Once Found: The Pocket Watch Chronicles (4 page)

Elsie shook her head.

“That isn’t terribly unusual. As I’m sure you know, people with head injuries often don’t remember details of the incident. Do you know where you are?”

“You said I’m…I’m…in a h-hospital.”

“That’s right. But do you know what city you’re in?” Although Jennifer’s voice was light, she frowned. “Do you remember flying here?”

Flying here? Could people fly? Gertrude said nothing about flying.
She had mentioned a city, but Elsie couldn’t remember it.

Jennifer must have read her stunned expression. “It’s okay, Dr. Quinn. Don’t worry about it for now. We are in the middle of a huge snowstorm and you were in an accident, but you aren’t seriously injured. Can you tell me your full name and birthdate?”

Elsie looked at her blankly.

“Dr. Quinn? What is your full name?”

Elsie swallowed hard. “I don’t know.”

After his chat with Chuck, Gabe crashed for a few hours in an on-call room and woke in the afternoon. He checked in with the emergency room before taking a quick shower. He had every intention of going to the cafeteria to get something to eat, but found himself heading up to the ICU instead.

When he walked into the unit, Jim, one of the nurses teased, “Hey, Dr. Soldani, are you lost? Peds is down a floor.”

Gabe chuckled. “No, I’m not lost. Elizabeth Quinn is an old friend of mine. I thought I would check on her. Has anything changed?”

“She’s conscious.”

“Can I go see her?”

“Maybe you better talk to Dr. Harper first. There she is.”

Christie Harper, the intensivist on duty, walked out of a patient’s room. “Hey, Gabe, pediatrics must be quiet if you decided to come play with the big kids.”

“It is, but I actually came to see Elizabeth Quinn. She’s a friend. Jim said she’s regained consciousness.”

“She knows you?”

“It’s been a few years, but yeah.”

“Gabe, she’s awake, but she seems to have profound retrograde amnesia. She doesn’t remember anything.”

“You mean about the accident?”

“I mean about anything—her entire life. She has no clue who she is or where she is. You’d never know she was a doctor. She has already freaked once when she realized she had a Foley in, and she almost pulled it out. I’ve called for a neuro consult.”

“Dr. Levi is in with her now,” offered Jim.

At that moment, a scream came from one of the patient rooms followed by a panicked, “Get away from me. Get away. Don’t touch me.”

Christie turned and ran toward the room.

Gabe did too. It was Elizabeth’s voice.

Martin Levi was backing away from the bed, an ophthalmoscope in his hand. Elizabeth was sitting in the middle of the bed with her knees drawn up and her arms over her face. Her nurse was trying to calm her, but Elizabeth struggled against her.

Without thinking, Gabe strode across the room and took Elizabeth’s hands in his. “Elizabeth, you’re safe. Everything’s okay.”

She calmed a little, lowering her arms. Her brows drew together as she looked at Gabe.

“Do you remember Gabe?” asked Christie.

Elizabeth searched his face. “I-I think I do. I don’t remember his name, but I think…I think I love him?”

All eyes turned to Gabe. “That’s right, sweetheart. We loved each other.” He put his arms around her and she rested her head against him, completely calm again. His heart melted. In response to the questioning looks from the others in the room he added, “We went to medical school together. We dated for a while.”

“I’m afraid,” she whispered.

“I know. Let me try to help you.”

“I want this thing on my neck off. Please take it off.”

Gabe looked over his shoulder. “Christie, can the c-collar come off?”

“Yes. The CT was negative. I just hadn’t written the order to remove it yet.”

Gabe released the straps and removed the collar. “Is that better?”

Elizabeth nodded, but glanced warily at Dr. Levi. “I don’t want him to touch me with that thing.”

Gabe glanced at Martin. Confused, Martin showed him the ophthalmoscope. “I need to check her fundi.”

“Elizabeth, he’s not going to hurt you. He’s just going to look into your pupils.”

“Why?”

“He’s checking for signs of increased intracranial pressure.”

“What’s that?”

Holy crap, she really doesn’t remember anything
. He shifted into pediatrician mode to explain. “It’s…well, it’s a sign that you might have hurt your brain.”

