"And the patients who don"t have NDEs tend to have coded from other causes?"
She nodded. "But of course we don"t know if they didn"t have an NDE, or if they had one but simply didn"t remember it," she said, and got in the elevator. "Remember, before techniques for recording REM sleep, it was thought that certain people didn"t dream."
The door shut. Heart attacks, drownings, car accidents, Richard thought, staring blindly at the door. All traumatic events, with a high level of epinephrine. And cortisol.
He went back to the lab and called up Mrs. Troudtheim"s a.n.a.lysis and looked at the cortisol level. It was high, but no higher than Amelia Tanaka"s during her fourth session, the one in which she had been under nearly five minutes. The epinephrine was slightly lower, but no lower than Mr. Sage"s, and he"d had no trouble achieving an NDE-state, even if he was maddeningly vague about describing it.
Maybe the problem was a lack of receptor sites. He brought up Mrs. Troudtheim"s scans and started through them, focusing on the hippocampus. Yellow activity along the hippocampus edges, where there were large numbers of cortisol receptor sites. He went forward through the frames and then backward, mapping the areas of activity. The anterior hippocampus went from yellow to orangeand then red. He clicked back another single frame, looking at the edges and then at the epinephrine receptor sites in the- He stared at the screen, clicked on "stop," made it go back three frames, and then forward again to the same frame, and stared at the screen again. He clicked on "side-by-side," and called up the standard and then Amelia Tanaka"s scan.
There was no mistaking it. "Well, at least I know it"s not insufficient epinephrine," he muttered.
Because what he was looking at was unmistakably the brain in an NDE-state.
He did a superimpose with Mr. O"Reirdon"s scan to make sure, but it was already obvious. Mrs.
Troudtheim had had an NDE.
The pattern only lasted a single frame, but it changed the whole nature of the problem. He had been focused on what was preventing Mrs. Troudtheim from achieving the NDE-state, but she had had one. The problem was that she hadn"t been able to sustain it. Why not? Why had she immediately bounced out of it and into a waking state? And had this happened before?
He began mapping the NDE frame, looking for anomalies that might explain the NDE"s nonsustainability. Nothing. It showed the same red-level activity in the right anterior temporal lobe, the amygdala, and the hippocampus, the same random scattering of orange- and yellow-level activity in the frontal cortex.
Joanna came back, her hair windblown and her cheeks pink from the cold and handed him an orange-and-yellow-green crocheted thing in a small clay pot. "From the Spring Fling," she said.
"What is it?" he said, turning the pot around.
"A marigold. A crocheted marigold. I thought of you as soon as I saw it. I know how fond you are of orange and vile green."
"Did you see Mrs. Haighton?"
"Yes, and interviewed her, and she"s fine, no secret supernatural beliefs, and she"s scheduled to come in Thursday afternoon. I know, that"s Mr. Sage"s slot, but between the Philharmonic Guild and the charity fashion show, it was the only time she was available, so I decided it was worth moving him. I"m going to call him now."
"Wait a minute," Richard said. "I want to show you something." He showed her the side-by-side of the standard and Mrs. Troudtheim"s NDE frame.
"She had an NDE?" Joanna said. "Do you think she"s lying to us about not remembering it?"
That idea hadn"t occurred to him. "No," he said. "It only lasted a tenth of a second, if that. I doubt if she"s even aware it happened. If she is, it"s probably only as a flicker of light. Or darkness.
But it changes the nature of the problem. She"s achieving the NDE-state, but something"s short-circuiting it. I"ve got to find out what that something is."
He worked on doing just that the rest of the day and the next morning. He mapped the framesbefore and after the NDE, and then went back over the scans of Mrs. Troudtheim"s other sessions.
He found an identical pattern in her second set of scans. There were none in the other sessions, but the RIPT images were a hundredth of a second apart. If the NDE-state was shorter than that, it would only show up part of the time, and the frames immediately succeeding the two NDE frames were identical to frames in the others.
He mapped them. They didn"t match those of the other subjects. They showed sharply decreased acetylcholine and elevated norepinephrine, both consistent with arousal. Mrs. Troudtheim was right. She"d jerked awake. When he compared them with the other subjects" arousal frames, the levels were identical.
He looked at the other neurotransmitters. High cortisol, no alpha- or beta-endorphins, traces of carnosine, amiglycine, and theta-asparcine. Carnosine was a variety of peptide, but he"d never heard of amiglycine or theta-asparcine. He"d need to talk to a neurotransmitter expert. He called Dr.
