She looks up. ‘Yes.’
‘It looks a lot like something else in this room.’
She wants his gamble to pay off. She looks to her right, to her left. ‘That brain diagram over there.’
‘Clever girl. The cerebral cortex.’ He beams. ‘Who would have thought?’
‘Weird.’ And he’s right. She can see it too. The same shape.
‘It’s even pink, same as the cloak,’ he says. ‘Because grey matter isn’t grey when it’s alive. And see these?’
‘What?’
‘These folds in the cloak.’
She nods.
‘They’re like the grooves that characterize the cortex. See over there? They’re called sulci. And this rise or bump in the cloak up here? A gyrus, or bump.’
‘Are the angels anything?’
‘Yup. Take this one here. Big eyes. Sad face. See him there, peeping out from the shadows under God’s arm? That’s the precise area we see activated in PET scans when someone is having a sad or mournful thought. And see all their legs and feet down here? Together, they make a brain stem. And this trailing veil, this swirl of green? The vertebral artery.’
‘They didn’t say anything about that in art history.’
‘If I had a transparency of the brain, of a mid-sagittal cross section, one big enough to lay over this print, I could show you, and bore you, a lot more.’
‘And God?’
‘Well, he’s reaching to the pre-frontal cortex, the most creative region of the brain; it’s the part which makes us most impressively human. So he reaches for the brain’s HQ and, presto, there goes the famous spark – which is also, coincidentally, the synapse’s signature.’
‘So is God just God? Or is he something too? Something in the brain, I mean.’
‘He’s what we’d call the old brain.’ He winks. ‘Hence the grey beard.’
She smiles, as you do when an older, avuncular man risks humour.
‘Specifically, God’s our limbic system.’
‘Our what?’
‘Limbic system – the ancient seat of our emotions. The source of our fears, our aggression, our sexual attractions, our instinct to nurture. Maybe also the source of transcendent feeling.’
The door opens. Two people walk in and introduce themselves to her father, who’s jettisoned now out of his own thoughts.
‘But how did Michelangelo know what was where in the brain?’
Bishop hesitates. ‘We know he performed some dissections . . .’
‘But he couldn’t have got all that from . . . Not in the fifteen hundreds.’
‘No.’ He looks at her. ‘He couldn’t have.’
She chews her lip. ‘Do you ever wonder if maybe we download stuff when we’re asleep?’
‘Download stuff?’
‘It sounds stupid.’
‘From where?’
‘I don’t know. From God, if there is one – Dad says there isn’t – or the universe, or something.’
He weighs her words, taking his time, though his colleagues are ready to start. ‘Our brains are certainly very active when we dream.’
‘Christina used to say it. That she did.’
‘Download stuff. Like ideas, you mean?’
She nods. ‘Or pictures.’ She looks at the carpet. ‘She said it was like her dreams were windows in her head, and that she got glimpses of things. Real things. Do you think that happens?’
He studies her. ‘I don’t know, Maggie. I wish I did.’
Dr Bishop introduces her to Dr Sperber, a neuropsychologist, and Ms Keegan, a cognitive therapist. When Ms Keegan smiles, Maggie wonders why she also looks as if she might start to cry. She has one of those faces. And Dr Sperber has a beard that makes him look like he’s hiding something. He’s dressed more casually than Dr Bishop. A jacket, no tie. Through his open shirt collar, she can see a simple gold cross and chain. Her father, she thinks, will behave better if he doesn’t see it.
He talks. They all talk. The burble of their words is like a radio she tries not to tune. Her head is already too heavy on her shoulders. Her neck aches.
She thinks about Michelangelo knowing what he couldn’t know – either that or Dr Bishop is simply seeing what he wants to see, like you do with clouds when you’re lying in the grass.
When the words stop, she watches Dr Sperber pick up the phone on Dr Bishop’s desk. He asks the switchboard to connect him. ‘Room 212, please.’ He passes the phone to her father.
