The Secret Room

by Sandra Block

  Jane’s arm drifts back down, her eyes still focused on the wall.

  “But why is she catatonic?” I ask.

  “That’s the million-dollar question, isn’t it?”

  Jane Doe is our mystery. A police officer brought her to our doorstep this morning like a stork dropping off a baby. A few days ago, she was found wandering the streets of Buffalo, dazed and filthy, clothes torn, but apparently unharmed. No signs of bruising or rape. But she wouldn’t speak. They coddled her, gave her hot chocolate (which grew cold in the mug), brought in a soft-speaking social worker, and Jane sat and stared. So the police canvassed the neighborhood, fingerprinted her, ran her image through Interpol, put up missing posters adorned with her unsmiling, staring face.

  NAME: UNKNOWN. RACE: AFRICAN AMERICAN. DOB: UNKNOWN.

  No one claimed her. They brought her to Children’s and ran some tests. The ER said there was nothing wrong with her physically. So they sent her up to the psych floor. So we can figure out who she is and what’s wrong with her.

  “Schizophrenia maybe?” I ask.

  “Could be.” His eyes crinkle in thought. “But we also have to rule out other, less obvious causes.” He leans over the bed and shines a penlight into her eyes. Her pupils contract, then bloom. “You ever hear of the hammer syndrome, Zoe?”

  “No,” I say, jotting this onto the back of my sheet.

  “It goes like this: When all you have is a hammer, everything looks like a nail.”

  I stop writing, and he drops the penlight into his black doctor bag, smiling at me. “What can we establish here?” he asks, more a statement than a question. “Our patient has catatonia; that’s all we know. So let’s start with that. What’s the differential for catatonia?”

  “Schizophrenia.”

  “Okay, that’s one.”

  “Right.” I wait for the list to scramble into my head. That’s the one good thing about ADHD. Alongside the scattered, ridiculous thoughts that pop up relentlessly (and which you have to keep banging down like a never-ending game of whack-a-mole) sprout elegant, detailed lists. Such as differential diagnoses. Lately that hasn’t been happening for me, though. I don’t know if my Adderall is working too well or not well enough. My dopamine isn’t cooperating in any case, which is inconvenient, seeing as I’m on probation. My brain grinds on in slow motion with no list anywhere in sight, so I plow through the old standby mnemonic for the differential diagnosis of any disease. Something medical students learn the first day they step on the wards: VITAMIN D. Vascular, infectious, traumatic, autoimmune, metabolic, iatrogenic, neoplastic, degenerative.

  “Status epilepticus,” I say.

  “Excellent thought. Did we order an EEG?”

  “I will,” I say, writing it in her chart.

  “What else?”

  A list crawls into my brain by inches. “Encephalitis?”

  “Okay. Does she have a fever?”

  I pull off the vital sheet hooked on the bed frame, scanning the blue, scribbled numbers from this morning. Vitals normal. “No fever, but it’s still possible. Her labs are pending.”

  “Get neurology to see her. They can decide on a lumbar puncture. She’ll probably need it, though, if the EEG is negative.”

  “They said she didn’t need an LP in the ER.”

  He doesn’t look impressed. “Just means the on-call didn’t feel like it.”

  “We could get an MRI,” I suggest.

  “Fine. What are you looking for there?”

  “Less common causes for catatonia…stroke, lupus, Hallervorden-Spatz,” I say, cheered as the differential diagnosis list starts to soar in. “That could show up on MRI. PET scan, too.”

  “Let’s start with an MRI,” he says, tamping down my overenthusiasm. “Let Neurology decide on the PET.” Jane blinks, grimaces, then stares again. I hand Dr. Berringer her chart, which he balances in his palm, adding a couple of lines under my note then signing it with a flourish. He hands it back to me. “Onward and upward?”

  We exit the quiet oasis of Jane’s room, emerging into the hallway awash with hospital noises: the overhead speaker calling out, food carts rattling by with the malodorous smell of breakfast that no one will eat, medical students scampering around the floor like lost bunnies. Dr. Berringer’s phone rings, to the tune of “When the Saints Go Marching In,” and he picks it up as we head down the hall.

  “Hello?” There is squawking on the other end. “She just showed up today.” He listens a minute while we walk. “I’m sorry. I don’t know any more than y’all.” This is met with more squawking on the other end. “Right. Listen, I’ll tell you as soon as I know something. I promise.” He hangs up with an eye roll, smiling at me. “Admissions wants her demographic info. Jane Doe, folks. That’s all I got.” He strides in front of me into the nurses’ station. Dr. Berringer has a jogger’s body, long and lean, verging on skinny. He is tall, taller than me even, and I’m over six feet. As he leans in the door frame, a nurse, roundish in her lavender scrubs, openly gapes at him. “Any other consults come in overnight?” he asks Jason, who is sitting at the little brown Formica table, poring through a chart.

  Jason adjusts his bow tie. He must have a hundred bow ties with matching shirts. I’ve never seen him repeat a color. “Three,” he says. “I have two, and Zoe’s got the new girl.”

