A secretary entered the immaculate office, bringing in cups and a pot on a tray.
“Excellent,” Santizo said. “On time. My herbal tea. Would you care for … ?”
“Yes,” Akira said. “I'd like some.”
“I'm afraid it's less strong than you're used to in Japan.”
Akira bowed. “I'm sure it's refreshing.”
Santizo bowed in return. “I went to Harvard with one of your countrymen. I'll never forget what he said to me. We were both just starting our internships. The long, brutal hours wore me down. I didn't think I'd survive. Your countryman said, ‘When you're not on duty, you must find an exercise you enjoy.’ I told him I didn't understand. ‘If I'm already tired, why would I want to exercise?’ You know what his answer was? ‘Your fatigue is caused by your mind. You must combat that fatigue by physical fatigue. The latter will cancel your former.’ That made no sense to me. I told him so. He responded with one word.”
“Wa,” Akira said.
Santizo laughed. “Yes! By God, you remind me of your countryman!”
“ ‘Wa’?” Rachel asked, assessed the word, and frowned. As everyone looked at her, she reached self-consciously for a cup.
“It means ‘balance,’” Akira said. “Mental fatigue is neutralized by …”
“Exercise,” Santizo said. “How right your countryman was. It's tough to find time, and after the days and nights I put in, I'm usually so exhausted I hate to do it. But I have to do it. Because racquetball makes me abetter neurosurgeon.” Preoccupied, he glanced at his watch. “And in fifty minutes, I'm due at the court. So show me these supposedly baffling X rays.”
He took the oversize folder. “Hey, don't look depressed. Remember ‘wa.’ Racquetball and neurosurgery. Sherlock Holmes.”
2
“Mmmmm.”
Santizo stood in a corner of his office, glancing back and forth at two X-ray films of skull profiles that he'd clipped onto a fluorescent screen.
He'd been studying the films for several minutes, his arms crossed, listening to Savage's explanation of the events that had brought them here.
“Executive protectors?” Santizo continued to assess the films. “It sounds like the two of you have a fascinating profession. Even so …”
He turned toward Savage and Akira, took a penlight from his shirt pocket, and examined the left side of each man's head.
“Mmmmm.”
He sat behind his desk, sipped his herbal tea, and thought a moment.
“The surgeon did an excellent job. State of the art, Mind you, I'm referring only to the cosmetic aspects of the procedure. The skillful concealment of the fact of the surgery. The minimal calcification around the portion of each skull that was taken out and then replaced. You see, the standard method is to drill holes in the skull, at the corners of the area to be removed. These holes are carefully calculated so the drill doesn't enter the brain. A thin, very strong, very sharp wire is then inserted into one of the holes and guided along the edge of the brain until the wire comes out another hole. The surgeon grips each end of the wire and pulls, sawing outward through the skull. He repeats the process from one pair of holes to another until the segment of skull can be removed. The wire is thin, as I explained, but nonetheless not thin enough to prevent the demarcation between the skull and the segment that's been removed and later replaced from developing obvious calcification. Even without that calcification, the holes in the skull would be impossible to miss on an X ray. In this case”—Santizo rubbed his chin—“there aren't any holes, only this small circle as if a plug of bone had been removed and then replaced. The demarcation between the plug and the skull is so fine that calcification is negligible. I'm surprised the general practitioner you went to detected the evidence. Someone not prepared to look for it might not have seen it.”
“But if a standard technique wasn't used, what was” Savage asked.
“Now that's the question, isn't it?” Santizo said. “The surgeon could have used a drill with a five millimeter bit to make a hole the same size as this plug. But he wanted a technique that wouldn't leave obvious signs. The only solution that occurs to me is …The plug was removed from the skull by a laser beam. Lasers are already being used in such delicate procedures as repairing arteries and retinas. It's only a matter of time before they become common procedure in other types of surgery. I've experimented with them myself. That's what I meant—this was state of the art. There's no doubt—in terms of getting in and out, whoever did this was impressively skilled and knowledgeable. Not uniquely so, I should add. Among the top neurosurgeons, I know at least a dozen, including myself, who could have concealed the evidence of the procedure equally well. But that's a superficial test of excellence. The ultimate criterion is whether the surgeon accomplished his purpose, and because we're not aware of why the surgery was required, I can't fully judge the quality of the work.”
