Lying (11 page)

Patient LJS underwent a posterior cingulate corpus callostomy on February 15, 1979. She was subsequently followed at the Beth Israel Neurology Clinic for four years. Her physical recovery from the seizures was good. Her seizures themselves were reduced by over 90 percent, thus qualifying the surgery as a success. Her side effects were minimal, as she had undergone extensive preoperative tests to determine cerebral dominance. However, we
did not note
a significant change in personality style, which was dysfunctional prior to and post surgical procedure. Patient’s MMPI scores prior to surgery were well above the mean on the test’s psychopathology
scales, the test’s lie scales and the test’s paranoia scales. Patient LJS was retested with the MMPI two years post surgery, when she had been nearly seizure-free for some time. MMPI scores remained the same. In addition, three years post surgery, this patient developed an intense fixation with writing, and, later, a subsequent fixation with religious/spiritual pursuits, all of which suggest that the TLE personality profile remained entrenched, and even continued to burgeon. Therefore, the personality traits associated with TLE
may not be
direct products of random electrical discharge—i.e., seizure activity—but, rather, consequences of an as yet undetermined source, possibly minute or even microscopic cortical scarring. Thus, patients with TLE may experience improvement via surgery in terms of their actual seizures, but it may be that the emotional exigencies of TLE remain largely unaltered. TLE, therefore, even when largely controlled or eliminated, remains at the very least a psychosocial phenomenon, continuing to affect the patient’s life course and intrapsychic functioning throughout the life span.

PART TWO

Patient LJS’s seizure disorder was serious enough to prevent her from participating in many age-appropriate activities, thus leading to social isolation and poor peer relationships.
TAT scores suggested a primitive psyche with a marked fear of social situations. At the age of thirteen, her seizures were brought under surgical control, and the question for her physical and rehabilitation therapists was how to help reintegrate this pediatric patient into an age-appropriate social sphere, especially in light of the fact—and the challenge—that while the physical seizures were gone, the personality patterns remained fixed.

Post surgery, the Beth Israel Rehabilitation Team worked closely with this young patient, teaching her a series of age-appropriate skills so as to aid reintegration. Of special note is that the patient’s family structure was such that she could glean little support from it. Her mother appeared to suffer from a narcissistic disorder, while her father, as is typical of this type of family constellation, remained in the largely passive role. Rehabilitation staff found the following activities helpful:

1. Role plays involving common adolescent social situations.

2. Structured reintegration activities. I.e., the patient was given a homework assignment—to attend a dance, to attend a sporting event—and then asked to rate her feelings about it on a Likert Scale and report back to her rehabilitation therapists, who then, with the patient, reviewed her reports so as to determine in which spheres and doing what activities she felt most to least comfortable.

3. Vocational counseling/early career exploration.

4. Cognitive restructuring techniques: Patient taught to restructure negative self-talk with positive or reality-based statements as exemplified in the work of A. Beck (1984).

5. Physical therapy involving sports activities. LJS responded particularly well to swimming and tennis.

6. Twice-weekly psychotherapy.

Most difficult for LJS post surgery was learning how to structure her time constructively. LJS had spent much of her childhood and early adolescence either having seizures or recovering from them. For the first year post surgery and 90 percent seizure-free, the patient appeared disoriented and complained of chronic boredom. Rehabilitation staff focused on helping this patient find or develop interests, hobbies and skills that had not been able to burgeon in what had previously been a crisis-ridden childhood.

After two years of intensive rehabilitation, patient LJS appeared better able to structure her time around subjectively experienced interests with a strong social component, interests from which she had previously been barred by epilepsy. For instance, this patient joined the school’s drama club, and, later, the tennis team. While she had difficulties participating in cooperative sports, her personality style was well-suited to the drama club, where she met with significant
successes that reinforced her fragile self-esteem. Important to note, however, is that, despite her modest social successes, she still displayed impulsive behavior, poor social judgment (as revealed on several psychological tests, projective and cognitive) and a limited ability to sustain age-appropriate friendships. She did not engage in age-appropriate sexual exploration, indicating either an unstable sexual identity or marked sexual anxiety due to as yet undetermined factors, factors possibly rooted in her experience with chronic illness. She was charming, even flirtatious, with the males and females on her rehabilitation team, but showed little interest in peers.

During the rehabilitation period, patient LJS displayed some disturbing depressive tendencies, which may have been an indication of an adjustment disorder with disturbance of mood, or of a more serious mood and/or anxiety disorder as a diagnosis separate from the TLE personality patterns.

1. While a corpus callostomy can dramatically reduce seizures in children, it does not appear, in this case, to have any mitigating effect on the attendant personality proclivities sometimes seen in TLE patients, namely proclivities associated with emotional lability, disingenuousness, hyperreligiosity and hypergraphia. Further research is needed to determine whether or not the unaltered personality style of
TLE patients post surgery is is indeed a statistically significant phenomenon.

2. Crucial to the success of a medical/surgical intervention is a comprehensive rehabilitation program that addresses not only the biological but also the psychological and social aspects of epilepsy.

Like squalls, then, brief bursts of rain in otherwise clear weather, my seizures were that way after the surgery. I had far, far fewer fits. I could go for weeks, for months, and then have a small storm in my brain, rain falling fast, I falling fast, and then over in a second or so, afterward the air clear, all the seagulls singing.

And yet, I still had my auras. The surgery had lessened the seizures but intensified the auras, and I wondered whether or not Dr. Neu had made a mistake in my brain when he’d split it. “Well, I’ve never heard,” Dr. Neu said, “of a person who has more auras after a corpus callostomy, and I’ve also never heard of having auras without a seizure following,” but both these things were the case with me. “Write me up,” I said,
and he did. In the months, the years following my surgery I had auras all the time, strange states coming over me morning, noon and night, clasping me quickly like the huge hand of God reaching down from the sky. The auras were feelings and tastes, delights and despairs, and they wrapped me totally for the time they lasted. They were not a problem. People called me “dreamy,” and “space cadet,” and my father chuckled when he saw me staring out the window and said, “This girl of ours is a guru.”

