Trauma (29 page)

Howard Bryant emerged from the garage, carrying a tray of gardening tools, dressed for that sort of work. He set down the tools and sauntered over to his kids.

“Who's up for a game of Horse?” Howard asked with a star-bright smile on his face. Like their mother, Howard wanted his two children living on their own, but the sparkle in his eyes said he would cherish every moment spent together as a family under any circumstance.

Adam passed the ball to his father with maybe a little less zip than his delivery to Carrie. Not missing a beat, Howard caught the ball with two hands, took a couple of dribbles, and fired off a shot that could have been a mirror of Adam's earlier jumper. It hit nothing but net.

The game commenced as the sun beat a final retreat and birdsong filled the sweet-smelling air with joyful chatter. Howard started off the game with a layup, made it, and passed the ball to Adam, who also made the shot. Carrie, still favoring her left ankle, dribbled awkwardly to the hoop and clanged the ball off the rim.

“Carrie's a bit lame,” Adam said.

Carrie acted indignant. “We're
playing
Horse,” she said. “I'm not one.”

“Just keep the move-and-shoot to a minimum, Dad. I'd hate for us to have to put her down.”

Howard made a face, but the truth was that he'd been encouraging Adam to lighten up, to relax. Any show of levity was a minor victory in an otherwise endless war. Howard saved his expression of concern for Carrie.

“Did you hurt yourself, sweetheart?” he asked.

Carrie shot Adam a nervous glance, fearing he might say something about the incident in the park. Her dad might not think it was so innocuous, either. The world was full of predators, and Carrie was not interested in a lecture on safety. Adam gave Carrie a look that said she could trust him.

“I'm fine,” Carrie said. “It's just a slight sprain, that's all. I fell while jogging. I can still take you boys on.”

The winner of the game was basically predetermined. The real contest was between Howard and Carrie for second place. Adam seemed to relish his expected victory, and a fraction of a grin overtook his face, until his gaze settled on the dysfunctional Camaro visible in the garage. Adam stomped over to the garage, pushed the button to shut the door, and returned to the basketball game with a look of disgust.

“Come morning, I'm turning that pile of metal into scrap,” he said.

The glower on Adam's face remained until he buried three free throws in a row. Neither Carrie nor Howard reacted. They had heard the same threat many times before.

Carrie tried another shot and missed.
H-O
. Not wanting to earn the final three letters, Carrie decided her ankle needed a more supportive sneaker. She excused herself to go inside and change footwear.

Carrie could not locate the sneakers she wanted in her closet at first, but eventually saw them to the left of her black riding boots. It was a bit odd; Carrie was normally fastidious about her closet, and those sneakers were always to the right of her boots, kept in order of size. She sat on the bed and put on her sneakers, then got up to feed Limbic.

While Limbic gobbled every flake of food offered, Carrie opened her dresser to change into a different T-shirt. Right away she could tell someone had rifled through her clothing. Her shirts were folded, but not exactly as she would have done it. Close, but not perfect. Not her stamp.

Carrie was on high alert, every muscle tense. She scanned her bedroom for other anomalies. They were not especially difficult to spot. The sheet on her bed had not been pulled as tight as she would have done, and a stack of papers on her desk seemed closer to the window by about six inches. All these details were minor, but Carrie cut her teeth obsessing over the minor details. She noticed everything. Somebody had been in her room. Not just in her room, but looking through her things.

Carrie tried to make sense of it and arrived at one disturbing conclusion—Adam had spied on her. Who else could have done it? As much as she tried, Carrie could not come up with another logical explanation. His mental state was obviously fragile, but he had never done anything this strange, this out of character. Carrie's pulse accelerated as she descended the stairs, but at the bottom step she paused.

Deep breaths … deep breaths …

The surge of anger subsided like the tide rolling out to sea. There was an answer, Carrie assured herself. It would just take a conversation with Adam to clear things up.

Outside, Carrie found her father and brother shooting around. She approached tentatively, hands on her hips.

Howard stopped dribbling and said, “What happened to you? You look pale.”

Carrie's heart fluttered as the anger returned. “Was somebody in my room?” She looked right at Adam, and her composure vanished.

