She exits the messages app and slips her phone back into her pocket.
She can’t tell anyone, she realizes, because the first thing anybody will try to find out is who, or what, “Marn” means. She needs to work this out herself.
She thinks of Joe’s text, she thinks of miracles. Of what happened eight days ago on the ward. But that wasn’t a miracle, she reminds herself, because there are no miracles—there are only people and their actions.
21
DR. EMMA LEWIS
DAY 8—ABOUT MATTHEW
“Has he spoken?” I ask carefully. “At all? To you? Has he said anything?” I’m sitting across from Rhoda Madiza in the hospital canteen. I want to keep the conversation as informal as possible, since I’m sure she’s wary of talking to anyone after the media mauling she’s been through over the last week.
As far as I can tell from the medical notes, Rhoda has been the patient’s primary caregiver for the duration of his stay here, which is highly unusual in an NHS hospital. Nurses tend to stick to departments, seeing whoever whenever; they do not move around with a particular patient. But Rhoda is the only person who’s been able to communicate with the patient since his arrival. And I need to know if I’m the only one he’s spoken to yet. If anyone could tell me, it would be her.
“No, nothing. He hasn’t spoken to me. Not a peep, from day one.”
My face must register a degree of disbelief, as she’s quick to add “I tried, trust me. If he’d said anything to me, I’d have been on the phone before he’d even finished his sentence. We’ve been trying language books and YouTube videos. But no. No talking yet, just pictures. He’s got a sketchpad like the police suggested.”
Oh God, just like the Piano Man. I bet the press lapped that up.
“He draws pictures of things, the forest mainly, the views from the windows. And it’s useful if he needs something—you know, he’ll just draw a picture of it, fold it up, and hand it to me. A hot drink. A snack. Something to keep him occupied. He enjoys jigsaws. But that’s as far as we’ve got.” Rhoda smiles warmly, but there’s a hint of disappointment there. I can see she wishes she’d gotten further by now. There’s a strength of character, a zeal to her—I can understand why the patient took to her so strongly. She blows on her tea before sipping.
I nod. “I see. So, no verbal communication.”
In that case he’s spoken only to me. Interesting.
Unless, of course, I imagined it. The last time I was here so many things happened. I wasn’t thinking clearly before we left. Could coming back here be subtly weeviling its way into my mind? Has it made me paranoid? I am definitely experiencing stress being back here, but can I realistically be suffering from full-on delusions so quickly? No. He definitely spoke, but there’s surely a strong chance I might be wrong about what he said to me.
Rhoda puts her cup down.
“And how does he seem to you?” I ask next. “Aside from the silence, has he shown any signs of mental illness? Any suicidal tendencies?” She blinks at the question, not what she was expecting.
Rhoda takes a thoughtful breath before replying. “Sorry, you just threw me a bit. Doctors don’t tend to ask my medical opinion very often.” She smiles. “It’s nice.” She clears her throat and considers her answer. “Well, at first when he checked in I thought maybe he could be suffering from schizophrenia or a personality disorder. But I’ve cared for patients with both and he’s—I don’t know—much moreswitched on,if you know what I mean. He isn’t listless and he hasn’t let himself go.” She gives a little frown, suddenly embarrassed that I might think she was referring to the way he looks. How handsome he is. Strange how no one is mentioning the way he looks. How good he looks. But then, that wouldn’t be appropriate, would it? We all know that wouldn’t be appropriate.
“The doctors are saying maybe depression or manic depression. But it’s not. He seems fine most of the time, you know, happy, in spite of everything that’s happening. More levelheaded than some people who actually work here.” She gives me a quick smile.
She’s not a doctor but her insights are important. They’re based on clinical observation, and are even more important in this instance, when the patient himself can’t describe his own symptoms.
“So, would you say he’s presenting quite normally except for the lack of communication and the panic attacks he’s been having?” I stop myself, I shouldn’t have mentioned panic attacks. I don’t want to lead her answers; I need to choose my words more carefully. “Sorry, is that how you would describe them? Panic attacks?”
“No. Not attacks, exactly.” She shakes her head thoughtfully. “It’s more like…well, this will sound strange, but more like he suddenlyrememberssomething. Like he sees it in his mind’s eye. It’s not panic so much as he shifts up a gear into a…like a heightened state, I suppose.”
Okay, now we’re talking.
What she’s describing is PTSD. But, of course, I don’t want to be the one to say it. As it’s my primary hypothesis I need to be certain I’m not the one seeding it in Rhoda’s head. She needs to tell me herself in her own words.
“Heightened in what way, Rhoda?”
She gazes out into the canteen concourse, frowning.
“Like a dog in a fight, I suppose. Like he sees something and he suddenly doesn’t know whether to run or to fight. Every time I see it happen to him, that’s what it reminds me of. But then, I’m not a doctor,” she concludes self-deprecatingly.
PTSD patients relive their traumatic event; they replay it every time something triggers the memory. The same event over and over in their heads. Anything can trigger it, a face, a tone of voice, a sound. It’s called hyperarousal and it’s one of the key symptoms of PTSD.
“How is his sleeping?” I ask.
Rhoda gives a throaty laugh. “No problems in that department.” She shakes her head merrily. “He loves an afternoon nap.” But she catches herself. “But, come to think of it, he does do most of his sleeping in the day, to be honest. I hadn’t thought of that until now. I couldn’t say if he sleeps at night, I’m not here for the night shift and no one’s mentioned anything.”
