If you live in Portland, Oregon you know that in the entire month of March you will get three sunny days, on average, and twenty-eight dark and gloomy days. On those three days you will get out and about if you possibly can in order to reassure yourself that there is still a sun. The air is chilly but often dry and crystal clear, rewarding those who get up to higher places with rich panoramas of distant snow-covered peaks.
On one such March day a group of hikers was walking up to a popular high point southwest of the city. One of the hikers had pushed ahead of the group, feeling energized by the sun and the crisp cold air. About a hundred yards from the top of the hill the trail steepened and she sped up, breaking away completely from her friends. She was in good shape and felt her calves and thighs drive her up, almost catapult her up each step, handling the steep grade as if she was riding some powerful machine. The cold dry air took away her perspiration.
At the top she stood looking out, feeling with some pleasure the easing of her deep breathing and the slowing of her heart to its normal rate, which was about 55 beats per minute. A man would have thought: “Damn good for 56 years old. And not many more pounds over time.” Instead she quietly appreciated her ability and was grateful for the activities she enjoyed.
Activities such as viewing the nearby mountains, Hood and St. Helens, blazing white in the bright sun. To the north she could see the shining tip of Mt. Rainier in Washington. It was 100 miles away on a straight line. Down below, using the city and country roads which were not straight but had twists and turns, it was almost twice that distance to the mountain. She took a picture of the far peak and sent it on her phone to her three children. It was an international sending: to her son in London, his twin brother in Paris, her daughter in San Francisco. Her ex, she thought briefly, God knows where. She hadn’t known for years. She enjoyed sending these dramatic outdoor shots to the children in their urban closets, as she put it. They returned the favor with comments about her living in a backwater hamlet.
She put on her jacket from around her waist and sat down to enjoy the sun and to wait for her friends. The clouds were showing up in the west but there would still be a couple of hours of sunshine. She recalled the visits she had made the last Christmas to both sons. She was glad to make the trip, to see the boys and their families, Christmas in London and New Year’s in Paris. Spending time with the four young grandchildren. The details of the trip were fresh in her mind. The happy sounds and piping voices of young children. The glee in opening presents and tearing the wrapping paper. She had come away with good feelings about the boys. They had about the right mix of career development and home life. There was healthy tension between the boys and their wives, she thought, especially with me visiting. Thomas has a real spitfire there, she thought. Another child or two will be perfect for that energy. And the tension would have been good for romance after I left.
And then the youngest, the daughter in San Francisco. She would write a note to her when she got back to her house in northeast Portland. Her daughter had been troubled but unwilling to talk about it much, which was unusual. Ordinarily she and her daughter would talk about most aspects of their lives. Maybe a letter can lay it out better, what I should say, and help her to respond. Help her to get it out. Troubles with her boyfriend, apparently. She’s thirty-two and still has boyfriends, she thought. It seemed funny to say that. There should be another word.
Her daughter might say I need a boyfriend myself, whatever the word is. I guess I do. I guess I could be someone’s lady friend, she thought. She acknowledged to herself that she did have several suitors. Most were considered great catches, and some were particularly nice, and the occasional dates were fine. But there wasn’t The Someone just yet.
Anyway, I need to help her figure this out. I am not sorry about this last fellow. Bland mama’s boy. She was so upset when they broke up, though. Her second big break up. I need to encourage her about her decisions. She’ll make the right choice. Her brothers have always been so fearless, always jumping in, that they made their little sister wonder about herself when she was appropriately thoughtful, as if she was dithering. And when she did jump in, with her first marriage, it was a mistake. And that mistake has affected her ever since, has made her doubt herself. She just needs a little reassurance. A prize like her can wait a little longer. It will happen for her.
She saw her friends coming up to the top of the hill and making jokes about her vigor. She took a last look at the hundred-mile view of Mt. Rainier and then went over to join them.
When she got back to her house in Portland she filled the water in the parakeet cage and then walked to the kitchen table where she had her laptop. She thought about the note to her daughter. As she sat down she felt a little ping in her chest, as if a tiny rubber band had snapped. It was an odd sensation she had never felt before. She leaned back in the kitchen chair, to sit up straight and take a deep breath. She was suddenly wrenched by a sharp, piercing pain in the same place. The pain was so intense that she slid off the chair and she knelt slowly, trying not to crumple altogether on the tile floor. The pain spread to a wider area, from her neck down to her abdomen. It was a huge clamp, a giant hand, squeezing her chest so she couldn’t take a breath or cry out. It wasn’t going away. It was getting worse. She could hear herself wheezing trying to breathe.
Methodically, deliberately, she moved her right arm…the left arm wasn’t working…to get her phone from her pocket. She carefully dialed the emergency digits and then put her head down on the tile. The cold tile felt good to her forehead. When the operator spoke she pulled the phone close to her lips and said hoarsely ‘Chest pains. Can’t breathe. Need help now.” She gave the address and had to repeat it twice because her voice was so ragged. She put the phone down, ignoring the operator’s plea to stay on the line. Better try and call her, she thought. She picked up the phone and tried to tap her daughter’s number. Her hand trembled and the phone slipped out and skittered away on the tile floor. She tried to reach over but could only lie on the floor where the sun was shining through the west windows. One last bit of sun, she thought. Really wish I could have talked with her.
The house was perched on a small bluff in El Granada, a little oceanside town about an hour southwest of San Francisco. As Alec drove up to it he thought once again: if you want a good view of the gloom and fog this is a great spot. Here it is June and it might rain again today. If you want to actually gaze at a peaceful ocean, or a sunny beach, go south a couple of hundred miles. Not many people in the Bay area would admit that but there it was. And how in the world could you expect someone to be diverted by a gloomy, foggy, rainy view. That’s the opposite of diversion. But we can’t move the guy again, he thought, so forget it.
