Ward Z Page 5

  Dr. Andrew Page

  "Have you ever seen numbers like these?" I ask, going over Dominique Ribery's platelet count for the thousandth time. "It's barely even..." I pause for a moment, aware of the stupidity of the sentence I was about to complete.

  "Barely even human?" Dr. Gerrold asks. My superior for the past twenty years, Dr. Gerrold is the man who taught me everything I know, and he's also the man who gave me the confidence to push on with my own research. He's long tolerated my failings, but I still worry about appearing foolish in his eyes.

  "It's barely even blood," I continue, unable to hide my exasperation. "It's like there's something in her system that's cycling through different reactions, changing her blood almost by the hour as if it's..." I pause for a moment, unable to get my head around what I'm seeing. Either our testing equipment is on the fritz, or this woman's body is out of control. "I'm tempted to give her a transfusion," I continue, "just to see what happens to the new blood we introduce."

  "It sounds like you're grasping for straws," he mutters.

  "What would you do?" I ask. "If she was your patient -"

  "I'm glad she's not," he replies with a faint smile. "How do you treat someone who's hot and cold at the same time?"

  "If I didn't know better," I reply after a moment, "I'd say that her body is trying to reconstitute her blood in some new form. It's almost as if..."

  He waits for me to continue. "Yes?" he says eventually.

  "It's almost as if I'm constantly on the verge of saying something stupid," I continue with a sigh. "There's a rational explanation for everything that's happening here, and just because I haven't found it yet, that doesn't mean it doesn't exist. This isn't magic. This is a woman's body, and she's subject to the same basic rules and laws of nature as everyone else. It's just that on this particular occasion, those rules and laws are conspiring to produce some unexpected effects that we don't understand."

  Instead of replying, Dr. Gerrold walks over to the bed and stares down at Dominique Ribery's face. The woman has been under sedation for hours, and although the cranial bleeding has stopped, her body seems to be going haywire. I called Dr. Gerrold to come and take a look because, frankly, I was starting to doubt the evidence in front of my eyes, and I desperately wanted him to come in, point out some pesky error I might have made, and get things back on track. Instead, he seems just as stumped as the rest of us.

  "Has she been anywhere?" he asks after a moment. "You said she was in Haiti -"

  "That was five years ago," I reply. "There's no disease or infection that could've lain dormant for five years. Not without some kind of symptom showing. She's a doctor herself, remember? She'd be onto something like that."

  "Not if she's scared."

  "She doesn't strike me as the kind of person who's easily scared," I point out.

  "Then maybe she's just very good at hiding it. Never underestimate the human capacity for self-deception, Andrew. Maybe she's just been ignoring the symptoms she doesn't like. You said yourself that you don't entirely trust her answers, so maybe that's the way to go. Assume she's bullshitting you." He pauses for a moment. "Have you checked for the obvious? Immune-deficiency, that sort of thing?"

  I nod.

  "Let me see the figures from Paris again," he continues.

  Grabbing the print-outs, I pass them over to him. "They're nonsense," I tell him. "I don't know what kind of tests they were running, but they fucked everything up. I don't even understand how supposedly intelligent people could seriously send that kind of data over and claim that it's accurate. They got it all wrong."

  "Or maybe they didn't," he replies, taking a look at the numbers. "Have you considered the possibility that they performed all the tests properly, and these were the actual results? Maybe her white cell count really was this low, and maybe her blood pressure really was swinging wildly. Maybe, just maybe, all these contradictory test results are indicative of some kind of manic biological disorder. One minute her temperature's soaring, the next she's freezing; one minute her blood pressure shoots up, then it plummets." He pauses again. "Do you know what it reminds me of? It reminds me of someone running into a house and frantically flicking every switch back and forth, just seeing what happens."

  "Careful," I reply as I check her temperature and see that she seems to have stabilized. "This is still a cancer patient, not a haunted house."

  "And that's exactly how you must proceed," he replies. "You must treat her cancer, and hope that everything else normalizes once you're successful." He holds up some of the printouts. "Despite all these unusual numbers, she's still just a woman, and her cancer is still just cancer, and you have to move forward on that basis. Everything else, hopefully, will resolve itself once the core problem has been dealt with. You don't need to start experimenting on her."

