Trauma: a gripping psychological mystery thriller Read online

  Emma stands at the edge of the rooftop bar. The same full moon reflects rippling sparkles off the gentle waves of the sea below.

  ‘I’m sure I’ve seen someone watching us,’ Cam says. ‘But I can’t make out the detail.’

  ‘That’s because you never look in the right place.’ Ivan’s voice comes to them from a table in the centre of the bar.

  Cam glances over. Two girls sit either side of him, both drinking something pink through straws.

  ‘Where the hell should I be looking?’

  ‘Somewhere shadows like to be.’ Ivan grins and throws his hands out in a gesture that says he has no idea.

  Tonight’s music is downbeat. Sounds like a chill-out mix.

  Emma lets her gaze drift down to the quayside below. ‘You think the answer to all this lies in the shadows?’

  ‘Maybe’

  Emma considers his answer and, still smiling, steps aside to reveal a mirror hanging on the edge of the parapet in mid-air. Within it, a coal-black image coils and billows. But it clears, and Cam finds his own reflection staring back at him, grinning.

  Ivan snorts. ‘See, the mirror has answers. If you want to find them you start with yourself.’

  ‘Liar, liar, pants on fire,’ the mirror image says. But it isn’t in Cam’s voice.

  He reaches his hand out but it isn’t glass he touches. Instead, his hand goes right through towards faceless Emma. And his touch pushes her over into the empty night.

  As she falls, she smiles at him.

  When I look up, I’m a quarter of a mile from where I originally sat staring out at the water. I’m still on the path, but I’m on my feet near what appear to be gun emplacements. Two iron canons, remnants of Britain’s troubled history, point out over the river, guarding London’s waterway. I take a moment to orientate myself. I turn full circle twice and bring up Google Maps on my phone. I need to head back east.

  But the fugue is still fresh in my memory. Seeing and hearing myself in the mirror speaking in another man’s voice is even more enigmatic than usual. I’m clueless what any of it means.

  Then I remember my hand reaching out. Towards the faceless girl.

  My hand doing the pushing.

  Primed with the fresh information Nicole has furnished, it’s an image full of disturbing and dread possibilities.

  I squash the idea as I hurry back to the car, get in and clutch the steering wheel with both shaking hands. I’ve still got the file that Nicole gave me. I open it out on the seat and pick up Emma’s tiny notebook. I read ‘pants on fire’ written on the back but one page again. Only the last few words of that silly phrase, but the implication is clear. And it was aimed at me. A comment about a date and a time.

  Liar, liar, pants on fire, Cameron Todd.

  Worse, the date on the entry in the notebook was just a week before we went to Turkey.

  How it might be important or what it means is anyone’s guess. But I can’t help remembering Nicole’s words:

  Softly, softly, catchee monkey.

  Liar, liar, pants on fire sounds like Nicole and I might not have been as careful as we thought we had.

  10

  WEDNESDAY 11 March

  It’s 9am, I’m in a consulting room at the Southwark clinic. Fourth floor. Community Mental Health.

  ‘Mr Todd, when was the last time you had one of these fugues?’

  I look at the questioner. She’s young, Asian, thick glasses, businesslike clothes. She’s the studious type. Rachel would say I shouldn’t mention Asian. Not woke. She says that a lot.

  I wouldn’t say it out loud but I can’t help the thought. It’s registering the facts. Filing people in the right boxes because I have to. A different kind of identity politics, but the way my brain works now. I need to think it through, process it, check it against a list so I understand. All the automatic stuff has gone. Her partner is Asian too. As clichéd a pair of trained medic nerds as I’ve ever come across.

  ‘Yesterday,’ I answer. ‘I was out walking. The Thames Path out near Woolwich.’

  The trainee frowns. ‘Do they always occur when you’re out walking?’

  ‘No.’ According to Dr Adam Spalding, my consultant psychiatrist and the chap whose clinic this is, I can be a little blunt. He tells me often I should be more forgiving. Of other people and especially of myself. He’s always trying to reassure me. We’ve talked about survivor guilt a lot, although in my case, because I can’t remember Emma, feeling guilty about anything is difficult. In my case, confusion and acceptance are the main contenders in my emotional battles.

