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The Hunters

Fan Fiction by Adam Smith (USA)

Chapter 8

Chapter VIII

When Jed introduced himself to Dr. Cook’s receptionist, a short, heavy-set brunette in her late 20’s with an honest-to-God native Virginian accent, she wasted no time in telling him to come around to the back; clearly, she had been told to keep her eyes peeled for him.  Once again he entered the back area, but this time they passed the exam room from the night before and she took him to the left down the hallway toward a door at the end. 

She knocked pertly on the closed door; then Jed heard Dr. Cook’s voice respond.  When she opened the door, Jed was confused because he thought he had heard another voice, too, but only Dr. Cook was inside the small office, sitting behind his desk.  Then he realized that someone else was on the speakerphone.

“. . . and that Potassium level is dangerously high.”

Dr. Cook spoke as he half-stood and motioned Jed to sit down in the chair opposite his desk, where some medical textbooks and a small sheaf of papers in a manila folder with colored tabs rested on his blotter.  “I know—and I agree with you that we probably ought to look at her CPK levels.  Hold on, Tom--I got Jed Inverness here; he just walked in. 

“Jed, Dr. Tom Goodwin is on the phone.  He’s a cardiologist.  I wanted to get his advice about Eli’s heart situation.”

Jed unzipped his jacket and lowered himself uneasily into the chair; then raised his voice and said hello.

“Hi, Mr. Inverness.”  The man on the other end of the phone sounded older than Dr. Cook; his voice was thick and raspy.  “Dr. Cook and I were just going over Eli’s CBC and ‘lytes.  You have a very unusual young friend, sir.  I’d like to see her as soon as possible.”

“Well, she’s eager to get medical help, Doctor . . . what’s your name again?”

“Tom.  Tom Goodwin.”

“Thanks.  Dr. Goodwin, she wants help, but she’s a little shy about being poked and prodded.  I had a difficult time just convincing her to come see Dr. Cook.  But I’ll do my best to get her in front of you, if that’s important.”

Dr. Cook nodded encouragingly as Dr. Goodwin spoke.  “It is, Mr. Inverness.  It’s—”

“You can call me Jed.”

“Jed.  It’s very important.  David’s exam and this blood work suggest that there are serious, possibly life-threatening abnormalities with Eli’s heart and kidneys.  I’d like to get her into Culpeper Regional today and get an MRI of her chest and abdomen.  I’ve called Medical Imaging and they’ve agreed to take her tonight at 5:30 p.m.  It’s after-hours work for them, but in light of this bizarre skin problem she apparently has, it doesn’t seem as though we have a choice.”

“Okay.  But let me tell you, there’s nothing ‘apparent’ about her reaction to sunlight.  I saw it myself.”  He looked at Dr. Cook.  “Did you tell him about her hang-up with hospitals?”

“Yeah, I was starting to explain that to him just before you came in.”

“Jed, David and I spoke about that.  We’re just going to have to work on her a bit.  See if we can reassure her that nothing’s going to happen.  She won’t need to be admitted—it can all be done on an outpatient basis.  But we really need to see what’s going on, structurally, inside her heart.  Because as I’m sure David has told you, with her numbers she really shouldn’t be able to be up and about.”

“He made that clear to me last night.  What’s involved with the MRI?”

“Well, it’s pretty straightforward.  She’ll need to come in and register.  Then you’ll go down to Radiology and she’ll have to lie on a table for about 45 minutes.  The table slides into the scanner, which looks like a big donut.  It’s not invasive, but she’ll need to wear earplugs or headphones, because it’s pretty loud.”

Jed thought about the Owl Tree and Eli’s sensitive hearing.  “Hmm.  Well, assuming we can get her in there, they’ll have to be really good earplugs.  She’s got very sharp hearing.”

“We can do that.”

Jed paused, troubled by the thought of multiple doctors all wanting to do their own physical exam.  “So Dr. Goodwin, do you intend to examine her at the hospital?”  He looked again at Dr. Cook.  “And what about these other doctors.  Are they all gonna want to do their own thing?  Is there some way we could coordinate things a little, here?  The less stressful we can make things for her, the better.”

Dr. Goodwin replied first.  “Yeah, Jed, I’ll probably want to do a focused exam, but it shouldn’t take long.  I can meet you at the ER before the MRI and spend a few minutes with the two of you, going over things.  Dave, maybe the thing to do, if we can, is have Dr. Silver, Dr. Harper and Lou all try to work things so we can see her tonight either before or after the MRI.”

“I’ve already spoken with Becky, and she’s willing.  Debbie is on sabbatical right now and her partner, Dr. Andrews, is covering her patients.  I’ve got a call in to him and I’m waiting to hear back.  And we’re in luck with Dr. Ferris, because he’s on call tonight at the ER anyway.”

“Excellent.  Well Jed, see what you can do to persuade this young lady to come in tonight.  I’ll let David fill you in on the details about her blood work.  David, if the plans change, page me, will you?”

“Will do.”  Dr. Cook put his hand lightly on the handset, getting ready to terminate the call.

“All right.  I’m gonna sign off for now, then.  Pleasure to meet you, Jed.  Take care, and hopefully we’ll talk in a few hours.”

“Same to you.  Thanks.”

Dr. Cook picked up the receiver and then dropped it back in place.  “Tom’s a good guy, Jed.  You’ll like him.   He’s an excellent cardiologist—in fact, my wife’s brother is a patient of his.  And he’s got a great bedside manner, which I think may be of critical importance in this case.”

Jed nodded.  “I guess you all need to figure out what’s going on with her heart rate and blood pressure, right?”

“That’s right.  I spent a fair amount of time last night after you left, trying to canvas the literature for any similar, reported cases.  Frankly, there are none.  Anyone with her cardiac picture would be in severe shock and obtunded.  How she was able to walk in and out of my exam room last night and carry on a conversation is nothing short of a medical miracle.”

“What does Dr. Goodwin think?”

“He’s not sure, either.  But he thinks some additional lab work would be useful, and the MRI to start ruling out potential causes.”
 
“What were you going to tell me about the blood tests?”

“Well, surprisingly, it’s fairly normal, for the most part.  But there are a few things that are extremely unusual.  Basically, she’s missing five things in her blood: glucose, bicarb, B-U-N, Creatinine, and uric acid.  Now, I’ve seen people who are hypoglycemic, but I’ve never seen anyone with no circulating blood sugar.  She should be in a coma, if that were sustained for any length of time.

