Mr. Nobody Read online

  He clears his throat, suddenly businesslike. “Well, here’s the thing, Emma—is it okay if I call you Emma? Or do you prefer Dr. Lewis?”

  “No, no, Emma is fine.” Now I realize that I’ve already called him Richard and I didn’t even ask. Ugh.

  “That’s great, Emma. Okay, so, I’ll cut to the chase. The last time we met was—”

  “In Dubai?” I cringe at the thought of our last meeting.

  “Yes, that conference on advances in neuropsychiatry, I think. We spoke about retrograde amnesia, and fugue. Misdiagnosis and testing methods.”

  “Um, yes, yes we did.” We spoke about memory loss and psychological trauma. We spoke about misdiagnosis. I feel the back of my neck flush hot because I know what’s coming. I push on, regardless. “Yes, that’s right. I think it was in regards to my paper….”

  “Yes. Yes, it was,” he agrees, and I hear a smile in his voice. His recollection of events obviously amusing him. Thank bloody God for that.

  Our conversation in Dubai was the second time we had met and it had gone pretty well, in comparison to the first time we met.

  The first time we met he was giving a lecture on the neurobiology of amnesia at Stanford. I’d received a research grant and I’d used the opportunity to travel to the U.S. to hear the talk and try to arrange to meet him in person to clarify some points about the cases he’d worked on. Now, to be fair to me, I was young. I still had the idea that confrontational debate in an educational setting was a productive method of getting anything at all done. Which it turns out is not, in fact, true. And on top of that it turned out that I had also sort of misunderstood the tone of the evening. So when the Q&A finally opened out to the audience, it would be fair to say that, as I lowered my shaky hand and started to ask the first of my three questions, I was not greeted with quite the professional curiosity that I had naively expected from Groves’s eight-hundred-seater auditorium of paying guests.

  I feel the cringe twang again deep inside me.

  “Listen, Richard, can I just say again, I am so sorry for what happened at Stanford. I just, I can even…”

  He’s chuckling now, oh God, somehow that makes it worse. What a lovely man.

  “Emma, I told you the last time we met. It’s fine. I mean, I wish we’d discussed your questions in a more private setting but, heck, that’s the nature of medicine, right? You’ve got to be able to question things. Anyway, put it out of your mind for now.”

  I hear the receiver pull away slightly at his end of the line and a muffled yawn.

  “Sorry, Emma,” Groves continues. “It’s not you. You’ll have to excuse me but I’m on Eastern Time, it’s, er, 3:32 in the morning here in Massachusetts. Long past my bedtime.” He gives a tired chuckle, warm and throaty. “We’re pulling an all-nighter in the lab. So I thought, why not call you in England at a decent hour while I’m up anyway.” I realize it’s still Sunday night where he is. He’s pulling an all-nighter on a Sunday; Jesus, the Americans work hard. Monday morning in London suddenly feels infinitely more manageable.

  “Well, I’m glad you called! So…what is it I can do for you, Richard?” Even as I say it I wonder if there genuinely is anything I could help him with. It seems unlikely. Unless, of course, he needs someone to embarrass him publicly at another upcoming function.

  I hear him sigh heavily. “Ugh, okay, Emma, I really hate all this. You see, I’m usually a planning-ahead man, not a fan of changes to my schedule, snap decisions, that sort of thing. I suppose it’s a pretty old-fashioned way of working but it’s what I’m used to. So, I apologize if you’re the same, but I’m afraid the reason I’m calling is all quite seat-of-the-pants. Anyway, to cut to the chase, I got a call this morning, my morning, from the UK about a patient over there and it made me think of you. Sorry, just one moment—” He breaks off; there’s the scratch of something being pressed against the receiver mouthpiece on his end. I notice I’m standing up; I’m not sure when that happened.

  I wait. I look at my gray office door, the gray slat blinds, the neat piles of green patient folders on my desk. Then his voice comes back like warm honey on the line.

  “My apologies. The natives are restless here. Where was I?”

  “You got a call and thought of me,” I prompt, sitting back down.

