If memory is a house, which rooms do you visit? Which are off-limits? And where do you greet visitors?

The Proximate

Beautiful spring day, but he wasn't having any of it.

David killed the motor, checked his messages one last time. Good. No cancellations, no delays. Which meant no avoiding it.

He slid out of the car. Normally, the walk in from the staff parking lot was a secret pleasure; not today. Warm wind in the trees, birds singing, but he was already thinking about her chart, her scans, her questions. 

 "Dr. Sutter," Edwin said in greeting. The retiree was a fixture at the Volunteer Desk, doling out information and advice in equal measure. He was always on duty, weekends included. Edwin gave him a look, the question obvious.

David shrugged. "Yes, me too on a Sunday."

A Sunday on a beautiful spring morning. That's what you get when you have a troubling case. David didn't like troubling cases.

"So, how's my Frankenstein?"

She looked up and grinned. Give it to the kid; she had a great sense of humour. She had taken one look in the mirror after the operation, and dubbed herself Frankenstein, much to the horror of just about everyone else on the floor. But it gave her a measure of control by treating her appearance with a touch of derision. So, yes, she was Frankenstein, and he was okay with it.

"Not bad. It's Sunday."

She was also smart, which he liked. He knew exactly why she was looking at him now.

"Yes, it's Sunday, and no, I'm not here to perform experiments on you." She was also a worrier, and he wanted her to know that nothing had changed. Which was both good news and bad.

Amanda Patillo: bright, active, a typical 14 year-old. Until the accident. Most of the dressings were off, but what remained only partially concealed the fact that hair from one side of her head was shaved to stubble. She had been on the table for six hours, the surgical team even more focused than usual because their patient was so young and her trauma so acute. Airbags were good, but they didn't protect anyone from a stop sign coming through the windshield. Everyone else in the car was fine, relatively speaking. Amanda took the edge of the stop sign to her head.

"So why are you here? Miss my company?" It was a tease, but that was okay. He had learned a lot about Amanda in the last week or so, and by all accounts, her personality and sense of humour were completely intact.

"A consult." He paused. "That's when..." He stopped when he saw her expression: it was a look of pure duh.  David shook his head, smiling. "Okay, you know what a consultation is. So, I'm consulting."

"With whom?" She emphasized the 'm'.

"Medical people."

"In a hospital? Say no."

He sighed. "A neurologist."

"You're a neurologist."

"Another one." She was smart, but not that smart.

She stared at him for a few seconds, then grinned again, and David suddenly realized she might have a bit of a crush on him. Well, he had a crush on her, too. Now, if she were twice as old, and he wasn't her doctor and didn't worry so much about her...

Sure, she's the worrier.

"And what will you talk about? You know, with this other doctor person in a hospital on a Sunday morning?

"Oh, I don't know. Baseball?"

Amanda pursed her lips. "Ok. But I'm not her Frankenstein. Or ‘his’, I guess, if it’s a boy." She also liked stirring the pot. 

David didn’t bite. "You know, technically, it's not really ‘Frankenstein’..." His voice trailed off when he saw the look. Again.

"Yes, I know," she said, sarcasm dripping. "All you older people keep pointing that out." She held his gaze until the gleam in her eyes gave her away.

He grinned at her. "Smart-ass."

Amanda watched Dr. Sutter leave. At least that seemed okay; same doctor, same sense of humour. At least for today. At least for right now.

That was something she had learned to do in the last few days, and it helped. Right now was right now, and that was always the case.

She shook her head. And if that isn't nuts, I don't know what is.

But she didn't feel nuts, despite evidence to the contrary. She had always had that knack, the 'logic bug', as she called it. Even when she maybe/possibly/allegedly smoked weed, she was always the one who looked at everything in a logical way. Her friends knew it, too; if they got a bit too high at a party, they always checked in with her, because she was always able to keep them grounded. 

So, let's try it again.

Amanda looked around her hospital room, remembering a) how thankful she was that her parents’ coverage got her a single room, and b) Hillary, the kid with whom she had shared a double room a few days ago. Not even this room; the double room down the hall, 4 E/F.

She remembered it clearly because it was the first time she could actually think straight. Out of ICU, into a double room, a curious Hillary staring. Redhead, sly smile, talky, even though Amanda was way tired. And she was tired, drifting in and out for hours, maybe even a couple of days, Hillary filling the room with details of her own life because Amanda didn’t have the energy to respond. Then Hillary wasn’t there anymore, and Amanda was in another room. This room, alone. 

So, where was Hillary? Not in 4 E/F; a couple of random patients there. Who was Hillary? No one seemed to know, and she had learned to stop asking, because of the looks she got.

