The Fear Index

3

According to the records subsequently released by the Geneva medical service, the ambulance radioed to report that it was leaving the Hoffmanns’ residence at 5.22. At that hour it was only a five-minute drive through the empty streets of central Geneva to the hospital.

In the back of the ambulance Hoffmann maintained his refusal to obey regulations and lie down on the bed, but instead sat upright with his legs over the side, brooding and defiant. He was a brilliant man, a rich man, accustomed to being listened to with respect. But now suddenly he found he had been deported to some poorer and less-favoured land: the kingdom of the sick, where every citizen was second class. It irritated him to recall how Gabrielle and Leclerc had looked at him when he had showed them The Expression of the Emotions in Man and Animals – as if the obvious connection between the book and the attack was merely the fevered product of an injured brain. He had brought the volume with him; it was resting in his lap; he tapped his finger against it restlessly.

The ambulance swerved around the corner and the female attendant put out her hand to steady him. Hoffmann scowled at her. He had no confidence in the Geneva police or in government departments generally. He had no confidence in anyone much, except himself. He searched his dressing gown pockets for his mobile.

Gabrielle, watching him from the opposite seat, next to the ambulance woman, said, ‘What are you doing?’

‘I’m calling Hugo.’

She rolled her eyes. ‘For God’s sake, Alex…’

‘What? He needs to know what’s happened.’ As Hoffmann listened to the number ringing, he reached over and took her hand to mollify her. ‘I’m feeling much better, really.’

Eventually Quarry came on the line. ‘Alex?’ For once his normally languid voice was strained with anxiety: when is a phone call before dawn ever good news? ‘What the hell is it?’

‘Sorry to call this early, Hugo. We’ve had an intruder.’

‘Oh, God, I’m so sorry. Are you all right?’

‘Gabrielle’s okay. I got a whack on the head. We’re in an ambulance going to the hospital.’

‘Which hospital?’

‘The university, I think.’ Hoffmann looked at Gabrielle for confirmation. She nodded. ‘Yeah, the university.’

‘I’m on my way.’

A couple of minutes later the ambulance swept up the approach road to the big teaching hospital. Through the smoked-glass window Hoffmann briefly glimpsed its scale – a huge place: ten floors, lit up like some great foreign airport terminal in the darkness – then the lights vanished as if a curtain had been pulled across them. The ambulance descended along a gently circling subterranean passage and pulled to a halt. The engine was cut. In the silence, Gabrielle gave him a reassuring smile and Hoffmann thought: Abandon hope all ye who enter here. The rear doors swung open on to what looked like a spotlessly clean underground car park. A man shouted in the distance, his voice echoing off the concrete walls.

Hoffmann was instructed to lie down, and this time he decided not to argue: he had entered into the system; he must submit to its processes. He stretched out, the bed was lowered, and with a horrible feeling of helplessness he allowed himself to be wheeled along mysterious factory-like corridors, staring up at the strip lighting until, at a reception desk, he was briefly parked. An accompanying gendarme handed over his paperwork. Hoffmann watched as his details were registered, then turned his head on the pillow and glanced across the crowded room to where a television news channel played to a heedless audience of drunks and addicts. On the screen, Japanese traders with cell phones clamped to their ears were shown in various attitudes of horror and despair. But before he could find out any more, he was on the move again, down a short corridor and into an empty cubicle.

Gabrielle sat on a moulded plastic chair, took out a powder compact and started applying lipstick in quick, nervous strokes. Hoffmann watched her as if she were a stranger: so dark and neat and self-contained, like a cat washing her face. She had been doing exactly this when he first saw her, at a party in Saint-Genis-Pouilly. A harassed young Turkish doctor came in with a clipboard; a plastic name tag attached to his white coat announced him as Dr Muhammet Celik. He consulted Hoffmann’s notes. He shone a light into his eyes, struck his knee with a small hammer and asked him to name the president of the United States and then to count backwards from one hundred to eighty.

Hoffmann answered without difficulty. Satisfied, the doctor put on a pair of surgical gloves. He took off Hoffmann’s temporary dressing, parted his hair and examined the wound, gently prodding it with his fingers: Hoffmann felt as if he were being inspected for lice. The accompanying conversation was conducted entirely above his head.

