Timothy of the Cay (8 page)

"And that would fix it?" I asked.

"Perhaps. But it's a very long, risky operation, requiring a team of surgeons."

I liked the way he was talking directly to me.

"...I've done nine so far, all on adults, all within days or weeks of the injury. You've had yours for going on six months..."

My father asked, "What kind of success have you had?"

Dr. Pohl did not hesitate. "Three out of nine regained partial vision. One died on the operating table. One is brain damaged. So five are still as blind as the day I performed surgery on them..."

"Three out of nine," my mother said, a quiver in her voice.

Dr. Pohl replied, "Phillip's age may possibly be to his advantage." Then he said to me, "But I doubt if you'll ever have a complete return of vision."

"The three that were successful—how much vision did they have?" I asked.

"Two had eighty, one ninety percent with glasses. Not that much at night."

Ninety percent with glasses. I'd be able to see most things, read, move around without a cane.

I guess he was studying my face when he said, very clearly, "I repeat that there is risk, Phillip. I have to be honest with you and your parents. Major risk. This will be inside your skull, against the brain..."

Inside my skull? Against my brain?

"My biggest concern is with the lining of the brain. I'll be a fraction of an inch away from three very important vascular structures, blood channels. I'll skip the scientific names for them, but they carry much of the blood away from the brain and return it to the heart. Any of the three could have been injured at the time of the accident or could be injured during surgery. Your life could be lost; you could be paralyzed..."

My mother said, "I don't think we need to hear any more, Dr. Pohl."

It was my vision he was talking about, not hers. I asked, "What happened with the one person who died?"

"Hemorrhage that we couldn't stop."

A ruptured blood vessel.

"What you have here, Phillip, and Mr. and Mrs. Enright, is a choice between remaining blind as a relatively functional person for an undetermined period versus the possibility of an acute problem during immediate surgery that may leave you, and I repeat, paralyzed and vegetative, or dead..."

My mother said firmly, "With those options, Phillip will have to remain blind."

My father said, "Not so quick, Grace. He has to have a voice in the decision. What do you mean by 'undetermined period,' Doctor? That sounds scary..."

"Well, until we can take a look at the problem, beyond X rays, there's no way of knowing exactly how severe it is. It just takes a small amount of blood to disturb the function of the brain. There can be lasting side effects."

Silence from all three of us. We knew he meant that I might die anyway, from malformation.

He said, "You don't need to decide today, but each day that goes by lessens the chance for any success."

"Eight didn't die," I said.

"But five can't see," my mother said.

There was another long pause, then my father said, "Doctor, Phillip faced life-and-death decisions on that island. He survived..."

I knew he was talking to my mother as well. Saying to her,
Stop thinking of him as a child.

"...so he has the right to make the decision. It's his sight, his life..."

I sat there, knowing they were looking at me, waiting for me to say something. I'd thought a lot about this moment since the session in Dr. Boomstra's office, thought about it on the plane to New York, thought about it almost all the time I was awake since arriving. I wanted to know exactly what was going to happen and said so.

The doctor hesitated. Later, he told me he'd hesitated because he was afraid I'd become frightened. "How much do you want to know?"

I said, "I'd like to know how you get there."

Dr. Pohl hesitated again, then I heard a deep sigh. "All right. Simply because you did survive alone on that island, and that means to me you're mentally strong, I'll tell you. I'll also tell you, Phillip, that most adults wouldn't want to hear about the exact procedures."

I was physically strong but didn't know about the mental part.

"Stop me whenever you wish," he said.

I nodded.

"You'll be put to sleep and your respiration and blood pressure will be carefully watched. You'll be placed on your belly because we have to have complete access to the back of your head..."

As if he'd written it down, word for word, I remember what he told me: The first step would be an incision on the back of my skull ... a straight incision; then instruments would pull the skin of my scalp to the side, to expose the skullbone.

After that, he'd make four or more holes in my skull.

"How do you make them?" I asked.

"With a hand drill."

I heard my mother moan.

"Like woodworkers use?"

"Exactly."

