Crash (14 page)

34

World Cup Circle

Neil’s dream since middle school had been to be a teacher. Through those precarious years after the crash, I worried that the accident had derailed those dreams. But on a rainy May day, Neil took his place on stage at Skidmore College to receive his degree: a bachelor of arts with double majors in mathematics and classics. He wore his long black robe proudly, his sandaled feet poking out the bottom, the beanie part of his mortarboard pulled down awkwardly over his ears.

Saul’s mother was with us, the proud Bubbe watching her third grandchild graduate from college. Neil showed us around campus. We toured the Tang Museum of Art. We saw his messy apartment. We walked on the brick with his name on it, part of the senior class gift to the school. He introduced us to his girlfriend, a woman he’d met on the set of the
Fiddler on the Roof
play they both acted in. The romance had barely gotten off the ground and didn’t make it past graduation day. But it was a start.

We bundled all of Neil’s possessions into our two cars: boxes of textbooks, notebooks from class, and every yellowed copy of the
Skidmore News
that had ever been printed during his college years. They sit in my basement to this day, my soft-hearted son unable to part with even one of them. Neil had had this sentimental streak ever since he was a kid. He always liked routine. He disliked change. When we moved from our apartment in Worcester to our home on the North Shore, I cut pieces of wallpaper from every room and put them, along with the metal number four from the front door, into a shoe box he could take with him to his new home.

Neil is his mother’s son. I am every bit the sentimental pack rat that he is. Recently Saul and I were cleaning our cellar, preparing for a yard sale. I have clear plastic boxes stacked six feet high with every report card and certificate my sons ever received, every art project and Mother’s Day card they ever made. Saul has no such streak of sentimentality. He handed me a box of clothes to toss. But in it I saw a pair of Trista’s socks, white with red reindeer. Was I supposed to give that away? Throw it away? Inside the box were also T-shirts with Trista’s face and her locally famous expression, “Life’s too short to be sad” iron-on transferred to its front. Surely those were not yard sale items. I retrieved them from the pile and slipped them into another box.

Next Saul handed me the letter that informed Neil he’d been chosen as one of the recipients of the Trista Rose Zinck scholarship fund.

“Here, throw this away,” he instructed.

“Okay,” I lied, folding it into my pocket.

When Neil had left for college, he had made me promise not to go into a drawer in his bedside table. He told me there were writings in there he would rather I not see. I respected his wishes. I dusted around it. Now the table was going to the curbside, up for sale. I took out the drawer with Neil’s writings, tipped it over a shoebox, and closed my eyes.

After graduation many of Neil’s college friends were leaving school with concrete plans: graduate school, paid internships, or real jobs in their chosen fields. Neil was leaving with the same hopes and dreams he started with.

He spent the summer job hunting. He worked with a headhunter. He scoured the Sunday want ads. He utilized a website that specialized in finding teachers for private schools. He got callbacks. He went on interviews, always dressed the same: his one pair of pressed brown slacks, tan tasseled loafers, pressed white shirt. The accoutrements could vary. He had more than one tie, and he added a V-necked sweater, depending on the weather.

In the end his search came down to two schools: one in Vermont and one in New Hampshire. The New Hampshire school was a second-chance sort of a program for troubled kids. They really wanted Neil. They made him an offer and followed up with phone calls. But Neil was holding out for Vermont. The school catered to Olympic-level elite skiers. The day began and ended with ski practice. The vacation schedule was arranged to allow for national competitions. A large contingency of students spent several months skiing in Brazil. Neil kept putting off the school in New Hampshire, hoping the offer would come through from Vermont.

And it did. Finally. I was so happy for him, achieving his dream. And relieved too. There was a lot of breath-holding in our family at that time. Would Neil be able to find a job in his chosen field? The ecstatic answer? Yes! We once again helped our son pack up his belongings and move 175 miles away.

He shared faculty housing with a couple of roommates. He taught classes in pre-calculus and algebra II. He spent his evenings grading papers and planning lessons. He seemed happy enough.