  ‘Fate is a cold, uncaring mistress, Cameron. You’ve done nothing to deserve this.’

  That’s one of Adam’s poetic favourites and I want to believe him but I can’t. I have triggers. Maybe the trainees use of the word ‘they’ presses my buttons. Objectifying my little fugue party pieces. Shouldn’t annoy me but it does. I’m here at Adam’s request because my ‘party pieces’ are something these two are unlikely to ever see again. So I’m trotted out periodically. I don’t mind. At least I try not to. They’re both ST2s, run-through trainees two years into specialising. An aeon away from being able to cope with someone like me alone. Hence Adam’s supervision from a back seat near one wall. He sits, vigilant and amused. Occasionally, he’ll sense my irritation and answers for me. His replies are always more fulsome than mine and always worth listening to. As is this one.

  ‘No, they occur not only when out walking. Other opportunistic triggers arise when Cameron is relaxing at home or while asleep, but usually during the early stages towards sleep or on the way back to wakefulness. Hypnagogic or hypnopompic phases in the sleep cycle.’

  ‘So they’re not sleepwalking episodes or dreams?’ the other trainee asks. He’s male, no glasses. Wears contacts from the way he keeps blinking. Spring has not yet sprung in London and the air in Adam’s room is crisp from the radiator blasting out heat. Not good contact-lens-wearing conditions.

  ‘No,’ Adam answers. ‘The distinction is clear. The remarkable thing here is that we have video EEG evidence of Cameron experiencing one of these hallucinatory fugues during his time in rehab. He appeared to get up from stage 1b sleep, dressed, walked four feet from his bed and sat down. Nine minutes later, he got back into bed and, now awake, wrote an account of what he’d experienced in great detail.’

  I slide him a look.

  Adam tilts his head back towards me. ‘Believe me, I realise you think there are gaps, but the detail is rich. The smells and sight of the bar–’

  ‘It’s always a bar?’ Trainee 2 probes.

  ‘Not a bar. That bar. Always,’ I reply.

  ‘And it typifies a hallucinatory fugue,’ Adam continues. ‘Stereotypical venues, and dialogue or involvement with imagined characters. The patient remembers the experiences as if they were real. However, close observation of Cameron while he is experiencing this fugue shows that he is engaged in activity quite separate and distinct from the hallucination. Automatic activities such as dressing, walking across his bedroom, or walking in the park. All physical activities he has no recollection of doing. What he recollects is the hallucination. There is also an element of time slippage. Cameron’s experience is that he is away at the bar far longer than he truly is. Sometimes his appreciation is one of hours when in fact it is no more than a few minutes.’

  The trainees blink, lapping it up. But I can see confusion and scepticism etched in their faces.

  My irritation flares. ‘Before you ask, no, not drug-induced and no, not sleepwalking.’

  Adam smiles and explains. ‘We know that because drug-induced hallucinations are neither internally coherent nor stereotyped. We also know that somnambulism does not play a part because the EEG results showed waking patterns.’

  I watch the trainees’ expressions. They’ve deliberately left one possibility out of the differential. I sit, waiting to see if anyone will be brave enough. Rigorousness overcomes Thick Glasses’ reserve. ‘What about fabricated confabulation?�
��

  I snort. She’s gone for the big words. Perhaps in the hope that I might not understand.

  Adam smiles. ‘Malingering is unlikely because…’ He lets it hang in the air.

  The second trainee takes the bait. ‘Because there’s cooperation with the evaluation. He let himself be EEG’d.’

  ‘Correct,’ says Adam. He grins at the trainee like the adept teacher he is. Praise where praise is due. ‘He’s also happy with the diagnosis. People who make things up want no end point.’

  I shake my head. So not true. All I want for Christmas is a bloody end point.

  ‘And there’s enough supporting pathology to provide an explanation.’ Thick Glasses redeems herself.

  Adam adds another encouraging smile. ‘History of traumatic brain injury is a known risk factor for both hallucinatory and dissociative fugue. Before we discuss that, what’s the difference?’

  No one answers.