“What are you talking about?” Howard asked.

“Somebody went through all my things. My clothes, under the bed. Somebody was in my room.”

Adam's eyes narrowed and his face reddened like a boiled lobster. “Why are you looking at me?” he asked.

“I'm just asking,” Carrie snapped. “I'm trying to figure it out.”

Howard said, “No. No. Of course not. Nobody went into your room.”

Adam took a step forward. “Are you accusing me of something?” His voice held violence. His eyes were like pools of lava bubbling just below the surface and about to go volcanic.

Carrie changed her approach. One slight push might be enough to send Adam over the edge. “I'm trying to figure out if somebody went into my room, or not, that's all.”

The answer, of course, was that
somebody
had been in there. The question was who.

Adam was not about to beat a retreat. He had been accused of wrongdoing and felt victimized. “Maybe you're getting paranoid,” he said. “First you think a guy is chasing you in the park, and now they're rummaging through your stuff?”

“What guy?” Howard asked, turning to Carrie.

“It's nothing, Dad.”

Adam let the basketball roll into the woods and approached Carrie in a menacing, threatening manner. His shoulders were forward, his arms out in front of his body, palms facing up. “Maybe the jogger is the guy who went into your room,” he said.

Maybe,
Carrie thought.

But that seemed incredible. It was too bizarre to reconcile. Why would somebody go into her room? What could they be looking for?

“Were you here all day?” Carrie asked, not yet ready to back down.

Easy, Carrie … Easy …

“Yeah, I've been here all day. Going through your crap.”

“Adam, that's not necessary,” Carrie said in a softer tone. “I'm just trying to understand what happened.”

“Understand this,” Adam said. He held up two hands with his two middle fingers fully extended, then turned and marched his indignation all the way down the driveway.

Carrie felt sick to her stomach, but it had been the most logical conclusion. While her father and mother were out and about, Adam had free rein around the house.

Howard appeared crestfallen. “You have to be careful with him, Carrie,” he admonished.

Now she felt even worse. Disappointing her father, her hero, even a smidge, put a crimp on her heart.

“I'm sorry, Dad, but somebody was in my room.”

“Well, obviously it wasn't your mother or me, and I'm willing to believe Adam. You're under a lot of strain, Carrie.”

Carrie took a sharper tone. “Are you suggesting I'm making it up? I know what I saw, Dad.”

Howard did not take the bait, and he was not going to get into it with her. “Just go easy on your brother,” he said. “You two need each other. And I need to know that you're there for him in case we're not.”

Carrie understood the subtext. She nodded glumly at the thought of her parents' demise. It would be many years away, she prayed, but one day they would be gone, and her dad was right: She would be Adam's lifeline.

“You can count on me, Dad,” Carrie said. “I won't ever let him go.”

Howard leaned forward and kissed his daughter gently on the cheek. “Good,” he said. And with that, Howard headed down the driveway to go looking for his son.

 

CHAPTER 39

At five thirty the next morning Carrie was back at the VA for Gerald Wright's DBS surgery. Parkinson's disease had crept into and enveloped the retired lieutenant colonel's life over the previous fifteen years, and as with all the other PD candidates for DBS, medication management had become unreliable. The surgical team, including Carrie, Dr. Finley, and the anesthesiologist, Dr. Kauffman, met to review Wright's MRI from the day before and the CT scan from that morning to determine where best to insert the leads.

To Carrie's surprise, Dr. Evan Navarro showed up for the meeting. The images had just been brought up on the computer when Navarro entered the conference room without knocking, as though he belonged there. He gave Carrie a cool smile as he walked through the door.

“What are you doing here, Evan?” Carrie asked.

“Sandra wanted me to observe this morning,” Navarro said. He fell silent, feeling no compulsion to further elaborate.

Carrie's heart began to thunder. In the aftermath of yesterday's tumult in the park, she gave serious consideration to the possibility that the missing vets, the encounter with the jogger, and the ransacking of her room were all somehow connected. Now that Navarro had shown up unexpectedly, this notion took deeper roots.