‘He lost a lot of blood,’ said Gabrielle.

‘Wounds to the head always bleed heavily. He will need a few stitches, I think.’

‘Is it a deep wound?’

‘Oh, not so deep, but there is quite a wide area of swelling. You see? It was something blunt that hit him?’

‘A fire extinguisher.’

‘Okay. Let me make a note of that. We need to get a head scan.’

Celik bent down so that his face was level with Hoffmann’s. He smiled. He opened his eyes very wide and spoke extremely slowly. ‘Very well then, Monsieur Hoffmann. Later I will stitch the wound. Right now we need to take you downstairs and make some pictures of the inside of your head. This will be done by a machine we call a CAT scanner. Are you familiar with a CAT scanner, Monsieur Hoffmann?’

‘Computed Axial Tomography uses a rotating detector and X-ray source to compile cross-sectional radiographic images – it’s seventies technology, no big deal. And it’s not Monsieur Hoffmann, by the way – it’s Dr Hoffmann.’

As he was wheeled into the elevator, Gabrielle said, ‘There was no need to be so rude. He was only trying to help you.’

‘He spoke to me as if I were a child.’

‘Then stop behaving like one. Here, you can hold this.’ She dropped his bag of clothes on to his lap and walked ahead to summon the elevator.

Gabrielle obviously knew her way to the radiology department, a fact that Hoffmann found obscurely irritating. Over the past couple of years the staff had helped her with her art work, giving her access to the scanners when they were not in use, staying late after their shifts had finished to produce the images she needed. Several had become her friends. He ought to be grateful to them, but he wasn’t. The doors opened on to the darkened lower floor. They had a lot of scanners, he remembered. It was the hospital to which they helicoptered the most serious skiing injuries, from Chamonix, Megeve, even Courchevel. Hoffmann had a sense of a huge expanse of offices and equipment extending into the shadows – an entire department stilled and deserted, apart from this one small emergency outpost. A young man with long black curly hair came striding across to them. ‘Gabrielle!’ he exclaimed. He took her hand and kissed it, then turned to look down at Hoffmann. ‘So you have brought me a genuine patient for a change?’

Gabrielle said, ‘This is my husband, Alexander Hoffmann. Alex – this is Fabian Tallon, the duty technician. You remember Fabian? I’ve told you all about him.’

‘I don’t think so,’ said Hoffmann. He looked up at the young man. Tallon had large dark liquid eyes, a wide mouth, very white teeth and a couple of days’ growth of dark beard. His shirt was unbuttoned more than it needed to be, drawing attention to his broad chest, his rugby player’s chest. Suddenly Hoffmann wondered if Gabrielle might be having an affair with him. He tried to push the idea out of his head, but it refused to go. It was years since he had felt a pang of jealousy; he had forgotten how almost exquisite the sharpness could be. Looking from one to the other he said, ‘Thank you for all you’ve done for Gabrielle.’

‘It’s been a pleasure, Alex. Now let’s see what we can do for you.’ He pushed the bed as easily as if it were a supermarket trolley, through the control area and into the room containing the CAT scanner. ‘Stand up, please.’

Once again Hoffmann surrendered mechanically to the procedure. His overcoat and spectacles were taken from him. He was told to sit on the edge of the couch that formed part of the machine. The dressing was removed from his head. He was instructed to lie on his back on the couch, his head pointing towards the scanner. Tallon adjusted the neck rest. ‘This will take less than a minute,’ he said, and disappeared. The door sighed shut behind him. Hoffmann raised his head slightly. He was alone. Beyond his bare feet, through the thick glass window at the far end of the room, he could see Gabrielle watching him. Tallon joined her. They said something to one another that he could not hear. There was a clatter, and then Tallon’s voice came loudly over a loudspeaker.

‘Lie back, Alex. Try to keep as still as possible.’

