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Authors: Katherine Howe

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“You mean, like the bear?” the reporter asked.

Nurse Hocking tossed her hair back and laughed like the reporter had just said something utterly hilarious.

“Not exactly!” Dr. Strayed said, also laughing. “PANDAS is an acronym. It stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. PANDAS.”

“Pediatric . . .” TJ Wadsworth tried to repeat the acronym that Dr. Strayed had just explained, and was at a loss.

“Basically,” Nurse Hocking jumped in, thinking that perhaps too much time had been spent on the good epidemiologist, “what it is, is sometimes kids, after getting a strep infection, they’ll appear to get completely better, but for reasons we don’t fully understand, those same kids can later go on to develop unusual neurological symptoms. In this case, those symptoms would be verbal tics, spastic physical jerking, and anxiety. Though oftentimes the anxiety can be traced to distress caused by the tic behavior.”

“That’s right, Laurel,” the doctor said, elbowing her way back into the discussion. “In some instances, the patient will present with symptoms that in all other respects might be taken for OCD.”

“That’s obsessive-convulsive disorder,” TJ clarified.

The doctor started to agree, but checked herself. “Ah, no, actually. OCD stands for obsessive-
compulsive
disorder.”

“Oh! So it does. Excuse me,” the reporter said, trying to laugh off her mistake.

In a funny way, though, I could understand why she’d made it. Clara and the others didn’t seem to have OCD, not the way I always pictured it. Granted, I’d gotten most of my ideas about OCD from watching movies, and then it seemed mainly to be about wanting to wash your hands a lot.

“Um. Does this seem right to you guys?” I asked.

What did my parents know? They weren’t doctors either. I wondered what Dr. Gupta would say when she saw this. I wondered where Anjali was right then.

“I just don’t know, Colliewog,” my father said.

“Sometimes young people present with uncontrollable physical behaviors—tics, stuttering, and so forth—that will be initially diagnosed as OCD or occasionally as Tourette’s. But then upon closer investigation,” the doctor was saying, “the timing of the onset of patient symptoms, even subtle ones that don’t initially gain enough notice for the patient to be brought in for medical care, can be found to coincide with their recovery from a strep infection. The good news is, these kinds of effects are pretty rare.”

“Let’s talk about that, Doctor. How common is this? And what can families do to make sure that their children aren’t affected?”

“The most important step is prevention,” Laurel Hocking said, not to be outdone in the expertise department. “Washing hands, using good hygiene, getting regular checkups—basically the best thing parents can do is take good precautions against their children being exposed to strep throat.”

“I see. And what about for those families where the children may already have strep, or have already had it? What do they need to be looking for?”

“Well, the thing that I want to stress here is that despite what you may think about this cluster of cases at St. Joan’s, this is a highly unusual autoimmune response. Some children who’ve had strep infections might experience tics, but the vast majority of kids who’ve had these infections—and as any parent will tell you, they’re very common—will have no adverse effects like this at all,” Dr. Strayed said.

“We have another two guests today who have a very personal investment in the development of the Mystery Illness at St. Joan’s Academy, and we’re going to hear from them, right after this.”

Michael muted the TV before we even got to the jingle for cling wrap.

“Well, I can’t wait to hear from Kathy Carruthers, I don’t know about you guys,” my mother remarked. “Mike, could I get a warm-up?”

My dad and my brother were both Michael. Dad is called Mike. My parents called my brother Mikey. He’d been trying to go by Michael since sixth grade, and I was finally able to switch this year. The thing about New England is, we like to keep it simple. Everybody with the same name. Anyway, my dad got up to take my mother’s mug to the kitchen. Without a word he collected mine and Mikey’s, too. Mikey! I slipped. It happens.

“PANDAS,” my mother mused while my father busied himself in the kitchen. “Well, at least they know what it is now. Better than everyone getting hysterical about a harmless booster shot.”

“That’s a weird name for a sickness,” Wheez said. “That’s like saying, ‘Oh no! I’ve got a bad case of giraffe!’”

Nobody laughed.

I pulled the blanket more tightly around myself and said, “No way. No way. If it’s so rare, why would it all be breaking out at school right now? I don’t get it.”

“Well,” my mother said, rubbing her fingertips under her glasses, “maybe there was a kind of mini epidemic of strep throat at your school last year, sweetie. If a lot of girls got it all at the same time, they could be getting this aftereffect on about the same schedule. The important thing is, they know what it is, and frankly, we know you’re going to be okay. You didn’t have strep last year.”

