by C. J. Lyons
“What kind of symptoms?” Andre asked, clearly out of patience for the academic BS. “What’s going on with Morgan? How can we help her?”
“The main symptom is confabulation. Which my nurses and the therapists have already noted,” Gino said. His voice was higher pitched than Andre’s but held a soothing cadence of authority.
“What’s confabulation?” Jenna knew Andre would never ask; she thought she knew, but wasn’t sure, so she asked herself. “You mean lying? Making things up?” If so, they might think twice about using Morgan for this special research project—the girl’s entire life was made up. Jenna didn’t think Morgan could tell you what color the sky was without twisting it into a lie.
“Unlike lying,” Nick answered, “confabulation is unconscious. The patient has no idea that what they’re saying isn’t actual reality. They firmly believe it—even if they go on to contradict themselves in the very next sentence.” He’d mentioned the possibility of Morgan not understanding how sick she actually was, but now he seemed guarded, wary of Morgan’s new diagnosis—or the man who’d given her it.
“Exactly,” Lazarus beamed at Nick as if he were a prize student rather than a fellow healthcare professional. “It’s the brain’s way of making sense of the chaos around them. Because of the damage to memory, cognitive facilities, precortical judgment centers, sensory processing, patients with Lazarus Syndrome fill in the gaps with confabulation.”
“They tell stories to make sense of what no longer makes sense,” Andre said.
“Very good, Mr. Stone. Excellent way to simplify it.”
“Why?” Jenna asked. “Stalling for time until their brains heal?”
“Unfortunately, no, Ms. Galloway. What makes Lazarus Syndrome so fascinating is that unlike other confusional states exhibited by patients with neurotrauma, Lazarus Syndrome is often the end result, not a transition phase.”
Jenna frowned and turned to Nick. He did not look happy. “He’s saying it’s permanent. That patients with this Lazarus Syndrome never regain their normal cognitive function.”
“Yes.” This from Paterson. “They go through life in a haze—recreating their worlds minute by minute to ease the pain of confusion.”
“Wait. You mean Morgan’s not going to get any better?”
“Her physical strength will improve, eventually returning to normal, probably,” Lazarus said. “From our initial assessment, her speech and fine motor skills may still remain impaired, but functionality should be close to normal. Eventual cognitive function—relearning to care for herself, to read again, recover higher reasoning skills—that’s all too early to tell. I can tell you that patients with Lazarus Syndrome do often exhibit much greater improvement over time in those areas than other patients with similar neurotrauma.”
“So, that’s all good news. If everything can get better with rehab, why wouldn’t the Lazarus Syndrome symptoms also improve?” Jenna asked.
“Exactly why Lazarus Syndrome is so fascinating. The damage takes place at such a microscopic level—probably at the level of neuroconnectomes. My theory is that branches are pruned by the hypoxic event to the point where neuroplasticity cannot repair or replace them—that the rest of the brain can heal, and return to pre-trauma levels of functioning, yet the patient’s sensory processing remains damaged to the point where they resort to confabulation.”
“She could be as smart as she used to be on the inside, but she’ll never understand the world around her?” Andre asked in an appalled voice. “You mean, she’ll be like a sleepwalker, creating her own dream world? Minute by minute, out of touch with reality?”
“More like a blind person filling in the gaps of what they cannot see for themselves—often coming to the wrong conclusion. But yes, that is the eventual outcome.”
“Wait, wait.” Jenna needed a moment to process all this. “Before we go any further. Can people with Lazarus Syndrome function? I mean, in the outside world? Take care of themselves?”
Silence filled the room. Nick shifted in his seat, and Jenna realized her own palms were sweating.
“What aren’t you telling us?” she asked.
Lazarus answered in his detached, clinical tone. “Despite the rest of their neurocognitive functioning returning to near baseline levels, patients with Lazarus Syndrome all eventually clinically deteriorate. When their awareness of the world around them returns, their cognitive dissonance becomes so overwhelming that they retreat into a state of withdrawal.”