  “And one more I haven’t seen yet,” I add. “Just came in this morning.”

  “So let’s round later. Around two?” Dr. Berringer asks.

  “That’s good for me,” Jason answers. Jason is chief resident, so he’s in charge of rounding. I was all but promised the job when Dr. A (the smartest in our threesome and also the one who saved my life) transferred into the neurovascular fellowship. But then I was put on probation, so that was the end of that. Jason calls me Probation Girl.

  “All right. See y’all later,” Dr. Berringer says with a wave. His teeth are white-bright, bleached maybe, in perfect rows like pieces of Chiclets gum. My brother Scotty accuses me of having a crush on Dr. Berringer, claiming that “every sentence you say has his name in it,” but he’s exaggerating. If anything, it’s a minor crush. Minimal.

  “You want to bed that guy so badly,” Jason says as soon as he’s out of earshot.

  “Please. That is beyond ridiculous.”

  “Whatever you say,” he mutters, leaning over to grab another chart from the rack.

  I crack open Jane’s chart and finish off the orders. Neurology consult. IV fluids because she’s not eating. DVT precautions because she’s not moving. “Anyway, you’re one to talk.”

  He pauses to think. “Okay, empirically he’s good-looking, I agree with you. But he’s just so…white.” He pronounces the word with some distaste. Jason, being Chinese American, can say this.

  “What about Dominic? Last I looked, he was white, too.” Dominic is a nurse at the hospital and Jason’s on-again, off-again boyfriend. Mostly off-again.

  “Yeah, but he’s Italian. He could pass as Hispanic or something. He’s not Mr. Ralph Lauren.”

  “Sure, well, as long as he could pass as something ethnic.” I shove Jane’s chart aside, leaning back in the stiff, metal chair. “So are you back to dating Dominic this week?”

  “I don’t know. That guy’s so hot and cold,” he complains. “I see him at the bars and he’s all over me. Then we come to work and he flirts with girls. I’m, like, just pick a goddamn team and play for it.”

  “You should just dump his ass,” I say.

  “Yeah, probably. Hey, speaking of dumping, whatever happened with that French dude? You ever hear any more from him?”

  “Who, Jean Luc?”

  “Yeah. That boy was smoking hot.”

  Jason is right on that one. Jean Luc was smoking hot. Hotter than I am, that’s for sure. I’ve always been a solid six, maybe seven on a good hair day. Jean Luc was more like an eleven, or a twelve. Still is, I imagine. “Not in a while,” I answer. “Still with Melanie,” I mention, before he can ask. Melanie, the model-beau
tiful girlfriend he left me for.

  “Oh well. All’s well that ends well,” Jason says, meaning Mike. And he’s definitely right about that one.

  Jason turns back to his progress note, and I stash Jane’s chart back in the rack, ready to see my next patient. On the way down the hall, I pass by Jane’s room and see Dr. Berringer standing by the bed, staring at her. He lays his hand on her head, tenderly. Like a father patting his child’s head.

  Or a priest bestowing a benediction.

  THANK YOU TO:

  Rachel Ekstrom, my rock star agent, who provides both literary and moral support.

  Alex Logan, who helps me see what’s broken and how to fix it. (I put a cat in the next book for you. :)

  The whole team at Grand Central Publishing for their unwavering support.

  Natasha Cervantes, MD, who patiently and painstakingly spelled out the forensic psychiatry fellowship for me. Here’s to you, PMG sister…

  Daniel Antonius, PhD, who explained the entirety of forensic psychiatry, including all those acronyms, over lunch at Spot Coffee (not the Coffee Spot).

  Let it be known: All errors are officially mine, not theirs!

  Dennis Delano, detective extraordinaire, who let me spend the day in jail without arresting me. In all sincerity, you are a man of integrity and courage, a credit to your profession and our city, and I am proud to call you a friend.

  Superintendent Thomas Diina, for providing an in-depth, no-holds-barred tour of Erie County Holding Center.

  My lovelies at Tall Poppies, who provide virtual hugs and laughter daily.

  My PMG sisters: Aliquot made it into the final draft!

  Jordie and Lexi (and oh yeah, their parents), who try to sell “Aunt Sandra’s books” to their teachers, even though they shouldn’t even be reading them.

  Margaret Long, who is always there to help us out, and who cheerleads my books at the library at Canterbury and beyond.

  Mom and Dad, who love and support me no matter what.

  Patrick, my forever love and truest partner. I couldn’t do it without you.

  And finally, Charlotte and Owen, my sun, moon, and stars.

  ABOUT THE AUTHOR

  Sandra Block graduated from college at Harvard, then returned to her native land of Buffalo, New York, for medical training and never left. She is a practicing neurologist and proud Sabres fan and lives at home with her family and Delilah, her impetuous yellow lab. She has been published in both medical and poetry journals. The Secret Room is her third novel.

  Learn more at:

  SandraABlock.com

  Twitter @block_sandra

  http://facebook.com/sandraablockauthor

  Also by Sandra Block

  Little Black Lies

  The Girl Without a Name

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