I hunted back through my mind, trying to remember if people had seemed to go out sick in greater numbers last winter than usual. I couldn’t remember. I mean, people were always out sick. Colds, flu. I guess we could’ve mistaken strep throat for the flu, if everyone was telling us we probably had the flu.

My father reappeared and passed around mugs. “We need to start thinking about getting ready to go,” he said.

“We’ve got to see the Carrutherses first,” my mother said.

She patted the couch seat next to her. Now that she was reassured that nothing was going to happen to me, my mother could treat this like spectacle. I’m sure she wasn’t thinking about Anjali.

But I was.

“And welcome back to
This Is Danvers
. I’m TJ Wadsworth. We’re talking this morning with Laurel Hocking, school nurse and first responder to the infamous Mystery Illness that has sickened a shocking sixteen girls at the exclusive St. Joan’s Academy in the past month. We’re also joined by Dr. Sharon Strayed, professor of epidemiology at the University of Massachusetts, and by Kathy Carruthers, a parent of one of the students who has been touched by this tragedy. Kathy, welcome.”

“Thank you, TJ.” Kathy Carruthers was made up like a Vegas showgirl, or at least like what I imagine a Vegas showgirl would look like if she were going on a small local morning talk show. She was clutching a handkerchief. My mother and I rolled our eyes at each other.

“And a very special welcome to you, Leigh.” TJ leaned forward and raised her voice a little, the way people sometimes do when speaking to someone they think is slow or who doesn’t speak English very well.

“Thanks,” Leigh said.

“We just really think it’s important that the truth get out. And that’s why we’re here today.” That was Kathy. She hadn’t even been asked a question yet.

“Exactly,” TJ agreed. “So tell us, Leigh. How
are
you? Really.”

The camera zoomed in on Leigh’s face, and her lower lip was quivering. At first I couldn’t tell what, beyond a bad case of melodrama, might be troubling her. But after a minute, I could see it.

Leigh was vibrating.

I didn’t know how else to describe it. She wasn’t twitching. She wasn’t rocking. She wasn’t shaking. She was
vibrating.
The camera couldn’t really keep her in focus, because while it looked like she was just sitting there completely normal, she was just . . . oscillating. Blurry. She brought a hand up to tuck a hank of hair back behind her ear, and the hand was vibrating.

“How is she doing that?” Michael asked from the recliner.

When Leigh spoke, her voice sounded like she was speaking through the blades of a box fan.

“I have to say, it’s just a really, really weird feeling. Like there’s something inside of me that’s making me do this. I try to control it and, like, tamp it down, but then it builds and builds, and I feel like I have to let it out. It’s better if I just let it happen. But once it starts happening, it’s like I can’t stop it.”

“Her father and I want everyone to know that we’re holding the school responsible,” Kathy said. “We deserve answers, and we deserve to have a plan in place to help our girls feel normal again.”

“Well, I can certainly understand that,” TJ said. “Laurel, do you have any response for this concerned mom?”

“Of course I do. Kathy and Leigh, as well as all the afflicted girls at St. Joan’s, know that we want nothing more than for them to all feel better. Helping them get well is absolutely our first priority. I can’t stress enough how everyone at the school only has the girls’ best interests at heart.”

“We just want to know, you know, why has it been so hard to get a straight answer? I mean, how were we supposed to protect our kids if no one was being honest with us?” Kathy said, not looking at the school nurse. Leigh trained her vibrating eyes on her mother in a worshipful way. Her hand was clutching Kathy’s sweater sleeve.

“Well, that also brings us to an important question, I’m sure you’ll agree, Kathy, and that is, what’s the treatment? How do we help these girls get back to leading normal lives?” TJ directed her question to the doctor.

“That’s a completely natural question, and I think one that’s on many parents’ minds watching this program. But unfortunately there isn’t one particular answer. What will be happening in the next few days is that each girl who thinks she’s come down with PANDAS symptoms will be meeting with us, and we’ll be coming up with a special plan of action tailored for each individual. Everyone’s different, and we’ll be treating everyone accordingly.”

“Kathy? Is that what you wanted to hear?”

“Oh, great,” said my mother to the television. “Goad her. Sure. That’s a great idea.”