  Adam, the good teacher, explains. ‘The typical dissociative fugue involves patients in a confused state physically travelling to a strange place, often significant distances, sometimes by car or other transport. They may stay at this new location for some time, suffering reversible amnesia characterised by loss of identity and personality. These states may last days, sometimes even months. When they recover, patients usually remember their previous lives and past. Hallucinatory fugues, as with Cameron, on the other hand, are short-lived, display clear recollection of the occurrence but no real major physical displacement. What links both fugues together is causation. In this instance, severe traumatic brain injury.’

  And there it is. My monster in the locked cupboard.

  Adam turns to me. ‘Cameron, why don’t you grab a coffee while I finish up with Meesha and Han. I’ll join you in ten minutes, okay?’

  I smile graciously at the muttered thank yous of the trainees and exit, my job done. I wonder if models who pose nude for art classes feel like this. I’ve read up on those. Some, the obvious narcissists, do it because… they’re narcissists. Others see it as a challenge to their own self-image issues. A few wrap it up in psychobabble, sharing a connectedness with the artists, being a part of the mindful creative process. That’s where the analogy starts and ends for me. After all, I’m not baring my all physically. What I’m exposing is my damaged mind. As with life drawing, the students always find it fascinating.

  And possibly, in some convoluted, cathartic way, it helps.

  I’m here to bare my all figuratively. But then a scene from one of Josh’s recommended films flashes into my head. Hannibal Lecter making District Attorney Krendler eat his own sautéed brain at the dinner table. All politeness and gore. I reach for my head in an automatic gesture. My skull is intact. I smile. If Josh could see me now he’d laugh and say something pithy like ‘always good to keep an open mind, right, Cam?’

  Josh has a lot to answer for.

  11

  I sit in the soulless waiting room. Stimulus-free apart from a smattering of magazines scattered over a battered laminated coffee table. I don’t pick up the Sept 2017 copy of Nat Geo that’s on the top. A thousand people will have thumbed through to look at the ridiculously cute proboscis monkeys it features. That’s a thousand layers of someone else’s unwashed commensals I could gather up and smear over my unsuspecting mucous membranes the minute I rub my nose or massage my eyes, which on average we do sixteen times an hour. Not a good idea at the best of times. And with Covid-19 roaring across Europe like a virulent tsunami these are not the best of times by a long chalk.

  The coffee comes in the form of paper tubes full of freeze-dried granules and a silver flask of tepid water. I mix both in a Styrofoam cup, tear open a capsule of long-life milk, sanitise my hands with a little bottle I carry, and sit. The coffee swirls in the cup, whirlpooling undissolved granules on the surface like survivors from a torpedoed ship. I wait for one of them to yell ‘help’ before I take two sips and then discard the cup and its contents as undrinkable. Fifteen minutes later Adam comes to the door and beckons me back in.

  The clinic is an NHS outreach, and the room reflects that. There’s no couch, just a clump of chairs previously occupied by the trainees, and a desk pushed against the drab wall with a drab view of South London housing through a drab, anodised, aluminium-framed window. Bits of paper and a screwed-up tissue lie discarded under Adam’s desk. I remember seeing them here that last time I visited. He needs to admonish the cleaners. Wake them up to a better level of hygiene. All well and good to attempt informality, create a relaxed atmosphere for the troubled patients. But this room falls well short and only just achieves tawdry. Still, that’s not Adam’s fault.

  The trainees have gone. Adam waits for me to sit down, and then follows suit.

  ‘Thanks for doing that, Cam.’

  ‘Pleasure,’ I reply and do my best to make it sound genuine.

  It doesn’t, and Adam chuckles. ‘After you’d gone, Han asked if there was much difference between a hallucinogenic fugue and a lucid dream.’

  ‘Is there?’

  ‘You know there is. With a lucid dream you’re in REM sleep whereas you are wide awake when you fugue.’

  This is old ground we’ve trodden over many times.

  ‘So,’ Adam says. ‘The last one. Anything new?’

  I shrug and think back. My fugue venue never changes. Always the rooftop bar. The people are always the same too. Sometimes others appear, come and go. For instance, there’s a chatty bloke that wanders around clearing glasses away. He has an accent. But I can’t pinpoint it. Then again, he wasn’t there two days ago. ‘Just Ivan and Emma,’ I say. ‘Plus the shadow man.’

