Posts Tagged ‘atul gawande’

the ground beneath her feet.

6 May 2009

i met her for lunch at a mexican restaurant near her house. it was the first time i’d seen her since i spent the night four days previously. that morning i’d been awakened briefly by a loud noise before drifting back to sleep, ruling that she had knocked over a hair dryer or similar device in the bathroom and that i had nothing to worry about but catching some more zzz’s.

i woke up again with her sitting on the edge of the bed looking confused and speaking sporadically, as if she were uncomfortable with the english language. i pieced together her false starts and mumbled phrases, repeating questions until i got an intelligible answer, eventually deciphering that she had had a seizure in the hallway, hitting her head when she fell. she suffered a concussion as a result. the rest of the day was spent in the hospital undergoing a battery of neurological tests.

she had never experienced anything like this before, and, as a consequence, i wasn’t sure how to approach her. i ended up taking the less tactful route. over a plate of arroz con pollo which was still too hot to touch, i began listing the hockey players whose careers ended prematurely as a result of too many hits to the head, some who had enjoyed a few very productive years before crisscrossing over the middle, puck on the blade of their stick, with their head down; others who had such promise, high draft picks who never even made it to the national hockey league because of a jarring blow to the head.

the outcome of her tests was largely inconclusive, but, at any rate, the doctors told her that it was nothing to worry about. her fall was an isolated incident that likely would never be repeated. i told her to proceed cautiously, warning her that science was imperfect, uncertain, and perplexing. she laughed nervously as i continued, comparing a concussion to an earthquake (i had read a book by salman rushdie where he had made a similar connection between strokes in the heart and earthquakes, so i figured i was in safe territory, speaking about facts, albeit cold and hard ones).

i said an earthquake, even minor rumblings that do not cause much damage, leaves a mark on the earth, rendering it forever vulnerable. once hit, the potential for another strike remains tucked away, promising to return with more devastating force. i took a sip of horchata, a milky-looking drink made from ground rice, almonds, and cinnamon, hoping that the pause would tone down my message, making it more palatable, less a doomsday prediction than a concerned friend who often gets carried away once he begins with a theory or a joke. all i knew is that i could not stop yet, before i had finished my analogy and united the two events based on this conceived similarity.

your head is the same way, you know? sure, everyone is telling you that you’ve escaped unscathed and you need not change your life in any way, but buried somewhere in your brain or skull or spinal cord (i told her i wasn’t sure which option since i’m not a surgeon) there was a tiny indelible imprint containing the scribbled details of the occurrence, sort of like microfiche. one night she would fall asleep, tucked into a warm bed, calm and whole, only to wake up the next morning bewildered and unsure of how she had arrived in the hallway. some part, an echo of her past, would be missing, like california drifting off into the pacific ocean.

i repeated the last line about california again for impact and partly because i liked the sound of it and was starting to have fun. we asked the waitress to box our remaining food, then walked back to her car, with me acknowledging that i had not delivered the motivational message i had envisioned. my only hope was that she had forgotten most of it as she was still foggy from the fall (that is, if she were a hockey player, she would have to sit out a few more games while her concentration returned and the headaches subsided).

maybe she would only recall that a guy who once treated her to lunch talked passionately about earthquakes and athletes while she ate.


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