Frank Read online

  “No,” he said. “Frank’s wife. She wants to see him.”

  3: Sidney Bernstein, M.D.

  Howard first came to my attention on July 21 after having been referred by my old and dear friend Dr. Stanley Gardner. Stan, an excellent internist, was worried and baffled by Howard’s strange and perplexing illness.

  I was playing a card game, Go Fish, with my six-year-old stepson, Stephen. I was purposely losing the game, but that wasn’t good enough for him because he didn’t like me. He told me so all the time. “I don’t like you,” he enjoyed saying, but not in a mean way. He said it as if he were reading from a list of trivia facts. But that didn’t prevent him from talking with me or, occasionally, playing a game of cards. But I knew he didn’t trust me. He wouldn’t call me Dad yet. Anyway, I had to beg him to play the game. He’d rather be playing with matches, which we’d caught him doing twice in the previous month.

  I was throwing the game and purposefully not asking for cards I knew he had when Stan called. I knew straight off that something was wrong because Stan is one of the most confident physicians I have ever known. He doesn’t like to refer patients unless it’s absolutely necessary. His hesitancy to refer isn’t born from any desire to keep the money in his office. Rather, he prides himself in being so well-rounded and knowledgeable that if he can’t make the diagnosis, no one can.

  When he called and I heard the resigned tone of his voice, I knew that he had accepted defeat.

  “Sid,” he said, “I’ve got a patient I’d like you to see. But it’s kind of unusual.”

  “Stan, your phone call was the first surprise,” I said. “Now I’m intrigued.”

  “Intrigue? Sure, you might call it that. It’s a mystery to me. In fact, it’s a stretch for me to call you because it isn’t really directly related to a neurological incident. Just the opposite, in fact. It’s not what you think. Actually, it’s not what anyone thinks.”

  “I’ve never heard you talk this way before, Stan. What’s the matter?”

  “It’s like this, Sid. The patient was involved in a boating accident earlier this month. Cut him up pretty good. A bunch of sutures. Treated with the usual meds. But he was fine, really.”

  “I’m following you.”

  “Then he comes down with everything that points to tetanus. Stiffness in the neck. Muscle hardness and spasms. Convulsions. Difficulty swallowing. Pissed-off attitude. The whole nine yards. Classic symptoms. Tetanus, right?”

  “That would be my guess,” I agreed.

  “Only it isn’t. His immunizations are up to date. And we gave him a booster. Shot him with enough antibiotics to wake the dead. I’m telling you. We opened him up again and explored his wounds thoroughly, intending to clean them out. Ready to drain them. But nothing.”

  “So what is it?”

  “That’s beside the point now. His body is dying, and I can’t stop it. His organs are shutting down. Took a major turn for the worse this morning. I’ve got him sedated. He’s got a few days. A week at tops.”

  “And you’re calling me because?”

  “Because I don’t know what to do. Because you’re the best goddamn neurosurgeon I know. And because, what the hell, the only part of his body that seems unaffected is his brain, and I thought you’d have some idea of what I’ve missed. And ... I thought you might be interested.”

  “What does his EEG say?”

  “I’m telling you, Sidney. Normal straight on. It’s like his brain is completely fine and the rest of him is going to hell.”

  Sid was right. Late that evening I examined Howard and found him stiff, rigid, and fading fast. Sid had not been exaggerating. As advertised, Howard’s brain was in perfect shape and had, somehow, sealed itself off from the contamination that was destroying every other cell of his body.

  He was awake when I saw him but couldn’t speak because of his lockjaw and the ventilator, but his eyes were open and pleading.

  “I’m Dr. Sidney Bernstein, Howard. Dr. Gardner asked me to take a look at you and see if I could help. Are you experiencing any discomfort?”

  Stupid question, I know, but that’s what I cared about the most. The pain. That’s what’s always bothered me about modern medicine. We spend most of our time focused on healing a patient, but not enough time blocking the pain. Especially for terminal patients who deserve nothing less. People should die peacefully, their last days and hours spent resting comfortably surrounded by family. Pain free.

