Lucidity

by CJ Lyons

  "And you're still a bigot to this day?"

  "Objection," Vincent's lawyer put in blandly. "Argumentative."

  "In fact, Doctor, the fact that Mr. Nguygen spoke with an accent did not make him an incompetent parent, did it?"

  "No. But he ignored my advice for treatment and left our hospital with a critically ill infant."

  "He came to you for help initially. Is it not true that it was your incompetence which led to Mary's death? Your own inability to adequately communicate your concerns to her parents and obtain consent for treatment which could have saved her life?"

  "He said he understood what I explained to him about her condition. I left for a few minutes to attend to an urgent patient in respiratory distress and when I returned to draw the blood work and do the spinal tap, they were gone."

  "Did you try to call them after they left?"

  "Yes, several times. But the only person who answered the phone did not speak English and hung up on me."

  "So what did you do then?"

  "I finished my shift."

  "You finished your shift. Knowing there was a potentially ill baby roaming the streets of Pittsburgh, you finished your shift and went home to bed. Tell me, Dr. Emberek, did you sleep well?"

  "Objection," Vincent's lawyer said, his tone bored.

  Vincent got to his feet, his anger roiling over. "I did everything I could! I had the nurses call the family during the night. When I came in the next morning and found they hadn't reached the family, I called the police and CYS to report a case of possible medical neglect."

  "But by the time they arrived, it was too late for Mary Nguygen, wasn't it?"

  "What did you want me to do?" Vincent asked. "I wasn't the one who decided to take that baby out of the hospital without treatment--"

  "It's okay, Vincent." His lawyer twisted his wrist, glanced at the diamond studded Rolex there.

  Vincent swallowed his anger and almost choked on it. He would never own a watch like that. Or wear silk suits. All he did for a living was save lives--unless the lawyers took that away from him. If he lost this case, his career was as good as over.

  He'd never be able to face his family, his father's friends--men Vincent had worked side by side with summers since he was sixteen. He'd never have the life he dreamed of.

  "It's late. Shall we resume this later?"

  The other lawyer stared at Vincent a long, hard minute as if assessing if it would be easier to break him now or to let him stew a while.

  "Fine with me." He gathered his papers into a neat stack in front of him. "Don't take it so personally, Doctor." He turned to Vincent's lawyer. "We still on for squash tomorrow?"

  Grace bent and lifted Kat into her arms. "Let's get you to your room," she murmured to the disoriented girl. Often it would take an hour or more for a patient to become fully alert after a generalized seizure like the one Kat had.

  "I didn't wet my pants, did I?" Kat asked, her eyes half closed, her words blurred.

  "No," Grace assured her, moving through the Annex door Alex held open for her.

  "S'okay, then." Kat slumped in Grace's arms.

  She was thin but lanky for her age. Grace was glad that until a few weeks ago she'd been religious in her workouts on the climbing wall Jimmy had built for her. Alex rolled his chair ahead of her and opened the door to the Skyway. Before Grace crossed the threshold, he stopped her.

  "Maybe I should go back to Peds." His eyes went wide as he stared down the length of the Skyway to the entrance to the Extended Care Unit.

  Grace looked down in concern. He was breathing heavily but did not appear to be in any distress. Instead he seemed afraid. His lips had gone ashen and a thin sheen of sweat coated his forehead.

  "What's wrong, Alex?" she asked, shifting Kat's weight in her arms. The girl was getting heavier by the minute.

  "I don't like it over there. The Freak Show, Kat calls it." He cut his eyes to the doors at the opposite end of the Skyway.

  Grace followed his gaze. Hairs standing on end along the back of her neck prickled. Her chest constricted with an effort to breathe that had nothing to do with how heavy Kat was.

  She shivered hard enough that Kat stirred in her arms and mumbled something unintelligible. "All right," she told Alex. "Go back downstairs. I'll take care of Kat."

  She looked down on the wasted boy dwarfed by his wheelchair and its paraphernalia. Suddenly Grace didn't want him anywhere near the ECU. If she could think of a way to keep Kat out of there, she would have taken her somewhere else as well.

