Chapter 5: Decoherence
Monday, August 14, Boston, Invita, NRI Labs, Morning
The morning felt ordinary. That was the thing Ted would remember later, turning it over in his mind like a stone worn smooth by handling. How completely ordinary it had been.
He held the lobby door for Anya, morning sun warm on his back. She moved past him with her usual impatience, already thinking about the data, the volunteers, the work. Her gait was slightly off, he noticed. A hesitation in her left step that hadn’t been there a week ago. He filed it away with all the other small changes he’d been cataloging since the garden: the way she squinted against light that wasn’t bright, the pauses when she searched for words, the headaches she thought she was hiding.
She caught him watching. “Stop it.”
“Stop what?”
“Looking at me like I’m about to break.”
“I’m looking at you like I love you.”
“Same thing, lately.” But she smiled, and for a moment she was just Anya, sharp and impatient and utterly herself.
The NRI lab was already active when they arrived. Imani stood at the main workstation reviewing protocols, a box of Kane’s donuts open beside her tablet. The smell of sugar and coffee filled the space, mixing with the sterile undertone of electronics and climate control.
“I’ve got the new volunteer at ten,” Imani said. “Already ran their cognitive baseline.” She glanced at Anya, her medical training cataloging what she saw: the pallor, the careful movements, the slight tremor in the left hand. “You alright? Ted mentioned your fall.”
“Who knows? I promised Ted I’d get checked out. Probably nothing.”
Imani’s expression said she didn’t believe that, but she let it go.
By ten-thirty, the volunteer was in the scanner performing emotional recognition tasks. Video clips played on the monitor: a baby crying, puppies playing, a man being struck in the face. Each selected to evoke specific responses they could record and measure. The data flowed across screens in rivers of color, neural patterns blooming and fading.
Anya stood at the main display explaining patterns to Dr. Helen Liu from MIT’s neuroscience program. Her voice was steady, professional, the voice of a scientist in her element.
“See how the signal propagates from the amygdala through the anterior cingulate? The delay is consistent. About forty milliseconds in all subjects. That processing time, those neural loops, they’re essential for emotional experience.”
She gestured at the hologram, tracing pathways with her finger. The light caught her face, and Ted saw how thin she’d become. The bones of her cheeks more prominent than they’d been a month ago.
Then the room tilted.
Anya’s hand stopped mid-gesture. The monitors swam in her vision, doubling, tripling, the data streams fracturing into meaningless noise. She tried to focus but her eyes wouldn’t cooperate. The holographic brain in front of her split into two brains, then four, then a kaleidoscope of overlapping images that made no sense.
Her thoughts scrambled. The words she’d been about to say vanished mid-formation, like files corrupted before they could save. She knew what she wanted to explain, could feel the shape of the concept, but the pathway from thought to speech had severed. Her tongue felt thick, foreign, a piece of meat that didn’t belong to her.
“Anya?” Helen’s voice came from very far away. Another dimension.
She tried to answer. The command was clear in her mind: speak, say something, tell them you’re fine. But the signal died somewhere between intention and action. Her arm wouldn’t move when she reached for the desk. Her left leg buckled, the knee folding without warning.
The floor rushed up.
A distant part of her mind, still analytical even as it failed, noted the irony. The neuroscientist watching her own brain shut down from the inside. She could feel the cascade happening, the timing breaking apart, the precise synchronization she’d spent her career studying dissolving into chaos. This was what her patients experienced. This was what the data looked like from within.
Then nothing.
Imani was beside her before she hit the ground.
“She’s out!” Years of emergency training took over, professional detachment masking the terror building beneath. She checked Anya’s pulse: weak, rapid. Pried her eyelid open: pupil blown, unresponsive. “Ted, call 911. Now.”
Ted stood frozen for half a second, his mind refusing to process what he was seeing. Anya on the floor. Anya’s eyes rolled back. Anya’s body limp in a way he’d never seen a living person go limp.
“No signal down here!” Panic sharpened his voice. He was already running for the door. “I’ll find a landline!”
“I’ll go.” Helen was faster, sprinting down the corridor, her voice echoing off concrete walls.
Ted dropped to his knees beside Anya. Her hand was cold in his. Her face had no color at all, white as the lab walls..
“Anya.” His voice cracked. “Anya, please.”