Jamison, who had an office up on eighth, and made an appointment to see her, but she wasn"t much help. "Amiglycine is present in the anterior pituitary gland. It acts as an inhibitor. Theta-asparcine is an endorphin that seems to primarily be involved in digestion."
Digestion, Richard thought. Wonderful.
"It"s been produced artificially," she said helpfully. "I think someone did a study on it recently. I"ll see if I can find it. It may have other functions. Endorphins frequently have multiple functions."
And maybe one of them is inhibiting NDEs, Richard thought, going back to the lab, but when he looked at the other NDEs, theta-asparcine was present in one of Mr. Sage"s and two of Amelia Tanaka"s, and he didn"t find any other anomalies in the neurotransmitter a.n.a.lysis or the bloodwork that might explain its instability.
He spent the next two days going over the scans again, but to no avail. When Mrs. Troudtheim arrived the next day, he still had no idea what the problem was.
She oohed and ahhed over the crocheted marigold. "Well, isn"t that the cutest thing?" she said to Joanna. "You don"t have the pattern, do you?"
"Sorry, I don"t," Joanna said. "I bought it at a bazaar."
"I"ll bet I could take a pattern off it," Mrs. Troudtheim said, leaning over the console to examine the yarn flowers. "This is just double crochet with a sh.e.l.l st.i.tch-"
"You can take it home with you if you like," Richard said, handing her the pot.
"Are you sure?" Mrs. Troudtheim said.
"I"m sure. Keep it as long as you like. You can have it."
"Well, how nice," she said, pleased. "Look, Tish, isn"t it the cutest thing?"
Tish oohed and ahhed, too, and they all examined the petals. Maybe the problem"s nothing but simple anxiety, Richard thought, and talking like this will calm her down to the point where she cansustain the NDE, but it didn"t. She was in the NDE for the s.p.a.ce of a single, perfect frame, and then wide awake.
"I feel so embarra.s.sed that I can"t do this," she said. "I don"t know what my problem is."
I don"t either, Richard thought, looking at the scans after she left with her crocheted marigold.
The NDE frame was a dead-on match for Mr. O"Reirdon"s.
Joanna came in. "Mrs. Haighton just called," she said. "She can"t come Thursday after all.
Emergency Friends of the Ballet meeting."
"Did you reschedule her?"
"Yes," she said. "For Friday after next. Listen, I"ve been thinking about what we talked about, and there"s another reason you should send me under. It would make me a better interviewer. The accounts are all so vague, even from good observers like Amelia Tanaka, and I think the reason is that I simply don"t know what to ask. It"s like if you were asking someone to describe a painting without knowing whether it was a Monet or a Salvador Dali. No, worse, it"s like if you were trying to get them to describe a painting without ever having seen a painting yourself. Right now I have no idea what they"re experiencing. They all say it"s not a dream, that it"s real. What does that mean?
"If I went under and saw that painting for myself, I"d know. I"d know if dark meant dark as in Carlsbad Caverns or the hospital parking lot at nine o"clock at night. I"d know if peaceful meant "tranquil" or "anesthetized." And I"d know what they"re experiencing that they"re not even mentioning because they don"t realize it"s important, and I don"t know how to ask them about it. I think you should do it. I think you should send me under."
He shook his head. "I haven"t given up on Mrs. Troudtheim yet, and we"ve still got Amelia Tanaka. We do still have Amelia Tanaka?"
She nodded. "At eleven."
"That means I"d better get things set up." He turned his attention back to the console. "I want to lower the dosage again. The lack of detail you"re worried about may not have anything to do with your questions. It may be due to endorphin levels, and if it is, it"s simply a question of finding the right level, and even Mr. Sage will turn into a fountain of observation."
"And if it doesn"t? What then?"
"We"ll deal with that when it happens. Right now, you need to call Tish and tell her to get up here. Amelia will be here any minute."
"There"s plenty of time," Joanna said. "Amelia"s always late. She won"t be here for at least fifteen minutes."
But she came in right on time, carrying her backpack. Richard shot Joanna a triumphant look.
"Go ahead and get ready, Amelia," he said, and started over to the console.
"Can I talk to you a minute, Dr. Wright, Dr. Lander?" she said, and he saw that she hadn"t madea move to shed her backpack or coat.
"Sure," he said.
"The thing is, my biochem professor is really piling it on, and I"m getting totally swamped..."
"And you need to reschedule? That"s not a problem," Richard said, trying not to show his disappointment. "What time will work for you?" he said. "Thursday?"