“What does that mean?” Andre’s voice held an edge Jenna rarely heard. He was as tired of this medical mumbo-jumbo as she was.
“It means that patients become unresponsive. Catatonic,” Paterson said.
“She’ll go back into a coma?” Jenna asked.
“No. What we call ‘locked in’ syndrome,” Lazarus explained. “Her brain will be functioning almost normally, except she won’t be able to communicate or control her body.”
“That’s worse than being buried alive.” Andre shuddered and reached for Jenna’s hand once more. “There’s a cure, a treatment, something, right?”
“I’m afraid not,” Lazarus said. “That’s one of the new facets of the syndrome that my research here has revealed. After initial improvement, the patients become catatonic. And then they die. Lazarus Syndrome is universally fatal.”
Chapter Nineteen
Morgan knew the nurses and aides would be busy cleaning up after lunch and giving everyone their afternoon meds—not to mention covering their own staff lunch breaks. Perfect time for her to do a bit of snooping.
She sat on her bed, doing nothing that would alert anyone watching the safety camera overhead, just thinking, making a mental checklist.
As she sat, she smoothed her thumb in a circle over the surface of her phone hidden deep in her jacket pocket. She hated that Micah wouldn’t be back to visit, but having the phone gave her comfort, as if she had a new superpower the other kids lacked.
First thing, she needed to check at the nurses’ station and see exactly how much attention anyone paid to the safety cameras. From what the other kids said, she bet the staff mainly watched them at night and focused on the other wards, where the patients had more risks of falls or spells of agitation.
No, wait. She glanced at her wristband, twisted it inside out, and examined the thin strip of flexible coated material that ran along its inside. Tia had used hers to unlock the game closet—said it was also how they tracked patients. That must be how they knew Morgan had snuck out to have lunch with Micah. Okay, new first thing: ditch the tracking bracelet.
Even though the extra calories they fed her through the damn PEG had helped her gain back some weight, she was still bony thin, especially at her wrists. It didn’t take much effort at all to squirm her way free of the ID band. For now, she pocketed it until she was ready to move.
The planning was exhausting, but it also helped to pierce the fog that choked her brain. What next, what next? No way could she hack into the security computers to check footage of the cameras that did record to see who might have been wandering the hallways the night before around the time of Honey’s death. Maybe Jenna could, if the files were stored in the cloud. Morgan had shared some of her not-quite-legal software with Jenna, and although not as good with mobile devices as Morgan was, Jenna was a half-decent hacker.
If the other kids were drugged when the whistler visited, then she also needed to know who was on duty when he came, to see if the same people had been working when Honey died.
She squinted, pushing her sunglasses up higher on her face, thinking hard. It still didn’t make sense—other than the night before, she couldn’t remember getting extra sedation. She also didn’t remember the whistler ever coming into her old ward. But then the entire last week was a blur—maybe he depended on that, especially in the wards that held more debilitated patients? How did he handle patient families who might be staying overnight?
Maybe he had access to security cameras? Knew when the wards were empt
y, other than for the patients? Because there was no way he could arrange to sedate family members—unless he somehow drugged them via the communal coffee or something like that?
She shook her head at herself. No, that was too complicated. Her father always said complicated was what got crooks caught. Keep it simple, stupid was the best way—but simple didn’t mean expected.
Use the Wolf, he’d say. Do what Sheep and Fish don’t expect, can’t even conceive of except in their worst nightmares. They’ll lock their doors, keep a gun by their bed, and consider themselves safe. Then we hit them when they relax their guard and are vulnerable. Hence his use of his ten-year-old daughter as a decoy to lure his prey.
Families would expect their children to be safe here in the clinic, with nurses and cameras watching. How did the whistler get around that?
No way to find out sitting here on her bed. Time to move.
She started out with her walker, pretending to take a stroll, all the while keeping an eye out for security cameras and their blind spots, building a mental map. Except she was having a hard time holding it in her brain, so she resorted to scribbling hash marks on the map Tia had given her earlier.