Hoffmann did as ordered. There was a hum and the couch began to slide backwards through the wide drum of the scanner. It happened twice: once briefly, to get a fix; the second time more slowly, to collect the images. He stared at the white plastic casing as he passed beneath it. It was like being subjected to some radioactive car wash. The couch stopped and reversed itself and Hoffmann imagined his brain being sprayed by a brilliant, cleansing light, from which nothing could hide – all impurities exposed and obliterated in a hiss of burning matter.

The loudspeaker clicked on and briefly he heard the sound of Gabrielle’s voice dying away in the background. It seemed to him – could this be right? – that she had been whispering. Tallon said, ‘Thank you, Alex. It’s all over. Stay where you are. I’ll come and get you.’ He resumed his conversation with Gabrielle. ‘But you see-’ The sound cut out.

Hoffmann lay there for what seemed a long while: plenty of time, at any rate, to consider how easy it would have been for Gabrielle to have had an affair over the past few months. There were the long hours she had spent at the hospital collecting the images she needed for her work; and then there were the even longer days and nights he had been away at his office, developing VIXAL. What was there to anchor a couple in a marriage after more than seven years if there were no children to exert some gravitational pull? Suddenly he experienced yet another long-forgotten sensation: the delicious, childish pain of self-pity. To his horror, he realised he was starting to cry.

‘Are you okay, Alex?’ Tallon’s face loomed above the couch, handsome, concerned, insufferable.

‘No problem.’

‘Are you sure you’re okay?’

‘I’m fine.’ Hoffmann wiped his eyes quickly on the sleeve of his dressing gown and put his spectacles back on. The rational part of his mind recognised that these sudden lurches in mood were likely to be symptoms of head trauma, but that did not make them any less real. He refused to get back on to the wheeled bed. He swung his legs off the couch, took a few deep breaths, and by the time he walked into the other room had regained control of himself.

‘Alex,’ said Gabrielle, ‘this is the radiologist, Dr Dufort.’

She indicated a tiny woman with close-cropped grey hair who was seated at a computer screen. Dufort turned and gave him a perfunctory nod over her narrow shoulder, then resumed her examination of the scan results.

‘Is that me?’ asked Hoffmann, staring at the screen.

‘It is, monsieur.’ She did not turn round.

Hoffmann contemplated his brain with detachment, indeed disappointment. The black-and-white image on the screen could have been anything – a section of coral reef being filmed by a remote underwater camera, a view of the lunar surface, the face of a monkey. Its messiness, its lack of form or beauty, depressed him. Surely we can do better than this, he thought. This cannot be the end product. This must be merely a stage in evolution, and our human task is to prepare the way for whatever comes next, just as gas created organic matter. Artificial intelligence, or autonomous machine reasoning as he preferred to call it – AMR – had been a preoccupation of his for more than fifteen years. Silly people, encouraged by journalists, thought the aim was to replicate the human mind, and to produce a digitalised version of ourselves. But really, why would one bother to imitate anything so vulnerable and unreliable, or with such built-in obsolescence: a central processing unit that could be utterly destroyed because some ancillary mechanical part – the heart, say, or the liver – suffered a temporary interruption? It was like losing a Cray supercomputer and all of its memory files because a plug needed changing.

The radiologist tilted the brain on its axis from top to bottom and it seemed to nod at him, a greeting from outer space. She rotated it. She twisted it from side to side.

‘No evidence of fracture,’ she said, ‘and no swelling, which is the most important thing. But what is this, I wonder?’

The skull bone showed up like a reverse image of a walnut shell. A white line of variable thickness encased the spongy grey matter of the brain. She zoomed in. The image widened, blurred and finally dissolved into a pale grey supernova. Hoffmann leaned forward for a closer look.

‘There,’ said Dufort, touching the screen with a bitten-down, ringless finger. ‘You see these pinpoints of whiteness? These bright stars? These are tiny haemorrhages in the brain tissue.’

Gabrielle said, ‘Is that serious?’

‘No, not necessarily. It’s probably what one would expect to see from an injury of this type. You know, the brain ricochets when the head is struck with sufficient force. There is bound to be a little bleeding. It seems to have stopped.’ She raised her spectacles and leaned in very close to the screen, like a jeweller inspecting a precious stone. ‘All the same,’ she said, ‘I would like to do another test.’

