick up another scalpel. Not now, and despite what he said, maybe not ever.

“You’re a grown woman, and these are ultimately your decisions. But I have some years and some perspective, so I ask only that you hear me out. A couple of weeks ago I went to a dinner on Parkinson’s disease sponsored by a pharmaceutical company. I sat next to a man who was taking their drug, a patient. Turns out he had deep brain stimulation to help his treatment and now, with the combination of DBS and his meds, he’s doing better. He was able to attend meetings like this one.”

Carrie knew all about DBS, a surgical treatment involving the implantation of a brain pacemaker and wires that delivered electrical impulses to targeted areas of the brain. It was used to treat movement disorders such as Parkinson’s, but researchers and clinicians were exploring other applications, including treatments for OCD, major depression, and chronic pain.

“This man was very pleased with his results,” Howard said. “He talked at great length about his treatment at the VA under Dr. Alistair Finley, whom I know from way back when I did my internship. I haven’t seen him since, but why don’t you go talk with him? He’s right in town. Use my name. We weren’t especially close, but I’m sure he’d remember me.”

“Thanks, Dad,” Carrie said. “I’ll give it some thought.” She turned her coffee cup in her hands. “I’m not particularly interested in Parkinson’s. I mean, that’s not what we really do in neurosurgery.”

Howard conceded with a nod. “I understand it may seem less glamorous. But maybe, given your … your reluctance to get back in the saddle, it could be just what the doctor ordered.”

Carrie smiled. She was about to tease him about dads being doctors when the doorbell rang.

Howard got up to see who was there. A moment later, Carrie heard him exclaim, “Oh my gosh!”

Howard returned to the kitchen with a tall, lanky man who was bleeding profusely from the nose. The oily rag he was using to stanch the flow had smeared a good portion of his face with engine grease.

“Adam apparently took offense to something.” Howard spoke without emotion. He’d long since realized it didn’t help to get upset about his son’s new hair-trigger temper. “Could you please get this gentleman some ice? I’m going to go look for your mother and my boy.”

Carrie took the stranger by the arm and led him to a chair at the kitchen table. “Tilt your head back,” she said once he was seated. He looked like a boxer ready to concede the fight.

“I’m David. I’m from the Lowell Observer.” Between the rag and the injury, his voice was especially high and nasal.

Carrie got a clean roll of paper towel from the pantry, then filled a plastic bag with ice from the freezer. Applied to the bridge of the nose, the bag of ice reduced the swelling and the pressure, and the bleeding stopped after a minute or two.

“What the heck happened?”

David smiled sheepishly and shook his head. “It was my fault,” he said. “Really. I’m to blame here, not Adam.”

Carrie gave David a fresh paper towel and refilled his plastic bag with ice. She studied her patient. Probably around her age, he had attractively messy hair and a kind face. She suspected he was something of a charmer.

“Go on,” Carrie said. “I’m all ears.”

“I came here to interview Adam for a story I’m writing about PTSD, but your mother showed up and Adam had a change of heart. No longer wanted to talk.”

Carrie grimaced. “You didn’t take no for an answer, did you?”

David laughed, and Carrie thought the sound was warm and inviting. He was obviously embarrassed, but he had enough humility to see a little humor in it.

“No’s not my style,” he said. “I didn’t think I was being pushy, but I don’t back down so easily.”

Carrie thought of her conversation with her dad. Neither do I, she realized.