Mr. Nobody – Catherine Steadman

If the car crashed at this speed the impact wouldn’t be enough to kill us instantly. Which you might think is a good thing. But it’s not. The one thing worse than dying on impact is not quite dying on impact. Trust me, I know, I’m a doctor. And now that I’m thinking about it—I’d be genuinely surprised if this rental car even has airbags. Sparkling snow-covered fields hurtle by at speed. White-dusted hedgerows, sheep, ruts, and ditches—the background of my childhood, a winter blur of pastoral England. Crisp sunlight high in a rich cobalt sky. I flash a look to the driver—face locked in concentration—as the brakes squeal and we change down a gear, grinding into another blind corner. All I can do is will us on and hope we make it in time. Before my patient does something terrible. We accelerate out of the bend, the drag of it pulling us sideways, perilously close to the narrow lane’s now forest-lined edges. I let the imagined consequences of a car crash flash through my mind: I see the fragile sweetmeat of our neocortexes smashing forward at a hundred miles per hour into a quarter of an inch of solid skull bone. I hear the thick packed-meat sound of our heads connecting with the dark matte-gray plastic of the dashboard and then, instantly, whiplashing back into our headrests with blunt force.

A double cranial impact. War on two fronts. The reason armies get defeated. That delicate gray matter that we all take for granted, the part of our bodies that makes us us. All that we are, crashing forward and backward at high velocity into our own skulls. Frontal, parietal, and occipital blunt-force trauma. Massive hemorrhaging, internal bleeding, bruising, and atrophy. Dead tissue. The brain damaged beyond repair. Who we were: gone.

And then a new thought tops those terrifying images: Even if we somehow managed to survive all that, I’m probably the only person who would be able to fix us afterward. I’m the only doctor with relevant clinical experience in a hundred-mile radius. The irony smarts. We swerve tight around another bend, branches jab into the broken window next to me, and I dodge farther into the car. I need to focus. I squeeze my bleeding fist, hard, letting the pain thunder through me. Focus. No more mistakes. This is all my fault. Everything that’s happened.

I could have stopped all of this if I’d only done better, looked harder. If I’d picked up on certain things, if I’d seen the signs. My eyes flick up to the road ahead of us. I see it fast approaching on the horizon: the lay-by, the path that leads directly down to the sea. That wild expanse of water. That’s where he’ll be. If we’re not too late. There was another time, long ago, when I wasn’t focused either. I missed the signs then too and I let something very bad happen. But not this time.

I promise. This time will be different. So different. This time I will stop something awful from happening. I will fix it this time. And, if I’m brutally honest with myself, perhaps this is exactly what I’ve always wanted it to come to. A chance to fix things this time around. I mean, no one becomes a psychiatrist by accident. 1 THE MAN DAY 1 The bright glare of light as the soft skin of two eyelids part. A body sprawled on the sand.

The fast flutter of eyelashes as awareness blossoms within and, just like that, he’s awake. Consciousness floods through him; he feels the skin of his cheek pressed against the brittle cold of the beach. Confusion. Sounds of the sea. Waves crash and pull back, the pop and shhh. It’s early morning in January. A British beach in the depths of winter. Miles of golden-white Norfolk shore with the crisp dawn light throwing everything into high definition. Wind-borne sand grains blow in architectural ripples across the flats straight into the man’s unprotected face. He squeezes his eyes tight shut against the sting of it.

A hot throb of pain crests sharply inside his skull, and the papery skin around his eyes creases deeper, his forehead puckering, as he flinches from it. The unanticipated pang lengthens, stretching itself inside his head, almost too much to take. A sharp gasp of breath and the pain stabs back, harder. His hot exhale drifting away in the cold sea wind. He tries to relax into the pain, letting the wave of agony wash through him, over him. And it seems to work; the feeling begins to still within him. He lies there limp on the sand for what seems like an eternity, letting the restless throb slowly quiet. He hurts everywhere. The ghost of a thought drifts through his mind. Where am I? It floats gossamer thin in the air, fluttering just beyond his reach.

