Prognosis Page 3

  “Take your time,” he says, which I interpret as, What on earth is wrong with you?

  “Good,” he says, when I’ve finally sorted them out. “Now let’s try something else. I want you to find the red triangle on the desk and put it inside the cutout triangle here, and then do the same with the yellow circle.” He points to an empty red space in the shape of a triangle. “Do you understand?”

  Yes, I nod, registering that no one has asked me if I understood something since I was in kindergarten. It’s a game meant for kids aged between two and four. I struggle. I manage to place the triangle in the triangle space—I remember what he pointed at—but when it comes to the circle, I can’t for the life of me find it. It’s a trick. “There’s no yellow circle,” I say.

  Toby points at the circle.

  Something inside me bursts. I bury my head in my hands and sob. Toby passes me a box of tissues, but I am beyond tissues. I sob while he tells me it will take him a day to write up his report and send it to the hospital. I sob as I leave his office and make my way to the car park, Edward trailing behind me silently. I sob all the way home and long after Edward has dropped me off and returned to his life with Kate. I sob as I take the dogs to the park. I sob until I fall asleep that night and moments later when I wake.

  I don’t go back to the hospital. I don’t need to. The neurologist rings me at home to tell me he has received the results of my psychometric tests.

  “Look, you probably guessed the results are not good,” he begins.

  I don’t speak.

  “You scored very poorly on the psychometric tests. If we were talking in terms of IQ, yours would be around eighty.”

  He does not tell me what an IQ of eighty means, but I know enough to realize that an IQ of eighty is very low. Perhaps he thinks I will not understand.

  “These kinds of results are consistent with a mild traumatic brain injury,” he says. “Unfortunately, the longer-term prognosis isn’t terribly good. I don’t see that you’re going to be able to return to work.” He pauses. “Not to white-collar work, anyway.”

  I struggle to follow. What does he see me doing in the future? Going down a coal mine? Working on the railways?

  “Outdoor work might suit you. Do you like the outdoors?” he asks.

  I don’t answer.

  “Working in a park, that kind of thing.”

  I cannot speak. The number eighty sloshes around inside my head, like dirty water inside a bucket. What was my IQ at age eleven? I knew it once; how can I have forgotten it? Eighty. Eighty. Eighty. A frighteningly low number for someone holding down an executive job, someone who is partway through her PhD.

  “We’ll organize some rehab for you. You’ll have your own social worker, and she’ll be able to help you. She’ll let work know too. That you won’t be going back. The main thing to avoid is another blow to the head. That could be very dangerous.”

  I listen, and as the words register, I feel as though something inside me might implode. “What about my PhD?” I ask.

  He clears his throat, and I hear what sounds like a scoff. “There is no way you’ll be able to finish a PhD.”

  And there it ends. My prognosis. Our conversation. Life as I knew it.

  2

  THE POCKMARK ON THE WALL

  On the wall of my living room, directly opposite the fireplace and approximately one foot above the back of the sofa, was a slight recess about an inch in diameter, where part of the plaster was gouged from the wall.

  I bought this house for my dog, Bess, after Edward and I were threatened with eviction from our old apartment block. Bess, a mixed-breed dog about the size of a spaniel, had barely been living with us for a fortnight when an elderly woman with gray hair set atop her head like fairy floss stopped me in the lobby of our block and hissed, “We have had multiple complaints about your dog. Get rid of it or find somewhere else to live.”

  I put the apartment up for sale and found a buyer almost instantly who paid double what I had just two years earlier. A week later I purchased an unrenovated terrace house barely a block away, on Darling Street in Balmain, and hitched myself to a large mortgage. Bess got a home, and, for the first time in my life but not the last, I had bought a house almost entirely based around the needs of a dog.

  I painted the inside of the house after Edward and I broke up. An old brick house built in 1870, it was prone to the ills of old Sydney terrace houses—dampness, darkness, mustiness. I chose a hue of burnt yellow for its walls, which the paint chart called “corn bread,” and I diluted it by half. I hoped yellow might improve my mood and help me forget that I had once shared the house with Edward.

