The Nirvana Plague (5 page)

She picked up her tablet and fiddled with the screen icons, found her GPS coordinates and dropped them into Marley’s channel.

“Got it,” Marley said. “It’ll take me a little while to get there. Sit tight.”

Marley called her back an hour later. “I’m almost there now. What does your car look like?”

“Don’t worry, I’m sure I’m the only car anywhere near these coordinates.”

A minute later she saw in her foggy mirror a blob of light rolling up behind her. The thump of a door, and a shadowy figure walked up to her door and knocked on the glass. She threw off the silver blanket, popped the door, and rolled out.

“Sorry it took me so long,” Marley said. “It’s hard to find your way around when it’s so dark. — No word, I guess?”

“No. I’ve been calling home every five minutes or so. Nothing.” Karen threw her bag into the backseat of Marley’s car.

Marley clicked a couple of buttons on his console computer. “Where do you live?”

A heads-up display appeared on the windshield in front of him — a local street map traced in colored lines. A pointer showed their current position.

She looked at the insignia on the steering wheel — Mercedes. “Nice car.”

He smiled. “At least it’s warm. You looked like you were getting pretty chilly.”

“I was all right. I had a blanket. — My apartment is not far from the campus. Seven-oh-three Hamlin.”

“Oh, I know where that is,” he said. “That’s not far from my wife’s coffee shop. Do you know it? Coffee Alley?”

“Ally is your wife?”

“I believe this is the point where one of us is supposed to say
small world.
”

“Well, you just did.”

He turned into a bigger street and kicked the car up to speed. “So you know Ally?”

“I’ve met her. I go there all the time for breakfast. Latte and croissant. But I don’t really know her. She’s very nice. Good coffee.”

“I’ll tell her we met. Maybe she’ll give you a free latte next time you’re in. My influence and a Lincoln will get you a cup of coffee in this town.”

“It’s only four fifty.”

“But now you’ll have to pay the friend-of-husband surcharge. That’s another ten percent.”

“Four ninety-five.”

“Plus tax.”

Marley followed his windshield map back to the main road, then clicked it off and headed north.

He told her he was very sorry about the situation with her husband, but that Roger had given the staff no options. Absent explicit terms of commitment or compelling medical justification, they had no legal authority to physically restrain him, and that appeared to be the only way they could have kept him in the hospital.

“Well, that’s just it, doctor. Considering the shape he was in when he was admitted, don’t you think you had compelling medical justification to hold him?”

“Two weeks ago, we would have had, yes. But your husband’s condition has been improving since then, and in the past twenty-four, thirty-six hours his condition has changed dramatically. That’s what I’ve been wanting to talk to you about today.”

“What’s happened?”

“I talked with Roger first thing this morning. I’ve been his doctor now for ten years, and I’ve seen his condition in many phases, in and out of psychotic episodes. But he’s never shown any significant progress overall. Even during his most high-functioning periods, he has been very obviously ill. It’s only because of you that he is able to live anything like a normal life outside an institutional setting. You’ve done a wonderful job with him, Mrs. Hanover.”

“Let’s drop this ‘Mrs. Hanover’ business, OK? How about you call me Karen and I’ll call you — whatever you like.”

“Carl will do fine.” He flashed her a smile. “When’s the last time you spoke with Roger?”

“Yesterday morning before I left the apartment to go to my office.”

“How did he seem?”

“I didn’t notice much difference. He seemed distant and cold, just as he has been for the past week. I asked him if he’d had his morning meds, and he said yes.”

“That was the last round of medication he took. Sometime yesterday things began to change for him.”

As he continued, she looked away, out her window. She watched the dark blocks of the suburban landscape gliding past like half-sunk hulks. No streetlights were lit. No neon signs. Now and then she caught warm light spilling from a bare window, or the fluttering glow of a television backlighting a closed blind.

“But the Roger I interviewed this morning was unlike any Roger Sturgeon I’ve seen since I began treating him a decade ago. In fact, in some ways, he was unlike any other patient I’ve ever had. I haven’t been able to put my finger on exactly what was so different about him. I’ve been thinking about it all day. Now I never knew Roger before he was ill, of course, but I can get a sense of Roger’s normal personality beneath the distortions of his illness, as I’m sure you can still see the echoes of the Roger you knew before.”

She didn’t answer. She was crying again, and kept her face turned away. Out over the lake, the blinking red and white lights of approaching jets slowly circled in toward the city.

“Well, in a similar way, when I talked with him this morning, I could still see the echoes of the diseased personality, and the symptoms typical of his form of disorder, but it was largely obscured by a completely new set of behavioral and speech patterns. It’s rare for anyone — whether normal or diseased — to manifest sudden and dramatic personality changes. Your basic personality tends to be pretty stable — by definition. Your personality
is
those characteristics of your behavior that don’t change much over time. Generally, dramatic sudden-onset personality changes only happen as a result of physical or chemical insult to the brain. However, there is, in this case, no reason to suspect that anything like that has occurred.”

“So what happened?”

“I don’t know. I need to work with Roger some more.”

“Letting him walk out of the hospital probably wasn’t the smartest thing to do then.” She regretted saying it the instant it was out of her mouth.

“I’m sure he’ll turn up soon.”

“Let’s hope alive.” She said it sadly, not sarcastically. And it hurt to be genuine.

“When he does turn up, I’d like for you to call me right away. I want to try to get to the bottom of this quickly before it gets out of control.”

“Seems to me
it
is already out of control.”

“I didn’t mean your husband, or his condition,” Marley said coolly. “Though, of course, that is also my concern. But whatever has happened to your husband, it may be catching.”

Karen laughed. That was quaint.
“Catching?”

