SO MY aim for today is to work out your mental and physical state before the accident and compare it with your condition now. Apples with apples.” Rory and Jesse are in a consulting room in the oldest part of St. Barts. Anonymous, white-walled, the space has a desk, Jesse’s chair, and a pin board with fire-regulation notices. Deep-set windows and the low height of the door are the only hints of the history of the building.
“Most of what I’ll do shortly will be familiar, but I’d like to ask some questions first.”
“Okay.” Most. What does that mean?
“I prefer to take notes as we go, if that’s all right?”
Jesse nods.
Rory pulls a lined pad closer. “Right. Here we go. How would you describe yourself before the accident?”
“In what way?” That tight, cold feeling is back. Why does she feel so fearful?
“Well, your principal character traits. For instance, would you say you were a practical person?”
She considers. “That can mean anything. Give me a hint.”
“Okay. Resourceful, decisive, good at making plans and carrying them out?”
“On that basis, I’d say I was practical.” She smiles at him nicely.
Rory makes a note. “And did you think of yourself as physically competent—play tennis, climb ladders, drive a car? Actions that require mental and physical coordination?”
She nods again. “Hockey, not tennis, and I learned woodwork in high school. The only girl in the class, but I wasn’t bad. I could even use a lathe.” True story, Dr. Brandon.
“Good at math?”
“Better than words, that’s for sure.”
“And could you think your way through problems—life, not just equations?”
Jesse lifts her left shoulder into a half shrug. “I could always rely on logic to see me right.”
He looks up from the notepad. “And what were you most proud of about yourself?”
Jesse says promptly, “That I faced my fears and did something about them.”
He’s working to keep up. “Good. Very good. Now, a change of tack. Would you have described yourself as imaginative or creative before the accident?”
“Not creative, I think. And maybe not especially imaginative, either.” Or anxious. How things change.
“Could you sing?”
“Sing? No. They always stuck me in the back of the choir at school.” A faint smile. Some of that stuff had been funny. A bit. When it wasn’t humiliating.
Rory nods thoughtfully. He puts down his pen. “So, Jesse, play a little game with me. Just word association. Say the first thing that comes. Don’t think about it.”
“This is the other side of ‘most,’ is it?” She’s trying not to be defensive.
Rory leans forward. “Just try. The results are often interesting.”
In the end, she nods.
“Thank you. So. Fear?”
“Loathing.”
“Love?”
“Landscape.”
“Together?”
“Sometimes.”
“Black?”
“Red. Look, is this helping? I’m not an ink blot.”
Rory laughs. “Just mapping the boundaries, nothing sinister. Your word association is interesting, by the way. Tangential.” He picks up the pad again. “And just to make a formal note for the record”—he holds up his pen—“in the ward yesterday, you told me you could not draw.”
“Yes.”
“Please consider your next answer, take your time. The pictures I saw of the castle. Do you think you drew them?”
She closes her eyes and the seconds tick by.
Rory says nothing.
“It might have been someone else.” The eyes stay closed.
“Do you have any idea who?”
“No.” A pause, then a false start. “I suppose, well, I have to think it might have been me. But I don’t know how.”
He makes another note. “I’m going to suggest we come back to that in a little while, Jesse, but meanwhile, have you ever heard of a person being referred to as left- or right-brained?”
She shakes her head.
“Medicine has made some strides into brain functioning and consciousness in the seventies, but the research that interests me is the broad biases that make up different kinds of functioning and personality—how they’re created and how they interact. As you’ve described yourself before the accident, I’d say you stacked up as a classic left-brain person: organized, methodical, process driven. But listening to you today and having seen the sketches, it seems to me you exhibit an increased, or increasing, right-brain bias. The right-brained person, by the way, is broadly defined as creative, intuitive, good with language, an innovative thinker. And it’s interesting too that you spoke of ‘seeing words’ just after the accident; that could be a description of synesthesia. That’s where nerve impulses get scrambled in the brain: sounds can seem to have form, smells exhibit colors instead of scent. That sort of thing. That seems to have died away, but it could be a useful pointer to the other things you’ve been experiencing.”
Jesse settles deeper into her seat. What’s he really saying?
“It’s striking, don’t you think? There you were—rational, competent, no-nonsense, in your own estimation. And now. How would you describe yourself now, Jesse?”
