While I was in elementary school, Benjamin put himself through graduate school twice: first microbiology, then medieval history. By the time I was dissecting my first fetal pig in ninth grade biology, he’d become an expert on the Plague, particularly as it applied to medieval Italy. Ben and I approached medicine from opposite directions. I went forward, straight to the patient, while he went back—to the past.
Having a sibling really takes the pressure off trying to do too much—you just divide everything up. I became the physician, Benjamin the academic, so my scholarly side didn’t complain, and he never had to wonder whether he should have become a doctor. I suppose it might have gone another way—we could have vied for excellence in the same domain—but competition never occurred to me. Neither did collaboration, until it was too late.
When I was thirty, Ben followed a project to Siena, Italy, and fell in love—not with a person, but with the city.
“Little B, I’m head over heels,” he wrote. “It’s like time travel but without losing all the amenities—medieval life plus hot showers and toilet paper. I’m set on buying a house big enough for family. Otherwise known as My Little Sister Beatrice.”
I liked seeing the word family on paper, but I wasn’t used to letter writing. The last paper letter I’d turned out was at Girl Scout camp, on stationery decorated with mice curling their tails around an inkpot. But Ben was weird about email—I think the medieval scholar in him resisted the march of technology.
Ben eventually bought his house in Siena, but three years later I still hadn’t made plans to go to Italy, and he hadn’t come back to New York. It was the longest we’d gone without seeing each other. We kept in touch with rare precious phone calls across time zones, and resorted the rest of the time to Ben’s favorite, if archaic, mode of communication. I had even gotten into the medieval spirit by digging up the old fountain pens I’d once used for calligraphy.
Dear Ben,
I know I need to visit you soon, and meet your new girlfriend, I mean, hometown. But I can’t imagine getting out of here right now. I spend twelve hours a day looking at three square inches of someone’s body, willing my hands to do exactly the right thing. One little mistake, and it’s blindness, or left-sided weakness, or death, just like that. I’ve got one day off every seven, not really enough to get me to Siena and back. But soon, OK? The OR has been more intense than usual—I feel like my usual self-protective doctor’s reserve is wearing a little thin and I need an antidote to all this surgeon stuff. What time of year is best to come?
Love, Beatrice
The OR had been more intense than usual, and not in a good way. The day before, Linney and I had scrubbed in on a far-gone basal cell carcinoma case. Skin cancer doesn’t usually involve a neurosurgeon, but in this case the patient had kept pulling her wig down over the slowly growing lesion on her forehead. Fifteen years later, the wig was so low over her eyes she couldn’t see. By the time she got to us, the cancer had eaten through her skin and skull, and she had a quarter-size hole between her eyebrows through which we could see the dural membrane covering the brain. The sight made me cringe when I saw her in the office. I have seen dura plenty of times—just never outside of surgery.
In the OR things took a downturn quickly. Just after I made the first incision, the heart monitors registered ventricular tachycardia—a dangerously fast rhythm that can deteriorate, preventing blood from going where it’s supposed to. Not good. I took a quick look at the monitors—blood pressure was holding, but that might not last. Out of the corner of my eye I could see Linney moving quickly, asking for procainamide. Then, suddenly, I heard a hum in my ears, and after that, incongruously, the sound of my brother Ben’s voice. My vision grayed, and then my heart and head filled with the fear of losing him.
* * *
Benjamin didn’t tell me about his heart until I was in medical school. I’d reacted badly.
“Ventricular tachycardia? For God’s sake, you’re a walking time bomb!”
“My cardiologist says it’s under control. In the meantime, please avoid doing anything shocking or sudden in my presence. . . .” He grinned lopsidedly while I fumed to cover the panic I felt.
“Why didn’t you tell me before?”
“You were a kid—my kid, basically. I didn’t think you needed to know. Now you’re a big girl.”
I hit him. He deserved it. Ben grunted, then started over.
“You’re a big doctor, I mean. . . .”
“That’s better.”
“And I thought it was time you knew me from a grown-up perspective. It’s been years; I’m fine.”
I tried to incorporate this new frailty into my image of indestructible Ben. My own heart was pounding, though, in sympathy. I don’t want to lose him.
“How about a hug, Little B,” he said, “like the old days?”
I buried my head in his wool sweater and listened to his heart beating, slow and steady.
* * *
The next thing I knew Linney was whispering harshly in my ear. “Beatrice, blood pressure is stable, she’s back in sinus rhythm. What’s going on?” I wasn’t sure what was going on, but it wasn’t something that could happen again. There is no time for drifty emotional lapses when you’ve got a scalpel in your hand.
“I’m OK,” I said. But I wasn’t.
Siena, May 2
Hey Little B: What do you mean the OR is much more intense than usual? If you look up intense in the dictionary I bet you’d find NEUROSURGEON right at the top of the page. I like thinking of you taking people apart and (ideally) putting them back together again. I try to get into people’s heads too, but my subjects are already dead. You might say I’m a forensic pathologist of the distant past. I can imagine you saying “Come ON Benj, spare me the convoluted metaphors.” I love it when you say stuff like that. Hey, happy almost birthday, Big Girl.
I have some news, to the extent that any medieval historian could be said to have “news.” There is something funny about the Plague and Siena. I’ve got my hands on some sources that explain why Siena did so badly during the Plague, and it will make a big splash when I’m ready to publish. In fact I think I might already have made a splash—I dropped hints at a conference of Tuscan medievalists, and a few “colleagues” got worked up about what I was suggesting.