by Meg Gardiner
Officer Paterson lurked by the back doors, baby face puckering with suspicion. His left hand ran back and forth over the handcuffs on his utility belt.
Jo shook her head at him. “You can’t cuff a seizure patient.”
“One hand to the stretcher.”
“No. We need to be able to maneuver him. If he vomits we have to keep him from inhaling it, or he could die.”
“He’s a loose cannon. And he’s going to be under arrest,” Paterson said.
“If you think you can Mirandize him in this condition, you’re the one who needs sectioning.”
Kanan groaned. The paramedic said, “Ian, can you hear me?”
A gust of wind whistled over the ambulance and flung rain across the windows. Kanan’s eyes woozed open.
Jo took his hand. “What’s your name?”
He blinked as though trying to focus. “Ian Kanan.”
His gaze cleared. His pupils were equal, reactive to light, and had a wolfish glow. Jo felt a prickle along the back of her neck.
On the jetliner, Kanan had dropped Paterson to his knees with the speed of a train wreck. Despite her spirited defense of him, Jo didn’t want Kanan to do worse to anybody in the ambulance.
“You had a seizure. Lie still,” she said.
“I what?”
“Do you have epilepsy?”
He frowned. “That’s a crazy question.”
Jo was board-certified in both psychiatry and neurology, but as a forensic psychiatrist, her work dealt almost exclusively with history. When the police or medical examiner couldn’t determine why somebody had died, they called her to perform a psychological autopsy on the victim. She spent her days deciphering the countless ways the pressures of the world could end a person’s life.
Now she had a live case, a man with a huge and unidentified problem, who she sensed might turn on her at any moment.
“Do you recall hitting your head?” she said.
“No.” Hands on his jeans pockets. “Where’s my phone?”
“I have it.”
“I need to make a call.” His gaze zinged to Jo. “You’re American? Did the embassy send you?” He looked around the ambulance and his face tightened with alarm. “Where am I?”
“On your way to San Francisco General Hospital. Are you on medication?”
“No. San Francisco?” He tried to sit up. “Who are you?”
“Dr. Beckett.” She pressed a hand on his chest. “You were in southern Africa. Are you taking antimalarial drugs?”
“Quinine? Sure—Tanqueray and tonic.”
“Lariam?”
Lariam could have severe side effects, including seizures and psychosis.
“No,” he said.
“What were you doing in South Africa?”
His pale eyes looked eerie. She couldn’t tell why he hesitated. But whether he was confused or calculating, it took him ten full seconds to say, “Business trip.”
The wind rattled the ambulance and a burst of rain sprayed the window. Jo didn’t tell Kanan the two reasons they were heading to San Francisco General—it was the area’s only level-one trauma center and San Francisco’s designated evaluation facility for patients placed on psychiatric hold. Kanan glanced around. His gaze reached Officer Paterson and stuck.
Jaw tightening, he lurched against the straps on the gurney. “My family. Did something—”
“Hey.” Paterson moved instantly to Kanan’s side. The paramedic pressed Kanan back against the pillow.
Jo put a hand on his arm. “What about your family, Mr. Kanan?”
For a second he looked fearfully bewildered. Then he blinked and forcibly slowed his breathing. “What happened to me?” He looked at Paterson. “Am I under arrest?”
Paterson said, “Not yet. But you wanted to get off your flight so bad, you tried to jump out while the plane was rolling.”
“Did we crash?” He looked around the ambulance. “Did the plane go down?”
Jo gazed at him, puzzled. In the space of two minutes Kanan had gone from unconscious to intensely alert, articulate, strong, and confused.
“Mr. Kanan—”
“Ian.”
“Ian, I’m a psychiatrist. The police called me to the airport to evaluate you because—”
“You think I’m nuts?”
“I think you have a head injury.”
He stared at her for a long moment. A look of pain, and understanding, seemed to jolt him. His breathing became choppy. “They’ll say it’s self-inflicted.”
The cold trickle ran down Jo’s back again. “Your injury?”