She opens her mouth. And closes it. Twice.
“Does what I’ve said bother you?”
“There’s so much I can’t seem to control about myself anymore. Like someone else is driving.” The words are a blurt.
“Ah, control. Who says that’s real?”
“Hello? The concept of free will?” Jesse can hear herself—she sounds so vulnerable, and this man is an almost-stranger. She really, really hates that.
Rory responds patiently, “But that’s just what it is. A concept. In my terms, that means a hypothesis that needs rigorous testing if we’re to accept it as having merit. There’s little hard science that favors the existence of free will, by the way; it’s more a matter for philosophy.”
She stares at him in confusion, and his gaze softens. “Philosophy of Science 101. Sorry. I’m here to listen. Literally.” He holds up a stethoscope. “And that’s a cue for the basics. Heart first.”
“Haven’t I done enough of this?”
He nods. “Yes. But it’s consistent monitoring that counts. And I always feel happier checking patients myself.”
Jesse hesitates, then gestures to the buttons of her shirt. “Shall I?”
“Just the first couple.” Calm and professional, Rory holds the end of the stethoscope in his palm. “Shouldn’t take long to warm this.”
Jesse nods, but she watches his hands.
Rory says gently, “It’s okay to be nervous. You’ve had a difficult time with the profession lately.” His eyes are kind. “Ready?”
She nods, and he slips the head of the stethoscope inside her shirt on the upper left side. “So, deep breath, and hold it. . . . Good. And again.” Eyes unfocused, he listens to her chest. “Excellent. Now, we’ll do the same for your back to check lung function.” He waits without fuss while she pulls up the back of her shirt and gives him a nod when she’s ready. She rates him for that.
Rory taps Jesse’s back in several places, efficient but not perfunctory. “Absolutely all clear. We worry about problems with lungs after prolonged bed rest. But you’re young and fit and healthy. Excellent outcome. So, just temperature, pulse, and eyes to go. Not long, I promise.” Rory holds up the thermometer encouragingly. She is a fit girl, and well put together—long legs, small waist, wide shoulders. Pretty, too, with an open face and striking eyes. Rory smiles faintly. A doctor can still be a man.
“Funny, am I?” Jesse wills herself to remain calm as he slides the little glass stick under her tongue and picks up her wrist.
“Me, I’m lousy at telling jokes. No sense of timing.” Rory concentrates on her pulse.
They’re so close, Jesse can feel him breathe, hear the sound as air moves in and out of his nostrils. It occurs to her that she’s with a man she hardly knows, in a small room in a hospital where she’s a name on top of a list of injuries and little else. Even her parents don’t know where she is. If she disappeared, it might be days or weeks before— Stop this!
“Something wrong?” Rory looks up.
She forces herself to speak. “Imagination, that’s all. It’s a riot in here.” She taps her skull.
“You don’t have to be brave, Jesse. And it’s okay to be vulnerable. We both want to get at the truth of what’s happened to you.”
She mutters, “Happening, you mean.”
Rory nods. “Yes, happening, and it’s making you anxious every time you think about it. Maybe too anxious to actually help yourself get well.” He’s watching her.
“What does that mean?”
“What if I said there was a way I could help you deal with all the worry?”
“Not more pills!” Jesse scrambles to sit up. “Because I’ve had enough of drugs and—”
He shakes his head, amused. “Not pills. Hypnosis. It can take you into a very deep state of relaxation. I’ll be able to ask you challenging questions and you’ll be able to answer without becoming upset.”
Jesse looks at him pityingly. “I’m immune, trust me. I used to bite my nails, and Mum”—there’s a self-conscious pause—“well, I had a couple of sessions. It was crap.”
He smiles. “Most people think that. So what happened?”
“Oh. Well, I just stopped chewing them naturally. Growing up, I suppose.” Jesse resists glancing at her nails; she likes them long these days. “I’m not suggestible. Truly.”
He nods. “But you’re not, what, fifteen anymore?”
She can’t help it. She grins. The man is good.
“I wouldn’t suggest hypnosis if I didn’t have faith it would help. I think you’re blocking things you can’t explain, and that’s driving fear you can’t deal with or really acknowledge. Rational people can be like that, but it makes the unknown worse when that scaffolding gets kicked out from under.”