Her father takes the receiver, swallows and waits. Then: ‘Christina?’
. . .
‘It’s even better to hear you, sweetheart.’ He smiles. He looks at the psychologist. The psychologist nods.
. . .
‘Of course we haven’t forgotten you.’
. . .
‘She’s right here.’
. . .
‘That’s right.’
. . .
‘Do you want a word?’
. . .
‘Great.’ He turns in his seat and passes Maggie the phone.
What will she say? What can he possibly expect her to say?
‘I’ll be outside, Dad. I’ll wait for you outside.’
3
It’s like an elaborate hoax.
‘I can only be honest with you, Dr Carver. We can’t say with any certainty.’
‘But the tests will show something?’
‘Something. Yes. But there are billions of neural cross-connections. Your daughter stopped breathing. She went into a coma. There are T-wave irregularities – cardiology still wants more tests. The quality and speed of any eventual recovery was always going to be difficult, if not impossible, to determine.’
‘But she woke up. In less than three days.’
‘Yes, and I’m delighted to say that she has bettered our predictions by far. Her short- and long-term memories seem relatively unaffected. There appears to be slight aphasia and some confusion, but it’s too early to say. From what you’ve told us, it’s possible she’s suffered right-side lesions because she falters, particularly, when reaching for what we call emotionally potent language – a right-brain skill. So my guess is that ‘‘Back off ’’ and ‘‘Fuck off ’’ collapse into the one command ‘‘Buck off ’’ in the pressure of the moment, and the panic button becomes the ‘‘panic buckle’’. Do you see? She’s also experiencing mild dyspraxia, a motor impairment related, in her case, to visual and spatial orientation – again, consistent with right-side lesions. But it could all be far worse.’
‘She doesn’t know who we are, Dr Bishop.’
‘No, not at the moment. But she can recognize your voice, which is why we’re reasonably confident that we’re looking at Capgras Syndrome. As I say, primarily a – ’
‘ – misidentification syndrome. You don’t have to be a neurologist to – ’ He stops himself. ‘I’m sorry.’
‘I understand your frustration, Dr Carver. But my job is to look at the whole picture. And almost everything is educated guesswork right now. Given the history, we can probably assume the cause of the Capgras, if it is Capgras, is organic: acquired brain injury; likely cause, cerebral hypoxia – possible lesions in the posterior area of the right hemisphere, where face recognition is performed. Or, as more recent research suggests, possible damage to the neuronal pathway that wires the primary visual cortex to the limbic system. As I was telling your other daughter a little while ago, that’s the brain’s emotional centre.’
‘She looks at me like I’m some kind of conman.’
‘You need to understand. She’s not hallucinating. She sees you as clearly as I do. She also remembers without difficulty what her father looks like. The problem is, she feels no emotion when she looks at you. A galvanic skin-response test would most likely tell us what you know already. She looks at you and Maggie and feels absolutely nothing.’
‘It’s absurd.’
‘It is. And Christina herself may even admit that it sounds absurd. There’s no indication at this point
that her logic or reason is impaired. But where there is no emotion, there is no recognition. And where there is no recognition, there is no meaning.’
‘So she decides her family are impostors.’
‘She’s not doing it on purpose, I promise you, Dr Carver.
There’s simply no other way for her brain to make sense of her situation.’
‘Except on the phone . . .’
‘Exactly. Because the signal from her primary auditory cortex to the limbic region – the centre of the emotions, remember – is unaffected. Therefore, when she is required to rely only on her sense of hearing, she recognizes your voice and feels you are her father. She feels you are her father, so you are her father.’
‘Even if I wasn’t twenty minutes ago in her room.’
‘You and Maggie now exist for Christina in duplicate. One version is true and one is false.’
‘What if we prompt her with memories and photos? Say, some of her mother, whom she recognizes, with Maggie and me.’
‘She’ll recognize the three of you in pictures, I’m sure. But that’s not the issue.’