“Also, she’s got no bicarbonate in her serum.  In you or me, our bicarb levels can drop if, for example, we got diarrhea.  She’s got zero, so she should be acidotic as hell.  I mean, it points to a major imbalance in her metabolic acid-base status.  Unless there was a problem with the blood I drew, which is one reason why, if she’s agreeable, I’d like to draw another sample—just to rule out the possibility of a lab error.”

“Okay.  What about the other things?”

“Well, the other three go hand in hand, and they’re the ones that really have me scratching my head.  They’re all related to how your kidneys function.  If the numbers are too high, they can indicate a problem with the kidneys’ ability to filter the blood properly, which could be a major concern.  But hers are extremely low.  Now, most of the time we don’t get too excited if the BUN is too low, but if it’s really low, it can point to malnutrition or a very low-protein diet.  Likewise, a low Creatinine suggests muscle atrophy, a problem we usually only see in the elderly.  But I’ve never seen anyone with a zero.”

“Huh.  So you want to do some more tests, is that it?”

“Yes.  Which brings me to the urine sample.  You say you had no luck with that?”

“She can’t make urine.”

Dr. Cook frowned.  “Is she drinking plenty of water?”

“I’ve seen her drink water—but not very much.”

“That could be part of the problem.  She might be dehydrated.”

Jed paused, unsure of how to proceed.  At last he spoke.  “Dr. Cook . . . she’s told me that she don’t pee at all.”

“Everyone makes urine, Jed.  That doesn’t make sense.”

Jed shrugged.  “You ought to talk to her about it, I reckon.”

Dr. Cook sat back in his chair, clearly uncomfortable.  “This is very troubling.  I have to tell you, Jed, that I’ve been worried since last night that we aren’t moving fast enough to ensure her safety.  Frankly, if she hadn’t behaved so normally during my exam, I would have insisted she be admitted—and not to Culpeper Regional, but to a Level I center, like the hospital over in Fairfax where they have a pediatric ICU.  Now I’m even more worried.  People who don’t urinate don’t live very long.”

“Well, what do you want to do?”

“If she were any normal patient, I tell you what I’d do:  I have an EMS squad sent out to your home to bring her to the hospital ASAP.  But for the reasons we discussed last night, I think that would be problematic.  So I’m thinking maybe I’d like you to take me to her now, so I can take a look at her and be there when she wakes up.  I want to do everything I can to persuade her that it’s in her best interests to be hospitalized.”

“Doc, I’d be happy to.  But I can tell you, she’s been living with me the better part of four weeks now, and I’ve seen her drink exactly two glasses of water.  And except when she’s been asleep, she’s beeen totally with it.  No problems, mentally—alert, focused, you name it.  She’s a real joy to be around--just an extraordinary youngster.  So I guess I’m not as worried as you that she’s going to drop dead in a heartbeat.  Because she’s acting the same as when I first met her.”

Dr. Cook slowly shook his head.  “That makes no sense.”

“Maybe not, but it’s the truth.”

“Huh.  Well, I’d still feel better . . . would it be an imposition for you to take me to her?”

“Nope.”

“Good.  Then let me leave another message for Dr. Andrews and tell my staff what I’m doing.”

“Gotta black bag?”

“Black bag?”

Jed smiled.  “You know.  For house calls.”

“Oh.”  Dr. Cook smiled, then chuckled softly.  “As a matter of fact, I don’t.  We’ll have to ad lib on that.”
†

Jed sat the waiting room, feeling out of place because he wasn’t sick, and worrying about how Eli would react to meeting Dr. Cook at the cabin when he woke up.  Probably not good--but was there anything Jed could do about it?  Of course the doctor was concerned; anyone with an M.D. after their name would be.

He yawned wearily.  He felt exhausted, but very anxious.  Events were moving too fast, and somehow needed to be slowed; yet, perhaps things were not moving fast enough.  Eli had said they had about a week--and that was yesterday.  Just what, exactly, would happen when time ran out?  He remembered how Eli’s eyes had become reptilian and his hands had started to change when he’d grown angry, and he shivered.

(So you’ve got fangs?   When I get hungry, they come.)

For the first time, the thought occurred to him:  was he putting Dr. Cook at risk by getting him involved?  By taking him out to the cabin?  All along he had been thinking only of Eli’s needs.  But what if Eli became upset when he woke up to find Dr. Cook there, felt cornered and trapped by his presence?  What would happen if he changed like that, right before Dr. Cook’s eyes?  He knew how strong Eli was. 

He could kill both of you, just like that.

And oh, by the way, the same hard-edged, pragmatic voice continued, what might happen if the thing takes over when Eli's in your arms?  While you're holding him close?  What was it that he had said?  That if he was hungry, he might smell blood; might sense it inside of Jed?  He had come to love Eli, but it was easy to forget that he was never alone—that he always lived with something murderous.

Dread built in the pit of his stomach and climbed up his throat, clamping down on his chest with inhuman fingers.  They had to get to the bottom of this thing as soon as possible—root it out and kill it.  There wasn’t time to worry about the ramifications.  There wasn’t time to get a lawyer and become Eli’s guardian.  All of that would have to wait.  Hopefully, Eli would not change her tune when Dr. Cook and the rest of them started crawling all over her.  He hoped.
†

 Wednesday, December 18, 2002 – 3:37 p.m.

“You sure have some pretty country out here.”

Jed nodded in agreement as he slowed and put on his turn signal to turn right onto 522.  “You from Virginia, Dr. Cook?”

“No, New York--Syracuse.  You?”

“Nope.  I was a military brat, so I grew up all over the place.  But I’ve been living out here all my adult life, and this land up here has been in my father’s side of the family for a long time.”

“I’ve often thought it’d be nice to have a cabin.  But my wife’s not all that interested in roughing it; she prefers the beach.  So we own a vacation home down in the Outer Banks.”

“Ah--nice.  Duck, or . . . ?”

“Corolla, actually.  We go down several times a year, as my schedule permits.”

“I’ve never been much for the beach,” Jed mused.  “But my last wife was never too keen on coming out here.  So this cabin was pretty much my deal.”

“Do you have any children of your own?”

“Nope.   Had a daughter by my first wife, but she died very young.”

“I’m sorry for your loss.  I’ve always considered myself fortunate that in my practice, I don’t see many really sick children.  I’ve got a friend who practices Pediatric Oncology downtown, and some of the cases he’s told me about are simply heartbreaking.”

“I suppose you see enough of that, it might make you question your faith.  To see suffering inflicted on the very young.”

“Yes.  I asked him one time how he deals with it.  His answer wasn’t surprising, really—he tries to think about the ones they save.”

“So how long have you known Katie?”

