Past Lives

Five

Kansas City

USA

Macandrew looked anxiously at his watch. Karen Bliss was late and he was becoming impatient. He lifted the phone and was just about to hit the third number of her extension when a knock came to the door and he put it back down on the rest.

‘Come in.’

‘Sorry, I got held up,’ said Karen. ‘It’s always the same when you’re in a hurry.’

Macandrew nodded. ‘All set?’

‘Lead on,’ said Karen, holding up the portable recorder she was carrying so that Macandrew could see that she hadn’t forgotten.

They started out along the corridor.

‘You’re nervous,’ said Karen.

‘What makes you say that?’

‘You checked that you had your keys twice when once would have been enough. That tells me your mind was on something else the first time.’

‘God save me from psychiatrists,’ said Macandrew. ‘Do you analyse Jeff’s behaviour like this?’ he asked, referring to Karen’s husband, also a doctor.

‘Can’t help it,’ smiled Karen, ‘If he’s feeling guilty about anything, I’ll know it before he does.’

They reached the surgical recovery suites and Macandrew checked with the head nurse about Jane Francini.

‘Nurse Leiden is with her at the moment. She’s showing signs of coming round.’

Macandrew and Karen entered the room and found a young black nurse trying to reason with Jane Francini and coming off second-best.

‘Mrs Francini, you’re in hospital. You’ve been very ill but now you’re getting better. Just take it easy, will you. Relax.’

‘Stop calling me stupid names,’ stormed Jane. ‘I want my mother. Where is she? Why isn’t she here?’

Macandrew stayed in the background while Karen switched on her recorder, adjusted the levels and approached the bedside. She nodded to the nurse to step aside and took her place.

‘There’s obviously been some kind of mistake here,’ she said soothingly.

‘Yes... a mistake. Have you seen my mother? Why isn’t she here? Did she send you?’

‘I’m afraid not,’ said Karen. ‘But maybe I could find her for you. What’s your name?’

‘Emma.’

‘And your last name, Emma?’

‘Forsyth.’

‘And your address?’

‘Address?’

‘Where do you live, Emma?’

‘Fulton Grange.’

‘Sorry, Emma, I’m new around here. Is that the name of a town or a house?’

‘A house, of course.’

‘Sounds like a big house Emma. Is it?’

‘Yes. Why are you asking me this?’

‘So we can be friends. I’d like us to be friends. Wouldn’t you?’

‘Yes... at least, I think so...’

‘Tell me about the house. Tell me about your room.’

‘Oh, it’s just perfect,’ said Emma, starting to relax. ‘It’s round, you see, and I can see just about all the garden from the windows.’

‘Round?’

‘It’s in the tower. Father didn’t want me to have it because of the stairs but I begged him so in the end he let me if I promised to be careful; the stairs are very steep. If we are friends, maybe you could go there and ask my mother to bring my doll? It’s in the secret place.’

‘What secret place Emma?’

Jane paused for a moment.

‘You can trust me.’

‘If you promise never to tell?’

‘I promise.’

‘There’s a big stone in the wall beneath the big window in the middle; it has a mark on it like a rose. If you push one of the petals in a special way, the stone turns and there’s a secret place inside. Father showed me. He said it was to hide valuable things from robbers so I always put Lucy there when I go out so I know she’ll be safe.’

Karen smiled and took hold of Jane’s hand.

‘Please will you go there and tell my mother to come?’ asked Jane.

‘Of course,’ said Karen. ‘But first you’ll have to tell me exactly how to get there.’

‘I told you. I live in Fulton Grange.’

‘Yes but that’s the name of your house. I need to know what town Fulton Grange is in so I can go there.’

‘It’s not in a town. It’s in the country, silly.’

‘But surely it must be near a town, Emma?’

‘It’s near Moscow I suppose but I don’t see what that has to do with it. Everyone knows Fulton Grange.’

Karen turned and looked at Macandrew who shrugged. Up until that moment he had been worried by what he was hearing. It almost came as a relief to have something remind him that he was listening to the ramblings of a sick woman.