He takes another cautious breath and tentatively tries to raise his head, careful not to stir the lurking pain nestling in his skull. Damp sand, like candied sugar crystals, sticks to his stubbled cheek as he shifts his weight up onto aching forearms, cautiously testing the limit of their strength as he squints out into the morning light. How did I get here? Gulls skip along the sand as he searches the landscape for an answer—but nothing here looks familiar. What happened? He takes in the silent forest that backs the beach, its dark canopy beyond unreadable. No clues. No hook to hang understanding on. Okay. Where was I before I was here? He looks up at the haunting gray vault of winter sky hanging overhead and wonders if he might be dreaming. If he might be in bed, safe back at home, wherever that might be. But the clouds look back, heavy and full of rain.

He shivers. It is only now that he notices his clothes are wet, their sodden fabric clammy against his skin. He shudders, cold to his bones. He must move, he knows that much, he must get warm, or risk freezing in this weather. He needs shelter. He looks back toward the trees that skirt the beach. The wind whips sharp needles of sand into his skin, tiny pinpricks against his numbed flesh. Struggling clumsily to his feet, he begins to process the extent of his injuries as each muscle is asked to move. Upright, he hesitates. He turns in a small circle, checking the sand around where he lay.

A natural instinct telling him to look, nothing more. To look for things he may have lost, belongings left behind, although what those would be he does not know. But then, he must have some belongings, mustn’t he? He thinks for a second before jabbing his numb hands into his wet pockets. There must be something. His pockets are empty. He is momentarily flummoxed into inaction. Wait. What the hell is going on? He runs a quick hand through his damp hair, trying to grapple back control of the situation, trying to wrangle the logic of it. He must remember something, surely? His hand skims the back of his head, and the throb of agony at the base of his skull washes over him again, pinching tight. He sucks in a sharp breath and whips back his hand to see the dark smear on his fingers.

Blood. He squeezes his eyes shut, breathing through the pain as it slowly subsides. When he opens his eyes, he notices something, on the other side of his hand. He turns his palm over and there on the back in blue ink—writing. A faint ink mark faded by seawater, a word. He stares down at it, perplexed. Strange. What does it mean? The word dances on the tip of his recollection, the answer so close he could almost reach out and grasp it. But it rolls away, out of reach, evasive, mercurial. Like the bright filaments that play on the inside of his eyelids each time he closes them.

He shudders, the cold snapping him back to the immediate situation. He needs shelter. It will come back, he tells himself. He gives himself a brisk shake and starts to walk inland purposefully. Wet sand squelches up between his bare toes as he walks, cold and thick like poured concrete. All the while the tendrils of his brain search, delicately, for something to cling onto. What is the last thing you remember? Silence. The sound of sea-foam bubbling and popping as it dries in the wind. His thoughts roll on. How did I end up here? Did something happen to me? Suddenly the realization hits him.

He stops abruptly. Wait. Who am I? What’s my name? He stands frozen, his short brown hair tousled by the wind. His mind races. Where am I from? He can’t remember. He looks down quickly at the blood smear across his hand. The word on the other side. The panic rising now with incredible speed. Why can’t I remember? Why can’t I remember my name? The weight of what this means bears down on him with each cold snatched breath he takes. Fear pumping through him, primal and quickening.

Oh God. It’s all gone. His world shrinks to a pinhead and then dilates so wide, suddenly terrifyingly borderless. He has no edges anymore. Who is he? He has no self. He feels the panic roaring inside him, escalating, his heart tripping faster. His mind frantically searches for something—anything—to grab hold of, his eyes wildly scanning the landscape around him. But there is no escape from it, the void. He is here and there is no before. There are no answers.

Thoughts thrumming, he fumbles to check his empty pockets again. Nothing. No ID, no phone, no wallet, no keys, nothing with a name on it. No way to find out. He tries to slow his breathing, to stay calm. He tries to think clearly. If something has happened, someone will find me. Someone will find me and take me back to where I was before. I’ll remember. Someone will know me.

