Trauma

CHAPTER 44

Carrie’s stomach knotted when Dr. Finley pushed open the conference room door. What would she see through the looking glass? Would it help her better understand Adam, give her a glimpse into his world of constant fear? She could hardly imagine how horrible the simulation must have been, how real, how visceral, to elicit such a violent and disturbed reaction in Abington.

It was ironic, Carrie thought, that before she’d joined this endeavor to cure PTSD, she’d had no profoundly disturbing memories. Nothing of real substance she could draw upon as fodder for simulation. Now she had a whole host of experiences to use.

On the long table inside the windowless conference room, Carrie saw a laptop computer and some futuristic eyewear, a cross between ski goggles and wraparound sunglasses. The eyewear was connected to the laptop via a USB port. Calvin Trent stood to greet Carrie and Dr. Finley, wearing a blue suit that fit snugly against his broad shoulders. With Trent was the bald man Carrie had seen at grand rounds.

Trent extended a hand to Carrie, warmth entering his gray eyes. “Nice to see you again,” he said. It was then he noticed Carrie’s face. “Goodness, what happened to you?”

Carrie said, “Car accident.”

Trent grimaced in solidarity. “Well, I’ll make sure there are no car crashes in your simulation. I can imagine you have a little PTSD already from that experience. Wouldn’t want to make things worse.”

Carrie gave a little laugh. “Yeah, let’s do that,” she said.

Trent turned to his companion. “This is Bob Richardson,” he said. “He’s been helping with operations. Bob, this is Dr. Alistair Finley and Dr. Carrie Bryant with the VA.”

Carrie watched Dr. Finley shake hands with Richardson for what appeared to be the first time, confirming her earlier belief that he had not been introduced to her at the grand rounds simply because the two had never met before.

A related question popped into Carrie’s mind. “How many people are involved with this program?” she asked.

Trent said, “I’d say with all the technicians, and medical staff and such, we’re probably close to a hundred.”

“Close to a hundred,” Carrie repeated. “Where is everybody?”

“Spread out,” Trent said. “We don’t have an official base of operations just yet. Believe it or not, the government is always looking to save a buck or two, so to minimize costs we utilize the workspace of our experts and consultants whenever possible.”

“I explained to Carrie that there’s a lot more going on here than just neurology and neurosurgery,” Dr. Finley said.

Trent nodded in agreement. “That’s correct. We have psychologists, physiologists, simulation technicians, a wide variety of specialists involved. There are even plans in the works for building a dormitory or semi-permanent housing, but for now vets in the program who come to us without a permanent residence have to settle for Motel Six, which is a lot nicer than the streets where most of them had been living. We have contracts in place with a car service to shuttle our program participants to all their various appointments.”

Richardson said, “Having everything decentralized does create some operational challenges.”

“I can’t imagine driving Abington anywhere without an armed guard,” Carrie said. The memory of Abington’s assault replayed in her mind.

“I heard you had a terrible experience there,” Richardson said in a sincerely apologetic tone.

Carrie said, “That’s for sure.”

Trent said, “We intentionally run the simulation on the premises here at the VA to minimize travel time. Once the DBS system is installed, most of the vets are a lot more docile, I can assure you. But I’m sorry about what happened to you.”

“I’m assuming you know that he’s gone,” Carrie said to Trent. “Fasciani too. Both vanished.”

Trent grimaced. “Yes, I’m aware. We’re looking for both of them. Many in our program have issues with alcohol and drugs, which can lead to all sorts of erratic behavior.”

“They left AMA,” Carrie said. “We signed them out.”

Trent looked at Dr. Finley. “Yes, Alistair told me. In fact, we have a meeting scheduled with Dr. Goodwin to come up with better protocols moving forward. We don’t want this to become a trend. We’re too close to finishing phase three.”

“What’s the next phase?” Carrie asked.

“Full deployment of the solution. Tested, validated, and FDA sanctioned. It’s the game changer,” Trent said.

Bob Richardson manipulated the laptop and did something to make the screen turn black.

“We’re ready whenever you are, Cal,” he said. Richardson spoke in a hard, dry voice. It was the voice of someone accustomed to commanding a crowd. He did not strike Carrie as a subordinate. Who was this guy, really?

“Are you ready, Carrie?” Trent asked.

Carrie had that funny feeling in the pit-in-her-stomach that preceded any roller coaster ride. “Sure thing,” she said.

“We’re using a simulation from one of our program participants,” Richardson said. “But for privacy reasons, I’m not at liberty to tell you which one.”

Carrie smiled politely. “Of course. I understand.”

Carrie took a seat at the conference table with Richardson on her right, Trent on her left, and Dr. Finley across from her. The goggles were lightweight and fit over Carrie’s head with minimum adjustments required. The earbuds slipped right into place. Through the lens Carrie could see only black.