“Oh, gosh.  I met her after her late husband Henry had his first heart attack.  He wasn’t happy with his regular doctor, and somehow he found me.  Then I met Katie and began following her for her osteoporosis.  And, let’s see . . . he died in 1984, so his first MI must’ve been in . . . hmm.  I’d say about 22 years.”

“Fine lady.”

“Yes, she is.  She’s actually spoken of you from time to time, although not by name . . . more just about her wonderful neighbor who looks in on her and helps her with repairs.  But now that the dots have been connected, I’m sure you’re the one.”

Jed nodded.  “Well, Dr. Cook, home construction was my deal, so that was never a burden.  And I enjoy her company immensely.”

“You can call me Dave.  So you say Eli’s been with you about four weeks?”

“More or less.  Right before Thanksgiving.”

“I’m still not terribly clear on how this came about.  Is she some kind of runaway, or are you helping out someone in your family who’s having marital problems right now, or . . . .”

“I found her in a cave on my property while I was hunting.”

Dave turned his head to stare at him, nonplussed.  “In a cave?   What do you mean, ‘in a cave’?”

“Well, it weren’t much of a cave, to be honest.  Just a glorified overhang—a niche in the rocks.  She was wrapped up in a tarp from head to toe.   At first, I thought she was dead.”

“What—was she camping or something?  I mean, was she . . . .”  His voice trailed off in confusion.

“No—she was asleep.  I mean, really asleep.  You’ll get a flavor for it in a few minutes, I think--scared me to death.  And she was that way for over a day before she woke up.”

They pulled up in front of Jed’s cabin and stopped.  Jed threw his truck into park and cut off the engine.  “We have arrived.”

Dave climbed out and shut the door; then looked around the clearing and at Jed’s home.  “Wow—it’s gorgeous up here.  You live here all year ’round?”

“That’s right.”

He grunted approvingly; then looked for power lines, and saw none.  “I know you don’t have phone service.  You don’t have electricity, either?”

“Nope.  Nor runnin water.”

Dave offered him an admiring smile.  “You really are roughing it.”

“Well, I’m not livin in a tent.  That’s roughing it, in my book.  Come’on inside.”

The fire had burned out in the stove and the air in the cabin was cold as they stepped inside.  Jed nodded at the blanket-covered windows.  “I put those up after I discovered her skin problem.”  He moved to the table and lit a lantern as Dave held the door open to provide some light.  Once Jed had finished, he closed it and then approached Eli, asleep in the bed.  He frowned.  “What on earth is that sound she’s making?”

Jed went to the stove and began to build a new fire as he spoke.  “I dunno.  It’s like a little growl she makes while she sleeps.  Sometimes she sounds more like a cat.”

“I’ve never heard anything like that.  Sure is strange.”  He sat on the edge of the bed and looked closely at her face.  “Tell me more about the sunlight problem.”

“Well, shortly after I brought her back here, she was lyin’ in the bed, pretty much as she is now.  I slept on my cot, and when I woke up I found her under the bed.  I tried to fish her outta there, but her hand began to smolder just as soon as I pulled it out into the light.  She thrashed around a bit and crawled back in, but didn’t wake up.  That’s when I realized there was an issue, and hung up them blankets.  They seemed to do the trick.”

Dave touched her face.  “She’s cool and pale, just like yesterday.  Colder, even.”  He removed a thermometer from a backpack he’d brought, pulled the covers down to expose her chest, and slipped it under her arm.  Jed lit the fire, then came over and stood beside him.

“Why’d you put it there?”

“It’s a reasonable proxy for core body temperature.  I don’t want to put it in her mouth while she’s asleep.”  The small plastic device soon chirped; then Dave withdrew it and read the number.  “Damn--fifty degrees.”  He pulled a traditional mercury thermometer out and handed it to Jed.  “Put that on the table for  a minute, will you?  I want to see if she’s poikilothermic.”

He withdrew his stethoscope and pressed it to Eli’s chest.  “Heart’s the same as yesterday.”  He moved the scope to the right, held it there for a few seconds, and then frowned.  “I don’t hear any air movement.”  He checked the other side, then rechecked the right.  He removed the scope and then carefully lifted her head with one hand as he removed the pillow with his other.  When he laid her head down, he tilted her forehead back and lifted her chin.  Then he put his ear down next to her mouth and nose as he watched her chest carefully.  After a short time, he stopped and stared at Jed incredulously.  “She’s not breathing.  For God’s sake, Jed, she’s not—”

Jed nodded.  “I noticed the same thing, but it don’t matter.  She’ll wake up all the same.   Seems like for Eli, breathing is . . . optional.”

Dave rubbed his temples.  “God damn.  It’s incredible.”  He took a small penlight out and cautiously lifted an eyelid.  “Well, her pupils are reactive.  What’s that thermometer say?”

Jed held it up close to the lantern and peered at it.  “Fifty to fifty-five, somthin like that.”  Jed handed it to him, and he confirmed the reading.  “Fifty-two.”  He pulled out a small dictaphone and began speaking into it as Jed went to the kitchen area and got them something to drink.  When Jed returned with some water, he stopped and took a drink.

“Jed—she’s not getting oxygen and if the blood work is right, she’s got no glucose.  Do you know what that means?”
“She’s somethin else again, I reckon.”  He managed an ironic smile.

“That’s an understatement.  It means that she’s staying alive through some form of metabolism that’s entirely different from how you or I function.”

“So what’s that mean?”

“It means, Jed, that she’s radically different from any other person on the face of the planet.  That’s what it means.”  He ran a hand over his face and then pulled a cell phone out of his pocket.  “I need to get ahold of Tom.  Oh—hang on a sec. I want to check her abdomen.”

He put the pillow back under Eli’s head, then pulled the covers down to her waist, exposing her bare stomach.  Once again he checked her with his stethoscope.  “It’s what I thought.  Absent.”

“What’s that mean?”

“It means her intestines aren’t making the usual sounds they make as they digest food.”  He turned to Jed.  “You ever seen her eat?”

“No—but she stays up all night and has told me she’s eaten.”

“Mmm.”

“What do you think could cause this, doc?”

“I don’t know.  She reported being bitten.  The blood cultures aren’t back yet, so I don’t know if she’s septic.  Maybe a virus—I don’t know.”  He paused, thinking.  “Have you had any contact with her?”

“Contact?  Like . . . .”

“Of any kind.”