Navarro looked snappy in his white lab coat, red-and-white-striped tie, and dark trousers. His hair looked extra oily, slicked back as if in homage to Eddie Munster, widow's peak and all. Carrie bristled at the thought of him joining her. A glance told her that Dr. Finley was equally displeased.

“Why would Dr. Goodwin want that?” Carrie asked.

“Surgery is her department, Carrie,” Navarro answered coolly. “I don't ask how she runs it. I just do my job.” His tone was condescending, implying Carrie would benefit from doing the same.

Dr. Finley stepped forward. “This is entirely inappropriate, Evan.” His face was a shade of crimson Carrie had never seen on him before. “Nobody cleared this with me.”

Navarro just shrugged. “You'll have to take that up with Sandra, too, I guess.”

“And I damn well will do just that,” Dr. Finley said. “We both know what this is about, don't we, Evan? And it's total bullcrap.”

Navarro's smarmy expression set Carrie's blood on fire. “Well, Alistair, last I checked, this is surgery that you're doing here. And that would be my boss's area of responsibility. So I can only offer the same reply to you that I just gave to Carrie, which is if you don't want me here, you'll need to take that up with Sandra. Otherwise, I'm not interested in pissing her off today—or any day, for that matter.”

Navarro set his beady little eyes on Carrie. She glanced over at Dr. Finley, who glowered at Navarro until he softened. No value in wasting energy, his expression conveyed. He pulled Carrie aside.

“I suspect this is a bit of payback for questioning her AMA orders,” Dr. Finley said in a whispered voice. “I know her style. She's letting you know you're on notice. Don't worry about it, and try to ignore Navarro if you can. I'll speak to Sandra after and see if I can smooth things over. Nobody wants to work under a microscope.”

Carrie gave a nod. She had her own payback in mind for Goodwin, and after the surgery she would help David make that plan a reality. For now, Carrie would dedicate all her attention to her patient and ignore Navarro as Dr. Finley advised.

The question now was where to place the electrodes.

Wright's facial inexpressiveness, unblinking vacant stare, and almost inaudible whisper of a voice belied a reasonably intact intellect, but significant personality and behavioral problems had influenced Dr. Finley's decision. The apathy and depression, for example. Were these behaviors a direct consequence of his disease, or an understandable psychiatric reaction to the devastations of a failing motor system?

Wright had had enough problems for Dr. Finley to decide on the right globus pallidus interna for the stimulating electrode target. This would seem to afford the best opportunity to reduce the left arm tremor and improve Gerald Wright's overall motor status. Dr. Finley and Carrie considered other target placements, but the risk of psychiatric complications favored the GPi as the better choice.

“He may be a bilateral case,” Dr. Finley told Carrie as she went in to scrub for the surgery, “but let's see how he does with this side first. He's pretty intact cognitively, but I'm concerned about his behaviors and the neuropsych testing reports we've gotten back.”

Carrie was still schooling herself in the subtleties of Parkinson's disease and the options of DBS surgeries. Like everything else in medicine, this was a rapidly evolving discipline, meaning patient and doctor alike were on steeply ascending learning curves. Carrie reprimanded herself for not spending more time studying about PD, even though she was still new to the program. She'd had too many distractions.

Like missing vets.

The familiar harsh smell of Betadine scrub and the lather up above her elbows brought her mind back to the problem at hand, retired LTC Gerald Wright. She smiled slightly beneath her mask. Despite all that was going on, she was still a surgeon at heart, and she could focus all her attention on her profession and the task at hand.

Funny how at the most unpredictable of times, she became aware of the transformational effects of training. No one had ever taught her to feel like a competent doctor, a leader. But that was how she felt as she did her second scrub midway up the forearms, and then the third, just the hands.

She entered the OR not feeling as comfortably in the zone as she was accustomed.

The procedure was becoming commonplace, which played in her favor: affix the stereotactic frame with four screws under local anesthesia first thing in the morning, then down to MRI for ultra-thin slices, with the images sent over to the planning station in the OR. Carrie selected the optimum XYZ coordinates to minimize risk of brain injury or hemorrhage as the needle advanced its way to Gerald Wright's globus pallidus interna.