Stay Awake Read online

  “It’s seven-thirty,” she said, and glanced at her cellphone. He didn’t know what she had been doing with her own night, while he had been following various branching trails of information, one Internet search leading to another and then another. Sometimes he would find her sitting in the television room, watching a sitcom; sometimes he would find her sleeping, curled up on the bed, on top of the covers with her shoes off, and he would lean over her, wishing that he had found a useful bit of information to give her, some kernel from his long foraging.

  “I’ll see you at the hospital at six,” she said. She touched the screen of her phone, used her thumb to scroll, furrowed her eyebrows, and he ran a hand through his hair.

  “Even when a child’s death is imminent, the parent must forever carry the image of the child moving forward, alive, into the future.” After Amber left, he had found this written in his own handwriting on a Post-it note on his desk. Was it a quote from something? Had he thought of it himself?

  He was thinking about all of these things as Amber spoke to him. “You’re awake,” she said and he opened his eyes and Amber’s face floated above him.

  He was aware of specific thoughts, images, connections: the fused skull in the museum, the movement of Amber’s fingers against her phone, the little Post-it note. All of these things had been in the process of sliding into place, connections were being made, and then the links seemed to unfasten as his mind rose out of sleep. He lifted his hand and some kind of monitor was clipped to his index finger.

  “I’m sorry,” he said, and there were so many things that he didn’t even know what he meant. Was he sorry for the two-headed boy, exhibited by his parents; for all the time he’d spent reading such stories, staring at his computer while Amber moved through another part of the house; for falling asleep at the wheel and leaving her alone to deal with the terrible details of their child’s last days; for being yet another burden to worry about; for the life they had been thrust into, which was unexpectedly difficult and unexpectedly unexpected; for his hoarse voice, which was a crackling of paper. I’m sorry, I’m sorry, I’m sorry.

  “Zach,” Amber said firmly, as if she hadn’t heard him. “Are you able to focus? Can you hear me talking to you?”

  There was still a little paperwork to be done concerning Rosalie’s upcoming operation. Release forms and so on. These documents needed to be signed immediately.

  “Yes,” he said. “I’m listening.”

  Meanwhile, upstairs, the babies had opened their eyes again as well.

  Above them, a mobile was turning in a slow circle: blue giraffe, yellow duck, red doggy, bobbing on wires, turning slowly around an axle, and the babies followed the motion of the shapes as they wheeled by.

  Rosalie moved her tongue inside her mouth and the other one’s brow furrowed. Rosalie’s hands waved gently in the air and the other shifted her eyes back and forth, searching. After a time, they could see the pointed cap of the nurse above them, a blurry white peak on the horizon. A hand emerged and lowered itself toward them and they felt the cold of the air as their diaper was undone. The legs gave bright, athletic kicks, a burst of energy or excitement, and the parasitic head smiled dreamily.

  “There, there,” the nurse murmured. “It’s all right, it’s all right.” She began to hum, and the babies liked the music, the sound of a lullaby and the touch of the warm cloth as their body was cleansed.

  The surgery would need to be performed immediately if there was to be any possibility of saving Rosalie’s life.

  The parasitic head had begun to grow faster than Rosalie’s own, and the doctors feared that the pressure from the growth would start to hinder Rosalie’s brain development. Because the two brains shared common arteries that were dependent on Rosalie’s organs, Rosalie was now in constant danger of heart failure. The other head was getting nutrition from Rosalie’s body, blood from Rosalie’s heart, oxygen from Rosalie’s lungs. Keeping both heads alive was becoming a daily struggle for the body.

  Zach listened as Amber repeated these things to him. She was reporting the information in a careful, formal voice, the way one might recite a lesson in a foreign-language class. “Sagittal sinus,” she said. “Venous drainage.”

  “Well,” he said. He considered for a moment. He was a college graduate, but he had no idea what to say. No one had ever prepared him for such an occasion. After the head was removed, would they bury it? he wondered vaguely. Would it require a headstone?

  “You don’t have to say anything,” she said. Her expression flinched, and she looked at the hand he had lifted to hold out to her. She patted her palm against his knuckles, pressing his hand back down to the bed. “Just rest,” she said.

  When this is over, he thought. When it was over, there would have to be a way to repair their marriage. They would have to find their way back to the life they once had. Maybe a trip, he thought. They had once liked to travel. They had gone bird-watching in the cloud forests of Ecuador; they had walked through Roman ruins in the Dordogne of France, holding hands as they passed through the archway of an ancient gladiatorial arena; they had driven recklessly on one-lane roads in the Scottish Highlands, singing. They were a happy childless couple once. They could be that again.

  “Everything will be all right,” he said.

  “Yes,” she said.

  He lay there, waiting, awake. The operation would take many hours. He didn’t know how much time had passed. It was now the middle of the night and he could see the snow was falling again onto the parking lot outside his window.

  From time to time he would hear the clip-clop of someone’s hard-soled shoes against the floor of the hallway outside his room. The footsteps would gradually grow louder and then they would grow softer.

