Trauma (24 page)

Carrie stiffened.

“Don't worry,” Dr. Finley said. “I didn't get the sense Goodwin knew about your after-hours visit. And from what I'm reading here, Abington had signed himself out earlier in the day. His cardiac condition had stabilized. In fact, she said he had no more arrhythmia and his mental status had cleared dramatically. They sent him to the neuro unit and he demanded to be discharged, just like Fasciani.”

“Well then, why wasn't there any record of Abington in the med ICU?”

“That's a good point. I forgot you told me that. Let's have a look, shall we?” Dr. Finley logged into his computer. Moments later he was able to access Abington's electronic medical record. Carrie stood and looked over Dr. Finley's shoulder as he navigated a series of menus and forms displayed inside various gray-colored boxes.

Right away Carrie could see a long list of medical treatments and corresponding chargemaster codes pertaining to his care. Toward the bottom of the ledger was an entry for Abington's transfer to med ICU. It was all there. Everything the med ICU nurse could not find, including treatments, nursing notes, physician notes, and lab tests ordered. The last entry was the AMA request and signatures. Abington had not gone missing after all. He had simply wanted out.

A fresh spike of anxiety put a tight band around Carrie's chest. Could the DBS be affecting their judgment, too? The electrodes had been placed in the amygdala, that almond-shaped nucleus deep in the anterior medial temporal lobe. That section was at the heart of the brain's processing of fear and its memory. This type of DBS work was uncharted territory, and Carrie's concerns about having caused post-op complications had doubled. The need to locate the missing vets and gather the pertinent data felt even more pressing than before. She had to rule out all other possibilities before she'd willingly shoulder the blame.

“What now?” Carrie asked.

“Now we have a new vet scheduled for surgery later this week. I guess we'll have to proceed as planned, and hope these two missing guys turn up.”

Another person for me to injure?
Carrie thought.
No, thanks.

On the spot
,
Carrie made herself a promise. If she could not locate Abington and Fasciani in time, there would be no more surgeries. Simple as that. She would resign and the whole program would be cast into limbo. Her deadline was set, and would not move.

“Are you worried about infection?” Carrie asked. “What about trouble with the DBS system itself?”

“Well, of course, I'm worried,” Dr. Finley said. “On both those counts. But what do you suggest?”

“Looks like I have some days off before our next surgery. Let me see if I can find them.”

Dr. Finley gave no apparent objection. He mulled over the idea a moment, humming softly with a tip of the glasses back in his mouth. “I do think the situation warrants a bit of extreme measures, if you're willing to put in the effort.”

“What about Goodwin? Should I go speak with her?” Carrie asked. “Maybe she has some thoughts on where they might have gone.”

Dr. Finley scratched at his head. “To be honest, I'm not sure that's such a great idea,” he said. “She doesn't know you went looking after her patients.”

“What if I told her?”

“If you speak with her, what would you say?”

“I'd ask what the patients were like when they requested the AMA,” Carrie said.

Dr. Finley raised his eyebrows. “And how do you think she'll respond?”

Carrie thought a beat. “She'll want to know why I care. It's not my problem. It's none of my business.”

“And then?” Dr. Finley was goading Carrie, encouraging her to play out the scenario to its inevitable conclusion.

“She'll wonder why I haven't understood my job here.”

“And that will put us right back to square one, that being Goodwin doing her very best to get you ousted. So I'll have two missing patients and no DBS surgeon, and that might just put an end to my involvement with DARPA. I think I liked your other plan better.”

“Go looking for them?”

Dr. Finley smiled and returned a playful wink. “I know it's outside your job description.”

“I'm highly motivated,” Carrie said.
For reasons you don't even know,
she thought.

Carrie's phone buzzed inside her lab coat pocket. The sound startled her. She retrieved the device and saw a text message from David Hoffman.

I'm at the VA for an interview. Can I buy you a cup of coffee?

“Well, it's our lucky day,” Carrie said with a slight smile.

