“I’m sure it’s not a major injury and it was an accident.”
“I’m not. Sure, that is. Julie’s been . . . unpredictable lately. She didn’t used to talk. Now she babbles like you heard today. And she’s never thrown anything before. I am—truly—sorry.”
I wished she’d mentioned the talking and throwing things earlier, but I only said, “Nothing to be sorry for. I’m not quitting. I’ll be back.”
She bit her lip and nodded, frowning and disbelieving me. But I would be back—I wanted to know what was going on with Julianne as much as she did. There were ghosts, and there was something guiding her actions—if not actually possessing her body, which I wasn’t quite sure of.
I did, however, need to do something about my eye. The longer I let it go, the more the sting came back. Unlike another Greywalker I’d met, I had no desire to give up my sight—either Grey or normal. I’d gotten used to seeing the invisible, but it was not an adequate substitute for the normal view.
My eyes were watering badly by the time I got in to see my doctor, who sent me to an ophthalmologist for some kind of chemical test, who in turn sent me back to Dr. Skelleher with the results—dealing with the labyrinth of health care and insurance can be a royal pain in the ass, not to mention the time it takes.
Skelleher’s an odd young duck, but he understands my situation as much as any medical professional is ever likely to and he doesn’t believe there’s a pill for every problem. He gave my eyes a good looking-over and read through the ophthalmologist’s report. He always looked rumpled and sleepless, though a bit less so than usual today—his spiky hair might actually have been styled that way rather than having happened by accident. He had a small following of ghosts standing just behind him everywhere he went. They didn’t seem hostile and he was oblivious to them and any dampening effect they might have had; his aura was bright and colorful, shifting through gold and pink and shimmering, pale blue. Maybe he finally had a girlfriend—or a boyfriend; I had no idea what revved his engine. Whatever it was, he was tired, but pretty content with his life, which is something I rarely get to see.
He plopped onto the backless stool and took a deep breath before giving me the news. “You have some chemical irritation to the lid and sclera. It’s fairly mild, but it’s going to feel uncomfortable and itchy for a few days and may cause you to have some minor vision problems—blurry vision, watering, and so on. Like the ophthalmologist, I’d advise you to rest your eyes as much as possible, but I know you’ll ignore that. Try anyhow. Dr. Michaels prescribed some drops for the pain and some ointment to clear up the irritation, which you need to use twice a day, as I’m sure he told you. If the irritation doesn’t clear up with these meds, I’ll have to insist on your going back to Dr. Michaels. And I know you don’t like to do that. Also, don’t rub your eye. At all. Use the drops and make sure you
“If you start seeing anything weird . . . Well, that’s pretty much normal for you, so let me rephrase that: If the irritation gets worse or you seem to be losing sight, seeing dark spots, having an unusual degree of tearing or blurring, bloody tears, literally seeing red, or the eyelid swells significantly, take yourself to Emergency. And I mean it. You do not want a major eye infection—at least the green pigment wasn’t radioactive, so you missed that complication. But I will bust your chops about it if you don’t do as you’ve been told.”
“Whoa, Skelly! Nice bedside manner.”
He shook his head. “Seriously. This is not something you can ignore. Chemical burns create conditions that can lead to severe infections and we don’t do eyeball transplants. And I shouldn’t have to remind you that your eyes are in your skull, very close to your brain, and you really don’t want massive infections anywhere near the blood/brain barrier.”
“I’m sorry I sounded flippant. I understand the implications.” I didn’t have to pretend to be abashed. “And I know I’m a difficult patient.”
“Actually, you’re not. But you are stubborn and prone to extraordinary accidents.”
I couldn’t argue against that. After all, Skelly had treated me for monster bites, ribs broken by ghosts, and any number of more usual injuries from physical confrontations. Not to mention a small case of being dead once or twice.
“I promise to do as instructed. I’ll go straight home and rest my eyes. But can I ask you a question first?”
Skelly pushed his hands through his hair and gave me a tired smile. “Sure.”
“What can you tell me about persistent vegetative states?”
“PVS?”
I nodded. “Yeah.”
“Why do you ask?”
“I have a case that touches on it.”
“Ah. Well, I can’t talk about specific cases and I’m not a neurologist but I can give you a broad rundown. Do you know what a PVS is?”
“It’s like a coma, isn’t it?”
“No. It’s a separate thing. Coma is a short-term state that mimics very deep sleep—it only lasts hours to a few days while the cortex of the brain is severely traumatized. Then the patient either dies because the brain can’t survive the trauma, or they move on to a vegetative state where they may respond to some stimuli, may seem to be awake for a few minutes at a time, but they aren’t actually aware. Usually that state lasts a few days—a couple of weeks at most—while the brain heals from whatever trauma caused the initial coma, and after that the patient wakes up and resumes normal response to stimuli—or as much as they can.
“This kind of thing happens in . . . say, meningitis cases or head trauma cases and usually resolves one way or the other very quickly. But if the patient’s state doesn’t change—if they don’t wake up and start responding to stimuli after four weeks—we call it a persistent vegetative state, or PVS. To most people it still looks like deep sleep, but the patient may seem to respond to some stimuli and to do things like sigh, laugh, or cry. It may seem like they’re aware, but it’s just autonomic function. They are actually nonresponsive because the brain stem is functioning but higher functions are shut down.”
“So, is this common?”
“Oh no. PVS is rare. Comas aren’t common, so the states that evolve from them are even less so, and most—as I said—resolve long before a persistent state occurs. I’ve never actually seen a case of coma or PVS in my career. Most non-neurologists don’t unless they work in emergency or trauma. And then there are fugue states, which are psychiatric cases of personality disassociation in which the patient has periods of amnesia and denies actions they undertook at that time—not just don’t remember, but actively deny doing them. Fugue states can be related to temporal lobe epilepsy, schizophrenia, and multiple personality disorder,” he added, ticking them off on his fingers.
I shook my head. “That’s not the situation here. The person in question is literally bedridden and seems to be asleep, but she keeps sitting up and painting compulsively. But I have to say, she doesn’t really seem to be ‘there’ when it happens.”
Skelleher stared at me. “You saw this?”
I nodded.
“When?”
“Today. That’s how I got paint in my eye—the patient flipped her brush at me while she was painting, but it was more like she was a puppet being operated by someone else because she didn’t actually open her eyes or seem to respond to anyone in the room. And then she started babbling and lay back down.”
“That’s . . . that’s impossible. Not even in a minimally conscious state would that happen. It has to be a hoax.”
“Unless the home care nurses are in on it, I don’t think so. I hear there may be other PVS patients in town who are doing similar things. . . .”
Skelly seemed appalled. “Really? That’s freaky.”
“You haven’t heard about them?”
“I’m a GP. When would I have
“Do you think I could talk to the other people involved with those cases . . . ?”