  Grace crossed the threshold and took a step onto the Skyway. A jolt of lightning crashed, shaking the glass walkway. Rain beat against the glass, hurled by wind that blew from every direction simultaneously, pounding through the glass walls and into Grace's head, giving birth to a migraine that made her feel faint, the pain was so sharp and sudden.

  She stumbled, catching her breath. Pain as intense as the lightning bolts thundered through her. The sky grew menacingly dark. The only light came from the door to the Annex behind her.

  Grace kept going, pain screaming through her brain, blinding her in a red haze. She'd never felt pain like this before. Maybe the exertion of carrying Kat had caused the delicate blood vessels around the tumor to burst?

  If so, then these might be the last steps of her life.

  CHAPTER 6

  Welcome to the Freak Show

  Grace closed her eyes against the pain and leaned her hip against the railing, using it as a guide as she shuffled down the walkway. If she was going to die, she had to get Kat to safety first.

  You can wait a few minutes longer, can't you, Jimmy?

  Jimmy was silent.

  A hand reached up to touch Grace's arm. Her eyes shot open in surprise. "I'll get the door," Alex said, his voice barely audible over the tympani pounding in her head. He moved past her, opening the door to the seventh floor of the Tower just in time for Grace to stumble through it.

  She leaned breathlessly against the wall on the other side, sliding Kat's limp body onto a love seat upholstered in raw silk. The entrance to the Tower was a lobby with two banks of elevators, just like the entrance to the Annex. But unlike the Annex, there were no scuffed linoleum or cracked tile walls here. Instead, there was Berber carpet and furniture that looked like it belonged in the office of an expensive plastic surgeon.

  The lobby was empty except for the three of them. Two solid mahogany doors stood across from the elevators. The only other door was a fire exit leading to the stairwell.

  "Welcome to the Freak Show," Alex said glumly.

  "Doesn't look so bad," she said, before realizing that her arms were wrapped tight around her chest, warding off something. "Which room is Kat's?"

  "703. Down the hall and to the right." He jerked his chin at the double doors.

  "I can take her if you want to go back downstairs."

  He bit his lip but shook his head vehemently. "You shouldn't go in there alone."

  As she lifted Kat once more, he wheeled forward and opened the thick, wooden door. Grace carried Kat through it, wrinkling her nose against the smell. Not the antiseptic that tinged the air of the rest of the hospital. A sweet scent of carnations and lilies--almost like an expensive French perfume. But too sweet. To Grace it smelled like death.

  She looked down and saw Alex also breathed through his mouth, his nostrils pinched in distaste.

  "This way," the boy said, leading her down a corridor with dark paneling on the walls and expensive reproductions of famous paintings, all with a floral motif. Halfway down the hall there was a receptionist desk, also mahogany. The clerk had his back to them, head bent low as he spoke with someone on the telephone.

  Grace and Alex moved quietly past several large, well-appointed treatment rooms, all of which stood empty. Dinner hour, Grace guessed. She'd lost her appetite.

  At the end of the paneled hallway stood a sturdy metal door with a large lock and a reinforced glass window.

  "What's down there?" she
whispered, feeling like a prisoner trying a jailbreak.

  Alex frowned. "The Beast. Never, never, go there." He led her along another hallway flanked on both sides by patient rooms.

  As they walked, Grace couldn't believe how silent this floor was. Most hospital wards bustled with activity and noise--even ones like the NeuroICU where the patients were comatose. Where was the gossip of nurses and medical staff? The cafeteria workers with their trays, the housekeepers, the bleep of machinery and monitors?

  It was as if they had left the hospital for another world.

  The patient doors were all open and Grace glanced inside the rooms. They also bore little resemblance to the typical hospital room. Instead they were furnished like an upper class hotel room, complete with floral chintz curtains and mahogany sleigh beds.

  In the first room a young woman, painfully thin to the point that Grace expected the lamplight to shine right through her, sat cross-legged on a sofa, leafing listlessly through a fashion magazine.

  "The Skeleton," Alex whispered.

  Grace glanced down, hoping his voice hadn't carried inside the room to the woman. "Hush."

