'The facial nerve, or cranial nerve VII, originates in the brain stem at the pontomedullary junction near the middle of the brain. Incorporating both sensory and motor components, the somatomotor is the essential nerve grouping responsible for movement of the muscles for facial expression. It emanates from neurons in the facial motor nucleus in the ventral pons, and is then divided into five branches extending into the superfical fascia of the head and neck.'

~from Gray's Anatomy


Through the small, wire-reinforced windows in the double doors down the corridor, I can see that she is already there. Typically, she arrives before 8:30am, after dropping off her seventeen year old daughter at an expensive, private school uptown. The daughter cannot drive, you understand--an inconvenient result of her never having had to.

The daylight on the floor is a dead giveaway. She's opened the door, sat down at one of her two desks, and gotten to work. Work is a series of phone calls confirming with which of her New York acquaintances she will have breakfast at 10:00, coffee at 11:00, and lunch at noon. No breakfast date usually means a closed door and a dark hallway, time to put down your bag, take your coat off and eat your bagel before the cream cheese entirely liquefies. Not this morning. This morning, she is already there, waiting, the open door gaping like the missing tooth in an evil grin. The nausea that used to wash over me in a flood has by now been reduced to the equivalent of flicking my ear. There it is, the kind of day I will have, right there on the floor. I attempt the math in my head. 186,000 miles per second. Fifty feet. Have to convert the units, miles to feet.

Something like 100 million.

50 divided by 100 million. That's how long it took me to know.

In a further fraction of that time, the information had evoked an emotional response, to be manifested in expression via all the normally--hopefully--reliable channels. Instantaneous incorporation of data, reflected in more than 10,000 almost infinitessimal pathways, functioning within and beyond conscious control. Flawlessly.

The buccal branches: Rami buccales. Extend horizontally across the lower part of the cheek to an orbit around the mouth. They are larger than the other nerve branches, serving the superficial facial muscles around the upper lip and corners of the mouth as well as forming an infraorbital plexus with a branch of the maxillary nerve.

I smiled at the idea, but gave up the numbers. My last math course was already six years behind me; long division in my head a further five. I hadn't imagined then it would ever be useful, and if I had, I would not have foreseen wanting to calculate in billionths of second the prospect of another day of occupational unhappiness.

Still grinning, I leaned forward against the bar and eased it in slowly, shifting my weight just enough to open the door and quietly slip through. There's no one else here before nine; sound reverberates along the walls and rattles off the metal lockers opposite her office. Moving closer, I could see the phone cord swinging on the other side of another narrow window.

Flat-feet, this morning, I think.

Each day, the spare moments before nine were swallowed by a particular style of walk, appointed by necessity for quiet or difficulty of progression. With three minutes left, I would have to challenge myself with a laborious gait, guaranteed not to deliver me to her an instant before I was due by the terms of my job description. To arrive early is simply to be set upon early; I had discovered that within the first week and grown to resent it before two months had passed. Therefore, any indiscrepancies were resolved by the morning shuffle.

It is very difficult to place each foot evenly on the ground with every step. The natural inclination is to roll from heel to toe in a normal walk; the reverse for a stealthy approach. Planting the entire surface area of the sole takes practice, and is ideal for absorbing my accidental earliness.

Tomorrow, perhaps, I'll walk on the edges.

Even this form of petty vengeance was, for a time, sufficient to make me smile. Though small and ineffectual, at least it was absurd. A college graduate employing the same strategies a six year old might use to prolong his recess. Juvenile. Immature. Ridiculous. How appropriate.

Focusing on my footfalls, I almost forgot that the floorboards begin to creak ten feet away from the office. Happily, her forceful, halting laughter usually masks the approach, and as it is still shy of nine, I was not expected. The theme music to Raiders of the Lost Ark crept into my ears as I carefully avoided the loudest spots in the floor and approached the pool of light, flecks of dust reflecting in the air.

The Posterior Auricular Branch: Auricularis posterior. Arises close to the stylo-mastoid foramen, and runs upward in front of the mastoid process. The auricular branch supplies the intrinsic muscles on the cranial surface of the auricula.

No papers on my desk yet. The computer is still on, the wallpaper a still shot from Casablanca. I'd rather see Rita first thing in the morning, but she told me that was inappropriate. Ingrid, she said, would be fine.

A post-it note on the screen.

The laughter from her office stopped the moment I saw it, as if she'd known I was here all along and had waited deliberately. My ears shifted back on my head at the sudden, penetrating silence. One of us would have to speak first. I could announce myself, or wait to be called. Every second that passed made the next more awkward. I strained to hear through the sliding doors for a sign.

"Are you here? Come in here."

And good morning to you. I reluctantly, almost mournfully, released my bagel, and strapped on my work-face.

Extend horizontally across the lower part of the cheek to an orbit around the mouth.

Her office has blue carpeting. The walls used to be white; she had them redone in a yellowish tapioca . The window trim was done in a thick brown. It was like going to work in a Cadbury Creme Egg.

"Good morning, boss." I presented myself as a smiling soldier, a lieutenant, armed with clipboard, pen, and positive attitude, ready to take down my orders.

My ears recoiled at the first syllable, creeping away from the sound and dragging my scalp.

"I have to go to the airport."

"OK,"I said. "Which one?"

"LaGuardia."

Excellent. A flight out of LaGuardia always meant California, and at least three days. I would have preferred to hear Newark or JFK, as international trips were worth a full week, but leaving on a Tuesday, she'd probably take the weekend as well.