He let himself into the house and greeted the housekeeper, a Korean woman who spoke little English. “Hello, Soo-jin”, he said, and then slowly “Tsah hay sing yoh poom.” The woman smiled and bowed slightly without replying, but walked out to the car. Close enough, he thought. She’s getting the groceries. He walked into the master bedroom, which had a huge bay window overlooking, he remarked to himself needlessly, the cool foggy day outside. He saw the patient on the hospital bed they had brought in. The bed itself was enclosed by clear plastic sheeting, which reached from the floor to the ceiling, for infection control. Inside this plastic bubble were two clean air filters whirring softly. The patient was on his side, not his back, which Alec hadn’t seen before.
He moved over to the wall with the chart and reviewed the latest entries. He looked up at the monitor, mounted so it was facing away from the bed. The monitor showed various vital signs and in the top right corner was a stylized 3-D image of a human brain. The image showed a slowly diminishing glow, similar to how fireworks fade out after bursting in the sky. He looked at his watch and waited. After about 5 minutes the brain image on the monitor flashed brilliantly for a few seconds and then slowly faded as he had seen it before.
Dr. Yun was sitting in the far corner of the bedroom, tapping on a laptop computer. He looked up at Alec and gave a barely perceptible nod. Alec walked around the bed to stand next to him. “Dr. Yun,” he greeted him quietly. “Chart looks good. But more weight loss. Anything going on? Any problem with being on his side?”
Yun looked up impassively through wire-rimmed glasses. “Vitals unchanged,” he said, “Weight loss from little eating. Patient has been shifting positions. No seepage from incision after few minutes. Longer try, no seepage. Patient more comfortable.
“No change in intervals,” Yun added.
“Okay, comfortable is great, as long as we don’t see any leaking.”
Yun shook his head, paused and then said in the same flat tone, “No fluids.” He looked up at Alec. “Also, no need to learn Korean. Wasting of your time. Tell me what you want. Housekeeper has no need to understand accent.”
Alec laughed and quickly cut it short, trying not to be loud. He put his hand on Yun’s shoulder. “It’s no trouble for me at all. And new languages are good for the brain, haven’t you shown in your research?
“But I will be more careful with my pronunciation,” Alec said. Yun didn’t answer, just stared up calmly at Alec through the glasses.
I’ll never know if that was a sincere gesture or some deviousness, Alec thought. Either way the last thing I will do is give Yun more control. Who knows what he is telling Soo-jin even now.
“Dr. Yun, how is that ultrasound imaging? Is the resolution better?”
Yun rose from his chair with a muted expression that Alec recognized as pride and pulled up some images on his laptop. Yun had adapted an ultrasound machine for the imaging of the tumor but the resolution at first had been poor. “With new chemical agent, contrast is much better,” Yun said. “Here, you see. Tissue differences are manifest.” Alec looked at the screen and saw the usual random blobs in an ultrasound image. “It might be manifest to you, doctor, but not to me. Can you color that in for the layman?” Yun tapped and the image came into better contrast. The previous ultrasounds hadn’t distinguished the tumor tissue from the normal brain tissue. Yun had adapted contrast agents which were typically used for cardiac ultrasounds. After the adjustment Alec saw clearly the darker shaded tissue of the tumor, the glioma, on the surface of, and penetrating, the brain. “Yeah, this is much better. Can we use these images to see the progress of the tumor?”
Yun nodded, pleased to offer an alternative to the big MRI scan at the hospital. “And we can do this every day?” Alec asked. “The contrast agent has no damaging effect?” Yun again gave a barely perceptible shrug. “Not in short term,” he replied.
That is very good, Alec thought. It might help us get the patient, David Buckley, back to the hospital if we can show faster growth of the tumor.
He looked at chart again. At noon Soo-jin had brought in to Buckley, in sequence, bacon, freshly baked bread, roasted chicken, and an apple pie. They were working on the smell aspect. Buckley had not responded to any of them … he hadn’t eaten anything. Other food choices, supposedly Buckley’s favorites, hadn’t had much success either in getting him to eat.
Alec pulled up a chair to the bed next to the plastic sheet. He swiveled the monitor so he could see it and then sat down facing the patient.
“David,” he said. Buckley was on his side, facing Alec, eyes closed. Alec saw Buckley’s shaved head and two small wires coming through a white bandage on the back of his head, which had been implanted in the occipital lobe of the brain. These two wires were connected to a controller box just outside the plastic sheeting. Buckley held a small button in his right hand which controlled the electrical stimulation directly into his brain.
“David Buckley,” he repeated gently.
Buckley stirred and then breathed deeply as if he had been underwater for a while. Not gasping breaths but slow and full. His eyes opened, blank and unfocused, and then closed. A minute later Buckley opened his eyes again and looked at Alec.
“Is our … is our agreement still in effect?” Buckley said in a raspy voice.
“Yes it is, David,” Alec answered. Buckley closed his eyes again, his expression saying: “Then I’ll get back to what I was doing.”
“But I would like to check with you on a couple of things,” Alec said in a louder tone. Buckley opened his eyes and looked at Alec, deliberating, weighing if he wanted to talk.
“Let me sit up,” Buckley croaked after a moment. Buckley slowly turned onto his back and reached over with the left hand to raise the head of the hospital bed. He kept the button in his right hand. “What’s the first of the two things?” he asked.
“The new controller,” Alec said immediately. “Yesterday we gave you the version that controls the pulse duration. How is it working out?”
“The result is fine. Don’t you see the readout? The monitor shows frequency and intensity, doesn’t it?”
“Sure it does. But would be great to know how the additional control feels to you.”
“It’s fine,” said Buckley tersely. “What’s the second thing?”
So much for that distraction, thought Alec. “Calories. You aren’t eating much.”
Buckley shifted a little and laughed. It came out as sort of a gargle, sounding like “Glah glah glah.”
