The Girl Without a Name - Sandra Block

Chapter One

We call her Jane, because she can’t tell us her name.

Can’t or won’t, I’m not sure. She lies in a hospital bed, a strangely old expression upon her teenaged face. We don’t know her age either. Twelve, fourteen maybe. A navy-blue hospital blanket sits across her knees in a neat square like a picnic blanket. A picnic in a hospital room, with a stained white ceiling for a sky and faded blue tiles for grass.

Dr. Berringer lifts the patient’s arm, and it stays up, like a human puppet. “What do you think?” he asks.

“Catatonia,” I answer. “Waxy catatonia.”

“Bingo, Dr. Goldman,” he says, his voice encouraging, with just a hint of New Orleans, where he’s from. His voice doesn’t match his face. He looks like a Kennedy, with sandy, wind-blown hair as if he just walked off a sailboat and blue eyes with lashes so long he could be wearing mascara. He is, in a word, handsome. He is also, in a word, married, much to the disappointment of the entire female staff at the Children’s Hospital of Buffalo. Let’s just say the nurses perk up when Dr. Tad Berringer hits the floor.

Jane’s arm drifts back down, her eyes still focused on the wall.

“But why is she catatonic?” I ask.

“That’s the million-dollar question, isn’t it?”

Jane Doe is our mystery. A police officer brought her to our doorstep this morning like a stork dropping off a baby. A few days ago, she was found wandering the streets of Buffalo, dazed and filthy, clothes torn, but apparently unharmed. No signs of bruising or rape. But she wouldn’t speak. They coddled her, gave her hot chocolate (which grew cold in the mug), brought in a soft-speaking social worker, and Jane sat and stared. So the police canvassed the neighborhood, fingerprinted her, ran her image through Interpol, put up missing posters adorned with her unsmiling, staring face.

NAME: UNKNOWN. RACE: AFRICAN AMERICAN. DOB: UNKNOWN.

No one claimed her. They brought her to Children’s and ran some tests. The ER said there was nothing wrong with her physically. So they sent her up to the psych floor. So we can figure out who she is and what’s wrong with her.

“Schizophrenia maybe?” I ask.

“Could be.” His eyes crinkle in thought. “But we also have to rule out other, less obvious causes.” He leans over the bed and shines a penlight into her eyes. Her pupils contract, then bloom. “You ever hear of the hammer syndrome, Zoe?”

“No,” I say, jotting this onto the back of my sheet.

“It goes like this: When all you have is a hammer, everything looks like a nail.”

I stop writing, and he drops the penlight into his black doctor bag, smiling at me. “What can we establish here?” he asks, more a statement than a question. “Our patient has catatonia; that’s all we know. So let’s start with that. What’s the differential for catatonia?”

“Schizophrenia.”

“Okay, that’s one.”

“Right.” I wait for the list to scramble into my head. That’s the one good thing about ADHD. Alongside the scattered, ridiculous thoughts that pop up relentlessly (and which you have to keep banging down like a never-ending game of whack-a-mole) sprout elegant, detailed lists. Such as differential diagnoses. Lately that hasn’t been happening for me, though. I don’t know if my Adderall is working too well or not well enough. My dopamine isn’t cooperating in any case, which is inconvenient, seeing as I’m on probation. My brain grinds on in slow motion with no list anywhere in sight, so I plow through the old standby mnemonic for the differential diagnosis of any disease. Something medical students learn the first day they step on the wards: VITAMIN D. Vascular, infectious, traumatic, autoimmune, metabolic, iatrogenic, neoplastic, degenerative.

“Status epilepticus,” I say.

“Excellent thought. Did we order an EEG?”

“I will,” I say, writing it in her chart.

“What else?”

A list crawls into my brain by inches. “Encephalitis?”

“Okay. Does she have a fever?”

I pull off the vital sheet hooked on the bed frame, scanning the blue, scribbled numbers from this morning. Vitals normal. “No fever, but it’s still possible. Her labs are pending.”

“Get neurology to see her. They can decide on a lumbar puncture. She’ll probably need it, though, if the EEG is negative.”

“They said she didn’t need an LP in the ER.”

He doesn’t look impressed. “Just means the on-call didn’t feel like it.”

“We could get an MRI,” I suggest.

“Fine. What are you looking for there?”

“Less common causes for catatonia…stroke, lupus, Hallervorden-Spatz,” I say, cheered as the differential diagnosis list starts to soar in. “That could show