The Syndrome (36 page)

“You see,” Shaw said, gesturing toward Adrienne with an open palm, “you recall it perfectly. As you should. Losing a tooth is a rite of passage—and almost everyone has some recollection of it. But not Jeffrey. Jeffrey doesn’t remember anything about it at all.”

He glanced at Duran, who shrugged.

“Any way, as I was telling Jeff—I have a catalog of unimportant incidents of that kind. Things we all did—like eating lunch in elementary school, going out for a haircut, going to the dentist. I could give you dozens of examples of what amount to collective memories, memories that you might say are common to the human condition—or at least to the American condition. But—” Shaw turned to Duran with an apologetic smile. “Our friend, here, might as well be from Mars. Of all the events I suggested—and there were a dozen of them—Jeffrey responded to exactly two.” He held up his fingers, like a peace sign. “He remembers going to the beach—Bethany Beach—with his parents. And he remembers
blowing out the candles on a birthday cake. Everything else is a blank—and that’s
not
what I expected.”

Adrienne looked puzzled. “Why not? We know he has amnesia.”

Shaw tilted his head from side to side. “Yes, but we also know he’s a confabulator. And that’s what makes the case so interesting: he’s a twofer. And not just any twofer. Mr. Duran is convinced that his recollections are true—that’s why he passed the lie detector test that you mentioned, and that’s why he naively took you to a beach cottage that didn’t exist. All of which is consistent with what I learned this afternoon. When I asked Jeff about these insignificant events that we’ve been talking about, he made no effort whatsoever at invention. Either he remembered them, or he didn’t. Mostly, he didn’t.”

“But what does that mean?” Adrienne asked.

“That he’s not a con man.”

“And?”

“That he’s delusional as well as amnesic.” Shaw turned to Duran. “Are you sure you’re comfortable with me discussing you in this way?”

Duran rolled his eyes. “Yeah. Adrienne and I are old friends. Ever since she stopped suing me.”

Shaw looked surprised. “You’re suing him?”

Adrienne shook her head. “No. I
was.
But I’m not.”

The psychiatrist took this in stride. “At any rate, we went through some of the clinical tests I mentioned earlier.”

“And?”

“Everything’s normal—except the patient.” He smiled. “So I hypnotized him.”

Adrienne frowned. “But … I thought you were opposed to hypnosis.”

“On the contrary. It’s a useful tool—and I thought it might relax him. Loosen his inhibitions.”

“And did it?” Adrienne asked.

“No—even under hypnosis, he was still drawing blanks. But the incidents he
did
recall—going to the beach, his first
birthday cake (and first birthday party)—well that was even more interesting.”

“How so?”

“He told me the same stories. And I mean,
exactly
the same stories. Almost word for word. As if he were reciting a poem, or a speech.”

“Which means what?” Adrienne asked.

Doctor Shaw shook his head. “Too soon to say. But there are a couple of tests I’d like him to take—just so we can rule a few things out.”

“Like what?”

“Hippocampal damage.”

“And these tests … what are they?” Adrienne asked.

“CAT scan. PET scan. MRI.”

It was Adrienne’s turn to roll her eyes. “I don’t think Mr. Duran has the money—”

“He’s insured,” Shaw told her. “We checked.”

“Is he?” she asked. “With Mutual General?”

“No,” Duran told her. “I’ve got Traveler’s. The other was malpractice insurance—for the tapes.”

Shaw got to his feet, and went to the receptionist’s desk. Opening one drawer after another, he finally produced a map and some papers, which he handed to Duran.

“What’s that?” Adrienne said, looking over Duran’s shoulder.

“A map of the hospital, shows you where the lab is. Consent forms.” Shaw glanced at his watch, and made a helpless gesture. “Oh, Jesus,” he said, “I’m going to catch hell.”

“Sorry,” Adrienne told him, pulling together her little bundle of shoes and sweaty running clothes.

The psychiatrist waved away her concern. “Won’t be the first time.” He led them out the door to the elevator. “You the nervous type, Jeffrey? Claustrophobic?”

Duran shrugged. “How would
I
know?”

Shaw chuckled. “Well, if you think you’ll have a problem with the MRI, tell the technician. He’ll give you something that will help you chill out.”

