Mr. Nobody Page 2

  He thinks of the word he removed from the back of his hand, and blinks.

  Why do I need to find her?

  The memory is what it is. There is no more. Whoever she is, he needs to find her.

  They must have said more.

  He tries to force the memory but the throb awakens deep at the base of his skull. He lets the thought go.

  All he knows is he was told by someone, instructed by someone…he can’t remember who told him, or what they sounded like, or their face. But he trusted them, he knows that much.

  How can he find her—this woman—if he doesn’t know who or what he’s looking for?

  A sound in the distance breaks the man’s concentration. A voice calling out. Instinctively he turns toward the forest, his heart pounding. There is no one there. The wind perhaps, though it sounded more like a person calling—a name. It came from the forest, a voice carrying over the wind. He stares long after the sound has gone. Certain he heard it. Someone.

  But there is no one.

  He turns back to the water.

  The sound comes again. This time from immediately behind him. A voice. He freezes. There is someone standing right behind him.

  He turns slowly on the wet sand. Someone is there. A young woman. She wasn’t there before.

  Where did she come from?

  He blinks, trying desperately to make sense of what is happening. His thoughts racing.

  She wasn’t there before, was she? Is this her? Is she the one I need to find?

  But in the same instant he knows.

  It isn’t her.

  He studies her as she stares back at him. She is talking to him, her expression confused, concerned, as if she may have been speaking for a while. She’s saying something, words he can’t quite understand; her language garbled, the sense not apparent.

  His head throbs deeply.

  But there is a look in her eyes and everything he needs to know is in that look. He’s safe for now. That’s as clear to him as the sand, and the cold, and the bright high-vis yellow of the woman’s coat.

  And suddenly, for a heartbeat, he understands exactly what is happening to him. That this has happened so many times before, this exact scene, it’s a loop he can’t ever escape. And he briefly understands a tiny part of what he needs to do next. And with that knowledge panic, in a giant wave, crests over him. The bright pinch of pain inside his skull explodes to life and he crumples onto the sand.

  2

  DR. EMMA LEWIS

  DAY 6—LONDON

  This is my pager. There are many like it but this one is mine.

  Like a song I can’t shake, or an advert jingle, it runs through my head as I jog to Ward 10, the pager vibrating deep in my pocket, in time.

  This is my pager. There are many like it but this one is mine.

  I know, as mantras go, it’s not original. But to be fair to all concerned, it only started out as a joke at medical school. And the joke became a habit and, weirdly, these days, it does actually calm me down. That’s the thing about habits. They’re comforting. They’re hard to kick. Like smoking. And I don’t do that one these days. I’m not that kind of girl anymore.

  I’m not any kind of girl anymore—I’m a thirty-year-old woman. I’m the lead consultant neuropsychiatrist in a busy London hospital. If I ever actually left work, it wouldn’t be “Ms.” on my restaurant reservation, it would be “Dr.” If I ever had time off to go to restaurants, that is.

  You have to watch out for habits, when twelve-hour shifts slide effortlessly into twenty-four-hour shifts. But as habits go, there’s nothing wrong with mantras.

  God, I need a cigarette.

  When I get to Ward 10, Mr. Davidson is yelling at the top of his seventy-eight-year-old lungs. Which has the combined effect of being both disturbing and at the same time strangely sweet. But perhaps the main takeaway is the sheer volume. A visiting couple and a porter stand stock-still in the hallway, heads cocked toward the commotion coming from his room.

  Their expressions settle when they clock my doctor ID lanyard; it tends to have that effect. Over the years, I’ve noticed the doctor’s lanyard tends to illicit either relief or apprehension.

  I flick off my angry pager and plop it back in its pocket. Doctors are some of the only people left in the world you’re likely to see carrying pagers. We still use them because they’re reliable. Unlike mobile phones, pagers don’t have dead zones; they work everywhere, even on the heavily insulated X-ray wards of a hospital. And they don’t run out of battery after a few hours; pagers can run for over a week between charges. And they’re durable. Throw them as hard as you possibly can against a concrete wall while crying, for example, and they just won’t die.