Saul and I drove up to visit him in his new environs one beautiful fall day. As we drove farther north, the tips of the oaks and maples were starting to turn and “leaf-peeping” traffic became thicker.

Neil showed us his apartment, which took all of five minutes it was so small. He played a video for us that his friends from college had made for him. We walked around the campus with him.

“Hey, Mr. B,” his students called to him. Neil smiled and waved back, clearly reveling in the warmth and respect he was being shown. My own peacock feathers spread out proudly as I strutted alongside him.

His classes went well. His students were highly motivated teenagers, used to success. He did get calls from parents, concerned that their son or daughter was being graded too severely, but he seemed to work it all out on his own.

And he was on his own. The headmaster was gone for weeks at a time, acting as an ambassador, promoting the school. Neil had no mentor. There were no faculty development programs. There was no set curriculum to inherit—no one ever observed him in the classroom or gave him any feedback on his teaching style.

Neil was also one of the only nonskiers on faculty. He tried to snowboard, outfitted by his students in their hand-me-down boards and helmets, goggles, and boots. But it didn’t take.

I give him credit for trying. He and I are two peas in a pod—not big fans of heights or speed. When the kids were small and one of Saul’s cousins owned a condo at a ski resort in Maine, Neil took lessons at the Ski-Wee program, making “pizza pies” with his skis and parallel skiing through a course of metal hoops, ringing the bell as he passed under each bridge. But at the end of the day, Neil thought the hot chocolate and coloring sessions were the best part of the program.

“C’mon, Neil, it’ll be fun.” I’d cajole Neil onto the lift even though my own heart was doing backflips in my chest at the prospect. He gave it a go, but he never really found his passion in skiing.

And he did the same here in Vermont. He tried. But in a place where skiing was the only game in town, being a novice at the sport didn’t win you too many friends. The place itself was also very isolating. Groceries were a forty-minute drive away. The only people he knew were other teachers, all older than he. He did have a girlfriend for a time, but when that didn’t work out, he spent more and more time by himself. He used to eat lunch with his students or “the ladies in the business office.” They adored Neil and were constantly trying to fix him up, but toward spring he was eating alone.

I didn’t realize how bad things had gotten until one day in April, when Neil called to say he was not being hired back for the fall.

“Too depressed” was the reason the headmaster gave for letting him go. He told Neil that he could either finish out the year, which ended the next month, or he could pack up and leave immediately. Neil chose the latter.

I’m embarrassed, as a doctor, to admit how little I knew back then about depression and traumatic brain injury. In college I thought Neil’s depression was all about losing his girlfriend. In Vermont I thought it was the isolation. It took many years of reading and research, of going to conferences put on by the Brain Injury Association of Massachusetts, of observing my own son, to realize that his depression was organic, a result of his injury. I also learned that depression caused by a traumatic brain injury can be more recalcitrant, more difficult to treat than reactive depression or even a major depressive episode.

Over time Neil went to various therapists. He stayed on antidepressants for years. But his pattern—long months of stability followed (usually in the spring) by some kind of backslide—would repeat itself for a long time after the crash.

Never one to give up, Neil spent the summer looking for another teaching job. He landed one, this time in an inner-city public high school with no shortage of troubled and rebellious youth, a far cry from the elite skiers he was used to. He didn’t last more than a few months. He was smoking marijuana pretty heavily over the summer (“self-medicating” my therapist friends called it), and although he had given up the stuff before he started work, his mandatory drug test came back positive and he was reluctantly let go.

“I’d love to keep you, Neil,” the principal told him, “but my hands are tied.”

He told Neil he could use him as a reference. He said his record would not reflect the reason for his being let go. I’m not sure that was true. I’m not sure those were his decisions to make. In any case, Neil hasn’t taught in over two years now. Saul and I worried that, unwittingly or not, he may have sabotaged his dreams of a teaching career. The economy also became bleak for teachers. Large-scale layoffs were common, and Neil was finding himself competing with teachers with many more years of experience.