“Yes, I heard your talk just now,” Buckley said. “Dr. Franken Jong Un here wants to put a feeding tube in me. He thinks eating is an unnecessary risk. Right doc?” Buckley’s voice was stronger but still a little croaky.
Yun was silent for a few seconds then said in his calm Korean accent, “Patient concentration is on brain stimulation. Less concentration on swallowing. A bad swallowing may aspirate food into lungs, or cause damaging coughing. Parenteral nutrition – feeding port in vein – will be sufficient for patient calorie needs.” Alec and Buckley exchanged a brief and slightly bonding look, acknowledging the small humor in Yun’s answer. Yun’s manner also seemed to encompass, if not forgive, Buckley’s insulting comment.
Alec had no complaints about Yun. He was a proficient neurosurgeon, and nurse, and image technologist, all in one. And Yun was willing to do what other doctors were not, which was to treat a brain tumor patient outside of any recognized medical facility. On the down side, Yun was an asylum-seeker from North Korea, a high-ranking medical officer on the run from the government there. It wasn’t going well. Great Britain had turned him down flat. He managed to sneak into the US, but after a roundabout inquiry the Feds weren’t sure whether they wanted any part of him either. So there was some uncertainty, to put it mildly. But I don’t need him for his bedside manner, Alec thought. Just to take care of the patient.
Alec said to Buckley, “You heard us?”
“Yes. I am not deaf, just busy elsewhere.”
“Well, you looked like you were busy sleeping.”
“It’s like hearing the talking through an intercom. I am still aware of my surroundings. That’s not important, is it?”
“No, I guess not. Back to eating. Do you think it’s a risk yourself?”
“Yeah, I suppose it is. I’ve choked a couple of times recently when eating. But I don’t want to do the feeding tube right now.”
Alec heard rain start tapping on the bay window behind him. More and more cheer, he thought. “It’s been a while since you ate. Does anything sound good?”
“How much weight loss for me?” Buckley asked.
“Another pound in the last three days, but the IV has added a pound of fluids. So maybe two pounds of flesh over the last three days. Four pounds over the last six days.”
“Glah. You said I was down to 150. Only 110 days left at that rate.”
Alec laughed. “If it worked that way,” he said, “but at six feet, 150 pounds is thin. Not much in reserve. Nothing sounds good to eat? Strawberries, ice cream, hamburger?”
“No,” said Buckley, “it doesn’t sound good.”
“Could you just get something down, I guess is the question.”
“I’ll tell you why it doesn’t sound good,” Buckley said without answering Alec’s question. “One, there’s no desire, no relish. No hunger. It’s like eating plain oatmeal when you are already full after a delicious dinner. Two, Dr. Yun is correct, swallowing is a chore and an interruption. I have to concentrate. To be careful to not choke. Eating or drinking. The swallow function needs a lot more control from me now. I don’t like to concentrate on that. Three. After I eat I can now feel the food get digested, and go through all the tubes inside me. I feel it every step and I don’t want to feel that. More interruptions. Four. Peeing is nothing, not a problem. The catheter takes care of that. But crapping is a distraction. Is there a Foley catheter for crapping?”
“No. I mean yes but we don’t want to go there,” Alec answered.
“Then there you have it. Go ahead and put in the feeding port, but if you can wait a while that’s better.”
Buckley paused for a moment. “Because I am getting to another level with this stimulation. Another state. I don’t want to interrupt that.”
Alec moved the chair a little closer. “Can you explain?”
Buckley shook his head to convey his annoyance, but slowly so as not to disturb the electrodes. He said, “Alec, I am not interested in these talks. Nothing against you but nothing for you either. I am talking to help you understand how this works so it might help the next patient. And so you will leave me alone, considering that my time is limited.”
“You mean how the sensation works.”
“Yes. What else would I mean?” Buckley said impatiently.
“Well, we know how it works. You’ve got a couple of electrodes about 10 mils thick inserted into the occipital lobe. You can apply voltage from 2 to 5. Pulse duration about a hundred microseconds. Frequency from 130-200 Hertz. You control the voltage and duration. And the interval.”
“Thank you Mr. Science Guy. I meant how the sensation feels. How it affects me.”
Alec flushed, embarrassed at his wrong guess. He saw Yun looking over at him, understanding Buckley’s tone if not understanding the reference. I really don’t like this case, Alec said to himself, again. He changed the subject.
“Our agreement included a weekly discussion to re-confirm your decision. How about if we get that out of the way?”
“Fine,” said Buckley, terse again.
“Okay, I am recording on my phone here. Name?”
“Do you know where you are?”
“You said it was El Granada. I wouldn’t know from here.”
“And so it is. Do you know why you are here?”
After a pause Buckley said, “I have instructed you to provide care and treatment for me for a brain tumor and for any complications, outside of and apart from licensed and certified medical providers. You have agreed to help me with the brain stimulation which is my preferred treatment.”
“David, the attending neurosurgeon, and your neurologist, and, well, all of your doctors, and your nurses, and the hospital orderlies, all have advised against this and have urged you to return to the medical center for prescribed treatment. Or any medical center with qualified providers.”
“Treatment meaning surgery,” said Buckley.
“Yes, most likely, to surgically remove the tumor.”
“I decline these recommendations.”
“David, why are you declining these recommendations from qualified physicians?”
“The brain stimulation produces a beneficial feeling that I consider to be therapeutic and palliative for my condition. The physicians are unwilling to continue the stimulation and will try surgery to remove the tumor, but in doing so will likely cause permanent brain damage. As they have stated.”
“Do you expect the stimulation to cure the tumor?”
“No, of course not. I expect it to provide an improved quality of life compared to the expected results of the surgery, which include vision impairment and probable permanent dizziness and vertigo. And I will add, since the stimulation started, the headaches have not come back at all. Gone completely.”
