The young doctor stared at the new X-ray under the fluorescent ceiling lights, his mouth hanging open.
He lowered the film and rubbed his eyes. “Hold on.”
He went over to the viewing board mounted on the wall, thrust the X-ray up into the holder and switched on the bank of lights behind the frosted white glass. They flickered to life.
He blinked at the sudden brightness. “That’s better.” He studied the plate closely again.
The strange series of holes drilled through the boy’s cranium was still there.
He shook his head in disbelief. “What the hell is all this?”
The doctor glanced around the empty room, wishing for the first time that there were other doctors on the graveyard shift with him so he could get their opinion.
He stepped into the hall and looked towards the nurse sitting by the information desk, eager to show someone what he had found.
“Nancy?” he called. “You got a minute? I want to show you something really mysterious over here.”
She got up and hurried over.
“What is it, Doctor?”
“Look what’s underneath that second bandage on the boy.” He pointed at the X-ray.
The nurse adjusted her glasses. “What is that? Some kind of brain surgery?”
“Yeah, but for what? I’ve never seen anything like it. I’m not a neurosurgeon, but this is just way too strange. It’s an elaborate series of small holes in some kind of bizarre, overlapping, symmetrical pattern. It doesn’t make any sense.”
She peered steadily at the image. “Too bad you can’t do more tests to see what it’s all about.”
The doctor slowly turned his head and looked at her. “I can’t? Or you mean I shouldn’t?”
“You shouldn’t.” She saw the look on his face and shrank a little. “But you’re going to, aren’t you? I know you too well already.”
He nodded mischievously. “Let’s put him through the PET scanner. I want a better look.”
“The PET scanner? You’re on thin ice, Doctor. Can’t you wait until tomorrow morning and go through proper channels? If Doc Williams finds out you didn’t consult him . . .”
“He won’t. It will be just our little secret. Go ahead and prep him with FDG. That radioisotope reveals a lot of different things about brain activity. I want to see if I can figure out what’s going on here.”
She hesitated. “I’m not so sure about this, Doctor. We have strict rules and regulations here you know, and—”
“I’m sure you do. This is a very nice little clinic Williams has. But since I’m here and he’s not, we’re still going to do it.” He turned back to study the X-ray. “Besides, body scans were once all the rage. Why shouldn’t the boy have one, even if it’s just his head?”
Nancy wondered briefly if she should consult with the young nurse on duty on the second floor who was monitoring their few overnight patients, then decided the other nurse would know even less what to do than she did.
She finally sighed. “All right, Doctor.” And she reluctantly went to do as he instructed.
Half an hour later, she wheeled the boy into the room where a machine composed of a sliding table poised in front of a large, upright metal ring stood waiting.
“The doctor wants to do another test. That’s what the shot I gave you was for,” she explained as she helped the boy up on the table and strapped him down. “Now, you have to hold perfectly still again as you go in.” She noticed he looked worried. “There’s no reason to be afraid. This machine won’t hurt either, but it is going to take a while. Try to relax. It just makes a faint humming sound. Actually, it’s kind of boring.” She smiled pleasantly to put him at ease.
He squeezed her hand. “Have you found Dorning yet for me? It’s very important.”
She realized he wasn’t worried about the test at all. “No. I’m . . . still looking.”
“Good. I must talk to him as soon as possible.”
“I’ll . . . do what I can.”
The nurse joined the doctor in the console room nearby. He sat down behind the controls.
“I sure hope you know what you’re doing,” she said. “If you break anything, Williams is going to skin you alive. This is his pride and joy, you know. Not too many clinics like ours have one of these things.”
The doctor brought the console to life with the flip of a switch. “I know, I know. Even the city hospital doesn’t have one as Williams loves to remind us. Don’t worry, these things practically run themselves.” He grinned as he adjusted a series of knobs. “You know, this one only creates still images but the newer PET scanners and functional MRI machines can even produce movies of brain activity.”
