PATIENCE

(c) 1989 Aya Katz

Word Count:4800

He examined her pupils. Small, sharp, boding good health, even in this indoor light. He measured her vision through the image cast by her lens, much as a vet might calculate the eyesight of a dog. Twenty/twenty.

She blinked, an involuntary reflex. For an instant he was almost certain that the sea-green orbs had focused on him. Glancing again, he saw nothing but a blank stare.

Odd, her unconsciousness. The mouth was somehow not loose enough. She hardly ever drooled, though he never saw her swallowing. She defecated on herself, but one could never catch her in the act. It wouldn't happen when a nurse was bathing her, for instance.

Even her muscles seemed too well toned for one who spent days motionless. "Sometime she'll go into a fit," Nurse Carper had told him. "Starts running around like crazy. Nurse Hayden had to chase her all the way to pediatrics, only last week."

But mostly, Patience Palmer sat motionless, staring blindly in front of her, oblivious to the other occupants of the room.

"She's a very interesting case," Dr. Leech had said, rubbing his hands together, excited. "There is no brain damage. Physically, she's a perfect specimen. And yet there is no reaction. Totally autistic. Perfect for the project, wouldn't you say, Lance?"

He agreed.

"Unlocking the secrets of the mind..." That's what Dr. Leech's fundraising brochure said. And the powers that be were generous, so that the Neuroanalyzing Cerebrodigitizer(TM) had plenty of Federal funding for computers, and oscilloscopes and surgical equipment and the best breed of lab mice available. Dr. Leech called it the Cerebrodigitizer for short, but Lance just thought of it as "the mindreading machine."

"Now, Lance, I wish you wouldn't use those words," Dr. Leech had chided him. "It sounds unscientific and antisocial. We're not going to misuse our knowledge. The last thing we want is for people to get all into a panic that we'll read their petty little thoughts. Of course, the Cerebrodigitizer will never be used to infringe on civil liberties. It will probably never be admissible as evidence in a court of law. But think of all the sick minds we could heal, all the psychotics and other violent criminals we could help to rehabilitate."

So Lance didn't call it that out loud. Not that he thought there was anything the least bit derogatory about a mindreading machine. Actually, he was very excited about the project. For the first time in years, he enjoyed his work.

"Dr. Perkins?" a voice called behind him. It was Rosa Stallani, the other, newer patient. Lance turned. "Yes, Rosa?"

Rosa had curly red hair and almond eyes. She was always cheerful, probably because she had read somewhere that good cheer helps the body heal. Lance doubted that it made much difference. An inordinate amount of good cheer on the part of a very sick patient usually depressed him.

"Dr. Perkins," Rosa repeated as he approached. "Have they scheduled the surgery yet?"

Lance shook his head. "Not yet, Rosa. Dr. Leech is still waiting for that new piece of equipment." The project was funding Rosa's surgery, in return for the right to conduct certain minor tests while her brain was still exposed. Of course, the mind reading machine would need no direct contact with the brain. But Leech wanted to pinpoint more precisely the various nerve centers.

"Oh, I hope they do it soon," said Rosa, smiling. "After all, the sooner they do it, the sooner it's over, isn't that right, Dr. Perkins?"

Lance nodded, and tried to turn away. Her Pollyanish attitude was making him sick, not to speak of the obsequious way in which she kept saying "Dr. Perkins" in every sentence.

Lance had not wanted to be a doctor. He was much more interested in computers. But he tested well in the MCAT and everyone thought he should study medicine and he had given in. It wasn't for the money, because Lance was not a crass materialist. He did it for humanity. Someone like him was needed, someone with his sharp mind and analytical abilities. Anyone could design computers and write software - but only a few had what it took to be a neurosurgeon. (This was already in medical school, when he was thinking of dropping out and they discovered his steady hands and his cold self-possession under pressure.)

Lance grew up in a secular household where usefulness and productive work were considered the highest virtue. His mother's favorite pejorative was "parasite." Lance did not rebel, because you have to have values, and his parents' choice made more sense than anything else he found outside.