  The doctors would need to separate Rosalie’s brain from the conjoined organ in small stages. Blood vessels and arteries were shared between the two heads. The doctors planned to slowly cut off the blood supply to the extra head. The doctors would clip the veins and arteries and finally close Rosalie’s skull, using a bone-and-skin graft from the second head.

  If Rosalie died, he imagined that someone would come to tell him. Or—if the operation was successful, they would come and tell him that, too. He had called once and a nurse’s aide had come to assure him that he would be the first to know. Whatever happened, she said.

  The television had been turned off for a while now, its gray face blank and neutral. If there was consciousness, he thought; if there was consciousness, even if there was some rudimentary consciousness, the head would be asleep, under anesthesia. It would not be aware of the moment in which the blood supply stopped, the oxygen cut off, the brain cells began to shut down.

  The room was dark but he could see something trembling on the ceiling. A piece of light, a reflection, quivering like a leaf on the surface of a pond. He moved his fingers, then his toes. He could feel the screws that held the halo crown to his skull, and he knew that once his condition had stabilized he would have to begin rehabilitation; that would have to be discussed at some point, once the situation with Rosalie was resolved.

  His life had started out pleasantly enough. He and his sister growing up uneventfully in a suburb of Chicago, moving dutifully through elementary school and middle school and high school and college and finding jobs not far from their parents, who had then died abruptly when Zach and Monica were in their early twenties. Their father, a heart attack in his car, in the parking lot outside of the little strip-mall office where he’d had a dentistry practice. Their mother, about six months later, in the same car, sitting in the garage of their old childhood house with the engine running.

  It was not something he liked to think about. “You should get a little therapy,” Monica had said. “I’ve found it very helpful, just to talk about my feelings, and sort of put everything in perspective,” and he agreed that it sounded like it would be a good idea and he’d visited a mental-health professional who had given him some medication, temporary medication, which had basica
lly been enough. Shortly thereafter he had met Amber and they had fallen in love and gotten married and his life had moved back onto the track; they had their honeymoon in Scotland and they’d bought a house and two cars, and they’d worked fastidiously to pay off their student loans and mortgage and tried to save a little for the future.

  Even when our death is imminent, we carry the image of ourselves moving forward, alive, into the future. He had read that somewhere, but it came to him like a voice speaking from the back of his mind, and he shuddered. The titanium pins that held his halo traction in place, the pins that had been drilled into the skull above his ears, felt like they’d loosened a little. It was as if he could sense them twisting and untwisting.

  He fingered a buzzer that would call a nurse to help him, but didn’t press it. What did he need help for? He could feel the nipple of the button beneath his thumb.

  He was remembering an article he had read on the Internet about the transplantation of heads. In 1970, Dr. Robert White first successfully transplanted the head of a rhesus monkey onto another monkey’s body. It lived for several days, paralyzed from the neck down but aware. Eating. Following people with its eyes. Sometimes trying to bite.

  He came alert abruptly and the nurse was leaning over him. She looked surprised, drew back abruptly.

  “Mr. Dixon,” she said, and adjusted her nurse’s hat, which looked a little like a paper boat. “Mr. Dixon,” she breathed, and he felt the pinch of an injection. “You shouldn’t be up at this hour,” she murmured, and then she began to hum to him. An old lullaby he thought he remembered, the whispered words barely audible, coming as if from a great distance.

  … while the moon … drifts in the skies … stay awake … don’t close … your … eyes.…

  And then suddenly morning sun was streaming into the room. The morning, and Amber appeared, backlit against the window with a rind of light around her.

  “Is—?” Zach heard himself whisper. “Dead?”

  It was the first thing that he thought of, the first word that his lips formed. He couldn’t see her expression, but he felt fairly certain. “Dead?” he whispered, and she came forward and bent down and the features of her face came into focus.

  “No,” Amber said. Her face was pinched and her eyes were lit and fierce, in the way of a marathon runner, or an all-night gambler. Her lips drew back and she showed her teeth but it was too exhausted and intense to be a smile. “She’s alive,” Amber said. “She made it through. She—”

  He watched as her eyes scoped along the edges of his traction, the halo crown and the metal bars that ran past his ears and attached to the vest at his shoulders; the web of rope and pulleys that held his legs suspended—as if she had noticed for the first time.

  “It’s not—as they expected,” she said at last.

  Rosalie’s condition was described as serious but stable.

  After the surgery, she had been given barbiturates, which put her into a beneficial pharmacologically induced coma. Over the course of several days, she would be slowly weaned from the drugs, and this, it was hoped, would help to reestablish normal blood flow. Her heart was accustomed to beating faster to pump out more blood for the second head, and now it had to learn to pump more slowly. Otherwise, she was likely to have heart failure. In her bassinet in intensive care, you could see the scar that ran along the top of her head, the seam over which skin had been folded over and closed. Zach had not actually seen Rosalie since the operation, but Amber had brought photos for him to look at. One of the pictures had been taken by a photographer for the Associated Press, and had gone out over the wire service to news outlets across the world. It was probably the most flattering of the photographs. In it, Rosalie appeared to be sleeping blissfully, her eyelashes like little feathers.

  The doctors were said to be cautiously optimistic. At the same time, they reported to the media, “Rosalie’s survival of the operation was a big achievement in itself.”

