Mr. Nobody

by Catherine Steadman

  “Nurse!” he barks at Rhoda.

  She gasps and she begins to step forward, then remembers that her shift is over. Technically, she shouldn’t even be here. She holds back a moment, watching the doctor’s hopeless attempts to pacify her patient. “Sir?” he says. “Sir, I’m going to need you to calm down please. Sir!”

  Rhoda takes a breath and makes a decision. She pushes her way back to the gurney, leans over to look down at the struggling man’s face. Then, carefully, she places both hands on either side of his head, a hand on each cheek. Seeing her, he stops struggling.

  “Easy now. Easy now,” she croons. She slips his oxygen mask back over his mouth and nose.

  It’s just the two of them. The rest of the scene disappears. The whoosh of air in his oxygen mask. His heartbeat thundering in his ears.

  The patient lets his body relax back into the thin mattress beneath him. He breathes. He looks up into Rhoda’s warm brown eyes and blinks.

  “Look,” the doctor says, “I know it’s not your department and I know your shift’s over, but this will all be so much easier with you here. It just will. I don’t know how we’re going to get him in the scanner otherwise. We’d need another two members of staff just to hold him down. If I ring down to Triage and let them know what’s happening, will you stay for the scan?”

  Rhoda peers over the doctor’s shoulder. The clock on the wall behind him reads 8:37. She’s missed the handover in Triage anyway. And Annie will figure out what’s happened if she’s a couple of hours late to pick up Coco. It should be fine.

  Rhoda stays.

  The man lies quietly in the creamy bulk of the CT scanner as it swirls around him. He breathes as Rhoda told him to. He tries to remain calm. He thinks of Rhoda’s face looking down at him earlier. He knows she’s not the one, not the one he’s looking for, but she’s all he has right now. He lies motionless as the machine accelerates around him, the sound of an airplane pounding down the runway seconds from catching the air and taking flight. A sound memory that seems to have no source as he interrogates it further. He squeezes his eyes shut tighter and tries not to think about everything else he can’t remember. He tries to clear his mind.

  The man is retracted from the machine by a whir of mechanisms. Rhoda lifts his head from the plastic frame and gently removes his earplugs. With the help of a female radiology nurse they transfer him back to his trolley.

  Behind the glass of the suite the radiologist stares down at the images loading up onto his screen. The shadowy slopes and ridges of the patient’s brain tissue mapping out digitally before him. His eyes trip quickly, darting over the images as he looks for diffusion, patches of nebulous white, which could be signs of a stroke. Or a cranial bleed. Either could explain the patient’s erratic behavior after a head wound.

  No diffusion, no bleeds.

  But there. A tiny flare of white. Something. Maybe.

  A neurologist is summoned. This man is older, his movements slower as he leans in and studies the scan.

  “Ah, interesting,” he says. But he does not sound interested. “I think we should call Dr. Carver, actually,” he says, removing his glasses. “This is more his sort of thing. Carver will have a better idea. Best page him.” He smiles a placatory smile and leaves.

  The man on the gurney is moved onto a temporary open ward with five other patients. Rhoda makes him as comfortable as she can. He looks across at her sitting next to his bed, the ward bustling around them, patients in various stages of illness and recovery going about their bedbound days.

  Rhoda gives her patient a quiet smile; he smiles back. And that is when the man three beds down starts to shout.

  And what happens next happens very quickly.

  12

  DR. EMMA LEWIS

  DAY 7—IN THE DARK

  The winter light starts to fade outside Cuckoo Lodge.

  I perch on the front garden bench watching as the sun dips beneath the densely packed treetops. Smears of pinks and peaches streak the sky and the forest is full of evening birdsong. I check my watch: four-thirty, much earlier than I would have expected sunset to be, but then, it’s been a while since I’ve seen an actual sunset. At this time of day, I’m usually stuck deep within the bleached white bowels of an overlit hospital. The cold from the flagstones underfoot is beginning to seep up through the wool of my fisherman socks. A shiver runs through me. I wrap the cashmere blanket I brought out tighter around me. I suppose I’d better go inside. I gather my things and start to head in. I throw a glance out into the close-packed forest, the tangle of branches just visible between trees, the murk beyond. A Rorschach test in the woods.