Sure. Java du Jour, 15 minutes?

She sheathed the phone back in the pocket of her lab coat.

Dr. Finley returned a curious look.

“And why's that?”

“Well, I may not be a detective, but I just got invited out to coffee by an investigative reporter.”

“Will he help you?”

“I can be pretty persuasive,” she said. “I'm going to find them, Alistair. It's a promise.”
And with luck, I'll prove it wasn't me who did anything wrong.

Leon Dixon seemed destined to loom over Carrie like a shadow she could never discharge. Her thoughts went from Dixon to Abington, and her mind flashed on Abington's terror-filled eyes during the attack. She saw him hovering over her, and felt his strong hands around her throat applying exquisite pressure.

She paused at the door, thinking. What had triggered Abington's insane outburst? She knew prior to surgery Abington had been subjected to his most traumatic war memory via virtual reality. At that moment, Carrie wanted to know as much about these vets and the DBS program as she could. Goodwin could think what she wanted, but Carrie would never willingly put herself into a silo.

“Dr. Finley?”

He turned to face her.

“I'd like to try out that virtual reality device.”

 

CHAPTER 33

Java du Jour, the quaint and cozy coffee shop a block away from the VA, was surprisingly only half full. The place was usually jumping with activity, so perhaps four thirty was a slow time. Carrie stepped inside and saw David sitting alone at one of the few wooden tables adjacent to the stone fireplace, tucked invitingly beneath the large bow window. Their eyes met. He got to his feet and held out a chair.

Nice touch,
Carrie thought. Her ex hadn't been given to such chivalrous behavior—nor were most of her contemporaries, for that matter.

“Thanks for meeting me,” he said. “Cappuccino?”

Carrie took notice of David's style of dress. He had on a blue oxford shirt, dark jeans, and polished black shoes. He was taller than she remembered, and his outfit revealed a pleasing fit and trim frame. Not a gym rat, but clearly somebody who liked to keep his body in shape. As for the coffee, Carrie usually went for the black gold, but the way David said “cappuccino” somehow made it seem like the perfect choice.

“Yeah, a cappuccino sounds great.”

Carrie took a seat and was already starting to doubt her plan when David went to place the order. Maybe it was foolish to go looking for these men, but she didn't know what else to do. She could not shake the thought that somehow the DBS, and more specifically her technique, might be behind the singularly rare complications of palinacousis and poor judgment. These conditions would surely have presented before in other PTSD patients. Since it had never been reported, Carrie could look only at the mirror for a culprit. She struggled to fit all the pieces together.

Carrie glanced up and saw David already seated, looking soothingly at her with two cups of cappuccino in front of him.

“Twenty seconds,” David said with a glint in his eyes.

“What?”

“That's how long it took for you to realize I'd come back.”

Carrie gave an embarrassed little laugh. “Sorry. I was just thinking. Excuse me.”

“No worries,” David said. “I've been accused of doing that from time to time.”

Carrie laughed again as David pushed her cappuccino across the table. She picked up the cup and the aroma came at her with force. She savored it before taking a sip. Maybe she was a cappuccino girl after all.

“I'm glad we could meet up,” David said. “To tell you the truth, I'd been meaning to give you a call. I thought we could talk about Adam, but I'd first like to find out what's going on with you.”

Carrie found something very comforting about David. The way he'd handled her brother's assault was impressive enough. But more was going on here than that. He radiated confidence, and perhaps that was what intrigued her. He seemed so comfortable in his journalistic skin that she held no reservations about confiding in him. It did not hurt that he was damn good-looking, too.

Carrie knew her work at the VA would be of great interest to David and his story, but she had a different agenda. The conversation hit a lengthy lull as Carrie contemplated how to proceed.

“Are you always silent as a lamb?” David asked playfully.

Carrie laughed a little.

“Sorry. Lost in thought again. And that was an utterly terrifying movie, by the way. Couldn't watch it.”