  "It's almost as if her body's performing experiments on itself," I reply, before staring down at her chest. "I want to remove that mass. I want to open her up and get that thing out of her. It's the only option."

  "How are the biopsy results?"

  "I haven't had a chance to go through them yet," I reply. "I've been awake for twenty-four hours straight. I need to sleep or I'll start making mistakes. I keep trying to push myself, but I'm going to collapse."

  "Then why are you standing here yammering with me?" he asks. "Go home. I'll keep an eye on your patient."

  "I'll sleep in my office," I reply, heading to the door. "I just need to close my eyes for a few hours, and then I'll take a look at the sample from her tumor."

  "I can take a preliminary look if you like," he says. "I've got nothing better to do all night."

  "No," I mutter, glancing back at him. "I want to do it. As you said, she's my patient, not yours. But if you can book an operating theater for the morning, I'd be grateful. Whatever's going on, that mass needs to come out so I can get a better idea of its composition. None of this makes sense. I feel like we're missing something."

  Heading out into the corridor, I make my way to my office. Although my mind is racing, I'm fully aware that I need to get some sleep. Dominique Ribery is a fascinating and unusual case, but I need to be as alert as possible. By the time I reach my office, I feel as if I'm about to keel over, so I lock the door, turn off the lights and arrange myself on the sofa in the corner. Finally, taking a deep breath, I close my eyes. My mind and body are exhausted, but sleep doesn't come immediately; I can't shake the feeling that I'm missing something, and that Dominique Ribery's cancer might prove to have qualities that I've never seen before.

  And that's when it hits me.

  Opening my eyes, I realize the truth.

  Maybe I have seen this before after all. Once, a long time ago.

  Cally Briggs

  "What do you think of my new ass?" June asks, holding up a life-size pair of rubber buttocks.

  I open my mouth to reply, but suddenly I realize that there are no words that can do justice to the weirdness of this situation. It's 8am and June's husband has wheeled her into my room, pre-breakfast, to show off one of her birthday presents. The poor guy looks faintly embarrassed as June tosses the buttocks onto my bed.

  "Check the crack," she says with a sad, earnest smile. "Go on, check."

  Picking up the buttocks, I gently ease them apart and take a look at the smooth rubbery crack.

  "No piles," she continues. "See that? No piles, no haemorrhoids, no nothing. That's how an arse should be, huh? It's pretty perky too. Not like this flat old pancake I've been sitting on for years."

  "You must be so proud," I say, passing the buttocks back over to her.

  "When I get out of here," she says, "Derek's going to pay for me to get the real thing fixed."

  "It's all she really wants," her husband says wistfully. "I asked if she'd like jewelry, or a party, or a dress or new shoes, but she said all she wanted was -"

  "A new arse," June says proudly.

  "A new bum," Derek continues, "so this is a down-payment. When she's done here, we'll do whatev
er it takes to get an operation and fix things down there."

  "It's true," she continues. "To me, paradise would be sitting on the toilet and passing a big fat log without feeling excruciating pain. Sorry to be so blunt, but I might as well be honest. Just one, pain-free poo before I die... It's all I want."

  Derek smiles at me, but it's a smile that hides the truth. June's never going to get out of this place. She's like me, if not worse, and her days are numbered. As she admires her fake rubber buttocks, it's clear that moments like this - of pure joy and good humor - are running low for both of us. I want to join in, to muster the enthusiasm to joke about June's piles, but I'm feeling weaker than usual after a difficult night, and I'm constantly on the alert in case the pain in my side comes back.

  "Hey," says a voice over by the door.

  Turning, I'm shocked to see Kieran and Emma entering the room. As ever, Kieran is leading Emma by the hand and, if I'm honest, she doesn't look like she wants to be here. She knows she has to come for my sake, but she holds back a little, as if she wants to make sure that Kieran is always between us. It's been a long time, more than a year, since Emma seemed pleased to see me, and the worst thing is, I don't blame her at all. If I was in her position, I wouldn't want to see me either.