He had never wanted to be a doctor, because he disliked disease. He didn't have the temperament for it. When he saw sickness, he felt no compassion for the sufferer, only a kind of dull revulsion. Deep down inside, he didn't believe that the sick should be cured. He felt they ought not to have gotten sick in the first place.

But Lance Perkins was not one to follow personal whim. He had discipline. He became a doctor because that's where he was needed. And being a doctor, he had to be good at it. Biology had never been his thing, but as soon as he was able to think of the body as a machine, he did exceptionally well fixing it.

He turned back to Patience Palmer, she of the healthy body and the sick mind. Let Leech tend to Rosa. She was his patient, after all. And there was nothing unusual about the tumor. Palmer presented a puzzle.

She was nineteen years old, slim, pale, long straight brown hair tucked carefully behind her ears by the nurse. Sea weed eyes staring into eternity. Up until her seventeenth birthday, Patience had led a normal life, and on that day she turned her back on it. Total autism. He had studied her records and there wasn't a clue.

"The Palmer girl is suffering from some kind of psychological shock ... although goodness knows what it might have been. The social worker seems to think the parents are hiding something. According to them, the child never lacked for anything. No traumatic experience, no nothing. One day she's a high school student with the requisite extracurricular activities and the next day she's a vegetable. At first, they thought she had overslept. But she never truly woke up after that." Dr. Leech spread out his hands. "The Cerebrodigitizer could tell us ..."

But the Cerebrodigitizer was only a fuzzy idea. Leech had the backing and the equipment, but he hadn't the foggiest notion as to how to go about it. They were playing with mice and oscillators and getting nowhere.

A piercing scream woke him from his reverie. It was Rosa. He wondered whether the tumor was causing her to hallucinate. "Doctor! Doctor!" she cried, all the while pressing the pager for her nurse. "Over there, under the bed."

Nurse Carper rushed in. Lance looked to where she was pointing under the Palmer bed. Then he saw it. A long pinkish tail covered with fine white hairs.

"I'll get that rodent, yet," the intrepid Nurse Carper proclaimed poised for battle. She ran toward it, but tripped over Patience's outstretched leg. The mouse scurried off.

He helped her up. "Are you all right?"

She shook dust from her uniform. "Of course," she said. Then, perplexed: "I could have sworn that leg wasn't there before."

Lance looked at Patience and for a split second their eyes met. And that's when he knew. There was nothing wrong with Patience Palmer. Nothing at all.

***

"The principle of the Neuroanalyzing Cerebrodigitizer is quite simple," Dr. Leech expounded. "The brain is a biological entity, organic,analog and continuous. But we think in discrete units. So, even though we can now measure all of the electrical impulses passing through our cranium, we have no way of interpreting them into human language. And yet, the brain is the source and origin of all language. Our thoughts are stored there even before we utter them. And they are there, regardless of whether we choose to give them outward form.

"The information is already there. The technology exists to read it. All we have to do is sort the significant from the insignificant. All we need is the code..."

He paused then, looking at the audience from above his reading glasses. "Your funding has furnished us with the equipment. Our labor will provide the solution."

Leech was no orator. The meat of the speech had been handed him by Lance and the rest he had pasted together from all his other fundraising lectures. But for whatever reason, he kept the funds coming, as no one else could have. That was his most important contribution to the project. That and his boundless enthusiasm.

Dr. Leech was not without talent. He was a skilled neurosurgeon. His powers did not extend further. And this was not truly a biological puzzle. Not any more. What was required was a linguist or a computer expert. Or perhaps a neurosurgeon who should have been a computer expert. Like Lance.

"That went rather well," Leech said to him afterwards, as they were walking down the corridor.

Lance nodded. "There was something I've been meaning to mention to you," he said. "About Palmer."

Leech stopped in his tracks. "What about her."

"I think she's faking."

Leech smiled. "Now what makes you think that?" His tone was patronizing.