He then used a lot of scientific words like
transverse venous sinus
and
superior saggital sinus,
without even thinking we didn't know them, then brought himself up short, apologizing.

"What we'll do, Phillip, if you make the decision to go ahead, is place a guide between the four burr holes, and then pull a gigli saw, a wire saw, back and forth until the necessary bone cuts are made to provide an oblong window for surgery..."

A window in my skull?

"The second procedure will be to go in through that window and try to repair the blood vessels...."

"Will you put that window part back?"

He laughed a little, softly. "Yes, we certainly will. When we replace it, we'll make up a paste out of shavings from the bone, to hold the piece in place. Then your own cells will grow together, though you'll always feel a little depression back there."

"How long will I be in the hospital?"

"You should be on your feet in two days, but we'll keep you for about a month for observation. If everything goes well, your vision will return in about two weeks."

"What about aftereffects?" my father asked.

"Probably some residual headaches, but they should go away after a while. A possibility of some seizures, but they can be controlled with drugs if they occur."

"Seizures?" my father said. "Similar to epilepsy?"

"Exactly. As you likely know, there are two types. Petit mal and grand mal. The petits are more of a nuisance than anything else. You might be drinking soup and for a split second will stop the spoon in midair. The grand mals are a lot more serious; the patient loses consciousness."

We had a boy at school with epilepsy. Without warning he'd pass out, fall down, then his muscles would jerk. He might froth at the mouth.

"Drugs can control them and eventually they'll go away. But you have to take the drugs regularly," Dr. Pohl said.

"What causes them?" I asked.

"Disturbances of the brain's electrical activity. In your case there will have been quite a shock to your circuits."

I'd heard enough.

"It's a very serious, risky operation, eight to twelve hours long, and you may lose your life, Phillip. Or as I said before, become almost totally incapacitated."

"Or I may see again," I said.

"Yes," he agreed.

"You said ninety percent for one of the adults."

"No guarantee of that percentage," he said, bluntly. "Another thing, there could be problems even if the operation is successful—infection of the wound, a blood clot forming on the surface or inside the brain..."

"You don't sound too optimistic," my father said.

"I'm being honest with all of you," the doctor said.

Finally, after a few minutes, I said, "Can I think about it?" Never had I been so scared. Not on the raft or on the cay.

"Of course, but the sooner you make the decision the better. If you decide to go ahead, we'll need to do an pneumo-encephalogram. That's the procedure I mentioned before."

Again I was lost in the medical terms. "What's that?"

"More X rays. We'll put you in a chair and inject air into your spine, then rotate the chair in different directions. By putting air in, we can see more of what the problem is, then go in and operate..."

We left his office at Columbia Presbyterian and talked about what Dr. Pohl had said the rest of the day and into the night.

I'm not sure when I went to sleep or when my parents did, but I remember thinking that what I wanted to do in life required vision. Even more than that: I never wanted to question myself when I was older about not accepting the challenge of risky surgery.

Scared that I'd lose my life on the operating table, I also thought of those seven adults who'd survived without brain damage. Four were still blind, but they'd tried to do something about it. Should I?

I awakened early that morning and lay there trying to go over everything Dr. Pohl had said. The traffic noises from Forty-second Street were faint.

I finally asked Timothy, "What should I do?"

"No rain, no rainbow," he replied.

I remember him also saying, "Night bring day." Sorrow during darkness, joy in the morning.

Finally, I asked my parents, "Are you awake?"

They were.

I took a deep breath. "I'm going ahead with the operation," I said.

"Are you certain?" my father asked.

"Yes, I want to go back to the cay."

"Oh, Phillip, you said that the other night. You have to have more than that for a reason," my mother said. "
You have to!
..." I could tell she was almost in tears.

"He has to have a goal, Grace," Father said, quietly but firmly. The decision was made.

He called Dr. Pohl just after nine o'clock and the pneumo-encephalogram X rays were taken that afternoon.

