I’m looking at an MRI scan of my brain. Right there on my occipital lobe, circled in red, is a small black spot where no black spot should be. Even before I understand what I’m looking at, I don’t like it. I double- check the name at the top of the page to see if there’s been some kind of mistake and I’ve been sent the wrong file. I’m sure this is the case. I’m so sure that I smile and shake my head as I glance at the top of the page. I think: Someone’s going to get in trouble for this. But no, there’s my name in the top right corner. So it is my brain I’m looking at, or rather, a scan of my brain. And that black spot represents an infarct. I don’t know what this word means and I have to look it up. I’m disheartened by its definition: necrosis, dead tissue. I am discovering, here, alone in my bedroom, that there’s a part of my brain that is damaged, and will forever remain so. I look away from the image and read the rest of the file that accompanied the scan—a file that, for some reason, I have received before my doctor.

In clinical terms I don’t at first comprehend, I’m being informed that an ischemic stroke is what caused the infarction. This is already a lot to process, but there’s more. I am also being informed I have something called a patent foramen ovale. I have to look this up, too, and I soon discover I have a hole between the left and right atria of my heart. A hole in the heart sounds poetic; a romantic affliction for those of us who are unlucky in love. I should be so lucky as to be unlucky in love. In my case, a blood clot slipped through the hole in my heart and blocked an artery leading to my brain, depriving it of oxygen, and thereby causing that black spot. It all begins to feel like too much. I glance again at the top of the page. Maybe my doctor has two patients named Ian Roy, and I’ve been sent the other Ian’s file. This seems plausible to me. I think: This is obviously a mistake because wouldn’t I know if I’d had a stroke? My next thought: Maybe that’s precisely what someone who has had a stroke would think. The same sort of someone who also has an infarct and a patent foramen ovale. That kind of person might have all kinds of mixed-up thoughts.

I’m reeling—which is how I felt when this all began. Weeks earlier, a serious bout of vertigo knocked me to the floor. It felt like I was sinking, like I’d been encased in cement and thrown into the ocean, spinning the whole way down. If I moved even a limb or opened my eyes to look at the floor, I would vomit. When it was over—hours later, maybe—I was so exhausted I couldn’t lift my head off the floor. This happened two more times. I saw several doctors, and when they asked me to describe how I was feeling, I said the same thing every time: I feel fucked up.

I put the file down and close my bedroom door. So this is it. I’ve had a stroke. I have permanent brain damage. I have a hole in my heart. And now I am going to die. I think: I had a good run, but now it’s over. I decide right then that I won’t tell anyone about this. I won’t tell my wife, and I won’t tell our sons. I won’t tell my mother, my grandmother, my siblings. I won’t tell my friends. I will keep this to myself. I will be like an animal that crawls away and dies in a hole in the ground or in the rotted, hollowed out trunk of a dead or dying tree. I convince myself that I will be doing this as a favour to those around me. If there was an ice floe upon which to float away, I would float away on it. For reasons that aren’t clear to me at the time, I begin humming a Joni Mitchell song. I start crying. Sunlight refracts through the suncatcher my wife has hung in our bedroom window and dances on the walls all around me. The window is open and I can hear the trilling song of a sparrow, children playing in the yard next door. I think: The world is beautiful and I’m going to die.

My wife comes into the room and I blurt out that I’ve had a stroke and there is permanent damage to my brain. And also, I have a hole in my heart. Then I remember I wasn’t going to tell anyone. My wife is calm, eerily so. Does she not care? Did she not hear what I said? I say it again. Stroke. Necrosis. Hole in my heart. She says, too calmly for my taste: I heard you, my love. You’re going to be fine. I know you are. She uses the word neuroplasticity, and it feels like I’m hearing this word for the first time, which in a way, I am. While none of this reassures me, I shut up and take deep breaths as she has instructed me to.

Days pass like this, weeks, months even. One day I open my eyes and a nurse is shaving my groin. I remember this like a dream I awake from before it has ended. In that moment, I allow myself only two thoughts: I will give myself over to this experience, and I will put my trust in these people. A doctor makes two incisions in my body: one on my inner left thigh, one on my right. A video camera will be inserted in one and a titanium patch threaded through the other. I remain awake for all of this, but high on the drugs they’ve given me. Before inserting the patch, the doctor asks if I want to see it. Totally, I say. I totally want to see it. He shows it to me. It’s a mesh screen, so not a patch exactly. My heart tissue will grow over and around it. Soon, the doctor is inserting the thing that is not exactly a patch inside of me. My only thought while I watch this happen on the giant screen next to me is: It’s very cool that I will have a titanium patch in my heart. Again, I am very high. At some point, I fall asleep.

The next time I open my eyes, I’m in a different room with two nurses checking the incisions on my thighs. One of the nurses might be the same one who shaved me earlier. I can’t be sure. My incisions won’t stop bleeding. The nurses are doing their best to look like this is normal. I am still high, but not so high that I don’t see the look that passes between them. I feel weak, not quite right. The part of my brain affected by the stroke is the part that processes visual information. My eyes are slow to focus and refocus. I look past the nurses to the yellow curtains that surround my bed. They are pale and worn thin like the gown I’m wearing. Through an open space where the curtains don’t quite meet, I see a man, like me, waiting to be wheeled to the operating room. Looking at one thing and then another puts a strain on my eyes and brain and leaves me feeling fucked up. Looking down at my bloody thighs and then up at the nurses puts a strain on my eyes and brain, and leaves me feeling fucked up.

I don’t know how much time passes, but the bleeding eventually stops. My thighs are itchy and bruised, and will remain so for weeks. I will watch in horror as the bruising spreads and shifts through a rainbow of yellow and blue and purple hues like motor oil in a puddle. My heart, now minus one hole, feels no different than it did the day before. Or the year before. It feels no different than it ever has. This is both a relief and a disappointment.

The entire experience is both a relief and a disappointment. I am relieved to live in a time when a doctor can slide a video camera into my thigh and patch my heart with titanium. Not that long ago, I’d have died by now. I will still die, but I haven’t died yet. I am disappointed in my body, and it takes a while to get over this. You let me down. I whisper these words with my head bent forward as if speaking to my own heart. But then I remind myself that my heart is still beating and my brain is busy reorganizing itself by forming new neural pathways to work around the necrotic tissue. I become the kind of person who tells people unselfconsciously that life is beautiful and we are amazing creatures and our bodies are wonderful and complicated machines. My body is, I tell anyone who will listen, a wonderland, and so too is yours. I am unaware these words come from a song until I’ve said them a hundred times and one of my sons points this out. I stop saying it. But I don’t stop thinking it; I will never stop thinking it.

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Image: Caro Dubois, Dreaming for Holidays, 2022, mixed media collage