He was visibly excited by the theory, and Susan said, “If what you say is true, what difference does it make?”
“I’m not entirely sure. I haven’t had much time to think about all the ramifications. But I suspect it could be important in helping me decide whether or not the official diagnosis should come down on the side of a physical cause.”
She didn’t like what she was hearing.
Frowning, she said, “If my hallucinations aren’t merely random, spontaneous sparks thrown off by an injured brain, then perhaps the root cause of them isn’t physical at all. Is that what you’re saying? If the visions are triggered by some subtle psychological mechanism, then possibly the entire problem is best left to a psychiatrist.”
“No, no, no,” McGee said quickly, making a placating gesture with his hands. “We don’t have enough data to leap to conclusions like that. We still have to pursue a physical explanation because that seems by far the most likely possibility, considering that you
did
suffer a head injury and were in a coma for more than three weeks.”
Susan wanted very much to believe that her problem was entirely physical, nothing more than the expected consequences of vital tissue damage. If it was a tiny blood clot in the brain, a lesion, or some other malady of the flesh, medical science would take care of it posthaste. She trusted medical science precisely because it
was
a science. She distrusted psychiatry because, to her way of thinking, which had been shaped by her education as a physicist, psychiatry was not really a science at all; she thought of it as little more than voodoo.
She shook her head adamantly. “You’re wrong about the trigger effect of the initials. JS. It wasn’t that. This isn’t a psychological condition.”
“I tend to agree with you,” he said. “But we can’t rule out any possibilities at this stage.”
“
I
can. I’ve ruled it out.”
“But I
can’t.
I’m a doctor. And a doctor’s got to remain objective.”
For the first time since entering the room, he took her hand, and his touch was wonderfully soothing.
Squeezing his hand, she said, “What were the results of the spinal?”
With his free hand, McGee pulled thoughtfully on his ear. “The protein analysis showed no abnormalities. Then we did a blood count. If there had been too many red cells, that would’ve told us that there was bleeding either inside the skull, at the base of the brain, or somewhere along the spine.”
“But the red count was normal,” Susan said, anticipating him.
“Yes. Now, if there was an abundance of white cells, we’d know there was a cerebral or spinal infection.”
“But the white count was normal, too.”
“Yes.”
Susan felt as if she were being backed into a corner by an advancing army of cold, hard facts.
You’re as healthy as a teenager, the facts seemed to be shouting at her. Your body hasn’t betrayed you. Your brain hasn’t betrayed you, either. It’s your mind that has gone rotten. You’re not physically ill, Susan. There’s no organic problem. You’re just plain crazy; that’s all. Nuts. You’re as nutty as a jumbo-size can of Planter’s Party Mix.
She tried very hard not to listen to those invidious inner voices, tried to tune out the increasingly loud chorus of self-doubt, self-loathing, and confusion.
Plaintively, she said, “Didn’t the spinal show
anything
out of the ordinary?”
“Not a thing. We even analyzed the sugar content of your spinal fluid. There are some diseases in which bacteria eat that particular sugar, so a low count would have set off alarms. But your spinal sugar is two-thirds the level of your blood sugar, and that’s also normal.”
“Sounds as if I’m a textbook example of a thirty-two-year-old woman in perfect health,” she said with heavy irony.
McGee was clearly troubled by the difficulty he was having in pinpointing her illness. “No.
Something
is wrong somewhere.”
“What?”
“I don’t know.”
“That’s not terribly reassuring.”
“We’ll just keep looking.”
“I have a feeling I’m going to be here a long time.”
“No. We’ll find it soon. We have to.”
“But how?”
“Well, first of all, I’m taking the EEG printouts, the X rays, and all the lab data home with me. I’m going to go over everything one more time, with a magnifying glass if I have to. Maybe we didn’t look carefully this morning. Maybe the answer was there and we just failed to spot it. Some little thing that was easily overlooked ... some subtle anomaly ...
“And what if you still don’t find anything?”
He hesitated, and he looked worried as he finally said, “Well, then ... there’s another test we can run.”
“Tell me,” she said.
“It’s not a simple procedure.”
“I could figure that much just by taking a look at your face,” she said.
“A cerebral angiogram. It’s a diagnostic technique that we usually reserve for functionally impaired stroke victims who’ve got to undergo brain surgery for clot removal or for the repair of a hemorrhaged blood vessel.”
“What’s it entail?”
“We’d inject a radiopaque substance into your bloodstream, into an artery between the heart and the brain, which means in the neck, and that isn’t pleasant.”
“I guess not.”
“There’s pain involved.”
Susan put one hand to the side of her neck and rubbed the tender flesh uneasily.
McGee said, “And the procedure isn’t entirely risk-free. A small percentage of patients suffer complications leading to death subsequent to an angiogram. Notice that I didn’t say it was a ‘tiny’ percentage or an ‘infinitesimal’ percentage.”