His new strategy, implemented some years later, included a graduate program in math education. His dream was not dead, just on hold for now.

35

Med School

I was in my early thirties, married with children, when I got into medical school. I remember driving our Ford Tempo, maroon except for one mismatched black door, to my first day of class. It was a warm July morning in 1987. I drove with the windows all rolled down. I passed some railroad tracks where homeless men slept under heavy cardboard, their jackets balled up under their heads for pillows. I remember thinking how lucky I was. How blessed to be given this chance to be a doctor, to make a difference.

I had visited numerous day care centers trying to choose one that would be right for the boys. They were two and four at the time. This was their first time at full-time day care. I chose a YMCA center that was housed in the basement of a church near St. Vincent’s Hospital. I assuaged my guilt by telling myself that I was setting an example for my sons by being a strong, intelligent, and capable woman. Maybe I was kidding myself.

I was one of only three women with children in my class. Karen, Pat, and I found one another right away and became fast friends over those four years. We sat in the same seats in Amphitheater A. It wasn’t so much that we chose our seats; they chose us. With our wife-and-mother duties—fixing lunches, bringing the kids to school or day care—we wanted the seats right next to the side door, the ones we could spill into just seconds before the lecture was to begin, not to mention bolt out of if we got the call that one of the kids was throwing up.

The hardest part of being a mom and a medical student was finding time for everything. When I was studying I was feeling guilty that I wasn’t spending time with my family. But when I took time from my studies to get down on the floor and play with my kids, I was convinced everyone else in my class was studying, and I was certain I was going to fail.

Luckily one of my boys’ favorite games at that time was “shipwrecked.” The three of us would gather our favorite toys, books, and snacks and climb up on the top of Dan’s bunk bed and pretend we were lost at sea. I got pretty good at killing two birds with one stone, memorizing the Krebs cycle while pretending to fish.

One of the things that got me through those four years was a women’s group that was started by two psychiatry residents. Maybe it fulfilled some course requirement for them; maybe they did it just to pay it forward. In any case I benefited enormously from those sessions. I saw that I was not the only one who struggled to balance home and academic commitments. I heard about other women’s fears and goals, not so different from my own.

One of my fellow students, a second-generation Indian woman, always managed to put things in perspective for us. When we would be commiserating about our struggles with work-life balance or our angst over this test result or that rotation, she would say, “These are the worries of the privileged,” reminding us that women in some countries worried about their very survival. Reminding us of our blessings.

The most difficult course for all of us in medical school was gross anatomy. It wasn’t just physically and academically challenging but emotionally hard as well. We were assigned our cadavers on the first day of medical school. We were nervous. Most of us had never been this close to death before. Few of us, I’m sure, had ever touched a dead body. We walked slowly into the cool tiled room, those of us near the back trying to peer over the heads of our classmates, the sharp smell of formaldehyde hitting our nostrils hard. Twenty-five stainless-steel tables were arranged around the room. On each lay a body, wrapped head to toe in plastic and bagged in a zippered white shroud.

Four of us were assigned to each cadaver. The only piece of information we were given about our cadavers was the cause of death. The instructors were respectful, even reverent in the care of the corpses. They were also mindful of the impact the experience would have on us, the students who would spend an entire year, scalpel in hand, carving every inch of these bodies, knowing them inside and out, more intimately than anyone ever had. The most human parts of them, their hands, their faces, were the last to be studied, kept wrapped in white gauze until after the chest, back, neck, arms, and legs were all thoroughly dissected.

Our cadaver was a gray-haired heavy-set elderly woman. She had a sweet, pudgy face. You could just picture her with a plate full of freshly baked chocolate-chip cookies for the grandchildren she surely had. We treated her gently; mindful of the ultimate gift she was giving us every day. The experience of dissecting a human body is one that few people share. It bonded us together in knowledge, in respect, as doctors.

