The Syndrome

by John Case

  “I made a reservation at a hotel on Washington Square.”

  “Great.”

  She laughed. “I doubt it. It’s going for seventy bucks a night.”

  “Ah… and what does Lonely Planet say about it?”

  “That it’s ‘reasonably clean. Safe. A budget alternative.’”

  “There you go!” Duran exclaimed. “That’s the trifecta.”

  “Well… “ she said, her voice doubtful.

  “What’s not to like?” he asked.

  She thought about it for a moment, and said, “‘Reasonably.’”

  Chapter 26

  The hotel was a dive.

  Their room—a “kitchenette”—was “clinically depressing,” according to Duran. It had the tired and dingy look of a place that had been slept in too often by people who’d only recently been “released.” Lumpy twin beds were covered with suspect chenille bedspreads which looked (from the evidence of a few dark streaks) as if they had once been orange, but were now a played-out blond. In the corner, a low table stood on an expanse of wall-to-wall carpeting, mottled with stains. Peppered with cigarette burns, a mustard-colored chair waited beside the window, itself opaque with grime. Nearby, a twenty-seven-inch Sony Trinitron rested on a built-in cabinet.

  In the kitchen area, behind a formica counter, was a sink in desperate need of reenameling, a small refrigerator with a very big hum, and a wall of Sears cabinetry that held a stack of Melamine plates and cups.

  Adrienne opened the refrigerator, and glanced inside. Happily, there was nothing to be seen but an ice cube tray that looked as if it had been handmade of compacted aluminum foil.

  “I hate it here,” she said.

  Duran wedged a chair under the doorknob.

  In the morning, they took the subway uptown to the Pashten Medical Center, where the staffers in the neuro-imaging suite greeted them in high spirits. The Asian receptionist slid open a translucent window and gave Duran a big smile. “Oh yes,” she said. “Duran. You’re here for the works, right? Let me call Victor.”

  Moments later, a sharp-featured Latino emerged through the door. He wore aqua scrubs and had a face that looked as if it had come from an Aztec frieze. “If you’ll give Melissa your consent forms,” he said, “we can get started.” Then he turned to Adrienne. “You Mrs. Duran?”

  She felt her face begin to burn. “No,” she said, a little too hurriedly. “Just a friend.”

  “Well, I don’t think you’re gonna want to wait around,” he told her. “‘Cause it’s gonna be a while. Maybe you could come back at four?”

  When Adrienne had left, they took Duran’s vital signs and led him into an examination room, where he waited to be summoned. The room was decorated with a pastel, geometric border at the junction of the ceiling and wall. A single Norman Rockwell print hung on one wall. It showed a white-coated doctor with a kindly smile and a stethoscope, approaching a quaking boy, his bare bottom exposed beneath a too short surgical gown.

  The syrupy image of the kindly pediatrican harkened back to a time that had little in common with the world in which Duran found himself. The neuro-imaging center was a technophile’s dream, a forest of computers and diodes, oscilloscopes, and putty-colored machines that seemed, at once, modern and prehistoric.

  The CAT scan came first.

  For this, Duran was asked to lie down in a prone position with his head braced upon his chin. A rubber device was put in his mouth, and he was told to bite down upon it, the better to keep his head still. Movement, he was told, is the enemy. And so he lay there like a fallen log, suddenly aware of every itch and tingle, determined not to move and inspired by the unending patter of his nurse-technician-cheerleader.

  All the while, she operated a device that rolled along the armature around his head, taking a series of forty-eight cross sections of his skull. The device moved with a dense whir, and it was difficult not to react when it locked into place, and clanked and snapped to register an image.

  Listening to his cheerleader-nurse, it occurred to Duran that her tone was precisely the one that people use to address dogs and babies.

  After the CAT scan, an Indian woman grabbed his color-coded chart and ushered him into a room whose door bore a sign that read:

  ECHO-PLANAL MAGNETIC

  IMAGING RESONANCE

  This time, things didn’t go so well.