“But”—Akira hesitated—“could the surgery explain … ?”
“Your dilemma? Perhaps,” Santizo said. “And then again maybe not. What was the term you used? The opposite ofdéjà vu?”
“Jamais vu,” Savage said.
“Yes. Something you think you've seen, but you've never seen. I'm not familiar with the concept. But I enjoy being educated. I'll remember the phrase. You realize”—Santizo set down his teacup—“that if it weren't for these X rays, I'd dismiss you as cranks.”
“I admit what I told you sounds bizarre,” Savage said. “But we had to take the risk that you wouldn't believe us. Like you, we're pragmatists. It's our business to deal with facts. Physical problems. How to get our principal safely to his or her destination. How to anticipate an assassin's bullet. How to avoid an intercepting car. But suddenly the physical facts don't match reality. Or our perception of it. We're so confused, we're not just nervous—and it's normal for us to be nervous. We're scared.”
“That's obvious,” Santizo said. “I see it in your eyes. So let me be honest. My schedule's so crowded the only reason I agreed to see you was that my former classmate asked me. He thought I'd be intrigued. He was right. I am.”
Santizo glanced at his watch. “A half hour till I'm due for my racquetball game. After that, I need to make rounds. Meet me back here in”—he calculated—“two and a half hours. I'll try to arrange for a colleague to join us. Meanwhile, I want you to go to Radiology.” He picked up his phone.
“More X rays? To make sure the first sets are accurate?” Savage asked.
“No. I'm ordering magnetic resonance images.”
3
A frail-looking man with a salt-and-pepper beard, wearing a sportcoat slightly too large for him, was sitting across from Santizo when they returned. “This is Dr. Weinberg,” Santizo said.
They all shook hands.
“Dr. Weinberg is a psychiatrist,” Santizo said.
“Oh?” Savage's back became rigid against his chair.
“Does that trouble you?” Weinberg asked pleasantly.
“No, of course not,” Akira said. “We have a problem. We're eager to solve it.”
“By whatever means necessary,” Savage said.
“Excellent.” Weinberg pulled a notebook and a pen from his sportcoat. “You don't mind?”
Savage felt ill at ease. He tried never to have his conversations documented but was forced to say, “Make all the notes you want.”
“Good.” Weinberg scrawled several words. From Savage's perspective, they looked like the time and date.
“Your MRI scans are being sent up to me,” Santizo said. “I thought, while we wait, Dr. Weinberg could ask you some questions.”
Savage gestured for Weinberg to start.
“Jamais vu.The term is your invention, I'm told.”
“That's right. It was all I could think of to describe my confusion.”
“Please elaborate.”
Savage did. On occasion, Akira added a detail. Rachel listened intently.
Weinberg scribbled. “So to summarize. You both thought
you saw each other die? You failed to find the hotel where the deaths supposedly occurred? And you can't find the hospital where you were treated or the physician in charge of your case?”
“Correct,” Savage said.
“And the original traumatizing events took place six months ago.”
“Yes,” Akira said.
Weinberg sighed. “For the moment …” He set down his pen. “I'm treating your dilemma as hypothetical.”
“Treat it any way you want,” Savage said.
“My statement was not antagonistic.”
“I didn't say it was.”
“I'll explain.” Weinberg leaned back in his chair. “As a rule, my patients are referred to me. I'm given corroborating documents. Case histories. If necessary, I can interview their families, their employers. But in this instance, I really know nothing about you. I have only your word about your unusual—to put it mildly—background. No way to confirm what you claim. No reason to believe you. For all I'm aware, you're pathological liars desperate for attention or even reporters testing the gullibility of what the public calls ‘shrinks.’ “
Santizo's eyes glinted. “Max, I told you their story—and their X rays—intrigue me. Give us a theory.”