“No, that’s not what I wanted to hear!” Kathy’s voice rose. “If it’s some real disease, then there’s got to be a real treatment for it, right? Look at my daughter. She can’t control herself. She can barely talk. Last week she was a regular, happy kid, and now look! What are you going to do about it? I want to know exactly how you plan to help my daughter!”

The doctor’s eyes shifted left and right, and her smile grew fragile. “Well, to be honest, it’s a complicated question. Treatment for PANDAS might involve certain medications, and in some instances cognitive behavioral therapy will—”

“Therapy? Are you saying my daughter’s crazy? Is that what you’re saying?” Kathy got to her feet and starting pointing a finger at the doctor’s chest.

My mother laughed.

“Linda, jeez,” my father murmured.

“Sorry,” my mother said. But she didn’t look sorry.

“I’m not trying to suggest that—” Dr. Strayed stammered, instantly seeing her mistake.

“How dare you? My daughter is NOT crazy. She’s sick! Look at her! And nobody’s doing anything to help! Nobody!”

The camera cut away just as we spotted a burly stagehand begin to approach Kathy Carruthers from behind. We heard scuffling, and the camera zoomed in on TJ Wadsworth’s face, whose smiling mouth paired uncomfortably with two worried eyes.

“The Mystery Illness at St. Joan’s Academy, now, it seems, with more questions than we have answers. Kathy, Leigh, Dr. Strayed, Nurse Hocking, thanks for joining us today. Up next, has Cupid’s arrow struck you yet? Valentine’s Day is coming up, and we’ll be getting ready by talking to—”

Michael snapped off the television.

Chapter 15

DANVERS, MASSACHUSETTS

MONDAY, FEBRUARY 6, 2012

Y
ou can change your mind,” Dad said.

A forest had sprung up overnight on the front steps of St. Joan’s. A forest of vans and antennae, klieg lights and sound equipment, cameras and wires, production assistants and monitors, microphones on booms and reporters in trench coats and sprayed hair. I stopped counting past eleven or twelve. Danvers stations, and all the Boston stations, too. One from Providence. A couple from Maine. Framingham. Burlington.

And one from New York.

I tightened my grip on my backpack.

“I’m serious,” my father said. “We can just turn around and go home.”

I looked at him, and then looked back at the steps of the upper school, which were completely obscured by milling strangers. The microphone booms studding the crowd made it look like a many-legged monster, blistering with metal spikes. I couldn’t even see the Gothic front doors, only the snarling mouths of the gargoyles crouching on the drainpipes just out of reach. Over everything loomed the reverse image of the stained-glass window of St. Joan being burned at the stake, its colors dulled by the winter light. Joan’s face looked as smooth and beatific as ever.

“What’s the point?” I said. “Anyway, I’ve got stuff to do. I’m this close to catching Fabiana. And I don’t see how staying home is going to get everything back to normal any faster.”

“Suit yourself,” Dad said. “But if you change your mind, you can call me at work, okay? Just this once.”

“I’ll be fine, Dad.” To prove it, I got out of the car, slammed the door, and leaned back into the window, backpack over my shoulder. “Really,” I said.

“Well. Okay, then. Have a good day. Enjoy your fifteen minutes.”

Was that why I wanted to run the media gantlet to get into school? I asked myself this as I approached. All this attention being lavished on everyone else. Leigh going on television. It’s not like I wanted to go on television or anything. At least, I don’t think I did. But the things we tell ourselves aren’t always the truth.

I spotted a harried-looking Father Molloy on the outer fringes of the camera-toting mob. He was ushering students from the sidewalk to the front doors, herding them like worried sheep. He raised his eyebrows in greeting when he saw me, and took my arm, saying, “Colleen. Here. This way.”

And then, before I had time to prepare myself, it started, like a hail of rocks raining down on my head.

“Young lady, young lady! Are you worried about going to school today? Do you think the school is telling the truth?”

“Can we get a quote from her, Father? What’s her name?”

“Hey, beautiful! Look this way! Just look over here!”

“Do you think this is just about sex? Have you had the HPV vaccine? If you haven’t, are you going to now?”

“Miss, have you had strep throat? Do you think there’s something to this PANDAS hypothesis?”

“Are you friends with any of the afflicted girls? Have you talked to any of them?”

Father Molloy kept a gentle hold on my arm and raised his palm between my face and the thrusting glass eyes of the cameras, shielding me from the encroaching boom microphones with his shoulder.