Oranges, blood red and drooping from trees. The delicious cinnamon scent of burning leaves. A tower of white smoke, a dragon in a garden where roses grew. And this one, over and over again. A staircase descending through layers of feminine moss, with odors dank and promising, a single star in the sky above. The auras were dreams during the day, and I discovered I could be talking to a person like, “Hello, how are you,” and be staring at this star too. The star was like a speck of salt in my eye, but it didn’t hurt.

I was fourteen, fifteen, sixteen, and I appeared to grow more normal. It took me only forty-eight hours to recuperate after the operation. Nothing felt any different, at least at first. Then one day, two days, three days, a whole week passed, without a single seizure. That was different, wow! I was confused. Suddenly I had all this time on my hands, all this time on my feet. I got very, very bored.

Luckily, though, they sent a whole team of rehabilitation therapists to reintegrate me. Susie, Jennie, Craig and Chris, a team from Beth Israel, I went to them; they went to me. In
general, the team tried to teach me social skills, with minimal success. They took me swimming and to volleyball. In the tenth grade, I joined the drama club. In the eleventh grade, I started tennis. I played junior varsity field hockey, but I never danced with a boy.

Sometimes my auras were tinglings that moved from my mouth to my belly to you know where. I was seventeen, but matters of sex so embarrassed me that I could only speak of our God-given anatomy in terms like “you know where,” and “down there.” One day, when I was typing a story for an English class, I had an aura that ended in an orgasm. I pressed the
Q
key, and heat went through me; I pressed the
U
key, and the heat turned to a sweaty shiver, and I came to the sound of
I-E-T, quiet
, clack,
quiet
, and each pulse of pleasure was a word, and the words were turquoise, as beautiful and complex as coral in the Caribbean Sea.

Something happened to me then. The next time I felt an aura descend, I went straight to my desk, straight to my notebook. Holding my pen, I wrote, faster and faster, and although no orgasm came, the words were pure pleasure, physical rhythmic objects that released dreams like birds from a magician’s fist. Faster and faster I flew, yellow bird, red bird, and when I was done, I saw a story before me. The story started like this:

Where had I found such language, such elegance, I who did not dance with boys? I didn’t know, then, about the proven link between epilepsy, auras and creativity. Even though the surgery was successful, I was still an epileptic, just less seriously so. And I didn’t know that Dostoevski’s best moments often came during his epileptic auras, when he perceived the shapes of sounds so acutely he could have cried. Or van Gogh, who, standing in a field full of sunflowers, painted the yellow the way he saw it in a preseizure state, a yellow of fairy tales, of melted gold.

So started my interest in the arts. I bought
Esquire
magazine because the cover advertised an author interview. The author looked like a film star, looming out with her dark hair, her eyes all dream. Jayne Anne Phillips. Her stories, the article said, were “stunning,” were “bits of crooked beauty,” as though her words themselves had given her skin such glow. I stared at the picture and then I bought her book. “Oh Jamaica Delilah,” I read, “how I want you, your smell a clean yeast, a high white yogurt of the soul. Raymond never made it with you in the bathtub, did he, soap flowers white on your high Mongolian cheeks, your lips mouthing a heavenly
O
of surprise.”

Wow
, I thought.
Making it
, I thought. I decided to write like that, all spike and sex.

So I did. I held
Black Tickets
in one hand, a pen in the other, and I wrote, “Long time ago, Janey walked in the dark, breasts beneath her nightgown slow as the sea; she rises only for Raymond, her pimp.”

I began to dress in filmy scarves and black leggings. I bangled myself with silver. I took long bubble baths and, like Jamaica Delilah, saw the soap flowers on my nipples, which were cherry red and perfect.

The summer before my freshman year in college I applied to a place called Bread Loaf, a fourteen-day writers’ conference in Vermont. Anybody who was anybody knew Bread Loaf was the best around, a significant step on the road to recognition. I said on the application that I was nineteen years old, the minimum age. I sent in the story about Janey and her pimp, a very avant-garde piece that faced sex squarely on. I was sure I’d get in. I could tell I had talent. I could see it, but more important I could feel it in the way the words slid from me, so fast, so smoothly, as though all my openings were oiled and the birth was meant to be.

“Bread Loaf,” my mother said. She’d never gotten famous as a writer of maxims, and this was maybe a disappointment even greater than I. She lay on her chaise longue, and she took Elavil, and sometimes I wanted to say, “Mom, what happened to you? You used to sizzle.”

“Bread loaf?” she said. “That sounds,” she said, and paused. “I have a hard time believing a place which calls itself a loaf of bread has anything worthwhile to offer.”

But she gave me the money. Now all I had to do was wait.

•  •  •

A week passed. Then two weeks. Every day I checked the mail. Every day I called Carol, the secretary at the conference, to find out when I would hear. “This is Lauren Slater calling,” I would say. “Soon,” Carol would say. I was just so excited. I saw myself at that conference in Vermont, in a room made of mahogany, at a desk facing a field, and every day, after a supper of wilted greens, famous people attending to my work.

I pictured editors with horn-rimmed glasses and pocket watches, and fresh milk in the mornings.

“This Slater girl,” people would say. “She’s young. She’s raw. She’s brilliant.”

Brilliant were those days of waiting, those days of May, when the sky was soft, the air warm, and the sun went down in a pool of red. I lay looking for the mailman on a lounge chair in our side yard, Pepsi snapping in my frosted glass.