“I bet you’d love that, wouldn’t you?” She watched his every move, relieved that he seemed to know what he was doing.
He rubbed his hands together. “You bet. I’m the ultimate gadget freak. I figure if we’ve got it, we might as well use it, or what’s it doing here, right? I’m glad Williams bought this rather than a plain old CAT scanner. It might not be as useful, but it’s a hell of a lot more interesting, that’s for sure.”
He turned another set of controls; the front of the table moved smoothly into the ring and stopped when the boy’s head was in the center. The boy remained motionless.
“Good. The hardest part was learning to interpret the results. I just want to see if there’s anything really unusual happening in the boy’s brain. My hunch is that there is.”
He looked at his watch and saw thirty minutes had passed since the FDG had been administered. “Well, here we go.”
He turned on the radiation detectors; they began collecting a stream of data.
She shook her head in exasperation. “You’re like a kid in a candy store with all this expensive equipment.”
He grinned again. “That’s me.”
She stirred uneasily, still bothered the clinic rules were being so blatantly ignored. “I better get back to the front desk, Doctor.”
The doctor waited until the detectors shut themselves off and the images were ready to be displayed on the computer screen. He turned a knob and brought the table out from inside the ring then stepped out into the hall.
“All done, Nancy.”
She left the front counter to go unstrap the boy.
“Now that wasn’t so bad, was it?” she asked as she helped him back into the wheelchair.
“Not at all. Any sign of Dorning?” He looked past her, still anxious.
She shook her head. “Uh, no. Not yet. Wait here. I’ll be right back.”
She went to join the doctor in the console room again.
Just as she stepped in, a ghostly gray picture of the boy’s brain came into view on the monitor. They both stared at it intently.
“Now. Let’s see what we’ve got.” He rotated the image several times. “Looks normal enough. But take another look at this.” He held the X-ray over the monitor, superimposing the image of the boy’s skull over the brain image. “Look at how many holes were drilled into his skull. Whoever did this was very skilled. Very skilled. The holes are just millimeters apart, in perfect alignment.” He tapped the X-ray. “Too bad I have absolutely no idea what they’re for.”
He rubbed his chin, studying the images again and then took a sudden inward breath. “You know, if I didn’t know any better, I’d almost say it looks like these holes were drilled so something could be injected directly into specific areas of the boy’s brain. But that’s absurd, isn’t it?” He laughed uneasily, shaking his head at the very idea. “What would you inject, and why?”
He set the X-ray aside and used the computer mouse to slide a scale at the bottom of the screen. “I’m going to add some false color to the image and see if that reveals anything.”
He froze. “Uh oh. That can’t be right.”
“What do you mean ‘Uh oh’? Don’t tell me you broke it! If Williams finds out, I’m telling you . . .” She shook her head.
He slid the scale back to gray. The normal-looking image returned.
“No, everything’s working just fine. Come on Nancy, have some faith in me here.”
He moved the scale back to false color. The image glowed brightly again.
He sat back, baffled. “This can’t be.”
“What can’t?”
“Let me print out a few of these scans, and I’ll show you.”
He rotated the color image several ways. Pages poured from the side of the console.
He gasped as he studied them one by one. “This is incredible, just incredible.”
“What is? So tell me already, will you?”
“Look over there.” He pointed at a laminated poster on the wall. “See that series of pictures? Those are transverse and coronal views of an ‘average’ brain in false color, whatever average is supposed to be. The scale rises from black, through purple, blue, green, yellow, orange, and finally red. Some parts of the brain are highly active, others not so. Now, look at the boy’s brain scans.” He handed her the sheets.
She paged through them. “Why, they’re mostly red and orange, with just a little bit of yellow here and there.”