‘We can explain to her that this is happening to her. That there’s a syndrome that affects her in this way. If her logic is unimpaired – ’
‘We’ll try, of course.’
‘Very gently,’ adds Ms Keegan.
‘But you don’t hold out much hope.’
Dr Bishop looks at his desk, choosing his words. ‘Dr Carver, it seems that, at our most fundamental, we are emotional beings. And truth is, first of all, a feeling.’
Carver rubs his hands over his face.
‘Of course we’ll consider certain cognitive techniques – ’
‘Reality testing and reframing,’ notes Ms Keegan.
‘And if necessary, in the long run, we’ll consider certain antipsychotic drugs. Clozapine has yielded some good results, for example, as have some SSRIs at higher starting dosages.’
‘Jesus.’
‘I understand. It’s a lot to take in.’
‘You said the cause was probably organic. What else could it be?’
‘Well, some argue there’s a psychodynamic dimension.’
Dr Sperber, the neuropsychologist, leans forward. ‘In the case of Capgras, Dr Carver, not everyone in the patient’s circle is perceived as a stranger. Often it’s only the person or persons closest to him or her at the time of onset who are recast as impostors. In some instances, we’ve found that the Capgras patient has had ambivalent responses to that person or persons, feelings which are usefully explored.’
Carver hates him.
‘Do you have any other questions, Dr Carver?’ Bishop is a father too. He wants the man released.
Giles Carver closes his eyes. ‘All she did was run for the phone.’
4
He walks the surrounding streets. He asks passers-by if they’ve seen her, a girl, eighteen, about this tall. They shake their heads. They seem somehow ill at ease in his company. He’s ill at ease in his own.
Two daughters lost.
He crouches down, out of the sun, in the shadow of the cathedral’s west tower. Flies buzz.
And it occurs to him. She will have gone to the scriptorium. She will ask Brother Bernard if she may resume her duties. She will want to turn pages again.
And the bishop will find her there.
It is true then. What he said.
He has nothing. He has already disappeared. In a matter of days his life has become an emptiness – the negative impression on the wrong side of a mask or a mould. Without his wife, without his daughters, he is only the image of the man he used to be.
None of her fellow librarians sees her enter. And still, no one knows anything. Not Mrs McFarland. Not Helen. Not Miss Slack. She doesn’t want Christina to become another strange and tragic story at coffee break.
Maggie finds a desk in periodicals and sits, hidden from view by a microfiche machine. The silence is good. And she likes the smell of old glue that permeates the place. It calms her. It makes her think everything will be all right. Her father will stop asking her to pretend. And in time her sister will slip out of the dream she’s still dreaming.
*
It has been agreed. Christina’s recovery and rehabilitation will be managed by the Skilled Care Unit. She will be moved from room 212 into a ground-floor room that features full cable TV, a cordless phone, hand-painted wall borders and a quilt hanging. The Skilled Care Unit also includes a recreation room, a private courtyard, two lounges for social activities, an on-site pharmacist, dentist and beautician.
As a patient of the unit, she will have access to a full range of rehabilitative and diagnostic services. Her medical team will be led by Dr Bishop, her neurologist. It will include Dr Sperber, her neuropsychologist, and Ms Keegan, her cognitive therapist. She will spend one night at the Chicago Sleep Lab, at Dr Sperber’s recommendation.
There is only one problem. Christina Carver has informed the team that she is discharging herself. She tells them she’s going home.
Giles Carver is sitting on a bench in Austin Gardens, hoping Maggie will at any moment pass, when his phone rings. Dr Sperber. Carver sits up. He feels his heart lift. Sperber is telling him that Christina wants to come home.
‘Thank God.’
But the psychologist’s words racket him back into the real. ‘You forget, Dr Carver. She’ll come back and find another you and another Maggie living in her family home. She’ll leave more confused, more upset, than when she arrived.’
‘Maybe at home things will be different.’