  The woman looked up and Grace immediately saw why the children had given her the name they had. Her face was angular, all sharp planes as if it had been carved from stone, her eyes sunken deep within their sockets, reminiscent of a cadaver's. The woman met Grace's eyes with no expression, as if she were in a drunken stupor. Her mouth parted in a rictus-like smile. Thin, pale lips peeled away to reveal rotten, stained teeth, gums shrunken to the point that her teeth appeared ready to fall out of their sockets.

  Grace hurried past. Severe anorexia and bulimia, she diagnosed. Teeth rotting from purging, skin thin from lack of body fat and muscular wasting.

  The woman's body was essentially cannibalizing itself.

  The room across the hall was occupied by a middle aged man pacing back and forth, almost colliding with the wall before pivoting in a burst of energy. He mumbled to himself, touching each finger as he made a point, head swinging back and forth and shoulders hunched with the weight of the world.

  "Mr. Atomic," Alex said.

  Grace looked again, then smiled. These kids were good. The man showed all the symptoms of chronic, severe anxiety--symptoms she knew intimately well herself. In addition, she could see his neck veins bulging, the dangerous ruddy complexion of a severe case of high blood pressure. Indeed a patient ripe to "explode".

  They arrived in Kat's room and Grace gently deposited her on the bed. Kat immediately rolled over and curled up in a small ball.

  Grace went to close the door but Alex stopped her. "Don't do that," he whispered.

  "Why not?"

  He pointed up at the ceiling. A video camera hung at an angle where it could take in the entire room. "That turns on whenever the door's closed."

  Grace nodded. She could understand the need for close monitoring--especially patients like the anorexic who could potentially hurt themselves. But every room?

  Kat rustled in her sleep. Grace leaned over, stroking her arm, soothing her. "What is this place?"

  "I like to think of the Extended Care Unit as my own version of Never-Never Land," Eve confided to Vincent when she met him at the reception desk of the ECU after his deposition. "A place where dreams come true." He smiled at that. She linked his arm in hers and led him into one of the treatment rooms. "A lot of our patients have no hope when they come here. We're their last chance."

  "I never knew you were such a romantic, Dr. Warden," he said and was rewarded by a brilliant smile.

  "Eve, please."

  He gave her a long look. She effortlessly met his gaze. As if they both knew how this would end. "Eve."

  "Usually I'm not. Romantic, I mean. Ask Jonas sometime, he'll tell you I'm as cold hearted as they come."

  Vincent frowned at the mention of the neurosurgeon. "Think I'll pass on that. I'm trying to stay on the Chief's good side."

  "Your presentation on Katherine Jellicle was a good start. Now, if you can convince her to stop sabotaging her readings, that will go a long way to getting in his good graces."

  "I thought you were going to use your miracle drug, Lucidine, on her."

  Eve's lips turned down in a small frown. He'd never met a woman before whose frown was as endearing as her smile. "I already tried. Last week when I realized we weren't getting enough data to complete her brain mapping. She had a," she hesitated slightly, "adverse reaction. She's not a good candidate."

  "Are there problems with Lucidine?"

  "No, the drug is perfectly safe. But, as with any treatment, it's not 100% effective for every patient. Some respond better to it than others." She pulled the chart for her next patient and handed it to Vincent. "Like Mr. Barbarosa."

  Vincent flipped the chart open and saw a photo taped to the inside cover. A man, only in his mid thirties, but grotesquely obese. He scanned the pertinent data on the initial history. 456 pounds, compulsive eating, not responsive to drugs or psychological therapy, failed gastric stapling, heart failure, hypertension, diabetes, renal involvement, fatty liver. At thirty-four, Mr. Barbarosa was a train wreck with more health problems than many men twice his age.

  Eve flipped to the last page of the chart, a progress note of their last session. "Weight now 328 pounds, blood pressure normal, diabetes under control, cholesterol improved. All in six months."

  Vincent nodded his head. "Impressive. Was he in the hospital for the entire time?"

  "The first four months. Mainly because of all of the medical complications of his obesity. They were even contemplating possible dialysis at one point. Now he comes in twice a week for Lucidine therapy."

  "How does it work?"

  She crooked a finger at him, smiling. "Come and see. He should be ready for us next door."