  It took me a week to prepare the walls for painting, plugging the holes with putty, waiting the requisite two hours for drying time, sanding them, applying a second layer of putty, and finally sanding again, first with coarse paper and then with extrafine. I used wood putty to mend the scars and scabs on the doors, molding, and baseboards before giving everything three coats of high-gloss white paint. I used turpentine and a clean sponge to remove the paint from George and Bess, who had leaned against the freshly painted doors, eager for me to finish. I was certain I had plugged every fissure, every blemish, every hole made by picture hooks over the past 120 years. My dedication to this task was astonishing. I am sloppy by nature, but the results I achieved were nothing short of remarkable. Had I been so inclined, I could almost certainly have tossed my job with the government and set up shop as a painter.

  Days after I learned of my prognosis, I lay on the sofa, entranced by this gouge in the plaster. I didn’t wonder how it slipped my notice when I was preparing the walls for painting. I wasn’t struck by my pockmarked wall in need of putty to seal its holes as a metaphor for my life. I didn’t imagine the pockmark was a hole that would suck me in and transport me to a different world.

  I didn’t think anything at all.

  I just stared at it and lost all concept of time. Spittle ran down the side of my chin, reminding me that my mouth kept falling open. Time passed without me realizing it, and my memories of that period are murky and disordered. My life was crammed inside this spot on my wall.

  I had just been told I had suffered a mild traumatic brain injury, but even in my brain-damaged state, the words “mild” and “traumatic” seemed contradictory. If my injury was mild, why couldn’t I return to my job and resume my former life?

  I was not the only one who was confused about the meaning of a “mild” traumatic brain injury (TBI). I have since learned that there is no consensus among health-care professionals as to what the term actually means, making diagnosis rather difficult. To complicate things further, the term “mild TBI” is often used interchangeably with “concussion.”5 Mild traumatic brain injury is commonly thought to refer to any loss of consciousness that lasts less than thirty minutes, any loss of memory of events immediately before or after an accident, any change of mental state (such as feeling dazed or confused), and any problems with focus. Patients are generally assessed according to the Glasgow Coma Scale, which is used, among other purposes, to measure the level of consciousness after a TBI by testing basic eye, verbal, and motor responses.

  Not that I knew any of this at the time.

  I spent most of each day stretched out across my sofa. George preferred the coolness of the floorboards, while Bess sacrificed her own comfort, and mine, to nestle against me and let me know she was there. The summer heat seeped through the walls of our house. I wore shorts and a T-shirt, and the skin of my arms and legs prickled with heat and dog hair. My head felt as though a train rattled through it as I gazed into the pockmark on the wall.

  George and Bess stepped willingly into their respective roles as protector and caregiver. In the unlikely event someone knocked at our door, George barked savagely and bared his teeth. If anyone wanted to mess with his brain-damaged owner, they would have to deal with him first. Bess, a gentler dog than George, licked my hands and face and wagged her tail to let me know that every
thing that existed outside my brain-damaged world was fine.

  George, our pack leader, assumed control over my days. He seemed to enjoy the redistribution of power in our household—he was the man and he liked to be in charge. Unless there was a thunderstorm, in which case all bets were off while he convulsed with fear under the kitchen table, or sat on my head when a storm struck during the night.

  Each morning he woke me at seven to take me to the park. I dressed myself in whatever clothes I could find that were nearest to the bed and attached leashes to the dogs’ collars. We walked in any one of three directions, depending on George’s mood. Bess and I followed him, grateful that someone in the family was capable of taking charge.

  Three parks were nearby, and George liked variety. At the park, he led Bess and me to an empty bench, where I sat, removed the leashes from their collars, and stared out at the harbor. George and Bess spent an hour or so gamboling with other dogs, sniffing trees and busying themselves. From time to time, if a man approached or came too close to my bench, George would bound up to him out of nowhere, snarling and flashing his teeth. I belonged to him. A former stray, George wasn’t fond of men. His fondness was for pretty blonde women. If he spotted an attractive woman on the other side of the road, he would happily put our lives in danger, dragging us in front of cars and buses, in the hope of a pat or a kiss.