‘I’ll be frank, Dr Carver. They won’t be. But if you’re willing to let her risk some happy homecoming scene, she’ll be in a taxi outside your front door in ten minutes and life for Christina will go from bad to worse.’
‘Let me talk to her.’
‘And tell her she can’t come home? As far as she’s concerned, she’s walking and talking, and that qualifies her as a going concern. What will you say when she demands to know why she can’t come home?’
‘Tell me what to do.’
‘Help us proceed with involuntary admission. In the short term, that’s to say now, a quick petition for emergency admission will buy us twenty-four hours.’
‘You mean commit her.’
‘By tomorrow we’ll probably be able to persuade her to admit herself voluntarily.’
‘She’s not crazy.’
‘No. But she is vulnerable. You saw that yourself this morning. And, in light of the Capgras, the one place she won’t rest easy is at home.’
‘So tomorrow you get her to admit herself, and she tries to leave again in a few days. Then what?’
‘According to the Mental Health and Disabilities Code, voluntary admission is by no means the same as informal admission. Under its terms, Christina will not be able to walk out any time she wishes.’
‘You’re going to have to spell it out, Sperber.’ He can feel his blood pressure rising. His gums start to throb. ‘Because it sounds to me like you’re about to trick her into locking herself up.’
‘No, we want to outline her options. Most patients will choose voluntary admission if they understand that involuntary admission is inevitable.’
‘So you give her a rock and a hard place.’
‘If you want to see it like that.’
‘And you need my permission to proceed.’
‘Strictly, no. But we prefer to have the support of the family.’
He stares at a blot of starlings on the afternoon sky. ‘I don’t know.’
‘She’s at the information desk now, Dr Carver. A taxi is on its way. Emergency admission is the only course of action that will guarantee Christina the stable environment she needs to make a full recovery.’
Rubbing his temples. ‘I hear you.’
‘With respect, Dr Carver, that means what exactly?’
‘I’ll sign.’
‘You give your consent?’
‘Either way I feel like I’m lett
ing her down. But it’s not about what I feel.’
‘The situation will, in all likelihood, normalize within a week or two.’
‘And in the meantime?’
‘We’ll stay in close touch.’
‘And Christina?’
‘She’ll probably try to phone you. She’ll ask you to come and get her.’
‘And I do what?’
‘Don’t answer.’
‘What?’
‘If possible, switch off your phone.’
Carver feels the day dissolve. ‘It’s her lifeline to her family.’
‘Give us twenty-four hours at least. Forty-eight if you can.’
In periodicals, the wheel of the microfiche machine is clattering away. Two elderly men take a seat at her table. Maggie’s safe haven is gone, and her headache is back. How long has she been here?
Her eyes are heavy. She can feel her mother taking her into her arms. She’s saying, Poor lovely thing. You’re just a button on a thread, aren’t you?
Yes, says Maggie. Yes. I’m barely holding on.
Make up with your sister, sweetheart. Don’t stay mad.
She got mad first.
Try, Maggie. Try for me.
The phone in the foyer is free. She finds St Thomas’s number on the scrap of paper in her wallet.
It rings and rings. At last, someone picks up and puts her through to the nurse’s station on the second floor. ‘Room 212, please,’ she says. ‘Can you connect me to room 212?’
‘I’m sorry. That room is currently vacant.’
Vacant?
‘Who was it you – ’
Maggie hangs up. She feels like someone in deep space, trying to hold on to her family – to mother, father and sister – when gravity is gone.
In Beauvais there has been discussion. The bishop, the abbot of St Germer and Brother Bernard inform her that her father has left Beauvais.
‘Why,’ Marguerite asks, ‘why would he leave Beauvais? It is not possible.’
Her father, they begin again, has left Beauvais. It is understood he will seek commissions in Paris. Soyez tranquille. She will not go without. Arrangements have been made. The bishop, in his largesse, has found her a home. She will join the Dominican Sisters of Fanjeaux.
The Wave Theory of Angels Page 18