Chapter 2 - The Sound of the Solenoid
The MRI scanner at Westchester Medical Center sounded like a machine designed to demolish bridges.
Thump-thump-thump. Clack-clack-clack-clack.
Emily lay inside the white plastic cylinder, her head immobilized in a plastic cage that resembled an antique diver’s helmet. Above her eyes, a small angled mirror reflected a four-inch strip of the control room window. Through the heavy leaded glass, she could see the silhouette of a man in dark blue scrubs and a grey-haired woman leaning over a high-resolution flat-panel monitor.
Every twenty seconds, the machine shifted frequencies. A high-pitched, metallic shriek would tear through the chassis, vibrating against the fillings in her molars, followed by a rhythmic pneumatic thumping that felt as if someone were dropping heavy bags of sand onto the floor directly beneath her skull.
The numbness had begun to climb.
It was no longer at her navel. It had reached her ribs.
It felt like cold motor oil being poured slowly down the interior of her chest cavity. With each breath, her intercostal muscles felt less responsive, forcing her to rely on the downward stroke of her diaphragm to pull air into her lungs.
One. Two. Three.
She counted the ceiling perforations reflected in the mirror.
She thought about the yellow dress.
Not the dress she had worn today—today she had worn a simple green linen top and white pants—but the yellow dress from the summer she was sixteen. The one with the white eyelet lace around the hem. The summer she had spent three months in her bedroom with the curtains drawn, while her mother told the neighbors she had contracted a severe case of mononucleosis from a girl on the track team.
She remembered the taste of cherry-flavored cough syrup that had made her sleep twenty hours a day.
She remembered waking up with her back feeling stiff, as if someone had replaced her spine with an iron rebar, and her father standing in the doorway holding a cardboard box filled with her track medals, her running shoes, and her high-jump ribbons.
“Doctor says you have a congenital weakness, Emily,” Arthur had said that August afternoon in 2012, his voice flat, not looking at her eyes. “The cartilage between your discs is like wet cardboard. One more season on the hurdles and you’ll spend your twenties in a wheelchair. We’re throwing this stuff out so you aren't tempted. You need to learn to be still.”
She had wept for three weeks. She had loved the hurdles. She had loved the split-second of flight between the approach and the landing, the feeling of her hamstring stretching taut like a violin string as she cleared the wooden crossbar.
After that summer, she had never run again.
She had become the quiet girl in the library. The daughter who helped her mother file household receipts. The sister who typed Ryan’s college application essays while he sat on the back deck drinking beer with his lacrosse friends.
Thump-thump-thump. Whirrrrrr.
The magnet died with a long, descending whine that sounded like an aircraft turbine spooling down on a wet tarmac.
The motorized gurney hummed, sliding her out of the bore into the bright, freezing air of the imaging suite.
Dr. Gregory Marcus, the chief of neurotrauma, was waiting beside the console. He was fifty-two, with dark circles under his eyes that looked like thumbprints of charcoal, and fingers that were long, hairless, and perpetually steady. He did not smile when the gurney cleared the rim.
“Emily,” he said. He did not use the patronizing sing-song tone of junior residents. “We have your scans. I’m moving you to Neuro-ICU Bed Four. Your husband is waiting in the family consult room.”
“Can you fix it?” Emily whispered. Her tongue felt heavy, as if the cold oil had reached the base of her throat.
Marcus looked at her for three seconds. In those three seconds, Emily saw thirty years of medical school, thousands of clinical tragedies, and something else—something rare in a chief of surgery.
Bewilderment.
“I am going to take you to the operating room in two hours, Emily,” Dr. Marcus said softly. “We need to decompress the thoracic canal. But before I open your back, I need to talk to your husband. Because the hardware inside your body should not be there.”
“Hardware?”
“We’ll talk in a moment,” Marcus said, turning to the charge nurse. “Ten milligrams of dexamethasone IV push. Hang a liter of normal saline. Keep her mean arterial pressure above eighty-five. If that sensory level moves one centimeter above the nipple line, page me on the emergency code line.”
They wheeled her through the double doors.
The hallway of the trauma center was lined with stainless steel crash carts and computer terminals. As the gurney turned the corner toward the ICU elevators, Emily caught a glimpse through the glass doors of the waiting area.
Her father was there.
Arthur Vance was not sitting in the blue vinyl armchairs. He was pacing the carpet near the water dispenser, his cell phone pressed to his right ear, his left hand chopping the air in short, aggressive, downward motions. Beside him, Eleanor was sitting with her ankles crossed, her purse held tightly in both hands against her stomach, her lips moving rapidly as she spoke to a man in a dark grey business suit who carried a leather legal portfolio.
The man in the suit was not a doctor.
He was Harrison Croft, the Vance family’s corporate attorney. The man who had handled the incorporation of Ryan’s wealth management firm, the settlement of Arthur’s disputed construction liens, and the transfer of the family’s summer property on Lake George.
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Why was Harrison Croft at a county hospital at six o'clock on a Sunday evening?
Then the elevator doors closed, their rubber gaskets sealing with a heavy, pneumatic thud, cutting off the view of her family like a trapdoor dropping into an empty room.