“And you are aware that without surgery, within six to twelve months the tumor will invade the posterior cerebral artery and cause a vascular blowout? A fatal hemorrhage?”
“I am aware that this is the best guess of the physicians.”
Buckley looked over at Alec. “Now are we done with that?”
“Yeah, we’re done. That is what the agreement called for. On a weekly basis you would re-affirm your decision and your ability to make that decision. This is what your lawyer set up to protect your wishes. It should make it harder to declare you incompetent.”
“If it ever comes to that,” said Buckley. “And anyway he is against me now.” A week earlier he was animated and bitter about this. Now he was more detached.
Alec shook his head. “He’s not against you. He is still your attorney. But he has changed his view of the best treatment for you. He’s not trying to bring you back, but he does advise you to return to the hospital of your own volition.”
“They are still looking for me, right?”
“Yes, your family is still looking for you.”
“They wouldn’t let me keep doing this.”
“You have to admit, it doesn’t translate all that well. The optics aren’t great,” Alec said, looking at the EEG electrodes and the two wires sticking out of Buckley’s bare scalp. “It’s hard to argue that you are of free and unencumbered mind.”
“Because they don’t know how it feels.”
“David, nobody knows how it feels except you. Let’s try to tell them.”
Buckley slumped back into the bed. “You are pulling me back in with talk like this. It feels bad. It’s like sandpaper on my brain.”
He paused for a moment. “All right, let me try to describe it again. So everyone will leave me alone.” After a minute he started speaking in a low voice, almost too faint to hear behind the plastic. But his voice was clear. The gravel had gone.
“It’s not like drugs. It’s not like heroin.”
Alec looked up, startled. Didn’t see that in his profile, he thought.
“I did it for a while. You get…well I got …in addition to the overall pleasure, a warm glow, like a cozy blanket protecting me. It felt good as in no pain and no worries good. It turned off the link between something bad, a problem, and the worry or pain. The problem was still there – like physical pain, or the bank calling in a loan – but I was insulated. I didn’t feel anxiety or worry. Somewhere in the back of my mind I knew it was artificial. It didn’t really register – I didn’t care – but there was the knowledge that it was temporary and … and synthetic.
“The initial rush of feeling was great, and the glow after, was great, of course. But even after a couple of times I could see it diminish. My tolerance built up pretty quickly I guess. I had to do it more often, do higher doses. This brain stimulation – it isn’t wearing off. Maybe the opposite.”
Alec didn’t want to break in but couldn’t help asking, “Well, did you get addicted?”
“A little I guess. But I stopped after a few months.”
“Just like that?”
“Yes, I guess so. I was terribly disappointed that the initial good feeling was gone. It was such a lousy trick. After just a few times I was taking heroin to not feel bad, not to feel good. So I stopped. I got sick but after a few days it was okay. I was partly hoping that after a while I could try again and get that first time feeling.”
So you stopped just like that, Alec thought. “Did you? Try again?”
“No, I never did. I got wrapped up in work and things, you know.” No, I don’t know that it works that way, thought Alec, at least not for anyone else I know. But he didn’t interrupt again.
Buckley went on. “The stimulants, the meth, MDMA, they are fine. A good high, in that I get enthusiastic and the happy feeling that anything you do will work out. It will turn out good. And everyone around is happy. But then you come down. And that, for me, is worse than the high. And even before that, the knowledge that the feeling is artificial and there will be a crash, is a big downer. It spoils it.”
He looked at Alec. “There’s no crash with the stimulation. And it couldn’t feel more real. It’s better.”
Buckley dropped his head slightly. When he was looking down like that Alec could clearly see the two leads going through the scalp, ready to provide their tiny charge of electricity.
“I spent years putting the business together. Working all the time. It felt good to be a success, for all that work and planning and betting to pay off. This feels better. I had a bad time some years ago…capital low, banks distanced, friends stopped being friends. I kept at it, took more risks, and finally things turned around and we got some big contracts. We pulled it out. That felt great, triumphant almost. This feels better.”
“It’s not wearing off? The sensation is just as strong?”
“Is it supposed to wear off?”
“Synaptic desensitization, or some term like that.”
“Well, it isn’t wearing off.
“Is it like an orgasm?”
Buckley thought about it. “An orgasm of the brain. And the spine. And then of everything. A hundred times more intense. Have you ever been shocked hard, like the 110-volt shock?”
“Yes, I have.” Alec recalled the intense vibration and burning which had dominated and shaken his right arm. And which seemed to last forever though it was only a second.
“Imagine that the shock brings pleasure instead of pain,” Buckley said. “Imagine that same power and pervasiveness bringing euphoria. At that intensity. But with the stimulation, it starts out slowly. When I press the button it seems to spark cells in the brain, a few of them at first, tiny surges of sensation. I can feel them. And then those cells spark other cells, more and more, like a chain reaction, like a nuclear reaction. The sparking builds and I am feeling super alert, hyper aware of everything, all sensations, all input. My whole skin prickles like there is static electricity around, a lot of it.
“And then the burst comes. Where everything, every cell, lights up at the same time with an intense ecstasy. I can feel the burst in my head and then a pulse down the spine. I can feel the pulse as it travels, it’s fast, almost instantaneous but not quite. I can feel the pulse as it goes down…down to the tailbone. And then it splits into two. One pulse goes back up to brain and I feel that every inch, as fast as it went down. The other pulse, it splits again, it goes down on the insides of both legs. I feel it go down to the insides of both ankles. Then back up to the tailbone, and rebound back to the ankles a few times.
“I feel that in my legs, while the first pulse is rebounding up and down from the brain to the tailbone. The pulses are somehow different, the lower from the upper. Both are wonderful, intense bliss. Sometimes they mix it up and switch places. And all this time the burst is still in my head, still lighting up, slowly fading away.”
“Every time the button is pushed?” Alec asked.