It took a lot longer than she’d anticipated—three treks around the clinic areas that weren’t off limits. Frustrating, because she was certain that in the past, noting things like camera angles and a building’s layout would have been virtually automatic. Better than she could have done yesterday, though, she told herself, as she pushed through her brain’s weary haze and forced herself to concentrate.
Her visit to the nurses’ station confirmed her theory: the centralized station with its banks of video monitors had them tuned so that they concentrated on the more critical patients, like the ones in Morgan’s old ward. It looked like they had special custom settings to alert when high risk patients might fall or became agitated—which meant Morgan’s new ward was probably a low priority for monitoring. A single aide sat watching them, obviously bored, sipping coffee as the screens flipped from one view to the next.
Morgan couldn’t get past the front desk attendant to see inside the security office, but hit pay dirt when she approached the women’s locker room. A nurse’s aide, her scrub top smeared with what appeared to be mashed carrots, was just opening the door, unlocking it with her ID card. Morgan hurried to block it from closing, waited for the aide to disappear behind the lockers, then sidled inside. She hid with her walker in the bathroom until she heard the aide leave, and then quickly took a tour of the area.
She grabbed a pair of nurses’ scrubs that would fit and shoved them under her jacket. There was a TV and small lounge area with a kitchenette; nothing suspicious there. But on a clipboard hanging from the wall was a thick wad of papers—the nursing schedule going back months.
The words and letters shuffled in and out of focus, meaningless to Morgan. But Jenna or Andre would have no trouble deciphering them. She grabbed the sheets of paper, wrapped them around her calves, rolling the cuffs of her sweatpants tight to hold them in place, retrieved her walker, and slid back out the door.
Feeling triumphant, she returned to her ward. The others were doing therapy with an aide, working with their resistance bands. Ugh, she hated those things.
Justin and his mother weren’t there—she must have taken him to the atrium or out for a walk. All his stuff was still at his bed space, so his mom hadn’t gotten him discharged yet. Tomorrow, she’d said.
“Morgan, come join us,” the aide called out cheerfully, as she pulled a bright pink length of the stretchy latex between her arms.
“Sure.” Morgan matched her upbeat tone, somehow managing to barely sound fake even to her own cynical ears. She had a feeling that once upon a time, she had been a very, very good actress. “Let me just use the restroom.”
She pushed her walker into one of the two bathrooms that sat on either side of the ward’s main entrance. No cameras in here, just several big red alarm buttons and pull cords near the toilet and sink. The shower and bath areas were in a separate room that only staff could access—they didn’t trust kids not to accidentally drown themselves. Morgan pulled out her loot and tried to figure out where to put it so she wouldn’t get caught.
She ended up folding the schedules into her walker’s pouch along with her map and phone. Too late she realized that she’d forgotten to ditch the tracking wristband some place safe—if Paterson or anyone checked, they’d see she’d been inside the women’s locker room.
Stupid, stupid, stupid, she berated herself as she wrapped the scrubs inside the hoodie, tying the arms around as if she were just making the jacket easier to hang from her walker’s handles. Wouldn’t fool anyone who felt the jacket, but it should work long enough to keep things safe until Andre came for his usual afternoon visit. Wait. She slid her phone free and checked the time. Almost three. Where was he?
Paterson had said Micah’s visit would have consequences. Surely she hadn’t stopped Andre from coming? Maybe she was going to cancel Nick and Jenna’s visits as well?
Morgan slumped against the sink, turning the water on to give her something to focus on other than the hollow ache that carved through her gut. The stream of rushing water sounded so happy and blissful even as it ran down the drain, heading out to the sewer.
She’d always prided herself on her independence, on not needing anyone. Even her father had needed her in order to do his work, murderous as it was. But not Morgan.
After she left him, she’d reveled in creating a life where she had everything she needed without relying on anyone else. Loneliness was never an issue; boredom was the main danger that threatened to topple her back into the far easier path of violent lawlessness.