“Precisely. This kid’s brain is on fire. I’ve never seen one so active. This is amazing.” He took them back and went through them again. “He’s burning up the glucose in the FDG at an astonishing rate. Just look at the parietal, temporal, and frontal lobes, the sections of the brain associated with learning and memory. In most people, they’re a little green, mostly yellow, some orange, touches of red, but in him they’re mainly red. That doesn’t seem possible, yet here it is. And the odd thing is we didn’t ask him to perform some mental task to make those areas active. They just are. I can’t explain it.”
“So what does it all mean?”
He stared at her. “I don’t have a clue. But I’m willing to bet the operation he had—whatever it was—has something to do with it.”
“So are you saying it hurt the boy somehow, or that something improper was done?”
He shrugged. “No. I was just curious, that’s all. But it is damn peculiar.” He examined the scans again.
The nurse put her hands on her hips in renewed exasperation. “Did you at least determine if the boy has any serious problems, due to the accident or anything else?”
He finally looked up from the scans. “You said his pupils aren’t dilated and he hasn’t thrown up?”
“No. But I still think he’s mildly delirious. He keeps asking me if his father’s here but he’s calling him by his last name. It’s sort of amusing.”
The doctor’s gaze dropped back down to the printed images. “Under normal circumstances I would say he might have a mild concussion, but based on his scans, he doesn’t seem to have any mental impairment at all. In fact, just the opposite seems to be true. He must be phenomenally alert.” He shrugged again, finally put the scans aside. “Well, I know it’s outdated advice, but tell his parents to keep him awake for about eighteen hours just as a precaution, and he should be fine. That way they’ll think they’re helping somehow. We don’t really have any reason to keep him.”
“Oh for God’s sake. Here I thought there was some big medical mystery, and it’s just some operation you’re not familiar with. If I had known that, I never would have agreed to go along with this.” She turned and walked out.
“Hey, I said I wasn’t a neurosurgeon.” He held the X-ray up to the lights again. “My God, this looks like real Frankenstein stuff,” he said quietly. “I’d sure like to know what the hell’s going on.”
He turned off the machine, then fell back in the chair with a groan when he realized he hadn’t saved any of the data. “Damn! Well, at least I have these.” He stood and scooped up the printed scans and X-ray plate.
The nurse went to wheel the boy out of the room, knowing she should hurry and get back to the front desk where she was supposed to be.
“Come on, Professor. You’re just fine.”
He looked up at her sharply. “Why did you call me that?”
She stepped back, surprised by the intensity of his gaze. “I don’t know. You were talking about electromagnetic radiation before. I guess I just thought the name fit.”
“Oh. Of course.” He regarded her warily then decided he should be more careful about what he said and to whom.
“I hope someone’s coming to take you home soon.”
“So do I. With any luck, it will be Dorning.”
“Yes, of course. My thoughts exactly.”
She wheeled the boy back down the hall towards the information desk. It was then she heard the counter buzzer sound repeatedly.
“Oh no,” she groaned. She hoped whoever it was hadn’t been waiting too long and regretted leaving the desk unattended while the doctor led her on a wild goose chase. “I’m going to put you right here for a moment,” she told the boy, parking the wheelchair. “Be right back. Don’t go to sleep on me now.”
She hurried to the desk and immediately recognized the man standing there as the same one who had brought the boy in for the stitches.
“Oh, thank goodness,” she said. “Hello, Mr. Dorning.”
“Hi. I understand a neighbor brought my son here. Apparently he had a bicycle accident. Is he going to be all right? I hope it’s nothing too serious and we can take him home tonight.” Dorning’s right eye twitched.
“Yes, he should be just fine. He doesn’t need to be admitted.”
Dorning visibly relaxed.
“I just need you to sign some insurance paperwork for me and he can go. The doctor’s instructions are that—”
“—the boy be kept awake for the next eighteen hours just to play it safe. He might have a mild concussion but probably not,” the doctor finished for her. He carried the X-ray and PET scans with him into the room, walked up to Dorning and warily shook his hand. “Good to meet you.” He stared steadily at Dorning, the handshake becoming slower and slower. “You look familiar. Have we met?”