Jed had not anticipated this question, and suddenly felt flushed.  He had never suspected that a spotlight would be turned on his ambiguous relationship with Eli.  But of course, now that the question had been asked it seemed obvious, and he mentally kicked himself for being so blind to the inquiry.  After all, they were trying to determine what was wrong with her, and part of that assessment was whether Eli was suffering from some kind of disease. What was he supposed to say?  How would Dave react if he told him the truth?  To him, Eli appeared to be a twelve-year-old girl.

The voice he was beginning to dislike spoke up.  How would Eli react if he learned you’d lied?

(You’ve been very kind to me.  You deserve to know the truth.)

To hell with it.  The chips will fall where they may.

He cleared his throat.  “I’ve kissed her a coupla times, I reckon.  A friend of hers died recently, and she’s still pretty upset.  She’s been kinda emotional about it, and a few times I just felt like she needed to feel loved.”

Dave was now giving him his full attention; Jed felt as if his eyes were boring into him.  “That’s it?  A few kisses?”

“That’s right.”  He could hear himself becoming defensive, and hated himself for it.

“On the mouth?”

Shit.

“Yeah.  On the mouth.”

Dave stared at him for what seemed to Jed to be an eternity.  Then he looked back at Eli.  “All right.  Well, depending on what we find, you may need to be tested.  You should probably avoid that kind of contact with Eli until further notice.  Do you have a girlfriend or anything?”

“No.”

“Good.”

Jed scrambled for a sensible question that would change the topic.  “When will you know more about the infection issue?”

“It usually takes twenty-four hours for the lab to begin reporting growth, so tomorrow morning.  I’ll probably ask Eli to let me swab her throat, too, although she’s got no respiratory issues.  Setting aside the absence of lung movement, of course.”  He smiled wryly.

“Dave.”

“Yeah.”

“I just want you to know somethin.  I’m not sure what you think about me, but I ain’t no child molester.”

“I’m not accusing you of anything, Jed.”

“I know, but people can take things the wrong way.”  Once again, his throat began to tighten, but he forged ahead.  “And I do want you to know one thing:  I’ve come to love Eli very much.  I’ll do whatever I can to take care of her, and that includes footin’ the bill for all this medical care that we’re gettin into--I don’t care a whit about that.  I just want her to be happy, and if it’s possible, cured.”

“I understand how committed you are to her, Jed.  It’s fine, really.”  He made a mental note to ask Eli, when the time was right, about just what she and Jed had done together.

“Okay.”

“Okay.  Let me page Tom now.”  He got up from the bed and began to punch some numbers on his phone. 

Feeling humiliated despite his speech, Jed sat down at the table and stared despondently at Eli, wondering how long it would be before someone from Child Protective Services showed up.  Somehow, he knew that even if they didn’t, things would never be the same again.  He was going to lose Eli—he felt it in his bones.  Once word of Eli got out, they would be overtaken by events; the world would swoop in and fundamentally alter the landscape of their existence in a way that would separate them and leave him out in the cold. 

After awhile he got up, and feeling deeply discouraged, shuffled out onto the porch to get Frito Bandito’s food pan and fill it.  The sky was fading from bright blue to a silvery yellow as the sun slipped down behind the mountain.  He glanced at his watch as he stepped back inside:  4:25.  It would be dark soon.

He had returned the pie pan filled with cat food back to the porch when Dave got off his cell phone.  Once again, both of them returned to the bedside.

“Anything new?”

“Tom agrees with me that she must have a radically different way of getting energy to her tissues than everyone else.  We’ll check her pulse oximetry at the hospital, and he’d like to run an EKG before the MRI.  Both of those things will take only a few minutes and they’re not invasive.  He also thinks that while she’s in the magnet, we should do her head while we’re at it.  And I agree it’s the smart thing to do.”

“That’ll take longer, I reckon.”

“Yeah, a bit.   Not terribly longer, though.”  He sat down and once again listened to Eli’s chest with his scope; shook his head.  “Nothing.”

“Dave, I suspect she’s gonna wake up shortly.  She won’t be expecting anyone except me out here.  I’m thinkin’ maybe it would be best if you wait in the truck for a bit so I can explain things to her first.  Then you can chat with her and do whatever it is you need to do before we head back to town.”

Dave nodded.  “Yeah, I understand.  I wanted to observe her when she emerged from sleep, but you’ve made a good point.”  He patted Eli’s face, then stood.  “I’ll go out and finish my dictation.  Just let me know when she’s ready.  And do me a favor—note the time she wakes up, will you?”

“Will do.”  Jed looked around for something short and simple to occupy himself.  He found his broom and began to sweep the floor.

It did not take long for Eli to wake up, and as the doctor had requested, Jed checked his watch; it was 4:48 p.m.  He swept the dirt into his dustpan and threw it into the trash as Eli padded over to the kitchen table and sat down.  He pulled the lantern a little closer to the towel with the egg pieces, and quietly began to poke through them.

“Evenin’, Eli.”  Jed put away his broom and came over to the table to sit down.

“Hi.”  Eli did not look up.  “Why is Dr. Cook here?”

Jed, surprised, felt a trickle of anxiety as he turned up the lantern a bit.  “Dr. Cook?  Oh—he’s—”

“Outside.”

“Yes.”

“Why?”

Jed fumbled for words.  “Well, he’s here because we weren’t able to give him a urine sample.  And that got him very worried about you.  How’d you know he’s here?  I asked him to wait outside so you wouldn’t get upset.”

“I can smell him on me.  And I hear him talking right now.”  Eli stopped assembling the egg and looked up at Jed.  “He looked at me, didn’t he—while I was sleeping?”

“Yes.  He listened to your breathing.  Or I mean, your chest, he—”

“He knows I don’t breathe when I sleep.  That’s what you mean.”

“Yeah.”  Jed ran a shaky hand through his hair.  “Eli, I—”

“I don’t like being looked at when I’m asleep, Jed.  It makes me feel unsafe.”

“I’m sorry—I didn’t think it’d upset you.  He’s trying to help, and—”

“When I’m asleep, I’m helpless.  That’s when I need you to protect me.”

“Protect you.  He wasn’t—”

“I’m not someone’s science project.”

“I know.  I know you’re not, Eli, for heaven’s sake.  He’s just extremely worried about getting you into the hospital.  He wants to do some more tests.”

“I don’t want to be locked up in a hospital.  They’ll try to tie me up in there, or give me drugs to control me.”

“No, no.  No one wants to lock you up or give you a drug.  They just want you to lie down in a tube for an hour or so, so they can scan you.  All you have to do is wear some earplugs to protect your hearing.  We can go home after that.”

Eli laughed softly.  “I thought we had agreed that we were going to lay everything out for Dr. Cook.”

