Authors: Julie Cohen
It is terrifying. This is me.
‘You said the left temporal lobe,’ I say. ‘This is on the right.’
‘CT scans are inverted.’
‘Is it a tumour?’
asks Quinn, leaning over to look at it. ‘She had the scan yesterday. Why didn’t you show us this then?’
‘We wanted to make certain we knew what it was, before alarming you unnecessarily.’
‘I’m alarmed right now,’ I say.
‘It’s not an unusual problem,’ says the doctor, ‘though it is quite large, and the positioning is rare. Here’s a sagittal image from the MRI you had this morning. That is, a
side-on image. You can see the mass clearly.’
This print-out is more of a Hallowe’en horror than the other one. I can see my skull from the side, looking more fragile here, my eyeballs as round shadows, my clenched teeth, and the soft coils of my brain. There’s a glowing sphere in the centre of it, a few inches behind my eyeballs. He passes me another print-out, this one from the top. The mass
glows less here, and is more of a bean than a sphere. But it is still something that definitely should not be in my head.
‘I can’t feel it,’ I say. ‘Surely I should be able to feel something that’s this big?’
‘You have been feeling it, as a scent and an emotion. It’s been putting pressure on your temporal lobe and causing the seizures. Most likely it’s grown lately, which is why the seizures
have become more frequent and why you had a tonic-clonic. It’s been putting pressure on all of your brain, not just this little bit.’
‘But what is it?’ asks Quinn. ‘What can be done about it?’
‘Ah, so this print-out shows us exactly what it is.’ Dr Chin hands over another piece of paper with a flourish. It’s as if he’s enjoying the slow reveal, like a burlesque dancer. I glance at the four students,
who are rapt, and pretty much prove my suspicions: this is a show for them. I hope they’re enjoying it.
The last picture is not recognizably mine or anyone’s head. It looks like a round sac filled with water into which someone has released a slow stream of black dye; or possibly a fluid tree in autumn drawn by a watercolour artist. One of the branches has a black lump on it, a full bladder.
‘This is a cerebral angiogram. A picture of the arteries in your brain. As you can see here, one of the arteries in the left posterior has ballooned out into an aneurysm.’
Quinn’s hand lands on my shoulder. As he has avoided touching me – aside possibly from the time when he scraped me up from the grass – I can tell this isn’t good news.
‘Is that like a blood clot?’ I ask.
‘It’s a weakness in
the walls of the artery. It bulges out and fills with blood, which is why this one is growing. It’s causing pressure in your temporal lobe, which in turn is causing autonomic aura – the funny tingle in your stomach you describe, which is typical of temporal lobe seizures – along with somatosensory hallucination of smell, and the psychic aura of emotion. Love,’ he adds with relish. ‘It’s one of the
great philosophical questions of the universe: what is love? In your case, the answer is right here on this angiogram. Love is caused by this malformation of the artery in your brain.’
The students are going crazy with the writing now.
‘I am guessing that love caused by aneurysm is fairly rare,’ I say.
‘I’ve never heard of it before,’ says the consultant, almost gleefully. I restrain myself
from slapping him. ‘There’s a wide literature on temporal lobe hallucinations, but I haven’t yet encountered this particular hallucination, and this aetiology is also rare. Ninety per cent of cerebral aneurysms are anterior, rather than posterior, as yours is. So you not only have unusual symptoms, but an unusual disease. It was probably a good thing you were admitted for the tonic-clonic seizure
rather than the hallucinations, as otherwise this might have been misdiagnosed as mental illness.’
‘Love is insanity,’ I say quietly.
‘On the contrary – your experience proves that love is not only entirely normal, but an infinitely repeatable human condition. And that any one love affair, any single emotion, can be preserved in the brain indefinitely, waiting for the right physical conditions
for it to recur.’
I picture this: every emotion I have ever experienced, lined up in my brain like paintings in a gallery. Bundles of neurons, each one clearly labelled with its event and consequential feeling.
First kiss, age thirteen: awkwardness. Hug from mother: security. Laughed at by whole class in primary school: humiliation. Finding best friend in a youth hostel in Mumbai: discovery.
Butterfly lands on hand on summer’s day: serenity
.