“If there are no interruptions,” Buckley said, looking pointedly at Alec.
“Did you know Dostoevsky had epilepsy?” Buckley continued. “He would describe moments of rapture, of ecstatic bliss, before his seizures. When he was in joyful harmony with the universe. He said he would trade his life for these few seconds. Alec, these are not fleeting seconds for me. They are not followed by wracking seizures. It’s something that I can have anytime.” Buckley stopped and leaned back into his pillows. “Unless they find me and take it away,” he added.
“That’s why you are tucked away like this, so you won’t be found,” Alec said. Then he asked, “What about sex?” That sounds feeble, he thought, which I never would have expected. Just for the record though.
Buckley shook his head slightly, somewhat dismissively. “Sure, make me 18 again.”
Buckley’s talking, his descriptions, seemed to get him in a good mood, Alec, thought, or at least less of a bad mood. He decided to push a little more. “You mentioned another state earlier, another level or something.”
“What about it?” Buckley said, prickly again.
“Is this also happening during the stimulation?”
“No, it’s something after.” He paused and Alec heard the whirring of the air filters and the tapping of the rain on the window behind him.
“It’s like I am stretching time,” Buckley said slowly, thinking about the words. “Like I am carving up intervals of time into smaller and smaller bits that last longer. I am on a different time track. It’s jarring when I come back to this one. It’s hard to adjust and uncomfortable.
“At first, the surge and euphoria would fade after the stimulation, and I had to hit the button again. For the last few days, the surge fades but the feeling is still there, the euphoria, still powerful. It is stretching out. And somehow I see the sparking in my brain, I see the tiny sparks from the stimulation. It looks like … it looks like how lightning looks inside of clouds, the flashes muffled deep inside. I am seeing that. And then the sparks will be all around me, and then I am somehow floating up with them. Me and the sparks are floating up. I know I am not pushing the button any more but the sparks stay. Suspended around me, like an electric field. Kind of spread out evenly in the electric field. We float up, up into the clouds, the clouds that had the lightning inside. It stays that way. I don’t know how long. The sparks flicker and flicker but stay near me. I am there for I don’t know how long. I thought maybe days. Here it was maybe an hour.”
Dr. Yun looked over at Alec and shook his head. With his watch he pantomimed 30 seconds.
“What are you thinking about when this happens?”
“Well, at first, I was not thinking at all. No thoughts, no monkey chatter of the brain. Just the glow of the stimulation and being in the energy field. I stayed that way for a long time. Feeling the energy. Not absorbing it. It’s not flowing through me or anything like that. But I can feel it flowing around me, like the workers on high voltage power lines. They wear this metal suit so that the electricity flows through the suit and not through their bodies which would kill them. I mean, for me it’s not electricity but it’s like that. And I can unzip the suit a little if I want and let the energy, the light, flow through me.”
Buckley looked up at Alec. “It’s not what you are thinking,” he said.
I am not thinking any goddamn thing at the moment, Alec said to himself. Up to this point he had thought Buckley was getting a novel buzz from the stimulation but that it would soon diminish, and then he would agree to return to the hospital for surgery. Now Alec felt overwhelmed by Buckley’s sensations, even felt a little duped as he listened to the description of these intense moments. And we’re countering those moments with apple pie, he thought.
“It’s not the white light at the end of the tunnel,” Buckley continued. “It’s not anything outside of me. It’s inside me, inside my brain. And why not? The brain is the most complex thing in the world. Why can’t it contain its own world? And now, it’s as if I can move around a little bit. I’ve been seeing images, memories, in different places.”
He sat up and adjusted his blanket. The electrodes caught the ceiling light and flashed briefly as he moved his head.
“When the doctors were telling me what they were going to do, and the potential brain damage…“ he trailed off for a moment. “The doctors keep saying ‘potential’ damage, because it wasn’t 100 percent certain. It could be a 90 percent chance of damage and they would still say ‘potential’, you know what I mean?” He didn’t wait for Alec to respond. “Anyway, they were talking about memories. They said memories are groups of neurons that fired in a certain way when the image was first seen, or the sound was first heard. When the neurons fire again in the same way, that’s the memory. If you disrupt either the group or the sequence the memory is gone or changed.” He paused. “Those sparks that I was telling you about. The ones floating around. They are coming together, converging, making images. I have seen groups of sparks coalesce and then there were images, memories, clear, wonderfully clear, as if they were happening in front of me.”
Alec thought: I don’t know what “in front of me” means in this case. But that’s too complicated for now. “Images of what?”
Buckley was slow to answer, as if he was trying to distinguish an ordinary memory from these new spark-induced images. “Places, people. My mother, a hundred years ago. A church when I was young. Christmas tree one year. I think I can move around, go to different places, see different sparks come together. I can initiate that, have some control. What if I am able to see, to relive, all the memories that are there?” He looked over at Alec again. “This is what I want you to know. I can stay in that place. That energy field and what’s there. And it feels bad to come back, back here to talk to you. It’s like when you have the flu and you hurt all over. It’s like getting on a treadmill that’s going too fast. It’s hard to adjust.”
“You said you can stay. Do you want to stay in ‘that place’?”
“Well, what do you think?” Buckley said, impatiently. “In the six months, or twelve, or whatever months I have for this body, it might be a hundred years for me in ‘that place’. No surgery, no blindness, no dizziness, no headaches. A hundred years.”
Alec felt compelled to defend this place. “And no people, no other voices, no new thoughts, no …. no women.” he said, a little more strident than he had intended.
Buckley gazed up at Alec, observing him a little curiously. Alec kept going. “Yes, you got a bad deal. But you don’t know for sure about the damage from surgery. You do know about the tumor and the inevitable hemorrhage.”
“What do you care?” Buckley said with sudden bitterness. “I thought you were the guy that helped people die. Helped them go out in the way they wanted.”
