And the seizures were horrible. Usually she knew when they were coming because she would smell the strangely familiar odor. But sometimes they came without warning, descending on her like an avalanche. Once in a movie theater, after she'd been given a long course of heavy medication and assurances that the problem was under control, she smelled the horrid odor. In a panic she'd jumped up, stumbled to the aisle, and ran back toward the lobby. At that point she became unaware of her actions. Later she "came to" propped up against the lobby wall by the candy machine, with her hand between her legs. Her clothes were partially off, and like a cat in heat, she'd been masturbating. A group of people was staring at her as if she were a freak, including Jim, whom she'd punched and kicked. Later she learned she'd assaulted two girls, injuring one enough to be hospitalized. At the time she'd "come to" all she could do was close her eyes and cry. Everyone was afraid to come near her. In the distance she remembered hearing the sound of the ambulance. She thought that she was going insane.
Lisa's life had come to a standstill. She wasn't insane, but no medication controlled her seizures. So when Dr. Mannerheim appeared, he seemed like a savior. It wasn't until Dr. Ranade's visit that she began to comprehend the reality of what was going to happen to her. After Dr. Ranade, an orderly had arrived to shave her head. From that moment on, Lisa had been frightened.
"Is there some reason why he wants local anesthesia?" asked Lisa. Her hands had begun to tremble. Dr. Ranade had thought carefully about his answer.
"Yes," he said finally, "he wants to locate the diseased part of your brain. He needs your help."
"You mean, I'll be awake when…" Lisa didn't finish her sentence. Her voice had trailed off. The idea seemed preposterous.
"That's correct," said Dr. Ranade.
"But he knows where the diseased part of my brain is," protested Lisa.
"Not well enough. But don't worry. I'll be there. There'll be no pain. All you have to remember is no coughing and no sudden movements."
Lisa's reverie was cut short by a feeling of pain in her left forearm. Looking up she could see tiny bubbles rising up in a bottle over her head. Dr. Ranade had started the IV. He did the same thing in her right forearm, threading into her a long thin plastic tube. Then he adjusted the table so that it tilted slightly downward.
"Lisa," said Carol Bigelow. "I'm going to catheterize you."
Picking up her head, Lisa looked down. Carol was busy unwrapping a plastic covered box. Nancy Donovan, another scrub nurse, pulled back Lisa's sheet exposing her from the waist down.
"Catheterize?" questioned Lisa.
"Yes," said Carol Bigelow, pulling on loose rubber gloves. "I'm going to put a tube into your bladder."
Lisa allowed her head to fall back. Nancy Donovan grasped Lisa's legs and positioned them so that the soles of her feet were together while her knees were widely apart. She lay exposed for the world to see.
"I'm going to be giving you a medicine called mannitol," explained Dr. Ranade. "It causes you to make a lot of urine."
Lisa nodded as if she understood while she felt Carol Bigelow begin to scrub her genitals.
"Hi, Lisa, I'm doctor George Newman. Do you remember me?"
Opening her eyes, Lisa gazed into another masked face. These eyes were blue. On the other side of her was another face with brown eyes.
"I'm the Chief Resident in Neurosurgery," said Dr. Newman, "and this is Dr. Ralph Lowry, one of our Junior Residents. We'll be helping Dr. Mannerheim as I explained to you yesterday."
Before Lisa could respond she felt a sudden sharp pain between her legs, followed by a curious fullness in her bladder. She took a breath. She felt tape being placed on the inner part of her thigh.
"Just relax now," said Dr. Newman without waiting for her to respond. "We'll have you fixed up in no time." The two doctors directed their interest to the series of X rays that lined the back walls.
The pace in the OR quickened. Nancy Donovan appeared with a steaming stainless steel tray of instruments, and with a bud crash she heaved it on top of a nearby table. Darlene Cooper, another scrub nurse, who was already gowned and gloved, reached into the sterile instruments and began to arrange them on a tray. Lisa turned her head when she saw Darlene Cooper lift out a large drill.
Doctor Ranade wrapped a blood pressure cuff around Lisa's right upper arm. Carol Bigelow exposed Lisa's chest and taped on EKG leads. Soon the sonar-like beeps from the cardiac monitor competed with John Denver on the transistor.
Dr. Newman came back from studying the X rays and positioned Lisa's shaved head. With his pinky on her nose and his thumb on the top of her head, he drew a line with a marking pen. The first line went from ear to ear over the top of her head. The second line bisected this one, starting at the middle of the forehead and extending back to the occipital area. "Now, Lisa, turn your head to the left," said Dr. Newman. Lisa kept her eyes closed. She felt a finger palpate the ridge of bone that ran back from her right eye toward her right ear. Then she felt the marking pen trace a looping line that began at her right temple and arched upward and backward ending behind her ears. The line defined a horseshoe-shaped area with Lisa's ear at its base. This was to be the flap that Dr. Mannerheim had described.
An unexpected drowsiness coursed through Lisa's body. It felt like the air in the room had become viscous and her extremities leaden. It took great effort for her to open her eyelids. Dr. Ranade smiled down at her. In one hand was her IV line; in the other hand a syringe.
"Something to relax you," said Dr. Ranade. Time became discontinuous. Sounds drifted in and out of her consciousness. She wanted to fall asleep but her body involuntarily fought against it. She felt herself being turned half on her side with her right shoulder elevated and supported by a pillow. With a sense of detachment she felt both wrists bound to a board that stuck out at right angles from the operating table. Her arms felt so heavy she couldn't have moved them anyway. A leather cinch went around her waist securing her body. She felt her head scrubbed and painted. There were several sharp needles accompanied by fleeting pain before her head was clamped in some sort of vise. Despite herself, Lisa fell asleep.
Sudden intense pain awoke her with a start. She had no idea how much time had passed. The pain was located above her right ear. It occurred again. A cry issued from her mouth and she tried to move. Except for a tunnel of cloth directly in front of her face. Lisa was covered with layers of surgical drapes. At the end of the tunnel, she could see Dr. Ranade's face.
"Everything is fine, Lisa," said Dr. Ranade. "Don't move now. They are injecting the local anesthetic. You'll only feel it for a moment."
The pain occurred again and again. Lisa felt like her scalp was going to explode. She tried to lift her arms only to feel the cloth restraints. "Please," she shouted, but her voice was feeble.
"Everything is fine, Lisa. Try to relax."
The pain stopped. Lisa could hear the doctors breathing. They were directly over her right ear.
"Knife," said Dr. Newman.
Lisa cringed. She felt pressure, like a finger being pressed against her scalp and rotated around the line drawn by the marking pen. She could feel warm fluid on her neck through the drapes.
"Hemostats," said Dr. Newman. Lisa could hear sharp metallic snaps.
"Raney clips," said Dr. Newman. "And call Mannerheim. Tell him we'll be ready for him in thirty minutes."