Authors: Martyn Bedford
She can’t tell things apart any more: five minutes ago and five hours ago; being awake and being asleep; what’s in the room and what’s in her head.
For all she knows, she could be imagining Caron.
“So,
have
they?” The girl’s voice tugs at her attention. Shiv gets the impression she’s repeating a question Shiv must not have heard.
“Have they what?”
“Said when they’ll let you out of here.” The medical room, she means.
“Not today – they want to fatten me up some more. Also, they think I might’ve knocked myself out when I fainted,” Shiv says. “Dunno, maybe tomorrow.”
“Then what?”
Shiv shakes her head.
“Only, we’re so close to the finishing line,” Caron says, leaning forward.
“Finishing line? You think there’s a finishing line?”
“There can be, Shiv. If you—”
“Did Pollard put you up to this?” Shiv asks, suddenly cross. “Eh?
Let’s send Caron in, see if she can talk some sense into her
. Is that why you’re here?”
“No, I
asked
to come.” Caron is annoyed. “If you want the truth, you’re ‘at such a crucial point in your recovery’ I had a job getting Dr Pollard to let me near you.”
“Recovery? That’s a laugh.”
“’S’what she said.”
Shiv fixes her a look. “So why
did
you want to be anywhere near me?”
“Bizarrely enough, because I
like
you. And I’m worried about you.”
“Yeah, well, don’t be. I feel good. I feel strong.”
“Sure.” Caron gestures at her. “I can see that.”
Shiv taps her head. “Up here, I’m talking about.”
“Right. ’Cos, of course, what Declan would’ve wanted –”
“Don’t tell me what my br—”
“– is for his sister to starve herself to death for him.”
“Oh, like you never tried to kill yourself over Melanie?”
“That was before.”
“Before? Before what?”
“Before I came here.”
Shiv shakes her head. “All therapy comes down to the same thing in the end.”
“What?”
“You have to learn to think like your therapist. Same in school – ‘right’ is what the teacher says is right; ‘wrong’ is what the teacher says is wrong.”
“No. It’s true, what I just said. It’s what I believe.”
“Really? Or is it just what you need to believe to get yourself through this?”
Caron leaves. No big scene or stropping out of the room – she even finds another smile for Shiv and gives her hand one last squeeze. Then she lets herself out of the medical room and Shiv is alone once more.
Shiv calls after her, shouts out that she’s sorry. Too late.
Her gaze settles on the hand Caron just touched – it was the one with the tube. Shiv looks at the tube, where it goes into the vein. Then she yanks it right out in one quick rip, releasing an arc of startlingly bright red blood across the sheet and, with another swipe of her arm, sends the IV stand crashing to the floor.
It’s another couple of days before Shiv’s considered well enough – reliable enough – to be discharged.
She’s barely in her room ten minutes when Hensher appears at the door.
“Dr Pollard wants to see you.”
Shiv follows him. When she realizes where Hensher is taking her, she begins shaking. Stops in her tracks, starts to turn back. Not until he assures her that the room won’t be “active” does she finally agree to step inside.
“You know why this place is called the Korsakoff Clinic, I take it?” Straight in. She hasn’t even said
Hello
or
How are you?
, or anything like that.
Shiv nods. “I read the stuff you sent my dad. Googled it and that.”
“So, you’ll know Dr Sergei Korsakoff was a
neuro
psychiatrist. Psychiatry examines
what
we think and
why
we think it,” Dr Pollard says, “while neuropsychiatry looks at
how
we think. In particular, the effects of neurological damage or disorder.”
They’re sitting on the floor in Shiv’s Personal Therapy Unit – facing each other across the room, backs against the walls, voices echoing. The projectors are switched off, the walls, floor and ceiling a uniform off-white. Stripped of its picture show, the PTU looks smaller, ordinary. Nothing to fear.
Why has she been brought here, of all places?
The Director is talking about Korsakoff’s Syndrome.
“Also known as amnesic-confabulatory syndrome. Amnesic, as in memory loss; confabulation, as in false memories or perceptions. In basic terms, sufferers of this disorder not only have gaps and lapses in memory or perception, they
create
memories of things which didn’t happen in the past and perceptions of things which aren’t happening now.”