Okay, logic. Obvious what's happening, right? You're going to feel weird, a bit loopy, they had said. And she did, along with the chills, and the tiredness. So ‘Hillary’ was obviously part of the 'loopy'. After all, they had been digging around inside her head. Maybe she should just admit she was a little nuts, a little weird.

But she didn't feel nuts, she felt pretty... normal, despite looking like a freak.

Normal.

Except for Hillary. Except that some of her TV shows were a bit off. Except that she didn't know one of her friends who kept texting.

"And she doesn't remember things?"

"She remembers, but not... the right things."

Lawson frowned. A look flitted across his face, but then it was gone, replaced by a sour scepticism. It was starting to annoy David. That's why I asked for the consult, guy. Deal with it.

The other man turned to the image board showing the crystal-clear outline of a skull. "If you don't mind," Lawson said, "-once more. How did she present? And what are your concerns?"

Odd vibe to the guy. Lawson had seen a lot, done a lot- and let you know it. There was more to it than that, though, not that David could put his finger on it. Of course, that's exactly why he had sought out Lawson in the first place.

"Week and a half ago, car accident..." David launched into it: the crash, the injury, the emergency surgery, then the long, agonizing wait afterwards. He had been called in early on, had even stepped into the operating room for a few minutes to watch.  He knew there was a good chance that he would catch this new patient, and sure enough, he had been assigned as her primary caregiver. He had been with her ever since, ten days now and counting.

Dr. Lawson stared at the x-ray as David wound up, "...unremarkable improvement; vision, strength, coordination, reflexes, all positive. She's a kid, and a fighter". Meaning: kids have amazing resilience to injury, and that, along with Amanda's positive attitude, had helped with her recovery. 

Again Lawson nodded. He looked at the younger doctor. "And then?"

"Little things. The occasional wrong name, a forgotten memory here."

"Memory loss." David read a so why am I here? in the tone.

"Well, that's the thing. Not so much memory loss, but a memory... change. A shift. She remembers alright, but they were... different from what had happened."

Lawson raised an eyebrow.

David added, "Not consistently different, and not in major way, but... different enough that her parents are concerned. I'm concerned."

"Their kid had a traumatic brain injury. There are consequences." The shrug in his answer wasn't cold; it just reflected reality. Life in all of its vagaries could be cruel, and that extended to bright, energetic kids having life-altering injuries.

"I know, and I've seen it. We all have,” David said. A reminder that he had the experience to recognize the same things. He wasn't a resident anymore. "The thing is, I've never quite run across this before." He paused to gather his thoughts, and Lawson leaned in. At least he had his attention. "Some of her memories are different. She remembers a school trip, but to a different place. She remembers a favourite cousin- who doesn't exist."

"You said it yourself. Memories shift."

David nodded. "Uh-huh. You can conflate memory. We all do. But it's one thing to mix and match- it's different to remember things that didn't happen at all..."

Ok, that was stupid. They both had plenty of experience with that syndrome. To his credit, Lawson let it slide, even if he did it with that damnable shrug of his.

"I've been practicing for years," the older doctor said, "-and let me tell you, memory is a weird thing. It's nothing more than an electro-chemical construct rattling around in here." He tapped his temple. "And when I say 'nothing more'- well, that doesn't begin to convey how strange it is. I remember with crystal clarity things that happened 40 years ago. So- a memory is an electrical impulse shooting back and forth for 40 years? Come on, how is that possible? And yet it is."

He shook his head. "And it's not even the same memory as yesterday. Every time I remember something, it changes the construct a bit. So when I 'remember' something, I'm actually remembering what I thought the last time. You might always remember the broad strokes of that trip you took to the lake when you were 10, but the finer details might change. Were you in the front seat, or back? Was your sister annoying, or not? Memories change. And it sounds like your patient has had a few shifts."

David frowned. "But what if you remember the trip to the lake as a trip to Disneyland? Or you don't have a sister? That's not a shift, that's a ... memory of something that didn't happen."

"Don't know. Maybe she saw it in a movie, maybe it's oneirataxia. What I do know is that when you're dealing with the brain, weird things happen. Listen, a hunk of metal went sub-cortical. Right into her memory vault. I could give you a dozen theories about what might be happening, but every patient is different. This ain't math; sometimes two plus two one doesn't equal four. No two people react the same way, especially with the brain." He spoke without humour, without warmth. Cold, clinical, like the man himself.

"Any of them fit?" When Lawson frowned, David added, "The theories. Any of them fit my patient?"

The other doctor made a dismissive sound. "You can make anything fit, that's why they're still ‘theories’."