‘So you live near Moscow, Emma,’ said Karen, ‘but you don’t speak Russian.’

‘Why should I?’

Karen smiled at the absence of logic in Jane Francini’s reply. ‘Tell me about Moscow, Emma. Do you go there often?’

‘Jane Francini opened her mouth to reply but suddenly froze as if she’d been struck dumb then she let out a loud, harsh wail of anguish.’

‘What is it, Emma?’ asked Karen. ‘What’s the matter?’

Jane Francini had totally changed in demeanour. Gone was the timid little girl who wanted her mother and her doll. In her place was an angry woman who let out a stream of unintelligible words at Karen who stepped back in surprise.

Jane Francini was now completely out of sedation and obviously in great distress. She threw her head from side to side and slapped her hands angrily down on the bed. There would be no further discussion with her.

‘Aren’t you going to give her something?’ asked Karen who had stepped back to join Macandrew near the door.

‘Her husband has forbidden us to sedate her. If I give her a shot, he’ll sue the Med Centre.’

Karen asked, ‘Has he seen her like this?’

‘No, it’s only when the sedation has completely worn off that she gets like this. He’s only seen the little girl character.’

‘So that happens under partial sedation...’ said Karen thoughtfully. ‘Interesting, I’ve heard about this and I’ve read about it in the journals, but I’ve never actually seen it for myself,’ said Karen. ‘Your patient seems to have developed Multiple Personality Disorder or Dissociative Identity Disorder as they’ve started calling it these days. We’ll talk further when I’ve listened to the tape and had a think about what’s going on.’

She returned to Jane’s bedside and switched off her recorder. She had to move smartly out of the way to avoid a flailing arm. ‘I’m sure her husband will change his mind about sedation when he sees her like this,’ she said.

‘What in Christ’s name have you done to her?’ stormed Tony Francini when he entered the room and saw the disturbed state of his wife. Two nurses were trying to restrain her.

‘She has been allowed to recover full consciousness on your instructions,’ said Macandrew coldly. ‘I strongly recommend that she be put back under sedation immediately in view of her cardiac history.’

Francini’s eyes were wide and unblinking as he watched his wife rant and rave. He appeared to have been shocked into silence by the sight.

‘Mr Francini, do you understand what I’m saying?’

Francini turned slowly towards Macandrew and nodded. ‘I understand all right,’ he said. ‘You’d rather no one saw the full horror of what you’ve done to Janey, you butchering bastard!’

‘Mr Francini, your wife’s condition is the result of a brain tumour, nothing else. Now, can I sedate her?’

‘Go ahead. Do what you have to to get her through the night,’ said Francini with a shake of his head. His shoulders slumped forward in obvious despair. ‘After that, you leave her alone. Understand? My man’s flying into Kansas City in the morning.’

Macandrew nodded and told one of the nurses what he wanted given to Jane Francini. He wrote it into her treatment records.

‘Oh Janey,’ murmured Francini as he stood at the foot of the bed. ‘What have they done to you, honey?’

Much as he disliked the man, Macandrew felt his heart go out to him. ‘I’m very sorry,’ he said.

Francini’s eyes hardened. ‘Sorry?’ he mocked. ‘Oh no... but you’re gonna be, pal. Promise.’ With that he left the room.

Jane’s ranting subsided almost immediately the injection was given and became a murmur as she relaxed on the pillow. Her eyelids flickered briefly before she fell into a deep sleep.

Macandrew returned to his office and called Saul Klinsman. ‘Did Francini say who he was bringing in?’ he asked.

‘Kurt Weber, from the Mayo in Rochester.’

‘Jesus,’ said Macandrew.

‘Almost as good, I hear,’ said Klinsman.

‘He’s going to have to sell extra harvesters for that one,’ said Macandrew. ‘And all for no good reason.’

‘You think so?’

‘I know so. She’s going to have to be certified: that’s what happened to all previous Hartman patients according to Carl Lessing.’

‘Lessing was absolutely sure about the nature of the tumour wasn’t he?’ asked Klinsman. ‘I have to be sure of our position. Francini is determined to apportion blame for this one and with his financial muscle he’s going to be a formidable proposition.’