  “Ah, yes. So, I got a call from Peter Chorley, at Cambridge. Do you know Chorley?”

  I rack my brains, but I feel like I would remember a Peter Chorley if I’d ever met one. “No. I don’t think I do. No.”

  “He’s got tenure, head of Neurolinguistics at Cambridge. No background in our field but he does a lot of advisory stuff, freelance, over there in the UK, government consultancy, initiatives, boards—that sort of thing. Jack of all trades, to some extent. Anyway, he called to gauge my interest on working with a patient over there in England. He thought it would be exactly my kind of thing—but as you can tell, I’m pretty swamped up here. So, long story short, I suggested you.”

  I clutch the phone hard as if it might suddenly and inexplicably be yanked from me, my breath catching in my throat.

  Oh my God.

  Richard continues. “You’re there already, you know your stuff, it’s a small field and this is exactly what you’ve been after, am I right?” He asks it triumphantly, a man doing someone a solid favor.

  I genuinely cannot believe this is happening. “Er…” is all I manage.

  “It’s an intriguing case. I promise you, you’ll love it,” he adds encouragingly.

  And I’m absolutely certain I will love it, but that’s not the problem. The problem is I’m pretty sure Richard Groves has made a mistake and dialed the wrong number.

  I try to think if there are any other neuropsychiatrists who (a) look like me, or (b) have names similar to mine.

  He must be trying to get hold of someone else, surely? Things like this don’t happen. Or at least they don’t happen to me.

  But then, neuropsychiatry isn’t a huge field, especially in the UK, especially when it comes to specialists in memory. And now that I really think about it I might be one of the few British specialists who’s actually had the balls to introduce themselves to Groves and spoken to him in person—we don’t tend to get out much, neuropsychiatrists; social time does tend to eat into precious work time. So perhaps I am pretty high on his list of options after all. And who am I kidding? I pushed for this, didn’t I? I pushed so hard for this chance. Every time I’ve met Richard I’ve pushed. I talked, I listened, I hung on his every word. I basically low-level stalked him for this opportunity. I’ve foisted my diagnostic theories down his throat at every juncture. And I sure as hell never saw anyone else pushing through the crowds to get to him to debate diagnostic methodology. God knows no one’s pushed to be at the forefront of his mind more than I have. So maybe it isn’t so strange? Perhaps in a way I chose him.

  “I know it might seem like a shot out of the blue, Emma. But you’ve been on my radar for a while now. You know how rare these cases are. And you’re over there. I could’ve called Tom Lister at John Radcliffe; he’s…well, he’s not as—shall we say—invested as you are in new research. Let’s be straight. You’ve got ideas, theories—I’ve read your research material—but you haven’t had a real stab at a fugue case yet. And you were right, about brain imaging, we should have used it, every case should, it should have been used to rule out or verify fugue. If I’d had the tech twenty years ago, I’d have been shouting at doctors in lecture halls too. It’s what I’d use now myself, and I know for damn sure it’s what you’ll use.” He gives a youthful laugh. “Listen, I know you’re busy over there, you’ve got your own thing going on in London, it’d mean traveling north, uprooting for a while, but I really think this could be the opportunity you’ve been after. I wouldn’t be where I am today if someone hadn’t taken a shot on me, and this is me giving you yours. What do you say?” He leaves the question hanging in t
he air, an ocean between us.

  Richard Groves has read my work. Of course he has. He’s a fucking genius, I bet he reads everything. But he liked it. He agrees with it. It’s right. I’m right.

  I peer up at the anemic gray of the ceiling tiles above me: huh, somehow there’s a coffee stain up there. I have no idea what he’s suggested me for yet, but whatever it is I should definitely do it, I’d be crazy not to.

  “What’s the case, Richard?” I ask, grabbing a pen and a stack of Post-its from the desk.

  His tone is enthusiastic. “Mr. Nobody,” he says. My pen hovers over the Post-it paper expecting more but nothing comes.

  “Sorry? What was that, Richard? Mr….?”