‘You’re saying that everything I felt is … chemical? Electrical? Just impulses in my brain?’
‘You say “just” impulses in your brain, but there is no emotion that isn’t caused by these impulses. So as far as that goes, your seizures do create authentic emotion.’
Quinn’s hand tightens on my shoulder and I glance at him. He appears as irritated
with the doctor as I am. ‘Leaving aside the philosophical questions for the moment,’ he says, ‘isn’t a brain aneurysm dangerous?’
‘If it ruptures, yes, extremely. A subarachnoid brain haemorrhage can cause severe brain damage and death if not treated in time.’
‘So you have to take it out.’
‘Of course.’
‘Do you mean brain surgery?’
‘I think that Felicity is a good candidate for endovascular
coiling, which is much less invasive. But she’ll have to be assessed by the interventional neuroradiologist before we can make any decisions.’
‘Wait,’ I say. ‘This is my head. I have a few more questions. If you take this thing out, are you saying that everything I felt will be gone?’
‘The desired outcome is that you won’t have the seizures any more, though we’d also keep you on anti-convulsive
medication post-surgery for some time, to help with that. And you’ll have to be monitored to make sure the aneurysm doesn’t recur.’
‘You don’t understand. I’m asking about the feelings, not the seizures.’
‘You want to
keep
the feelings?’ asks Quinn.
‘I just want to know.’
The doctor glances back at his students to make sure they’re getting this. ‘The emotional kernel that you keep revisiting
will still be in your temporal lobe. You most likely won’t experience it in the same way, as if you’re living through it again. It will be like any other memory, though perhaps a particularly strong one.’
‘I’ll lose it.’
‘You’ll keep it as a memory. Unless the pressure from the aneurysm, or the surgical procedure, causes some damage. Which isn’t impossible. Despite incredible developments in
our knowledge and techniques, the brain is still unpredictable.’
‘Could this aneurysm have caused other symptoms besides the seizures?’ asks Quinn. ‘For example, behavioural changes?’
‘Have you noticed those?’
‘Yes,’ says Quinn, at the same time that I say, ‘No.’
The consultant laughs. ‘Marriage, eh? Damage to the temporal lobe can change behaviour. Loss of memory, impulsiveness or lack of
inhibition.’
‘But that’s just the way I am,’ I tell Quinn. ‘I’ve always had a rubbish memory. And I’ve always been impulsive.’
‘How long has she had this aneurysm?’ Quinn asks the doctor.
‘Difficult to say. Unless they cause symptoms such as these, unruptured cerebral aneurysms can go undetected for a person’s entire lifetime. Some studies estimate that ten per cent of the population have them
but will never suffer any problems because of them.’
‘So I don’t necessarily need to be treated,’ I say.
‘Yes, you do,’ says Quinn.
‘Your husband is right, you do. You may have had this weakness in your artery for years, and it could have been growing for some time without causing any perceptible problems, but it’s of a size now to cause seizures, and therefore surgery is indicated. As soon
as possible.’
‘And it could have ruptured at any time during the past however many years?’
‘An aneurysm of this size has a greater than six per cent chance of rupturing annually. As I said, a rupture can lead to catastrophic brain damage. And yours is growing with every day it remains untreated.’
I take the print-outs again and leaf through them. A glowing kidney bean. A black bladder of blood.
This is where love lies. This has been my passenger for who knows how many years, lying in the folds and shelter of my brain, filling itself with blood, stretching and growing. Possibly it was there when my mother was alive. While the cancer was eating her body, this bean was pushing outwards, testing its walls. All the time I may have been nearly as close to death as she was.
What would I have
done differently if I had known?
I wouldn’t have let her lie in the hospital bed. I would have carried her outside; her body was light as air. I would have sat with her on the beach and run the sand through her fingers and tucked the feather of a gull behind her ear. I would have tasted salt on my lips and held her and lived our moments together as if they were our last.
I touch the shape on
the egg-like CT scan. It could have been any memory, any feeling that was triggered. It could have been my first day of school, or learning to tie my shoes. It could have been my fear of what was under my bed, a drunken afternoon in Paris, a moment on the train from Cornwall to Paddington.
