I hope she won’t say anything. But there is nothing I can do about it.
Okay, so I said I was sick. Naomi accepted that, but Julian is more inquisitive and asked what I have. I said that the doctor doesn’t know yet and that I sometimes have an attack, but that it always goes away in a jiffy, even though it may look very scary. I told him that he was a wonderful big brother and that if it were ever to happen again, he should take his sister to the bedroom and wait there till it was over.
Later, when he was in bed, he said something terrible. He said there had been someone next to me.
I asked him what he meant, but he couldn’t tell me much more other than that he thought he had seen a man in the room when I was screaming and swinging my arms. But he hadn’t seen who it was, because the man didn’t have a face.
Don’t tell me I still have to be rational now! Or that there is some natural explanation for all of this.
Julian said something else. That it had looked like I was floating.
He fell asleep and I collapsed.
Oh, will I ever be able to explain to anyone what it’s like? What I feel when I’m falling?
Let me at least try. Maybe by writing it down I can at least create some sort of order. Maybe that way, I will find a way out of this misery. A clue I didn’t see before.
As I am writing this, I am looking out over the city through the attic window. Hidden under a nightly glow beyond the houses across the street is Amsterdam-Zuidoost: the ArenA, the Ziggo Dome, the Amsterdamse Poort retail park. Farther south is the AMC. That’s where it all started, so that’s where I will start.
My patient’s name on the night of August 18 was Tim van Laerhoven and he was only fifteen years old. After a trip through South America in late July, he started getting headaches, fever, and dizziness. A series of tests at the outpatient department and General Internal Medicine later, he was sent home with a provisional diagnosis of a chronic infection and a prescription for co-trimoxazole. His fever went down, but Tim remained listless and complained, his father told me during the intake, of a “pressure” behind his temples. “I didn’t give it much thought, I get the occasional migraine too.” The senior Van Laerhoven shrugged (the anesthetist said he was the slap-a-Band-Aid-on-it kind of type, even if his son were to be dismembered). On the evening of August 17, he found the boy in the bathroom, unconscious, convulsing, eyes half-open, and now he did give it some thought. An ambulance rushed Tim to the AMC, where a CT scan showed an enormous abscess under the cerebral membrane with acute symptoms of impingement. That’s how Tim van Laerhoven came to be my emergency call that night.
Stella, a young nurse in Neurosurgery, was the first to see it, and I will never forget her choked scream.
“Jesus, he’s moving . . . That’s impossible—the sedation!”
“Stella, behave yourself,” Stefan snapped at her from behind his surgical mask (Stefan is Stefan Rudnicki, assistant surgeon). I think he didn’t say it in reaction to what she said—in his eyes, that must have been an impossibility—but to how she said it, because OR protocol stipulates that under no circumstances should one raise their voice, so as to not disrupt the operating surgeon’s concentration. (For the same reason, the OR is practically soundproof, and that’s why we had no idea what was going on in the corridors right then—what was going on in the whole building. It was just after three a.m.)
We had sawed open a flap in Tim’s skull and opened the meninx. It’s very possible to treat a cerebral abscess if you operate on it in time, and we did, but only just. The moment it started to go wrong, I had been focusing on the neuronavigation monitor and was on the other side of the tent of sheets we had put up around his head. Therefore I didn’t see what Stella had seen. But I heard it all right, because the beeping from his electrocardiograph started to suddenly increase. “Fast heart rate,” the anesthetist announced. “Heart rate 96, guys.”
“96?” I asked, looking up from the monitor. “Where’s that coming from?”
“Cerebral functions stable, blood pressure a bit high, heart rate now 104.”
“Sufentanil and vecuronium, and stat,” I said. There was no way he could be waking up from his sedation, but you’d better be on the safe side. “And what do you mean, ‘he’s moving,’ Stella?”
“Look, his arms!”
Irritated, Stefan looked around the tent, and he gasped, “Jesus Christ.”
I looked, and then I saw it too. The boy’s arms—both arms—had risen off the operating table’s blue sheets and were hovering five inches above them. “Vecuronium, now!” I said. “Stefan, check for hemorrhaging and leakage. Hold his arms, Stella. His head is in the clamp, but if he gets a seizure it can come loose.”
“How can he get a seizure if—”
“No hemorrhaging or leakage,” Stefan said. The anesthetist had given him the sedatives, but to no effect. The electrocardiograph monitor was going wild. His heart rate had gone up to 130 and was still rising.
I think Stella screamed when the boy’s body started to rise. He wasn’t floating, not like in those cheap horror flicks about people who are possessed. His hips came off the operating table and his body formed a supple bow, and it reminded me of a circus trapeze artist who gets hoisted into the air by his hips. Stella let go of him and shrunk back, bumping against the microscope, and now his arms were floating too. His shoulders and heels never came off the table, and although with some muscular strain one might imitate the posture his body had assumed, the boy’s limbs were completely relaxed. I could feel it when I tried to push him down, and that made it seem so unnatural. There were no cramps, no spasms, no epileptic seizure, nothing of the sort. Tim van Laerhoven’s sleeping body was behaving as if it were floating on air . . . or falling through the sky.
I think all four of us were too dumbfounded to do anything but stare at our patient. Stefan was the first to have the presence of mind to react. “Strap him down before he falls to the ground.”
“What with?”
“What difference does it make, damn it!”
Under the tent around his forehead, Tim’s eyes opened. We all saw it. The boy was under general anesthetic, we had sawed open his skull, but all the same, his eyes opened. Only there weren’t any eyes, just bulging white. And he was smiling. That smile was the creepiest thing I have ever seen in my life. It was a blissful smile, the smile of a boy riding a roller coaster and enjoying the butterflies in his stomach.