  It got dark so quick. And no one wants to be alone in the forest, in the dark, that’s for damn sure.

  * * *

  —

  Time to turn on some lights. I lock the door and flit from one room to the next, flicking on lights, their warm glow creating company of sorts.

  Next I set about getting a fire going. The woodstove in the living room is beautifully stacked and ready to be lit, the handiwork of some poor assistant, no doubt, along with the fully stocked fridge. I needn’t have worried about running short of supplies out here. I’m basically a bear ready to settle in for winter.

  And for some reason I’ve also been supplied with my own brand-new wellies. I found them box-fresh waiting by the back door. God knows how they knew my size. Actually, now that I come to think of it, they probably got that information from the hospital, which has my scrub sizes. Someone has really thought of everything. Peter and whoever. I suppose, as far as Peter’s concerned, the less reason I have to leave the house, the better.

  The fire crackles to life, leaping from paper to lighter brick to kindling. I close the woodstove’s door, then go in search of Peter’s “Welcome” half-bottle of wine in the kitchen. Just to warm me. Just to settle those first-night nerves and send me off to sleep at a sensible hour. Because, God knows, tomorrow is going to be one hell of a first day at work.

  I curl up on the Persian rug in front of the flames, glass in hand, and sip my wine, the patient’s medical records spread out all around me.

  There’s a lot to go through, yet as I sit there surrounded by the sea of papers, the case feels more manageable somehow, like a puzzle that I might actually be able to solve, piece by piece, a thousand-piece jigsaw that just needs time and focus. My patient a tangled knot to be gently loosened. Peter was right, I do prefer working with hard copies. I like being able to see what I have.

  I pore over the test results again, eyes flicking from the patient’s CT scans and the newer MRI scans on my laptop, to printouts of blood tests, cerebrospinal fluid analysis, virology reports, and hormone levels.

  A clearer medical picture is starting to form of my patient. Just the edges at the moment, but the tests and scans he’s already undergone show me the faintest outline of something already.

  Here’s what I know. His brain is not physically damaged—that much is evident. The concussion he arrived with a week ago has left no lasting damage. There are other potential physiological causes that could be in some way responsible, which I can and will start testing for tomorrow. He may suffer from epilepsy or a nutritional deficiency; he may suffer from a non-related condition that requires medication, the side effects of which could somehow be responsible for his memory loss. Testing for outlying conditions would certainly be worthwhile. I jot down a quick list of possible tests in my notepad. Some screenings we’ll have to send away for results. Princess Margaret Hospital, where I’m heading tomorrow, isn’t big; its resources are acceptable, but they’re nowhere near London standards.

  The tiny fleck I noticed when Peter first showed me the CT scan is clearer on these new MRI scans. Pituitary cysts aren’t uncommon. Most people can live and die without ever even knowing they have a cyst on their pituitary gland; these cysts only tend to get found accidentally when
doctors are scanning for other things, and are rarely a cause for concern. However, if this cyst had recently fluctuated in size and exerted pressure on a neighboring area of the brain, it could be in some way responsible. But it’s unlikely. The area of the brain responsible for memory retrieval, the hippocampus, is nowhere near the pituitary, so I’m not sure exactly how the cyst could directly affect it. But it’s certainly strange that other fugue cases have had similar growths. Something to look into further. I note it down. The speck is something to monitor but, at this stage, I’m happy to put it on the reserve bench in terms of possible causes and instead consider it a potential symptom, or anomaly.