“Right. And I never would have guessed.” Jesse frets at her bottom lip. Does she want to do this? “Will you keep me in the hospital if I don’t agree?”
Rory leans forward, his hands on his knees. “Jesse, you have the right to sign yourself out at any time. But, I have an absolute duty to help make you well; that is, to assist in your progress to the full extent of my training and knowledge. And that is what I intend to do if you will let me do it. Your situation is”—he searches for the word—“unusual. To treat you best I need more information than, perhaps, conventional diagnostics and treatment will provide. X-rays only give us so much. And I think you want to know what’s happening to your mind as much as I do.” He lets that sink in, and when she says nothing, he murmurs, “You’re in pain, Jesse, and not just from broken bones. It’s holding you back.”
“What are you, Sherlock Holmes?” But the laugh is shaky, and she stares at her hands, willing herself not to sniff.
“Something neurologically profound has happened to you.” Rory hesitates. “And we don’t yet know if that’s good or the opposite—but I do think it’s important. And not just for you, but for other people who’ve experienced brain injury because yours is such an unusual case. At the very least you’re displaying characteristics I’ve never seen before.”
Jesse’s alarmed. “But the fracture was minor, you said that, and the bleed was small too?” She’s not sure if that’s the term, but he nods. “You told me it wasn’t serious.”
“I still think those things. But there’s nothing in the literature I’ve so far found that is able to explain the phenomena you’ve been experiencing. The sketching, for instance.”
She stares at him unhelpfully.
He moves on quickly. “There could be an elegant and simple explanation for what’s happened. You might, for instance, have a genetic tendency for being ambidextrous, and not being able to use your dominant right hand has flushed that out. The ability to draw might’ve been similarly latent; perhaps the bleed after the fracture put pressure on an area of the brain that allowed those talents to finally express themselves. And yet . . .”
“You don’t believe it, do you? That the answer is as simple as that?”
“Simple is often right, I’ve seen that over and over again, but asking questions under hypnosis may tell us things you have never consciously known about yourself. That could be very useful in the search for answers.”
She stares at him for a long minute. “It doesn’t explain the castle, though, does it? The fact the pictures show things I’ve never seen before.”
“Let’s see what we find out, shall we?”
Jesse exhales, a long sigh. “So you think there is an explanation?”
“Of course. There’s always an explanation.”
“First, make yourself really comfortable.”
Jesse burrows deeper into the armchair, tips her head against the high back.
“Good. Now, I want you to think of something pleasant. A place you like going to, or an enjoyable pastime—something that gives you pleasure. Soon I’ll count from ten down to one, but right now, all you have to do is breathe deep, relax, and listen to the sound of my voice.”
Relax? Huh.
“So, here we go. Ten, nine, eight, feeling happy, and peaceful, and quite safe. And very relaxed.”
Safe? But Jesse’s eyelids drift down.
“. . . seven, six, five; you’re in your favorite place now, you love being where you are.”
Swimming in a warm sea . . . No. It’s not the ocean. There are reeds: bending and dancing. Sun on the water . . .
“. . . four, three, two . . .”
Like a mirror, the water, liquid silver . . .
“. . . one. You’re feeling peaceful, Jesse, so comfortable. Zero. Nothing worries you at all.”
I’m swimming. . . . It’s cool and clear and green and . . . What’s that?! Jesse’s eyes leap open and the flesh on her arm dimples.
Rory says soothingly, “Just remember, you’re safe and calm and warm—mind awake, body asleep. And you’re detached, just an observer, like someone watching a movie. Nothing bothers you, or frightens you . . .”
The sound of his voice has a rhythm like a chant and Jesse’s eyes droop closed.
“Jesse?”
No reply.
“Can you hear me, Jesse?”
The girl moves her head in a slow nod, as if it’s an effort, as if her head is heavy.
Rory scribbles a quick note. “So, we’ll count down just like before. Peaceful thoughts, so comfortable, and with every breath you’re more relaxed, even more deeply relaxed than before. Ten, sleepy now; nine, lovely thoughts, so happy; eight, look around at where you are, this is your favorite place, remember; seven, focus on one thing you’re drawn to; six, go toward it.”
Jesse’s head lolls. She’s smiling. Under the lids, her eyes move as if she’s watching something.