David pretended to look offended. “It's only one of the best.”

“What about
Titanic
?”

“Knew the ending going in. Kind of spoiled it for me,” David said with a wink and a smile. “What about
The Killing Fields
?” he asked.

“Never saw it,” Carrie admitted. “And my father and I watch old movies all the time.”

“
New York Times
journalist covering the civil war in Cambodia?” David said. “No? Doesn't register? Now that's a film after my own heart.”

“Have you always worked for—” Carrie looked somewhat embarrassed. “What's the paper again?”

“That would be the
Lowell Observer,
” David said. “And no. I'm a stringer, what you might call a freelancer. I go to places like Cambodia and Thailand, and pretty much anywhere the government would warn us against visiting.”

David went on to talk at some length about his adventures overseas and his kidnapping episode in Syria that led to his taking a job with the
Lowell Observer
. Carrie found this facet of David's personality quite intriguing. In medical school, she had done a research paper on why some people were drawn to intense, often fear-inducing thrills while others shunned the thought.

Evidence exists to suggest that dopamine stimulates the insular cortex, a portion of the cerebral cortex deep within the temporal lobe. The trait was thought to be a carryover from the earliest humans who'd risked everything to feed and shelter their families. Carrie had often caught herself analyzing her ex Ian's behavior based solely on what she imagined was going on in his brain. She was doing the same now with David, after only minutes alone together. Carrie had wished she and Ian had more adventures together, and David's active insula fascinated her.

“So enough about me,” David said. “Tell me more about your work at the VA.”

“I don't know quite where to begin,” Carrie said. She slowly circled the rock sugar swizzle stick in her cappuccino, and looked up directly into his hazel eyes. “This is pretty confidential stuff and you're a reporter.”

“Meaning you don't trust me.”

“But I'm desperate for some investigative expertise. My career may depend on it.”

“Oh, a conundrum. I love it. Do you know the term ‘deep background'?”

“No, but if you hum a few bars I can fake it.”

It took David a minute before he smiled.

“Cute,” he said.

“Old family joke.”

“Deep background means you can't be quoted in any story I might write. You're just enhancing my view of a topic.”

“This might turn into a story, but for now, I'd like to talk friend-to-friend—or maybe as colleagues on the issue of PTSD.”

David was cautious. “All right, I'm not taking notes. But if you tell me something I think I can use, I'm going to be pushy about asking for permission to use it. That's my job.”

“I understand that,” Carrie said. “And I wouldn't tell you any of this if I didn't think it might eventually turn into a story for you.”

“Go on, then,” David said.

“DARPA and the VA have launched a joint pilot program to try and cure PTSD. Not treat it, cure it.”

David's expression brightened as if a movie star had walked into the coffee shop. He leaned forward with an ardent air. “You might be my new hero,” he said. “Although my editor will think otherwise.”

Carrie pulled back. “Why is that?” she asked.

“Because if you have something really interesting here, I'll have to push out my deadline again, until you give me permission to use this. Anneke will be none too pleased.”

“Until I get permission from my boss, this is off the record,” she repeated.

“Deal,” he said.

“No, I'm being serious, David. I need your help with something and I'll trade information for assistance, but we have to do everything aboveboard. If word leaks about the program, it could jeopardize funding. A lot of vets are counting on this, my brother included.”

“Helpful is my middle name. Well, actually it's Charles.”

“We're off the record,” Carrie reminded him. “Because I need your help.”

David held up two fingers and said, “Scout's honor.”

Carrie appeared dubious. “Adam was a Boy Scout,” she said. “I think it's three fingers, and your hand is supposed to go the other way.”

David took his hand down and gave Carrie a sheepish look. “You get the point,” he said.

Carrie smiled. For whatever reason, she trusted him. “Well, I'm the surgeon responsible for inserting electrodes into the brains of vets with PTSD. We're using DBS—that's electrical deep brain stimulation—to try and eliminate the emotion from memory of what's causing the PTSD.”