  If I’m totally honest I’m already erring on the side of this not being a physiological condition. The scans show the patient’s hardware is intact. If he were a computer and you took him to the Apple Genius Bar, they’d tell you it’s a software problem.

  So, assuming the patient’s hardware isn’t broken, then we’re looking at a software problem. Psychological trauma.

  And mental trauma isn’t that unusual a cause of memory loss. Post-traumatic stress disorder being the prime example; whether it’s soldiers back from war or children in the care system, PTSD is a lot more common than people think.

  Up until fairly recently, in medical terms at least, the general wisdom was that psychosomatic illnesses were controlled by the sufferers. As if somehow the patient could just “pull themselves together” and then they’d miraculously recover and return to their normal lives. These days we know better. Psychosomatic illnesses are software errors, not user errors. If a patient’s memory loss is due to psychological trauma, he would have about as much control over his illness as you would have over a system failure on your laptop. No matter how much you wanted those wiped family photos back, they are locked in that old hard drive and you’re going to need a lot of patience and a pretty pricey specialist to help you get them out of it.

  I take another sip of wine. The good news is that memory loss caused by psychological trauma is often only temporary. It tends to return over time once the real or perceived threat is removed. Patients slowly begin to regain memories—the trick is making sure the patient is in a safe and therapeutic environment when those memories, good and bad, do resurface. Or the consequences can be troubling.

  A week ago, something very bad may have happened to this man. If he’s been through intense trauma, then hopefully, now that he has some distance from it, we should be in a position to help him remember what happened. Or, at the very least, help him move on from it.

  I start to draw up my plan of action for tomorrow. I need to be prepared. This is important, for me and for him. We can’t afford to mess this up, not with the whole country watching. My pen glides fast in wide loops and curls across my yellow legal pad as I pour out my ideas.

  The low lights in the living room flicker.

  I glance up at the lamp nearest me. It glows steadily. But there was a flicker before, I’m sure of it. A break in the electric current. I stare at the bulb. It flickers again, like a moth against glass, then all the lights in the room and through the hallway flicker back in response. Oh no. No, no, no. Not the lights…

  And as if the thought were a wish, the whole house plunges into darkness.

  * * *

  —

  It’s just the fuse box, I tell myself. Houses aren’t haunted, people are.

  The edges of the room are no longer visible; armchairs, bookcases, and cushions have been swallowed up into the darkness. The kitchen is nothing more than a black void beyond the archway. Only the firelight remains, carving deep shadows into the space.

  My pulse is racing high and fast in my chest. Jesus. There is only darkness all around me.

  These things happen all the time in the countryside, I tell myself. These things happen all the time in remote cottages deep in the woods.

  It takes my eyes a fraction of a second to adjust to the light of the fire.

  I hear a noise outside, low and animalistic, a creature, a fox perhaps. I look to the patio doors, suddenly keenly aware of all the life outside this cottage. I realize that up until this moment I’ve been lit up like a Christmas tree in here, exposed for all to see. But in the dark glass I see only myself. My own ghostly face looking back at me, reflected, flickering in firelight. I quiet my breath and listen again for noises outside; I listen so hard the room buzzes with silence and the popping fire.

  It’s just a power failure. Grow up, Em.

  I’d better find a flashlight and the fuse box and hope it’s just that. If it’s not, then it looks like I’ll be heading to bed. I know from experience that you can’t do anything useful after dark during a power outage.

  I find a flashlight under the sink in the kitchen and head for the basement.

  My mind creeps back to Holt again, to our old house. The staircase downstairs into the dark, the glow of a light from the study, the sound of dripping. I shake the memory away, shuddering.

  It’s colder in the basement, the air damper. Shadows leap and dance at the corners of my vision. I remember the thick pooling of dark arterial blood, from long ago, the sound of breath rasping behind me.

  Stop it, Em. Stop it.

  I throw the switch on the electric panel and the house leaps back to life. The darkness vanishes and I’m standing in a basement laundry room. No spiderwebs and rot here, just appliances and laundry detergent.