“It’s over, isn’t it? I failed.”
“Failed at what?”
He squeezed his eyes shut. For a second, Jo thought he was fighting back tears. Paterson’s radio guttered. The sound caught Kanan’s ear. He opened his eyes and looked at the young cop. And as Jo watched, Kanan’s face relaxed. He blinked, breathed deeply, and turned to her, eyes shining and untroubled.
“Hey. What’s going on?”
“We’re taking you to the hospital.”
Puzzlement. “Why?”
Slowly, Jo said, “Do you recall what I told you a minute ago?”
“No. Who are you?”
The paramedic wrapped her stethoscope around her neck. “Man.”
Paterson braced his hand against the wall of the ambulance. “What is it?”
Jo felt grim. “Amnesia.”
She looked at Kanan, thinking, And not the good kind.
Seth sat on the floor with his back against the frame of his bed. He was quiet. He’d been quiet for days. The men had told him to keep his mouth shut.
But inside, his mind was full of noise, like feedback from an amplifier. Because he hadn’t kept his mouth shut when the men dragged him into the park. He had talked. He’d told them about his dad.
His stomach hurt. It hurt like a fist was squeezing it, a fist made of wire. He wrapped his arms around his shins and put his head down on his knees.
My dad’s gone and you’ll never catch up with him. He’s in the Middle fucking East and if you think you . . .
He’d said it to scare them. So they’d know his dad wasn’t like some tour guide who herded people around on vacation. He was a mean mofo who could take on the Middle East, alone. But why had he said it? Why why why . . .
The room was dim and the floor was hard. That was okay—he wanted it that way, preferred the hard floor to the creaking bed. The hard floor forced him to stay alert, kept him thinking.
What was he going to do? The men—the human hot dog and the brick with acne and the Mickey Mouse rapper—had told him the consequences of not keeping his mouth shut. Of trying to tell anybody at all. They’d been specific and elaborate. We’ll demonstrate on your dog. Then we’ll do it to your mom.
He squeezed his eyes closed and put his hands over his ears, trying to shut out the memory.
Whiskey was okay for now. Seth heard the dog in the kitchen, lapping water from the bowl. But Whiskey wasn’t safe, and neither was Seth’s mom. The men had Seth where they wanted him. And they could get to him without warning, at any moment.
The wire fist tightened around his stomach and then grabbed his throat. He had to do something. He had to figure a way out. But how? He was trapped.
Neurologist Rick Simioni found Jo in the hospital hallway. His face was a beacon of alarm.
“Was I right?” Jo said.
“Anterograde amnesia. Unquestionably.”
Simioni’s dress shirt and lab coat were swan white. He smoothed his tie. “Kanan knows who he is. Remembers everything about himself, his life, and the world, right up till the beginning of the flight today.”
“Then?” Jo said.
“Blank.”
Mild amnesia was common following a head injury. But it was often limited and transient—as patients improve, so could their memories. Not, however, in Ian Kanan’s case.
“Nothing new sinks in?” Jo said.
“It hits, sticks for a
while, and slides off. His brain receives new information but isn’t absorbing it.”
“How long can he retain information before he forgets it?”
“Five, six minutes.”
“What happens?”
“He doesn’t lose consciousness. Doesn’t have a seizure—EEG shows no ictal patterns. But if his attention wanders for very long, all the information he’s gathered simply evaporates.”
“Short-term memory loss,” Jo said.
“His vision, hearing, and speech are perfect. You tested him and noticed no muscle weakness . . .”
“He was post-ictal with a Glasgow Coma Score of eleven. He’d suffered one partial complex seizure, one grand mal.”
The news was grim. Short-term memory loss—anterograde amnesia—didn’t mean you forgot things for a short while. It meant you couldn’t form new memories. And it was both a symptom and a result of catastrophic brain injury.
“What’s causing it?”
“You need to see the MRI,” Simioni said.
In the radiology suite, light boxes hummed on the walls. A PET scan glowed on a cinema-display computer screen, somebody’s lungs and liver imaged as Timothy Leary might have hallucinated them, rendered in crimson, cobalt, and screaming yellow.