Alec jerked as if he had been slapped. Buckley must have gotten that from his lawyer, Aaron Fisher, who had helped set up this situation. He stared at Buckley for a few seconds. “No, that’s not what I do,” he said finally, trying to control his voice. “The idea is to help people live. These six months of yours…what they would mean to someone with six days. What they would mean to a person with –” Alec broke off. A memory of his own arose, an image of a dying woman standing, willing her failing body to stand erect, using the time for one more act of her own choosing. One final “I am.”
“And anyway you aren’t dying, you don’t need to,” Alec continued after a moment. “You want to. You are trading real life for an illusion. A repeating illusion of yourself. A never ending echo chamber.” That’s not what I do, he said to himself.
Buckley had been watching Alec through the plastic sheeting with keen interest. “Sure, I have thought about that,” he said evenly. “This stimulation thing could fade out tomorrow, or trap me in some grotesque brain maze forever. But for now, I am choosing this wonderful sensation over a highly probable, but yes, I acknowledge is not 100 percent certain, surgery outcome of blindness and vertigo which would prevent me from doing just about anything that I value.
“Our agreement still holds, right? You will help me with my decision?”
Alec had calmed a little with Buckley’s steady demeanor. “Of course I will help,” he answered, and couldn’t help adding “…because of our agreement. Not because of what you think I do.”
Buckley smiled. “All right. I might miss these talks after all,” he said. Before Alec could respond Buckley’s face closed up and he said, as though he was giving direction to an employee, “So for now we will continue with the stimulation. Come back in another few days, but don’t be surprised if I am busy.” He lowered his bed and slowly turned away from Alec.
Alec stood up but didn’t leave, looking down at the bed and then up at the monitor, waiting for no particular reason to see the brain image light up. He looked over at Yun, who stared back impassively. Then Yun stood up himself and started walking out of the room, motioning Alec to follow.
In the hallway Yun said, “Patient is waiting. Your talk elevated heartbeat and patient is waiting to normalize before stimulation.”
It elevated? Alec thought. He didn’t look like it. “I guess mine elevated too,” Alec said.
Yun looked at him. “Patient at times have infusion of beta blocker to lower pulse when needed,” he said. “We can lower yours also.”
Alec stared at Yun, startled again. Yun looked back without expression. Just the tiniest crinkle around his eyes. A shout of laughter burst out from Alec, involuntarily. “Goddamn, I may need that,” he said, feeling a bit of his tension subside. Yun didn’t answer. Instead he showed Alec his tablet which had the same screen as the big monitor in the bedroom. Alec watched the 3-D image of the brain flare up brightly. “It’s funny,” Alec said aloud, but mostly speaking to himself. “For Buckley that flare means euphoric bliss. For me it means failure.”
Alec left the house and got into his car. The rain was harder than ever as he got back on Route 1 toward San Francisco. Still nothing that could compete with David’s button.
When Alec got back to the city he stopped into an office on California Street, a small three-room space on the 20th floor. It was small and barely furnished but was quite useful as a downtown base. Jerry was already there and greeted him as he entered. He was sitting in the small lobby area thumbing through a sports magazine.
“Hey, Alec. Hey, did you want to go in with me on the bet for the Warriors game tomorrow? I told you about the arm scan, right?”
“Hi, Jerry. No I don’t and no you didn’t. Let me remind you that from what I see, you lose three times for every win.” Alec wasn’t happy to see him there. He was going to meet with Bill Ellis soon and wanted some time to collect his thoughts.
“Yes, I let you see that on purpose,” Jerry replied. “Maybe I don’t want you to know how much money I win.
“And anyway,” he added, “if you really believed that, you would bet against me.”
Alec nodded. “Maybe I do bet against you, and I don’t want you to know that. What about the scan?”
Jerry jumped to his feet, instantly excited. “This is really good. I am doubling my bet against the Warriors for tomorrow. Remember that med tech I told you about?” Jerry looked at Alec and waited for a reply.
“I don’t, Jerry. Haven’t there been multiple med techs?”
“Whatever. So Randi, not her real name by the way, she works for a certain radiologist in the city. She sees a certain scan, a bone scan, of a certain person’s right arm. A stress fracture of the radius. Patient’s initials: T.D., namely Tyrone Dunlap, Warriors. Tyrone as in ‘Tyrone three-point’ Dunlap, as in ‘Tyrone won’t be playing tomorrow’ Dunlap. The Warriors average four points less without Dunlap. Four points!” he cried. “They probably will announce this later today. So do you want to go in with me on the game, before the odds change?” Jerry’s enthusiasm radiated and Alec, standing at the reception counter and observing him, felt his own annoyance fade.
At age 31, Jerry Watkins still had a few years of adolescence left. Not as in living-in-the-parents’-basement adolescence. As in what-new-things-can-I-do-today adolescence. He was impressionable and easily caught up in the moment, any moment. He still hurt himself doing stunts on his skateboard. He bet large. He had a new best-girl-ever often. When he got new audio speakers he would blow them out within a few days. He thought most people snoozed through life and was always willing to disturb their slumber, like a kid waking his parents on Christmas morning. He was also, Alec knew, best taken in small doses.
“Her made up name is ‘Randi’? Jerry, I’ll pass. The game is going to be exciting enough without betting on it.”
Jerry snorted. “Yeah, sure,” he said and then changed the subject. “You are going to see the Padrón now?”
“He’s not a Padrón. As I have said. There’s no sense of obligation on his part. He’s more like a venture capitalist, looking at the return on investment project by project.”
Jerry thought about it. “A venture human capitalist,” he said brightly. “Hey, have you asked him about the traffic idea?”
“No, not yet.”
“C’mon, Alec. You said you would.”
“I said I would put it on the list. It’s on the list.”
“Are you going to push it? Do you like the idea?”
“Yes, I will bring it up. No, I don’t like it.”