Imani worked with steady hands, tilting Anya’s head back, checking her airway, monitoring her breathing. Her professional mask held, but Ted could see the fear in her eyes. She knew what this looked like. What it meant.
After a minute that lasted a year, Anya’s eyes fluttered open.
“Wha...?” She closed them again, face twisting with confusion.
Imani took both of Anya’s hands in hers. “Anya, try squeezing my fingers.”
A pause. Then weak pressure, barely perceptible. Left side noticeably weaker than right. Severe vertigo, left-sided weakness, loss of consciousness. This isn’t a migraine. Imani’s mind ran through differentials, each worse than the last. She needs immediate imaging.
Anya’s eyes opened again. She tried to sit up, but her body refused. Nothing worked the way it should. Her left arm lay beside her like it belonged to someone else.
“Focus on breathing,” Imani said, keeping her voice calm. “It’s okay. Help is coming.”
Four minutes. That’s how long it took for Anya to return fully, for her eyes to focus, for words to form properly. Four minutes that Ted spent holding her hand and bargaining with a universe that wasn’t listening.
When the paramedics arrived, Anya was arguing. She was fine. This was ridiculous. They had work to do. But Imani’s medical authority overrode her protests. Soon she was on a gurney heading for Mass General.
Ted climbed into the ambulance beside her for the short ride that felt like hours.
Mass General’s emergency department was controlled chaos. The smell of antiseptic and stress. Alarms competing with monitors. Nurses moving between curtained bays with tempered urgency. The worried faces of families, the hushed consultations, the particular silence that surrounds bad news.
Ted counted at least eight medical personnel as they wheeled Anya through the swinging doors. Doctors checking her eyes, her pulse, her blood pressure. Assistants covering her body with sensor patches. It was chaotic but somehow reassuring, all this expertise focused on the woman he loved.
The nurse closed the curtain around them. The tiny space became a refuge from the surrounding chaos.
“What’s your name?”
“Anya Chikacheva.”
“What day is it?”
“Monday. August 14th.”
“Who’s the president?”
“Still the same incompetent as this morning.”
The resident smiled briefly. “Your cognitive functions appear intact, but you’re showing signs of neurological damage. Left-side weakness with loss of consciousness. We’re going to take you for imaging.”
Anya nodded. Neurological damage. The words landed hard. The air felt too thin. She closed her eyes and squeezed Ted’s hand harder.
He stood beside the gurney, stroking her arm. Outside the curtained bay, someone was vomiting. A child cried. Normal sounds that felt surreal, belonging to a world where people had ordinary problems, ordinary days, ordinary futures.
“I feel hand,” Anya said, flexing her fingers slowly. “Tha’s good, right?” The slight slur in her speech, the way she couldn’t quite form the sentence. She heard it and he saw her hear it, saw the fear flicker across her face before she pushed it down.
Ted bit his lip, not trusting his voice. He’d watched that incredible mind falter in real time. The woman who could hold neural architectures in her head, who could see patterns in data that eluded everyone else, struggling to form a simple sentence.
“Ted.” She found his eyes. “We’ll deal. K?”
The CT tech called her name. Ted helped her into the wheelchair though she insisted she could walk. She couldn’t. Her left leg dragged. Imani appeared, nodded to the tech, and took over, wheeling her down the corridor toward imaging.
Ted stayed in the ER bay. Sat in the plastic chair. Stood. Paced three steps to the curtain and back. Sat again. The clock on the wall had a stuttering second hand that caught on every third tick. Twenty minutes felt like hours.
His mind ran through every possibility. Stroke. Tumor. Hemorrhage. Aneurysm. He’d read about these things, understood them abstractly. Now they were happening to Anya. Now they were real.
When they returned, Imani’s face was carefully neutral. The face she wore when she was about to deliver news that would change everything. She pulled the curtain fully closed, a futile attempt at privacy.
“Anya.” A pause. Choosing words. “Your scan shows an arteriovenous malformation. An AVM.”
Silence. The monitors beeping. The clock ticking. Anya’s face tightening as the analytical mind engaged, processing, calculating implications.
“How big?”
“Three centimeters. About the size of a golf ball. High flow. It’s causing acute venous hypertension. That’s the headaches, the pressure.”
“Fuck.”
