A smiling face appears in front of her – chalky skin, too-pale blue eyes, flyaway fair hair; the face of a fairy. Of an angel. It takes her a moment to recognize it as Zena’s.
“Where is he?” Shiv asks, panicky, trying to sit up.
The nurse’s smile crinkles into a frown. “Who?”
Shiv can’t recall. She’s in a bed, in a light white room, and the bed is so soft, so comfortable. “He climbed too high,” she says.
“Here, you’re all unwrapped.” Zena tidies the covers, straightens the pillows behind Shiv, helping her to sit up a little. “Drink this.”
Blue beaker, green straw. Blue and green should never be seen. Where does Shiv know that from? Mum, she supposes. Or is it red and green? Shiv fumbles with her lips for the tip of the straw and for some reason is reminded of a giraffe’s rubbery mouth as it plucks at a leaf on a high branch.
“Go easy,” Zena says. “Just small sips.”
Fruit juice. It’s so unbelievably delicious. Shiv has already swallowed several mouthfuls before she remembers she’s only meant to drink water.
“I shouldn’t be dr—”
“You’re in the medical room,” the nurse says. “My rules, not yours.”
The medical room. She looks around. Yes, she knows this room – she’s been here with Mikey. Mikey – that’s who she was asking about just now. “He got stuck in the tree,” she says, urgently, batting away the straw as Zena offers her the beaker again. “I went up after him and … I must’ve fallen.”
“You fainted.”
“No, I was—”
“You passed out as you were leaving Write.” The nurse touches her own chin. “Got yourself a bit of a bump – a carpet burn.”
Shiv mirrors the gesture, wincing at the sticky, tender skin. Lowering her hand, she realizes – although it must have been there all along – that an intravenous drip is attached to her hand. The IV stand beside her bed holds a plastic pack of clear fluid.
Zena follows Shiv’s gaze. “We had to get some nutrients into you.”
“Did Caron tell you?”
“You did a very good job of hiding it from us. I’m impressed.”
It’s clear from her tone that the nurse isn’t at all impressed; that she thinks Shiv has been stupid but, also, that the staff have been stupid not to realize sooner.
Shiv examines the tube taped to the back of her hand, where it enters the vein.
“If you pull it out,” Zena says, as though reading her thoughts, “I’ll just sedate you and put it back in again. Keep you sedated, if I have to.”
The hours in the medical room drag and drift. Nothing to do but doze, or stare at the ceiling, or lie there watching the fluid bag slowly drain into her body.
Are they trying to bore her into submission?
In an often-repeated family tale, Mum tells of the time when everything went quiet in the delivery room while she was in labour with Declan. A temporary lull in the contractions, that was all. But as it dragged on, her mother, woozy with pain-relief drugs, looked at Dad and the midwife and asked, “What are we all waiting for?”
“For you,” the midwife had said, laughing.
Dec took twenty-seven hours to be born. He lived twelve years, six months, seven days.
How Mum was, that’s how Shiv feels: in suspended animation, with everyone (including Shiv herself) waiting for her. To do something. Everyone’s waiting to see what she does next.
Right now, she has no idea what that might be.
Towards evening, judging by the failing light at the window, Zena announces that she has a visitor. Not Mikey – they’ve told Shiv she can’t see him – but even so she half hopes he’ll step into the room.
“Hey,” Caron says, smiling, but looking uncertain.
“Oh, hey.” Shiv sits up, manages to smile back.
“Now, I’m a bit out of practice with you,” the older girl says. “So, is that your good-to-see-you-please-come-in smile, or your piss-off-and-leave-me-alone smile?”
“Both.”
“’Zuss, girl, you were nowhere near this complex when I first met you.”
Actually, Shiv is glad to see her. The hours by herself with no one to talk to have worn her down. Her eyes well up.
“Hey, hey.” Caron crosses the room, takes up the hand that isn’t snagged with an IV tube and massages it between both of hers.
After a moment, she pulls up a chair and sits beside the bed. They don’t have much to say at first; at least, they have lots to say but leave most of it unsaid. They just sit there like two women working on a patchwork quilt, sharing odd scraps of conversation between bouts of silence.
At one point, Caron says, “I was going to wear my red dress, for old time’s sake.”
In fact, she’s in a navy sweatshirt and her faded, ripped-at-the-knee jeans. She points at Shiv’s pyjamas. “You not wearing your—”
“Underneath,” Shiv says, tugging the pyjama top. “Fifty days out of fifty.”
Even on laundry days, Shiv has got them to tumble-dry the Salinger T-shirt so she could put it back on as soon as possible.
“Was your brother wearing it when he died?” Caron asks.
An image comes to her: yellow T-shirt. “No,” she says. “He wanted to wear it on the flight home, so Mum put it in the wash.”
It was still pegged on the line at the villa the morning after; Shiv took it down, stashed it in her case – to stop Mum from seeing it, more than with the intention of keeping it for herself. That came later, back at home.
“I used to imagine it smelled of him,” Shiv says. “But it didn’t. It smelled of Greek washing powder.” She stifles a yawn.
“Bored of me already?” Caron asks. “Or just tired?”
