White Matter Disease

Part I of a two-part science fiction short story.

BMJ article via Duck Duck Go search. Uncredited MRI image

Session Eight

They’ve taken something else from me. I can only wonder what it is and how long it will be before there’s nothing left. I was too unsure at the start, felt stupid. Then it was too late to say anything, and what would I have said? Who would have believed me? I can barely believe it myself…Can I trust my own eyes, my own mind? Now I am trapped in here and escape seems impossible. All I can do is wait for the next time, and the next time, wondering what’s to come, or if I will even notice. All I have left is memories. Those haven’t gone yet.

12 months earlier.

“And when was this car accident?”

The doctor was a new one, he seemed young, but everyone was starting to look too young for their job to me.

“About a year ago, I suppose.”

I remember thinking his trousers were too tight, but they’re all wearing them like that.

“And you didn’t suffer any injury to your head at the time?”

I couldn’t place his accent.

“Honestly…I felt fine; it was just a bump. And I got a nosebleed from the airbag but apart from that, I felt fine.”

I won’t forget the airbag – you’ve got no idea until one smacks you in the face.

“A nosebleed? Right. And you weren’t checked out? You didn’t go to accident and emergency?”

I didn’t want to waste anyone’s time.

“No. I really felt fine. It wasn’t a serious crash; the cars were barely damaged. The police turned up, but nobody called an ambulance and I just drove home.”

“And when did you start getting these symptoms?”

I remember his eyes, bright grey with black circling the edge. Very striking. I’d never seen eyes like that, except on those dogs.

“Erm… well I think I had the headaches all the time, really. I just thought that would be normal, you know, after a bump like that. But then after a few weeks, they didn’t go away. I mean I got them less often, but they didn’t go away. But you know, a couple of paracetamol and I felt ok. It’s never terrible…it’s just… it just never goes away.”

“And when did the other symptoms start? The nausea, difficulty walking, impaired vision?”

He seemed so nice…so normal.

“Just the last three or four months, I think. Yes, about that long. Again, it’s never been terrible, just sometimes. I put it down to what I ate, or standing up too quickly. But the eyesight thing? That’s different. It’s annoying more than anything. Like shadows, in the corner of my eyes, moving. Then my fiancée kept insisting I see someone, and I promised, so here I am.”

The one at the Centre…her eyes were the same, weren’t they.

“Well, it could be something and it could be nothing, so let’s book you in for an MRI, that way we can tell if there’s anything going on in there, shall we? I’ll refer you to the new Centre. If you see Lucy at reception, she’ll take some more details and give you a leaflet.”

Bright grey…with a black edge.

“Ok, thanks Doctor.”

Or am I imaging that too? And everything else? Is it just the white matter disease, or whatever they called it. Why had I never heard of that before. The brain is grey matter, isn’t it?

Omnimage

I was expecting to go to the Wellbeck, or the Freeman – those were the two nearest hospitals, but when I got the appointment for the Omnimage Centre, I didn’t recognise the address and had to satnav it.

“I’m sorry I’m a bit late,” I said, at reception “I got a bit lost on the way.”

“That’s perfectly alright,” said the receptionist. His name badge said “Luke”.

“I’ve never heard of this place before. I was expecting to go to the Freeman Hospital. That’s where you go for x-rays, usually. Or the Wellbeck.”

“Omnimage is a specialist medical imaging facility, part private, part public. We take referrals from the health service. We’ve only been operating since the start of the year.” His smile seemed as practiced as his introduction. He tapped away at a keyboard, but his eyes flicked up and down to my face repeatedly.

“Yes, it does look very new.” I said, after a while. He took my name, address and medical number and then asked if he could scan my fingerprint “So we can link your biometric ID to your medical records. It’s more secure,” he explained. I did so without question. You would, wouldn’t you.

They got my consent, right then and there, only… I didn’t realise.

I pressed my finger onto the scanning pad. It felt warm. There was almost a tingling, almost, but not quite. Luke’s eyes kept flicking up and down between my face and the screen. He tapped away at a keyboard. There was a soft bing and the scanning plate turned from red to green.

Was that part of it?

“You’re in for cranial MRI I see. I’ll alert the Technologist to your arrival. If you’d like to take a seat in the waiting area and help yourself to water. Someone will come for you. Please try to drink 500ml or more of water, as hydration is important for optimal imaging.”

“Technologist?”