  But Howard was clearly hurting. He couldn’t talk, but his eyes opened wide and his head rocked a little from side to side.

  I rested my hand on the top of his forehead and patted him gently. “I’m going to do everything in my power to help you.”

  I had to stop his pain, so I quickly called for a spinal block and placed it myself. It’s similar to epidurals that women routinely receive during childbirth. But this one was significantly riskier because I wanted to insert it high. It took two tries to get the thin needle in but I succeeded, and within just a few minutes Howard’s brow softened. His eyes relaxed. Best, he seemed to smile.

  * * * *

  I need to come clean and admit that there’s another reason Stan called me about Howard—he is one of the very few people who knew about the experiments I had been conducting. That’s what he meant when he said he thought I might be interested.

  Specifically, I had long been fascinated by the prospect of transplanting a human brain.

  This is not a new area of medical investigation. Numerous attempts to keep the brain alive outside the human body have been documented since ancient times. It’s also an area that has attracted me for twenty years and one that I’ve done quite a bit of work on.

  There’s no secret to transplantation. Whether it’s the cornea, heart, kidney, liver, or whatever, transplanting relies on three things. First, preserving a donated organ until the surgery. Second, keeping the recipient alive without the organ until the procedure can be successfully performed. And third, preventing rejection of the transplanted organ.

  Theoretically, it has always been my belief that the removal and sufficiency of a brain is possible if its blood flow is maintained. That seemed easy enough to accomplish by retrofitting a heart-lung machine. That’s been done before.

  But it’s been the nerves and spinal cord, the connection to the body, that have stood in the way of serious brain transplant attempts. After all, what good would it be to transplant a live brain into another person’s body if it wasn’t connected to anything that made a difference? If the person couldn’t use any of his senses, if he couldn’t move, then what would be the point? Not to mention the quality-of-life issues. I can’t think of anything worse than a living, thinking brain trapped inside itself without any outlets or senses. We call it the “locked-in” syndrome.

  Surgeons at Emory University and Case Western Reserve University have done a lot of work in this area. But the breakthrough has been my two successful attempts to transplant pig brains and reconnect their hearing.

  Modern gene therapy and nerve regeneration techniques have brought added hope to this research. In experiments at the Christopher Reeve Center, severed nerves placed end-to-end have been shown to heal through a newly grown bridge of sorts after being “basted” in a genetically enhanced regeneration solution. I’ve seen some astonishing results.

  Needless to say, this work has been hush-hush. I’ve been very careful to have as few people involved as possible. Only Stan knows the whole story. I have a small group of doctors and technicians who have been working with me on these experiments, but I’ve severely limited their knowledge and access. Through luck and a bit of intimidation, I’ve been able to keep this all under wraps until now because none of us wants to experience the wrath of the scientific community.

  I must confess that, after Howard was resting comfortably that evening, the pain having been blocked, it began to occur to me that perhaps the time was right for a human experiment. But more than just timing, I felt like the recipient of a d
ivine intervention, as if I were being “handed” Howard on a silver platter.

  Later that night, as I returned home and crawled into bed, I nudged Amanda awake and told her about my plan.

  “Dear,” she said, turning toward me and resting her head on my shoulder, “do you think you’re ready?”

  “I don’t know,” I said, but her question’s weight was a burden. She hadn’t meant it as a dig at my skill. She was referring to whether the world was ready. “It’s going to be time sooner or later.”

  Amanda yawned and ran her fingers lovingly over my chest as I told her about Howard. She was always a good listener.

  “It sounds like the choice has been made for you,” she said.

  “I suppose so.”

  She smiled and kissed me. “Stephen was disappointed you had to leave so suddenly. I had to finish the card game with him, but he said it wasn’t the same.”

  “What did you tell him?”

  “What would you have wanted me to tell him?”

