Still Life (10 page)

“Casey, please. Spare me the lecture. I’m tired. I’ve been traveling all day.” She glanced down at her dirt-streaked Windbreaker. “God, I’m a mess.”

“What do you mean, you’ve been traveling all day? How did you get here?”

“I hitchhiked.”

“You hitchhiked? Are you nuts? Don’t you know the number of crazies out there? Do you have any idea what could have happened to you?”

“Casey,” Janine warned under her breath. “Lighten up.”

Casey took a deep breath. “Okay. Sorry. No more lectures. Just tell me what happened.”

“I got suspended.”

Casey bit down on her lower lip to keep from yelling “Suspended!”

“Just for a week. It’s no big deal. Anyway, I decided I might as well go home.”

“And what? Dad and Alana gave you a hard time?”

“Hardly.”

“They weren’t upset?”

“They weren’t there.”

Casey tried to remember her parents’ travel schedule. As far as she knew, they were in Philadelphia. “Wouldn’t the housekeeper let you in?”

“She wasn’t there either.”

“Nobody was there?”

“Oh, somebody was there, all right,” Drew said. “A very nice couple named Lyle and Susan McDermott. Apparently they bought the house several months ago.”

Casey was confused. “You went to the house on Brynmaur Avenue?”

“Of course I went to the house on Brynmaur Avenue. That’s where we were living last time I checked.”

“But Dad sold that house months ago.”

“You knew?”

“You didn’t?”

“How would I know? Nobody ever tells me anything. I just get shuffled off to boarding school, and when I decide to come home, I discover my parents have sold the fucking house right out from under me, and moved away without saying a word. Who does that sort of thing? Who moves and doesn’t tell their kids? Oh, I forgot,” she cried. “They told you.”

“I’m sure they thought they told you, too.”

“Where the hell are they anyway?”

“They bought a smaller house close to the golf course. Smaller being a relative term,” Casey added, picturing the ten-thousand-square-foot showcase her parents had moved into on Old Gulph Road. “I’m really sorry, Drew. I just assumed you knew.”

“Yeah, well, next time, don’t assume. I could really use a hit of that wine.”

“No.”

“Come on, Casey,” Janine urged, handing Drew the bottle. “One sip won’t kill anyone.”

Drew took a long swallow before Casey could object. “Okay, Drew, that’s enough,” she said finally, when it looked as if Drew might chugalug the whole thing down.

“Can you believe people like that?” Drew asked Janine, kicking off her sneakers and bringing her knees up around her chest, then rocking back and forth. “Would your parents do something like that?”

“My parents divorced when I was seven,” Janine replied evenly. “My father never paid a dime in child support, despite the fact he had a good job and a steady income. My mother kept taking him to court, but it never did any good. Then he got married again and had another family, and the court forgave what he owed us and reduced the amount he was supposed to pay my mother every month, which of course he didn’t pay anyway. So my mother was forced to work three jobs, which meant I hardly ever saw her, and then she got too sick to work, and she died of cancer three months before her forty-seventh birthday.” Janine downed what was left of the wine in the bottle.

“You never told me any of that,” Casey said to Janine later, Drew snoring peacefully on the sofa. “That must have been so hard for you.”

“You know what they say, don’t you? Life’s a bitch.” Janine flashed her most beatific smile. “And then you die.”

“So, what happens now?” one of the doctors asked as Janine literally vanished into thin air, leaving only her smile behind, like the Cheshire cat in
Alice in Wonderland.

“Well, she seems to be breathing quite nicely on her own,” Dr. Ein said with obvious relief as Casey returned to the present, “so I guess we’ll just have to wait and see.” Casey pictured the doctor shaking his head. “Your guess is as good as mine.”

TEN

“… M
iracle she didn’t die,” a voice was saying. “If I were a betting man, I’d have wagered her chance of survival at less than ten percent.”

“She’s a fighter, all right,” a second voice confirmed.

