Under the Knife

And a hopeless schizophrenic.

It had begun during his second year of med school: inappropriate outbursts in class; an abrupt academic tailspin; long-standing social connections severed without warning. A classic pattern for schizophrenia onset in an otherwise healthy, white male in his early twenties.

Is that what the psychiatrists told his parents? she’d wondered, gazing at the young man’s mother, who’d pawed the air anxiously as she’d posed her own questions. That his age of onset and initial symptoms fit the textbook definition of schizophrenia?

Would they have cared?

She doubted it. He’d been an only child and a source, no doubt, of great pride: graduation with distinction from an Ivy League college, acceptance into a top-notch med school. How must they have felt, watching all their hopes trampled underneath the weight of his paranoid delusions?

His pathology focused on his firm belief that he was Moses—or, rather, a modern version of Moses. He’d explained to Rita that Moses’s second coming had been foretold in Scripture, and that he was Moses reborn. Rita had never heard of a second coming for Moses and told him as much, so he’d pulled a dog-eared copy of the Old Testament from his back pocket and quoted to her passages marked in four different shades of colored highlighter and annotated with dense scrawls in the margins.

His mother had smiled tiredly and twisted her hands.

He hadn’t ranted, or raved. He’d made his case with the eloquence of a skilled trial lawyer. And he’d made perfect sense. By the end of the interview, it made her question, if only a little, if he was right, and everyone else (including herself) was wrong.

I know you don’t believe me, he’d told her, his green eyes drilling into hers. I don’t care. I don’t need you to believe in me.

Rita had looked at the man’s mother, who’d nodded and raised her hands in a noncommittal gesture. Indulgence? Capitulation? Rita couldn’t tell.

His surgery had gone well, and he’d gotten better. She hadn’t seen Moses for a long time. She’d wondered sometimes how he was doing, and what it was like to live in his self-formulated version of reality.

Well, now maybe she was finding out.

“Dr. Wu?”

Or was she? The voice in her head calling itself Morgan Finney sounded so real, and exactly how she remembered him. How could it be a hallucination? It didn’t make sense.

Or did it? After all, that was the whole point of a delusion: It was completely real to the person suffering from it. Maybe she was developing schizophrenia, like Moses, a disease that would slowly choke her off from reality and from everyone she cared about.

Darcy.

Spencer.

The thought terrified her.

Waking up naked in an operating room, with no memory of how I got there.

Now a voice talking to me in my head.

Is this how psychosis starts for me?

Is this how it started for Moses?

Maybe, but …

But she knew schizophrenia was unlikely in her case. It could, she suppose, be some type of early-onset dementia, like Alzheimer’s. But she didn’t think Alzheimer’s usually gave people these symptoms, at least in its early stages.

A holdover from last night, maybe? A year later, her experience with Morgan Finney still pressed heavily on her conscience; and his voice, surfacing with last night’s flotsam, implicated her remorse in whatever was going on.

Delirium.

That’s what it must be, she decided. An acute change in mental state, typically caused by fevers, or surgery, or intoxication—

—(alcohol, couldn’t possibly be alcohol)—

—or some other type of stress on the body.

She saw it often in her patients after surgery, especially the elderly ones. At night, it happened with enough regularity that doctors and nurses had an informal term for it: sun downing.

“Dr. Wu?”

Delirium was common. Delirium wasn’t serious. Most important, delirium was temporary.

Delirium. Okay. So, now what do I do?

Diagnosis was the first step, she reasoned. Physician, heal thyself. That’s what Spencer liked to say.

(Spencer—wish he were here)

It was just a matter of convincing herself that she was chatting with an errant series of electrical signals in her brain rather than a real person.

All in my head. Not real. Just delirium.

She took a few deep, controlled breaths. Her breathing rate slowed—not quite to normal, but closer to normal. The shaking in her body continued but with less violence.

“Dr. Wu.”

Not happening. Delirium.

“You can still hear me, can’t you? Answer me, please.”

All in my head.

“Dr. Wu.”

All in my head.

“We need to talk about my wife. Jenny Finney.”

She opened her eyes and stared at her hands, still gripping the sides of the sink. Her knuckles had turned bone white. Her breathing sped back up; her heart hammered at the back of her sternum, as if trying to break free of her chest.

Kelly Parsons's books