In the spring we held a memorial service to honor all the people who had donated their bodies and contributed immeasurably to our education, both as doctors and as human beings. We learned our anatomy lessons of course. But we also learned to face death. We held death in our hands. We learned about sacrifice. The families of some of the living donors, as they are called, came to the ceremony, anxious to see for themselves, I’m sure, that their loved ones were treated with dignity. We were not introduced. The donors remained anonymous to us.

Each student contributed in some way. Some students made art projects, paintings, drawings, or sculptures. Some sang movingly. One woman played the harp. I remember sobbing as I watched my fellow classmate Ray Colon perform a beautiful ballet of thanks. His lithe body arced and drifted across the stage, his expression strained with emotion.

That night, as I read my children a bedtime story and tucked them into their beds with a kiss, I thought about my cadaver; her wisps of gray curls, her friendly face, her pudgy hands. I felt her watchful presence, another blessing in my life.

My first two years of medical school were all academic: lectures, workshops, and labs. Third and fourth years were our clinical years, with clerkships in medicine, surgery, pediatrics, obstetrics, and psychiatry. We took call every third or fourth night, depending on the rotation. We could choose to do some of our electives at different hospitals. I did a pediatric intensive care elective at Mass General, a cardiology and hematology-oncology rotation at Children’s in Boston.

The time away from my family stung. One night in the pediatric intensive care unit at Mass General, I got a call from Saul. Dan had cut himself on some metal on the ladder of the swimming pool at the Jewish Community Center. Saul had taken him for stitches. Saul told Dan that they were just going to the hospital to have “one of Mom’s friends” take a look at his cut. Dan was fine until they pulled into the parking lot. Saul decided to warn his son about his impending sutures. On hearing that, Dan wound his arms around the seat belts in the car, refusing to let Saul pull him out. He needed “one of Mom’s friends” just to extract him from the front seat. The next day, knowing all about this scene in the parking lot, I nevertheless commended Dan.

“That must have really hurt Dan. You must have been so scared.”

Dan rolled his eyes, scoffing at the thought.

“Don’t make me laugh,” he said, as if he’d been the bravest patient in the ER. I smiled at his bravado but was secretly guilty that I had been away when his accident occurred.

Neil had his share of trips to the emergency room during my time at UMass too. One day we were kneeling in the garden planting green beans. When Neil stood up, blood dripped from his knee. I searched briefly in the dirt for the broken glass that surely must have been there, but I didn’t come up with anything. I washed and wrapped his knee then told him I’d need to take him in to “my hospital” for stitches. At the mention of the word, all color drained from his face and he staggered visibly.

At the hospital, the triage nurse took our information, typing down our answers to her questions.

“How did this happen?” she asked.

“I don’t know,” I stammered. “We were out in the garden. When he stood up he was bleeding.”

Son cut knee. Mother has no idea how it happened,
she typed.

“That’s not exactly what I said,” I pointed out, making her change the wording before anyone called DCF on me.

One of my fellow residents stitched Neil up expertly. His only advice was that he find another story for his scar.

“Tell him a tiger got you, Neil,” he told us. I was grateful for his humor and his skill.

Neil would remain my “woozy one.” The one to get queasy at the sight of blood. The one to catch every virus in his school and be hit hardest. Dan was stocky as a boy and much hardier than his brother. A cold that landed Neil in bed for days with a fever and chills barely roused a sniffle in Dan. Neil had strep throat four times as a boy while the rest of the household escaped unscathed.

Each time one of the children became ill (usually Neil), Saul and I had to figure out who was staying home as the caretaking parent. One day Neil was home ill and Saul was the one to stay home with him.

“I’m sorry, Neil,” I told him before leaving for my shift. “I can’t miss a day from this rotation. There are lots of sick children in the hospital who need me. Besides, you’ve got Dad.”

Neil didn’t miss a beat, laying the guilt on pretty thick.

“So not only are you not staying home with me,” he said accusingly, “but you probably brought the germs home that got me sick in the first place.”

We couldn’t have predicted then that such a vulnerable child would grow up to be such a resilient young man. The brain injury, the broken leg: They took their toll, but they never broke Neil’s spirit. He just did what he had to do, one foot in front of the other.