  When I enter the room in question I find a junior doctor, two nurses, and Mr. Davidson’s forty-year-old son standing impotently by as the bedbound Mr. Davidson continues to shout, his voice quavering at the assembled group, tears rolling softly down his tired, crinkly face. All heads turn to me as I enter. The lanyard does its thing.

  The junior doctor throws me an imploring look, his expression telling me he’d be more than happy for me to take over. I give him a nod. This is, after all, why they paged me.

  Mr. Davidson’s screaming and the general vibe in the room make it clear that an impasse has been reached. Mr. Davidson doesn’t want to be touched or manhandled.

  “Good morning, Mr. Davidson,” I say brightly, trying to top his energy.

  There’s a slight break in the rhythm of his yells. He looks at me, surprised, and I continue with his full attention. “My name is Dr. Lewis. Do you remember me, Mr. Davidson? I’m your doctor. Emma Lewis.” I give him a reassuring smile as if to say, Of course you remember me, we’re old friends.

  He clings to my smile, seduced from his train of thought, and his yelling finally subsides. He gives me a tentative nod. Not fully invested in the idea that we know each other just yet.

  “Can you tell me what’s wrong, Mr. Davidson?”

  His tearstained face uncrumples as he struggles to unpick my question.

  “Are you in pain, Mr. Davidson? Whereabouts do you feel it?” I nudge him on. He looks away from me now, toward the window.

  It’s hard to tell to what extent Mr. Davidson recognizes me, if he does at all. Howard Davidson has problems accessing and storing memory; I’ve been treating him for three weeks, ever since he was admitted. Recognition is a complex neurological process and humans are very, very good at masking the absence of it. People adapt around memory losses. They rely on other things—visual cues, social cues—they get good at reading people, situations; they find ways around things until an answer presents itself. But regardless of whether Howard Davidson recognizes me, he trusts me, he’s stopped shouting, and that is definitely progress.

  I approach his bed cautiously. He turns to look up at me with his big wet eyes, curious, and exhausted. I gently place a hand on his arm as reassurance.

  He peers down at my hand, his chest rising and falling as he fights to get his breath back to normal. He doesn’t pull away from my touch, he doesn’t lash out. Patients with memory disorders can often become uncharacteristically aggressive, physically violent, but when his gaze floats back up to me it isn’t hostile, it’s entreating.

  “Where exactly are you feeling the pain, Mr. Davidson?” I ask again, softly.

  He takes in air in great heaves, not a huge surprise—he’s been yelling continuously at the top of his voice for quite a while to a confused and frankly deeply concerned audience. As he stares up at me, gulping in snatched breaths, he looks like a man lost in a foreign country.

  He taps his chest. His heart. That’s my answer. The answer to my question. That’s where he feels the pain: in his heart.

  I nod and give his arm another gentle squeeze.

  I understand.

  Mr. Davidson
nods back solemnly, and promptly bursts into a cataclysm of coughs.

  There’s nothing wrong with his heart—well, not physically, anyway. What’s physically wrong with Howard Davidson is his brain. As far as Howard is concerned he’s a thirty-two-year-old man trapped inside the body of a seventy-eight-year-old. He woke up three weeks ago with no memory of the last forty-six years of his life. In his mind he left his house in 1973 and woke up here, an old man. What’s wrong with Howard Davidson is visible only on a scan. Large sections of his neocortex have atrophied, died. All the memories stored in those areas are gone; a huge portion of his life, to his mind, never happened. Three weeks ago, he was fine, pottering around his garden, walking his dog, reading, deep in the flow of his own life, enjoying his retirement, but that old man is gone now.

  Howard Davidson was found wandering down the middle of a four-lane highway near Shepherd’s Bush, and brought to the emergency room. After we ascertained from his relatives that he had no history of Alzheimer’s, that up until that morning he had apparently been quite happily enjoying the life of a retired MP, an MRI scan was taken.

