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May 2024


by Travis Flatt

Remember Blue Elephant

          The Witch

          My friends claim it's terrifying. When I'm startled, the jolt can launch a seizure. With Amber watching alongside, I squirm at the stilted dialogue, like I directed the thing.

          Twenty minutes in, she’s clearly bored, yawning behind her mask. I shut my laptop. Although the stress of embarrassment can trigger a seizure, I can’t take it. She’s soldiered on for days, but this feels rude.

          Amber intrigues me. Her hair towers in enormous red curls that cascade and tumble. Behind spangled cat-eye glasses and a surgical mask, I can't guess her age—somewhere between thirty-five and fifty?

         Sleep Deprivation

          I’d hoped for a regular seizure, the absences—petit mals—I suffer, on average, every forty-eight hours. They scorn my insurance policy, it seems.

          The movie having failed, I resolve to torture myself. Lack of sleep enrages my illness to the point that it’s frightening. My sleep schedule is religious—nine every night. Often I’m in before my parents. This cramps my social (and sex) life. I’m here to learn my surgical options, reduce meds, leave my parents’ house, begin dating—the list becomes simultaneously more hopeful and depressing.

          I now switch to cups of coffee. We watch Only Murders in the Building. Despite my ratcheting nerves, this wakefulness feels wrong. I laugh. So does Amber. We drown out the nearby patients who wail in pain, or for loved ones. Postictal epileptics emerge confused, scared, angry, apologetic.

          The technicians’ shifts end at midnight. My new tech is John, a tan guy with thick, gray eyebrows. He speaks little. In the hours we sit, I discern nothing whatsoever about him. After hours without sleep, I feel miserable. Long ago, I stayed up voluntarily, playing Xbox or watching foreign films—Breathless, Stalker, Rashomon—back when Netflix shipped DVDs. 

          Flashing Lights

          If the patient hasn’t seized after four days, they bring in a strobe. I'm not photosensitive, so the light just annoys me. This morning, my room fills with doctors to discuss the procedure’s apparently impending failure. Conversation with people this smart intimidates me, makes me feel childish.

          After minutes struggling to answer their questions, a jump of nerves tricks me. I think I’m finally getting sick and say, “It’s happening.” A nurse rushes in and asks me to remember “blue elephant.” John prepares the injection.

          I realize I’ve declared a false alarm, only tension and wishful thinking. When nothing happens, the room falls silent in disappointment. Ninety seconds later, when asked, I remember “blue elephant” just as you would. The doctors warn that with the failure of caffeine and sleep deprivation, they'll be forced to take drastic action.

          Reduce Medication

          Altering a patient’s scheduled meds is last-ditch. Tampering with my chemistry could affect the results.

          Tech shifts change again. Amber brings me a portion of her lunch. Hattie B’s screwed up her order, giving her a “Shut the Cluck Up!!!”-level sandwich, which is reserved for crazy people. I’ve mentioned I’m a spicy food enthusiast. Or masochist.

          The chicken is sludged in cayenne pepper paste so thick that rather than rust colored it's black. On my first bite, my eyes water, my nose snots, and I begin hiccupping. The chicken is so astoundingly hot it literally blows my mind.

          While Amber chuckles and teases, I feel the déjà vu-like wobble—the aura—that signals my true seizures, but manage to warn her between coughs. She presses the red button taped to the bed, filling the room with nurses. One asks me to remember something.

          Between aura and seizure, I generally have two minutes. Amber injects the dye. When it floods my arm, it's cold. I taste pennies. I'm rushed downstairs, the foot of my gurney banging open a series of doors.

          Later, after the scan, a nurse, presumably the same one, asks me to recall his words. I offer “blue elephant,“ but he corrects me. “Purple umbrella,” it turns out, is what he said. Somewhere enroute from my ears to my seizure focus, those two words —“purple umbrella”— crashed on the synapse interstate, instantly reduced to smoldering neuron wreckage. When the weather was clear, the words “blue elephant“ whizzed along those same neuron highways to arrive safely at their destination.

          A Cyborg

          My doctor says, “Here, I can show you,” and darts out of the exam room and returns with a little cardboard box. Inside is what looks like a small, steel pork chop. It’s branded “Neuropace” with tiny, black letters.

          I run my hand across the fuzz on my scalp and say, “Like, a plate in your skull?”

He shakes his head. “It sits on top of the skull. And it learns.” He explains how the RNS device, the Responsive Neurostimulator, is affixed to a patient's skull with tiny wires. It continuously gathers information about seizure activity.

          “We’d put it here,“ he says, pointing to his temple but meaning my head, and explains that one wire of these wires would—painlessly—penetrate my skull and live inside my brain matter, sending small pulses into my seizure focus. In time, the RNS will learn to disrupt seizure activity.

          “It’s not a cure,” he reminds me, but adds that treated patients often lower their medication slowly with time.

          And that’s a sigh of relief. Fewer medications mean fewer side effects, less feeling sleepy all the time, fewer mood swings—the list goes on and on.

          It’s long-game thinking that gets you through. The RNS didn’t exist when my seizures started. The trick is understanding that they can’t lift the boulder off your back, but they’ll chip chunks of it away.

          I say, “The kids—(I’m a substitute teacher)—will call me a cyborg.”

          He’s younger than me, the doctor, and always very busy. This is the first time I’ve ever seen him laugh.


Travis Flatt.jpg
Travis Flatt
Tennessee, USA

Travis Flatt is a teacher and actor living with his wife and son in Cookeville, Tennessee. His stories appear in JMWW, HAD, Bending Genres, Maudlin House, and other places. He enjoys theater, dogs, and theatrical dogs. 



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