“Just ignore them,” he whispered to me. “Don’t worry, don’t look, you don’t have to say anything to anyone, okay?”

“Okay,” I said, keeping my eyes on my feet.

“Excuse me, miss, excuse me! Just one question!”

“Aren’t you afraid that with twenty students sick, this is just the beginning?”

“What do your parents think of how the school’s handling the crisis?”

“Just keep walking,” whispered Father Molloy.

I nodded.

“Miss! Miss! Hello, are you deaf?”

“Young lady, just a quick photo!”

“Colleen!”

I froze.

“Colleen Rowley, how’s it feel to know you could easily be next?”

I swiveled, hunting the crowd of unfamiliar faces to see who had called my name. Microphones crowded into my face, and a bright spotlight mounted on top of a camera blared into my eyes. The faces blurred in an indistinct haze behind the glare, and I couldn’t see who had spoken.

“Just a quote, miss, just a couple of words! Tell us what you think!”

“I’m just trying to get to class,” I said, squinting against the lights.

Father Molloy was pulling at my arm.

“Aren’t you scared? Do you think it could be something inside the school itself?”

“I . . . Everyone just wants everything to go back to normal. Excuse me.”

Camera flashes exploded across my eyes and more questions were shouted, but I couldn’t tell them apart. I hunched my shoulders up to my ears, slouching under the protective arms of Father Molloy.

“That’s it, that’s all, give her some room, please,” he bellowed at the press.

We had to force our way through the wall of arms and legs and reporter notebooks and cameras, and when we finally reached the studded front doors, Father Molloy hustled me through them, whispering, “That was okay, you’re just fine. Just go to advisory. Okay?”

I nodded, eyes wide, and the door slammed shut.

Inside, the halls were eerily silent.

I turned my back to the door and surveyed the length of the upper school hallway, usually teeming with girls in matching skirts, beehiving our way to our different lockers and classrooms in the complicated dance of early morning in high school. But today I noticed the flagstone floor, a huge expanse of slate darkened with a century of Old English polish. Thin winter light slanted through the pebbled glass of the classroom doors, glowing in the glass transoms overhead. Each transom was engraved with the quote from St. Joan that was our school motto:
Il est bon à savoir.
It is good to know.

Here and there, clusters of girls huddled by wooden lockers, books clutched to their chests. Through the silence we could clearly hear the muffled bray of the press outside, crushing against the doors. Every few minutes the front door cracked open and another St. Joan’s student tumbled through, hair disheveled, gasping for breath and looking hunted and afraid.

“Colleen . . . I’m Colleen, and feelin’ so loneleeeeeeeeeey! I’m Collleeeeeen, Colleen and feelin’ soooooo bluuuuueeee . . .”

I smiled, feeling swept with relief.

Deena.

Deena was here somewhere, and she was making fun of me with a Patsy Cline song. I clung to this life preserver of normalcy, moving quickly down the vacant hallway to our advisory. I could hear each of my footfalls on the flagstone.

When the door swung open, I saw that advisory was two-thirds empty.

Jennifer Crawford was resting with her forehead on her desk in the back of the classroom, her hair a newly applied, deeper shade of shocking pink.

But there was no Anjali.

No Leigh Carruthers.

No Elizabeth.

No Other Jennifer.

No Fabiana.

I tried not to feel a surge of excitement when I noticed that Fabiana wasn’t there, but I couldn’t help it. Today was the day. I could work hard, and I could scratch a few hundredths of a point closer. I resolved to start my extra-credit paper for Ms. Slater in study hall that afternoon.

Deena was there, and when she saw me, she smiled broadly and waved. I was always happy to see Deena, but today I could have run over and hugged her. So that’s what I did.

“Hey, whoa,” said Deena, laughing. “What gives? It’s just Monday.”

“I know. I’m sorry. It’s just I still haven’t been able to get Anjali on the phone, have you?”

Deena and I had texted fast and furious over the weekend, and neither of us had had any luck raising Anjali.

“No,” Deena said. “But look. If your mom were some big medical researcher, and some weird ‘Mystery Illness’ were breaking out at your school, don’t you think your mom would pull you out for a couple of days? Whether you were sick or not?”

“I guess so,” I said.

“My dad thinks that a lot of the girls they’re saying are sick are really just staying out of school as a precaution. He tried to keep me home today, too.”

“So did mine.”

“So the fact of the matter is, we don’t actually know how many of us are sick. Right? Even some of the ones who’ve been reported to the school could just be faking to get some time off.”