“Bored, definitely.”
They smile. It feels good to share a smile with her. Caron looks better, the shadows under her eyes nowhere near as bad as they were. PTU seems, finally, to have begun working for her.
“Actually,” Shiv says, “you’ve lasted longer than my other visitor.”
“Who was that?”
“Dr Pollard. I totally blanked her and after about five minutes she gave up.”
Shiv frowns. Was that today, or another day altogether? No, it must have been here, because Nurse Zena was changing her IV bag at the time. But then, Declan was standing across the room earlier, when she surfaced from a doze – doing his wave, like there was a window between them and he was wiping a hole in the condensation.
She can’t tell things apart any more: five minutes ago and five hours ago; being awake and being asleep; what’s in the room and what’s in her head.
For all she knows, she could be imagining Caron.
“So, have they?” The girl’s voice tugs at her attention. Shiv gets the impression she’s repeating a question Shiv must not have heard.
“Have they what?”
“Said when they’ll let you out of here.” The medical room, she means.
“Not today – they want to fatten me up some more. Also, they think I might’ve knocked myself out when I fainted,” Shiv says. “Dunno, maybe tomorrow.”
“Then what?”
Shiv shakes her head.
“Only, we’re so close to the finishing line,” Caron says, leaning forward.
“Finishing line? You think there’s a finishing line?”
“There can be, Shiv. If you—”
“Did Pollard put you up to this?” Shiv asks, suddenly cross. “Eh? Let’s send Caron in, see if she can talk some sense into her. Is that why you’re here?”
“No, I asked to come.” Caron is annoyed. “If you want the truth, you’re ‘at such a crucial point in your recovery’ I had a job getting Dr Pollard to let me near you.”
“Recovery? That’s a laugh.”
“’S’what she said.”
Shiv fixes her a look. “So why did you want to be anywhere near me?”
“Bizarrely enough, because I like you. And I’m worried about you.”
“Yeah, well, don’t be. I feel good. I feel strong.”
“Sure.” Caron gestures at her. “I can see that.”
Shiv taps her head. “Up here, I’m talking about.”
“Right. ’Cos, of course, what Declan would’ve wanted –”
“Don’t tell me what my br—”
“– is for his sister to starve herself to death for him.”
“Oh, like you never tried to kill yourself over Melanie?”
“That was before.”
“Before? Before what?”
“Before I came here.”
Shiv shakes her head. “All therapy comes down to the same thing in the end.”
“What?”
“You have to learn to think like your therapist. Same in school – ‘right’ is what the teacher says is right; ‘wrong’ is what the teacher says is wrong.”
“No. It’s true, what I just said. It’s what I believe.”
“Really? Or is it just what you need to believe to get yourself through this?”
Caron leaves. No big scene or stropping out of the room – she even finds another smile for Shiv and gives her hand one last squeeze. Then she lets herself out of the medical room and Shiv is alone once more.
Shiv calls after her, shouts out that she’s sorry. Too late.
Her gaze settles on the hand Caron just touched – it was the one with the tube. Shiv looks at the tube, where it goes into the vein. Then she yanks it right out in one quick rip, releasing an arc of startlingly bright red blood across the sheet and, with another swipe of her arm, sends the IV stand crashing to the floor.
It’s another couple of days before Shiv’s considered well enough – reliable enough – to be discharged.
She’s barely in her room ten minutes when Hensher appears at the door.
“Dr Pollard wants to see you.”
Shiv follows him. When she realizes where Hensher is taking her, she begins shaking. Stops in her tracks, starts to turn back. Not until he assures her that the room won’t be “active” does she finally agree to step inside.
“You know why this place is called the Korsakoff Clinic, I take it?” Straight in. She hasn’t even said Hello or How are you?, or anything like that.
Shiv nods. “I read the stuff you sent my dad. Googled it and that.”
“So, you’ll know Dr Sergei Korsakoff was a neuropsychiatrist. Psychiatry examines what we think and why we think it,” Dr Pollard says, “while neuropsychiatry looks at how we think. In particular, the effects of neurological damage or disorder.”
They’re sitting on the floor in Shiv’s Personal Therapy Unit – facing each other across the room, backs against the walls, voices echoing. The projectors are switched off, the walls, floor and ceiling a uniform off-white. Stripped of its picture show, the PTU looks smaller, ordinary. Nothing to fear.
Why has she been brought here, of all places?
The Director is talking about Korsakoff’s Syndrome.
“Also known as amnesic-confabulatory syndrome. Amnesic, as in memory loss; confabulation, as in false memories or perceptions. In basic terms, sufferers of this disorder not only have gaps and lapses in memory or perception, they create memories of things which didn’t happen in the past and perceptions of things which aren’t happening now.”
“Seeing things?” Shiv asks.
“Hallucination can be a symptom, yes.”
Shiv thinks of all those sightings of “Declan” in the grounds. The holding of hands during Walk. The other day in the medical room.
Dr Pollard sits up a little straighter, like a propped-up Barbie. Smart, suit-wearing, psychiatrist Barbie. “In some of the incidents after Kyritos – whether or not you realized it – it’s probable you were experiencing amnesic-confabulation.”