“Well, yeah . . .”

“And you honestly think that once he knows what I am, he and the others will want to treat me just like another patient.  Is that it?”

“He already knows that you don’t get your energy like normal.  He—”

“Don’t be naïve, Jed.  You’ll get me killed.”  He looked anxiously around the cabin.  “I can’t sleep here again tonight.  It won’t be safe.”

“Eli, I think you’re—”

“No, I’m not overreacting, Jed.  And I’m not going to show them my teeth, or my claws, or my flying, or anything else like that.  It’ll cause a scene and bring this whole house of cards down on my head.”

“Our heads.”

Eli looked at Jed and smiled apologetically.  “Yes--our heads.”  He reached across the table and took Jed’s hand into his.  “I didn’t mean it that way--you know that.” 

“I’m in this thing, too, Eli.  With you all the way.”

“I know, Jed.  I’m sorry.”

“I’m scared shitless right now, Eli.  Scared and tired, and—”

“You don’t have anything to be scared about, Jed.” Eli’s voice was soft and reassuring.  “You’re not the one who has the problem.”

“Yes I do.  Losing you—that’s my problem.”

He gave Jed’s hand a gentle squeeze.  “I won’t leave you, Jed.  Unless you tell me to.  And maybe not even then.”

“I’m never gonna tell you that.  I don’t care what happens.”

Eli nodded slightly.  “I’ll go to the hospital.  But no one’s giving me any drugs.  And no one’s going to tell me I have to stay.  And when we get back tonight, I’m going to have to find another place to sleep.”

Jed took a deep breath.  “Good.  We can find some place to stay.  Rent a hotel room, or something.”

“It’d probably be better if it’s just me.  They can find you with your truck.  Me, they can’t track.”

“Aw Jez, Eli.  I’d hate that.  The thought of you runnin off to sleep in a cave again, or something like that . . . .”

“Let’s just play it by ear, okay?”

He nodded.  “Okay.”

Jed began to get up, but Eli motioned him to stay.  “I’ll get him in here.”  But instead, he came around the table and gave Jed a hug; whispered into his ear.  “Thank you for everything you’re doing for me, Jed.”

He hugged Eli back, loving the feel of him in his arms.  “I’m sorry about Dr. Cook.”

“It’s all right.  It’s all right, Jed.”

“’kay.”

For a few moments, they continued to embrace one another; to Jed, it felt like a lifetime.  Then Jed released him, and Eli went to the door to get Dr. Cook.  After he was inside, all of them sat around Jed’s table.  Dave put his backpack on the floor by his chair.

Dr. Cook smiled brightly at Eli.  “Hi, Eli.  I guess Jed’s told you why I’m here.”

“Yes.  You want me to go to the hospital for some more tests.”

“Right.  I don’t think you’ll need to be admitted.  It’s just that some of my findings, and some of your blood testing, are very unusual.  If we can get an MRI, we’ll have a very detailed picture of the inside of your body.  And that could help us determine what your problem is.”

“How long will we be there?”

“I’d imagine two to four hours, something like that.  The people who run the MRI have a slot available at 5:30, so we need to hustle if we’re going to do this.”

“Okay, I’ll do it, but on a couple of conditions.” 

Eli rose, came around the table, and stood directly beside Dr. Cook, only a few inches away.  He involuntarily straightened in his chair, a little taken aback.  He was not used to patients, especially children, laying down terms. 

Eli’s eyes seemed unnaturally dark in the dim light of the cabin, and when her hand lightly touched his shoulder, he felt something; a sense of pull.  His eyes were dragged to hers, and once there, he felt helpless to look anywhere else, although a part of him badly wanted to.

“I’m choosing you as my doctor.”

He nodded wordlessly.

“No one else.  If someone else needs to do a test, that’s fine.  But you’re my doctor.”

“Yes.”  His throat suddenly felt dry.

“I decide what happens to me—not you, or Jed, or anyone else.”

“All right.”  He knew there was a problem with this, but felt powerless to say anything else.

“I’m starting to understand how strange I am.  Jed’s told me that anything you learn about me, you have to keep secret.  Is that true?”

“Yes.  The privacy laws in this country are quite stringent.”

“So if I read about myself in the newspaper, I’ll know who to hold responsible, right?”

“I . . . I take those obligations very seriously,” he croaked.  “There are federal penalties . . . .”

“Good.”  Once again Eli touched Dr. Cook; this time, on his cheek.  “Now you listen.  I won’t stay in the hospital.”

“Okay.” 

“I’m not taking any medications.”

“Got it.”

“No one’s injecting me with anything.”

“Okay.”

“No one’s going to lock me up or tie me down.”

By this time he was no longer able to speak.  He could only nod.  Eli removed his hand and nodded, too.  “All right.  Then let’s go.”
†

Eli and Jed followed Dr. Cook as they stepped out of the elevator in the basement of Culpeper Regional Hospital.  Eli still wore his street clothes; Dr. Cook had said he could keep them on as long as there was no metal on them.

They approached a large set of double doors that swung open automatically when Dr. Cook swiped a card dangling from a chain around his neck across a scanner on the wall.  A sign above the doors announced that they were entering Medical Imaging.  A man and a woman wearing white coats and blue scrubs stepped out as they went in.

Dr. Cook talked to Eli as they went along.  “Welcome to the radiology suite.” They passed a couple of empty gurneys and a portable x-ray machine, and then came to an open door on the right.  “That’s the reading room.  Evening, Ted.”

In the darkened room a bearded, chubby man in his late 30’s sat at a desk, staring at a solid wall of x-ray films, his features ghostly in the dim fluorescent glow.  He glanced up as they passed and gave them a little wave.  “Evening, Dave.”

“Dr. Oliverio is a radiologist, Eli.  He’ll be helping us interpret your MRI.”  They went a short distance further and then turned left into a spacious, well-lit room.  A huge, white cylindrical device was situated at the far wall.  It had a round opening at its end with what appeared to Eli to be another gurney resting immediately before it.  On the ceiling was a large, backlit picture of a nature scene—the blooming branches of a dogwood tree against a blue, springtime sky.

A young woman in pale green scrubs and a clipboard got up from a chair to greet them; she had black hair pulled back into a bun, and wore glasses with black plastic rims.  She smiled and shook their hands warmly.  “You must be Eli.  I’m Emily.”

“Hi.”

“Hi.  I’m the radiology tech.  I’m going to help you get your MRI tonight.”