  “I’ll just have to take everything one step at a time,” Amber told him as she sat there by his bedside. “Get through one thing and then worry about the next thing. Right? Isn’t that the way life goes?”

  “Yes,” he said. He was elevated into a sitting position, and Amber was spooning small cubes of gelatin into his mouth. Occasionally she would wipe his lip with a napkin. “That’s right,” he said, though he didn’t like it that she said “I” instead of “we.”

  “We’ll get through it,” he said. His voice croaky, tiny. “We’ll …”

  Behind Amber, the nurse poked her head into the room from the doorway and peered in. Checking, he guessed, to see if Amber was still there. He watched as the nurse paused and observed them for a moment, then withdrew.

  “I know that it’s going to be touch-and-go for the next few months,” Amber was saying. “For the next few years, probably. It might be premature to say anything, but I just feel like …”

  “I know,” Zach said. “I know what you mean. I haven’t even had time to think much about my own situation. I imagine I’ll have to start rehab soon, and then I’ll eventually be able to help more, instead of just—”

  “Mmm,” Amber said. Her eyes rested distractedly upon his hand, and he made an effort to flex his fingers. “Mmm,” she said. “Yes, well …”

  “—instead of just lying here.”

  “Everything will be fine,” she said, and gave him a firm, noncommittal stare. “Why can’t it all be fine? I mean, it’s a miracle she lived through the surgery and we should just be grateful for that, and then whatever else happens … we don’t have any control over that.…”

  “Right,” Zach said. “Of course.” He watched as she put the spoon down on the tray, next to the empty gelatin container.

  They were silent. They were both looking forward—momentarily, looking forward very cautiously—thinking about the possibility of life together with a living child. Zach was aware that they were probably considering some of the same images in their minds.

  For example, Rosalie walking for the first time. Rosalie’s uncertain feet, her arms held out, Rosalie wearing one of those bell-shaped dresses that little girls wear. Or, for example, Rosalie starting kindergarten. Her hair would be long enough to cover the scar on her scalp—it wouldn’t even be noticeable—and she would carry a lunch box and backpack and there would be certain cartoon characters that she liked, certain favorite books and songs. She would have her own personality at that point.

  They were still silent. Of course it was bad luck to say any of these things, probably bad luck even to think about them.

  Amber tapped her knuckle against the fiberglass vest across his chest. It was a weary but gently playful gesture, Zach thought. Partly, it was meant to bring good luck, like knocking on wood. Partly it meant: I can’t really think of anything else to say at the moment. “Well,” she said. “I guess—”

  “Sure,” he said. “You better get going.”

  They both tried out a smile, experimentally. But it felt a little dangerous to be smiling, and they stopped almost at once. As if their greedy sense of hope might be spotted—and punished?!—by some stern Higher Power.

  After Amber left, Zach lay there for a long time, staring up at the ceiling. It will be okay, he thought. It was all going to be fine. He tried again to picture them—himself, Amber, baby Rosalie—in the future. Standing in the backyard, beside the tree with the old swing. All three of them smiling. He could see it as if someone had taken a photograph.

  He would undergo rehabilitation, and eventually, after a struggle, he would walk again. Perhaps there would always be a limp, he thought.

  And even if his body didn’t ever start to work again, at least his brain continued on. Right? He still had his mind, and really wasn’t the flesh just a container, a shell that you inhabited?

  Back when he was spending his nights on the Internet, he had come across a long article about astral projection. According to some philosophies, the self existed outside of the physical body. There were man
y religions that believed the soul could lift away, a noncorporeal version of your mind could rise up from the tether of muscle and skin and bone and blood and float off on its own.

  Its own journey.

  People who experienced astral travel reported that it seemed to happen from a vantage point such as high in the sky looking down. Astral travel was frequently reported by people who had near-death experiences, in which they could view themselves from above, watching themselves as hospital staff worked on their bodies. Frederik van Eeden presented one of the first studies of out-of-body dreams to the Society of Psychical Research in 1913, and he described a “silver thread” that connected his projected self to his sleeping physical form.

  “In these lucid dreams,” van Eeden wrote, “the reintegration of the psychic functions is so complete that the sleeper remembers day-life and his own condition, reaches a state of perfect awareness, and is able to direct his attention, and to attempt different acts of free volition.”

  Zach didn’t know whether he believed in this or not, but he thought that there must be—well, something—

  There was a snail track of sweat moving down the back of his neck, leaving an insistent itch in its wake.

  Outside the window, in the parking lot, there was a female clown holding a bouquet of blue and pink helium balloons, each with a cartoon face printed on it. He watched as the woman stood there, flipping through a small notebook. The balloons were revolving upon the axis of their strings, the smiling faces slowly rotating, facing his window and then turning away in a slow circle.

  Zach was aware of the sound of a small voice calling to him, a sound in the back of his mind, and then another trickle down the back of his neck, an odd feeling in his hair, like the ticklish legs of an insect. Movement.

  Why do people, he thought. He was thinking of something that Amber had asked him once, right after the baby was born.

  Why do people want to have babies? she had said, her eyes upon him heavily. What does a baby have that we want from it?