And everything will come back. It will be okay. I just need to find someone. He looks up, eyes finding the forest again, and the indent of a path. He sets off, his pace frenetic. He needs to find someone. Wait. He stops abruptly again. A jolt of self-preservation. Maybe you’re out here alone for a reason.

He studies the word written on his hand. It is all he has to go on but it is not enough. Is it a reminder? A warning? Perhaps something very bad has happened? He thinks of his head wound. If he was attacked, being found wouldn’t be the best idea, at least until he knows what happened, or who he is. He could still be in danger. It’s impossible to tell yet. He commits the word on his hand to memory and then he rubs the ink away against his wet trousers until the mark is gone. He’ll remember it. Best to cover the evidence in case he’s found. A thought flexes itself deep inside his head, awakening.

Something creeping on the edge of recollection, a memory, or the ghost of one. Just out of reach. Someone saying something to him. If he could only remember. Someone telling him something important, so important. Something he needed to remember. Something he had to do. Suddenly it comes to him. Don’t fuck it up. A memory.

That’s what they had told him, but who exactly he can’t recall. He grasps at the memory. Its warning, the threat, so strong and clear. Don’t fuck it up. Don’t fuck what up? Think. Think. He chases the thought but it disappears out of sight. He notices his own bare feet beneath him on the sand. A thought surfaces; he remembers reading once that suicides often remove their shoes before killing themselves. Is he a suicide? How he knows the fact about the shoes he does not know.

Did he take off his shoes, did he leave them, and his things, and his life, in a tidy pile somewhere? Abandoned? But why would he do that? He doesn’t feel sad. He doesn’t feel like the kind of person who would kill himself. But then, maybe nobody ever does? Don’t fuck it up is all he has to go on. But what if he already has? Another memory flashes out of the darkness. A burst of something. Someone telling him. You need to find her. Find her? He straightens. It’s a crystal-clear directive. A purpose.

Is that why I’m here? To find someone? Who is she to me? He thinks of the word he removed from the back of his hand, and blinks. Why do I need to find her? The memory is what it is. There is no more. Whoever she is, he needs to find her. They must have said more. He tries to force the memory but the throb awakens deep at the base of his skull. He lets the thought go. All he knows is he was told by someone, instructed by someone…he can’t remember who told him, or what they sounded like, or their face. But he trusted them, he knows that much. How can he find her—this woman—if he doesn’t know who or what he’s looking for? A sound in the distance breaks the man’s concentration.

A voice calling out. Instinctively he turns toward the forest, his heart pounding. There is no one there. The wind perhaps, though it sounded more like a person calling—a name. It came from the forest, a voice carrying over the wind. He stares long after the sound has gone. Certain he heard it. Someone. But there is no one. He turns back to the water.

The sound comes again. This time from immediately behind him. A voice. He freezes. There is someone standing right behind him. He turns slowly on the wet sand. Someone is there. A young woman. She wasn’t there before. Where did she come from? He blinks, trying desperately to make sense of what is happening.

His thoughts racing. She wasn’t there before, was she? Is this her? Is she the one I need to find? But in the same instant he knows. It isn’t her. He studies her as she stares back at him. She is talking to him, her expression confused, concerned, as if she may have been speaking for a while. She’s saying something, words he can’t quite understand; her language garbled, the sense not apparent. His head throbs deeply. But there is a look in her eyes and everything he needs to know is in that look. He’s safe for now. That’s as clear to him as the sand, and the cold, and the bright high-vis yellow of the woman’s coat.

And suddenly, for a heartbeat, he understands exactly what is happening to him. That this has happened so many times before, this exact scene, it’s a loop he can’t ever escape. And he briefly understands a tiny part of what he needs to do next. And with that knowledge panic, in a giant wave, crests over him. The bright pinch of pain inside his skull explodes to life and he crumples onto the sand. 2 DR. EMMA LEWIS DAY 6—LONDON This is my pager. There are many like it but this one is mine. Like a song I can’t shake, or an advert jingle, it runs through my head as I jog to Ward 10, the pager vibrating deep in my pocket, in time. This is my pager.

