Twenty-fourth of September. Morning at Ågårds Plass.
“Yes,” Dr. Morris said, “that’s right. Carmen Cesilie Zita comes to me when she needs to. I’ve been her physician for more than four years now. Nicolai is also registered here, by the way, but he’s never really been in. He’s never ill. That’s to say, he’s thin and anemic, but there’s nothing wrong with him. He’s got a robust constitution. So yes, I know about Carmen’s epilepsy; that’s our main concern. It’s almost fully under control now, but she does still have seizures every now and then. There’s no denying it’s a problem, but not on a day-to-day basis. And yes, I heard about her little boy. What a tragedy. I comfort myself with the thought that they’re young and can start again, though I wouldn’t dream of saying that to Miss Zita. It’s a cold comfort. Things are no less painful when you’re young. The opposite perhaps. But they can have more children, and I believe they will, given time, once they have mourned enough. I would give them a couple of years. In my experience, that’s how long it takes.”
“What is epilepsy?” Sejer asked. “Can you explain it to me? In a way that I can understand?”
Morris folded his hands on his desk. “Well,” he started, “contrary to what most people think, epilepsy is not an illness, even though many experience it as such. Let me put it this way: epilepsy is in fact the symptom of various conditions, all of which involve neurological disorders, which result in seizures, convulsions, and blackouts.”
“A neurological disorder,” Sejer repeated to himself. He was thinking about his own dizziness. Perhaps that was some form of neurological disorder. Then he thought, stop. Get a grip. You’re here about something else.
“Yes, that’s what we call it,” Morris said. “And the causes of epilepsy can vary; it might be the result of a number of things. In around fifty percent of cases, the cause remains a mystery. But Carmen sustained brain injuries during birth and so has had epilepsy all her life, her young life, I should say. They were twins. One, Louisa, died at birth. She only lived an hour.”
“What about Tommy’s birth? Was the C-section planned, or was it an emergency?”
“It was planned,” Morris confirmed. “Her pelvis is extremely narrow. It’s almost a miracle that she could carry the baby to term. And despite having Down syndrome, he was a healthy baby.”
“Can you tell me a bit about her seizures?”
Morris took off his glasses and fiddled with the arms. “Yes, of course. Carmen has what we call GTC seizures, that’s to say generalized tonic — clonic seizures. These comprise two phases. In the tonic phase, the patient loses consciousness, which is dramatic enough in itself. The body then becomes rigid and the air is forced out of the lungs, which can sound like a scream and is very alarming for those present. Then the patient stops breathing and the face and lips turn blue. After a few seconds, the seizure then goes into the clonic phase, which causes the convulsions normally associated with epilepsy. The face turns red and the patient starts to breathe again.”
“And how long does a seizure last?” Sejer asked.
“Oh, it varies considerably. As a rule, it’s a matter of seconds and minutes. But sometimes the patient experiences a persistent series of seizures, one after the other, a condition that is called status epilepticus. Maybe you’ve heard of it? It is a very serious condition, and it is important to get the patient to the hospital as quickly as possible.”
“Has Carmen ever suffered from status epilepticus?”
“Yes, she has. But only once since I’ve been her doctor, and it was pretty serious. She was kept in the hospital under observation for a couple of days. It’s some time ago now, and I hope that she doesn’t have to go through that again, because it is very stressful.”
“And she is medicated now?”
“Yes, she’s got medicine. And we’re managing to keep seizures to a minimum. I would say she has a seizure about once a month, which is not so bad. She can live with that. But after a seizure, she can be rather out of it, confused and weak and tired.”
“And how do you feel she copes with it? Is she bothered by it?”
Morris shook his head. “No, I wouldn’t say that; she takes it in her stride. But then I’ve never really asked her directly. Even though she’s a slip of a thing, she’s tough as old boots. It’s just awful what happened to the little boy. I heard about it on the news and was horrified. It’s dangerous to live so close to water when you’ve got small children. How are they? I haven’t seen them for a couple of months. It’s a terrible tragedy to lose your child.”
“It’s actually Nicolai who’s taking it the worst,” Sejer told him. “As you said, Carmen is tough. She’s the one who is coping best; she’s forward-looking. She’s talking about having another baby, so she’s back in the driver’s seat.”
“And that’s of little comfort for Nicolai,” Morris said.
“Exactly, no comfort at all. He’s taken this very badly. To be honest, I’m worried about him. And he’s so alone, without any family.”
“Excuse me for asking, but I’m curious,” Morris started, leaning forward over his desk. “Why are you asking for information about Carmen’s epilepsy? I mean, does it have anything to do with the child’s death?”
“Yes, perhaps,” Sejer said and stood up. He pushed the chair back into place and got ready to leave. “But I’m afraid I can’t divulge that information; I’m sure you appreciate that. Let me just go back to something you said — that after a seizure, she is generally pretty out of sorts, tired and dizzy and weak.”
“Yes,” Morris replied. “In a language you no doubt understand, given your profession, after a major seizure she is in fact of unsound mind.”