“As an exercise in logic,” Weinberg said. “Purely for the sake of discussion.”
“Hey, what else?” Santizo said.
Weinberg sighed again, then spread his hands. “The most likely explanation is that you both experienced, you're suffering from, a mutual delusion caused by the nearly fatal beatings you received.”
“How? The X rays show we weren't beaten,” Savage said.
“I disagree. What the X rays show is that your arms, legs, and ribs weren't broken, that your skulls weren't fractured as you believed. That doesn't mean you weren't beaten. I'll reconstruct what conceivably happened. You both were assigned to protect a man.”
“Yes.”
“He went to a conference at a rural hotel. And while he was there, he was killed. In a graphically brutal manner. With a sword that severed his torso.”
Akira nodded.
“In the process of defending him, the two of you were beaten to the point of unconsciousness,” Weinberg said. “On the verge of passing out, you each were tricked by your failing vision into thinking mistakenly that the other was killed. Inasmuch as neither of you died, something caused the hallucination, and the combination of pain and disorientation is a logical explanation.”
“But why would they both have the same hallucination?” Rachel asked.
“Guilt.”
“I don't follow.” Savage frowned.
“If I understand correctly, your profession means more to you than just a job. Obviously your identity is based on protecting, on saving lives. It's a moral commitment. In that respect, you're comparable to devoted physicians.”
“True,” Akira said.
“But unlike physicians, who inevitably lose patients and are consequently forced to put a shell around their emotions, I gather that both of you have had remarkable success. You've never lost a client. Your success rate has been an impressive one hundred percent.”
“Except for …”
“The events in the rural hotel six months ago,” Weinberg said. “For the first—the only—time, you lost a client. A major threat to your identity. With no experience in dealing with failure, you weren't prepared for the shock. A shock that was reinforced by the vividly gruesome manner of your client's death. The natural reaction is guilt. Because you survived and your client didn't. Because your client's safety meant everything to you, to the point where you'd have sacrificed yourself to save him. But it didn't turn out that way. He died. You're still alive. So your guilt becomes unendurable. Your subconscious struggles to compensate. It seizes on your murky impression that your fellow bodyguard died as well. It insists, it demands, that your client couldn't possibly have been defended if both he and your counterpart were killed and you, too, nearly died in your heroic but demonstrably futile effort to fulfill your vocation. Given your similar personalities, your mutual hallucinations are understandable, even predictable.”
“Then why can't we find the hotel?” Savage asked.
“Because deep in your mind you're struggling to deny that your failure ever took place. What better way than to convince yourselves that the hotel, where your failure occurred, doesn't exist? Or the doctor who treated you? Or the hospital where you recovered? They do exist, at least if your account is authentic. But they don't exist where your urge for denial compels you to search.”
Savage and Akira glanced at each other. As one, they shook their heads.
“Why”—Akira sounded skeptical—”did we both know where the hotel ought to be? And the doctor? And the hospital?”
“That's the easiest to explain. You reinforced each other. What one of you said, the other grasped at. To perpetuate the delusion and relieve your guilt.”
“No,” Savage said.
Weinberg shrugged. “I told you, this was all hypothetical.”
“Why,” Akira asked, “if our arms and legs weren't broken, were we put in casts? Why did we endure the agony of rebuilding our muscles for so many terrible months?”
“Casts?” Weinberg asked. “Or were they immobilizers required to help repair ligaments detached from your arms and legs? Were the casts on your chests actually thick, tightly wound tape that protected bruised—but not broken—ribs? And possibly your bandaged skulls indeed had fractures, hairlines that healed so perfectly an X ray wouldn't detect them. You admit you were given Demerol. It affects one's sense of reality.”
