Book of the Dead

“Can we start, please?” Dr. Self’s voice.

Intercom off, and Dr. Lane says to Benton, “You ready for the PANAS?” Positive and Negative Affect Scales rating.

Benton pushes the intercom button again and says, “Dr. Self, I’m going to start with a series of questions about how you’re feeling. And I’ll be asking you these same questions several other times during our session, all right?”

“I know what a PANAS is.” Her voice.

Benton and Dr. Lane exchange glances, their facial expressions relaxed, revealing nothing as Dr. Lane says sarcastically, “Wonderful.”

Benton says, “Ignore it. Let’s just do this.”

Josh looks at Benton, ready to start. Benton thinks of his conversation with Dr. Maroni and the implied accusation that Josh told Lucy about their VIP patient, and then Lucy told Scarpetta. It still puzzles Benton. What was Dr. Maroni trying to say? As he looks at Dr. Self through the glass, something comes to him. The file that isn’t in Rome. The Sandman’s file. Maybe it’s here at McLean.

A monitor displays vital signs remotely relayed by Dr. Self’s finger holder and a blood pressure cuff. Benton says, “BP one twelve over seventy-eight.” He writes it down. “Pulse seventy-two.”

“What’s her pulse ox?” Dr. Lane asks.

He tells her that Dr. Self’s arterial oxyhemoglobin saturation — or the measurement of oxygen saturation in her blood — is ninety-nine. Normal. He presses the intercom button to start the PANAS.

“Dr. Self? Are you ready for a few questions?”

“Finally.” Her voice over the intercom.

“I’ll ask questions, and I want you to rate what you’re feeling on a scale of one to five. One means you feel nothing. Two means you feel a little. Three is moderately, four is very much, and five is extremely. Make sense?”

“I’m familiar with a PANAS. I’m a psychiatrist.”

“It appears she’s a neuroscientist, too,” Dr. Lane comments. “She’s going to cheat this part of it.”

“I don’t care.” Benton presses the intercom button and goes through the questions, the same ones he’ll ask her several more times during the testing. Is she feeling upset, ashamed, distressed, hostile, irritable, guilty? Or interested, proud, determined, active, strong, inspired, excited, enthusiastic, alert? She assigns a rating of one to all of them, claiming she feels nothing.

He checks her vitals and writes them down. They are normal, unchanged.

“Josh?” Dr. Lane indicates it’s time.

The structural scan begins. What sounds like loud hammering, and images of Dr. Self’s brain are displayed on Josh’s computer screen. They don’t reveal much. Unless there is some gross pathology, such as a tumor, they will see nothing until later, when thousands of images captured by the MRI are analyzed.

“We’re ready to begin,” Dr. Lane says over the intercom. “You all right in there?”

“Yes.” Impatient.

“The first thirty seconds, you’re not going to hear anything,” Dr. Lane explains. “So be silent and relax. Then you’re going to hear an audiotape of your mother’s voice, and I want you to just listen. Be completely still and just listen.”

Dr. Self’s vitals remain the same.

An eerie sonar sound that brings to mind a submarine as Benton looks at Dr. Self’s blanketed feet on the other side of the glass.

“The weather here’s been perfectly wonderful, Marilyn.” The recorded voice of Gladys Self. “I haven’t even bothered with the air conditioner — not that it works. Rattles like a huge insect. I just keep the windows and doors open because the temperature isn’t so bad right now.”

Although this is the neutral set, the most innocuous one of all, Dr. Self’s vital signs have changed.

“Pulse seventy-three, seventy-four,” Benton says, writing it down.

“I’d say this isn’t neutral for her,” Dr. Lane says.

“I was thinking of all those gorgeous fruit trees you used to have when you lived down here, Marilyn, the ones the Department of Agriculture had to cut down because of the citrus canker. I love a pretty yard. And you’d be pleased to know that silly eradication program has pretty much ground to a halt because it doesn’t work. Such a shame. Life is all about timing, isn’t it?”

“Pulse seventy-five, seventy-six. Pulse ox ninety-eight,” Benton says.

“…The darnedest thing, Marilyn. This submarine going back and forth all day about a mile offshore. Has a little American flag waving from the whatever you call it. The tower where the periscope is? Must be the war. Back and forth, back and forth, some kind of practice, the little flag waving. I say to my friends, practice for what? Did anybody tell them they don’t need submarines in Iraq…?”

The first neutral set ends, and during a thirty-second recovery period, Dr. Self’s blood pressure is taken again. It’s gone up to one sixteen over eighty-two. Then her mother’s voice again. Gladys Self talks about where she likes to shop these days in South Florida, and the never-ending construction, high-rises sprouting up everywhere, she says. A lot of them empty because the real estate market has gone to hell. Mainly because of the war in Iraq. What it’s done to everyone.

Dr. Self reacts the same way.

“Wow,” Dr. Lane says. “Something’s certainly got her paying attention. Just look at her pulse ox.”

It’s dropped to ninety-seven.

Her mother’s voice again. Positive comments. Then the criticism.

“…You were a pathological liar, Marilyn. From the time you could talk, I never could get the truth out of you. Then later? What happened? Where did you get those morals of yours? Not from anyone in this family. You and your dirty little secrets. It’s disgusting and reprehensible. What happened to your heart, Marilyn? If only your fans knew! Shame on you, Marilyn…”

Dr. Self’s oxygenated blood has dropped ninety-six percent, her breathing more rapid, shallower, and audible through the intercom.

“…The people you threw away. And you know what and who I mean. You lie as if it’s the truth. That’s what’s worried me all your life, and it will catch up with you one of these days…”

“Pulse one hundred and twenty-three,” Dr. Lane says.

“She just moved her head,” Josh says.

“Can the motion software correct for it?” Dr. Lane asks.

“I don’t know.”

“…And you think money solves everything. Send your widow’s mites and it absolves you of responsibility. Pay people off. Oh, we’ll see. One of these days you’ll reap what you sow. I don’t want your money. I have drinks in the tiki bar with my friends and they don’t even know who you are to me…”

Pulse one hundred and thirty-four. Oxygenated blood down to ninety-five. Her feet are restless. Nine seconds left. Mother talks, activating neurons in her daughter’s brain. Blood flows to those neurons, and with the increase of blood is an increase in deoxygenated blood that is detected by the scanner. Functional images are captured. Dr. Self is in physical and emotional distress. It isn’t an act.

“I don’t like what’s going on with her vitals. That’s it. No more,” Benton says to Dr. Lane.

“I agree.”

He gets on the intercom. “Dr. Self. We’re going to stop.”

From a locked cabinet inside the computer lab, Lucy retrieves a tool kit, a thumb drive, and a small black box as she talks to Benton on the phone.

“Don’t ask questions,” he says. “We just finished a scan. Better put, had to abort one. I can’t tell you about it, but I need something.”

“Okay.” She sits in front of a computer.

“I need you to talk to Josh. I need you to get in.”

“To do what?”

“A patient is having her e-mails forwarded to the Pavilion’s server.”

“And?”