  The MRI machine was a long table that rolled into a large, but coffinlike, drum—“the magnet,” as the technicians called it. Lying down on the table, Duran was fitted with a kind of football helmet—the head coil—which was itself attached to a plastic grid that covered his face. The nurse handed him a device that was meant to serve as an alarm, and told him to push the panic button if he became claustrophobic. Then he was asked to lie still, and ignore the pumping sound that the machine was about to make.

  So far, so good. So far, no problem.

  Then the nurse touched a button, and the table rolled into the drum, swallowing him. Peering through the plastic grid, his eyes were about eight inches from the bottom of the drum—until the table rose, lifting him to within an inch or two of the surface above his face.

  He took a deep breath. You’re in your safe-place, he told himself—and hit the panic button—hard. An alarm went off. The nurse came running. The table subsided, and rolled back.

  Whispered conferences ensued, and eventually, Duran was returned to the examination room. There, a young man with a shaven head and a gold ring through his septum gave him a shot that he said would help him relax. And, indeed, it did. The remainder of the morning and much of the afternoon passed—not like a dream, but a documentary. Handheld. Black and white. No narration.

  Duran couldn’t remember how many tests were taken, or how often his veins had been “palpated.”

  But the last test was the PET scan. Aztec Charlie—which is how he was known at the clinic—explained to Duran that PET stood for Positron Emission Tomography. “Basically,” he said, “we’re gonna light you up with this.” He lifted a syringe out of a brushed aluminum tray. “It’s a radioactive isotope,” he explained. “Lights up your brain, so the doc can see what’s happening.” He tapped the syringe with his fingernail, and asked Duran to lie down on a paper-covered table.

  He did, and barely felt the needle.

  Two hours later, he joined Adrienne and Doctor Shaw in a small conference room at the clinic.

  A dozen images—cross sections of Duran’s brain—were clipped to a bank of backlit viewing screens. Holding a pointer, Shaw went from one image to another, tapping the pointer’s tip against a small, bright spot in a sea of gray.

  “Right here,” he said. “And here. And here. And you can see it on this one, too!”

  “It’s like a piece of rice,” Adrienne said.

  “What is it?” Duran asked.

  Shaw thought about it for a moment, frowned and said: “I don’t know.” Then he thought some more, and shrugged. “I can tell you what it’s not,” he assured them. “It’s not tissue. It’s not a bone, or a nerve. It’s not flesh. It’s not blood. Which is to say, it’s ‘a foreign object’—which is what we call things when we’ve exhausted every way of looking at them, and still don’t know what they are.” The physician frowned and paused. One of the fluorescent light fixtures on the ceiling fizzed. “You don’t recall suffering a head injury?” he asked Duran in a hopeful tone. “Maybe a car accident? Ever been in the army? Or a plane crash?”

  Duran made a wry face. “Not that I can recall.”

  Shaw smiled. “Very funny.”

  “Wait a minute,” Adrienne asked, looking at Shaw. “That’s what you think? That—”

  “A physical injury might be responsible for his condition?” Shaw’s arms flew up, and his face contorted in an exaggerated expression of perplexity “Let’s just say… it’s a working hypothesis.” He gestured toward the display of images. “The history of psychology and neurobiology is full of examples of the ways physical trauma can affect memory. In fac
t, some of our best information about memory comes from accidents—crazy accidents in which brains were maimed. Which isn’t surprising, really. I mean, these aren’t experiments you can carry out in a hospital.” Shaw beat out a little rhythm on the surface of the counter then let it fade.

  “Is it possible,” Adrienne asked, “that that thing… is interfering with Jeff’s memory?”

  Shaw shrugged. “Absolutely,” he said. “It’s quite possible.”

  “But you can’t say for sure,” Duran suggested.

  “Not without examining it.” Seeing Adrienne deflate, Shaw gave her a sympathetic smile. “Memory is a very strange thing,” he told her. “People like to think that we store memories in the brain the way librarians store books—side by side, in categories of one kind or another. But it’s not true. We know it’s not true because we’ve done experiments—lots of experiments. And what we’ve learned is that memories aren’t localized, but distributed. Like smoke, they’re diffused through the brain. So if you teach a rat to run a maze—then mutilate its brain to the point where the rat can barely walk—it will still remember how to get from A to Z. Not as quickly, perhaps, but it will remember.