“Certainly,” Rachel said. “And of course I wasn't there. I didn't experience their pain. I grant I'm fond of these two men. We've been through a lot together. But I'm not a fool, and of the three of us, I'm the one with the best claim to be objective. My friends have not been reinforcing each other's delusions.”
“Well, of course you've heard of the Stockholm principle,” Weinberg said. “People under stress tend to identify with those they depend on for their safety.”
“And of course you've heard of the ostrich principle,” Rachel said. “A psychiatrist who puts his head in the sand because he can't acknowledge a problem he's never heard of before.”
Weinberg leaned forward, scowled, and abruptly laughed.
“You were right,” he told Santizo. “This is amusing.”
“You're sublimating, Max. Admit it. She made you angry”
“Only hypothetically.”
Now Santizo laughed. “Hey, of course. Let's write a hypothetical article. About the phenomenon of being hypothetically angry.”
“What's going on?” Savage asked.
Santizo stopped laughing. “A test. To determine if you were cranks. I had no choice. And Max is wonderful. A gifted man with a marvelous mind and a talent for acting.”
“I wasn't acting,” Weinberg said. “What I've heard is so bewildering I want to hear more.”
Someone knocked on the door.
Santizo pivoted. “Come.”
A secretary, who'd brought in the teacups, now brought a large brown folder.
“The MRIs.” Santizo stood.
Two minutes later, he turned from the films. “Thanks, Max. I'll take it from here.” “You're sure?”
“Yes. I owe you a dinner.” Santizo faced the MRIs. “But the problem's back to me. Because psychiatry won't explain this.”
4
Savage stood next to Akira and Rachel, studying the dusky films. Each had twelve images, arranged in four rows and three columns. They made little sense to him, harder to read than the earlier single-image X rays.
“Beautiful,” Santizo said. “I couldn't ask for clearer pictures.”
“You could have fooled me,”Akira said. “They look like ink blots.”
Santizo chuckled. “I can see where you'd get that impression.” He studied the films again. “That's why, to help you understand, I have to begin with some basics, though I'm afraid the basics
will still sound technical…An MRI scan is an advanced technique of photography, based on magnetic resonance, that allows us to see past your skull and into your brain. It used to be that the only way we could get pictures of your brain was with a CAT scan. But a CAT scan isn't detailed enough, whereas these are the next best thing to actually opening up your skull and having a look. We take so many pictures from so many different angles, the combined result provides the illusion of 3-D.”
“But what have you learned?” Akira asked.
“Just bear with me a little longer,” Santizo said. “The brain has many parts.” He gestured toward portions of the MRIs. “The right hemisphere. The left hemisphere. Paradoxically the right hemisphere controls the left side of the body, and vice versa. Our ability to think spatially comes from the right hemisphere, our verbal skills from the left. The hemispheres are divided into parts. The frontal lobe. The parietal lobe. The occipital lobe. The temporal lobe. And these in turn contain numerous subparts. The visual cortex. The olfactory tract. The somatic sensory area. The pituitary gland. Et cetera. What makes this awesomely complex organ work is the presence of billions of interconnecting nerves that transmit energy and information. These nerves are called neurons. They're analogous to electrical wires and telephone cables, but that's a simplification. No analogy can truly describe them…. By the way, have you ever had epilepsy?”
The question was so unexpected that Savage blinked.
“Epilepsy? No. Why? What makes you ask?”
“I'm trying to account for something.” Santizo pointed toward a dark speck on a light portion of one of the images. The speck was on the left, near the middle. “This is a view of your brain from the rear. That speck is in your mesial temporal lobe—the amygdala hippocampal area. It's in line with the plug of bone that was taken out and then replaced in your skull.”
Savage felt as if he'd swallowed ice. “Speck? Jesus, what—?”
“A lesion. That's why I asked about epilepsy. An abnormality in this area sometimes causes that condition.”
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