Lance shifted. "Nothing definite, really. She met my eyes."

"Optical illusion," Leech said, dismissingly. "We'd all like to think there is intelligence everywhere around us. There is always hope, of course. No reason why she can't recover. But she's been through shock therapy with no response. Nobody could fake that."

Lance furrowed his brow. That would be hard. "Maybe you're right," he said. "But you should have seen her."

Dr. Leech patted his shoulder. "She has a human form, you expect her to behave like one. But the body is like the exoskeleton of an insect, it retains the shape long after the soul is gone."

Lance wondered what profession Leech would have chosen, if he weren't a neurosurgeon. Literature, maybe. Or the pulpit.

Lance started to walk away, to his rounds, but Dr. Leech stopped him. "Don't get emotionally involved with the patient," he said.

That was a silly admonition. Lance had never been emotionally involved with a patient in his life. He had never been emotionally involved with anyone, actually. His wife Carol often complained he was cold.

Sick people evoked no sympathy. But Patience Palmer was different, because he suspected her of being healthy. Lance was determined to get to the bottom of it, if only for the sake of the public at large. After all, the County was paying for her hospital bed.

He waited until Rosa was wheeled out for another battery of tests. He approached her. The eyes stared blankly ahead. He put his hand on her shoulder, lightly, and whispered in her ear. "I know you're in there."

There was no reaction. He spoke out loud, this time. "Why are you hiding?" A muscle in her right foot was twitching. All else was immobile. "What are you afraid of?"

Then Nurse Carper came in. "No use talking to her," she said, exuding common sense. "Nothing upstairs." She pointed a stubby finger at her own forehead.

Lance decided to change the subject. "Did you catch that mouse?"

"No, and it's really upsetting me. We've always prided ourselves on running a tight ship, and now this one little mouse ..."

"How do you know it's just one mouse?"

"I recognize him," she said knowingly. "You may smile, Doctor," she wagged her finger at him. "But I know mice. And there's only this one. One of Dr. Leech's mice, by the looks of him. Careless of the doctor. Could start a plague or something."

Everyone has his obsession. For Nurse Carper it was the white mouse. For Lance, it was Patience.

Her reflexes worked perfectly, but she showed little reaction to pain. The few efforts he made in that direction proved futile. He decided to devote himself to a more subtle approach. He would have to trick her into exposing her mind.

He discussed everything with Carol. She grew listless when he described the technical details of the mind reading project, but Patience Palmer was another matter. Suddenly, she was interested in his work. Maybe it was the empathy factor, he thought. Carol was very empathetic. But after a few weeks, she grew sour on the subject and began making barbed remarks.

"Maybe you should try waking your sleeping beauty with a kiss," she said, in a none too friendly tone.

Lance thought that over. "It may be worth a try," he finally said, oblivious to her expression.

He did not neglect the Cerebrodigitizer. At the moment, he was pursuing the audio theory. "After all, we cannot expect our thoughts to be recorded in the brain in binary or hexadecimal with each number standing for a letter, the way computers do," he had said to Dr. Leech. "We don't think in letters, we think in words. And language begins long before the written word ..."

What if there were patterns near the audio-speech center, symbolizing audio signals? What if the incoming and outgoing words always took that form, regardless of the way in which they were processed in the other parts of the brain? What if unspoken sentence were stored that way momentarily as the thoughts formed?

The experiment yielded no results with the mice, Rosa, or even Lance himself. The patterns once enunciated formed meaningless sounds, high pitched or low, depending on how Lance programmed the enunciator. With Patience, too, it was a failure.

He returned that night, after a spat with Carol over the proper way to cut a roast. "You are not in surgery," Carol had shouted. "This is just a roast. Can't you be more human?" He didn't understand what she wanted. What was the human way to cut a roast? So he drove to the hospital. He couldn't sleep anyway, so he fitted Patience with the skullcap and fiddled with the controls. And then something odd happened. The tones fit together. Not as words. It was a tune!