  "What are you doing here?" I ask, sitting up in bed.

  "There's been a slight chance of plan," Kieran says, placing Emma's backpack next to my bedside cabinet. "Helen can't look after her today, and I have to work, so I figured maybe it'd be okay if she could hang out with you until after lunch." He pauses, and it's clear that he knows this is very much not okay. The bastard is doing this on purpose. "Besides," he adds, "I know you've been wanting to spend some time with her."

  I take a deep breath. It's blatantly obvious that this is Kieran's attempt to force me to talk to Emma about my condition. I know I'm probably being unreasonable, but right now I feel as if I could reach out and wring his neck. The asshole knows this is difficult for me, and instead of understanding the situation and letting me handle things at my own pace, he's trying to force me to get it over with.

  "What do you think of these?" June asks, showing the fake buttocks to Emma. "Pile-free. Aren't they gorgeous?"

  Emma's eyes widen in shock.

  "I don't know if today's a good day," I say, keeping my voice low as Emma examines the rubber bottom. "I'm having tests later. I'm going to be tired."

  "It's just for a few hours," Kieran replies pointedly. "Enough for you to hang out, maybe have a little talk."

  I narrow my eyes.

  "That's the spirit," he says, tapping my legs before checking his watch. "Listen, I need to get going. I'll swing by and pick her up after lunch, okay? There are some sandwiches in her backpack, and..." He pauses. "It's important for you to spend time with her, Cally. She needs to be with you, and you need to..." He pauses again. "Well, you know what you need to do."

  I stare at him, filled with anger.

  "Have fun," he says, turning and tousling Emma's hair as she continues to play with the rubber buttocks. "Enjoy your morning with Mummy."

  As he leaves the room, I try to stay calm. I feel like crap, and the absolute last thing in the world that I need is to have to deal with Emma, especially considering that she and I need to have a serious talk. It's abundantly clear that this unannounced visit is Kieran's way of forcing the issue, of making me understand that it's now or never: either I tell Emma the truth about my condition today, or he's going to tell her tonight. He's always had a tendency to make subtle little attempts to remind me that I'm a bad mother, but I never thought he'd go quite this far.

  "I can keep her entertained for a while," June says, clearly sensing my discomfort.

  I shake my head, watching as Emma wraps the fake buttocks on top of her head like a pair of giant wobbly headphones.

  "I've got three kids of my own," June continues. "They're all grown up, but I still remember how to keep them busy." She pauses. "Why don't you take a nap, and then in a couple of hours we'll bring Emma back and she can have some quality time with you?"

  "No," I say with a heavy heart. "Thanks, but... I'll look after her. There's something I need to talk to her about."

  "Are you sure?" June asks, with a look of knowing concern in her eyes.

  I nod.

  "Okay," she mutters, tapping Derek's hand as Emma drops the rubber buttocks onto her lap. "Wheel me outta here." As he maneuvers the wheelchair toward the door, June glances back at me. "You know where I am, though. If you change your mind."

  Once she's gone, Emma and I stare at each other in silence for a moment. I swear to God, there's so much fear in her eyes, it's as if she knows what I'm going to tell her; in fact, I wouldn't be surprised if my smart, perceptive little girl had pretty much sussed the whole situation out by now. She must know that I'm getting worse, and the fact that she avoids me whenever possible means, in all likelihood, that she's trying to delay the inevitable moment where we have 'the talk'. I wish I could shield her from all of this, or at least talk to her in my own time, but now it's clear that the moment has come. There's no turning back, no way to delay. I have to tell her the truth, and I have to do it right now.

  "Emma, honey," I say, my voice sounding so hollow all of a sudden. "Do you want to come and sit on the bed with me?"

  She stares, without saying anything.

  "Come on," I continue, pulling back the bedsheets for her. "Come and sit with me."

  She doesn't move. I swear to God, she looks terrified.

  "Emma -"

  Silence.

  She looks as if she might start crying at any moment.

  "Do you want ice cream?" I ask eventually. "We can go to the cafeteria."