Jerry frowned and slapped the magazine on the counter. “Shit, which means Ellis won’t like it.”
Alec gave a brief laugh. “I wish that was how it worked. I wish I had that much influence.”
“It’s fucked that only you meet with him.” Jerry complained. “Can’t we meet with him together?”
“To be honest, Jerry, I am not sure about me meeting with him right now. It feels like he’s close to turning me over to the financial team, to wrap up. So right now, no, I feel better talking to him alone.” It’s this Buckley case, Alec thought. It doesn’t feel right, any of it, and it’s making me nervous about everything.
“Jerry, he likes what we do,” Alec went on, trying to explain and to calm Jerry. “He likes what you do. I want to keep it that way.”
Jerry slapped the magazine again. “I don’t like this second hand stuff. It’s the same with the tumor guy. I am just getting stuff, equipment and supplies, but not working with you. I don’t even know where the guy is.
“Ellis likes what I am doing?” he asked after a moment.
“He likes what you are doing,” Alec reassured him. “He likes your impact. He likes that tattoo on your neck. Says it fits.”
“Really?” Jerry crooked his neck and strained to look down at his shoulder. “What did you call this?”
“Tessellated arabesque.” Alec drew out the enunciation.
“Cool. They just called it ‘puzzle’ at the studio.” The distinctive pattern had intertwining shapes beginning at Jerry’s left shoulder and spiraling up his neck and under his thick short hair. Made it hard to work incognito however, Alec thought. You would remember this guy.
“No, I don’t like it,” Jerry said after thinking about it. “I want to go with you now to see Ellis.”
“No, Jerry. We’ll see after this one.”
Jerry looked down and shook his head slowly from side to side, stretching the tattooed figures on his neck. ”Forget it,” he said. “Just fucking forget it.” He stomped out of the office, as much as a 140 pound adolescent can stomp, toward the elevators.
The Ellis Group headquarters was in San Mateo, south of the city, but the company also had an office downtown in a building on Montgomery Street. That was where Alec usually met with Bill Ellis who used the downtown location for meetings with the banks or with legal counsel. The company had most of an entire floor in the building, although there was only a handful of staff there permanently. Within the space was a well-equipped gym, sleeping rooms for visitors, a full kitchen, and a large screening room for videos. These were hardly ever used, but as Ellis said, he wanted them when he wanted them.
Alec was buzzed through the glass doors a few minutes before his scheduled meeting. The receptionist looked at Alec’s ID and then checked Ellis’s schedule. He informed Alec, in an officious manner not at all consistent with the empty and informal setting, that he was 15 minutes late. “No, I am pretty sure this is right,” Alec said. “I got a message last week that the meeting time was pushed back.”
“My calendar is completely sure that you are wrong,” the receptionist said. “But you have 15 minutes left,” he added, in a tone that said if Alec was foolish enough to bother Mr. Ellis after being late that was his affair. “Mr. Ellis is in the screening room.”
Alec thanked him and walked toward the screening room trying to remember if he was wrong about the time. His meetings with Ellis were generally brief anyway but having only 15 minutes at this point could make things difficult. And it would be another month before he could get back on Ellis’s schedule. Did I miss the time on this meeting? he wondered. Am I getting everything wrong about this Buckley case?
The screening room was darkened and he recognized Ellis watching a video on a large screen about ten feet across. There were two other people with Ellis but it was too dark for Alec to see anything about them. On the screen was a hospital setting with a skinny woman, bald and naked, walking toward a hospital worker who appeared terrified. Ellis saw Alec and looked surprised. He looked at his watch and tapped it a couple of times. Then he signaled to Alec hello, be quiet, and to come back in 15 minutes. Good signaling, Alec said to himself as he left the room.
He sat down on a couch outside the screening room, facing the east windows that looked over the San Francisco Bay. At least I had the time right, he thought. I just hope I can get this Buckley thing figured out soon and get to other things on the list. Most of the time Alec brought cases to Ellis. This time Buckley was a personal friend of Ellis’s. When Buckley asked Ellis for help, help that involved thwarting Buckley’s family and their lawyers and just about the entire medical profession, Ellis gave it to Alec to handle. That was fine, but Ellis had stayed more involved and was more emotional about Buckley, rather than the more distant and detached appreciation of the other cases.
Alec had stood up and was headed to the screening room door when Ellis came out. Bill Ellis had one of the common Silicon Valley looks: slender but not toned, sandy shortish hair, pale complexion. Not much outdoor time. He might get sunburned once a year on some obscure island in the South Pacific, but Ellis didn’t really like vacations. He was too creative and too productive in his own environment. A week on vacation was a week in which he could have originated and developed a new idea.
“Hi, Alec. We were screening that video with a hookup to some others in Los Angeles,” Bill said pleasantly. He was cordial but he didn’t say “sorry” or anything resembling an apology. He might have said “sorry” ten years earlier before getting his millions but it wasn’t a relevant phrase in this situation. Neither did Bill suggest meeting in a room, or even sitting down. Alec knew that he preferred standing. It kept conversations brief and meetings short.
“Sorry to barge in,” Alec said. “I thought I was late. The receptionist had the meeting earlier.”
Bill nodded. “That’s okay. Earlier, huh?” Ellis looked at his watch and tapped it again a few times. “He was supposed to synchronize with my new watch. Hang on a sec,” he said and turned away slightly to make a call on his phone. “Hi Nital. It’s me. Hey, I wonder if we can make a change with the receptionist at the Montgomery office. Sure, today. Who hired him? Renee? Yeah, Renee too. Of course, severance, et cetera. Okay, thanks.”
He turned back to Alec. “You are thinking that I shouldn’t have showed the Katy video to the group,” he said without any preface. He was looking closely at Alec, giving him his full attention.
“I am,” said Alec. “And I am also thinking it’s flattering that you want to show me how thin the ice is around here.”
