The Memory Collector - Part 4
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Part 4

"You had a seizure. Lie still," she said.

"I what?"

"Do you have epilepsy?"

He frowned. "That's a crazy question."

Jo was board-certified in both psychiatry and neurology, but as a forensic psychiatrist, her work dealt almost exclusively with history. When the police or medical examiner couldn't determine why somebody had died, they called her to perform a psychological autopsy on the victim. She spent her days deciphering the countless ways the pressures of the world could end a person's life.

Now she had a live case, a man with a huge and unidentified problem, who she sensed might turn on her at any moment.

"Do you recall hitting your head?" she said.

"No." Hands on his jeans pockets. "Where's my phone?"

"I have it."

"I need to make a call." His gaze zinged to Jo. "You're American? Did the emba.s.sy send you?" He looked around the ambulance and his face tightened with alarm. "Where am I?"

"On your way to San Francisco General Hospital. Are you on medication?"

"No. San Francisco?" He tried to sit up. "Who are you?"

"Dr. Beckett." She pressed a hand on his chest. "You were in southern Africa. Are you taking antimalarial drugs?"

"Quinine? Sure-Tanqueray and tonic."

"Lariam?"

Lariam could have severe side effects, including seizures and psychosis.

"No," he said.

"What were you doing in South Africa?"

His pale eyes looked eerie. She couldn't tell why he hesitated. But whether he was confused or calculating, it took him ten full seconds to say, "Business trip."

The wind rattled the ambulance and a burst of rain sprayed the window. Jo didn't tell Kanan the two reasons they were heading to San Francisco General-it was the area's only level-one trauma center and San Francisco's designated evaluation facility for patients placed on psychiatric hold. Kanan glanced around. His gaze reached Officer Paterson and stuck.

Jaw tightening, he lurched against the straps on the gurney. "My family. Did something-"

"Hey." Paterson moved instantly to Kanan's side. The paramedic pressed Kanan back against the pillow.

Jo put a hand on his arm. "What about your family, Mr. Kanan?"

For a second he looked fearfully bewildered. Then he blinked and forcibly slowed his breathing. "What happened to me?" He looked at Paterson. "Am I under arrest?"

Paterson said, "Not yet. But you wanted to get off your flight so bad, you tried to jump out while the plane was rolling."

"Did we crash?" He looked around the ambulance. "Did the plane go down?"

Jo gazed at him, puzzled. In the s.p.a.ce of two minutes Kanan had gone from unconscious to intensely alert, articulate, strong, and confused.

"Mr. Kanan-"

"Ian."

"Ian, I'm a psychiatrist. The police called me to the airport to evaluate you because-"

"You think I'm nuts?"

"I think you have a head injury."

He stared at her for a long moment. A look of pain, and understanding, seemed to jolt him. His breathing became choppy. "They'll say it's self-inflicted."

The cold trickle ran down Jo's back again. "Your injury?"

"It's over, isn't it? I failed."

"Failed at what?"

He squeezed his eyes shut. For a second, Jo thought he was fighting back tears. Paterson's radio guttered. The sound caught Kanan's ear. He opened his eyes and looked at the young cop. And as Jo watched, Kanan's face relaxed. He blinked, breathed deeply, and turned to her, eyes shining and untroubled.

"Hey. What's going on?"

"We're taking you to the hospital."

Puzzlement. "Why?"

Slowly, Jo said, "Do you recall what I told you a minute ago?"

"No. Who are you?"

The paramedic wrapped her stethoscope around her neck. "Man."

Paterson braced his hand against the wall of the ambulance. "What is it?"

Jo felt grim. "Amnesia."

She looked at Kanan, thinking, And not the good kind.

Seth sat on the floor with his back against the frame of his bed. He was quiet. He'd been quiet for days. The men had told him to keep his mouth shut.

But inside, his mind was full of noise, like feedback from an amplifier. Because he hadn't kept his mouth shut when the men dragged him into the park. He had talked. He'd told them about his dad.

His stomach hurt. It hurt like a fist was squeezing it, a fist made of wire. He wrapped his arms around his shins and put his head down on his knees.

My dad's gone and you'll never catch up with him. He's in the Middle f.u.c.king East and if you think you...

He'd said it to scare them. So they'd know his dad wasn't like some tour guide who herded people around on vacation. He was a mean m.o.f.o who could take on the Middle East, alone. But why had he said it? Why why why...