The waiting area was much like the exterior of the building: subtly curved walls; white surfaces with matt textures; smoked glass and architectural plants. It all looked so sharp, so high contrast, almost like a CGI render. There was nobody in the waiting area but me.

How much this had cost to be so empty? That was what I thought. Nothing more than that.

I filled a plastic beaker from the water dispenser and had to press a button to make the water flow. It tasted of nothing, or maybe…was there a hint of something? Probably just the plastic beaker. Maybe not. I finished the water and sat back down. One of the floor to ceiling glass panels opened, and a young blonde woman emerged in crisp white uniform. There was a coloured tag on one shoulder and she wore vivid green-framed shades and carried a tablet computer in the crook of her arm.

“Good morning, Mr. McDonnell. I’m Lucy, your Technologist. How are you today?”

“Fine, thank you. How are you?” The question took her by surprise.

“Oh! Very well also. Thank you. If you’ve had a beaker of water, please follow me.”

I smiled and held up the empty beaker and she turned and motioned me through the doorway, beaming. Once in the corridor beyond, the doorway hissed slightly as it closed and we walked towards another glass door at the other end. Light shone through it as we approached. We stood in front of it until a green panel illuminated, then Lucy swiped us through. “The equipment is sensitive, so we maintain a sterile environment,” she explained. “If you will go into the changing room to your right and remove your clothes, there is a gown for you. Press the button when you are ready and I will return for you.”

“I have to get undressed? Completely?”

“Yes, if you don’t mind. The imager is an extremely powerful magnet, and there must be nothing metallic on your person. To avoid injury.” She smiled at me again. “If you don’t mind.”

You wouldn’t mind, would you? You would just undress. It’s a medical thing. That’s what you do. What the medics tell you.

I did as I was asked, and when I was ready Lucy led me into another room. Within it, the lighting was painfully bright and the MRI machine sat in the centre. I’d seen these before, on TV, and it looked essentially the same, only more organic. There was a large donut shaped opening within a smooth globular structure that seem as if it was growing out of the floor. In front of it, there was a contoured bed with a deep, body-shaped depression and flanges which extended up around the side of where the head would rest. I didn’t know what I expected, but there were no lights, no monitors, no cables, no screens. It looked more like a Henry Moore sculpture than any medical equipment I’d ever seen. I looked about, perplexed.

“If you’ll just lie down on the examination bed for me, it will adjust to your body. Once you’re comfortable I will explain the procedure. It is important that you follow my instructions.”

I climbed onto the bed and lay down. Lucy tapped away on her tablet, and then the sides of the bed began to press against me, gripping the whole of my body firmly. The flanges at the side of my head moved and began to fold over and grip me. The pressure grew until I grimaced, and then it relaxed and seemed to loosen. I let out a short gasp of surprise at the feeling.

“Don’t worry, Mr McDonnell. The scan is of your head and it is critical that you do not move it at all during the procedure. The device ensures that you cannot move. That’s all. It’s perfectly safe.”

Something about the way she said the word ‘safe’ triggered a sense of uneasiness, “Is there a doctor here, at all?” I blurted.

“Oh no. This isn’t a hospital, Mr McDonnell. These are not medical procedures, you are perfectly safe. I am a fully qualified Technologist. There is no need for doctors here, and they are not qualified to operate these devices.“ She laughed a quick musical laugh. “We’ll send the results to your Doctor immediately, once the procedure is over. You are perfectly safe.”

“I’m sorry. I didn’t mean to…”

“Oh don’t worry about that.” Again, the musical laughter. “Now, what would you like to listen to? During the procedure?”

“What?”

“The session lasts about 45 minutes. The imager will make a lot of loud noises and until you have experienced this, it can be troubling at first. We have sound cancelling headphones to help make things less unpleasant for you. You can choose anything you like from our library. Relaxing soundscapes are popular, or if you prefer, we can connect your mobile or tablet, and you can put your own music on. Whatever you prefer.”

As I thought about this, she came over and slid some shades like hers over my eyes. “It’s very bright in here, as you can see. These will help you relax.” As she leaned over me, she raised hers out of the way, just for a second, and I saw her eyes – bright grey with black edges. Like those dogs…huskies?

But that didn’t register then.

“Now, what music would you like? Restful Seashore is a lovely playlist. A very relaxing soundscape – you might even fall asleep. People do. Or you can put on your own playlist, if you prefer. If you trust us with your mobile phone.”

I was possessive of my mobile. “Let’s try Restful Seashore.” She laughed the tinkling laugh again and wagged a finger at me.

