by Jan Coffey
“You know that we have no interest in the specific content of an individual, per se.”
Ahmad shrugged. “I know that, but think of what the families are going through. They’re dealing with loved ones who have become paralyzed or have suffered mental impairment or have become comatose. They don’t know how long before these husbands or wives or brothers or sisters or parents will regain something of who they were…or if they ever will. This is as sticky as a Living Will. Decisions are difficult. There are privacy issues involved. There is always the chance that the patient might wake up tomorrow. What if your findings include revelations that are not particularly flattering…or are even criminal? Ethically and personally, the families have a problem with doing this. You can understand that.”
They stopped by the elevators.
“You’re supposed to be on my side, Dr. Baer,” Sid complained, half in jest.
“And I am. I understand the positive uses this program can have in the future for people who have become impaired,” Ahmad told the young man. “You are making important early steps here. What I’m saying is that you should take your time and not set your mind on the first good candidates you find in this hospital. I know that would have been very convenient. But taking the easy road is giving you the most trouble.”
The elevator doors opened and the two men stepped in. Ahmad pressed the button for their floor.
“Well, I have to come up with someone in the next couple of weeks, or I rewrite the grant to get it extended,” Sid told him, accepting the advice, but obviously disappointed. “Do you have any suggestions where I should be looking for subjects?”
They stepped out at their floor.
“As a matter of fact, I do. One of my patients at the extended care facility in Waterbury is a ward of state. A Jane Doe with no known family to have an objection to what you’re going to do or what information you’re going to abstract.”
“What kind of okay do we need to include her?”
“Just the permission of the conservator…who is an attorney in Waterbury, I understand. I’ll get the name and phone number,” Ahmad offered. “In her case, I doubt to be any objection. If anything you can help them to identify her, it would be a very good thing.”
“When can I see her?” Sid asked, perking up.
“You can come with me tomorrow to the nursing facility. We’ll put in the call to the attorney’s office when we’re down there.”
CHAPTER 9
York, Pennsylvania
Mark Shaw had a busier social schedule now than any time before going to Iraq. It had to be a plot.
The next door neighbors, who were always friendly with his family, have a cookout and he’s invited. The police chief’s wife throws a birthday party for their eight-year-old daughter…and Mark is invited. York College’s Criminal Justice department is having a retirement party for one of the professors Mark had while he was at school there…and he’s invited. Lucille and Abel from the diner have some reasonably attractive female friend over for supper on Friday night…and he’s invited. And there had to be a dozen more.
Between the people who knew him or his family, he had yet to go two days without being invited to one event or other. If things got any busier, he’d need to buy a calendar.
Mark appreciated all the invitations he was getting. He knew why he was getting them, too. Some forty thousand people lived in York, and between the tourists and the college kids, the population could swell by an extra ten thousand. As a result, York had some big city problems. That’s why the police force needed nearly a hundred officers. Despite all of that, though, York still had small town attitudes and values…and folks who cared about service men and women just back from overseas with no family around.
Mark knew it was a plot, but not a sinister one. It just didn’t help him figure out what he wanted to do with his life.
Thursday night, he was at another get-together. John Landis, a young police officer who was also the younger brother of Mark’s first partner on the force, was moving into a new apartment with his girlfriend. Mark had known John for a long time, so he and a couple of other guys had stopped in during the afternoon to help them move. Now everyone was staying for beer and pizza.
The conversation at dinner turned to the politics of the department. Mark went into the kitchen to get another beer. A small TV on the counter was on and tuned to a local station with the volume turned down. As he raised the bottle to his lips, a picture flashed on the screen, stopping him dead. He knew that face.
“Wait!” he murmured as the news story moved on. “Come on. What was that about?”
He searched on the counter for remote to turn up the volume or change the channel.
“Everything okay?” John asked, toting a handful of empties into the kitchen.
“I just saw…somebody I knew on the news. But it passed on. Do you get another news station? Where’s the TV remote?”
John reached under a phone book and handed him the remote. “Was it someone from here?”
“No,” he replied, occupied with finding another channel that might show the same clip.
“Was local or national news?” the young policeman wanted to know.
“I don’t know. I walked in and it was there…on the screen…and then it was gone.”
“Man or a woman?”
“A woman,” Mark said under his breath. The other news stations were covering the fire on the offshore platform he’d seen that morning. A related news story reported that the same company that had been funding research at the site had also suffered another loss today. A separate group from their Research & Development department had been killed in a plane crash. There had been no survivors.
“Anyone I know?” John persisted.
“No.”
“It’s really fun playing twenty questions.” John slapped him on the shoulder. “Who is she?”
The news channel he’d turned to put a grid of nine faces on the screen.
“Christ. It was her.” Mark pointed with the remote as he turned up the volume. “That’s her.”