‘Carl was certain and I don’t care if Francini’s got access to the Federal gold reserves. His wife had a malignant tumour and that’s what caused her condition.’ said Macandrew angrily. ‘Bringing in the best neurosurgeon in the country isn’t going to change anything apart from make the numbers in his bank account fall like leaves in October.’

‘That’s what I wanted to hear,’ said Klinsman. ‘We’ll be having a meeting with Francini and Weber after he’s had a chance to examine Jane tomorrow. Probably some time in the afternoon. Keep it free will you.’

Macandrew put the phone down. He’d had more than enough for one day. He told Reception he was going home.

Macandrew’s landlord was still away and the house was completely silent as he looked out of his room window and noticed for the first time what a beautiful day it had been. The sun was going down and the western sky had become a deep red. The sky directly above however, was still unbroken blue and marked only by a thin vapour trail from a jetliner heading east. It was too high to be heard.

He wished he could rid himself of the uneasy feeling that the Francini case had left him with but it persisted. The fact that someone thought he was incompetent bothered him; even it happened to be a guy like Francini. But he could see no easy way round the problem. He poured himself a large drink, put Miles Davis on the stereo and turned it up a little louder than usual.

Saul Klinsman called at four the following afternoon to say that Weber had finished his examination of Jane Francini and her medical records and case notes. Would Macandrew care to join them in his office? Macandrew was surprised to find not three men in the room but four. Klinsman introduced him to the two he didn’t know.

Weber was pretty much as he expected, expensively dressed in a light grey suit, pale lavender shirt and deep purple tie which set off his tan and swept-back silver hair to advantage. His handshake was firm and his smile a tribute to the dentists’ art. His voice had the practised modulation of a TV news anchorman.

The second man, Joel Kirschbaum, was introduced as Francini’s attorney. He was slim and dark and avoided eye contact. It was difficult to put an age on him because of premature baldness and a naturally sallow complexion but if Francini had retained him it was odds on that he was both experienced and good. His handshake however, was limp and wet.

‘Well, Doctor, what did you conclude?’ Klinsman asked Weber as they all sat down. He was doing his best to appear relaxed.

‘Mrs Francini is a very disturbed lady,’ replied Weber. He turned to her husband. ‘Frankly, Mr Francini, I would be offering you false hope if I were to suggest to you that I could do anything about her condition. I’ve examined the scans and the case notes and the path lab’s report and I have to agree with the conclusions of the Kansas University Medical Centre that Mrs Francini is suffering brain damage brought on by an aggressive, malignant tumour, which they successfully and skilfully removed. I’m sorry.’

Macandrew felt the tension in his shoulders relax.

‘But has it been confirmed beyond all doubt that Mrs Francini’s current condition is due to the tumour?’ asked Kirschbaum. He kept his eyes on the desk in front of him as if totally absorbed by the pencil he was turning end over end. The fact that he seemed to avoid looking at anyone directly made it difficult to know who the question was aimed at.

Weber looked uncomfortable when he concluded that it was aimed at him. He said, ‘I suppose not, in the strict sense that the conclusive evidence in this case is pathological and I haven’t seen it personally...’

‘So, just for the sake of argument, it is conceivable that Mrs Francini’s condition may have been caused by the removal of the tumour rather than the tumour itself? I mean, it’s not beyond the bounds of possibility?’

‘Now just a minute...’ interrupted Klinsman.

‘Well, Doctor?’

‘I have seen nothing at all to suggest that,’ replied Weber.

‘But, as you say, you haven’t actually examined the tumour yourself?’

‘Well, no,’ agreed Weber.

‘Our chief of neuropathology made the diagnosis,’ Klinsman interrupted again. ‘He is a very experienced man. Just what are you suggesting, Mr Kirschbaum?’

‘Collusion,’ interrupted Francini, cottoning on to Kirschbaum’s line of questioning. ‘It’s a stitch-up. They’re covering each other’s ass.’

There was silence in the room for a few electric moments while everyone wondered of they had heard correctly. Francini repeated it. ‘Collusion,’ he said. ‘The bastards have fitted it up between them.’