“Seeing things?”
Shiv asks.
“Hallucination can be a symptom, yes.”
Shiv thinks of all those sightings of “Declan” in the grounds. The holding of hands during Walk. The other day in the medical room.
Dr Pollard sits up a little straighter, like a propped-up Barbie. Smart, suit-wearing, psychiatrist Barbie. “In some of the incidents after Kyritos – whether or not you realized it – it’s probable you were experiencing amnesic-confabulation.”
The vandalism, she means. The violence.
Shiv is about to deny it but, no, of course, there was that time she smashed up the bottles of booze in the supermarket and, afterwards, had no recollection of doing so. There’ve been other episodes, now she thinks about it. Blank moments when she has zoned out of conversations or blacked out altogether.
“It’s involuntary,” Dr Pollard adds. “A misfiring in the brain that causes you to confuse imagined perceptions with actual ones, whether it’s a remembered event or something happening – or seeming to happen – right now, in front of you.”
“Why are you telling me all this?” Shiv asks.
“I’m right, aren’t I?” the woman says. “You
have
experienced confabulation.”
Shiv nods, conscious of being observed. Dr Pollard’s face is creamy, yellowed by the spotlights. It could be made of wax. Shiv is tired. She’d planned on being asleep in her bed right now, but she knows she has to focus on what the woman is telling her – to try to make sense of it.
“Korsakoff says this falsification can also apply to what people
believe to be true
. About themselves, or others. In how they interpret things.”
“Like what?”
“OK, so, even when they remember a true event, they create a false narrative from it. A boy tries to save his sister from drowning but, to his mind, he failed … not because the sheer force of the water made it impossible but because he didn’t have the courage to take the ultimate risk. To
die
in his attempt to save her, if need be.”
“Mikey.”
“To anyone else,” Dr Pollard adds, “the boy did everything he could. But, to his way of thinking, he didn’t do enough.”
“I don’t blame myself for not saving Declan,” Shiv says. “I blame myself for—”
“False narratives, Siobhan.” She holds Shiv’s gaze. “They come in different forms – the belief that your loved one is still alive, that you might have prevented their death, that you
caused
their death, that
your
life has no point without them – but, essentially, they are all rooted in amnesic-confabulation. They are all fictitious.”
“What if you
did
cause their death? Fact, not fiction.”
“An illusion is a belief derived from human wishes. D’you know who said that?” Then, “Sigmund Freud.”
“What – you’re saying I
wanted
to kill Declan?”
“No, of course not. But you want it to be true that you killed him.”
Shiv bangs the back of her head hard against the wall. “Because it
is
true.”
“Is it? You
literally
kil—”
“What happened happened because of me.”
“And if that means ‘I killed him’ you must be made to pay for his death. Yes?”
Shiv doesn’t answer. Just sits there, staring at the floor between her splayed feet, the boards patterned with tiny woodworm holes like a crazy dot-to-dot picture waiting to be filled in. Her head smarts from where she banged it. “Not everyone who’s bereaved suffers illusions,” she says, sullenly.
“That’s true. But, at this clinic, we specialize in treating people who do.”
“So why me? Why do I … confabulate?”
“There are two main causes,” Dr Pollard says, adjusting her glasses. “One is organic: a thiamine deficiency. Then there’s your sort, caused by trauma. It could be physical, such as damage to the brain’s prefrontal cortex, or due to a sudden, extreme shock. An Acute Stress Reaction.”
“Post-traumatic Stress Disorder,” Shiv says. “That’s what my counsel—”
“PTSD’s not quite the same. In PTSD people tend to have repressed memories or intense ‘flashbacks’ of the traumatic episode. Or both. I know this applies to you, but what you
also
display is the amnesic-confabulation we’ve been talking about.”
“Seeing things that aren’t real.”
“Yes. And believing things which aren’t true.”
The woman explains that, in Acute Stress Reaction, the patient can’t make sense of what has happened or what’s going on around them. “So they rewrite the story in their unconscious,” she says. “And what you end up with is
two
realities – the real reality and the false reality – merged into one.”
