Fallen: A Trauma, a Marriage, and the Transformative Power of Music by Kara Stanley Page A

the base of the skull. Nestled behind the brain stem is the cerebellum, or “little brain,” and immediately above the brain stem is the diencephalon, the mid- or through brain. Extending anteriorly from the base of the diencephalon and the brain stem is the cerebrum, the largest portion of the brain. Divided into left and right hemispheres, the cerebrum is internally connected by the corpus callosum, a broad band of white matter containing axons that communicate between the two hemispheres.

    Inside the brain are four narrow cavities called ventricles: one in each hemisphere of the cerebrum, one in the midbrain, and one that lies between the brain stem and the cerebellum. It is in the ventricles that cerebrospinal fluid is produced and circulated, cushioning the brain’s delicate tissues against the bony ridges of the cranial cavity and providing an optimal chemical environment for neurons to communicate in. The doctors have placed a vent, called an external ventricular drain, into Simon’s ventricular system, by drilling a hole through the bone on the right side of his forehead. Through this vent the doctors and nurses are able to drain the pooling cerebrospinal fluid, relieving the buildup of pressure inside his skull. It was also here, in the ventricular system, that early physicians and philosophers named the locus for our humanity, the feature that most notably separates us from the beasts. They believed that the key to our uniquely human mental faculties lay not in the flesh and blood tissue of the brain but rather in the fluid tides of this inner space. For centuries, this was the dominant theory of the human brain throughout Europe and the Middle East.
    Galen, the preeminent physician of the Roman Empire, believed that vital spirits were produced in the left ventricle of the heart and were carried upward in the carotid arteries. Once delivered to the ventricles of the brain, these spirits were transformed into animal spirits, the highest of spirits. Galen maintained that these animal spirits formed the “instrument of the soul” and, when needed, passed into hollow nerve cells to provide sensation or muscular movement. St. Augustine suggested that sensation belonged to the ventricles in the cerebrum, that memory belonged to the third or middle ventricle, and motion to the fourth, posterior, ventricle. Da Vinci injected molten wax into the ventricular cavities of cattle, cutting away the brain after the wax hardened in order to get a proper anatomical understanding. Although he challenged previous anatomical drawings with his work, he too unquestioningly accepted that the human faculties of imagination, memory, and intellect were located in the cavities of the ventricles. This basic belief—that animal spirits animate and elevate human thought by traversing the ventricular system—did not alter much until the eighteenth century.
    Seated beside Simon, I am unaware of the historical importance of the ventricular system. Barely able to recall the basic macroanatomy of the brain and the microanatomy of a neuron that I gleaned in grade 12 biology, the brain and the infinite wonders of its gray and white matter are as mysterious to me as the dark matter in the deep space of our universe. Yet I need no history or biology lesson in neuroanatomy to understand this basic fact: as the cerebrospinal fluid is drained from Simon’s ventricles, some vital life force is being lost. Here, now, the gradual dissolution of self from body that we all must eventually face is sped up to a frantic pace. Each time the drain is open, Simon leaks a little farther away from his broken body.

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YOU CAN’T STAND UP ALONE
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    MARC’S BROTHER JERRY and his wife, Barb, have opened their home, in North Vancouver, to Marc and Lorna, and tonight Emily makes the trip there for dinner. I read to Simon until she returns and takes my place beside his bed. I eat a bowl of soup and a piece of buttered bread at the tea shop across from the