Lance had no talent for music. He couldn't even carry a tune. But he could recognize one when he heard it. It was odd and exotic, not like anything he'd ever heard before. But it was a tune. The notes went together, pursuing a relentless logic. No random pattern here. It was melodic and soothing, like a lullabye, or a love song.

He fell asleep at the foot of Patience's bed, to the sound of Rosa tossing and turning, muttering something about a mouse. When he awoke, a few hours later, Patience's motionless fingers were twined in his hair and Nurse Carper was glaring at him.

***

"If what you are telling me is true," Dr. Leech said, "this could be quite a breakthrough." He's already thinking about the articles he will publish, Lance thought. "But what can it mean, that we think in musical arrangements. Or that disturbed people, like Palmer, do?"

Of course, that was nonsense. Dr. Leech was never very good at theorizing. But he was quite sharp once a fully formed theory was presented to him.

They tried to reproduce the experiment, to no avail. But Dr. Leech believed him, because of the small fragment that was still on the tape, the one right after the leader, that hadn't been erased.

Before she went into surgery, Rosa, dark rings under her eyes, confided to Lance that she thought she was losing her mind. She had seen the mouse talking to Patience. "I was scared to mention it before," she said, smiling wanly, "but now that I'm going in and I'll be well again soon ... I guess there is no harm in telling you." Lance nodded unthinkingly and turned to go. "Don't tell Dr. Leech, please, he'd think me so silly."

Lance wondered why patients were always confiding in him, rather than in the more sympathetic doctors. When Dr. Leech came in, Rosa was her usual cheerful self. "I'm looking forward to this operation so much," she said. "I can't wait to be all better again." And Dr. Leech patted her now shaven head in the most sympathetic manner imaginable.

After the tumor was successfully removed, Dr. Leech began conducting his experiments to pinpoint more precisely the various nerve centers of the brain.

"Shouldn't you begin to close?" Lance asked. The acceptable period had elapsed, and everyone knew that excess exposure greatly increased the risk of complication.

Leech grunted. "Just a bit longer. I'm not getting any reaction here. Increase voltage." And that's when Rosa's brain waves went flat.

***

No autopsy was performed, because Dr. Leech and Rosa's parents agreed that she would be kept on life support indefinitely at the project's expense. The hospital board did review the case and absolved Dr. Leech of any wrongdoing, as there had never been any documentation of such experimentation resulting in brain death. Lance didn't know what he felt, except that he knew Rosa did not have to die and that Dr. Leech's precautions were minimal. And every time he passed by her bed, (for she, along with her support machinery, were still lodged with Patience) he felt a little strange.

"There's nothing to feel guilty about," Carol soothed him when he mentioned it to her. "She wasn't even your patient."

Lance thought about that. He wasn't aware of feeling guilty, just very uneasy. Something was wrong. Somebody ought to fix it. It wasn't his place to do anything about it, he had told the board everything he saw and they absolved Leech. Lance didn't feel responsible, just vaguely derelict, as though he had shirked some duty. But the feeling was unfounded. He dismissed it.

It was about this time that Carol began insisting that he take a vacation, that he needed some time away from the project. She even had the audacity to speak to Dr. Leech about it, which angered Lance very much. In retaliation, he spent even more time at work.

He took to telling Patience the things he used to discuss with Carol. Ostensibly, this was in order to try to involve her in life. In fact, it seemed to do him more good than it did her. He stared into her big green eyes and told her about Rosa's operation and what the board had said and what Carol had said, and he just knew that she understood.

"Dr. Leech killed Rosa and nobody cares," he told her once, in the middle of the night, with Rosa's mindless shell as only witness.

He felt refreshed, absolved, set free. But there was no reaction from Patience.

The tune he had heard in the enunciator ran through his mind. Sometimes he would try to hum it, but it came out all wrong. Any attempts to reproduce the experiment failed. That is, except for once when he had forgotten to put a tape in the recorder, and the enunciator, drawing on the patterns in Patience Palmer's mind, played him a very long piece, with classical overtones. Lance sat there transfixed, and did not move until after it was done. So the work was lost to posterity.