  “What’s particularly interesting about your case,” Shaw continued, “is that we’re not seeing any of the usual profiles of memory loss. Your short-term memory is undamaged. And you seem to retain the ability to form long-term memories.”

  “So what’s your theory?” Duran asked.

  “I don’t have a theory” Shaw replied. “All I have is an object.” He tapped one of the images on the light panel. “That object.”

  Duran stared at the image on the wall, and felt a surge of elation. The psychiatrist might be right. The object could explain a lot. Not everything, of course—not the murder of Eddie Bonilla. But… a lot.

  “So where do we go from here?” Duran asked.

  Shaw hesitated. “Well,” he said, “that’s up to you.”

  “How so?”

  “We could go in,” the psychiatrist answered. “Take it out. See what it’s made of. See what it is.”

  “Is that dangerous?” Adrienne said.

  Shaw’s pointer beat out a rhythm on the table, then faded to a slow, monotonous tapping. The shrink seesawed his head back and forth. “Not especially. It’s in an area that’s relatively easy to access. You’d be in a semi-sitting position, and we’d enter the sphenoid sinus cavity through the anterior nasal septum.”

  “My nose.”

  Shaw stopped tapping the table and slapped the pointer into his open palm. “Right. You’d need broad spectrum antibiotics, but otherwise—I should think it would be a piece of cake.”

  “But there are risks,” Adrienne suggested.

  Shaw nodded. “There are always risks.”

  “Like what?” Duran asked.

  “Damage to the optic nerve.”

  “He could go blind?”

  “It’s very, very unlikely. I’d be more concerned about leakage.”

  “Of what?” Adrienne asked.

  “CSF. The brain’s floating in a pool of cerebrospinal fluid. In surgery of this kind… ?” He ended the sentence with a shrug.

  “Christ,” Duran muttered.

  “The mortality rate is less than one percent.”

  No one said anything.

  “Of course,” the psychiatrist went on, “there might be consequences to leaving it in place, too. It could be the cause of some localized infection or swelling—the PET scans show a sort of odd… excitation… around the object.” He shuffled through a sheaf of large colored prints of Duran’s brain. The colors were intense—cerise, magenta, sapphire—so that Duran’s brain had a psychedelic look, as if it might be the model for a line of retro T-shirts.

  The doctor placed a photographer’s loupe over one of the images. “Here. You can see the excitation quite clearly. Take a look.”

  They did, in turn. Duran saw a tiny yellow blip surrounded by a halo of purple.

  “So what do you want to do?” Duran asked.

  “An exploratory—see if we can get in and out without a lot of ancillary damage. If we can, we’ll remove it. See what it is.”

  “And you’d be doing the surgery?” Adrienne asked.

  Shaw shook his head. “I’ll find someone with better hands.” He whirled to a bank of files behind him, pulled open a drawer, extracted a folder, selected some papers. He tapped them into a neat stack, then clipped them together. “Here,” he said, handing the papers to Duran. “Consent forms. You’ll want to read them carefully. Get a good night’s rest and… call me in the morning.”

  They found a Cuban-Chinese takeout a block from the hotel, and returned to their room with cartons of rice and beans, and a six-pack of Tsing Tsao.

  Duran glanced through the consent forms as Adrienne brought their plates to the little table in the corner.

  “I could go blind,” he told her. “Or go through a personality change. Then, there’s my favorite: ‘loss of cognitive function.’”

  She handed him a beer, and asked, “What’s that supposed to mean?”

  “It means I could be an idiot.”

  “Jesus!” she said. “I don’t know… “ She threw him a glance.

  “What?”

  She shook her head. “I don’t want to say anything. I mean, I don’t want the responsibility.”

  The food was terrific.

  “Chinese-Cuban,” Adrienne said. “Not a combination I would have come up with. I wonder how that came about.”

  Duran shrugged. “There are lots of Chinese all over the West Indies,” he said. “At least in Jamaica and Haiti there are. So it stands to reason they’d be in Cuba, too.”