Casey fought back the wave of panic she always felt upon awakening to total darkness. Would she ever get used to it? Would she ever get used to waking up to strange voices talking above her head, commenting on her appearance and condition as if she were an inanimate object? As if she were nothing more than a piece of still life, she thought. Decorative, undemanding, consigned to an appropriate place, to be glanced at and dusted regularly.

Except that someone had wanted her life stilled altogether.

“When they first asked me to consult, I took one look at her and thought, ‘Consult about what? This poor woman’s a goner,’ “the first voice continued. “The extent of her injuries was just so horrific.”

“Nobody thought she’d make it through that first night,” the second voice concurred. Warren, Casey realized, his voice seeping into her subconscious.

“But she surprised everyone,” the first man said, his deep voice filled with admiration. “And now she’s breathing on her own—”

“Still …” Warren interrupted, obviously wrestling with his thoughts. “Her quality of life …” He cleared his throat. “I know there’s no way she’d want to spend the rest of her life in this condition.”

“I know how hard this must be for you, Mr. Marshall….”

“It’s not me I’m thinking about,” Warren protested vehemently. “It’s Casey. We’d actually had this conversation. You remember that woman, I forget her name, the one who’d been in a coma for years, whose husband wanted to disconnect her feeding tube and put her out of her misery, but her parents were desperate to keep her alive, and they went to court, and it was such a mess, a real media circus, and I remember Casey said that if, God forbid, anything like that ever happened to her, I had to promise I’d put an end to her suffering….”

Yes, I remember saying that.

“You’re saying you want to disconnect her feeding tube?”

No, you mustn’t do that. Not now. At least not until we find out who’s responsible for what happened to me.

“No, of course I’m not saying that.”

I need to know who’s responsible.

“To be honest, I don’t know what I’m saying anymore, Dr. Keith. I know that Casey wouldn’t want to spend the rest of her life this way, and I just want to do what’s right. I don’t want her to suffer anymore. I feel like such a traitor because I know I’m being selfish, that I’m not ready to let her go.”

What would she do if their situations were reversed, Casey suddenly wondered, if it was Warren lying comatose in this hospital bed, unseeing and unmoving, week after week, and she was the one standing watch over him? Would she not be saying the exact things he was saying now? Would she not at least be considering them?

“The situation is very different here,” Dr. Keith explained gently. “The woman you’re referring to was in a profound vegetative state. She was never going to regain consciousness. We still don’t know that’s the case with your wife.”

“When
will
you know? A year from now? Five years? Fifteen?”

Fifteen years? Dear God, no. He’s right, Dr. Keith. There’s no way I want to live like this for another fifteen years. Or even five. Five months is more than I can bear to think about. I’ll go mad. Warren’s right, Dr. Keith. I’d rather be dead than go on living like this.

But not yet. Not until I know who did this to me.

It was this mystery, she realized, as much as the various tubes to which she was connected, that was keeping her alive. It was more engrossing than anything she’d been listening to on TV, more stimulating than the conversations of her friends, more riveting than her myriad doctors’ reports. The fact that someone had tried to kill her filled her waking thoughts and occupied her brain, like a stubborn squatter. How bitterly ironic, Casey thought, that her main reason for living had come down to finding out who wanted her dead.

“I know this is difficult,” Dr. Keith said. “But there’s every reason to be optimistic. Your wife has already beaten the odds. She survived an accident that would have killed most people. Her bones are healing nicely. Her heart is strong. Her condition is improving daily. She’s off the respirator and breathing normally. Her brain is functioning, albeit at a slowed, decreased rate of activity.”

“What about doing an EEG to determine the exact level of brain function?”

“We only perform an EEG if we think the brain is dead. Because your wife’s body is functioning, we know that’s not the case. We just have to give it more time, Mr. Marshall. We don’t know anything for sure….”

“This assessment coming from the top neurologist in the city,” Warren said with bitter resignation.