“You said it was a ‘small’ percentage, and I gather that means it’s not large, but that it’s also not small enough to be considered insignificant.”
“Exactly.”
“What we’re talking about is a more sophisticated series of cranial X rays,” she said. “Is that right?”
“Yes. As soon as the radiopaque tracer reaches the blood vessels in the brain, we take a long, rapid sequence of X rays, following its dispersal. That gives us the most detailed look at your cerebral circulatory system that we could hope to get. We’re able to clearly define the size and shape of all the veins and arteries. We can pinpoint a clot, a hemorrhage, a bulge in an arterial wall, virtually anything, no matter how small it might be.”
“Sounds like just the thing for getting to the bottom of my problem,” Susan said.
“Ordinarily, I wouldn’t even resort to an angiogram unless the patient had serious functional impairment—loss of speech, loss of motor control, partial paralysis—or was suffering from apoplectic stroke-related mental confusion of such severity that not even a hope of leading a normal life existed.”
“Sounds like me,” she said glumly.
“Oh, no. Not at all. There’s an enormous difference between stroke-related mental disorientation and the kind of hallucinations you’ve been having. Believe it or not, your condition is the less life-disrupting of the two.”
For a long moment, neither of them said anything. McGee stood beside the bed, and Susan sat there in it, feeling small and weak, and they just held hands in silence.
Then she said, “Suppose you still don’t find anything when you look over the X rays and lab reports again this evening.”
“Suppose.” “Would you order an angiogram for me then?”
He closed his eyes and thought about it for a moment.
Susan saw that there was a nervous tic in his left eyelid.
Finally he said, “I just don’t know. It depends on so many things. I’d have to consider the old physician’s credo: ‘If you can’t do any good, at least don’t do any harm.’ I mean, if there’s not the slightest indication that your problem is physical, then scheduling an angiogram would be—”
“It
is
physical,” Susan insisted.
“Even if there was evidence of a physical cause, sufficient evidence to justify putting you through an angiogram, I’d want to wait a few days until you were a little stronger.”
She licked her lips, which felt dry and rough. “And if we did go through with an angiogram, and if it didn’t reveal any physical damage to the brain, and if the hallucinations continued anyway—what then?” she asked.
“We’d have exhaused every avenue offered by traditional medicine.”
“Surely not.”
“We’d have to rule out a diagnosis of physical cause and start looking elsewhere.”
“No.”
“Susan, we’d simply have to.”
“No.”
“Consulting a psychiatrist is nothing that you should be ashamed of. It’s only an—”
“I’m not ashamed of it,” she said. “I just don’t believe it would do any good.”
“Modern psychiatry has achieved—”
“No,” she said, cutting him off, afraid even to consider the possibility of submitting to years of therapy, years and years of continuing hallucinations. “No. There must be something wrong that you can locate, something you can do. There must be. There
has
to be.”
He dropped the subject of psychiatry. “I’ll do my best.”
“That’s all I’m asking.”
“I’m not licked yet.”
“Didn’t think you were.”
Apparently he saw that her lips were dry, for he said, “Like a drink of water?”
“Yes, please.”
He poured it for her, and she drank all of it in several long, greedy swallows; then he returned the empty glass to the tray on the nightstand.
“Have you remembered anything at all about your job?” McGee asked.
His question startled her. The last time she had given a thought to the Milestone Corporation or to her job there was when she had telephoned Philip Gomez in Newport Beach on Monday morning. More than two days ago. Since then, she had pushed the entire subject to the back of her mind, had thrown a dark cloth over it—as if she were frightened of it. And she
was
frightened. Now, the mere mention of Milestone sent a chill through her. Furthermore, she was suddenly stricken by the strange and unnerving conviction that her bizarre hallucinations—the encounters with dead men—were all somehow directly related to her work at Milestone.
McGee evidently sensed her fear, for he leaned closer to her and said, “Susan? What’s wrong?”
She told him what she had been thinking: that there was a link between the Milestone Corporation and her hallucinations.
“Link?” McGee asked. He was clearly perplexed. “What sort of link?”
“I haven’t the faintest idea. But
I feel
it.”
“Are you suggesting that you were having similar hallucinations
prior
to your auto accident?”
“No, no. How could that be?”
“You mean that you aren’t sure if you were or weren’t having them prior to the accident.”
“I wasn’t. Definitely not.”
“You don’t sound certain enough to please me.”
So she thought about it for a minute.
He watched her with keen anticipation.
At last she said, “Yes. Yes, I’m sure. These attacks have come only since the accident. If I’d had them before, I wouldn’t have forgotten them. Not something like this.”
McGee cocked his head and regarded her at an angle. “If there’s a physical cause of your condition—which is what both you and I want very much to believe—then it must be an injury arising out of the car crash.”