“As for that, it’s simply a time saver. I can send memos out and have motivational meetings. I can create ‘Centers of Excellence.’ Or I can give everybody a keen interest in doing their jobs well and thoroughly. That’s just quicker and more effective.
“Now about the video. Did you want to make edits? Another version? I thought the re-enactment was very good.”
“We agreed it was for you, not for the group,” Alec said.
“It wasn’t definite. I had discretion. I think your quote was ‘you will know best what to share’.” Bill didn’t say this in a confrontational manner, or even in a debating fashion. He was just reciting facts. Alec thought back. Ellis was probably right about having the option. He had a sharp memory.
Bill continued: “You are worried about respect for her memory? That seems a thin concept.”
“It feels like an invasion of privacy, to spread it around like this. This seems vulgar. Sensational.”
He looked intently at Alec. “But Katy, as you portray her, would love this, wouldn’t she? She would agree to a production like this, don’t you think? Is the character in the video accurate to Katy?”
“Yeah, I think it’s accurate.”
“Then she would not have a problem with telling her story to the group. From what you say, this woman enjoyed challenging people, and perhaps even more enjoyed enticing, or even charming, people into seeing things from a new angle.” Bill waited for an answer.
“Yes, all true.”
“Plus she’s dead,” Bill added.
Bill nodded but didn’t answer. He walked over to an east window and looked down on Montgomery Street, 30 floors below. It was later in the afternoon and the streets were filling with people headed home.
“I’m not good at conveying something like that,” Bill continued. “This was a wonderful story. The video really helped the group understand and appreciate. Enjoy vicariously. And the re-creation is much more effective than my re-telling, or pictures. The re-enactments are much richer, more revealing. Perry, one of the guys in the group, suggested a live re-enactment. You are making a magical, creative thing here.
“Alec, your stories, your people, their lives, are fabulous, unique. For someone who is there. You know how much gets lost in the telling. Showing it like this helps the group to do more like this.”
“Fine,” Alec said. He didn’t want to keep talking about it. As long as Bill was involved, this was how it would be. Alec would be able to assist people, and Ellis and his group would get an exclusive view of life that they would never get otherwise. Well, that nobody would get otherwise, Alec acknowledged.
“Tell Charlotte that I understand she doesn’t want it to get around. But I loved it. The group loved it.”
“Well, you are right, Charlotte is unhappy.”
Bill nodded again. “Figure it out with her. We need her.
“So how’s the patient?” he said, changing topics. He watched a couple of pedestrians confront a taxi in a crosswalk, 400 feet beneath them. It was hard to tell what was happening, but the pedestrians were upset, arms waving and shouting.
“About the same, physically,” Alec replied. “Scans show the tumor growth may have slowed a little. Mentally, he is still sharp. No degradation of faculties.”
“I guess the doctors would say too bad, right? They might hope for some degradation so that the patient will submit to surgery?”
“I don’t think that would happen. If he noticed much erosion he might check out altogether rather than go through surgery.”
“You found a good spot for him? Just asking, I don’t want to know where. His lawyer says the family is still looking for him.”
“It’s fine. Farther south would have been better.”
“I don’t think it’s going to be the weather that will get his attention.” Bill paused for a few seconds and then said, “The wires are in the occipital lobe?”
“My pal Buckley, sitting and zapping,” Bill reflected. “It’s not technically ‘deep brain stimulation,’ the wires aren’t that far in, right? Not down in the hypo … in the hypothalamus. I guess the voltage on those things is low, like 5 volts or so and hardly any current.” If you didn’t know him you would think he was showing off, Alec thought. But it was just Bill remembering every detail from a brief read he had done on the subject. “It’s supposed to work well for Parkinson’s patients,” Bill recalled. “Does he vary the duration?”
“Not much, mostly around 100 microseconds.”
“The frequency between stimulations is lengthening. Sometimes hours.”
Bill looked up at Alec. “The effect is diminishing?”
“We thought so, but it’s just the opposite, I think. Putting him in another state in which he can go longer between stimulations but still feels the euphoria.”
Bill shook his head in wonderment. “Like that movie with John Travolta. What was the name… Phenomenon. Travolta gets super smart from the tumor, Buckley gets a super rush. I think Buckley is better off.”
“Well, they both die. Buckley, in real life, will die without surgery.”
“The doctors still say six months?
“Based on the last scan they have, yes. Our scan, more recent, shows a slowing of the tumor growth.”
Bill thought about it for a moment. “I don’t like thinking of David lying around like a rat pushing the pleasure button until he starves to death. I know he asked us to let him alone, to fix it so his family would leave him alone. But I never liked that, never thought it would be permanent. Alec, I told you before, find something to bring him back. To get him off the button. He’s not a rat.”
“We don’t have anything so far. It won’t be his family – this seems a way to avoid them. Buckley seems deep in his world and it’s a fully informed choice.”
Bill looked intently at Alec again. He didn’t hear “No” much at all. “Well, the rat would say the same thing: it’s a fully informed choice, to button itself to death. Find something to bring him back, Alec. I don’t care if he gets back with his wife but I don’t want him to die a rat.” He’s repeating himself, thought Alec. A rare and bad sign.
“We’re trying. That’s what we are trying to do.” Alec was trying not to sound defensive but that’s all they had accomplished so far: to try. Bill was already looking at messages on his phone, nodding absently. “And we wanted to review some items on our list,” Alec added but Bill was walking away. “Let’s take care of David first,” he said over his shoulder. “Then we’ll talk.”
“Also, I’ve got this great idea from Jerry,” Alec said as Bill, out of earshot, went through the door into the screening room.
Walking out of the office, toward the big glass doors, he saw a security guard sitting behind the counter where the receptionist had been. When he got back down on the street Alec received a text from Bill: Call Fisher re family.