Deena sounded so reasonable. I felt a knot untie itself in my shoulders that I hadn’t even known was there.

“You think?” I guessed not everyone cared as much about maintaining her GPA as I did. Maybe not even Fabiana.

“Totally.”

I looked around the classroom. The bell had rung, but Father Molloy was still outside ushering students past the reporters.

“Even so,” I said, “I’d feel a lot better if she’d just text me back that she was okay. I saw Jason at my Harvard interview.”

“Jason!” Deena exclaimed. “Did he wear his grille? I hear Harvard really loves a boy with ice in his teeth.”

I smiled. “No grille. A tie with tiny ducks, but no grille. But you know, she hadn’t been texting him back, either.”

“Huh,” Deena said.

Her confidence slipped a fraction, and I didn’t like seeing the flicker of doubt in her face.

“Yeah. That’s what I thought.”

“But there must be a reasonable explanation for it. Maybe she’s finally come to her senses and dumped him.”

“They didn’t have a fight or anything, though.”

The door opened and a girl walked in, but Deena and I didn’t pay attention until she sat down next to us.

“Tzt tzt tzt HA—ha—ha—hello, girls,” said Clara.

I actually jumped in my chair.

Clara Rutherford smiled prettily at me. Her head was twitching, but it wasn’t too bad. Her ponytail looked perfect as usual. That’s hard to do when your head is always moving.

“Hey, Clara,” Deena said. “How’re you doing?”

“I’m—tzt tzt tzt—HA—okay, thanks,” she said.

She let the verbal tics come, without seeming embarrassed about it or anything. How Clara is that? She can make a Tourette’s outbreak seem cool.

“We were just talking about how many people are absent,” I said. “It’s kind of creepy, you know? It’s so quiet in here.”

Clara looked around, nodding as though her suspicions were confirmed.

“Well,” she said. “It’s—tzt tzt tzt—pretty serious, you know? Did you watch
This Is Danvers
this morning?”

Deena and I both nodded mutely.

Clara tapped the side of her nose. Her head jerked, and then she smiled.

I looked from her to Deena and back again, not sure what she meant.

Clara leaned closer. “Just you—tzt tzt tzt tzt—wait,” she said.

Clara rose from her chair like Venus stepping out of the scallop shell and drifted over to her usual desk. No one was sitting in that corner of the room, so I wasn’t sure why she wouldn’t just stay in Fabiana’s chair, with us. Deena and I stared after her for a second, and then turned to each other.

“Hey,” I said. “Where’s Emma?”

There’s one part I forgot to mention.

The upper school dean had been fired.

The truth is, I don’t remember when I heard that. I don’t specifically remember anyone telling me, either in a text or in person. I don’t remember if I got it from a teacher or one of my classmates. It was knowledge that I soaked up somewhere along the line that day, knowledge that wasn’t there when I arrived at school that Monday, and by the end of the day, I had it. It was fact.

The nun who was upper school dean was gone, and she wasn’t coming back. No more blowing into the microphone at upper school assembly. No more sitting in the office for a skirt rolled too high. She was gone.

Knowledge of her departure came with certain theories attached about why she’d been fired, and who was responsible, and what it might mean. Something about the board of trustees, which was a mysterious entity at St. Joan’s Academy. Everyone knew they existed, and everyone knew they ruled with an iron fist, but nobody’s parents seemed to be one of them. It wasn’t clear who they were, actually. Theories had always abounded that the board consisted of prominent families from Danvers, and that getting onto the board was even harder than getting into the Essex Bath and Yacht Club if you were Irish.

The phrase
didn’t get out in front of it
was bandied around a lot that day. That didn’t sound like a real reason to me, though. It sounded like a PR reason. What, exactly, was the upper school dean supposed to be in front of? A camera? The problem? The illness? The gossip? She was a watery, anxious nun who’d been a teacher before she was an administrator and who’d excelled at enforcing uniform requirements and needling the college guidance office about Ivy League acceptance rates. She wasn’t the kind of person to go on
This Is Danvers
and tell the world that the teenage girls at her exclusive private school were twitching and flopping like dying fish.

In any event, after that happened, it became less clear who was in charge. After the dean was gone, the truth grew to be this fat, amorphous, uncontrollable, invisible thing. A monster stalking the halls of St. Joan’s, which we all were hunting but couldn’t see.

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