Break a Leg –

“Damn, Sean, you really didn’t have to break a leg for the play! It was just a stupid high school play, after all. I was just joking before the performance.” My friend Derek couldn’t keep from laughing looking at me sitting in the hospital bed with my leg held up in the air and thoroughly wrapped.

I rolled my eyes at Derek and shook my head. “How was I supposed to know that they moved the mattress out of alignment underneath the trap door. At least it made the play look good when I screamed in pain during the scene.” I had to laugh too at the irony of it all.

“Well, they finished the play while you were taken here. Everyone took a bow, except you, of course.”

I smiled and waved my hand pretending to take a bow in bed. He and I laughed. My brief performance for the school play was in a Halloween production in which there were numerous vignettes from horror films and plays. In my scene, I played a victim of Sweeny Todd whose throat was cut and dropped into a pit from the barber’s chair in the blink of an eye. The chaos below stage was such that someone had moved the mattress I was supposed to land on by a bit. Instead of landing on it directly, I took a fifteen foot drop onto concrete with my feet. Luckily, my head hit the back of the mattress and it was just my leg or ankle that was broken. The audience that heard my painful scream thought it was part of the performance. I asked that they not use the siren out of the school parking lot so no one would know.

“How long will you be here do you think?” Derek pondered.

“Just the night. Mom is getting me some things from home. I will be in crutches for at least a couple of months. Gets me out of P.E. too. I hate wrestling, anyway.”

After everyone visited me from the drama department, I settled down for a nice rest. A knock came at my door. A nice looking doctor with long blonde hair and a sweet smile looked in. “Hi, I am Dr. Reynolds. How are you doing Sean?”

“As well as can be expected, I suppose.”

“Do you mind if I ask your Mom a question or two in private? Mrs. Jacobs can we talk for a moment alone?”

“What is this about?” Mom asked and the two of them went off to talk out of my earshot. The last thing I heard was Dr. Reynolds saying, “Oh nothing bad.”

After a few minutes, they walked back, Mom looked at me for a moment and then turned to her to say, “You know what, I worry. So, I am going to say yes to a freebie.”

I laughed. “Will it hurt? Whatever do you two have planned?”

“No pain, we just are going to stick your head in this machine. Ask you a few questions. Have you watch a slide show. And then they pay you about $100 for your time if you are injury free.” Dr. Reynolds said.

“Deal!” Dean said rather emphatically. “But I get the $100, Mom. I need a new game for my Playstation.”

“Before that, we will get you into surgery to fix some screws into your ankle.” Dr. Reynolds patted me on the shoulder and headed out the door.

After she left, I asked, “So, what was that all about, Mom?”

“Seems that our insurance isn’t going to cover a preventative MRI. Even though the school is going to pick up the tab for the essentials, I don’t like them not doing an MRI to make sure your head is okay. Dr. Reynolds found out that a research project is being done here and if you participate, the cost is covered by a research grant. And that means they can check your brain for any potential damage from your fall and you earn some money too.”

“Okay.” The whole thing seemed over my head. My head felt fine. So, I changed the topic. “When is Dad getting here?”

“He is stuck in Boston. His business convention gets out tomorrow. The earliest he could get out would be after your surgery anyway. It is leaf peeper season and the flights are all filled up. So, you get some sleep. They will be here in a couple of hours to get you into surgery on your broken ankle. Then, in the morning you get an MRI. Then they discharge you late in the afternoon. It looks like you get a couple of days off from school.”

“Awesome! My big brother has all the luck!” Charles said skipping into the room. Aunt Libby followed close behind. She had been taking care of him for Mom, but had to return him because of her night work. “Can I watch them cut you open?” He sneered at me with his evil grin. “I want to hear you scream again.”

Mom hit him on the back of the head. “Charles Darwin Jacobs, that isn’t funny. Your brother is lucky he only broke his ankle on the fall. It could have been much worse. Go give your brother a hug.”

Charles came over to my hospital bed. He really couldn’t climb up to give me a hug so he took my arm and put it around him. “Twerp!” he said with a chuckle.

“Dweeb!” I said laughing.

“See, Mom. We only are teasing. Did you want me to bring you any games from home, Sean?” said Charles as he played with my TV remote.

“No. Just a few books. I am supposed to be reading Huckleberry Finn for English class. Might as well get it out of the way. They have nothing on TV.”

I slept fitfully for a few hours. The pain medication didn’t help. I was groggy and not very happy. About five in the morning, a nurse came to give me a shave. When I protested, she said it was protocol. I was somewhat embarrassed. I had to think of ugly things so I didn’t rise at her touch. Thankfully, I only had a few hairs yet. It didn’t take her long.

They wheeled me downstairs where I had an x-ray done and then into what they called the operating theater. “I already landed in one theater today. Don’t drop me again. I don’t need another broken bone.”

The ladies in the gowns laughed. Dr. Knox, my surgeon, said, “Well, we are the performers here. You are just the audience. So, only we can break a leg.” I don’t remember much after that. Next thing I knew, a nurse was telling me to wake up in the recovery room.

“Everything went fine, young man. You should be able to go home later today.”