  Once he decided our park visit was over, George mustered up Bess and they trotted back to my bench and sat obediently at my feet, waiting for me to attach their leashes. They walked me home and waited in the kitchen while I prepared their breakfast of cooked mince and dry kibble. We repeated the ritual at lunchtime and late afternoon. Before bedtime, they settled for a quick walk around the corner to a small patch of grass.

  When we rescued Bess, I was twenty-six. I had been desperate for a dog ever since moving out of my parents’ house, but the apartment Edward and I lived in didn’t allow pets.

  Looking out our kitchen window one Sunday morning, Edward spotted a dog not far from the seawall in Sydney Harbor, struggling to stay afloat. He shouted at me to follow him, and we raced downstairs.

  Edward leapt the stone wall and waded into the water. Moments later he reappeared carrying a waterlogged dog. She was medium sized, white with black markings and a black patch the size of a baseball over one eye. We sat with her on the grass and waited for her to get her breath back. Moments later she lifted her head slightly, looked at us, and wagged her tail.

  “We are keeping her,” I said to Edward. “If she doesn’t have a microchip.”

  “Dogs aren’t allowed in our building!”

  “We’ll buy a house then.”

  Edward looked at me as if I was crazy.

  “She doesn’t have a collar,” I said. “Let’s see if she has a microchip.”

  Bess, as I decided to name her, didn’t have a microchip. Our local vet had never seen her before.

  We wrapped her in a large beach towel and carried her up in the elevator to our apartment. The first time we did it when the elevator was full, she let out a single yelp, signaling to our fellow passengers that she wasn’t a pile of laundry, but a dog, and not just a dog, but a dog we were disguising as something else in order to smuggle her inside our building.

  About six months after we settled into our new house, Bess and I were out for an afternoon walk beneath the enormous Moreton Bay fig trees at Birchgrove Park, when we spotted a terrified dog without a collar. A few blocks from our house, Birchgrove is one of the most exclusive suburbs in Sydney, comprising a ring of luxurious waterfront homes, a tiny harbor beach with an old wooden jetty, and a perfectly manicured sports field—not the kind of place you expect to happen upon a stray, hungry dog.

  The dog was darting back and forth across the road, his tail between his legs. I tried to approach him, and kneeled down on the ground with my hand extended in his direction, but he refused to come anywhere near me. I ran home, left Bess there, grabbed some fresh meat from the fridge, and hopped in my car to find him. Three days later I finally caught him after I followed him onto the jetty and managed to slip a collar around his neck. More fearful of water than he was of me, he relented. We sat together on the steps of the jetty, and I stroked his ears. Despite being thin, he was handsome, about the size of a German shepherd, with the red-brown coat of a dingo.

  Worried that he might slip his collar and leash, I picked him up and carried him to my car. Bones were visible on his sides, and his slack body felt like jelly. I took him home and introduced him to Bess. She was happy to see another dog and looked on amiably as he gobbled down a bowl of dog food. I decided to name him George, my father’s middle name. It was a name I liked, and it seemed to suit him.

  That afternoon, I took George to the vet for a checkup and a microchip. The vet estimated he was around twelve months old.

  The rivalry between Edward and George was instant. A neighbor told me Edward locked George out in the garden when I was at work. George disliked Edward and spent most of his time pretending Edward wasn’t there. The two vied for the position of top dog, and George won.

  One day, the social worker came to visit. The unusual sound of a knock at my door sent both dogs into a frenzy. Breathless after climbing the three steps it took to reach my hallway, Rosie introduced herself and told me she was frightened of dogs. I neither liked nor trusted people who were fearful of dogs. Dogs were all I trusted. George looked Rosie up and down, snorted his disapproval, and retreated inside the house.

  “Do you mind locking the dogs in another room while we talk?” Rosie asked.