Hoffmann had so often imagined this moment – the vast and impersonal hospital, the abnormal test result, the coolly delivered medical verdict, the first step on the irreversible descent to helplessness and death – that it took him a moment to realise this was not another of his hypochondriac fantasies.

‘What sort of test?’ he asked.

‘I would like to use MRI for a second look. It gives a much clearer image of soft tissue. It should tell us whether this is a pre-existing condition or not.’

A pre-existing condition…

‘How long will that take?’

‘The test itself does not take long. It’s a question of when a scanner is free.’ She called up a new file and clicked through it. ‘We should be able to get on to a machine at noon, provided there isn’t an emergency.’

Gabrielle said, ‘Isn’t this an emergency?’

‘No, no, there isn’t any immediate danger.’

‘In that case, I’d rather leave it,’ said Hoffmann.

‘Don’t be silly,’ said Gabrielle. ‘Have the test. You might as well.’

‘I don’t want the test.’

‘You’re being ridiculous-’

‘ I said I don’t want the goddamned test! ’

There was a moment of shocked silence.

‘We know you’re upset, Alex,’ said Tallon quietly, ‘but there’s no need to talk to Gabrielle like that.’

‘Don’t you tell me how to talk to my wife!’ He put his hand to his brow. His fingers were very cold. His throat was dry. He had to get out of the hospital as quickly as possible. He swallowed before he spoke again. ‘I’m sorry, but I don’t want it. There are important things I need to do today.’

‘ Monsieur,’ said Dufort firmly, ‘all patients who have been knocked unconscious for as long as you were are kept here in the hospital for at least twenty-four hours, for observation.’

‘That’s impossible, I’m afraid.’

‘What important things?’ Gabrielle stared at him in disbelief. ‘You’re not going into the office?’

‘Yes, I am going into the office. And you’re going to the gallery for the start of your exhibition.’

‘Alex…’

‘Yes, you are. You’ve been working on it for months – think of all the time you’ve spent here, for a start. And tonight we’re going to have dinner to celebrate your success.’ He was aware that he was starting to raise his voice again. He forced himself to speak more calmly. ‘Just because this guy got into our house, it doesn’t mean he has to get into our lives. Not unless we let him. Look at me.’ He gestured to himself. ‘I’m fine. You just saw the scan – no fracture and no swelling.’

‘And no bloody common sense,’ said an English voice behind them.

‘Hugo,’ said Gabrielle, without turning to look at him, ‘will you please tell your business partner that he’s made of flesh and blood, just like the rest of us?’

‘Ah, but is he?’ Quarry was standing by the door with his overcoat unfastened, a cherry-red woollen scarf around his neck, his hands in his pockets.

‘Business partner?’ repeated Dr Celik, who had been persuaded to bring Quarry down from A amp;E, and was now looking at him suspiciously. ‘I thought you said you were his brother?’

‘Just have the damned test, Al,’ said Quarry. ‘The presentation can be postponed.’

‘Exactly,’ said Gabrielle.

‘I promise you I’ll have the test,’ said Hoffmann evenly. ‘Just not today. Is that all right with you, Doctor? I’m not going to collapse or anything?’

‘ Monsieur,’ said the grey-haired radiologist, who had been on duty since the previous afternoon and was losing patience, ‘what you do, and do not do, is entirely your decision. The wound should definitely be stitched, in my opinion, and if you leave you will be required to sign a form releasing the hospital from all responsibility. The rest is up to you.’

‘Fine. I’ll have it stitched, and I’ll sign the form. And then I’ll come back and have the MRI another time, when it’s more convenient. Happy?’ he said to Gabrielle.

Before she could reply, a familiar electronic reveille sounded. It took him a moment to realise it was the alarm on his mobile, which he had set for six thirty in what felt to him already like another life.