“The brain is such a complicated organ. Here, let me draw you a picture.”

Casey heard the accompanying rustling of paper, the clicking of a ballpoint pen.

“This is the brain,” Dr. Keith began, as Casey imagined him drawing a large circle on the back of her chart, “and this area at the bottom is the cerebellum.”

She fought to remember such details from her high school biology class, berating herself for not having paid closer attention. She imagined a smaller circle trespassing into the bottom right half of the first.

“The brain is connected to the spinal cord by the brain stem, which is full of nerves, twelve to be exact, that control the various senses, as well as—”

“Is there any chance my wife is more aware than we think?” Warren interrupted. “That she can see or hear?”

Casey felt herself holding her breath. Could they tell?

“Highly unlikely,” the doctor responded. “But that’s relatively easy to find out. We could do an opticokinetic nystagmus, commonly referred to as an OKN test….”

“Which does what, exactly?”

“We use a cone-shaped instrument with alternating squares of light and dark, and we spin it slowly in front of the patient’s eyes. A normal person will blink with the change from light to dark.”

“Surely the attending physicians have already performed that test.”

“They have. Several times,” the doctor agreed. “Once, after your wife was admitted, and again later, after her surgeries. But we can certainly order the test again, if you wish, although …”

“Although …?”

“Well, I would think that if your wife could see, she’d be doing everything in her power to let us know.” Casey heard a deep intake of air. “Are you suggesting your wife could be deliberately faking her condition?”

“What? No. Of course not,” Warren said quickly. “Why? Is that even possible?”

“Well, there
is
such a thing as a neurotic reaction to stress. Conversion hysteria whereby high anxiety turns physical. It’s not voluntary, so the patient isn’t deliberately malingering. But I’d say we could rule that out in this case. We could test for corneal sensation, I suppose,” he added after a brief pause.

“Meaning what?”

“We put a wisp of cotton on the cornea. It will produce a very powerful blink, tell us whether sensation to the eye is being received. It’s very hard to suppress a blink.”

“But she
does
blink.”

“A purely reflexive act. What I’m talking about is blinking in response to a direct stimulus.” Casey felt the doctor leaning over her. She heard a click. “You see,” Dr. Keith continued, “I’m shining this light directly into your wife’s eyes. A normal person would blink. A person in a coma doesn’t.”

“Which means she can’t see anything,” Warren stated.

“Which doesn’t mean that might not change tomorrow.”

“And to find out if she can hear? I read about something called ‘ice water calorics’?”

“I see somebody’s been surfing the Net,” the doctor remarked, an indulgent smile in his voice.

“Dr. Keith, the idea that my wife could be conscious but unable to communicate, that she could be a prisoner of her own body, trapped inside her head, desperate to let us know …”

“I understand your frustration, Mr. Marshall, but the test you’re talking about is more than a little drastic. It involves squirting ice water directly into the eardrum with a syringe in order to stimulate the vestibular system. The patient will react by throwing up, possibly even convulsing….”

I don’t care. Do it. Do it.

“But if it meant we’d find out for certain whether she could hear or not …”

“Believe me, ice water calorics will raise you from the dead.”

“Then maybe we should do it.”

We should definitely do it.

“I’d prefer to start with something a lot less invasive.”

Like what? Yelling in my ear?

“I’ll order a BSAEP,” the doctor said. “That stands for brain stem auditory evoked potential.”

“How does that work?”

“We put earphones over the patient’s ears,” Dr. Keith explained. “Then we present a series of tones—clicks mostly—given at different rates, frequencies, and levels of intensity. We record the brain’s response with electrodes, and the results go into a computer. We can actually see waveforms responding to the stimuli. This can be a bit tricky because we also have to separate the microvolts the brain is producing from the ones being put out simultaneously by the heart, lungs, and other organs. The computer has to remove these external noises and register only the ones from the brain. If the picture we get on the screen is flat, that means the brain cell is dead. If there are waves, it means she can hear.”