  They moved into the treatment room beside them. Mr. Barbarosa wore loose fitting sweat pants and was lying on a comfortable recliner. A nurse taped electrodes to his chest. Floppy layers of skin cascaded from his chest and abdomen, a result of his rapid weight loss. Vincent wondered if plastic surgery was next on Mr. Barbarosa's schedule. The drapes of skin, although much healthier, were almost as disgusting to look at as the rolls of fat they had replaced.

  "Hey doc!" he greeted Eve, obviously delighted to see the physician who provided him with such a miracle cure. "Lost another six pounds since last week. And never felt hungry once!"

  "That's great, Bernie," Eve told him with a warm smile as she checked his vitals. "I think after today we'll try just once a week sessions."

  Bernie frowned. "You sure? I really look forward to coming here. It's the only place where nobody stares at me."

  Vincent hastily averted his gaze. He had been staring. The man's progress was remarkable, but Vincent still didn't understand how an anesthetic drug had affected such tremendous results.

  "Bernie, this is Dr. Emberek." Eve made the introductions. Vincent stepped forward to shake Bernie's hand. It was surprisingly small and delicate compared to the bulk of his body. "He'd like to observe today's session."

  "Sure, no problem." Bernie settled back in his recliner. "Let's go."

  Vincent watched as Eve slipped a gold wiremesh cap over Bernie's head, securing the electrodes carefully around his scalp. She then fitted him with special goggles and earplugs, all wired to the same machine as the electrodes. Finally she placed a mask over his nose.

  "Patients breath more shallowly while on Lucidine," she told him. "So I like to augment their respirations with a little oxygen and positive pressure."

  She nodded to the nurse who began running the infusion of the anesthetic. Within seconds, the patient's body became limp. "It's all right to talk, he can't see or hear anything except the stimuli I send him. But don't touch him. Lucidine blocks external pain receptors but not light touch."

  "So he's kind of in a state of sensory deprivation?" Vincent asked, trying to understand.

  "Except for the sensory data I send him, yes. He's paralyzed, entering a relaxe
d state not dissimilar from hypnosis." She pointed to the brainwave activity on the computer screen in front of her.

  "Now I'm going to start his input." The computer screen divided and began to flash still photos interwoven with video clips. Photos of Barbarosa before he lost weight, lying ill in a hospital bed, standing nude from every angle, shoving food in his mouth. From the speakers came an audio commentary in the patient's own voice describing how miserable he was, that he never wanted to go back to that life.

  Vincent frowned as he watched the EEG waves; several sharp spikes coincided with the images of Barbarosa eating, as if his brain were being stimulated by the images. "Are you doing that?" he asked, pointing to a spike.

  "He's doing it to himself. Remember Pavlovian conditioning from freshman psych? Do something bad you get punished, do something good you get rewarded. Repeat often enough and the unwanted behavior is extinguished and a new behavior, a desired behavior replaces it."

  Vincent nodded. About as basic psychology as it came. Even worked on dogs and other animals.

  "We start by using Farwell brain mapping to identify the individual's pain and pleasure centers and what triggers them, specifically anything we can use to modify the patient's condition."

  "Like a sight or smell or sound?"

  "Right. Then I use those stimuli to reinforce a healthy response to the stimuli. The first few weeks of therapy are intense, several hours a day, but over time the patient's own brain learns how to correct the aberrant response on its own."

  "Kind of like brainwashing?" Vincent joked.

  She looked up at that, frowning. "No, of course not. It's an extremely humane way to treat behaviors that otherwise would lead to self destruction."

  He loved the way her eyes blazed as she defended her work. A blush colored her cheeks as well, giving her a glow.

  "I'm sorry, I didn't mean to imply--"

  "Vincent," she interjected, her voice intense. "Think of the possibilities. No more depression, anxiety, suicide. Think of a world with no pedophiles, no homicidal urges, most psychiatric illnesses cured. And so many medical ones as well--how many diabetics could be saved if they were more compliant with diet and medication? How about hypertension? Patients with chronic diseases like Lupus? Or transplant patients--a few sessions of Lucidine therapy and they'd never have to worry about falling back into bad habits that may aggravate their illness--"