The room was dim and the floor was hard. That was okay-he wanted it that way, preferred the hard floor to the creaking bed. The hard floor forced him to stay alert, kept him thinking.

What was he going to do? The men-the human hot dog and the brick with acne and the Mickey Mouse rapper-had told him the consequences of not keeping his mouth shut. Of trying to tell anybody at all. They'd been specific and elaborate. We'll demonstrate on your dog. Then we'll do it to your mom.

He squeezed his eyes closed and put his hands over his ears, trying to shut out the memory.

Whiskey was okay for now. Seth heard the dog in the kitchen, lapping water from the bowl. But Whiskey wasn't safe, and neither was Seth's mom. The men had Seth where they wanted him. And they could get to him without warning, at any moment.

The wire fist tightened around his stomach and then grabbed his throat. He had to do something. He had to figure a way out. But how? He was trapped.

Neurologist Rick Simioni found Jo in the hospital hallway. His face was a beacon of alarm.

"Was I right?" Jo said.

"Anterograde amnesia. Unquestionably."

Simioni's dress shirt and lab coat were swan white. He smoothed his tie. "Kanan knows who he is. Remembers everything about himself, his life, and the world, right up till the beginning of the flight today."

"Then?" Jo said.

"Blank."

Mild amnesia was common following a head injury. But it was often limited and transient-as patients improve, so could their memories. Not, however, in Ian Kanan's case.

"Nothing new sinks in?" Jo said.

"It hits, sticks for a while, and slides off. His brain receives new information but isn't absorbing it."

"How long can he retain information before he forgets it?"

"Five, six minutes."

"What happens?"

"He doesn't lose consciousness. Doesn't have a seizure-EEG shows no ictal patterns. But if his attention wanders for very long, all the information he's gathered simply evaporates."

"Short-term memory loss," Jo said.

"His vision, hearing, and speech are perfect. You tested him and noticed no muscle weakness..."

"He was post-ictal with a Glasgow Coma Score of eleven. He'd suffered one partial complex seizure, one grand mal."

The news was grim. Short-term memory loss-anterograde amnesia-didn't mean you forgot things for a short while. It meant you couldn't form new memories. And it was both a symptom and a result of catastrophic brain injury.

"What's causing it?"

"You need to see the MRI," Simioni said.

In the radiology suite, light boxes hummed on the walls. A PET scan glowed on a cinema-display computer screen, somebody's lungs and liver imaged as Timothy Leary might have hallucinated them, rendered in crimson, cobalt, and screaming yellow.

By contrast, the black-and-white MRI scan of Kanan's brain looked dull. And devastating.

The radiologist was a precise man from Hyderabad named Chakrabarti who had little hair and expressed less emotion. He acknowledged Jo with an economical nod.

Jo approached the screen and examined the cross-sectional slice of Ian Kanan's head. Slowly, quietly, she said, "What is that?"

Chakrabarti touched the image with his index finger. "A lesion."

"Of the medial temporal lobes. I see. What's that?"

Deep within Kanan's brain, where the gray matter of the medial temporal lobes should have been, was a dark fuzzy s.p.a.ce.

"There's more on the next cross section," Chakrabarti said.

"More sounds bad," Jo said.

"It is." He typed on the keyboard. "Mr. Kanan had difficulty staying still in the scanner. He was quite agitated. He would lie calmly for a minute, then forget where he was and try to climb out, yelling, 'What the h.e.l.l is this?'"

"Like his brain kept resetting to Start?" Jo said.

"Groundhog Day," Simioni said.

Chakrabarti brought up a new image. Simioni took a breath. Jo felt a flicker of nausea.

Kanan's medial temporal lobes seemed to be etched with black strands. It looked as though somebody had scratched lines in the image with a rusty needle.

"Those... tendrils-are they causing the memory loss?" Jo said.

Simioni pointed with a pen. "The medial temporal lobe, and particularly the hippocampus, is the part of the brain that encodes facts and events into memory. So I'd say yes."

"What is it?"

Chakrabarti said, "I don't know. It's not a bleed. Does he remember suffering head trauma?"

"He says no," Jo said. "Is that viral? Bacterial?"

The two men stared at the screen but had no answers. Simioni said, "Have you reached his wife?"

"No answer. Left messages," Jo said.

They stared some more. Simioni turned. "Let's tell him."