“No, I don’t think so.”
The doctor squinted at the computer screen in front of the nurse. “And you are . . . Carl. Carl Dorning.” He finally let go of Dorning’s hand. “You know, for some reason even your name seems vaguely familiar. Are you sure I don’t know you?”
“I’m quite sure.”
“You don’t work in the medical field by any chance, do you? I swear you sure look . . .”
“No, not at all. I’m a . . . computer programmer.”
“Oh. I see.” He glanced down and tapped his fingers on the countertop. “Well, Mr. Dorning, we did some tests on your son and discovered something rather . . . unexpected.”
“Oh? What was that?”
“Did your son have any kind of unusual operation recently?”
“Why do you ask? Is there a problem, Doctor?”
“I was hoping you could tell me. There are indications he had some sort of unique brain surgery, one I’m completely unfamiliar with.”
Dorning took a deep breath and tried to look thoughtful. “Well, you’re probably unaware of this, but he’s narcoleptic and doesn’t respond well to the traditional medications for the condition. That’s why he fell and needed those stitches he had. I adopted Miguel not too long ago and only recently was able to add him to my insurance. His primary care physician said a new procedure might help him, and we were fortunate enough to get in on the trials just beginning.”
“A procedure? Where?”
“A hospital out of state. We’ve just returned but have to go back in a few days for a follow up exam. Fortunately, he wasn’t required to stay there. And so what does the boy do? He promptly falls off his bicycle, perhaps complicating matters. Boys will be boys, I guess.” He gave a strained chuckle.
The doctor ignored Dorning’s forced laughter. “Did they explain the surgery to you? I was wondering what they did exactly.”
“They tried to explain it, but I don’t really remember the specifics. It was all dry, hard-to-follow medical jargon. Rather boring stuff, I’m afraid.”
The doctor nodded. “I see. Well, that explains quite a bit.”
Dorning noticed the X-ray and brain scans tucked under the doctor’s arm. “What are those?”
“Hmm? Oh, I took an X-ray when he arrived then after discovering evidence of the operation we performed a PET scan since I was very concerned about what I found. The boy’s scans came out rather peculiar, but I’m really not an expert at reading them. Perhaps the fact he’s narcoleptic and had an operation I’m unfamiliar with could explain the results. I just don’t know.”
Dorning was impressed. “This clinic has a PET scanner?” He looked around. “I wouldn’t think such a small facility could afford one.”
The doctor grinned a genuine grin. “The clinic owner found a used one for a terrific price and couldn’t pass it up. It’s our one claim to fame. Who knows? Maybe someday we’ll give the Mayo Clinic a run for their money.”
Both men chuckled.
Dorning coughed pointedly. “But doctor, aren’t you suppose to obtain written permission from the parents or guardian of a patient under the age of eighteen before performing such a medical test—particularly one involving nuclear material—no matter how slight the risk? At least, that’s what I’ve been told.” Dorning’s expression was oddly blank despite the seriousness of the question.
The young doctor drew back in apprehension, not answering right away. “Technically, yes, that’s correct. But given the potential severity of his head injury, I felt it couldn’t wait for your permission. I hope you can understand.” He grimaced. “I mean, you’re not officially complaining, are you?”
Dorning’s apathetic, nearly bored expression remained. “No, of course not. Your explanation makes perfect sense. Only a fool slavishly follows the rules.” He had a sudden realization and feigned only a slight interest in what the doctor was holding. “Can I see those if you don’t mind? Just out of curiosity.”
“Well, sure you can. Here you go.” He immediately handed them all to Dorning, relieved to be forgiven so easily.
Dorning ignored the X-ray and studied the scans instead. His excitement grew. “Remarkable. Absolutely remarkable. Why, the entire cerebral cortex is positively . . .” He caught himself and shot a glance at the doctor.
The doctor stared back at him. “Yes, the entire cerebral cortex is highly active, unusually so. Apparently you know a lot more about PET scans than most people do, Mr. Dorning.”