Dr. Cook spoke.  “Jed, Eli--I’m going to leave you in Emily’s capable hands for a bit so I can check on the blood cultures and track down some of the other folks who are going to be helping us.  I also have some other patients on the Medical Unit tonight whom I need to see.  Emily, page me when you are getting near the end, okay?  Then we’ll go back upstairs and get through the other things we’ve discussed.”

After Dr. Cook had left, Emily asked Eli to remove her winter coat and sit up on the gurney.  As Eli handed his jacket to Jed, Emily remarked about how much she loved Eli’s new hightops.  “Did you pick those out yourself?”

Eli managed a nervous smile.  “No—Jed got them for me.”

“I love the rainbows.”  She pulled a pen out of her pocket.  “Eli, I need to ask you a few questions.  Have you ever had an MRI before?”

“No.”

“Can you tell me why you’re getting an MRI tonight?”

“Because I should be dead—but I’m not.”

Emily started writing and then stopped.  She looked up from her clipboard, her smile and earnest demeanor suddenly extinguished, like cold water thrown on a flame.  “’Should be dead.’  Umm . . .”

Jed gently intervened.  “She knows why.  Dr. Cook has explained it to us already.”

“Okay—good.” She tried to regain her composure.  “I’ll just put that you’ve been sick.  How’s that?”

Now it was Eli’s turn to smile.  “Fine.”

“Do you have anything metal in your body?”

“No.”

“You’ve never had any surgery, have you?”

“No.”

“I mean, anywhere on your body.”

Eli glanced at Jed.  “No.”

“Are you menstruating yet?”

“Menstruating?”  Eli looked at Emily, then to Jed, puzzled.

“Have you started having your periods yet?”

When Eli continued to stare blankly at her, Emily smiled.  “That’s probably a ‘no’.”

“I don’t think you need to worry about that,” Jed added.

Emily flipped through her papers as she talked to herself.  “Okay.  No contrast was ordered, so . .  . I think we’re done.”

At Emily’s direction, Eli lay down on the narrow bed attached to the open end of the machine.  SIEMENS was embossed above the tunnel at her feet.  The machine’s pristine whiteness seemed very foreign and strange, and he was grateful for the relaxing nature scene on the ceiling. 

Once she was sure Eli was comfortable, Emily explained how it was important not to move during the exam; then offered a choice of earplugs or headphones with music.  Once again, Jed intervened.  “You’d better give her both.  She has very sensitive hearing.”

“Both?”  Emily looked confused, but when Eli turned his head and nodded, she complied. 

Eli felt the cool pressure as Emily carefully inserted first one, and then the other plug into his ears; then the soft, padded pressure of the headphones settled onto either side of his head.  Faintly, he heard a local radio station playing country music.  The table began to move, and he slid steadily down into the small, claustrophobic tunnel.  The dogwood tree disappeared from view and was replaced by smooth, white plastic only a few inches from his face.  His anxiety rose, and he felt as though he was being buried alive in some futuristic coffin.  Then, over some female singer’s nasal twang, an unpleasant, electronic pulsing sound began.

In less than a minute, he decided that there was no point in continuing to stare at the curved, featureless surface in front of his face, and so he closed his eyes.  He knew that nothing was going to happen to him, and so he gradually began to relax, which was not difficult as he was neither cold nor warm, there was nothing to see, and he had nothing to do but lay still.  He did not like the music, and after a minute or so, he tuned that out as well.  Soon he was paying attention to nothing at all, and his mind began to drift to the continuous, throbbing da-da-da-da of the machine.

As time passed, faces and events of recent memory began to play out behind his closed eyelids, shifting softly from one to the next like water dancing among the rocks as it flows down a creek.  Riding in the truck with Katie and Jed, on the way to see Dr. Cook.  The egg, breaking in Jed’s hands, revealing the golden yolk.  Jed, asleep in his bed in the middle of the night and looking terribly lonely and alone, just before Eli had crawled into his arms.  Making night-time baskets on an empty court at the high school.  Jed, sneaking awe-filled glances at Eli in the lantern-light as he assembled the Escher puzzle.  Learning how to sharpen a knife in front of the stove.  Jed, sitting next to him, looking at his hand with concern as Eli emerged from his last hibernation, just before Eli had told him his name for the first time. 

Inside a room adjacent to the MRI suite, Emily adjusted the gradient of the scanner.  Inside the tunnel, the tone of the machine changed.  The images in Eli's mind were swallowed up in blackness, and there was only the memory of Jed’s voice, rising and falling above the rhythmic thumping.

Here’s your new sneakers.  Hope you like ’em . . .

Would you like a little chocolate?  Hershey’s is good . . .

I missed, you, Eli . . .

I have fallen in love with you . . .

Soon, Jed’s voice faded out and new images emerged.  Oskar’s pale, dead face, careworn and prematurely aged for his 31 years, on the night that Eli had awoken to find him dead on the floor of their last apartment in Malmö, the body of an interloper slumped nearby.  And with this image came, softly and insufficient to break him from his trance, pangs of anguish at never having had the opportunity to tell Oskar just how much he had loved him before he’d died. 

Then the painful image faded and was replaced by a younger Oskar, smiling down at him as they danced to candlelight.  Happily taking Eli’s hand as they splashed through a cold autumn rain in the darkened streets of Stockholm.  Lying in bed next to Eli, his head propped up with one hand, the other running through Eli’s hair as they told each other how much they loved one another.  Then this, too, faded away, to be replaced by . . .

. . . nothing.  And in the nothingness, Eli was able to step back and see, for the first time, his whole life as one, simple truth.

            I am blessed because I have been loved.

            I will be free so that I can continue to be loved, and to love in return.

Inside the hidden confines of the MRI scanner, unseen by the world, Eli smiled.
†

The table moved and he heard Emily's voice saying that he was done.  When he emerged into the bright light of the room, Jed was waiting, standing by the front of the machine, still holding Eli’s coat.  Eli turned his head and reached for him; took his hand.

"I love you, Jed."

 Jed blinked in surprise.  Emily stood next to him, smiling blandly as she looked up from jotting a note on her clipboard.  Then Eli realized that Dr. Cook had come in while he was in the machine.

Jed stuttered a reply.  “Well I . . . I love you too, Eli.”  He allowed himself to be drawn closer, and without breaking hands Eli sat up, slid down from the scanner bed, and wrapped himself around Jed.  Jed was a little taken aback by the power of Eli’s embrace, but did not hesitate in hugging him back.  Eli’s coat fell, forgotten, to the floor.

“Were you all right in there?”

Eli nodded yes.

“You weren’t scared?”

Eli shook his head.