“He can see into my brain?”

“Not exactly. But with that light, he can see the backs of your eyes and if you have certain brain injuries, he can see signs of it there.”

“The light isn’t…it isn’t hot? It won’t burn me?”

“No, it won’t. Martin, give me the scope so she can see it.” Martin handed it to him. Gabe turned it on and showed it to her. “See, it’s just a light, and a magnifying glass. Go ahead. Take it.”

She reached for it cautiously, turning it over in her hand to look at it. She frowned, handing it back to Gabe.

“Will you let Dr. Levi look in your eyes now?”

She nodded. “Yes.”

Gabe started to step away from the bed.

Elizabeth grabbed for his arm, panic rising again. “Don’t leave me.”

“I’m not going anywhere, sweetheart. I was just giving Martin room to examine you.”

Martin shook his head. “Stay beside her. I’ll work around you. I won’t be able to assess anything if she doesn’t stay calm.”

Martin checked her eyes and went on to do as complete a neuro exam as possible. Gabe explained everything that was being done. When Martin finished, he said, “Everything seems to be normal. Dr. Quinn, I’m going to ask you some questions. What is this?” He pointed to the bed.

“A bed.”

“Yes, and this?” he pointed to the curtain.

“A curtain?”

“That’s correct. What about this?” he pointed to his lab coat.

“It’s a garment.”

Martin frowned. “But what kind?”

“I don’t know.”

“What are these clothes that all of us are wearing called?” He pointed to his scrubs.

“I don’t know.”

“Look out the window and tell me what’s falling from the sky.”

“Snow.”

“Do you remember my name?”

“Martin Levi.”

“Good. And this lovely blond lady?”

“Dr. Harper.”

“Yes. Do you remember what we told you your name is?”

“Elizabeth Quinn.”

“That’s right. What about your nurse, do you remember her name?”

“Jennifer.”

“And this bearded beast holding your hand?” Martin teased.

“His name is Gabe.”

“And who is he?”

“I don’t remember exactly. He said we went to medical school and we…we…dated? I don’t remember that. I just know I love him.”

Gabe’s heart melted for the second time.

“What does it mean to date someone?” Martin asked.

“I don’t know.”

Martin’s brow drew together. He picked up the patient welcome packet from the bedside table and pulled a page out of it. “Read this aloud for me.”

Elizabeth took the page and frowned at it. “I can’t read it,” she said in a small voice.

“Is it blurry?”

“No. I can’t read it.”

“Then just tell me the letters in the first word on the page.”

“I can’t. I don’t know what they are.”

“Point to any number on that page.”

Color rose in Elizabeth’s cheeks and she shoved the page back to Martin. “I told you I can’t.”

Gabe’s shock that Elizabeth, the girl genius, couldn’t even recognize letters and numbers was mirrored on the face of everyone in the room. “Martin, what do you think is wrong?”

Martin frowned. “Elizabeth, there are rules that we have to follow. One rule is that your doctors and nurses don’t talk about your condition to anyone but you unless we have your permission. Gabe is a doctor in this hospital, but he isn’t your doctor.” Martin smiled at her. “You’re too old. He’s a pediatrician. Do you know what that is?”

“No.”

“He specializes in taking care of children. And he is a friend of yours. He was perhaps a very good friend a few years ago, but it has been a while. I cannot speak to him about what is happening with you or even speak to you in front of him unless you say I can.”

Elizabeth frowned. “There is a lot I don’t know, but I am absolutely certain I know and trust Gabe. You can talk to him.”

“All right. Well your short-term memory seems to be okay. You were able to recall all of our names. But there are huge holes in your long-term memory.”

“Can’t that be explained by the blow to the head?” Gabe asked.

“Yes. Amnesia can occur with concussion or as part of postconcussive syndrome. However, memory loss this severe is usually accompanied by significant brain trauma. Other than her extended loss of consciousness and amnesia, she has no signs of brain injury. Her CT and physical exam is normal. More disconcerting is that her memory loss is atypical. Profound retrograde amnesia most often affects both episodic memory and autobiographical memory, but not semantic memory—at least not to a great extent.”