“An unidentified source within the New Mexico Power Company has told the local Eyewitness News station that these nine scientists were members of a research team conducting studies in a subterranean facility beneath the converted monitoring station in the Gulf of Mexico. At this point, the company has yet to officially admit or deny the identity of the victims.” A split screen showed the burning platform and a photo of a man with the name “Dr. Robert Eaton” beneath the scientist’s smiling face.
“How could they put pictures of people up when there’s no official confirmation?” John muttered. “Who is she? Where did you meet her?”
The picture split into four images, showing the photos of the team with the person’s name and university affiliation beneath each one.
“Marion Kagan, UC Davis, California,” Mark said softly. “Last time I was on the leave, I got stranded in Boston airport because of bad weather. Her flight was cancelled, too. We just ended up talking.”
“Sorry, man,” John said, putting a hand on Mark’s shoulder. “You okay?”
Mark leaned against the counter and stared at the dark shoulder-length hair, the large eyes, the beautiful face. And then the image switched back to an aerial shot of the fire.
He barely knew her, really. But he remembered how something about her shone from the inside, especially when she smiled. How often had he thought about her over the past year? He ran a hand down his face.
“Marion Kagan. I can’t believe she’s dead.”
CHAPTER 10
Waterbury Long-Term Care Facility
Connecticut
“I still can’t believe how simple it was to get the conservator’s okay,” Sid Conway admitted as he read the papers the attorney had faxed to the office of the nursing home.
“You are doing clinical research, supported by the UCONN Health Center,” Ahmad Baer reminded him. “This patient’s care is provided by the State of Connectic
ut, and I am her attending physician. The testing is noninvasive and cannot harm the patient physically. I am on the advisory committee for this grant, so I am familiar with everything about the situation. Considering all these facts, this can only be a win-win situation, especially if the results help find out who she is. Why wouldn’t the conservator go along?”
“We don’t know if we can find anything about her identity or not. We don’t have any control over what kind of information we can pick up on the readings.”
“That’s fine,” Ahmad replied. “The bottom line is that you have another subject.”
“Can I see her today?” Sid asked.
“Of course.” Baer looked at the schedule of patients he had to see today. Jennifer Sullivan had put JD down as his first visit.
“When can we move her to the Medical Center?” Sid wanted to know.
Ahmad stopped and looked at the resident. “You can’t move her. She is getting the right care here, and I don’t want to disturb a good working arrangement for this patient,” he told him.
With the shortage of beds, nurses, and even doctors in the hospitals and nursing facilities across the state, there was no way Ahmad was going to risk having a Title 19 patient lose her bed here while the study was being done. Besides, he liked the idea that there were nurses here who kept a close eye on JD. No, Sid and his research partners could move their equipment down here.
“The nursing home can give you a place where you can set up your equipment. You and the other guys will have to do some commuting. But we’re going to keep the patient’s welfare at the top of the priority list.”
“Sure,” Sid said, seeming embarrassed for even suggesting it. “I understand. That’s no problem at all.”
Ahmad knew this was all part of the learning curve that new doctors had to go through. Classroom and textbooks didn’t teach you the reality of how the institutions functioned.
“Also, despite having all the right signatures, you and your group will need to be sensitive to any question or concern voiced by the staff at this facility. One complaint by them and the conservator will shut you down,” Ahmad told the young man. “One specific nurse in particular is like a watchdog with JD. I want you to treat her as you would if she were family to the patient. Explain what you can and be sensitive; she only has the welfare of the patient in mind.”
Sid nodded again, more agreeable than Ahmad had ever seen him. He figured the young resident was too excited at the prospect of starting the study to object to anything.
As he looked at the clock on the wall, there was a knock on his open office door.
“Here she is…the person I was just warning you about,” Baer said, loud enough for Jennifer to hear.
“Warning?” she said stepping in. “I like the sound of that.”
“Sid Conway, Jennifer Sullivan,” he made the introduction, intentionally dropping titles. “Sid is doing his residency in neurology at UCONN Health Center.”
Ahmad guessed Jennifer was in her forties. She was small built, attractive, but one wouldn’t call her beautiful. One thing she did have going for her was intensity. When she spoke, she had that mother voice that was impossible to ignore.
“I’m running a little late. But I haven’t forgotten. JD is the first one I see today,” Ahmad said. He figured he’d say more as far as Sid’s study once they were done examining the patient.
She nodded. “I didn’t mean to rush you, but the third shift nurse told me that JD had another episode about 4:30 this morning. They gave her the sedatives you prescribed.”
“How is she doing now?” he asked, picking up the clipboard with the list of patients he was seeing today off his desk.
“She’s still sleeping and I don’t like it. We’d never had to give her sedatives to keep her calm. There’s something more going on right now. She wasn’t like this before.” Jennifer held up a thick folder she was carrying. “I double-checked her files. Yesterday was the first episode.”
Ahmad took the folder and handed it to Sid. “This will bring you up to date with everything else that I might not have mentioned this morning.”
Jennifer looked at them in surprise.