By contrast, the black-and-white MRI scan of Kanan’s brain looked dull. And devastating.
The radiologist was a precise man from Hyderabad named Chakrabarti who had little hair and expressed less emotion. He acknowledged Jo with an economical nod.
Jo approached the screen and examined the cross-sectional slice of Ian Kanan’s head. Slowly, quietly, she said, “What is that?”
Chakrabarti touched the image with his index finger. “A lesion.”
“Of the medial temporal lobes. I see. What’s that?”
Deep within Kanan’s brain, where the gray matter of the medial temporal lobes should have been, was a dark fuzzy space.
“There’s more on the next cross section,” Chakrabarti said.
“More sounds bad,” Jo said.
“It is.” He typed on the keyboard. “Mr. Kanan had difficulty staying still in the scanner. He was quite agitated. He would lie calmly for a minute, then forget where he was and try to climb out, yelling, ‘What the hell is this?’”
“Like his brain kept resetting to Start?” Jo said.
“Groundhog Day,” Simioni said.
Chakrabarti brought up a new image. Simioni took a breath. Jo felt a flicker of nausea.
Kanan’s medial temporal lobes seemed to be etched with black strands. It looked as though somebody had scratched lines in the image with a rusty needle.
“Those . . . tendrils—are they causing the memory loss?” Jo said.
Simioni pointed with a pen. “The medial temporal lobe, and particularly the hippocampus, is the part of the brain that encodes facts and events into memory. So I’d say yes.”
“What is it?”
Chakrabarti said, “I don’t know. It’s not a bleed. Does he remember suffering head trauma?”
“He says no,” Jo said. “Is that viral? Bacterial?”
The two men stared at the screen but had no answers. Simioni said, “Have you reached his wife?”
“No answer. Left messages,” Jo said.
They stared some more. Simioni turned. “Let’s tell him.”
5
The black van idled on the driveway, waiting while the garage door opened. Rain sliced across the windshield. The door droned up and the van pulled in.
Alan Murdock shut off the engine. “Unload the supplies.”
Vance Whittleburg hopped out, hitched up the saggy jeans that hung halfway down his behind, and began shifting grocery bags and boxes of ammunition into the house. Even carrying sodas and ketchup, he made sure to strut like the gangbanger he dreamed of being.
Murdock put the garage door back down. This was a neglected rental house in Mountain View, off San Antonio Road. It was hard by the railroad tracks and hardly the only home on the street with a weedy lawn and garbage cans in which stray dogs foraged. The street didn’t have a neighborhood watch. It was a place where nobody cared. And nobody would take notice of temporary tenants coming and going.
The door from the house opened and Ken Meiring pushed into the garage. Gauze circled his overmuscled forearm, covering the bloody bite Seth Kanan’s dog had inflicted. Ken’s face was red, all the way into his crew cut. The acne that ringed his neck stood out like plague buboes. If the guy didn’t lose some weight and cut down his steroid dosage, he was going to give himself a stroke.
Murdock walked to a cabinet along the wall. “Got news that’ll lower your blood pressure.”
“Go ahead, Dirty Harry—make my goddamned day.”
Murdock ignored the mockery. So he wasn’t a San Francisco cop anymore—he was entitled to wear the SFPD T-shirt until it fell apart.
“You don’t complain about the parting gifts I brought with me from the department,” he said.
He opened the cabinet. It was stocked with goodies he had liberated from police custody, including plastic handcuffs, CS gas, and a handy nightstick. He set a box of nine-millimeter ammunition inside, next to his pistol.
Ken grunted. “Fine, sprinkle pixie dust on my mood.”
“He’s here.”
Ken’s eyebrows rose.
“Came in on a Virgin Atlantic flight this morning.” Murdock smiled, exposing his small teeth. “We’re back in business.”
“You positive?”
Outside, the Caltrain lumbered down the tracks. The bare lightbulb that hung from the roof of the garage jittered. Ken stared at Murdock like he was watching the light reflect off Murdock’s shaven head.