"What time is the plane?"

"Eleven-thirty."

"OK. I'll call for a car."

"I don't want a car."

The Temporal Branch: Rami temporales. Supplying the Auriculares anterior and superior, and joining with the zygomaticotemporal branch of the maxillary. The anterior branches supply the Frontalis and the Corrugator, extending through the forehead and around the eyebrows.

My brow furrowed. This was new. Instinctively, I detected the development of an original unpleasantness, some unnecessary challenge for me brewing in her mind. Limousine sevices had been the way of every previous airport run, with the exception of those impromptu departures that called for hailing a cab. I had spent months gathering a database of car services that could supply a vehicle of not less than twenty feet in not more than thirty minutes. I had arranged mutliple pickups for family members and pets. I had gotten New York City taxis at 4:00pm in the pouring rain.

But she didn't want a car.

"I want to take the train."

The auricular branch supplies the intrinsic muscles on the cranial surface of the auricula.

"What?"

"Don't say 'what.' I want to take the train."

"Is there one?"

"I don't know."

And therein lay the challenge. It was now 9:15am. I had around a half-hour to get her out of the office and onto a train that may or may not have existed. There was no point asking why she didn't want to take a car; that would only take time and generate argument. A train to LaGuardia.

I'd neven taken it. But surely, they'll have one?

Indeed. Almost. The subway will, in fact, get one out to within striking distance. A short bus ride takes you the rest of the way. It took less than ten minutes to find it on the MTA's website.

Printed instructions in hand, I returned to the inner office, hurried on her behalf, as I could not speak accurately to the transit time and refused to entertain the notion of her missing the plane. Had it been me, I simply would have left immediately and sacrificed the remainder of the morning to the terminal. She, however, lightly cast the printout aside and continued her conversation.

The Mandibular Branch: ramus marginalis mandibulæ. Passes forward beneath the Platysma and Triangularis, supplying the muscles of the lower lip and chin, and communicating with the mental branch of the inferior alveolar nerve.

My lips sank into a frown at her disregard for the time. 9:40am now, flight in an hour and fifty. Calm down. Turn away. Breathe deeply.

The anterior branches supply the Frontalis.

Relax. Look out the windows, there's usually someone in a state of undress in the opposite apartment building.

"No."

I had to turn around again, informed by the change of tone that the statement was intended for me. She held the printout in her hands, a curl to her lips, shaking her head.

"I don't want to take a bus."

Serving the superficial facial muscles around the upper lip and corners of the mouth .

"I know, it's a pain, but--"

"I don't want to take the bus."

"Then should I call you a car?"

"No, I don't want a car. I want to take the train."

"You can take the train, but you just have to get on the bus for the last bit, it takes you right there."

"NO."

The Zygomatic Branches: rami zygomatici. Runs across the zygomatic bone to the lateral angle of the orbit. Supplies the Orbicularis oculi, and joins with filaments from the lacrimal nerve.

My eyes shut, just for a moment. Too long would have revealed my frustration. I had to keep it to an extended blink, or I would have been reprimanded for disrespect.

"What would you like to do?"

"I told you. I want to take the train to LaGuardia. But I don't want to get on a bus. I know there's a way you can do that."

Passes forward beneath the Platysma

"No, I don't think there is. You'll have take a--"

"I don't want to take a fucking car. I told you that."

Runs across the zygomatic bone

"Find me a train to LaGuardia."

Supplies the Orbicularis oculi

"NOW."

Supplies the Orbicularis oculi

Supplies the Orbicularis oculi

Supplies the Orbicularis oculi

"What's wrong with your eye?"

Arises close to the stylo-mastoid foramen

"What? Nothing. You have to leave."

"Yes, I know that. How am I getting there?"

supplying the muscles of the lower lip and chin

extending through the forehead and around the eyebrows

"I don't know."

"Oh, Jesus, I'll do it my fucking self."

joins with filaments from the lacrimal nerve

communicating with the mental branch

I took her bags, three of them. My left eye tightened and closed, my lips twisted together and fused. She walked ahead of me, and so remained unaware. The elevator came, we rode down in silence. I had been at work for just under an hour.

runs upward in front of the mastoid process

forming an infraorbital plexus

She slid out of the elevator and through the front of the building. She did not hold the doors open. On the street, the colors blended together beneath a gray cast, and the air was heavy with the scent of dampened dust.

"When I get back, we have to talk about your attitude."

Supplies the Orbicularis oculi
Supplies the Orbicularis oculi
Supplies the Orbicularis oculi
Supplies the Orbicularis oculi

She hailed a cab, stepped in, and was away.

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The course of the facial nerve through the posterior fossa, temporal bone, and parotid gland renders this cranial nerve vulnerable to many neoplastic, traumatic, and infectious events.

When immediate repair in contaminated or extensive wounds is not feasible, proximal and distal stumps should be tagged. The transected ends lose response to electrical stimulation within 72 hours. If not properly identified, these endings may become involved in scar tissue.

Hemifacial spasm or paralysis may be caused by an injury to the seventh cranial, or facial, nerve.

The cause may also be unknown.


All Medical Research material provided by:

http://education.scd.yahoo.com/reference/gray/202.html
http://www.visionchannel.net/hemifacialspasm/
http://www.nlm.nih.gov/medlineplus/ency/article/000756.htm#symptoms
http://www.meddean.luc.edu/lumen/MedEd/GrossAnatomy/h_n/cn/cn1/cnb3.htm

This was not a fictional event.

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