  “That I cared. That I know he already has a dad and that I don’t want to replace his real one. But that I love his mother very much. And that he’s one of the reasons I married her.”

  Amanda hugged me and said, “I told him that, though not quite so eloquently. He wanted to beat you.”

  “Do you think he’ll ever give me a break?”

  “He told me a secret about you. He said he likes you but that I shouldn’t tell you, otherwise you might get the wrong idea.”

  “Wrong idea about what?”

  “I don’t know. But when he said it I pretended to understand what he meant and promised I wouldn’t tell.”

  “He’s a good boy,” I said, staring at the ceiling. “I wish I had more time for him.”

  “So do I,” she said.

  For a while we said nothing. I touched her thigh in an exploratory overture to sex.

  Then she asked, “When?” and I knew she was referring to Howard.

  “When God deals the next card,” I said.

  * * * *

  At about that precise moment a wannabe gang member out for initiation emptied his revolver randomly on the freeway and caught a young man named Frank Orlen with one bullet to the head.

  My call came at 4:30 A.M. and, with the news, I could honestly think of nothing else but how badly his head had been damaged. You may judge me harshly for not wondering if I could save the young man. But it all seemed too perfect to have a chance at finding a host for Howard’s brain.

  Frank Orlen was straight-line brain dead. The bullet, which had entered his head two inches above his ear, ripped through his brain in debilitating spirals. A scan quickly wrote the book on Frank—he would never regain consciousness. That easy diagnosis had been made even before I arrived at the hospital. Amazingly, his skull and head were mostly intact but for the bullet hole and a few abrasions caused by the car accident that ensued.

  There’s a standard procedure for acquiring organ donations. Depending on the hospital, the topic is usually broached in person by a hospital social worker, ethics specialist, even clergy.

  But I handled this myself in an effort to minimize the number of people who knew.

  Frank’s parents and wife were at the hospital that morning. I had them brought to a small room adjoining the hospital chapel.

  Frank’s wife, Janelle, a beautiful young mother of three, was distraught but weirdly remote.

  “His brain is gone. I’m sorry,” I said. “Very, very sorry. There’s nothing we can do.”

  “Can’t you operate?” Frank’s father pleaded.

  “There’s nothing left to operate on. I’m sorry.”

  Janelle didn’t say anything, just stared at me. Her face held a faraway gaze that didn’t quite fit. I can’t explain it any other way. Something else was going on in her head, something I couldn’t figure out.

  That’s when I lowered my voice and began to plow in to the idea of organ donation. About how Frank need not have died in vain. About how in death he can give life.

  His parents said no, but Janelle interrupted them. “Mom. Dad. It’s okay. Frank would have wanted this. He has the organ donation box checked on his driver’s license.”

  Then I pushed ahead and told them about how Frank had an opportunity to be a part of a significant medical breakthrough by donating not just individual parts but his entire body. I told them that, as compensation, I would work hard to set up college funds for the children.

  Again, his parents had reservations. But Janelle looked up at me and said in a strange, calm voice, “Yes. He meant so much to us. And he seems to mean as much to you.”

  * * * *

  “I can’t make any promises,” I told Howard and Catherine just a few hours later. I told them about my success with the procedures on the pigs and told them that, theoretically, there was no reason it couldn’t work on a human.

  “The odds are way against success,” I told them. “If I was a betting man, I’d put money on failure.” I stopped for a moment to gather my thoughts, then continued. “But look at it this way. It’s the only alternative I can present to you. Do nothing, and I must tell you that fate will take a hand in a few days. At the very worst, it’ll be over quicker. At the best, you have a chance at living pain-free. Of hearing and communicating. Of more, perhaps. You can live. And by living help others. In every medical advance there is almost always one man with a vision.”

  * * * *

  That afternoon, in one of the mostly long-forgotten emergency operating rooms in the hospital’s third basement, I wielded a scalpel.

