Flashback

address. For a number of patients the compound dislodges them from the objective present and sends them into flashback modes. In short, they relive long-forgotten experiences.”

“That’s impossible,” Moy growled. “Our brains aren’t like some Blockbuster video collection, for God’s sake.”

“True, but Louis out there has been experiencing some kind of throwback to his Korean War days. In his mind he’s twenty years old and with his buddies in Korea.”

“That’s ridiculous,” Moy said. And his medical director nodded agreement.

“But that’s what we just witnessed,” Nick continued. “And it’s what I think happened with Mary Curley. From police reports, the woman was clearly delusional, thinking she was a child again looking for her puppy. And she crawled under the trolley. In her mind she was back six decades. Like Louis Martinetti, she was locked into continuous dissociative experiences.”

Nick glanced at Jordan, whose face looked like red camouflage. The episode with Louis Martinetti had clearly upset him. Or maybe it was the way Moy was glaring at him. Jordan knew about these problems, of course. He had experienced similar episodes at his own trial site. So had the other investigators. “Luckily, nobody raised the question of a connection between Memorine and Mary’s suicide.”

“And there isn’t one,” Moy said.

The party line. Nick opened a file folder. “And they’re not just anomalies here. Maurico Rucci, who’s PI at the Providence trial site, reports similar problems. So does Peter Habib in Plymouth. He’s got a resident who refuses to change out of a party dress she’s worn around the clock for several days, and she becomes violent when aides try to make her. Apparently the dress was like one she had worn to her high school prom. And every time she has it on, she would hold full conversations with old classmates. It’s bizarre.”

“I don’t believe it,” Moy declared. And the others nodded.

“Another patient in the study from Schenectady was caught at the last minute trying to drown his three- year-old grandson in a sink.”

“What?”

“The mother stopped him in time. Later he said he thought the little boy was a fox. Then we learned he was raised on a chicken farm. He was trying to appease his dead abusive father, he said. This was not a violent person. Nor was Mary Curley suicidal.”

“Dr. Mavros, how do you know these anomalies weren’t the results of neuropsychiatric problems?”

“Because none of the placebo patients have flashback seizures. Look, I’m telling you that what we are seeing are intrinsically significant side effects that must be addressed.”

Thompson asked, “Any idea what these flashbacks are rooted in, Doctor?”

“No, but my guess is abnormal brain plasticity. Some people might be genetically susceptible to psychomotor seizures. Or it could be demographic. Whatever, we need to make a thorough dose-response profile of the population, since the numbers are high.”

“How high?”

“Thirty percent, maybe more.”

Throughout the exchange, Jordan remained quiet. But now he seemed to rise in his chair. “I beg to differ,” he said. “I’ve seen several reports, and these flashbacks are simply isolated cases that are clearly the result of the prior dementia and not Memorine.”

Nick nodded. “That was my suspicion, too, but when I withdrew patients from the drugs, the episodes disappeared. Unfortunately, that presents an even worse problem, as you know. Withdraw them too long, and the plaque returns.”

“So what are you recommending?” Moy asked.

“That we try to create a demographic profile while determining proper dosages and treatments. But we’ll need more time—maybe a year or two.”

Gavin’s face looked as if it had turned to brick. “We don’t have a year or two. The first weekend in June you, I, and every GEM Tech trial clinician are scheduled to meet at Bryce Canyon, Utah, to work out the final details of the application to the FDA. It has to be submitted by midmonth for a year-end market release. And you know that.”

Jordan cut in. “Nick, we’re talking about people who’ve suffered years of brain deterioration. And we all know that connections of the different areas lose control and get repatterned, resulting in different behavioral aberrations. With all due respect, dementia patients have adverse episodes—flashbacks, if you wish—but they’re caused by the rerepatterning from the original damage. In short, it’s the pathology, not the pill.”

“Then that’s something we better determine before we rush to the FDA.”

“Any idea what sets off these flashbacks?” Thompson asked.

“From what I’ve observed, external stimuli—odors, loud sounds, something somebody says, flashing lights. Almost anything can bring them on, in fact. Depending on the flashbacks, the experiences can be traumatic or delightful. Mr. Martinetti had clearly experienced trauma. So did Clara Devine and others, including one of Peter Habib’s patients, a Rodney Blake, who bled to death after he castrated himself for God knows what reason. Mary Hurley’s was just the opposite, and it killed her horribly.”

“And what do you do to stop them?”

“Dilantin, some of the other antiseizure medications. Heavy doses of antianxiety and antipsychotic drugs have been necessary also.”

“And how would you characterize the majority of these flashbacks?”

“For the most part pleasurable.”

“Is that a problem?”

“It is if they’re addicted.”

Thompson’s face screwed up. “Pardon me?”

“Many want to go back to their past,” Nick continued. “For them the present is a dull reality—like Dorothy returning from Oz to black-and-white Kansas. And they know that it’s Memorine that will get them to return.”

“You’re talking dependency.”

“Big time. And if they can’t get their flashback fix, some of them will try to bring themselves back by whatever means.”

“Such as what?”

“For Mary Curley, it was returning to a place where her parents had taken her—the Museum of Fine Arts. When her daughter brought her home, she somehow managed to make her way. But this was not your typical aimless dementia wandering. This was marked by purpose and destination. Others employ queer little rituals to trigger the flashbacks—like what you saw out there with Louis’s hand movements.”

“You mean hitting himself in the head?”

“He wasn’t hitting himself. He was saluting.”

“Saluting?”

“Yes, but on some weird fast-forward. It’s how he induces a flashback.”

“You’ve got to be kidding,” Moy said.

“I’m not kidding. Some subjects set off events by stimulating different sensory zones—rubbing parts of their bodies, pacing, bouncing on one foot. Or they play nursery rhymes and Christmas carols on their CD players. Whatever sends them back.”

“But Gavin’s right,” Thompson said. “Past experiences aren’t stored intact in the brain.”

“Yes. True memory is a matter of flashbulb recollections. With these patients, there are just more flashbulbs and a strong autosuggestive component, allowing them to create the illusion of being back when.”

“That guy was acting normal one minute, then he snapped.”

“Yes, and something set him off.”

“I am not happy about this,” Moy growled. “We’ve spent hundreds of millions of dollars in years of studies examining the efficacy and tolerability of Memorine with two dozen test groups and hundreds of patients, and consistently across all the damn scales the drug improved cognition—in some cases a hundred percent compared to placebos—and with no deterioration in global functioning and behavior. And now we have these goddamn flashbacks or whatever the Christ they are.”

Nick was aware that GEM’s marketing plan was to send scores of sales reps to physicians and health care