“Fine. Do it.”

Do it.

“Again, Mr. Marshall, I have to remind you we’ve already performed this test….”

“But not lately,” Warren stated.

“No, not lately. Tell me, has something happened to make you think your wife’s condition has changed?”

“No. Not really. It’s just something my wife’s sister said last week that I can’t get out of my head. She said that sometimes Casey gets this look on her face, almost like she’s been listening, as if she understands….”

Casey felt the doctor move in again to examine her more closely. “Frankly, I don’t see anything in her expression to indicate that. But then I’m not family. You know her much better than I do. And anything’s possible. So why don’t I schedule the auditory evoked potential test and we’ll take it from there.”

“How soon can you do it?” Warren asked.

“I would think we could get it attended to pretty quickly. Tomorrow or the next day.”

The sooner the better.

“You have to be prepared that even if the test indicates your wife
can
hear,” Dr. Keith added, “that doesn’t mean she necessarily understands what she’s hearing.”

“I understand. I just have to know.”

“Try not to make yourself too crazy, Mr. Marshall. If your wife
can
hear, which we know she couldn’t even a month ago, then that means her condition is improving. It could even mean she’s on the road to a complete recovery.”

A complete recovery, Casey repeated. Was it possible?

“Have you thought about where you’ll be sending her for rehab?”

“I’m taking Casey home,” Warren said forcefully.

“You might want to reconsider that,” Dr. Keith advised. “Casey is going to require round-the-clock care for at least another two to three months. She’ll still be connected to an IV; she’ll have the feeding tube; she’ll need to be moved every few hours so she doesn’t develop bedsores. Taking care of her will be a full-time job. It’s much too much for you to handle. If you’d like, my secretary can give you a list of places….”

“I’ve already arranged for a nurse and a physical therapist,” Warren told him, “and I’ve ordered one of those special beds to rotate her electronically.”

“Well, then, I see you’ve thought of everything.”

“I think my wife would prefer to be at home, Doctor.”

“I’m sure she would. Good luck, Mr. Marshall.”

Casey listened as Dr. Keith walked from the room.

“Well, did you hear that, Casey?” Warren pulled a chair close to her head and sat down. “We’re going to find out if Drew was right, if maybe you
can
hear. Wouldn’t that be something?”

It would be a start.

“If you
can
hear,” he continued, hesitating briefly before going on, “if you
are
listening, I want you to know how much these last two years with you have meant to me. You’ve been such a great wife, Casey, the best lover and companion any man could hope for. Our time together has been the happiest time of my life. It’s very important to me that you know that.”

I do know that. I feel the same way.

“Mr. Marshall,” a voice interrupted from the doorway.

Oh, for God’s sake, Patsy. Scram.

“I’m sorry to intrude. I saw Dr. Keith in the hall. Is everything all right?”

“Everything’s fine.”

You don’t stand a chance here. Go away.

“You’re sure? You look so sad.”

“I’m fine. And please, call me Warren.”

“Warren,” Patsy repeated softly. Casey could almost hear her purr. “How’s Mrs. Marshall today?”

“No real change.”

Casey felt a shift in the air as Patsy approached. The smell of lavender suddenly swirled around her head, danced beneath her nostrils, and sunk into her pores. Casey grasped at the scent as if it were the air itself. Was it real? And if it was, what did it mean? That another of her senses was returning? And if her sense of smell was coming back, how soon before her other senses returned as well? How long before she could see and move and speak, before she was a human being again, before she could hold her husband in her eager arms and whisper soothing words of love into his ear, just as he’d been doing before Patsy’s well-timed interruption? How long until she had the pleasure of telling Patsy exactly what she could do with her fake words of sympathy, and just where she could shove her good wishes?

“I see her hair’s growing back nicely where they had to shave it,” Patsy remarked, propping up the pillows behind Casey’s head. Then, “Is something the matter with your neck?”