  “I know, it’s ridiculous—as usual. The press are calling him Mr. Nobody. He’s the guy they found on the beach the other week. The one in the news.” He pauses expectantly once more, waiting for some kind of acknowledgment from me but I am still in the dark. I suppose now might be a good time to tell him that I don’t really watch the news. I mean, I hardly have time to do my own laundry and the last thing I want to do with the little free time I do have is fill it with problems I can’t solve. The most I read is the free paper on the underground on the way to work and I only skim that. Perhaps in this case, though, a little TV could have gone a long way.

  I depress the computer’s power button as stealthily as I can and swivel my chair and the phone away from its burst of startup noises. Google will be able to fill me in.

  “Er, yes, I think I saw something….” I fudge as the home screen settles.

  But he clearly sees through my delay tactics. “Ah, okay. I’m guessing you haven’t seen it. Let me give you the potted history. I’ll get the exact location details to you but he’s in England, it’s a coastal town, outside London. But diagnosis-wise, at this stage, it’s looking like retrograde amnesia or dissociative fugue.” He pauses to let that information sink in.

  Retrograde amnesia or fugue. The loss of all stored biographical memory, through trauma—physical or psychological. Patients with either would retain all skill- and knowledge-based memory, as these types of memories are stored in different areas of the brain, but lose personal memory. A patient would know, for example, what the idea of home is, but he won’t remember his. He’d remember how to drive a car but not where he usually parked it. His past would be a blank slate, he’d remember nothing of his life before the physical or psychological trauma that caused the amnesia. Like walking into a room and forgetting why—except you also don’t know where the room is, or where you were before you walked into it.

  Retrograde amnesia is caused by physical damage to the brain and it’s very, very rare. But fugue is even rarer and, unlike retrograde amnesia, fugue is caused solely by psychological trauma. I suddenly understand why Richard Groves is calling me in particular. In my thesis I argued Groves may have misdiagnosed certain fugue cases. I stuck my head out over the parapet of recent graduation and criticized the received wisdom, challenging the established method and arguing publicly that historically most fugue cases were likely misdiagnosed. He’s offering me a chance. A chance to prove it.

  I take a deep breath. “I see.” There’s silence on the other end of the line. I realize he wants me to ask the most important question of all, the nub of the matter.

  “Which do you think it is Richard? Retrograde or fugue?” I ask carefully. We both know how important the distinction is. If this is a genuine fugue case, it could give invaluable insight into an extremely rare condition. We’ve only really been able to test for it since the 1990s, which means study cases are few and far between.

  “I haven’t seen any scans yet,” Richard answers cautiously, “but what they’re telling me sounds intriguing. It isn’t presenting as malingering, and it wouldn’t have got this far if it was, especially in light of the oversights on the Piano Man case. People are very keen to spot that kind of thing early. I have it on very cynical authority from Chorley that we’re dealing with something much more complex here. The powers that be over there seem pretty eager not to fuck the situation up. Yes, it’s definitely fair to say they don’t want another Piano Man situation.”

  It suddenly occurs to me how big a deal this case could be. If I take it, I won’t just be treating an extremely rare RA/fugue patient, I’ll be responsible for averting another NHS diagnostic shit show. Because that’s exactly what the Piano Man case was.

  Ten years ago, another man was found, this time in Sheppey—the Isle of Sheppey in Kent—in a seaside town during the off-season. He was soaking wet and wandering along a coastal road, in an evening suit. He had no identification on him; the labels had been cut from his shirt and suit. Admitted to the local hospital, he seemed unable to speak to the doctors and after neurological testing and psychiatric evaluation he was diagnosed as fugue.

  Given a sketchpad, the man drew a detailed picture of a grand piano on a spot-lit stage. When the staff took him to the piano in the hospital’s chapel, he played the whole of Beethoven’s Moonlight Sonata from memory. And he was dubbed the Piano Man.

  The Piano Man’s procedural memory was perfect, he remembered how to play, in spite of the fact that he’d lost all personal memory.