  George shot me a look that said, How about we lock her in another room?

  “The dogs stay,” I said. “They’ve never bitten anyone and are unlikely to start now. We have no secrets here.”

  Rosie raised an eyebrow. She then told me she had contacted my boss and “explained the situation,” lingering over each word.

  “You suffered a serious brain injury. You’re not going to be able to return to work.” She said it as if she were telling me what she cooked last night for dinner.

  I sat for a moment, letting her words sink in. Weeks ago, I had a senior job in the government. Now I was being told I would not be able to work again. It was an outcome I could never even have imagined. “Please go,” I said. I could not believe that a decision like that had been made without my permission, without consultation. It infuriated me to think that the state had stepped in and decided my future. My life was in the hands of Rosie, a well-meaning woman with spiky red hair and arms like loaves of bread, a woman I had never even met before.

  “Go,” I said, and she did.

  Rosie called me about a fortnight later to tell me she had managed to get me a spot in a rehab group in North Sydney, cutting up fabric for stuffed toys. “It would help you, I think,” she said. I hung up. It was the last conversation we had—her final attempt at my rehabilitation.

  Rosie’s call made me decide to wrench the phone from the wall. I plugged it back in only when I needed to make a call.

  George, Bess, and I settled back into our routine. Each night around nine o’clock George nudged me from my torpor and made his way over to the foot of the staircase, where he waited for Bess and me to follow him up to the bedroom. He was the first to hop onto the bed and insisted on lying crossways over its middle. Bess and I squeezed in around him, legs dangling over the side of the bed. The dogs fell into a deep slumber almost as soon as they were horizontal.

  Sleep as I once knew it was impossible. When I closed my eyes, I was bombarded by flashing lights—my own private laser show. Sleep came in snatches of five or ten minutes and only when I sunk into slumber at the very instant my eyes were no longer able to hold themselves open. When I did fall asleep, I had horrifyingly vivid dreams of being locked inside a coffin and buried alive, with a torch flashing in my face. So disturbing were these dreams that I would wake to find myself standing somewhere in my bedroom, soaked in sweat, arms flailing, thrashing my way out of a locked wooden box
. Back in bed, I stared at the ceiling, at the shadows cast by the fan that whizzed above us and threatened to break loose and chop us all into tiny pieces.

  No one had told me that sleep disturbances affect most head-injured folk, sometimes permanently, or that a lack of sleep would significantly hamper rehabilitation. I would never have another normal night’s sleep without medication. I squirmed around the bed, trying to claim enough space to stretch out like a beanpole between the dogs.

  Grief consumed me, fanning the flames of my insomnia. I struggled to remember anything except my father’s death. That episode had been carved inside my brain like a knife cuts into the trunk of a eucalypt. I remembered little other than the most rudimentary requirements of daily living—to wake, walk the dogs, feed them, feed myself, swallow painkillers for my aching head, wash, dress, and retire to the sofa until the dogs reminded me it was time for me to move. My father’s death, though, I recalled as if it had just happened. I saw the outline of his body under the white hospital-issue blanket, like a matchstick bent in half. I heard him shriek with pain before we called the doctor and increased his morphine dose. I kissed his face, the face of a dead man. Every memory I ever had was wiped clean to make room for each minute detail of my father’s death. It played out in my head, over and over again, like a tape on repeat.

  Cancer had shrunk my father to half his former size. A tumor had burst the banks of his bowel and spread into his spine. Bowel cancer had become bone cancer, and the pain had been excruciating. He had still been handsome only a year before his diagnosis, but afterward he looked at least thirty years older than sixty-four. Gray flesh with eyes that retreated inside his face. A skeleton draped with skin.

  One morning he got up after tea and took his mug back to the kitchen. My mother and I watched him use all his strength to lever himself out of his chair. He didn’t stay upright long. Bess leapt up excitedly, thinking it was time for a walk, and knocked him back down. My mother and I picked him up and carried him to the bedroom. He never got up again.