The vandalism, she means. The violence.
Shiv is about to deny it but, no, of course, there was that time she smashed up the bottles of booze in the supermarket and, afterwards, had no recollection of doing so. There’ve been other episodes, now she thinks about it. Blank moments when she has zoned out of conversations or blacked out altogether.
“It’s involuntary,” Dr Pollard adds. “A misfiring in the brain that causes you to confuse imagined perceptions with actual ones, whether it’s a remembered event or something happening – or seeming to happen – right now, in front of you.”
“Why are you telling me all this?” Shiv asks.
“I’m right, aren’t I?” the woman says. “You have experienced confabulation.”
Shiv nods, conscious of being observed. Dr Pollard’s face is creamy, yellowed by the spotlights. It could be made of wax. Shiv is tired. She’d planned on being asleep in her bed right now, but she knows she has to focus on what the woman is telling her – to try to make sense of it.
“Korsakoff says this falsification can also apply to what people believe to be true. About themselves, or others. In how they interpret things.”
“Like what?”
“OK, so, even when they remember a true event, they create a false narrative from it. A boy tries to save his sister from drowning but, to his mind, he failed … not because the sheer force of the water made it impossible but because he didn’t have the courage to take the ultimate risk. To die in his attempt to save her, if need be.”
“Mikey.”
“To anyone else,” Dr Pollard adds, “the boy did everything he could. But, to his way of thinking, he didn’t do enough.”
“I don’t blame myself for not saving Declan,” Shiv says. “I blame myself for—”
“False narratives, Siobhan.” She holds Shiv’s gaze. “They come in different forms – the belief that your loved one is still alive, that you might have prevented their death, that you caused their death, that your life has no point without them – but, essentially, they are all rooted in amnesic-confabulation. They are all fictitious.”
“What if you did cause their death? Fact, not fiction.”
“An illusion is a belief derived from human wishes. D’you know who said that?” Then, “Sigmund Freud.”
“What – you’re saying I wanted to kill Declan?”
“No, of course not. But you want it to be true that you killed him.”
Shiv bangs the back of her head hard against the wall. “Because it is true.”
“Is it? You literally kil—”
“What happened happened because of me.”
“And if that means ‘I killed him’ you must be made to pay for his death. Yes?”
Shiv doesn’t answer. Just sits there, staring at the floor between her splayed feet, the boards patterned with tiny woodworm holes like a crazy dot-to-dot picture waiting to be filled in. Her head smarts from where she banged it. “Not everyone who’s bereaved suffers illusions,” she says, sullenly.
“That’s true. But, at this clinic, we specialize in treating people who do.”
“So why me? Why do I … confabulate?”
“There are two main causes,” Dr Pollard says, adjusting her glasses. “One is organic: a thiamine deficiency. Then there’s your sort, caused by trauma. It could be physical, such as damage to the brain’s prefrontal cortex, or due to a sudden, extreme shock. An Acute Stress Reaction.”
“Post-traumatic Stress Disorder,” Shiv says. “That’s what my counsel—”
“PTSD’s not quite the same. In PTSD people tend to have repressed memories or intense ‘flashbacks’ of the traumatic episode. Or both. I know this applies to you, but what you also display is the amnesic-confabulation we’ve been talking about.”
“Seeing things that aren’t real.”
“Yes. And believing things which aren’t true.”
The woman explains that, in Acute Stress Reaction, the patient can’t make sense of what has happened or what’s going on around them. “So they rewrite the story in their unconscious,” she says. “And what you end up with is two realities – the real reality and the false reality – merged into one.”
Like this room, Shiv thinks. This is real reality: blank walls, no audio, an empty, neutral space; the false reality is the one she experiences in her PTU sessions – when this room is a portal to the time she killed her brother. Perhaps that’s why the Director chose it today – to demonstrate its harmlessness.
Who knows? Shiv isn’t sure she knows anything any more.
A thought strikes her. “How do the film shows and photos help me sort out the real from the false?” She gestures at the walls. “Surely they’d just make it worse.”
“They do. That’s the point.”
“What?”
“In the First World War, a lot of soldiers suffered terrible facial injuries,” Dr Pollard says. “The medics in the battlefields patched them up as best they could then sent them home for proper reconstructive work – the pioneering experiments in what we now know as plastic surgery. But before—”
“What has this got to do with—”
“Before the surgeons could operate to repair and rebuild, they had to break apart the patch-up and return the face to its original, damaged state, let the wounds heal again and start from scratch. If they didn’t, the reconstructive surgery would be a botch job, causing even worse disfigurement – not to mention the risk of infection.”
The Director pauses, studying Shiv’s reaction.
“So, the PTU sessions…” Shiv begins.
“Are the psychiatric equivalent of reconstructive surgery, yes. D’you recall, at the start of Phase 2, I described it as Trauma Centred Therapy?”
Shiv nods.
“Well, this stage of your treatment is designed to break apart all the therapy you’ve had before, to strip away the scar tissue of your grief, cut through the layers of confabulation – take you right back to your original traumatized state.”
“And then what?”
“Let you see the truth of it.”