Dorning stiffened. “Well they did perform other scans like this on him prior to his operation. That’s why I knew the regulations. I do remember some of the things the doctors explained to me, if not everything.”
“Did those scans look similar to these?”
“No, they showed depressed activity, which they said is typical of narcoleptics. These look better. Much better.”
“That makes sense, I suppose. And I would imagine if this experimental procedure turns out to be a cure for narcolepsy, that would be tremendous news.”
“They didn’t use the word cure, Doctor. They said it might help.” Dorning set the X-ray and scans down away from the doctor, purposefully ignoring them. “Can I see my son now? It’s getting late, and I’d really like to take him home.”
The doctor turned to the nurse, who was still busy on the computer. “Are you almost done, Nancy?”
“Almost,” she said cheerfully. “I’ll go get him just as soon as I’m finished. You still have to sign a few papers for me, Mr. Dorning. They’ll be ready in a moment. And I have some patient instructions for you as well so you can do some neuro checks on your son tonight to make sure he’s all right.”
The doctor had an idea. “I’ll get the boy, Nancy. You stay right here with Mr. Dorning.”
Dorning stiffened as the doctor hurried back down the hall.
He tried not to stare at the unguarded X-ray and scans. “If you’ll excuse me, I have to run out to my car for a moment,” he said. “I’ll be right back.”
The nurse didn’t take her eyes off the printer as it clattered out a long form. “That’s fine, Mr. Dorning. Take your time.”
As he turned to walk away, he quietly scooped the X-ray and scans off the countertop and hid them in front of him as he hurried to his car.
Natalie looked at him anxiously, still wishing he had let her come inside.
“Is Miguel all right?”
“Yes, he’s fine, but the inexperienced, young doctor on duty thinks he knows more than he really does. He’s asking far too many questions. Here.” He gave her the X-ray and the scans. “Hold on to these for me. Put them under the front seat. The doctor was kind enough to do some valuable tests. I might find these useful. I should be back with Miguel in just a few minutes if all goes well.”
Dorning returned to the admittance desk to wait for the papers to sign, glancing with suspicion down the hallway where the doctor had disappeared.
****
The doctor walked up to the boy, smiling as he pulled up an empty chair to sit down in front of him.
“Your father’s here to take you home pretty soon,” he said.
Marlowe didn’t flinch.
“My father. Good.”
“I just had an interesting conversation with him. He told me all about your operation, the one on your head.”
The professor blinked twice. “He did?”
“Yes. It sounds fascinating since it’s still experimental. What can you tell me about it, Miguel? I’m curious.”
He hesitated. “Not too much. When I woke up it was over.”
“Do you feel it helped your problem?”
Marlowe cleared his throat. “Yes. Yes it did.”
“And, what was that problem again?”
“I . . . don’t remember the name for it.”
“Well, what was wrong with you?”
“I’d . . . rather not talk about it. I’m sure my father told you all he wanted you to know.”
The doctor nodded slowly. “Yes, I guess he did. I was just concerned about what was happening to you Miguel, that’s all. I’ve never seen such an unusual operation before. It just looks . . . well, very, very strange.” He laughed uneasily as he stared at the large bandage on the boy’s head. “And for some reason I had the feeling your Dad wasn’t telling me the whole truth about it. How about you, Miguel? Are you telling me the truth?”
The professor raised his head, his gaze clear and strong. “Yes. Yes, I am.”
The doctor stood up and patted the boy’s shoulder. “All right. Never mind. Come on, you’re going home.”
He wheeled the boy back down the hall.
“Here he is, Mr. Dorning.” The doctor barely smiled.
Dorning hastily finished signing the long insurance form. “Son! How are you feeling?”
“Just fine . . . Dad.”
The nurse took the wheelchair from the doctor and wheeled the boy through the automatic glass doors to Dorning’s waiting car.
The doctor followed them into the cool, cloudy night.