  Do not judge me. Simply understand that I was attempting something that, at least at the time, seemed plausible and correct. But don’t think for a second that I took lightly what I was doing.

  When I touched Howard’s brain I released my own tortured soul and soared away to my early days working on cadavers in medical school and the realization that these dead people were products of medicine’s failure. The cataloging of veins and organs, the labeling of obscure body parts. Time peeled back further to my days collecting butterflies and pinning them on cardboard to display their wings. Who was I to take God’s work into my hands? I was not dispassionate about what I was doing. I was troubled and frightened.

  My hands became disconnected from my body, and I stepped back to watch them open the skulls of these two men. Two floating hands waltzing above the table. Was I not just an ordinary physician simply doing the next thing? The latest in an unending march of pioneers?

  I told myself that there was nothing wrong with what I was doing. I looked nervously into Stan’s eyes and, without uttering a word, asked him to validate my actions. But was he wrestling with his own demons? What is a man other than the illusions that his brain creates? Doesn’t everything begin in the mind? Do inventions and actions and love have their genesis in an elbow or shoulder? No. Everything stems from the brain. The place of origination. How could I convince myself?

  And as I fitted Howard’s brain with tubes and made it a self-contained unit, I thought of being back at home and lying with Amanda and having her tell me over and over that I was not a bad man and that I was doing good. I thought about Stephen and his pairs of kings and jacks and that I had a seven in my hand and knew that he had three of them. But I would leave those sevens for him. How would Stephen judge me tomorrow? Harshly. Should I back away? It would be easy to pretend to slip and drop Howard’s brain. Or not tie off a suture correctly.

  The blood on my hands was dark and staining. And I, just a man, just a fallible unfortunate soul. It all came back to me. My hands in my gloves. Face covered. Then a small place in the back of my head began to pound as if to say stop. Stop what you’re doing. Pull your hands away. But I pressed on. Not with pride, but with contempt, I think.

  That’s what I thought as a light opened up from above and surrounded me and held my hands and took over. And as I finished I could not help doubting myself and wanting to wake up and make different decisions. What had I done? And w
hat would be the result?

  4: Neil Lavery

  Right off, I am responsible for what has happened to my father.

  That his brain has been removed and placed in another person’s body is entirely my doing. It’s my fault that he lies motionless in that room.

  There was a time not that long ago when my father was a person of great dimensions. I remember so clearly that, when I was a child, I would look up at him and his great elbows and nostrils and see him kneeling down to my level.

  That’s still the way I see him, always standing tall and then slowly lowering his body like an elevator and laying his hand atop my head. I would embrace him, my left cheek flush against his, the pointed stubble of his beard, his wisteria cologne.

  He has been a strong figure in my life. If not a completely positive one. But he has always stood tall to me, a monolithic presence, a ghost of sorts. Perhaps like everyone’s father.

  This afternoon, I gathered all my courage and went to see him. I was planning it for days. Dreading it, really. Partly pushed into it by my wife, Emily, and her words, “Put yourself in his shoes, Neil. Wouldn’t you want your children near?”

  She knows that it’s so much more difficult than that, because my father’s such a complicated man. And I suppose I’m much like him.

  But it wasn’t him I found in the hospital room. It was a stranger. And though I was warned, I could barely walk farther in than the door. I took a few steps toward the bed but then quickly backed away and stood against the wall trying to flatten myself and disappear. If I were a chameleon I would have activated my camouflage and turned the same off-white color as the walls.

  It was quiet in that white room. The buzz of the ventilator echoed eerily. Such a large room, I thought. And that person at the far end of it lying so cool and calm.

  He hadn’t heard me come in because he wore earphones and was listening to one of his CDs. That made me feel good because I brought one for him, a newly re-released CD of Hoagy Sings Carmichael, an old Hoagy Carmichael album recorded back in 1956. Although Carmichael was popular before my dad’s time, Grandpa was a big fan and he passed that down to my dad.