Murdock’s smile receded. “You should really have more faith in me, Ken. The deal is back on track.”
“When?”
Murdock locked the cabinet. “Patience.”
“Patience is dangerous. Kanan is a wild card.”
Murdock turned, stepped close, and lowered his voice. “But we hold all the aces.”
Ken slowly, gradually, nodded. Murdock stepped back.
“You need to expand your horizons,” he said. “This isn’t like hijacking a truck full of restricted electronic gear. This is the big leagues. Mergers and acquisitions, Ken.”
Ken looked unconvinced.
“Acquisition, anyhow,” Murdock said. He took out his phone. “And we have a monetary wizard setting up the next phase.”
“That who you calling?”
Murdock smiled again. His gums made a wet sound. “The sales department.”
As he listened to the phone ring, he slapped Ken on the back. “Get yourself geared up. Kanan’s bringing back liquid lightning. Enough to shock the whole world.”
Ken eyed him. “Maybe. But we have to get it from him.”
Jo walked toward the E.R. with Simioni, flipping through Ian Kanan’s passport and wallet. The passport showed visits to Jordan, Israel, South Africa, Zimbabwe, and Zambia, all stamped within the past two weeks. His driver’s license listed a home address near Golden Gate Park. A corporate photo I.D. said IAN KANAN, CHIRA-SAYF INCORPORATED, SANTA CLARA. Silicon Valley, she suspected.
Simioni had a printout of Kanan’s MRI. Jo knew it would hit Kanan like a hammer blow.
As a forensic psychiatrist, she mercifully avoided dropping doom on people. She analyzed the dead for the police—she didn’t break bad news. Not anymore. Not since the moment she’d told her mother- and father-in-law their son was dead.
She knocked and went through the door into the E.R. room. Kanan was pacing by the window, phone pressed to his ear. He was dressed in his street clothes. He looked like a penned animal.
“Misty, I’m back, babe. I’m on my way.”
The door clicked shut. Kanan turned, saw Jo and Simioni, and hung up. He extended his hand. “Ian Kanan. Doc, give me the word—what’s happening? Because I need to leave.”
Simioni hesitated, comprehended that Kanan didn’t remember him, and shook. �
��Rick Simioni. I’m the neurologist who sent you for the MRI.”
Kanan frowned. “MRI?”
Jo offered her hand. “I’m Dr. Beckett. You suffered two seizures and have a severe head injury. It’s affecting your memory.”
“What are you talking about? My memory’s fine.”
“Do you recognize me?”
His gaze slid smoothly up her body. It took in her athletic physique, her dark eyes, her long brown curls. It stopped at the laminated hospital I.D. clipped to her sweater.
“No. Should I?” he said.
“I’m a psychiatrist. I brought you here from the airport. I’ve been with you for nearly two hours.”
“I don’t remem—” His face dropped. In the sudden quiet, a lash of rain hit the window. “I have amnesia?”
“Yes.”
Simioni said, “A particular kind called anterograde amnesia. You haven’t lost old memories. But something has damaged the part of your brain that forms new ones.”
“‘Something.’ What?”
“We’re investigating that.”
“Don’t you know?”
“Not yet. We need your history. Talk us through what you were doing in Africa and the Middle East.”
Kanan held back, his face registering disbelief at not yet. Finally he said, “Business trip.”
“What do you do, Mr. Kanan?”
“Ian. I’m a security consultant for a tech company in Santa Clara.”
Jo had guessed right. “What does your job involve?”
“I help the company keep hold of its equipment and its people.”
“How?”
He raised a hand. “Stop. You’re saying I have a head injury and keep forgetting everything?”
“Yes. And help us. You just came back from the developing world. What does your job involve?”
He hesitated and then seemed to calm himself. “When company personnel head overseas, I go along to scout dicey situations. I ride herd on engineers and executives. Make sure absentminded programmers don’t leave their laptops on a train and that nobody plays away from home in a way that could get them hurt.”