  The atrophy present in the brain scan was found to be indicative of vascular dementia, specifically single-infarct dementia. A single stroke had instantly killed off a massive portion of his hippocampus.

  Forty-six years of life and memories erased in the blink of an eye. He has no recollection of having had children, or running for office, and he still believes he lives with his young wife, Ginny, near Goldhawk Road. All long-term memories end there.

  I pour him a glass of water from the jug beside his bed. He takes it with a shaky hand. Then I turn to face the ragtag lineup behind me, looking for some kind of explanation for Mr. Davidson’s current state, although I already have my suspicions.

  His son catches my eye. Simon Davidson and I have met before, briefly, on the day Howard was admitted.

  I’ll let you in on a secret they tell us at medical school: Sometimes things can’t be fixed. Sometimes things must be lived with. Adapted to. Simon Davidson didn’t want to hear that.

  I’ve been in this profession long enough to trust my instincts in situations like this, and right now my instincts are telling me that Simon is almost definitely the issue at fault here. Doctors and nurses don’t tend to make grown men cry. Well, not in a professional setting at any rate. So I give the medical team a nod and they shuffle, gratefully, out past Simon.

  “Simon, would it be possible to talk to you outside briefly?”

  Simon’s eyes widen slightly at being the only person singled out. “Er, yeah. Yes. Sure.” He gives me a pragmatic nod and starts to leave.

  “I’ll be right with you in one minute.” I offer him a reassuring smile as he pushes out the door, but he’s frowning, unconvinced. However, I need to settle Mr. Davidson, my actual patient, before I can deal with his son.

  I watch the door softly puff closed behind him.

  “Who was that horrible young man?” The voice comes shaky from behind me.

  I turn and take in Mr. Davidson’s frail form, his crumpled features, his kind eyes. I feel an ache of sadness in my chest. He means his son, of course. But the thing that really gets me is the caution with which he asks me the question, the caution for me, in case he offends me, in case the horrible man is a friend of mine.

  “It’s all right, Howard, it’s just me and you now,” I reassure him. I move back to the bed and take his delicate wrist in my hand, counting off his pulse. Elevated but fine. “Did the man who was just in here upset you, Howard?”

  I know the answer already. This isn’t the first time this has happened since Mr. Davidson’s been here, not by any means, nor is he the first patient who’s reacted in this way.

  Howard Davidson shifts to sit a little higher in the bed. “That young man. Not the other doctor, the small man. He told me that Ginny had died. My wife. Ginny. And I don’t know who he was or why he’d say a thing like that. I mean, why would he say it?” He studies my face, a fallen toddler unsure yet whether to laugh or cry. “And the way he said it, so strange. Just ‘She’s dead,’ plain and simple, when I asked when she’d get here, just like that, like it was nothing. My Ginny dead.” He thumps his fingers against his chest; he’s agitated again at the memory. “Why would he say that?” He peers up at me, watery eyes panicked. “Ginny’s okay, isn’t she? She was fine when I left the house. The other doctor wouldn’t tell me. She’s all right, isn’t she? I should never have left the house.” His frail hands become fists now on the bedsheets.

  Ginny died eleven years ago, at sixty-two, from thyroid cancer. To be fair to Howard’s son, he was probably just trying to remind his father, but no doubt would have done so in that slightly weary way people tend to reiterate facts to dementia patients.

  “Is Ginny all right?” Muscle tremors flutter under his eyes. He’s tired.

  I take his hand lightly. “Yes, Ginny’s perfect, Howard. She’s very good. She sends her love, and she told me to tell you that she can’t make it in this afternoon but she’ll see you first thing tomorrow.” I say it because he is my patient and it will make him feel really good, and he won’t remember I said it tomorrow.