Macandrew gripped the sides of his chair until his knuckles showed white. Klinsman shot him a warning glance. Kirschbaum tried to warn his client not to say any more. Klinsman intervened with, ‘Counsellor, my colleague and I understand the anguish Mr Francini feels over his wife’s condition but he is going too far. If he persists in making such scurrilous accusations we will have to consider legal action ourselves.’

‘You are right, Doctor,’ said Kirschbaum, ‘My client is under a great deal of stress and I am sure he did not mean to suggest what he appeared to.’

Francini snorted.

‘It appears to me,’ said Weber, ‘that this whole thing could be cleared up quickly and scientifically by an independent analysis of the tumour that was removed from Mrs Francini.’

‘How would they know it came from Janey?’ snarled Francini.

‘The lab could establish that too,’ said Weber. ‘They could run DNA tests on both the patient and the tumour.’

There was an uneasy silence for a few moments before Klinsman took the initiative. ‘Perhaps this would be the way out of our dilemma, gentlemen?’ he said. ‘Clear away any lingering doubts?’

‘Fine by me,’ said Macandrew.

Kirschbaum and finally Francini himself nodded in agreement.

‘What will happen to Janey?’ asked Francini, his eyes looking down at the floor.

‘I suggest that we make moves to have your wife moved to Farley Ridge Sanatorium, Mr Francini,’ said Klinsman quietly.

‘The funny farm,’ said Francini.

‘Medical advances are being made every day, Mr Francini,’ said Weber kindly. ‘You shouldn’t give up hope.’

Francini got up and left the room. Kirschbaum said, ‘Can we agree on arrangements for the tumour analysis?’

‘Of course,’ said Klinsman. ‘I’m sure Doctor Lessing will be happy to comply with whatever you have in mind.’

Kirschbaum turned to Weber and asked, ‘Perhaps the lab at the Mayo Clinic would be prepared to carry out the analysis, Doctor?’

Weber said, ‘As long as these gentlemen have no objection.’

‘Of course not,’ said Klinsman.

Macandrew nodded his agreement.

‘Would you like to speak to Dr Lessing before you go?’ Klinsman asked Weber.

Weber shook his head. ‘I think not. Pathology isn’t exactly my field. I’ll have our pathologist call yours and they can work out the details between them.’

‘Then that would appear to be it,’ said Klinsman.

Weber looked at his watch. ‘If I get a move on, there’s a chance I can get back to Rochester tonight.’

‘I’ll go find my client,’ said Kirschbaum.

Macandrew was left alone with Klinsman. He accepted the whisky that was handed to him and said dryly, ‘That was a bundle of laughs.’

‘It’ll all be over when the Mayo lab confirms the diagnosis,’ said Klinsman. ‘Put it behind you, Mac.’

‘Something tells me Francini won’t lie down. He’s determined to blame me whatever he hears. He hates me; I can see it in his eyes.’

‘Some people are like that,’ said Klinsman. ‘Come to think of it, a lot of people are like that. They need someone to blame. There’s no such thing as fate or an accident. Someone always has to be at fault and they have to be hunted down and punished. It becomes an obsession with them. You see people screaming their joy outside the courthouse after a guilty verdict’s announced. They’ve lost their kid or their wife and they’re jumping up and down and cracking open champagne because some bastard is going down for it. Strange.’

‘Maybe I’ll talk some more to Karen Bliss.’

Klinsman looked asked, ‘What did she think of Jane?’

‘She was thinking along the lines of Multiple Personality Disorder — or whatever the fancy new name is for it these days — but I haven’t had a real chance to talk to her about it yet.’ He looked at his watch. ‘Too late now, maybe tomorrow.’

There was a message on his answering machine when Macandrew got back to his own office. Karen had called at four thirty. If he got back before six, he should ring her; if not, he should call in the morning. It was a quarter before seven. Macandrew looked at his diary for the following day; there was no operation scheduled till the day after but he did have to see the patient and familiarise himself with the case notes. There was a clinical meeting pencilled in for two in the afternoon and a seminar he wanted to go to at four thirty. He wondered if Karen would be free for lunch. He called her extension and left a message on her machine, just in case he should miss her in the morning. He suggested they meet at noon.