“Mind awake, body asleep. Five, don’t hurry; four, nearly there, all the time in the world.” Jesse’s feet twitch. “Three, so close you can almost touch.” Her feet begin to move on the floor, as if she’s walking. “Two. Stop.” Jesse’s feet are still. “You’re there. One. Just take it all in, no stress, no rush. Nod if you can hear me.”
Jesse does not respond.
“Jesse? Can you hear me?”
She sighs deeply. Nods.
“That’s good. Very good.”
Jesse has the slight flush of a sleeping child. Rory stares down at her. He feels the urge to touch her face. But he does not.
“Excellent. Now I’m going to ask you a number of questions. You’ll find this an enjoyable process and you’ll remember what I ask easily and happily.”
“Don’t want to.”
Rory jumps. It’s as if a statue has spoken. His expression clears. “Okay, then, let’s play a game instead.”
She nods. “I like games.”
“That’s good, Jesse, that’s very good. So this is the question-and-answer game. Are you ready to play?”
Jesse frowns. “No. No questions.”
Rory stares at the girl with intense interest. “Remember, this is just like a movie. You’re watching what’s happening and you’re quite safe and happy and calm. I’m going to count from three to zero now, and when I say zero, you can tell me what you want to do. Okay, Jesse?”
The girl’s face relaxes. “Yes.”
“Here we go. Three, even more calm than you were. Two, no anxiety at all, you’re enjoying this process. One, so happy, so positive, and getting ready to tell me what you want to do. Zero.” He bends closer.
“I want to stay where I am.”
“Describe what you see.”
Jesse says softly, “The trees are all around me.”
“How does that make you feel?”
The girl chafes her arms. “Cold. The leaves block the sun. But I am happy. I like the forest because of the birds. They fly for me.” Jesse’s left hand rises and sweeps through the air.
Rory says cautiously, “Why is that?”
“Because they like me.” Her hand flutters to her lap, like a feather floating on the air. “They sing for me too.” She purses her lips and whistles. At first the sound is soft, then it rises and expands, long, liquid-sounding trills.
“Good, very good. But you can stop now, Jesse.”
The birdsong cuts, as if a tape has stopped.
She turns her head toward him. “My friend the blackbird. He has a lovely voice.” Her feet begin to move.
“What are you doing now?”
“I am walking.” The feet move a little faster and Jesse’s expression begins to change, as if a tide is rising. A tide of emotion.
“Remember how relaxed you are, Jesse. How warm and safe you feel.”
But Jesse’s face works, she’s panting.
“Breathing deep, nice and slow, Jesse. No anxiety, no fear. You’re safe and warm. Just watch the movie. Remember, you’re not in the movie, you’re a spectator and you can control what you see. You can tell me if you like.”
“Dark.” Her head turns from side to side. “So cold. Cannot feel my hands.” Her jaw trembles.
Feet stop. Head stops turning. Breathing . . . stops.
“Jesse?”
The girl does not move.
“I’ll click my fingers three times and you’ll be fully awake. Ready? Here we go.” A light sweat forms on Rory’s brow as he clicks his fingers—once, twice, three times.
The girl’s eyes remain closed, but her chest begins to rise. And fall. And rise again.
“Nice and relaxed, that’s good. So calm, so happy to listen to my voice. I’m picking up your wrist now, Jesse, but that does not worry you at all. Can you hear me?”
A nod.
Fingers on the inside of one wrist, Rory checks Jesse’s pulse. And swallows. The pulse beats evenly. “That’s good. That’s very good.” He puts her arm back at her side. “So, I’m just going to open a drawer.” He fumbles, pulls open a drawer in the desk. Nothing. Tries another. There’s a box of tissues, and hastily he blots his face. “More relaxed than you’ve ever been. With each breath you take, you sink deeper, much deeper; mind awake, body asleep.”
Jesse’s head lolls on her shoulder.
“Where are you now?”
The girl says nothing.
“Can you describe this place?”
“No. I want to go now.” Anger.
“Please describe what you see. Pretend I don’t know. Like the game we played before.”
“I want to leave.”
“Leave where?” Rory speaks carefully.
“You are cruel. You are trying to make me stay. I do not like it here.” She huddles in the chair, making herself small.