“Good.”  He kissed the top of Eli’s head; then Eli looked up, stood on tiptoe, and kissed Jed’s scratchy cheek.  “Thank you for being with me.”

Jed smiled.  “Why, Eli—I couldn’t imagine a better place to be.”

Dr. Cook waited respectfully, and after their embrace had ended he stepped forward.  “Eli, I know you’re uncomfortable being here, so if it’s okay with you, we’re ready for you to come back upstairs to the ER.  Dr. Goodwin and Dr. Silver want to do those other tests we discussed, and they have some additional questions.  Dr. Ferris, who as I mentioned specializes in Infectious Disease, told me that he does not need to see you, but asked me to get a throat swab so that we can check that along with your blood, which so far is negative.  Is all right?”

“Okay.  But can I see the MRI before we go?”

He gave her a little smile.  “No, I’m afraid not.  It takes awhile for the computer to compile all of the data we need to generate the images, and then I’ll need to review them with Dr. Oliverio.  I’m not sure we’ll have the full details on that until tomorrow.  But I’ll call Jed and let you know as soon as I can.”

When they arrived in the ER exam room, a nurse greeted them.  With Eli’s permission, she attached a small, plastic device with a red light to his fingertip to check Eli’s pulse oximetry, which, she explained, would help them determine the amount of oxygen in her blood.  After a brief time, however, she announced that she was unable to obtain an accurate reading.  Dr. Cook stated that he was not surprised, and then requested her to draw some more blood for retesting.  She was just telling Eli to hold pressure on the needle site with a gauze pad when Dr. Goodwin came in.

He was a short, overweight man in his mid-60’s, not much taller than Eli, with thinning gray hair and a bald spot on the top of his head.  His face was heavily lined from age, and his blue eyes peered out from under big, bushy eyebrows.  When he offered everyone a greeting, vigorously shaking first Jed’s and then Eli’s hand, the thought came to Jed—he’s a cardiologist, but sounds like a lifelong smoker.  Eli smiled when she saw his stethoscope, which had red tubing and a yellow smiley face on the chest piece; Jed found amusement in his white plastic pocket protector.

A TV hung in a corner by the ceiling; on it, the New England Patriots were trailing the Tennessee Titans, seven to 24.  Dr. Goodwin grabbed the remote.

“Is anyone watching this?”  When it was clear that no one was, he clicked it off.  After he shut the door, he returned and stood directly next to Eli, who was semi-reclined on a mobile hospital bed in the center of the small room.  He crossed his arms and regarded Eli keenly with eyes that were alive with intelligence.

“So you’re Eli.”

Eli nodded, and when he spoke his voice was very soft.  He seemed a little intimidated by Dr. Goodwin’s brusqueness.  “Mmm hmm.”

“I’m gonna do an electrocardiogram.  You know what that is?”

Eli shook his head.

“Did you know that your heart’s run by electricity?”

Eli frowned a little and then nodded.  “Yes--I think so.”

“Well you’re right—it is.  And with an electrocardiogram, we can study the electrical activity of your heart.  It’s only gonna take about ten seconds, once we stick on the leads and hook you up to the machine.  And don’t worry, you won’t feel a thing.  It doesn’t hurt.  That okay with you?”

“Uh huh.”

“Good.  But first, I got a few questions.  How come you don’t pee?”

Eli swallowed.  He’d known the time was coming, and had been dreading it.  Now it was here.

“I don’t have anything to go with any more.”

Dr. Goodwin’s demeanor changed; he had not been expecting this answer.  His eyebrows came together, and the smile he’d worn while he’d explained the electrocardiogram faded.  But it did not take him long to regain his composure.  “Mind if I take a look?”

Eli looked to Jed, his eyes large and pleading; then back to Dr. Goodwin.  Then the tears came.  He sniffed and turned his head to stare at the wall on the opposite side of the room as Jed hauled out a big red handkerchief and handed it to him.

“Go ahead.”

Dr. Goodwin gently lifted Eli’s sweatshirt, then stopped.  “Do you want me to unbutton your pants, or do you want to do it?”

“I’ll do it.”  He unfastened the button, pulled down the nylon zipper, and lifted his hips off the bed a little as he tugged them down.  When Jed saw the white panties underneath, he remembered the night they had argued and had to look away to Eli’s face, lest he also start to cry; when that did not help, he looked at Dr. Cook, who had been standing behind Dr. Goodwin but had stepped forward to get a better view.  Dr. Goodwin carefully pulled Eli’s panties down. 

No one was able to speak.

After a few seconds, he looked up at Eli and said very softly, “I need to get a better look.  Is that all right?”

Eli’s lower lip trembled.  He stopped using the handkerchief for a moment and nodded.  Then with his help, Dr. Goodwin pulled Eli’s pants and underwear down to his ankles.

“Eli, I know this is hard, but can you spread your legs a little?”  After he complied, Dr. Goodwin leaned in and studied his groin very carefully.  Then he glanced up at Eli.  “There’s no opening?”

Eli sobbed loudly and began to cry harder.  “No.”  Jed stepped around to the open side of the bed, took Eli’s left hand, and squeezed it gently.  “It’s all right, Eli—they gotta know.  They need to know, so they can help you.”

Dr. Goodwin sat up and looked at Dr. Cook.  When Dr. Cook nodded, he told Eli that they could get his clothes back up. 

After Eli’s pants were refastened, Dr. Goodwin sat down on the edge of the bed.  “Eli . . . when you were born, were you a boy or a girl?”

“A boy.”

“I understood that you have never had any surgery.  Is that true?”

“Yes.”

“So how did this happen to you?”

“A man cut me.  A long time ago.”

“Who?  Do you know his name?”

“No.  I don’t.”

“Why did he do it?”

“Because he enjoyed it.”

Dr. Goodwin shook his head and then rubbed his temples with one hand as he continued to speak.  “How long ago was this?  Was this man ever arrested?”

There was a long, long pause.  At last, Eli spoke.  “It happened in 1773.  And he was never arrested.”

Dr. Goodwin looked up, his mouth dropping open.  Jed glanced at Dr. Cook; his was the same.

“Did you mean 1973, or . . . .”

“No--1773.  Two hundred and twenty-nine years ago.”

“Eli—that can’t be true.”

“It is true.  I was born in Norrköping, Sweden, in 1761.  My parents were what you would call serfs.  The man who did it was our lord.  It happened when I was twelve.”

Dr. Cook spoke up.  “Hold it, hold it.  You told me yesterday evening that these problems began after you were bitten earlier this year.  You said you woke up, and noticed that you were different.  Was that accurate?”