  "Okay," she says, running to the door before stopping and waiting for me. It's clear that she's relieved, and to be totally honest, I feel exactly the same way.

  "I'm coming," I say, feeling a wave of relief wash through my body as I ease myself gently out of the bed. I know I'm only prolonging the agony and delaying the inevitable, but I don't care. I can't bring myself to tell Emma the truth, not yet anyway. Maybe I'm a bad, selfish mother, but I just want a few more hours of fun with her before the tears. As if to remind me of my true fate, however, the swelling in my side gives me a gentle kick as I shuffle toward the door. The pain is dull, but I know it's still there, just like the cancer that's dragging me closer and closer toward death.

  Dr. Andrew Page

  Slipping the scalpel beneath the surface of the biopsy sample, I peel away what turns out to be some kind of outer lining, revealing a layer of spongy tissue and then, at the center, a much darker core. I might be sleep-deprived and running on the dregs of an energy drink, but there's one thing I know for damn sure: this is not a normal tumor. This is something far more complex.

  "Aren't you supposed to be resting?" Nurse Aubry asks.

  Turning, I realize that she's snuck up on me.

  "I couldn't sleep," I reply, turning back to look at the sample. "Look at this thing."

  "Is that from Dominique Ribery?" she asks, leaning closer.

  "How's her temperature?"

  "Stable," she replies, "but with the way she's been fluctuating, I'm checking on her every ten minutes. I've never seen anything like it before. She must have the constitution of an ox to still be alive." She leans even closer to the sample. "I've never seen anything like that, either. What's going on with this thing?"

  "I have no idea," I reply. "Have you seen Dr. Gerrold?"

  "He's on the phone," she continues, clearly fascinated by the sample. "By the way, before I forget, Cally Briggs has got a large swelling on her left side, just above the hip. There looks to be some kind of thrombosis in the area, maybe, so I think you should take a look at it when you get a chance. She's in a lot of discomfort, although apparently she neglected to let us know about the damn thing for several days."

  "Cally Briggs can wait," I mutter, turning back to the sample.

  "She's still your patient."

/>   "She obviously didn't think the lump was important," I reply, "so it's clearly not urgent."

  "But if she -"

  "I'll get to her when I'm done here," I say firmly, before pushing the scalpel-blade deeper and exposing the lobe-like structure at the center of the sample. "What does that look like to you?"

  "It looks like something that's going to keep you obsessed for many days to come," she replies, leaning across and kissing the side of my neck, "and I pity the rest of your patients, who are clearly going to be sorely neglected." She pauses, before kissing my cheek. "Are you going to neglect everyone on the ward, or just people like Cally Briggs?"

  "How's Neil?" I ask.

  She pauses.

  "I'm not the only one who hasn't been home for a while," I point out, keen to reject her amorous advances. "Doesn't your loving boyfriend wonder where you are?"

  "He understands that sometimes I have to take cat-naps in the staff room," she replies stiffly. "Not that it's any of your business..."

  "The whole point of a stress-relieving dalliance with a fellow member of staff," I continue, "is that it's supposed to happen during downtime. Not when one or both of us have things to do." Turning the sample, I continue to examine its structure. "What does that look like?" I ask, using the scalpel to better expose the central lobe. "Forget what it's supposed to look like. Tell me what it actually looks like."

  "A slice from the side of a tumor."

  "Try again. Don't hold back, and don't worry about being ridiculed. Whatever you say, it won't leave this room."

  "I don't know," she replies wearily. "You're the specialist -"

  "It looks like a brain," I reply, finally giving voice to the concern that has been festering in the back of my mind since I first saw that mass during Dominique Ribery's colonoscopy. "It has an outer membrane, containing a small amount of fluid, and then there are three distinct layers in the main part of the mass. There's an outer section of spongy tissue, there's an inner section that resembles the Corpus Callosum, and then there's this mass in the center that could be seen as a hypothalamus and cerebellum kind of structure. And then -" Turning the slice again, I show her a dark red patch on the exterior. "Remember how I said that the mass was attached to Ribery's body by a kind of stalk?"