“Yeah.” Imani pulled up the scan on a tablet, showing them the tangled mass of vessels. Dark against gray brain tissue. A knot of malformed arteries and veins that had been growing for years, silently, patiently, waiting for this moment. “It’s diverting blood from healthy tissue. Steal phenomenon. That’s why you collapsed.”
“How?” Ted’s voice was tight, pitched higher than normal. “This doesn’t happen overnight, right?”
“She’s probably had it since childhood. It’s been growing for years, but now it’s become unstable.”
The words kept coming. Circle of Willis. Recent micro-hemorrhages. Location near the basilar artery. Ted heard them through growing static, his tinnitus rising with each new detail. Beside him, Anya sat motionless, eyes scanning the images on Imani’s tablet, processing the architecture of her own destruction. Her face remained impassive, but her hands had gone white where she gripped the gurney rails.
“Options?” she asked finally.
Imani’s jaw tightened. “I’m calling in specialists. We’ll review the imaging. But I’ll be honest, I’ve seen these before and the prognosis isn’t good.”
By late afternoon, Imani had pulled every connection she had. Anya had been seen by the chief of neurosurgery, interventional radiology, two cerebrovascular specialists. They gathered in a consultation room, images displayed on a large monitor. Ted stared at the scan, trying to see it clinically, trying not to see it as the thing that was killing his wife.
Their faces were grave. The consensus unanimous.
Spetzler-Martin Grade Five. The worst classification. Too large, too central, too intertwined with eloquent brain tissue. The malformation wrapped around the basilar artery, threading through structures that controlled language, movement, life itself. Any surgical attempt would destroy what it tried to save. Radiation would take months they didn’t have. The pressure was already critical.
“We can place an external ventricular drain,” the neurosurgeon said. “Manage the intracranial pressure. Maximize perfusion to healthy tissue. Buy time.”
“How much time?” Ted’s voice cracked on the question.
“The EVD will relieve pressure, keep her lucid.” The surgeon looked at Anya with the professional respect one scientist shows another. She wanted the truth. He gave it to her. “But the AVM is critically unstable. With aggressive management, possibly several weeks. If it ruptures...” He didn’t finish. They all knew what rupture meant.
Several weeks.
The words fell into the room like stones into still water. Ted watched the ripples spread across Anya’s face. The slight tightening around her eyes. The way she swallowed once, hard. The way her hands relaxed on the gurney rails, as if she’d made some internal decision.
“Show me the scans again,” she said.
The surgeon hesitated, then gestured to the screen. The AVM filled the display. Twisted vessels, dark against gray matter. The thing in her skull that would kill her.
Anya studied it with detachment. The same way she’d studied the dementia data, looking for patterns, understanding the architecture. Then she looked up.
“The EVD. I want it today.”
“We can do it this afternoon,” Imani said quietly. “Local anesthetic. Small burr hole through the skull. Catheter into the ventricle. It’ll relieve the pressure immediately.”
“Then let’s do it.”
They moved Anya to a pre-surgical room filled with warm afternoon light. Ted sat in the visitor chair, stood, paced, sat again. His hands wouldn’t stay still. He kept picking up his phone, putting it down, scrolling through search results that all said the same thing. Nothing to do. Just wait.
A young nurse with a warm smile arrived. Jennifer. “I’m going to braid your hair,” she explained, fingers already working through Anya’s dark strands. “We’ll only shave a small patch. About two inches. The braid keeps everything else out of the sterile field.”
Anya submitted to the preparation with unexpected grace. The French braid curved around where they would drill through her skull. A small kindness in the midst of catastrophe. Jennifer’s hands were practiced, gentle, patient.
Imani entered in surgical scrubs. “Anya, how are you?”
“About as expected.” Anya smiled, the right side of her face rising while the left lagged slightly behind. The same rueful expression she wore when experiments failed, when life refused to cooperate. “Let’s just fucking get this over with.”
“Okay. Thirty minutes, maybe less.”
Ted stared at his hands. “This morning she had a headache. Just a headache.” His voice broke. “Now you’re drilling holes in her skull.”
“Ted.” Imani touched his shoulder. “I’ll just be a second, Anya.”
Anya nodded. The nurse wheeled her toward pre-op. She looked back once. Their eyes met. Everything they couldn’t say compressed into that single glance.