APRIL
1886
—In sultry late spring, Timothy was rowing Charlie Bottle's boat, laden with the grass they'd cut on Thatch Cay—which wasn't really a cay at all; fresh water was beneath its soil. The grass was for Charlie's livestock.

A sheen of sweat coated Timothy's supple body, making it look oiled. As he pulled the oars, his arm and belly muscles flowed like warm molasses. He'd filled out since the
Amager,
had added two inches in height.

He said, "Almost two year I 'ave tried. Dey say, 'Grow up, boy...'"

"Tell de mates an' coptins you be sixteen. Den yuh may git de job." Charlie Bottle's bloodshot eyes were locked on Hannah Gumbs's foster son.

Timothy frowned. Tante Hannah had always said, "Talk d'truth an' shame de debbil."

"Long's yuh tell 'em yuh fo'teen, dey say, 'Grow up, boy,' an' yuh got no wark."

Timothy nodded. Charlie Bottle was known for his wisdom, like Tante Hannah and Wobert Avril.

"An' yuh look sixteen, yuh do. Yuh a big boy now," said Charlie Bottle.

There was no breeze to fill sail this day. The knock of the oarlocks, the slap of water against the bow, were the only sounds as they went south toward Coki Bay, where Charlie's donkey cart awaited.

Timothy nodded again. That was true, he thought. Big as most men. Strong as most men.

Six days later, he announced to Tante Hannah that he was finally going to sea, on a bark bound for Rio de Janeiro. He'd heard of that place down in Brazil. He'd seen ships from there. He'd heard their Portuguese-speaking sailors.

Tante Hannah congratulated him with a sad face.

***

Even though he'd signed an official-looking paper with his
X
(all the words on the document meaningless to him), Timothy still wasn't sure that he was finally going to sea in the four-masted
Gertrude Theismann,
a ship that called Philadelphia home port. She was square-rigged, except for fore-and-aft sails on her aftermast, some jibs and headsails forward. She was the color of milk; pretty as a giant butterfly.

He remembered Mama Geeches saying two years ago he'd get a goat-mout' ship, a bad-luck ship, unless he or Tante Hannah paid her two
kroner.
They'd talked about it and decided that was an idle threat. How could Mama Geeches know one ship from another, which was a bad-luck or a good-luck ship? Mama Geeches had gone too far that time. But he thought about her as he signed his
X.

Because of what had happened with the
Amager,
Timothy didn't actually believe he was going out in the
Gertrude Theismann
until Luther Oisten, the boatswain, boss of the deck, issued him a blanket and the cook handed over a tin plate, fork, and knife.

His board-slatted bunk, soiled straw-filled mattress, and stained pillow were in the cramped pineboard fo'c'sle, in the forward end of the ship, which was also quarters for five other sailors. A table and two benches were against the after bulkhead. The room smelled of sweat but compared to Back o' All it was rich-man living.

Aft of the fo'c'sle was the galley, with a sliding panel, the "pie hole," for food to be passed through. The food was good beyond belief. Timothy had helped load it.

But the first words that the bo'sun said to Timothy were harsh: "Yuh jump when I tell yuh, nigra boy. Yuh green as soursop, an' watch yuh step on deck less yuh die out dere..." He was a slim, thin-nosed Bajan from Barbados Island, in the Windwards above Trinidad and Tobago. With a few cups of
bukra
blood in him, his skin was more brown than black. He wore a sheathed knife at his right hip.

"Yes, sirrah," Timothy replied, standing stiffly, already frightened of Luther Oisten.

"Now, turn to," Luther ordered. "Go to work, loadin' stores."

Timothy had always heard that second mates and bo'suns, often one and the same on sailing ships, were naturally mean. Too well he remembered Nyborg, of the
Amager.
Maybe they had to be mean to survive. The white chief mate, Tanner, had seemed pleasant enough, as had the captain. They left the bully talk to the Bajan.

When the Bajan moved off, Horace Simpson, the oldest of the four Negro sailors, suggested, "Do as he tell yuh." White-haired Horace Simpson, from Alabama, reminded Timothy of Charlie Bottle. He was short and stocky.