“Yes. This afternoon, two more patients on the seventh floor refused their medications. The ward staff fears the outbreak of a general rebellion. That’s why I was at the hospital late again this evening. In fact, I’d only just got home when I called you in your car.”

“It was kind of you to come rescue me. I’m sorry if I haven’t been very gracious about it.”

“I understand.”

“That’s what we pay you for, right?”

Marley didn’t respond.

“Shit. See, I can’t stop myself.”

“Don’t worry about it. I’m a big boy.”

“I suppose if you couldn’t tolerate a little gratuitous abuse you wouldn’t be in this line of work.”

Marley laughed — a little. “No, I guess you’re right about that.”

“Anyway, you were saying. So what did you learn at the hospital?”

“I learned that your husband had been talking with these other two patients all morning, as well as some others.”

“Roger was talking to the other patients?”

“Yes. And more.”

“And more?”

“As I understand it, one of the female patients he was talking with this afternoon suddenly became quite agitated. This particular woman has a long history of depression, sometimes sinking into catatonia, but no history of mania or lability. According to the orderly who was sitting with them on the ward — I mean, Roger and the other two patients — she suddenly had quite a dramatic outburst. Screaming and rigid. She had to be isolated. However, she continued to be quite agitated. When I arrived, she appeared to be extremely frightened. We were discussing whether to try to stabilize her with a mild sedative when one of the staff came to tell me that Roger was asking if he could speak to her.”

“You’re putting me on.”

“No. I told them to bring Roger into my office and asked him what was going on. He said she was just confused. I asked him what she was confused about. He said it was like when you wake in the middle of a dream and you’re not sure what’s real. I didn’t really understand what he was getting at, but it struck me how aptly his metaphor captured her current emotional state. So I decided to let him go in and talk to her, and he did. She was still standing quite rigid in a corner of the isolation room, looking very frightened. Whenever anyone entered the room she would start screaming. But she didn’t when Roger went in. He walked straight over to her and embraced her.”

“He embraced her?” Karen couldn’t remember the last time her husband had held her, or allowed her to hold him.

“Yes.”

“Roger put his arms around her?”

“Yes. And she went limp almost at once. Then he led her over to the bed, and she lay down and went to sleep.”

“I can’t believe it. Who was the patient?”

“I can’t tell you that.”

“I know all the patients on the floor anyway.”

“I still can’t tell you that.”

“It doesn’t matter. He doesn’t have any friends in the hospital.”

“I know. But I was there. I saw it happen.”

Karen looked out again at the faceless dark buildings. Roger was out there somewhere. Like a dog lost in the wilderness. What was he doing at this moment? Trying to find his way home? Or just drifting along?

“In fact, he doesn’t have any friends at all,” she said, quietly. “He doesn’t even treat me like a friend.”

“It was quite remarkable.”

“Well, why do you say it’s catching? What else happened?”

“I interviewed the other female patient who had been seen talking to Roger. She exhibited behaviors quite similar to Roger’s new presentation. I have been treating this woman for several years, and her history and symptoms are quite different than Roger’s. The other woman, the one who had been isolated, is not one of my patients, but I spoke with her doctor by phone. I also talked to the orderly and several of the staff about what had happened. By that time, she was awake from her nap, and, with her doctor’s permission, I interviewed her as well. Her behavior now shows remarkable similarities with Roger’s new symptoms and the other patient’s.”

“Busy day in the loony bin.” It was better to be bitchy than helpless.

“Yes,” Marley said. “An interesting day.” Then added, “For a change.”

“Bored with your work, doc?”

They fell silent for a while. Karen watched the taillights of the other cars. Marley drove fast and passed frequently. But the car rode so smoothly it didn’t feel fast. It was like floating through a school of flashing red fish. After a while she said, “So what do you think is going on?”

“Well, as I said, it’s difficult to put my finger on it exactly. Each of them seems to be struggling to express something that they can’t find the words for, or can’t get clear in their minds. However, they don’t appear to feel confused so much as frustrated, or perhaps anxious. Each of them seems to avoid using personal pronouns, especially in the first person. Each of them seems much calmer than before. And, of course, each of them has refused medication.”

He didn’t say anything else for a minute as he negotiated traffic, exiting onto McCormick Boulevard.

“Now,” he resumed, in a lecture hall tone, “none of the symptoms I just described is a particularly unusual manifestation, either individually or as a set. What
is
unusual is that none of these symptoms has been a feature of the symptomatologies of any of these patients before now. In fact, until now these three people have been exhibiting rather different presentations, and now they are all presenting with strikingly similar behavioral and verbal symptoms.”

“So. What is it?”

“The three most obvious candidates are biochemical pollution, infectious disease, and sympathetic reaction. Frankly, I don’t think any of these is tenable. If there was some sort of chemical contamination going on, it would be affecting everyone on the ward.”

“And it would be a big coincidence that these happen to be three people who were talking to each other all morning.”

“Right. On the other hand, if it was infectious disease, then presumably the two female patients contracted it from your husband only today, which means—”

“That it would have to have a remarkably short gestation period.”

“Right again. And it would also seem to produce a remarkably well-defined set of rather sophisticated behavioral changes. We have never seen a disease that can affect human behavior that consistently and that profoundly. Humans are just too complex. Diseases like Alzheimers, or neurological toxins such as lead and mercury, take much longer to manifest their effects on the system.”

“So what about the third factor?”

“Sympathetic reaction isn’t particularly prevalent among these types of patients. One of the most debilitating aspects of schizophrenia is how isolating it is. Though chronic patients living together on a ward for a long time do tend to show similarities in their symptoms — that’s true of people in general — it’s a basic aspect of how our social groups work. But even so, patients don’t just sit down and have a conversation one morning and get up with radically altered personalities.”