Once alone, Imani’s professional composure softened. She sat beside Ted.
“The AVM was always there,” she said quietly. “The collapse, in a way, saved her. Without the scan she might have had a catastrophic hemorrhage with no warning. Just gone.” She took his hand. “This way you have time.”
“Saved her for what? A couple weeks of slowly dying?” The words came out harsh. He hated this. Hated everything. Hated the cruel mathematics of blood vessels and brain tissue.
“Two weeks of knowing. Of being able to use every day.” Imani’s voice carried the weight of too many difficult conversations, too many families she’d helped through this. “That’s something. Her mind is still good.”
He collapsed into her shoulder. The tears came suddenly, hot and uncontrolled, soaking into her scrubs. All the fear, all the grief, all the rage pouring out in the sterile pre-op room while somewhere behind those doors they were about to drill a hole in Anya’s skull.
“Shhh,” Imani murmured, rubbing slow circles on his back. Letting him break. Holding him together.
“There’s no good solution,” she said. “I’ve consulted everyone. But this is time, Ted. Time to say things. Time for her to choose how this ends.”
He pulled back, wiped his eyes roughly. Nodded. His throat was too tight to speak.
“I need to prep,” Imani said. “I’ll text you when we’re done.”
Ted wandered to the hospital cafeteria. Bought food he couldn’t taste. Stared at his phone without seeing the headlines he scrolled past. The clock in his head counted seconds. Thirty minutes, Imani had said. He’d been here forty-five.
His mind invented complications. Bleeding. Infection. The drill slipping. He forced himself to stop. She was in the best hands. Imani would take care of her.
His phone chimed. Imani: “All done. She’s fine. Room 4127.”
The evening sun colored the sky orange outside the windows when Ted entered the room. Anya was propped up in bed. The EVD emerged from a small bandage on her skull, tubing draining murky fluid into a collection reservoir. The French braid curved around the shaved patch, Jennifer’s handiwork preserved.
Her eyes were clear. Focused. More present than she’d been in days.
“The pressure’s much better,” she said. “I can think again.” She shivered. “It’s cold in here.”
Ted draped one blanket over her legs, another across her shoulders. His movements were slow, deliberate, careful. Like she might shatter if he moved too fast.
“How do you feel?” he whispered.
“Like I better do something amazing in the next couple of weeks.” She found his hand, held it. “Ted, I know you want to talk about treatment options. More opinions. Clinical trials. But I need you to hear me.” Her grip tightened. “This is happening. We both know what this diagnosis means.”
“Anya—”
“No, listen. We can spend my remaining time chasing false hope, or we can use it.” Her eyes held his. The same fierce determination that had driven her through every obstacle in her career. “Our research. The neural mapping. Everything we’ve discovered. We have time to document it. Make sure nothing is lost.”
Ted wanted to argue. Wanted to insist they’d find something, someone, some treatment the specialists had missed. But looking at her face, clear-eyed and resolved, already planning, he knew she was right. She’d done the calculations. Weighed the probabilities. Made her choice.
Outside, the sky had darkened. The city continued its ordinary evening while their world collapsed.
Ted stayed until Anya fell asleep, her breathing regular despite the drain gurgling softly beside her. In the hallway, Imani spoke quietly with the night nurse, ensuring proper monitoring, proper care.
“She’s analyzing it,” Ted said. “Even now. Treating her own death like a data set.”
Imani nodded. Through the window, Anya’s face was peaceful in the dim light. “She always was brilliant at optimizing under constraints. Now the constraint is time.”
Ted leaned against the wall. The day had started with morning sun and ordinary worries. Now midnight approached. The longest day of his life.
He looked through the window at the woman who’d been his partner for twenty years, sleeping while a tube drained fluid from her skull. He couldn’t comprehend a future without her.
The equation didn’t balance. The world without Anya was mathematically impossible.
He found a chair in the hallway. Pulled out his phone and found the recording app. Chose Bach’s Cello Suite No. 1, the one she loved, and let it play softly while he sat vigil.
The music filled the quiet corridor. The nurses moved around him, understanding. He sat there until his back ached and his eyes burned, listening to Bach and watching Anya breathe through the small window in her door.
Holding back the darkness with the only thing he had left.