There are many like it but this one is mine. I know, as mantras go, it’s not original. But to be fair to all concerned, it only started out as a joke at medical school. And the joke became a habit and, weirdly, these days, it does actually calm me down. That’s the thing about habits. They’re comforting. They’re hard to kick. Like smoking. And I don’t do that one these days. I’m not that kind of girl anymore.

I’m not any kind of girl anymore—I’m a thirty-year-old woman. I’m the lead consultant neuropsychiatrist in a busy London hospital. If I ever actually left work, it wouldn’t be “Ms.” on my restaurant reservation, it would be “Dr.” If I ever had time off to go to restaurants, that is. You have to watch out for habits, when twelve-hour shifts slide effortlessly into twenty-four-hour shifts. But as habits go, there’s nothing wrong with mantras. God, I need a cigarette. When I get to Ward 10, Mr. Davidson is yelling at the top of his seventy-eight-year-old lungs.

Which has the combined effect of being both disturbing and at the same time strangely sweet. But perhaps the main takeaway is the sheer volume. A visiting couple and a porter stand stock-still in the hallway, heads cocked toward the commotion coming from his room. Their expressions settle when they clock my doctor ID lanyard; it tends to have that effect. Over the years, I’ve noticed the doctor’s lanyard tends to illicit either relief or apprehension. I flick off my angry pager and plop it back in its pocket. Doctors are some of the only people left in the world you’re likely to see carrying pagers. We still use them because they’re reliable. Unlike mobile phones, pagers don’t have dead zones; they work everywhere, even on the heavily insulated X-ray wards of a hospital. And they don’t run out of battery after a few hours; pagers can run for over a week between charges.

And they’re durable. Throw them as hard as you possibly can against a concrete wall while crying, for example, and they just won’t die. When I enter the room in question I find a junior doctor, two nurses, and Mr. Davidson’s forty-year-old son standing impotently by as the bedbound Mr. Davidson continues to shout, his voice quavering at the assembled group, tears rolling softly down his tired, crinkly face. All heads turn to me as I enter. The lanyard does its thing. The junior doctor throws me an imploring look, his expression telling me he’d be more than happy for me to take over. I give him a nod. This is, after all, why they paged me.

Mr. Davidson’s screaming and the general vibe in the room make it clear that an impasse has been reached. Mr. Davidson doesn’t want to be touched or manhandled. “Good morning, Mr. Davidson,” I say brightly, trying to top his energy. There’s a slight break in the rhythm of his yells. He looks at me, surprised, and I continue with his full attention. “My name is Dr. Lewis.

Do you remember me, Mr. Davidson? I’m your doctor. Emma Lewis.” I give him a reassuring smile as if to say, Of course you remember me, we’re old friends. He clings to my smile, seduced from his train of thought, and his yelling finally subsides. He gives me a tentative nod. Not fully invested in the idea that we know each other just yet. “Can you tell me what’s wrong, Mr. Davidson?” His tearstained face uncrumples as he struggles to unpick my question. “Are you in pain, Mr.

Davidson? Whereabouts do you feel it?” I nudge him on. He looks away from me now, toward the window. It’s hard to tell to what extent Mr. Davidson recognizes me, if he does at all. Howard Davidson has problems accessing and storing memory; I’ve been treating him for three weeks, ever since he was admitted. Recognition is a complex neurological process and humans are very, very good at masking the absence of it. People adapt around memory losses. They rely on other things—visual cues, social cues—they get good at reading people, situations; they find ways around things until an answer presents itself. But regardless of whether Howard Davidson recognizes me, he trusts me, he’s stopped shouting, and that is definitely progress. I approach his bed cautiously.

He turns to look up at me with his big wet eyes, curious, and exhausted. I gently place a hand on his arm as reassurance. He peers down at my hand, his chest rising and falling as he fights to get his breath back to normal. He doesn’t pull away from my touch, he doesn’t lash out. Patients with memory disorders can often become uncharacteristically aggressive, physically violent, but when his gaze floats back up to me it isn’t hostile, it’s entreating. “Where exactly are you feeling the pain, Mr. Davidson?” I ask again, softly. He takes in air in great heaves, not a huge surprise—he’s been yelling continuously at the top of his voice for quite a while to a confused and frankly deeply concerned audience. As he stares up at me, gulping in snatched breaths, he looks like a man lost in a foreign country. He taps his chest.