A couple of hours later, they wheeled me up to the MRI chamber. The process was scary. They had to give me some sort of drug to ease my panic. I felt a little dreamy still from the surgery earlier in the day.

“Okay, Mr. Jacobs, I am going to show you pictures of various things. I want you to think about each item you see.”

“That is as tough as it gets?”

“Yes, that is as tough as it gets.”

For the next thirty minutes, I was shown images of dogs, cats, babies, cars, war, weddings, homes, etc. Then I was shown two brief movies. One was a war movie scene. The next one was watching someone proposing marriage.

“Okay, thank you Mr. Jacobs. You are done.”

They wheeled me out of the chamber. I overheard Dr. Reynolds talking to the tech. “No damage from the fall?”

“No, everything looks fine in that regard. But, there are a few structural anomalies that we ought to discuss later. Nothing serious. Let me process the data.”

“Will it affect his cognition?”

“Oh no, it only affects how his cognition works which is purpose of the study we are doing. It should never bother him at all.”

“Thank you Dr. Jones.”

Dr. Reynolds came over to me and patted me on the shoulder. “Let’s get you discharged. Your Mom will be here shortly. I bet you are anxious to get home.”

“Yes, Ma’am.” She kindly helped raise me up and then handed me my Mark Twain book. I just sat there on the gurney reading. It seemed like an hour before anyone moved me. But, an orderly finally rolled me back me to my room. I found my mother waiting for me along with Dr. Jones. The two were having a discussion about my results.

“Hello Sean, I hear you are going home today. Sorry for the delay. Can I talk to you for a minute alone please. Mrs. Jacobs, there is nothing wrong, but I have some follow up questions for him for our study, if you don’t mind.”

“Sure, I will wait out in the hallway.”

After Mom left, she turned to me and asked seriously, “Sean, I have to ask a very personal question and I need an honest answer. Nothing you say will leave this room. Nor will it affect your participation in our study.”

I felt a bit uncomfortable when she started out this way. “The MRI showed me something that makes your being completely honest paramount. If you lie, you could harm thousands of people. Do you understand?”

I took a deep breath. “Fire away, I guess.”

“Remember, this question will not leave this room. It is totally private. Your mother will never know unless you share it with her. If she asks, I will say I was verifying your age. Okay, here I go. Take your time before I answer. Have you ever had problems with your gender? In other words, have you considered yourself a girl at any time?”

“You’ve got to be kidding. Why on Earth would you ask such a question?” I stammered in disbelief.

“Because the MRI showed something we didn’t expect.”

“Which is?”

“The cortex of your right hemisphere is thicker than a typical male. We are investigating if it is an indicator or marker of transgenderism. That is why your answer is so important. A 2011 brain study showed that it may help aid in diagnosing gender dysphoria. This is a follow up study.”

I looked at the nails of my hand trying to sound dispassionate. “Oh, that is good to know. I hope it helps a lot of patients.”

“So do I. Do I take it that you are saying no to my question.”

I collected my thoughts. “You are sure that this won’t leave this room?”

“Yes, I am certain.” came her reply.

“Then, the answer is yes.”

“Yes to no or yes to yes.”

“Yes to yes. Since about the age of six. Is there a cure?”

“Yes and no. Some can work through it through therapy and stay the way they were born. Some just do hormone therapy. Some go through sexual reassignment therapy. It depends on the patient and the degree of severity.”

“What should I do?”

“Given your age, there isn’t much you need to worry about. However, I can recommend some one who can help you. I checked your insurance and I was considering giving you a referral to an orthopedic doctor. But, I can fill that role. Instead, I am going to recommend you see an endocrinologist to check your hormones and make sure they don’t interfere with your healing.”

“How will that help?”

“It means two things. One, that he and I can talk to you about treatment options after you turn eighteen as well as options before you turn eighteen. Two, you will get to meet Alice, a transgender girl your age. You were chosen for the test as a control to compare her brain scans with.”

"Really, I don't understand."

"The study we are doing is to compare brain scans of transgender patients with someone who matches them in age, race, and size. You and Alice are the same age, race, and size. We didn't expect to see your scans to look very much like hers."

“Thank you Dr. Jones. I will look forward to talking to you both and meeting Alice. What will you tell my mother?”

“Oh nothing, I am going to tell her that you think with both sides of your brain which means that you can handle lots of data.”

“She will like that.”

“I am sure she will.” As she left the hospital room, she stopped to talk to my mom.

While they talked, it occurred to me that maybe breaking a leg on stage is lucky after all. Instead of being a victim of Sweeny Todd, I went down the rabbit hole to join Alice in Wonderland.

I wonder if she likes frilly dresses too?

Copyright © 2017 by AuP reviner

-- If you like Sean's story, there is a companion short story telling Alice's story. Rabbit's Foot --

[Author's note: May 2018, a new's story is going round that a team of researchers in Liege, Belgium, have done MRI studies on 160 transgender and cisgender patients showing that there is a correlation between those diagnosed with gender dysphoria and their brain structure being consistent with the sex they identify with. The lead researcher, Julie Bakker, also has been researching how hormones affect sexual indentification in the womb and after birth. Her research includes studies of how the kisspeptide works in the brain too.]