"Well, that's not good enough."

"Pardon?"

"It's not good enough. What do I tell my patient? 'Hey kid, we don't know, deal with it'. That's the best we can do?"

"Sometimes it is."

"Well, shame on us, then." He was irritated, and didn't care that it showed. "You have a reputation for looking at things differently. If I had wanted status quo, I wouldn't have asked for the consult. Because this seems pretty status quo."

Lawson's jaw tightened. "You know, reputation works both ways. Toss around too many theories that confuse people, they start looking at you funny." He shook his head. "If you're looking for an easy answer, I don't have it. When it comes to the brain, the one thing I've learned is not to discount anything."

"So let's not discount anything. Any of the theories fit?"

For the first time, there was glimmer of a smile from the other doctor. "Well, I see that your reputation is on the money. They said you could be... direct." He rubbed his eyes. "Ok. You got me here on a Sunday morning- let me give you something to chew on. But." He looked at David. "You know the old cartographers' description about terra incognita? 'Here there be monsters'? Well, that's what we'd be getting into. But let's do it."

Lawson turned to the display. "So: penetrating head wound caught the edge of the frontal lobe, then skewed sideways into the medial temporal. You say her procedural and semantic memory are ok?"

David nodded. "Facts are fine. She knows how the world works."

"So- it's the episodic memory that's giving us the problem. I like to think of it as the patient's autobiography- times, places, events, experiences. And in someone her age, there's even more emotional charge than usual."  He paused. "You say it was shift, a memory of something that didn't happen? Well, maybe it did happen. Is happening, I don't know."

"I don't understand."

Lawson sighed. "Well, there's a whole school of thought about this very thing. So here's the theory. Correction, a theory. Again..."

"Yes, monsters, etc."

"Exactly," Lawson said. "Well, given all I’ve heard… maybe she's filling in… tone.”

David frowned, and Lawson continued. “We know memory is partly bio-electrical, which means it has a frequency, a tone. Like a transformer hum. So what happens if that tone disappears? What happens if a penetrating head wound knocks out electrical activity in part of the brain?” He paused. "Maybe the brain switches to a frequency nearby."

"Pardon?"

“Maybe it’s ‘synchrony’. When things close to each other vibrate, they tend to sync up. Fireflies blinking in unison, that kind of thing. Well, there’s big-time research into neuronal synchrony. It’s called CTC, ‘communication through coherence’. The bio-electricity we produce when we remember something, or think about something or just daydream – they all have frequencies. Which tend to sync with similar frequencies.”

Lawson looked at the screen again, thoughtful. "So maybe she's filling in the blanks with tone, one of those nearby frequencies. A slightly different version of what's happened. Or what's happening. Present tense.”

"I’m not following- a different Amanda memory?"

"No. Well.. sort of, I guess. Her brain is healing, finding new neuronal pathways. New frequencies. So yes to a different memory, no to a different Amanda." Lawson watched him with hooded eyes. "But even that's semantics."

“How do you even get to a ‘different memory’?”

“Well, this is where it might get weird.”

David gave him a look, and Lawson almost laughed. “Okay, weirder. Because it requires us to make a leap.” He barely paused before continuing.

“If we think something, or imagine something, that’s bio-electrical activity. That’s a given. We’re always bumping up against our own thoughts, our own choices, little swirls and eddies of things we did or didn’t do. And they all have frequencies or bio-electrical patterns or whatever you want to call it. Our brains are exquisitely attuned to them.”

Lawson stopped, deep in thought. “So… maybe she’s syncing up with one of those frequencies. If you think it, if you imagine it, hell, if you dream it- it has an electrical presence. All those different outcomes are almost literally just a thought away.” He shook his head. “So - maybe she’s remembering those real or imagined choices. Unconsciously or not.”

David stared for several seconds. "Lot of ‘maybe’ there.”

Lawson nodded. “Exactly. But just because they’re theories, doesn’t mean they don’t exist. I can even put a cherry on it.”

"Can't be any... different from what I've heard."

“Don’t be so sure. Next time you change your mind about something, consider this: what you’re doing is swapping one bio-electrical pattern for another. And every time that happens, you change the outcome. Outcomes always shift. They change, they mutate; even us talking about it will replace one outcome with another”.

He pursed his lips before continuing. “Most of us deal with the changes intuitively. Others can’t - schizophrenia may well be people not able to reconcile those thoughts. Depression, bi-polar disorder, PTSD: maybe that’s people unable to channel all those disparate frequencies and outcomes into a single coherent stream.”

Neither man spoke for several seconds. They both looked at the display screen, with its ghostly image of a skull. Finally, David said, “Okay, I want to get practical here."