His heart. That’s my answer. The answer to my question. That’s where he feels the pain: in his heart. I nod and give his arm another gentle squeeze. I understand. Mr. Davidson nods back solemnly, and promptly bursts into a cataclysm of coughs. There’s nothing wrong with his heart—well, not physically, anyway. What’s physically wrong with Howard Davidson is his brain.

As far as Howard is concerned he’s a thirtytwo-year-old man trapped inside the body of a seventy-eight-year-old. He woke up three weeks ago with no memory of the last forty-six years of his life. In his mind he left his house in 1973 and woke up here, an old man. What’s wrong with Howard Davidson is visible only on a scan. Large sections of his neocortex have atrophied, died. All the memories stored in those areas are gone; a huge portion of his life, to his mind, never happened. Three weeks ago, he was fine, pottering around his garden, walking his dog, reading, deep in the flow of his own life, enjoying his retirement, but that old man is gone now. Howard Davidson was found wandering down the middle of a four-lane highway near Shepherd’s Bush, and brought to the emergency room. After we ascertained from his relatives that he had no history of Alzheimer’s, that up until that morning he had apparently been quite happily enjoying the life of a retired MP, an MRI scan was taken. The atrophy present in the brain scan was found to be indicative of vascular dementia, specifically single-infarct dementia.

A single stroke had instantly killed off a massive portion of his hippocampus. Forty-six years of life and memories erased in the blink of an eye. He has no recollection of having had children, or running for office, and he still believes he lives with his young wife, Ginny, near Goldhawk Road. All long-term memories end there. I pour him a glass of water from the jug beside his bed. He takes it with a shaky hand. Then I turn to face the ragtag lineup behind me, looking for some kind of explanation for Mr. Davidson’s current state, although I already have my suspicions. His son catches my eye. Simon Davidson and I have met before, briefly, on the day Howard was admitted.

I’ll let you in on a secret they tell us at medical school: Sometimes things can’t be fixed. Sometimes things must be lived with. Adapted to. Simon Davidson didn’t want to hear that. I’ve been in this profession long enough to trust my instincts in situations like this, and right now my instincts are telling me that Simon is almost definitely the issue at fault here. Doctors and nurses don’t tend to make grown men cry. Well, not in a professional setting at any rate. So I give the medical team a nod and they shuffle, gratefully, out past Simon. “Simon, would it be possible to talk to you outside briefly?” Simon’s eyes widen slightly at being the only person singled out. “Er, yeah.

Yes. Sure.” He gives me a pragmatic nod and starts to leave. “I’ll be right with you in one minute.” I offer him a reassuring smile as he pushes out the door, but he’s frowning, unconvinced. However, I need to settle Mr. Davidson, my actual patient, before I can deal with his son. I watch the door softly puff closed behind him. “Who was that horrible young man?” The voice comes shaky from behind me. I turn and take in Mr.

Davidson’s frail form, his crumpled features, his kind eyes. I feel an ache of sadness in my chest. He means his son, of course. But the thing that really gets me is the caution with which he asks me the question, the caution for me, in case he offends me, in case the horrible man is a friend of mine. “It’s all right, Howard, it’s just me and you now,” I reassure him. I move back to the bed and take his delicate wrist in my hand, counting off his pulse. Elevated but fine. “Did the man who was just in here upset you, Howard?” I know the answer already. This isn’t the first time this has happened since Mr. Davidson’s been here, not by any means, nor is he the first patient who’s reacted in this way.

Howard Davidson shifts to sit a little higher in the bed. “That young man. Not the other doctor, the small man. He told me that Ginny had died. My wife. Ginny. And I don’t know who he was or why he’d say a thing like that. I mean, why would he say it?” He studies my face, a fallen toddler unsure yet whether to laugh or cry. “And the way he said it, so strange. Just ‘She’s dead,’ plain and simple, when I asked when she’d get here, just like that, like it was nothing.