  Adam purses his lips and throws in, ‘I told Han and Meesha that you had concentration problems that we were working on.’

  Whoop-dee-doo. For concentration read anger. It surges now and a shopping list of familiar sniping thoughts roll through my head like credits for a terrible film. Did you tell them I’m ridden with survivor guilt? Mention the fact that I’m still under suspicion by the Turkish authorities? Explain that my dead partner’s family have a private investigator hassling me?

  But I bite that back. Adam has taught me how to do that through cognitive therapy. Instead of ranting, I say, ‘Did you show them my images?’

  ‘Of course.’

  They were always worth looking at, my MRIs and CTs. They had the wow factor in the form of spectacular mid-facial and cranial fractures. No one with that amount of damage would emerge unscathed. Okay, there’d been no intracranial bleed, but lots of bruising with most of the damage in the frontal lobe topped off with a bit of temporal, and limbic dysfunction from the axonal torsion that comes from falling fifteen feet and meeting the immovable hard edge of a metal stanchion supporting a concrete ramp face-on.

  I’m au fait with all the technical words by now, though I am not medical. The vocabulary comes with the SBI territory along with a host of other things, like learning how to walk and swallow again, and, eventually, how to ride a bike and even drive. All of which has taken an age. Seventeen months, in fact. Adam says I’m lucky and uses words like ‘remarkable’ when he describes my recovery.

  It may be so but doesn’t feel like that to me. I can’t see much other than light and dark through one eye, I’m still a little slow to start movements from standing and my right foot sometimes feels like it doesn’t belong to me. I’m often irritable and I’m intolerant of too much of anything. Add to that a touch of confusion with words and I truly am a prize specimen. But the icing on the cake is the fugues. All thanks to what happened to me that night in Cirali.

  Adam sits, placidly waiting for me to change direction or complain. I do neither. I’m glad when he doesn’t say ‘Emma?’ and raise his eyebrows. He can probably tell that I still can’t see her face during my fugue. Not clearly enough to recognise her, though since it happened, I’ve looked at her photograph a thousand times. But I still don’t know her. She’s a stranger to me even though we’d been together for five years by the time
she died.

  That, perhaps, is one of the hardest things to accept.

  Adam knows that if I’d seen her face during the fugue, I’d let him know right away.

  ‘I got my licence back a week ago,’ I say.

  Adam punches the air. ‘Yes! I told you we’d get there.’

  ‘You did. Already been out for a spin.’

  Adam frowns. ‘Good. But don’t overdo it. You haven’t driven in what, a year and a half?’

  ‘I’ve taken some refresher lessons. All good.’

  ‘Very sensible. But remember that excessive psychosocial stimulation can make things worse from the fugue point of view.’

  At least he doesn’t wag a finger. ‘Come on. Give me a break. I’ve been a hermit for fifteen months. I don’t count the two before that when I was in a comb in that Turkish hospital.’

  Adam doesn’t correct my vocabulary. He knows I mean coma. He corrects my exaggeration instead. ‘Ten days.’

  ‘Whatever. I need to get out. Lay a few goats.’ It should be ghosts, of course, and this time Adam laughs. My intermittent aphasia can sometimes be hysterical. ‘Only kidding,’ I add by way of deflection and Adam laughs again. I don’t tell him about visiting Emma’s practice. I don’t tell him about Nicole. Not yet.

  ‘Not the best of timing though, Cam.’

  ‘Why?’

  ‘Rumour has it we’re following Italy on the Covid curve. They’ve been locked down for a week. Driving may not be so easy in a few days’ time.’

  ‘You really think things will get that bad?’

  Adam’s mouth turns down. ‘My brother is an epidemiologist. He says some kind of enforced social distancing is inevitable.’

  ‘Shut down the cities like in China?’

  ‘They have in Northern Italy. And even though as a country we don’t do Mediterranean Sundays with Mass followed by all the generations sharing a bowl of rigatoni at grandma’s house, we will need to make sacrifices.’