  The hospital staff encouraged him to play daily, in the hopes that it would help his recovery and trigger memory recall. Staff and patients would gather at the back of the chapel to listen, enthralled as the music flowed out of him from who knew where. Inevitably, the press got hold of the story. A photo circulated of the lost-looking man, in the hospital’s garden, in his formal evening suit, a stack of chapel musical scores tucked under his arm, supplied by well-wishers. He looked every inch the lost musical genius that he swiftly became in the eyes of the world. The media went crazy for him, the public went crazy for him. And, overnight the world found out about the Piano Man. The name was almost too perfect, considering the other meaning of “fugue”: a piece of music made up of many voices repeating the same melody.

  And the media storm that brewed became a fugue in itself. So many voices. People demanding to know who he was. Where he came from. But, most importantly, what had happened to him.

  It played out loud and brash across the tabloids and for one summer the Piano Man caught the imagination of the world. The public wrote their own stories, projecting their hopes and fears on his blank expression.

  Meanwhile, British neurologists, psychiatric nurses, and a host of other medical professionals fumbled and fudged different treatment plans and the police tried to track his family down. None of which came to anything. Until finally one day the Piano Man decided to speak. And what he said wasn’t what anyone had expected.

  He wasn’t the man the world had been hoping for; he was simply an ordinary man, an imperfect broken person just trying to disappear. He’d been misdiagnosed. He wasn’t in a fugue state; and he didn’t have retrograde amnesia.

  The National Health Service, police force, and government came under scrutiny for their complete and utter mismanagement of the whole case. The Piano Man was thrown out with the rubbish, a sad malingerer, a fraud who fooled everyone.

  But I wouldn’t call what he did malingering, that seems too harsh a term. Malingerers tend to fake for financial gain or to avoid incarceration or military drafting. But the Piano Man just wanted to escape his everyday life for a while.

  When Richard next speaks his tone is soft, parental. “I’d take the case myself if I wasn’t already neck-deep here at MIT. You know, I haven’t had a potential fugue for years now. There’s a lot I’d do different, a lot I know you’d do different.”

  He’s right. I’ve never had a fugue patient. There aren’t that many around and men like Richard with years of clinical experience tend to scoop them up. Groves has treated cases similar to this one, although he had nothing to do with the Piano Man case—though he did work on a similar case, “Unknown Young Male” in 1999. It was the case where a twenty
-year-old patient wandered into the Buffalo General Medical Center in upstate New York, soaking wet, with a shaved head, asking if anyone could help him find his way home, as he couldn’t remember where he lived or who he was.

  In fact there aren’t many fugue patients Richard hasn’t worked with. He led on the Lost Man case in 2007, where a businessman came to on the subway in Denver with no memory of his life up until that moment.

  And the case of patient H.G. (Heather Goodman), who found herself in a Starbucks queue in Portland with no wallet or idea of who she was or how she’d got there. It turned out her amnesia was epilepsy-led and she regained her full memory after only ten days.

  Richard has consulted on almost all the recorded fugue cases over the last thirty years, which is why he’s the go-to specialist for cases like this, but that might change, that could change, if this goes well. And it could go well, couldn’t it?

  “I’ll do it,” I say before I can think of the million reasons it’s a terrible idea and talk myself out of it.

  “Great! That is excellent news, Emma!” Richard crows, and I feel a warmth spread right through me. “Good. I had a feeling you would. Now, listen, I hope you don’t mind but—”

  There’s a sharp bang on the door and Milly pops her head around.

  Richard continues, “—there should be someone turning up there soon. I didn’t want to be presump—”

  Milly waves for me to listen, her face uncharacteristically animated.

  “Sorry, Richard, one second,” I say, lowering the phone. “What is it?” I ask.

  “There’s someone here to see you. He doesn’t have an appointment that I can see, but Greg from Caroline Miller’s office just called and said the appointment has already been okayed with them! With Caroline Miller!” Milly’s voice is hushed but her pitch is high. Caroline Miller is the chief executive of the whole hospital. We only ever see her at events and general meetings. “Did you know about this?”