  I guess I overloaded the circuit turning on all those lights. Lesson learned.

  13

  THE MAN

  DAY 1—MR. GARRETT

  Rhoda watches as the situation unfolds.

  There was nothing out of the ordinary about him at first, just another patient sleeping three beds down from Rhoda and her patient. He woke and shuffled awkwardly up to sitting, under the covers, his bleary eyes taking in the ward around him, perplexed.

  A young nurse along the ward noticed him waking too; her eyes flicked out toward the corridor, apprehensive, before she made her way over to the waking man.

  Rhoda watches as the young nurse places a gentle hand on her patient. He frowns. “Where is she?” Rhoda hears him ask the nurse, his eyes scanning the beds around them. “Where’s Claire?”

  Rhoda doesn’t hear the young nurse’s reply but she recognizes the expression on her face as she quietly speaks to the older man.

  Rhoda knows that bereavement notice needs to take place in a private consultation suite, with a doctor or with a member of the bereavement care team. You can’t give it on the ward. The young nurse will be asking her patient to wait for the doctor to arrive.

  “I don’t need the doctor.” His voice is tight and hoarse, a trill of panic running through it. “I just need to know where my daughter is.”

  Rhoda remembers his details from the Triage board last night. A car accident. A drunk-driving collision. The drunk driver had walked away with only bruises, but this man and his teenage daughter had sustained severe injuries. Rhoda’s eyes float up to the name on the whiteboard above his bed. Mike Garrett.

  Although she can’t hear the nurse’s words, it’s clear to Rhoda from the nurse’s body language that the daughter didn’t make it. Rhoda feels a deep ache in her chest. The worst news to give, the worst news to get.

  “I don’t need a doctor to tell me where she is, you can tell me. For God’s sake, just look on your system or something. You can tell me that, can’t you?” A few more eyes swivel onto the scene. “I want to know where my daughter is! Do you understand? I DON’T CARE IF THE DOCTOR’S ON HIS WAY!”

  Hearing a raised voice, the duty nurse pops her head around the ward doorway and quickly makes sense of the scene. She makes a decision and calmly heads over to join the young nurse at the red-faced Mr. Garrett’s bedside.

  “Can I help, Mr. Garrett?” she asks, her tone kind, delicate.

  “Yes, I want to know where my d
aughter is.”

  The duty nurse takes a breath and looks down, and when she looks up at him again his breath catches in his throat. Finally, he sees in front of him what Rhoda sees, two impotent nurses trying not to tell him that his daughter died from her injuries.

  “Oh God. Oh God.” He tries to choke back the sobs, wild eyes unseeing. “She’s gone, isn’t she? My God.”

  The duty nurse gives the younger nurse a look and starts to curtain off the bed. “I’m sorry, Mr. Garrett. I’m so sorry. If you can just wait until the doctor gets here, we can—”

  But Mr. Garrett is already pulling back his sheets. He staggers up out of bed onto unsteady feet.

  “No, no, no. I wanna know where the bastard is. Tell me where the guy is who did this to her. Where is he? Is he here?” Mr. Garrett turns around, taking in all the patient-filled beds on the ward. “You wouldn’t be stupid enough to put him here, would you?”

  Everyone on the ward is watching now.

  “Mr. Garrett! I’m going to ask you to return to your bed, or I’ll have to call security.” The duty nurse throws a look to the young nurse behind her, who turns to leave.

  “Don’t you dare! If you do, God help me!”

  A sharp burst of fear shoots through Rhoda. Her eyes widen, pupils dilate, her breath catches and holds, her posture stiffens. This is the thing that the quiet man lying next to her in his hospital bed notices. He turns his eyes away from the scene and back to her.

  But Rhoda does not notice. Rhoda is transfixed by the scene playing out as the hospital-gowned man strides farther into the ward toward their end, his wild eyes gliding over patients.