My Ginny dead.” He thumps his fingers against his chest; he’s agitated again at the memory. “Why would he say that?” He peers up at me, watery eyes panicked. “Ginny’s okay, isn’t she? She was fine when I left the house. The other doctor wouldn’t tell me. She’s all right, isn’t she? I should never have left the house.” His frail hands become fists now on the bedsheets. Ginny died eleven years ago, at sixty-two, from thyroid cancer. To be fair to Howard’s son, he was probably just trying to remind his father, but no doubt would have done so in that slightly weary way people tend to reiterate facts to dementia patients. “Is Ginny all right?” Muscle tremors flutter under his eyes. He’s tired. I take his hand lightly. “Yes, Ginny’s perfect, Howard. She’s very good. She sends her love, and she told me to tell you that she can’t make it in this afternoon but she’ll see you first thing tomorrow.” I say it because he is my patient and it will make him feel really good, and he won’t remember I said it tomorrow. He smiles and squeezes my hand as hard as he can, eyes filling. “Thank you. Thank you, I was so worried about her. I don’t know what I would do without my Ginny. And if I didn’t even get a chance to say goodbye, well…” Of course, he did get a chance to say goodbye—eleven years ago, at her bedside, in this very hospital. Mr. Davidson will not be able to remember the words of this conversation, but he will remember the feelings it brings up. I’m not lying to him. I’m just not being an asshole. We can’t inform Howard that his wife is dead every time he asks us, it would be beyond cruelty. Why repeat the worst day of this man’s life every day of his life? — Outside in the hallway I try to explain this to his defensive son. “Are you suggesting we’re just supposed to lie to him? Every day? Until he dies?” Simon’s voice is low but the tone is harsh. This isn’t a discussion for a corridor but I don’t think any venue would sweeten what I’m about to say. “You just have to ask yourself, Simon, who exactly would benefit from his remembering your mother’s death? Why are you so keen on making your father remember that one event?” He stares at me, blindsided by my questions. Confused by the subversion of the customer-is-always-right rule he assumed also operated in hospitals. He swallows whatever vitriol he was about to say and replies simply, “I want him to remember it because it’s true. It’s important he remembers it because it’s true.” “Yes, it is true, Simon. But lots of things are true. I could theoretically wander up to Oncology right now and tell everyone up there that ninety percent of them definitely aren’t going to make it, but what on earth would be the clinical benefit of that? Your father isn’t going to get any better. He won’t remember these things, no matter how often you tell him. It will only upset him. And if you tell him, he will hate you, Simon. He may well live another fifteen or even twenty years. He may outlive us all. I think we’d both like his remaining years to be happy ones. I’d advise you to let your sister take over as next of kin from now on and to limit your visits if you’re not happy with what I’m recommending. And if you do insist on continuing to visit your father, I’m going to have to ask you to stop deliberately agitating and upsetting him. He’s a vulnerable adult and what you’re doing is bordering on psychological abuse.” As harsh as that may sound, Howard is my patient, it’s his welfare I’m here to safeguard, not his son’s. Simon glares at me for a second before he replies. “I see,” he says finally. “Um, well, obviously, I hadn’t realized I was causing him so much distress….” People don’t want truth from us doctors, not really; they may think they do but they don’t. People want doctors to be like priests. They want hope delivered with authority. I catch sight of an RN waving over to me from the nurses’ station: she gestures to a phone receiver at her ear. I suggest family support counseling to Simon and say goodbye. With a rallying smile, the nurse hands me the phone. On to the next. “Hi, Emma.” The voice on the other end of the line is my secretary, Milly. “Sorry to chase you round the building but there was a phone call earlier from the U.S. I told them you were on call and they said they’d call back at half past. And I haven’t seen you since, so I thought I should let you know.” I look down at my wristwatch: 8:27. I can make it back to Neuropsychiatry in that time—at a jog. “Who was it, Milly?” “Er, a man named Richard Groves. Dr. Groves.”

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