"What to do with your patient."

"Uh-huh.

Lawson nodded, and for the first time, there was warmth in his tone. "We all want to 'do' something, especially when they're young. The thing is, she is doing something: she's rewiring. She's healthy, and from what you've told me, faculties, personality- it's all there. For someone with that kind of trauma, she's doing remarkably well. What can you do for her? Give her comfort. Give her support. Let her know she's not weird." The slightest of smiles. "I wouldn't necessarily talk about bio-electrical frequencies and neuronal synchrony."

Amanda hunched over her phone, wondering how to begin. All she had was a number; it was the last thing she remembered Hillary telling her, and even that was fading.

She took a breath, hit Chat. 

 Mander: Hi u there?

 Took a few seconds, then-

 Hill: Yup. Mander- do I know u?

 That was the key, wasn’t it? She remembered Hillary - sort of - but would Hillary remember her? .

 Mander: 4 E/F, Children’s Hosptl

 A pause, and Amanda waited.

 Hill: Sory. Long time ago.

Mander: last week. asthma, right?

Hill: No, last yr. 4strep. Y?

 That she hadn’t expected.

Weird: she knew Hillary, even if she couldn’t quite remember what she looked like, but the other girl had been here a ‘long time ago’. Not in Room 4 E/F last week.

So did she know her? Glasses, that smile… and talky, very talky. Amanda suddenly remembered a name. Hillary had gone on and on about a new guy in school, a guy with an unusual name.

She leaned in.

 Mander: Howz Vitus?

Hill: Good. U know Vito?

 Bingo! But then..

 Hill: ? ? ?Didn’t no Vitus last yr

 Amanda felt the suspicions looming. She keyed the next line quickly.

 Mander: peeps here.

She was working her phone, but killed it as soon as he walked in the room. "How you doing, Frank?"

Amanda gave him a tight smile. "Hello doc."

She said it in a crusty, old-lady voice, but plainly, she felt a bit uneven, and plainly, she was putting up a front. But she was dealing with it, a good sign. Most people didn't understand the struggle to recover from any kind of brain surgery. Tiredness, feeling dopey and unfocused- and on top of all of that, young Amanda was dealing with... well, whatever weirdness her memory was conjuring up for her. But she had that spirit he liked so much, and he wasn't going to rain on her parade.

"So- what did Dr. Consultation say?"

"Well, I wasn't going to tell you this without your parents here, but... we both figure you're pretty normal."

"Really?"

"I know, you don't want to be normal, you'd rather have some kind of special powers. But I can't do much about that."

"Normal is good, right?"

David gave her a smile. "Normal is good."

Relief flooded her face, and with it came that wonderful glow, something he had seen here and there over the last few days. This kid could light up a room, and to see the look on her face made him very happy. That was the only reality, not different versions of different memories, not a thousand different outcomes. The path you were on was the path you were on, and nothing else mattered.

"I think another few days max, you'll be out and about."

"And scaring people." She pointed to her scalp, and gave him a big grin. "That's going to be fun."

Amanda watched Dr. Sutter go. Sort of hot for an older guy; wasn't trying to be too cool, wasn't trying to be too smart.

So.

Here she was.

They said things might be weird, and they were right. Like Hillary, who shared her room last week. Hillary, whose parents had rushed her to the ER because of an asthma attack. The same Hillary who hadn’t been to the hospital in a year.

So, ya, things were weird. But this was odd, too: even though she knew Hillary… maybe she didn’t. It all felt more and more like a dream that wisps away just as you wake up.  

Amanda took a couple of long, slow breaths, which always took the edge off. What to hell, she was Frankenstein, she had an excuse.

Well, that was certainly... different.

Always a crap shoot with consultations; sometimes they were a waste of time, everyone chasing the same information around in circles. But then you might learn something that put a whole new spin on what you thought you knew.

This particular consult- well, he didn't know where it fit in. At all. He liked challenges; that was one of the things that had attracted him to neurology in the first place. A hundred billion neurons in the brain, and they still only had a vague sense of how they interacted with one other, or with the outside world.

David kept going back to what Lawson had said- when it comes to the brain, the one thing I've learned is not to discount anything. For Lawson, that clearly applied to things more... universal than the random firings of a patient's synapses. If you believed it.

David shook his head. 

"Your drive’s here, doc," Edwin said. He nodded to the outside doors. "Better zip up." Even though the main entrance had an overhead portico protecting it, the blustery wind kept pushing the rain against the sliding doors. Probably cold rain at that.

"Thanks." Well, at least that hadn't changed: Edwin was as helpful as always.

Tom New