Mr. Nobody(94)

Oh my God.

My mind whirs as I try to process what he’s saying. But the Unknown Young Male case was years ago. My eyes flash across his face, his handsome features, his cheeks sprinkled with graying stubble, his tousled hair silvered at its edges. He looks so different from that picture taken two decades ago, older, more muscular, not the skinny young man in that grainy photograph, not like the man I would have imagined he’d grow into. But those eyes. I inhale sharply. I see it now, that same oddly calm gaze, as if he were somehow outside of life looking in. A spectator. It is him. All this time and I had no idea. How could I have missed it?

But there were signs, my God there were signs. I recall the first instinct I had when Peter showed me Matthew’s brain scan, that day in the Wellcome Collection museum, Matthew’s pituitary cyst, the thing that really sparked my interest in the case. The symptom that reminded me of other fugue patients I’d seen. But Matthew’s cyst wasn’t a shared symptom among several fugue patients, it was just his symptom. I had been looking at a scan of the same brain, the same patient twenty years apart.

    “That was over twenty years ago,” he continues. “I was in my twenties when I first stumbled into that hospital in New York, two black eyes, a shaved head, and no memory of who I was. Richard Groves was my consulting neuropsychiatrist.”

Of course, it was Groves’s case.

“Wait, Matthew,” I blurt. “Are you saying Dr. Groves knew who you were? He sent you to me?” My brain scrambles, desperately trying to piece things together. Could Groves really do something like this to me? I can’t believe he would knowingly endanger me.

Matthew shakes his head. “No. Groves would have ruined everything. That’s the last thing I would have wanted. I needed to make sure Groves wouldn’t come. I knew they’d call him first, so I had to wait until I knew he would be too busy to take this case himself. I did my research, I waited until he was right in the heart of something far more high profile. I know the sort of man Dr. Groves is, trust me. That’s why I chose to come here, to the coast, instead of London. I knew Groves wouldn’t come over here for this. This isn’t a big enough draw, not me, not this nowhere hospital. He’s at MIT right now, I waited until he was right in the thick of it, his AI research project. I knew he’d call you. You’d be his obvious choice. I made sure you would be. I made sure a few of your colleagues were unavailable. I made sure the job fell to you.” He catches my expression, however fleeting I hoped it would be. “They’re fine, don’t worry,” he says. “Well, almost all. Tom Lister—I think he might be—I’m not sure—” He stops short.

Oh God. I feel sick. God knows what he did to get me to the top of Groves’s list.

He planned all of this. Before he’d even met me, he read me better than I read my own patients.

“You planned all of this?” I ask, incredulous. “And you just trusted the plan would work when you woke up? How could you know you’d remember enough? How could you know you’d forget enough for it to work?”

    “As I said, there’s not a big margin for error in my life. If I don’t plan ahead, I get caught out. I don’t have the luxury of absentmindedness. I can carry certain memories from one episode to the next. Physical pain helps memories carry better. I can control the resets now too. A bang to the head is usually enough these days. A mild concussion. I almost control it. Almost. I gave myself a message, in the bathroom mirror of this house, before I smashed one of Lillian’s heavy glass ashtrays into the back of my skull. And then I walked out of the house and down to the seashore. I told myself to find you. I told myself it was so very important that I do. I told myself not to fuck it up. When I woke up wet and lost, I had your name written on my hand. A trail of messages led us both here. I left myself a parcel in the garden of the hospital—the phone I’m guessing you found in my room. I knew you’d come and find me. And here we are. I don’t want to be this way anymore, Emma. It’s getting harder every year. I need your help.”

I stare at him, incredulous. “You want me to treat you?”

“Yes,” he says simply. “I want you to fix me.”

I look into his eyes, see the years of pain, the terrible things he’s done but not done, because every awakening seems to be a new birth to him. He must live with the actions of a hundred other selves. Splintered memories from half-remembered situations.

“Can you?” he asks.

I rub my hands over my eyes and desperately try to shake off the fug of stress clouding my brain. “Let me think.”

I feel his eyes on me, expectant. I need to get my head straight if I want to come out of this alive. I voice my thoughts as they come. “Okay, so, we know from the fMRI that your memory losses are real. We’re already ahead of anyone else in diagnosis terms with that. But the cause? We need the cause.” I pause; where to even start with potential causes? I try to relax, to put myself mentally back in Cuckoo Lodge on that warm rug in front of the fire that first night as I brainstormed.

    And then I remember—that night the power went off in the lodge—I overloaded the circuit by turning on too many lights. Lesson learned. “Um, okay,” I splutter. “When I first saw your CT, Matthew, before I accepted this case, I knew I’d seen scans like yours before. I thought I’d seen other patients with growths on their pituitary glands. But now I’m realizing that those other scans were probably all you. I think that what might be happening when your ‘resets’ occur is that the pituitary cyst is bursting. Every time you get a knock to the head, or whenever the cyst becomes too large, it’s popping. Secreting fluid into surrounding structures, releasing a surge of hormones that are flooding your brain. Overloading your circuits. Those surges could be responsible for the cycles you’ve described.” I watch him take this in, following the logic of my theory to its natural conclusion.