Hoffmann left his wife sitting with Quarry in the reception area of the accident and emergency department while he went back into the cubicle to have his wound stitched up. He was given a local anaesthetic, administered by syringe – a moment of sharp pain that made him gasp – and then a thin strip of hair was shaved from around the wound with a disposable plastic razor. The process of stitching felt strange rather than uncomfortable, as if his scalp was being tightened. Afterwards, Dr Celik produced a small mirror and showed Hoffmann his handiwork, like a hairdresser seeking approval from a customer. The cut was only about five centimetres long. Stitched together it resembled a twisted mouth with thick white lips where the hair had been removed. It seemed to leer at Hoffmann in the glass.

‘It will hurt,’ said Celik cheerfully, ‘when the anaesthetic wears off. You will need to take painkillers.’ He took away the mirror and the smile vanished.

‘You’re not going to bandage it up?’

‘No, it will heal quicker if it’s exposed.’

‘Good. In that case, I’ll leave now.’

Celik shrugged. ‘That is your right. But first you must sign a form.’

After he had signed the little chit – ‘I declare that I am leaving the University Hospital contrary to medical advice, despite being informed of the risks, and that I assume full responsibility’ – Hoffmann picked up his bag of clothes and followed Celik to a small shower cubicle. Celik switched on the light. As he turned away the Turk muttered, barely audibly, ‘Asshole’ – or at any rate that was what Hoffmann thought he said, but the door closed before he could respond.

It was the first time he had been alone since he recovered consciousness, and for a moment he revelled in his solitude. He took off his dressing gown and pyjamas. There was a mirror on the opposite wall and he paused to examine his naked reflection under the merciless neon strip: his skin sallow, his stomach slack, his breasts slightly more visible than they used to be, like a pubescent girl’s. Some of his chest hair was grey. A long black bruise extended across his left hip. He twisted sideways to examine himself, ran his fingers along the grazed and darkened skin, then briefly cupped his penis. There was no reaction, and he wondered: could a blow on the head render one impotent? Glancing down, his feet seemed to him unnaturally splayed and veined on the cold tile floor. This is old age, he thought with a shock, this is the future: I look like that portrait by Lucian Freud Gabrielle wanted me to buy. He bent to pick up the bag and for a moment the room went fuzzy and he swayed slightly. He sat down on the white plastic chair with his head between his knees.

After he had recovered, he dressed slowly and deliberately – boxer shorts, T-shirt, socks, jeans, a plain white long-sleeved shirt, a sports jacket – and with each item he felt a little stronger, a degree less vulnerable. Gabrielle had put his wallet inside his jacket pocket. He checked the contents. He had three thousand Swiss francs in new notes. He sat down and pulled on a pair of desert boots, and when he stood and looked at himself in the mirror again, he felt satisfactorily camouflaged. His clothes said nothing at all about him, which was the way he liked it. A hedge fund manager with ten billion dollars in assets under management could these days pass for the guy who delivered his parcels. In this respect if no other, money – big money, confident money, money that had no need to show off – had become democratic.

There was a knock on the door, and he heard the radiologist, Dr Dufort, calling his name. ‘Monsieur Hoffmann? Monsieur Hoffmann, are you all right?’

‘Yes, thank you,’ he called back, ‘much better.’

‘I am going off duty now. I have something for you.’ He opened the door. She had put on a raincoat and rubber boots and was carrying an umbrella. ‘Here. These are your CAT scan results.’ She thrust a CD in a clear plastic case into his hands. ‘If you want my advice, you should take them to your own doctor as soon as possible.’

‘I will, of course, thank you.’

‘Will you?’ She gave him a sceptical look. ‘You know, you should. If there is something wrong, it won’t go away. Better to face one’s fears at once rather than let them fester.’

‘So you think there is something wrong?’ He detested the sound of his own voice – tremulous, pathetic.

‘I don’t know, monsieur. You need an MRI scan to determine that.’

‘What might it be, do you think?’ Hoffmann hesitated. ‘A tumour?’

‘No, I don’t think that.’

‘What, then?’

He searched her eyes for a clue but saw there only boredom; she must have to deliver bad news a lot, he realised.

She said, ‘It probably isn’t anything at all. But I suppose other explanations might include – I am only speculating, you understand? – MS perhaps, or possibly dementia. Best to be prepared.’ She patted his hand. ‘See your doctor, monsieur. Really, take it from me: it is always the unknown that is most frightening.’