Like this room, Shiv thinks. This is real reality: blank walls, no audio, an empty, neutral space; the false reality is the one she experiences in her PTU sessions – when this room is a portal to the time she killed her brother. Perhaps that’s why the Director chose it today – to demonstrate its harmlessness.
Who knows? Shiv isn’t sure she knows anything any more.
A thought strikes her. “How do the film shows and photos help me sort out the real from the false?” She gestures at the walls. “Surely they’d just make it worse.”
“They do. That’s the point.”
“What?”
“In the First World War, a lot of soldiers suffered terrible facial injuries,” Dr Pollard says. “The medics in the battlefields patched them up as best they could then sent them home for proper reconstructive work – the pioneering experiments in what we now know as plastic surgery. But before—”
“What has this got to do with—”
“
Before
the surgeons could operate to repair and rebuild, they had to break apart the patch-up and return the face to its original, damaged state, let the wounds heal again and start from scratch. If they didn’t, the reconstructive surgery would be a botch job, causing even worse disfigurement – not to mention the risk of infection.”
The Director pauses, studying Shiv’s reaction.
“So, the PTU sessions…” Shiv begins.
“Are the psychiatric equivalent of reconstructive surgery, yes. D’you recall, at the start of Phase 2, I described it as Trauma Centred Therapy?”
Shiv nods.
“Well, this stage of your treatment is designed to break apart all the therapy you’ve had before, to strip away the scar tissue of your grief, cut through the layers of confabulation – take you right back to your original traumatized state.”
“And then what?”
“Let you see the truth of it.”
Kyritos
After Declan had helped clear up the mess and Shiv had changed out of her wine-soaked shorts, they sat on the low wall to watch the sun setting over the bay.
A chance to talk. To make up.
They were both still too raw, though, to set the ill-feeling aside completely. It would take more than a tennis ball. But, after the last couple of days, the simple act of sitting side by side – gazing at the shifting colours of the sky, the warm breeze bathing their faces – was a kind of healing. Or the start of one.
“What happens if Mum and Dad see there’s a glass missing?” Dec asked.
“We deny all knowledge. Anyway, it’s not my problem,” Shiv added, teasing. “
I
wasn’t the one who broke it.”
“No,” Dec said. “And
I
wasn’t the one drinking wine.”
Another silence gathered round them. “It
was
a good shot though,” Shiv said, at last, smiling.
“
I
thought so.”
They were still sitting there when the drone of a pair of mopeds disturbed the evening hush, turning off the main road and coming along the track.
Shiv glanced at Dec. “It won’t be him,” she said, her mouth dry.
Shiv met Nikos coming the other way along the path down the side of the villa. All the strength had drained from her legs. But she would not allow herself to be weak.
“Hey, there you are,” he said, his face unnaturally white in the glare of the security lamp. He was smiling, but tentatively. It was the first time she’d seen him so unsure of himself. “I thought nobody was home.”
She tried to keep her voice steady. “What are you doing here, Nikos?”
“I, uh,” he spread his hands, “I remembered what you said about your parents going out tonight. For their anniversary.”
“That doesn’t answer my question.”
They were a couple of metres apart, hemmed in by shrubbery on one side and the whitewashed wall of the villa on the other. Nikos hung his head, as though accepting that he deserved to be spoken to like that. “I had to see you,” he said, quietly.
Had to
.
“Suppose my mum and dad had been here?”
He gestured back towards the hire car. “I thought they
were
, at first.”
“Dad would’ve
killed
you.” The idea of her father killing anyone was ludicrous. Nikos just nodded though. “Who’s with you?” Shiv said, refusing to soften her tone.
“My cousin. Joss. We’re on our way to my brother’s party.”
“Uh-huh.” They continued to stand there, facing each other. He looked at a loss to know what to say or do next. “Well, have a nice time,” Shiv said, turning to go.
“
Shiv
, I wanted to say sorry.”
She turned back. “For what?”
“For everything. I … I’m sorry the way things worked out.”