Natalie got out of the car and opened the rear door for the boy.
His face brightened immediately when he saw her. “Natalie!”
She gently patted his shoulder. “I’m so glad you’re okay,” she said, and buckled him in before returning to her own seat.
Dorning faced the doctor. “Thank you for your concern about my son.”
“You’re quite welcome. I hope the experimental procedure the boy had turns out to be a success.”
“Me too, Doctor. You have no idea.”
They briefly shook hands then immediately stepped apart.
Dorning hurried to the car and gave a farewell wave to the nurse as he got behind the wheel. He started the engine and sped away from the emergency room entrance.
The doctor and nurse watched them go. A light rain began to fall. In the distance; lightning flashed, and thunder followed slowly.
“I don’t know, Nancy. Why do I feel so uneasy about letting that boy go?”
“You can’t keep him here if there’s no medical reason to.”
He followed her back inside. “I know, but I almost wish there was. Maybe I should have made something up. Hey!” The doctor grabbed the countertop and looked around. “Where’s the X-ray? Where are the scans? Don’t tell me the boy’s father took them!”
“I don’t know. Maybe he thought you were giving them to him instead of just letting him see them. Did you ask him to give them back?”
The doctor groaned. “Well, great. That’s just great. What’s his phone number? I’m going to call and ask him to return them.” He picked up the phone behind the counter, anxious to start dialing.
“Are you sure you want to do that, Doctor? If Williams sees those scans he’ll read you the riot act for not following procedures. And probably me too.” She stared at him with brief resentment.
The doctor ran a hand through his hair, paused, and then hung up the phone. “Maybe you’re right. But I would like to get that X-ray back. Maybe if Williams saw it, he’d insist on doing his own PET scan on the boy.”
The nurse laughed once. “So the boy can tell him you already did? What are you going to say then, Doctor? You’re probably lucky his father took everything. If I were you I’d just let it go. And please, follow the rules and regulations from now on, okay? Just because you’re willing to come in here and work a shift nobody else wants doesn’t make you indispensable. I like you, Doctor, but if you ever do anything like that again, you’ll leave me no other choice but to report you.” She gave him an even sterner look, then her expression softened. “Besides, I thought his father was very nice man. He seemed very sincere to me. You know, not too many people are willing to adopt an older child with a serious medical problem. It takes a very special person to do that.”
The doctor sighed and stuck his hands in the pockets of his lab coat in defeat. “I suppose. It’s just that I had the strangest feeling that Dorning and his son didn’t want to tell me the truth. I’m convinced they were hiding something.” He stared out the window to where Dorning’s car had been just a few minutes earlier. “What the hell was that bizarre operation all about? I’m not sure I believe that whole story about narcolepsy and a new procedure. You know what? I should have asked Dorning for the name of that out-of-state hospital, that’s what I should have done. Then I could have called them for verification. And why did Dorning look so familiar? I swear I’ve seen him before, or maybe his picture somewhere.”
The rain fell harder and the lightning and thunder grew more intense.
The nurse let out an exaggerated sigh. “I guess we’ll never know, Doctor. We’ll just never know.”
****
He sat quietly in the back of the Mercedes as it sped home, the rain drumming furiously on the car roof. Each flash of lightning illuminated the interior and the fierce, steady gaze of the professor.
He raised his hands until they were just inches from his face then flexed his small, limber fingers, still fascinated by them.
“Astonishing,” he said. “Simply astonishing.”
Dorning glanced at the professor in the rearview mirror. “I can’t tell you how good it is to see you again,” he said. “I’ve been waiting for this.”
“It’s good to see you again, too, Doctor,” the professor said.
Natalie turned around as far as she could to look at the boy. “All I can say is thank goodness you’re not seriously hurt this time, Miguel. You really are accident prone, aren’t you? I guess I’ll have to watch you a lot closer from now on.”
Marlowe and Dorning looked at each other in the mirror, sharing a secret grin as lightning cracked all around.