“Are you ready?” Trent’s voice was slightly muffled, but clear enough for Carrie to give him a thumbs-up sign.

Blackness gave way to light, and a desert scene unfolded in Carrie’s view. A digitally rendered lone figure stood on a bridge that crossed over a sand-covered road. What appeared to be palm trees stood in the background, with a few scattered tufts of vegetation. In front of the bridge were two heavily armed and armored Humvees, and behind those vehicles were two kneeling soldiers, each holding automatic weapons.

While shadows and lighting enhanced the reality of the 3-D graphics, the scene itself still looked like something out of a video game. Adam could no longer play “Call of Duty,” but Carrie had seen him shooting up the enemy enough times to be reminded of a lightweight version of that game.

The sound of Humvee engines rumbled in Carrie’s ear, and the graphics began to move. First, the kneeling soldiers stood, and then the Humvees inched ahead. Carrie turned her head from side to side, but her field of view remained unchanged. This was more like watching a computer-generated movie than the total-immersion experience she had expected.

The Humvees rolled under the bridge with the two soldiers bringing up the rear. There was movement from the figure on the bridge, and Carrie saw him using what appeared to be a cell phone. The animation was close to the natural arcs and curves of the human body, but not quite there.

In her headphones, Carrie heard the sound of an explosion, and in the next instant the ground in front of the lead Humvee became a debris field. The now-mangled Humvee lifted several feet above the virtual ground before it crash-landed hard on four tires. The graphics showed the vehicle’s shock absorbers doing their job as the wheels bounced several times before they finally settled. Dust and sand kicked skyward, but it was still video game dust and sand. While the whole sequence was surprising, Carrie did not find it overly frightening or hyper-realistic.

The gunmen on foot returned fire and shot at the man on the bridge, while three burned and bleeding soldiers crawled out from the wrecked Humvee. The graphics here were well done, and Carrie could see that two of the men had lost limbs, one an arm, and the other a leg. The third solider to climb out bled profusely from a head wound.

A second explosion followed. This one swallowed one of the two soldiers on foot. When that virtual dust cleared, the sand beneath the soldier’s body was colored red, and he was without limbs. The surviving soldier fired at the man on the bridge, this time striking him somewhere — torso, head, it was difficult for Carrie to tell. The dead insurgent tumbled off the bridge and landed on the desert sand with a thud.

The scene faded to black and Carrie removed her headset.

Richardson appraised Carrie as if she might need to be sedated like Abington.

“Well, I hope that wasn’t too traumatic for you,” he said.

Carrie removed the earbuds and stared down at her lap for several seconds. When she looked up, Carrie’s face showed signs of strain, and her composure was compromised.

“If you re-created my car accident, I’d be in tears right now,” Carrie said. “I can only imagine what the soldiers go through after seeing their own worst nightmares replayed on screen.”

Carrie glanced around the room and felt confident everyone believed her lie. She had expected so much more from the simulation, based on Abington’s violent reaction.

Dr. Finley said, “The reconsolidation of the negative memory is a necessary albeit unfortunate step in the process. With the memory fresh in the mind, we can use electric stimulation to remove the emotion associated with the event. Ramón Hernandez can watch his virtual reality simulation now like it’s the movie of the week, when before it would have sent him into a violent rage.”

Carrie believed Adam could see a similar demo of his traumatic experience in Afghanistan, and while it might add a few notches to his blood pressure, that would be it. It was simply not believable enough, in her estimation, to incite such a strong emotional reaction. Carrie recalled the crazed look in Abington’s eyes just before the attack, as well as the mysterious words he had uttered.

I don’t belong here … I don’t belong …

What had Trent really done to him prior to surgery?

By now, David had probably retrieved the recording device. Carrie could hardly wait to see him, to share what she had learned during the demo, and to listen in on Goodwin’s private conversations. She had a strong feeling they would reveal something significant.

“Amazing, I’m really impressed,” Carrie said. “Cal and Bob, I want to thank you for taking the time to arrange this demo for me. It really did open my eyes.”

“You’re very welcome,” Trent said. “We view you as a vital part of this team, Carrie. I speak for Bob and the rest of the DARPA organization when I say how grateful we are to have you on board. And, not to be glib here, but I’m also hopeful you’ll be able to operate with your injuries. If you asked Alistair, he’d say you’re one of the best surgeons he’s ever worked with. Everyone is simply devastated about what happened to Sam, but if we had to replace him, we’re glad it’s you at the helm.”

Carrie returned a slight smile, no teeth showing. “I’m glad to be a part,” she said. “And thank you for your endorsement. I really do appreciate it.”

Carrie took out her phone and pretended to type a message. In reality, she had snapped a photo of Bob Richardson. With David’s help, she hoped they could figure out who he really was.