"Autism," Dr. Leech declared, "results from a total lack of motivation. The patient has no ties to anything outside himself. No involvement. Therefore he cannot be motivated to react to stimulus and his behavioral patterns cannot be altered."

Leech made it sound as though all the rest of humanity were prisoners of their feelings for the world without. Lance thought that a ludicrous hypothesis. What could motivate anyone to be interested in anything other than the real world?

One night he fell asleep beside her bed (this was happening more and more frequently) and when he woke, the mouse was there next to Patience on the bed. She was stroking its soft white fur.

Lance knew what to do. He reached for the mouse and caught it by the tail and the mouse doubled over and bit him in the thumb, but he paid no attention to the pain and held on. "I'll kill the mouse," he said softly, looking into her sad green eyes, "if you don't talk."

She sat up in bed, hesitation on her features. He continued. "I mean it, Patience. It's a tough world out there. Nobody but you can save this mouse."

She reached out her hand for it then and he knew he had won. "Talk," he said.

She tried, but at first no sound came out. She cleared her throat. "Let Binky go," she said. Her voice was soft, childlike.

He was so startled that his grip on the rodent slipped and the mouse scampered off. He had not meant to release him. But he would not let her lapse into autism so easily, even now with the hostage gone. He rushed to her and shook her by the shoulders, roughly, but with feeling. "Why, Patience? Tell me why."

She smiled then and now she was like an adult talking to a child. "Why what, Doctor?"

He had to keep her talking. "Why are you faking autism?" For a split second he wondered whether she knew the word. What was her level of education or intelligence? But then he knew, as he had all along, that she was not merely sentient, she could think.

"I wasn't faking autism," she said. "I was autistic. Am autistic. The world doen't matter to me." She cleared her throat, for it had gone dry again. "Except for Binky. I hadn't counted on him."

Lance smiled now. This wasn't very flattering. "What was so special about Binky?"

"He was free. He found a way to escape. Not just from his cage and Dr. Leech's experiments. From any cage. The one you're in, or Nurse Carper or Rosa's pathetic attempts to convince herself that everything would be all right."

Lance remembered his last conversation with Rosa. "She said she saw Binky talking to you. Is that true?"

Patience laughed. "She saw me talking to Binky. She must have been so convinced that I was incapable of speech that she attributed it to Binky."

About this time, the moralist in Lance began to take over. "But why? How could you let people wait on you hand and foot and wipe away your excrement, when you were fully capable of productive work?"

She gave him a slantwise glance. "On the contrary, I chose to do this so that the mundane world couldn't interfere with my so called productive work."

He spat it out. "What work?"

"I'm a composer," she said with great dignity. He almost expected her to reach into the folds of her hospital gown and draw out a business card: Patience Palmer, Composer. He shook his head. "You mean, you'd like to be a composer?"

Her voice was firm. "No, I mean I am a composer. That's what I've been doing full time for the past two years. So far, I have written 12 concertos, 15 sonatas, and two operas ..." She smiled again and he noticed a small dimple on her left cheek that he'd never seen before. "They're very good, if I do say so myself. But then, you've heard some of my music."

"Yes, how did you do that?"

She shrugged. "I just imagined I was hearing it. I do that a lot. My teachers always said I had a vivid imagination. I can imagine a symphony orchestra sometimes so well, that I can hear every single instrument." She shook her head. "Your equipment isn't good enough for that, so I kept it simple."

Lance stored that away for future reference. But he turned to the other subject first. "Why couldn't you lead a normal life and compose?"

Patience turned grim then. "Because normal people are not composers. It's a contradiction in terms." Seeing his expression, she gave in. "All right, I'll try to state it in terms you can understand. I have normal, drudgy parents. Mother goes to Church every Sunday and Dad plays golf once a month. My case history is correct. Nothing traumatic ever happened to me. My decision to turn my back on the 'real' world" (she emphasized "real" in acrid tones) "was deliberate and premeditated and timed to coincide with the period when I was expected to start taking on 'adult' responsibilties."

