Last month our house was struck by lightning. There were no preliminaries. The solitary blue flash and deafening bang came from nowhere out of a calm summer's afternoon. As well as the phones, it blew my computer. "Your motherboard's wrecked," the engineer told me as he dismantled it. Several files seemed to have disappeared, one of them containing notes for an abandoned article on "risk evaluation." I hadn't backed it up. I mention this to Sacha Bonsor. She laughs. I was going to skim those notes ahead of our meeting. But it doesn't matter. This isn't a clinical consultation, and, anyway, she's the expert. We haven't met before, but I've read her book, Dipped into Oblivion, and feel I know her.
We settle in my office, which, I point out, sits at the fulcrum of science and religion. The front window is filled with the view of a tall-spired church. At the back, opposite and equidistant, there's a planetarium. The first is deconsecrated, the second defunct. Sacha is in her late twenties and used to work for the UN security council's counterterrorism branch, but her knowledge of risk evaluation comes from personal experience. She has a bomb in her head. Nine years ago she suffered a brain haemorrhage, which left her numb down one side and weak down the other. It might have been much worse. The bleed sprang from a cavernous angioma - a blood vessel malformation - in the brainstem. She sees it as a blackberry. The brainstem runs continuous with the spinal cord, conveying sensory and motor information between brain and body, cross-connecting central and peripheral departments of the nervous system. It is packed with neuronal control centres responsible for the regulation of basic functions like respiration, heartbeat and pain. You might lose a spoonful or two of brain matter from the higher reaches of the cerebrum and go on more or less as usual, but damage to the narrow channels of the brainstem is synonymous with severe disability or death. It's a bit like a motherboard. Nothing else works without it.
Once an angioma has haemorrhaged it will often do so again, and there's no telling when. Surgical treatment is sometimes possible but, in Sacha's case, was thought to be too risky to contemplate. So she finished her studies and got on with her life. But two years later, the neurologist's tone is grave. He has underestimated the risk of a re-bleed. "I never got my head around the laws of probability," Sacha says, but the revised estimate of a 10 per cent a year cumulative risk of recurrence is chilling. The doctor advises her to get a surgical opinion but warns her that some will want to operate because they see her as an interesting case - and they are bound to be American.
When it comes to advice on matters of personal destiny - or prognosis, at least - brain surgeons can be as vague and elusive as astrologers and, as a group, probably show less consistency of opinion. Sacha consults renowned surgeons in London, New York, Geneva and Phoenix, and gets a different appraisal from each. The first is full of doom. Without surgery she will have another bleed. The New York man has done the operation ten times: seven successes, two patients worse off, one dead. Would he undergo surgery? "Probably not." The charming Swiss surgeon disagrees with the others on risk factors and matters of surgical procedure. He dismantles a plastic model of a brain to illustrate the geography and the route he would take - and is unable to reassemble it. This doesn't bode well, he jokes. And so to Dr Spetzler of Phoenix. He's the man. Unlike the oak-panelled baronial halls of his predecessors, Spetzler's office is a broom cupboard. But he oozes confidence. He gives a lesson in the art of seduction. Surgery is possible and advisable. He can do it. Sacha just wants to know the gruesome details. Her old boyfriend, Tone, a Chelsea fan, quips that if she does end up in a wheelchair she will at least get a front row seat at Stamford Bridge. Dr Spetzler is as good as his word. The post-operative pain is indescribable, but he has picked the blackberry. It's Tone, meanwhile, who ends up in a wheelchair. A spinal injury caused by diving into shallow water has left him tetraplegic. Now he has a front row seat at the Bridge.
Sacha's story is remarkable. She, too, is remarkable. By the end of our meeting I feel uplifted by her courage and zest. Her book closes precisely two years after the operation and she's looking forward to a "sparkling new life without timebombs." I felt uneasy when I read that, and now find myself unsurprised to learn that she has recently had another, minor, haemorrhage and must return to Phoenix for further surgery - an even trickier procedure this time. Oddly, too, I don't feel especially concerned for her. I think she'll be OK, whatever the outcome.
We touch, briefly, on religious faith, she facing the deconsecrated church, I the defunct planetarium. And when she leaves I wish her luck, remembering too late that she said she doesn't care for the expression. Nor do I. "The Goddess Fortune," said William Blake, "is the devil's servant, ready to kiss anyone's arse." Lightning bolts, I gather, usually approximate the shape of a question mark.