Thankfully, there was so much to learn, so many people to observe, such a big world to explore, that she’d escaped boredom just as she’d escaped the constraints of a so-called normal life weighed down by friends and family and duty and consequences.
At least she thought she had. Her father’s laughter swirled louder than the water streaming through her fingers as she realized just how very wrong she’d been. She was such a good liar, it seemed she’d even been able to fool herself.
Chapter Twenty
Jenna stared at Lazarus as he dismissed Morgan’s life as a fascinating medical anomaly for him to study. “There has to be something we can do. You can’t just let her die.”
He shook his head with feigned sadness. “I’m sorry. A few therapies have shown promise, but there are no definitive clinical trials.”
“I’d like to review that research,” Nick jumped in.
Lazarus bristled at the challenge. “It’s not ready for review. You have to understand how rare the syndrome is. I have the largest unpublished collection of cases in the world, and in my forty year career, I’ve only been able to document fewer than fifty cases.”
“How do you confirm the diagnosis?” Nick persisted. “By clinical progression alone?”
“Yes.” From Lazarus’s defensive posture, Jenna was certain he wasn’t used to having his diagnoses questioned. “And decades of experience.”
Then his tone softened. “I can assure you that I’d never broach the issue if I had any doubts. My goal is not to alarm you but to allow you to prepare yourselves. Given what my staff have reported and what I’ve seen myself, I’m certain that Morgan has Lazarus Syndrome. I wish the news were better, I really do.”
There was a long silence as his words sank in.
“And since Morgan is only a clinical case study, not enrolled in one of your treatment research protocols, she’s not eligible for any treatment?” Nick asked, sounding resigned. Jenna wondered at that—it wasn’t like Nick to give up so quickly.
“Exactly.”
Wait. Now Jenna understood. “How much?” She directed her words at John Lazarus, the number cruncher. They spoke the same language.
“Excuse me?” Paterson answered.
“How much money to get Morgan enrolled in one of these treatment programs that
could help her?”
“That’s not—” Paterson sputtered to an indignant stop when Dr. Lazarus waved her to silence.
“That’s not how it works,” he said in his most patronizing tone. As if the lofty principles of medical research were beyond Jenna’s mental grasp. “First, there’s no guarantee she’d be assigned to a treatment—it’s a double-blind placebo control trial. Second, it would be unethical for me to accept any financial compensation to enroll a patient, even if I could at this late stage. Third,” he pushed back his chair and stood, “you have no legal standing when it comes to anything concerning Miss Ames’s care. In fact, given her changed medical circumstances, I’m afraid we’ll need to limit further visitation.”
“Wait.” Andre stood, glowering at Lazarus from across the table. “You can’t just shut us out of her life. We’re all she has.”
“As her symptoms progress, she won’t remember you anyway,” Lazarus said dismissively, as he strode to the door. “You can say goodbye, but this is your final visit.”
“We’ll go to the judge,” Nick said, joining Andre.
Lazarus exited, followed by the other clinical staff members, leaving Paterson to answer. “Children and Youth have placed Miss Ames in our custody. But feel free to seek an alternative arrangement,” she said. “Of course, you’ll need to get her case worker to sign off on it, and so far Mrs. Tompkins is in complete agreement with our treatment plan. Good luck.”
She turned to leave as well. Andre and Nick sputtered off after her, still protesting. The conference room grew quiet with only Jenna and John Lazarus remaining.
“How much?” Jenna asked again. “To fix this?”
He smiled at her with only his eyes. The rest of his face remained a neutral mask—perfect for negotiations. “You heard my brother. Money isn’t the issue.”
He wanted her to float a figure, to make the first move. But Jenna knew better. “Money is always the issue. Especially for a cash-strapped clinic fighting to stay open and continue its good work. Not to mention your brother’s precious research. I’m sure that drains your resources, all those patients he refuses to accept payment for.”