“Sid is going to get involved with JD,” Ahmad told her before leading her out the door and down the corridor. As the three walked, he asked her whether there might have been any changes in JD’s routines, in her medications, in the personnel seeing to the young woman’s care.
Jennifer had already checked into all of those things. She had the answers. Nothing had changed.
“She lost her roommate about ten days ago. We hadn’t needed to put another patient in there, yet. Her treatment has been exactly the same for the past five years…almost six years. Now she has these episodes.” Jennifer frowned. “Have you ever seen something like this with another patient?”
“Head injuries and patient response continue to be unpredictable.” He motioned over his shoulder at Sid, walking a step behind them as he paged through the folder. “That’s why we have to be nice to new doctors like him. Maybe they can open the door for the rest of us.”
Friday mornings were traditionally popular for visiting. There were more people around, in and out of the patient’s rooms—as well as in the glass solarium—than any other day of the week.
Running interference like a lineman, Jennifer moved a half step in front of them, warding off anyone who showed any intention of stepping into their path and speaking to Ahmad.
“The wing where JD is located is used primarily for patients in vegetative or minimally conscious states,” Jennifer told Sid as they went through a double set of doors. The noise level dropped considerably in this section.
“Is there a way we can set up our equipment in JD’s room or somewhere close to her?” Sid asked her.
“What equipment?” Jennifer asked immediately.
“Dr. Conway is leading a research team from UCONN Health Center. It involves vegetative or MCS patients.” Ahmad figured this was where formality mattered. “I was able to get approvals this morning from JD’s conservator to add her to the study.”
“What’s the object of the study?” she wanted to know, stopping outside of JD’s room.
“The first step of the study involves brain scanning,” Sid explained. “The tests are noninvasive. We’re recording the raw noise of neurons firing in the brain and feeding them through highly complex computer models to construct visual images of what might be at a particular moment in patient’s brain.”
“You can read her thoughts?” she asked, surprise in her voice.
“That’s partly what we’re hoping for. The ultimate goal is to develop a means of communication for people in her situation.”
“This is great,” Jennifer said excitedly. She gave Ahmad a soft tap on the arm. “I…I was hoping that there’d be something that you could do for her. It’s about time.”
Ahmad and Sid exchanged a look as Jennifer stepped into the room ahead of them.
“You are on your way,” Ahmad told the young doctor.
Inside, the patient’s face was turned toward the window. The shades were open. Sun poured in.
“Good news. My girl is awake,” Jennifer said cheerfully, moving to the head of the bed.
The nurse caressed the young woman’s short hair and whispered something to her. Ahmad looked at Sid. He was no more than a step into the room and staring at JD.
“Do you want to make some calls to Farmington and get the equipment ready to come down here?”
It took a second or two before the question registered. He turned to Baer. “I…I will. After we go through the examination.”
“Everything okay?”
“Sure. It just didn’t sink in that she’s so young.”
As a doctor, Ahmad tried to not differentiate between old and young or men and women. There was still something especially tragic, though, when you had to treat a person who was so young and in this condition. He reached for her chart from last night at the foot of the bed. There w
as a newspaper on a tray table next to it.
“Someone forgot their paper,” he commented.
“No. That was Pat Minicucci, the nurse you met yesterday. She brought it in this morning.” Jennifer picked up the paper, opened it to page four, and held up an article and photo.
“The accident in the Gulf of Mexico,” Ahmad said. “I caught bits and pieces of it on the news.”
Jennifer spread the page out on JD’s legs on the bed. “The pictures of the scientist who died in the facility. This one.” She put on her reading glasses and read the name. “Marion Kagan. Pat thinks our JD looks awfully similar to this young woman.”
Ahmad saw Sid lean over the paper, too. JD’s face was turned toward them. The eyes were focused on Jennifer’s face. He walked to her.
“Maybe,” he admitted. Six years in a minimally conscious state had taken its toll on the young woman. She was pale and extremely thin. Her hair was kept extremely short for the purpose of hygiene. “There are similarities, I suppose. In the cheekbones…maybe around the eyes. What do you think?” he asked Jennifer.
She shrugged. “I’ve heard that every one of us has a double out there.”
Ahmad noticed Sid had moved next to the bed, too. JD’s eyes were now focused on the young doctor’s face.
“Are you any relation to Marion Kagan?” Sid asked.
The patient’s right hand lifted off the mattress for a few brief seconds before dropping back down onto the sheet.
CHAPTER 11
Nuclear Fusion Test Facility
When Marion opened her eyes, everything was still pitch black. And silent. The only sound was her own breathing.
She closed her eyes again and waited a moment. She was lying on her back and her head was turned to the side. The pain was still shooting along the side of her head into the back of her brain.
She remembered what had happened. Careful not to roll her head, she flexed her fingers gingerly. She realized that she now had feeling in both hands and arms. She tried her feet; her ankles were stiff, but everything was moving. Bracing herself with one hand, she lifted the other above her, feeling in the blackness for anything above her. There was nothing.