She shook her head. "It isn"t just biochem. It"s all my cla.s.ses. My anatomy prof"s giving a test a week, and my genetics cla.s.s-there"s so much homework, and the labs are getting a lot harder. My biochem lab-" She stopped, an odd look on her face, and then went on. "I need the extra psych credit and all, but it won"t do me any good if I don"t pa.s.s the cla.s.s. Or all my cla.s.ses." She took a deep breath. "I think the best thing is for me just to drop out, and for you to find somebody else."
Somebody else, he thought desperately. There isn"t anybody else. "I"m sure that won"t be necessary," he said, avoiding looking at Joanna. "I"m positive we can work something out. How about if we cut your sessions down to one a week? Or if next week is bad, we could skip it altogether," but Amelia was already shaking her head.
"It isn"t just next week," Amelia said uncomfortably. "It"s every week. I just have too much going on."
"I"ll be honest with you," he said. "I"m short on subjects, and you"re one of my best observers. I really need you in the project."
For a moment he thought, from the look Amelia gave him, that he had swayed her, but then she shook her head again. "I just can"t-"
"Is it because of the project?" Joanna asked, and Richard looked at her in surprise. "Did something happen during one of your sessions? Is that why you want to quit?"
"No, of course not," Amelia said, turning to smile at Richard. "The project"s really interesting, and I love working with you, with both of you," she added, glancing briefly at Joanna. "It isn"t the project at all. I"m just so worried about my cla.s.ses. Like in psychology-"
"I understand," Richard said, "and, trust me, the last thing I want you to do is fail psychology, but I also don"t want to lose you. That"s why I"m so determined to work something out."
"Oh, Dr. Wright," Amelia said.
"What about weekends?" he said, pressing his advantage. "We could schedule sessions on Sat.u.r.day morning, if that"s better for you. Or Sunday. You just tell us what would work for you and we"ll do it." He smiled at her. "It would really help me out."
She bit her lip, and looked at him uncertainly.
"Or evenings. We could schedule sessions at night if that"s better.""No," Amelia said, and her chin went up. "I"ve made up my mind about this. It"s no use trying to change it. I want out of the project."
15.
"Adieu, my friends! I go to glory!"
-Isadora Duncan"s last words, spoken as she got into a roadster and flung her long scarf around her neck in a dramatic gesture. When the car pulled away, the scarf caught in the spokes of the wheel and strangled her.
Vielle had a fit.
"What do you mean, he"s sending you under?" she said when Joanna went down to the ER to talk to her about Dish Night. "That wasn"t part of the deal. He was supposed to send volunteers under, and you were supposed to interview them afterward."
"There"ve been complications," Joanna said.
"What kind of complications?"
"Some of the subjects turned out to be unsuitable," Joanna said, thinking, That"s putting it mildly, "and two have quit, and we can"t get approval on a new set of volunteers for at least six weeks, so-"
"So Dr. Right, or should I say, Dr. Frankenstein, decides to experiment on you," Vielle said.
"Experiment on-? I can"t believe I"m hearing this! You were the one pushing me to work with Richard in the first place."
"Work with," Vielle said, "conduct experiments with, go out for Happy Hour after work with, not become a human guinea pig of. I can"t believe he"d let you do something so dangerous."
"It"s not dangerous," Joanna said. "You weren"t upset about his subjects undergoing the procedure."
"They volunteered."
"So did I. This was my idea, not Richard"s. And the procedure"s perfectly safe."
"There"s no such thing," Vielle said.
"Richard"s done over twenty sessions without any adverse effects."
"Really? Then how come you can"t hang on to your volunteers?""Their quitting didn"t have anything to do with the project," Joanna said. "And dithetamine"s been used in dozens of experiments with no side effects."
"Yes, well, and people take aspirin every day without side effects, and get their teeth cleaned, and take penicillin, and then one day they show up in the ER in anaphylactic shock. Or cardiac arrest.
There are side effects to everything."
"But-"
Vielle cut her off. "And even if there aren"t any side effects, you"re taking a drug that mimics a near-death experience, right?"
"Yes-"
"So what if it does such a good job of convincing the brain that it"s dying that the body takes the hint?"
"It doesn"t work like that," Joanna said.
"How do you know? I thought you told me one of the theories was that the near-death experience served as a shut-down mechanism for the body."
"There"s been no indication of that in our experiments," Joanna said. "In fact, the opposite may be true, that the NDE"s a survival mechanism. That"s what we"re trying to find out. Why are you so upset about this?"
"Because interviewing patients and discussing death at Dish Night is one thing. Doing it"s a whole different matter. Trust me, I see death every day, and the best survival mechanism is staying as far away from it as possible."