Elizabeth frowned and looked at Gabe. “What did he just say?”

Gabe explained. “Getting hit on the head can cause memory loss, which we call amnesia.” Elizabeth nodded. “And there are three kinds of memory. Episodic memories are of things you have done or things that have happened to you. Autobiographical memories are details about who you are, like your name and birthdate. It is common to lose these kinds of memories with amnesia.”

Elizabeth nodded, appearing to understand.

“The other kind of memory Martin mentioned is semantic memory. Language is part of semantic memory, as is the ability to recognize familiar objects and know what they’re used for. Most people with amnesia don’t lose much semantic memory. You were able to correctly identify the bed, the curtain and snow, and you associated light with heat. Those are semantic memories. But you panicked when Martin wanted to look in your eyes. Not recognizing the device he was using is an example of semantic memory loss. Not knowing that the clothes we are wearing are called ‘scrubs’ or that this is a lab coat,” he motioned to the one he wore, “is another example of semantic memory loss. These are the standard clothes worn by doctors and nurses who work in hospitals. You would have known that from childhood because your father is a doctor.”

Martin nodded. “Not being able to read or even recognize letters and numbers is another example of unusual semantic memory loss. These deficits are extremely rare and hard to explain without any evident brain damage.”

~ * ~.

Elsie looked at the four people in her room. It was all overwhelming. She knew exactly why she couldn’t remember certain objects or even letters and numbers. She had never seen those objects before, and she had never learned to read, but she couldn’t tell them that.

What surprised her was that she remembered Gabe. Gertrude had said she might experience some of Elizabeth’s strong memories from time to time. But strong didn’t begin to describe it. The moment Gabe had touched her and she saw his face, images of him—younger and in a different place—flashed through her mind. Somehow, it was more than simply remembering his appearance. She felt a sense of connection that was instant and profound. She remembered his touch, his laugh, his embrace…his kiss. It was as if these things were all written on her heart and were as familiar to her as her feelings for Geordie. But even those paled now in comparison. She had only just begun to experience first love with Geordie—at least she thought it was love. She had wanted more and believed his feelings were as strong for her. Still, part of her feared loving him too much and perhaps losing her heart to someone who was destined to move on.

But if her love for Geordie had been like the warm glow of a gently crackling fire, what she felt for Gabe was as intense as the heat of a blacksmith’s forge. She knew instinctively that he was infinitely important to her, and her heart was bound to his.

She looked into Gabe’s eyes. She was afraid, but she found strength there. “I don’t understand anything that’s happening.”

Gabe caressed her cheek. “I know you don’t. If it makes you feel any better, we aren’t sure what’s happening either, but we are going to try to find out. Martin, could something have been missed on the CT?”

“Yes. Sometimes CT scans taken the day of injury are negative and an MRI performed later reveals the problem. For that reason, we will do an MRI, maybe tomorrow unless something changes. But even if there is a small amount of damage that the CT missed, I’m having trouble believing it’s causing this massive deficit.”

“So what are you thinking?” asked Gabe.

“A fugue precipitated by the physical trauma.”

Again, Dr. Levi was supposedly speaking English, but every time he opened his mouth, Elsie didn’t understand most of what he said. “What does that mean, Gabe?”

Gabe smiled at her. “It means you have amnesia that isn’t caused by a brain injury, but it happened because of the accident.”

“That’s actually good news,” said Dr. Levi. “Fugues don’t usually last long and most of the time are completely reversible.”

She frowned at him.

Dr. Levi chuckled. “I’m sorry. That means you’ll probably get all of your memories back soon.”

That was convenient. When she and Elizabeth switched souls again, her memory return would be expected.

Dr. Levi turned to Dr. Harper. “She is completely alert and stable. I don’t think she needs to remain in the ICU. I will admit her to a neuro step-down unit and keep her under observation. I’ll also request an ortho consult to take care of her arm.”

Christie nodded. “Jennifer, go ahead and remove the Foley, and let’s get her something for pain.”