  He smiles and squeezes my hand as hard as he can, eyes filling. “Thank you. Thank you, I was so worried about her. I don’t know what I would do without my Ginny. And if I didn’t even get a chance to say goodbye, well…” Of course, he did get a chance to say goodbye—eleven years ago, at her bedside, in this very hospital.

  Mr. Davidson will not be able to remember the words of this conversation, but he will remember the feelings it brings up.

  I’m not lying to him. I’m just not being an asshole.

  We can’t inform Howard that his wife is dead every time he asks us, it would be beyond cruelty. Why repeat the worst day of this man’s life every day of his life?

  * * *

  —

  Outside in the hallway I try to explain this to his defensive son.

  “Are you suggesting we’re just supposed to lie to him? Every day? Until he dies?” Simon’s voice is low but the tone is harsh.

  This isn’t a discussion for a corridor but I don’t think any venue would sweeten what I’m about to say. “You just have to ask yourself, Simon, who exactly would benefit from his remembering your mother’s death? Why are you so keen on making your father remember that one event?”

  He stares at me, blindsided by my questions. Confused by the subversion of the customer-is-always-right rule he assumed also operated in hospitals. He swallows whatever vitriol he was about to say and replies simply, “I want him to remember it because it’s true. It’s important he remembers it because it’s true.”

  “Yes, it is true, Simon. But lots of things are true. I could theoretically wander up to Oncology right now and tell everyone up there that ninety percent of them definitely aren’t going to make it, but what on earth would be the clinical benefit of that? Your father isn’t going to get any better. He won’t remember these things, no matter how often you tell him. It will only upset him. And if you tell him, he will hate you, Simon. He may well live another fifteen or even twenty years. He may outlive us all. I think we’d both like his remaining years to be happy ones. I’d advise you to let your sister take over as next of kin from now on and to limit your visits if you’re not happy with what I’m recommending. And if you do insist on continuing to visit your father, I’m going to have to ask you to stop deliberately agitating and upsetting him. He’s a vulnerable adult and what you’re doing is bordering on psychological abuse.” As harsh as that may sound, Howard is my patient, it’s his welfare I’m here to safeguard, not his son’s.

  Simon glares at me for a second before he replies.

  “I see,” he says finally. “Um, well, obviously, I hadn’t realized I was causing him so much distress….”

  People don’t want truth from us doctors, not really; they
may think they do but they don’t. People want doctors to be like priests. They want hope delivered with authority.

  I catch sight of an RN waving over to me from the nurses’ station: she gestures to a phone receiver at her ear. I suggest family support counseling to Simon and say goodbye.

  With a rallying smile, the nurse hands me the phone. On to the next.

  “Hi, Emma.” The voice on the other end of the line is my secretary, Milly. “Sorry to chase you round the building but there was a phone call earlier from the U.S. I told them you were on call and they said they’d call back at half past. And I haven’t seen you since, so I thought I should let you know.”

  I look down at my wristwatch: 8:27. I can make it back to Neuropsychiatry in that time—at a jog.

  “Who was it, Milly?”

  “Er, a man named Richard Groves. Dr. Groves.”

  I frown at her down the line. “Richard Groves? That can’t be right. Are you sure?”

  “That’s definitely what he said his name was.” She says it with mild disinterest. I can hear her continuing to type as she talks.

  “The Richard Groves?”

  The line goes silent for a second. “Um…I don’t know, Emma, sorry. He just said his name and I wrote it down. Why? Who is he?”

  I momentarily consider explaining who he is to Milly, then think better of it. She wouldn’t have nearly the right reaction if I told her who Richard Groves was. If she googled him, which I’m absolutely certain she won’t, she’d see a career spanning thirty years at the forefront of neuroscience, she’d see bestsellers, essays, university placements, corporate and political consultancies resulting in new tech, new procedures, new government policies. If she googled my actual job title, which again she wouldn’t, but if she did google the word “neuropsychiatrist,” Richard Groves’s name would come up in the Wikipedia “Notability” section. Mine would not. Well, not yet.

  “Okay. Did he at least say what he was calling about, Milly?”