The soundscape. There was no getting away from it; not once you had heard it.

Forewarned is fore armed; the imager made a lot of strange noises. Banging, clicks, silences and jarring buzzing; they began immediately once Lucy had slid me into the device and the process was begun. It was unnerving, at first, disappearing into that white tunnel, that mouth; would I start to cook and my skin start to crackle and burn? Would I be fired out somewhere, like a torpedo? Would I be transported to another dimension, another time?

Were you?

And I did fall asleep, I think; but there was a point, somewhere between the first few minutes of calmness, when the adrenaline-soaked strangeness faded, and the moment where sleep took me. There was a point where the dimness under the shades, the soundscape, the pressure all over my body, the subliminal stimuli, pushed my mind somewhere else. It felt like I could see the room, see shadowy figures flitting, even though my horizon was the tube, just a few inches above my head. I thought that I could hear… something… something beneath the white noise waves and electronic seabirds; voices, whispers.

And Lucy was right – I couldn’t move at all.

That’s when they could have done it, that first time.

White Matter Disease

I got an email and a text message, and then a letter arrived in the post. They all said the same thing: the same thing that the woman from the health clinic said when she called me. To make sure I had got all the other messages.

To make sure you went back to the Centre.

The Doctor welcomed me in, warmly, smiling, his grey eyes never leaving mine. Earnest.

“How did they treat you at Omnimage? Good? We’ve got the results already and we wanted to get you in as soon as possible. I’m afraid that I don’t have good news for you. Have you heard of white matter disease?”

He didn’t sugar the pill, did he.

I hadn’t. My mind was one step behind my emotions as it was explained to me, and it was the emotions that were the strongest. He showed me the MRI images of my brain; my eyes were black because they’re full of liquid, he explained. “You must have been moving them about a lot during the imaging; look at the lack of focus here, and here,” he said. And then he showed me the white spots, in the white matter. The disease.

“Here, around the edges, at the surface of the brain, and here, this globular area, at the top of your spine – these are what we call grey matter. The surface of the brain is where you think; your consciousness. The structures at the top of your spine, they are what keep you alive without having to think; your breathing, your reflexes. Your instincts. Everything in between is the white matter. The wires between the gray matter. Your wiring is damaged, and this is probably why you are having these disparate symptoms.”

What causes it? Was it the accident? Is it a disease? Something else? Can it be treated? Will it get worse? What can I do? Will I die? Questions questions. And fear.

“We don’t know what might have caused it, but if we carry out some more tests, there may be treatments. It may not get any worse, and your brain may adapt, rewire itself; you might feel better, in time. How are feeling right now? Any worse?”

“No. I suppose not. The same…I think? Is that good?” I said, blinking, trying to focus on how my body felt. How did you feel? How could you have possibly felt anything after that revelation?

“Well. That’s a good sign in my book,” he said. I nodded woodenly, as if I somehow knew about ‘good signs’.

They do that – their bad news breaks you; then they give you hope and you follow them, them and their light of hope. You follow them because they are going to lead you out of that dark tunnel they just dropped you into, aren’t they? But they are both the tunnel and the light.

“I’m going to write you prescriptions for two things,” he went on “One for anxiety - this is bad news, there’s no getting away from it, and this is a little bit of help for you right away. The other is for blood pressure. We need to keep this down. I’m booking you in for more scans, as soon as possible, at Omnimage. They have a suggested protocol, to focus on the areas of damage. These scans will take significantly longer, so have you got anyone who will go with you, who can drive you home afterwards?”

“My fiancée,” I nodded, wishing she was with me now, feeling the grip of rising tears in my throat, knowing how hard it was going to be for me to tell her this. He tore off the prescriptions and gave them to me.

“Take these to the pharmacy next door and see Lucy on your way out. She’ll make sure you get an appointment for the further scans.”

“Thank you… Doctor Harris,” I said, staring pointlessly at the prescriptions, and having to remind myself of his name from his ID badge.

“It’s my pleasure,” he said, smiling that warm smile. “And call me Luke. We’re probably going to see quite a bit of each other now. May I call you Matthew?”

“Matt. I prefer Matt. And yes, yes of course.”

I left, picked up the prescriptions, spoke to Lucy, drove home in a daze, sat in the kitchen until Edie came home. I had managed not to cry until the moment I saw her. She was wonderful; she always is. The next day, I got another email and a text with my appointment at Omnimage. Edie said that of course she would come too.

To be continued in Part II…Here