Lance's features darkened and he was filled with anger. "You mean, you chose to be a malingerer in order to avoid the necessity of facing up to life?"

She stubbornly refused the goad. "I had a grandfather who might have been a great composer if he hadn't been busy working as a band director in our local high school. When he came home from work there was always the garbage to take out, or the appliances to fix or ... Still, he managed to write a few fine pieces, that nobody would play and that my grandmother threw away the moment he was dead before I could even get my hands on them." Now Patience was losing her self control and angry tears muddied her voice. "I was twelve when he died. He told me not to expect the world to know how great I am. 'Write for yourself,' he said. 'They don't matter. Ignore them.' So that's what I did. I ignored them."

"That is sick," Lance responded, filled with revulsion.

"Hey, this is a hospital, right? So I guess I belong. But I'll tell you what I think is sick, doctor. I think it's sick to butcher Rosa Stallani. I think it's sick to scheme to take the last bit of privacy away from people ..."

His teeth were grinding. He enunciated each word separately, with, a finely reined anger. "You are a ward of the state. You have no privacy."

She calmed down. "Maybe so. But I'm just the lab mouse. When it's perfected, they'll use it on everybody, and no secret will be safe. And then the big shots will know that you hate being a doctor and that you can't stand your wife. And if Dr. Leech knew the things you think about him, how long do you think you'd last at this lousy job that you love so much because you can think about people as though they were computers..."

For a moment, he was shocked. Apparently Patience Palmer had no need of a mind reading machine. And then he remembered that he'd told her these things himself, and he was embarrassed, especially about the time he'd kissed her and whispered "I love you" in her ear.

Finally, he recovered. "Well, it's over now. You've been found out. You can't freeload at the expense of the people any longer. And I'll personally see to it that you return every red cent the County had to spend on you."

She shook her head. "You can't prove it. You can torture me and you can cajole me, but I won't give in. No one has heard me speak but you. And until you've got a working mindreading machine, I'm safe."

"Parasite," he spat out, reduced to his mother's level of name calling. He was so angry now that reason did not stop him. He picked her up in his arms and carried her through the halls and dumped her outside at the foot of the stairs. "Do something useful with your life," he said.

"You can't do this, it's against hospital regulations," she cried, bewildered.

"Why don't you file a complaint," he replied.

And he went back in, content that she would never get back in, without revealing her intelligence.

He was at the snack bar, replenishing his drained reserves with a snickers bar, when they paged him. He picked up the phone. Nurse Carper was on the other end, distraught. "It's Patience," she began. He expected her to say that she was missing. "It's Patience," she repeated. "She was in Dr. Leech's office and he tried to give her a sedative and ..." Now he was afraid for Patience. "Is she all right?"he asked. "Yes, yes, she's fine. As autistic as ever. But something awful happened. He ended up giving himself an overdose. He's ... dead."

***

The report stated that Dr. Leech had accidentally injected himself while struggling with a distraught psychiatric patient. But Lance knew that she had deliberately killed him. "For Rosa ..." she had said, when they were alone. "You see, doctor, I did as you said. Something useful. I've paid my debt to the County. This is worth bed and board for life, wouldn't you say?" He said nothing. "Now, leave me in peace. I have work to do." And then she lapsed into her usual unbroken silence.

And that was the last time Patience spoke to him, until five years later when he had perfected the machine, and suddenly her words came over the speaker of the Cerebrodigitzer. "I love you, too, Lance," came her thoughts. "Don't let the Feds have the machine."

"No," he said. "I won't." So he kept getting more and more grants to do research, but didn't deliver a thing. Which was just fine with the Feds, who never expected this crackpot idea to yield results anyway. It just padded the budget.

____________

Selected Literary Works