The car had a ticket tucked under its windshield. “God damn it!” Adrienne wailed. She rushed to pluck it free, as if it might replicate if she didn’t remove it in a hurry. “It’s a hundred bucks!” She looked at it and saw that the ticket had been written hours ago, during the time she’d been running. Getting lost in Central Park—she’d been worried about getting back late to Shaw’s office and had forgotten about the meter. It wasn’t fair but she turned toward Duran as if it was his fault: “Why did you have to take so long?”

He could sense her frustration, and knew better than to test it. So rather than making a wisecrack, or replying that the trip was her idea, he said, “I don’t know. I’m sorry you had to wait.”

Two minutes later, they were in the car, heading toward lower Manhattan, and she was apologizing. “It’s my fault,” she said, her tone emphatic and remorseful. “
I
parked there. I forgot to feed the meter. I don’t know why I’m yelling at you.” She sighed. “Sometimes, when I get stressed out—”

“Forget it.”

“No, that was bad. I know it wasn’t your idea to spend all that time in his office, being grilled from A to Z. I’m just a jerk.” She seemed so disconsolate that he wanted to put his arm around her.

Instead, he said, “I know you’re worried about money. You didn’t even want to spend the night here.”

“Yeah, but don’t try to talk me out of it,” she told him, beginning to laugh. “I like to wallow.” She let out an exaggerated moan. “A hundred dollars … shit!” The windshield fogged up and she rubbed at it with the heel of her hand.

“Where are we going?”

“I made a reservation at a hotel on Washington Square.”

“Great.”

She laughed. “I doubt it. It’s going for seventy bucks a night.”

“Ah … and what does Lonely Planet say about it?”

“That it’s ‘reasonably clean. Safe. A budget alternative.’”

“There you go!” Duran exclaimed. “That’s the trifecta.”

“Well …” she said, her voice doubtful.

“What’s not to like?” he asked.

She thought about it for a moment, and said, “‘Reasonably.’”

The hotel was a dive.

Their room—a “kitchenette”—was “clinically depressing,” according to Duran. It had the tired and dingy look of a place that had been slept in too often by people who’d only recently been “released.” Lumpy twin beds were covered with suspect chenille bedspreads which looked (from the evidence of a few dark streaks) as if they had once been orange, but were now a played-out blond. In the corner, a low table stood on an expanse of wall-to-wall carpeting, mottled with stains. Peppered with cigarette burns, a mustard-colored chair waited beside the window, itself opaque with grime. Nearby, a twenty-seven-inch Sony Trinitron rested on a built-in cabinet.

In the kitchen area, behind a formica counter, was a sink in desperate need of reenameling, a small refrigerator with a very big hum, and a wall of Sears cabinetry that held a stack of Melamine plates and cups.

Adrienne opened the refrigerator, and glanced inside. Happily, there was nothing to be seen but an ice cube tray that looked as if it had been handmade of compacted aluminum foil.

“I hate it here,” she said.

Duran wedged a chair under the doorknob.

In the morning, they took the subway uptown to the Pashten
Medical Center, where the staffers in the neuro-imaging suite greeted them in high spirits. The Asian receptionist slid open a translucent window and gave Duran a big smile. “Oh yes,” she said. “Duran. You’re here for the works, right? Let me call Victor.”

Moments later, a sharp-featured Latino emerged through the door. He wore aqua scrubs and had a face that looked as if it had come from an Aztec frieze. “If you’ll give Melissa your consent forms,” he said, “we can get started.” Then he turned to Adrienne. “You Mrs. Duran?”

She felt her face begin to burn. “No,” she said, a little too hurriedly. “Just a friend.”

“Well, I don’t think you’re gonna want to wait around,” he told her. “’Cause it’s gonna be a while. Maybe you could come back at four?”

When Adrienne had left, they took Duran’s vital signs and led him into an examination room, where he waited to be summoned. The room was decorated with a pastel, geometric border at the junction of the ceiling and wall. A single Norman Rockwell print hung on one wall. It showed a white-coated doctor with a kindly smile and a stethoscope, approaching a quaking boy, his bare bottom exposed beneath a too short surgical gown.

The syrupy image of the kindly pediatrican harkened back to a time that had little in common with the world in which Duran found himself. The neuro-imaging center was a technophile’s dream, a forest of computers and diodes, oscilloscopes, and putty-colored machines that seemed, at once, modern and prehistoric.