But it wasn’t. It was frangipani, and love for Ewan. Is that chance, or an inexplicable design? Does that
mean that this swelling was inside my brain when I met Ewan in that life-drawing class, when that memory of being in love for the first time was laid down? It was a part of me even then?
How much of my happiness and sadness, my impulsiveness and my joy, my decisions and actions, my me-ness, has been caused by this curled-up kidney bean of blood, nested in my brain like the embryo in an ultrasound
photograph?
QUINN HAD BEEN
in love three times in his life. Not counting temporary infatuations or girls he’d dated once or twice. He couldn’t even really count Andi, with whom he shared a flat and occasionally a bed soon after university; she was his best mate for a time, nearly two years, picking up an on-again-off-again relationship with him in between dating other people until she found Christianity
and emigrated to Australia. He cared about Andi but he hadn’t been in love with her, and she not with him, although his parents had hoped, not so subtly, that he’d get more serious with her.
The first time he fell in love was a missed opportunity. He was seventeen and everyone in the sixth-form common room knew that Kathy Lewis was head-over-heels in love with Quinn Wickham. She was a pretty
girl but shy, and Quinn already knew shy. He’d been shy through most of his senior-school years, being shorter and slighter than the other boys. Though he made up for his diffidence by being friendly and courteous to everyone, as his dad advised him to, he never had the confidence that many of the other pupils had, that Suz had always had. He knew shy, so he didn’t notice shy, because he was too busy
noticing the people who weren’t shy and wishing he were more like them. The ones who could joke loudly in the hallways and make people laugh, the performers and the athletes, the fellow students he wrote about in the school newspaper which he’d set up himself, written and laid out and printed and distributed ever since he’d been in Year Nine. The news spoke for itself; he didn’t have to. He could
stay shy.
Then he got his growth spurt in the middle of his first year of A-levels and he found it was easier to talk to people when you could look them in the eye, or even look down at them. He started wondering if Anastasia Jenkins would notice him now, after ignoring him for the past three years. That was why he never noticed Kathy Lewis, taking the seat next to his in geography, sneaking
glances at him over lunch. And then some of the girls started to giggle about it, and some of the boys nudged him and pointed. Then of course he couldn’t notice her, not beyond his normal polite friendliness, because it would embarrass both of them.
Anastasia Jenkins started going out with Damien Boynton, and that was the week that Quinn started looking at Kathy’s hair and noticing how shiny
it was, like strands of black silk. Then one day he noticed she’d had her ears pierced twice, her nails painted with glitter. Then her handwriting, which was much more dramatic than you’d expect from a girl so shy, all spikes and flourishes like a seventeenth-century clerk’s. They exchanged glances and smiles. They worked together to research a paper on the Euro Zone. She invited him to her house
to revise.
For half a term, February to April, he felt a warm happiness in sitting beside her. He thought about kissing her and the thought of it made him want to skip. He knew he didn’t have to say anything to her, because she was in love with him. Everyone knew it. There was a secret sub-text to every sentence that they spoke to each other. It was the first time he’d been in love, properly
in love, and it was wonderful.
For the Easter hols he went to visit Suz at her flat in Leeds and when he rang Kathy, for the first time, the night before they went back to school, her younger sister answered the phone. ‘She’s out with Mark,’ the sister told him, undisguised glee in her voice. ‘She says you never rang her and she was tired of it.’
Kathy went out with Mark for the rest of their
school career. Quinn went out with as many girls as would have him. He kissed Anastasia Jenkins at the sixth-form leavers’ do and her lips were sticky with a lipstick that tasted of too-ripe cherries.
The second time he fell in love, it was much more substantial. He met Maya during his first year at university and the two of them clicked. She was studying journalism too, was not-technically-a-virgin
too, had just missed Oxbridge too, her family was also traditional, though with different traditions. She and Quinn laughed at the same films and jokes and people. They met, and dated, and soon it was Quinn-and-Maya, a double act, a team, a partnership. They drank in the student bars together, spent afternoons exploring sex together, moved in together in their third year. His parents thought
they would marry. Her parents initially put up an objection, but after meeting Quinn several times were resigned, even pleased.