“Watch yourself from above, Jesse, like you’re in a helicopter. You don’t have to feel afraid; this is interesting. You’re curious.”
Jesse turns her head. Sightless eyes, blank as marble, stare at him. “I do not understand you.”
That gaze is eerie. Rory stumbles as he says, “Just remember, Jesse. This is a game. What do you think I mean?”
Her expression turns stubborn. “I do not know. You say things that seem strange.”
Rory shifts in his seat. “We’re just playing, Jesse. This is fun, and you’re very happy. And relaxed.” He speaks soothingly.
“Why do you call me that name? And I am not happy. I will not listen to you anymore.” Her left hand flies to her ear.
Rory watches Jesse’s right hand move as well, fighting the sling. “Well then, I’ll count back from three, and when I say zero, you’ll feel much, much better. So content, so pleased to be playing our game. Three, two, one, zero.”
Jesse’s left hand floats down to her chest. Her face relaxes.
Rory clears his throat. “So, what name should I call you by?”
“I have no name.” Jesse shakes her head. “They said you would ask me.”
“Who is ‘they’?”
“If you do not know, I cannot tell you.”
“Why can’t you tell me?”
Jesse sits up. Open-eyed, she points at him. “Because you have no right to know.”
The moment freezes.
His face is tense, but Rory says softly, “You are sleepy. Very, very sleepy. The chair is so comfortable. And warm. So soft. Much, much nicer than a bed . . .”
Jesse’s eyelids flutter and close. She leans back, sinks deeper as Rory says, “Now, I’m going to count down from five this time, and when I snap my fingers twice, you’ll be awake, fully awake, and you will feel happy and refreshed. Are you ready?”
Jesse nods, her face expressionless.
“Very good. Five, starting to wake, gently and happily. Four, closer to waking and you’ve just had a pleasant dream. Three, getting ready to stretch and open your eyes.” Jesse stirs but her face stays serene. “Two, sleep is almost gone.” Jesse’s eyelids twitch. “One, you can see the light. It’s lovely to be almost awake. Zero!” Rory snaps his fingers twice. “Fully awake.”
Jesse stretches luxuriously.
“Feel good?” Rory smiles at his patient.
“Yes. I really do. Did you find it useful?”
“Very.” He holds up the notes.
“Any answers about the . . .” She mimes sketching.
“Not as such. I’m not expecting the anxiety you’ve experienced will go away instantly, by the way, though this is a very good start.” He pauses. “Do you remember much of what you said?”
“Not really. It’s a jumble. I know there was water and”—she waves her hand vaguely—“there seemed to be someone else around. I could hear her talking, but it was my voice.” She hesitates. “That sounds a bit nuts, doesn’t it?”
Rory pauses before he makes a careful note. Then he leans forward and touches Jesse’s good shoulder. “Confusion often happens ahead of a breakthrough. Therapy takes the time it takes, but consistent effort, just chipping away, asking questions, is important. The good news is I haven’t picked up any cognition impairment.”
“Such big words.” Some kind of smile. “But what if I don’t have any time? Or money, either. I can’t stay here forever. My life’s on hold.”
He says carefully, “Your treatment as a result of the emergency is, of course, without charge.”
“There’s a but somewhere in there.”
A half nod of acknowledgment. “Rehabilitation is a separate issue.”
“And this is rehabilitation?”
Rory puts the cap back on his old-fashioned cartridge pen. “How about I do some work on what I’ve observed and we can talk later about your concerns.”
“Back in the ward.” Her expression is gloomy.
Rory manages a grin. “Don’t want to exhaust you.”
“I know, I know, ‘rest is best.’ ”
“Exactly.” Rory picks up the phone on the desk, dials a number, and murmurs into the mouthpiece, “Yes, ready now. . . . That would be good.”
Jesse makes a disappointed sound that is neither yes nor no, but she gets into the wheelchair without protest when the nurse appears. “Thanks, Dr. Brandon.” Somehow, she doesn’t want to call him by his first name. “I’m sorry to be such a difficult patient.”
“Not difficult—not compared with some.” His grin stays in place until the door closes, but he stares down at his notes as if the words make no sense. Finally he writes, Rehab and Where?
Distracted as he thinks, he doodles and a shape begins to emerge on the page.
He stares at what he’s drawn.