The CAT scan came first.

For this, Duran was asked to lie down in a prone position with his head braced upon his chin. A rubber device was put in his mouth, and he was told to bite down upon it, the better to keep his head still. Movement, he was told, is the enemy. And so he lay there like a fallen log, suddenly aware of every itch and tingle, determined not to move and inspired by the unending patter of his nurse-technician-cheerleader.

All the while, she operated a device that rolled along the armature around his head, taking a series of forty-eight cross sections of his skull. The device moved with a dense whir, and it was difficult not to react when it locked into place, and clanked and snapped to register an image.

Listening to his cheerleader-nurse, it occurred to Duran that her tone was precisely the one that people use to address dogs and babies.

After the CAT scan, an Indian woman grabbed his color-coded chart and ushered him into a room whose door bore a sign that read:

This time, things didn’t go so well.

The MRI machine was a long table that rolled into a large, but coffinlike, drum—“the magnet,” as the technicians called it. Lying down on the table, Duran was fitted with a kind of football helmet—the head coil—which was itself attached to a plastic grid that covered his face. The nurse handed him a device that was meant to serve as an alarm, and told him to push the panic button if he became claustrophobic. Then he was asked to lie still, and ignore the pumping sound that the machine was about to make.

So far, so good. So far, no problem.

Then the nurse touched a button, and the table rolled into the drum, swallowing him. Peering through the plastic grid, his eyes were about eight inches from the bottom of the drum—until the table rose, lifting him to within an inch or two of the surface above his face.

He took a deep breath.
You’re in your safe-place
, he told himself—and hit the panic button—hard. An alarm went off. The nurse came running. The table subsided, and rolled back.

Whispered conferences ensued, and eventually, Duran was returned to the examination room. There, a young man with a shaven head and a gold ring through his septum gave him a
shot that he said would help him relax. And, indeed, it did. The remainder of the morning and much of the afternoon passed—not like a dream, but a documentary. Handheld. Black and white. No narration.

Duran couldn’t remember how many tests were taken, or how often his veins had been “palpated.”

But the last test was the PET scan. Aztec Charlie—which is how he was known at the clinic—explained to Duran that PET stood for Positron Emission Tomography. “Basically,” he said, “we’re gonna light you up with this.” He lifted a syringe out of a brushed aluminum tray. “It’s a radioactive isotope,” he explained. “Lights up your brain, so the doc can see what’s happening.” He tapped the syringe with his fingernail, and asked Duran to lie down on a paper-covered table.

He did, and barely felt the needle.

Two hours later, he joined Adrienne and Doctor Shaw in a small conference room at the clinic.

A dozen images—cross sections of Duran’s brain—were clipped to a bank of backlit viewing screens. Holding a pointer, Shaw went from one image to another, tapping the pointer’s tip against a small, bright spot in a sea of gray.

“Right here,” he said. “And here. And here. And you can see it on this one, too!”

“It’s like a piece of rice,” Adrienne said.

“What is it?” Duran asked.

Shaw thought about it for a moment, frowned and said: “I don’t know.” Then he thought some more, and shrugged. “I can tell you what it’s
not
,” he assured them. “It’s not
tissue.
It’s not a bone, or a nerve. It’s not flesh. It’s not blood. Which is to say, it’s ‘a foreign object’—which is what we call things when we’ve exhausted every way of looking at them, and still don’t know what they are.” The physician frowned and paused. One of the fluorescent light fixtures on the ceiling fizzed. “You don’t recall suffering a head injury?” he asked Duran in a hopeful tone. “Maybe a car accident? Ever been in the army? Or a plane crash?”

Duran made a wry face. “Not that I can recall.”

Shaw smiled. “Very funny.”

“Wait a minute,” Adrienne asked, looking at Shaw. “That’s what you think? That—”

“A physical injury might be responsible for his condition?” Shaw’s arms flew up, and his face contorted in an exaggerated expression of perplexity. “Let’s just say … it’s a working hypothesis.” He gestured toward the display of images. “The history of psychology and neurobiology is full of examples of the ways physical trauma can affect memory. In fact, some of our best information
about
memory comes from accidents—crazy accidents in which brains were maimed. Which isn’t surprising, really. I mean, these aren’t experiments you can carry out in a hospital.” Shaw beat out a little rhythm on the surface of the counter then let it fade.