  She paused, chopsticks suspended on the way to her mouth. “How do you know?”

  “What do you mean, how do I—”

  “I mean really,” she said. “Think about it. Have you been there? To Jamaica? The Caribbean.”

  He thought about it. “I think so,” he said. “To Haiti, anyway.”

  “Well, let’s think about it! See what you can remember.”

  He savored another spoonful of rice and beans, then closed his eyes, and sipped his beer. Finally, he said, “Big, white house. Verandah. Palm trees.” He stopped for a moment. He could hear the traffic in the street, the dull roar of white noise. “When the wind came up and blew the palms around,” Duran said, “it wasn’t a soft sound, like wind moving through the leaves. It was a thrashing sound.” He paused, and then went on. “There was a gardener who used to climb the trees when a storm was coming… “ He fell silent.

  “Why?” Adrienne prompted.

  “To cut the coconuts—so they wouldn’t damage the verandah.”

  “Keep going,” Adrienne encouraged. She put the chopsticks down. “It’s like when we were playing chess. Remember? The rum, the heat, I think—”

  Across from her, Duran’s face had been relaxed, with just a tiny frown of concentration pinching at his eyes. Suddenly, he was on his feet, eyes wide.

  “What’s the matter?”

  He shook his head, looked away, then took a couple of deep breaths. Finally, he turned to her. “Sometimes… when I start to remember things… I see this room—and it scares the shit out of me.”

  “What room?”

  He shook his head, and walked to the window. Looked out. “I don’t want to talk about it.”

  “You have to.”

  He kept looking out the window, as if he was searching for something. A minute passed, and then he said: “I’ve been trying to figure out the color.”

  “What color?”

  “Of the room. It’s not yellow, but… ochre. And there’s blood everywhere.” He heaved a sigh. “I really don’t want to think about this.”

  “But you should, that’s exactly what you should do—you should think about it. Keep going. Maybe—”

  “No!”

  “Fine,” she said, picking up her chopsticks again. She ran them through the reddish sauce, then concentrat
ed on capturing a single black bean.

  “I’m sorry” Duran told her. “I just can’t do it. It’s… I don’t know. I can’t explain it.”

  “No problem,” Adrienne replied in a dismissive tone. “Whatever.”

  “Look—”

  “I just think, you know, you’ve got some kind of memory trace there, something important happened—I’d think you’d want to go with it.”

  He didn’t say anything for a while. A lock of his dark hair, which he kept combed back, had fallen down onto his forehead and he pushed at it with his fingers. “I’m not explaining this very well, but it’s like—I can’t go with it. I can’t stand it.”

  She sighed.

  “I see that room and… it’s like I’m going to pass out,” he told her. “It’s like I want to pass out.”

  She shook her head, as if it were a way to change the subject. “I guess you’ve got enough on your mind,” she told him.

  He looked puzzled.” I do?”

  “Well, brain surgery.” She placed the pointed end of one chopstick atop a single black bean, punctured it, then tried to obscure what seemed like an unfortunate metaphorical action by messing around with the rest of the food on her plate.

  “Do you always do that?” he said after a while, his tone light.

  “What?”

  He indicated the little mounds of rice and vegetables she’d constructed. “Because Dr. Freud has some pretty interesting opinions about that kind of thing.”

  She laughed. “Playing with my food,” she said, pushing the food into a single mound, then squaring it off. “My detractors would say it’s the only kind of play I’m capable of.”

  “You have detractors?”

  She drew diagonal paths through the square of food, separating it into four triangles. “Ummmm. ‘I’m not much fun. I’m a worker bee. I’m all business.’”

  He laughed. “I think your detractors are jealous.”

  She smiled. Said, “Thanks.” Thought, Uh-oh.

  She was starting to get attached to this guy. In fact, she was starting to like him—and maybe more than like him (which would be a real disaster). Probably the Stockholm Syndrome, she thought. While Duran wasn’t her captor, they were captive together in this weird situation, and it was natural, she supposed, that she would begin to feel that they were some kind of… team. She ran her thumb down the side of the Tsing Tsao bottle, leaving a clear path through the condensation. Then she picked it up and drained it.