Macandrew got Karen’s return message when he returned to his office next morning after examining his surgical case. Karen was free for lunch so he called an Italian restaurant down on the Plaza and made a reservation for twelve fifteen.

‘Maybe our answering machines should be having lunch,’ said Karen as they drove down to the Plaza.

‘I think mine is going steady with the administration people,’ said Macandrew. ‘I get reminders every day about forms I should have completed and returned but didn’t.’

‘Thank God I’m not the only one.’

The restaurant was just over half full. They were shown to a table in a booth well away from the door and left to consider the menu beneath Italian travel posters on the walls and fishing nets suspended from the ceiling. The nets only served to remind Macandrew how depressingly far the mid-west was from the sea. The sea was what he missed most of all. Not being able to drive down to the coast was a big minus.

‘Did you get permission to sedate Jane Francini?’ asked Karen.

‘Her husband gave it almost as soon as he saw her.’ Macandrew told her about his subsequent meeting with Weber and Francini’s attorney.

Karen shook her head in sympathy and said, ‘Heavy stuff. Sometimes the idea of being a country doctor seems very attractive.’

‘It certainly was last night,’ agreed Macandrew. He took a sip of iced water and asked, ‘What did you think of the Francini tapes?’

‘Complicated. Little Emma threw me; she seemed so real. I started out thinking multiple personality disorder but now I’m not so sure...’

‘What’s the problem?’

‘She never seems to be herself,’ said Karen. ‘That particular personality seems to have gone completely missing.’

‘I suppose that’s the saddest thing,’ said Macandrew.

‘There are lots of recorded instances of patients who’ve sustained head injuries in car accidents undergoing a personality change. They make what appears to be a good recovery as far as the nursing and medical staff are concerned, but once they’re home, their family and people who know them start complaining about big changes in the way they behave. The words, “different people” keep cropping up.’

‘That’s more or less what Tony Francini said,’ said Macandrew. ‘He said Janey was a different person. She looked like Janey but she wasn’t...’

Karen nodded. ‘Not too much is known about this but it’s been recorded in patients who’ve had strokes. It’s also been the basis of several lawsuits. Big insurance claims for changes of personality. Previous nice guy becomes selfish monster, that sort of thing.’

‘But this is more than a change of personality trait,’ said Macandrew. ‘Jane Francini becomes an entirely different person — maybe several.’

‘But it is interesting that she’s always, Emma when she starts to come out of sedation,’ said Karen.

Macandrew nodded. ‘It’s only when she regains full consciousness that she becomes totally confused.’

‘I tried working on the confused bits from the tapes I made but I’m really not sure what’s going on. She’s obviously suffering but the strange thing was that she didn’t look deranged at any point.’

‘That’s exactly what I thought when I saw her like that for the first time,’ said Macandrew. ‘She sounded deranged but didn’t look it. It was kind of spooky, almost as if she thought I was the one with the problem.’

‘I suppose that might fit with multiple personality disorder. Believe it or not, Carl Jung’s own cousin suffered from it. She was in reality a shy fifteen-year-old girl of only mediocre intelligence, hesitant and unsophisticated. Quite suddenly and without warning, she would change into a smooth, assured, educated lady who spoke good, literary German instead of the rough Swiss dialect she normally spoke. This is often a feature in reports of this sort of case. The foreign personality is that of a much stronger character altogether than the patient.’

‘Jane Francini is normally a quiet, reserved lady,’ said Macandrew.

‘The character she becomes when she’s not sedated is certainly not,’ said Karen. ‘But there again, when she is under partial sedation, she’s a little girl from Moscow who doesn’t speak Russian...’

Macandrew shook his head. ‘If only one of her personalities could be Jane.’

‘Mac, I know you’d like me to tell you that her condition might be treatable and, with time, she’ll get better but I can’t. I’d dearly like to but I can’t. I think she’ll have to be certified and sent out to Farley Ridge.’