“I couldn’t tell you the truth yesterday.  You wouldn’t have believed it.”

Dr. Cook stared at Eli.  For a few seconds Jed could see the consternation on his face; then it disappeared.  He shook his head.  “Well, I suppose you might be right.  I probably wouldn’t have believed it.  And frankly, I’m not sure I do now.”

Dr. Cook’s pager beeped.  He pulled it off his belt and looked at it.  “Hang on a sec.  It’s Dr. Oliverio.”  He took a telephone handset off the wall and pushed in a four-digit extension.

“Yeah, Ted—it’s Dave.  What is it?”

There was a pause.  Then he spoke again.  “Okay, I’ll be down there just as soon as I can.” 

He hung up the phone.  “It’s Dr. Oliverio.  He wants to discuss Eli’s MRI.  Eli, do you mind if I run downstairs while you finish up with Dr. Goodwin?”

Eli shook her head.

“All right.  I’ll be back up just as soon as I can.”  After shutting the door behind him, he sprinted toward the elevators.

Dr. Goodwin wheeled a machine with several wires hanging off the rear into position near the head of Eli’s bed.  “This is the ECG.  We’re going to get started with it while I ask you some more questions?  You up for that?”

“I’ll do it.”

“Good.  This time you’re gonna have to take off your shirt.”

After Eli complied, Dr. Goodwin checked his pulse and blood pressure; then he began using some alcohol pads to clean spots on Eli’s arms and chest for the electrodes.

“You are a skinny little thing.  You only weigh 52 pounds, I hear.”

“Mmm hmm.”

“So have you had the urge to pee since you were cut?”

“No.”

“How about the other?  Do you still use the bathroom at all?”

Eli shook his head.

“So you’re telling me you haven’t urinated or, pardon the expression, pooped for about two hundred and thirty years.  Is that right?”

“Right.”

He attached the first electrode on Eli’s upper arm; then patted his shoulder and smiled.  “Eli, I don’t know if what you’re telling me is true, but if it is, you’re the most extraordinary person I’ve ever had the privilege to meet.  I’m going to do whatever I can to help you get better, okay?”

“Thanks.”

“So you’ve been this way for a couple of centuries, and you’ve never once told a doctor about it?”

“No.”

He put another lead on the other arm, then one on Eli’s calf, and then began working on his chest.  “So if you don’t pee or poop, tell me about your intake.  What do you eat?”

Jed watched Eli carefully, and saw the reluctance as Eli struggled to answer.  Finally he said, “I don’t need to eat any more.  I only drink.”

“So if Jed said he thought you ate some of his food, he’d be mistaken, right?”

“That’s right.  I pretended to eat his food so he wouldn’t feel bad, and wouldn’t think I’m really weird.”

Dr. Goodwin nodded slightly.  “I understand.”  He put the last lead in place, somewhere below Eli’s left armpit.  “How’s that feel?”

“They feel a little strange, but—okay.”

“You want a blanket?”

“I don’t need one.”

“All right.”  He stood up and began pressing buttons on the machine.  “Try not to move, now.”  The small screen lit up and the device beeped; then a tracing began to scroll out.  After a few seconds, it stopped.  Dr. Goodwin announced that they were done, tore the sheet off the machine, and removed the leads. 

“You can put your sweatshirt back on.  And since Dr. Cook is down in Radiology, I’ll go ahead and get that throat swab.”  As Eli dressed, he removed a small, pencil-sized package from the supply cabinet and tore it open; inside was a cotton swab.  Once again he sat down at Eli’s side.

“You’re going to have to sit up, stick out your tongue and say ‘ahh.’  Don’t close your mouth, now.”

“Ahh.”

He inserted the swab into Eli’s mouth for few seconds while she resisted the urge to cough.  “Got it.”  He placed it into a small, glass tube.  “Hang on and let me give this to the nurse.”

After he had stepped out and they were alone, Jed spoke.  “How are you doing?”

Eli laid back down on the bed and stared at the ceiling; his voice was very soft.  “I’m okay.  Scared, actually.  Very scared.”

“Well, we kinda saw this coming, didn’t we?”

Eli nodded.

“There’s only way out of this, Eli . . . and that’s clean through the middle.”

Before Eli could reply, there was a knock at the door, and then it opened slightly.  A tall, black woman in her late 50’s peeked in.  “Excuse me—I’m Dr. Silver.  May I come in?”  After they nodded, she stepped inside and closed the door; then offered both of them a warm smile and a gentle handshake.  “I’m the dermatologist Dr. Cook wanted you to see.”

Jed introduced himself and then sat down under the darkened TV set.  Dr. Silver pulled a plastic chair to Eli’s bedside and sat down.

“So I understand you have a rather unusual skin problem.”

“Uh huh.”

“Want to tell me about it?”

“If the sun hits it, it catches fire.”

“You’re saying it literally burns.”

Eli nodded.

“Do you have any other skin problems?”

“No.”

“Rashes, red spots, dry skin, anything like that?”

“No.”

“Do you feel as though you’re sick right now?”

“No.”

“Are you allergic to anything?  You know—medications?”

“No.”

“Pets or animals?”

“No.”

“Do you own any pets?”

Eli shook his head.

“When did you first realize you had this problem?”

“I already explained all of this to the other doctors.”

Jed spoke.  “Dr. Goodwin and Dr. Cook.”

“Yes—the two of them.  But if—”

“Well, I’d like to—”

“--you want to say it again, I will.”

“Yes, please.”

“I’m actually a lot older than I look.  This happened to me years and years ago.”

“Years and years.  But you’re twelve, as I understand it.”

“Yes.  But I’ve been twelve for a long, long time.”

Dr. Goodwin opened the door and stepped in.  “Hello, Becky.”  He saw the bewilderment on her face and smiled.  “Tell me you’re not asking about Eli’s age.”

“Yes I am, actually.”

He chuckled.  “I’ll fill you in later.  We don’t want to take up too much of Eli’s time, because he doesn’t want to stay here all night.  Right, Eli?”

“No—I don’t.”

Dr. Silver looked even more confused.  “He?” She frowned, then checked a small sheaf of papers she had brought with her.  “I thought you were a girl.”

Dr. Goodwin spoke.  “We’re quickly learning there’s nothing about Eli that’s simple.  Becky, Dave and I have a pretty good picture of Eli’s medical history.  What we need now is a skin punch biopsy, so Pathology can give us some idea of what’s going on.  Because she doesn’t have a problem with incandescent bulbs or fluorescents—only sunlight.”

“I would at least like to examine his skin.  And I need a signed consent.”

Eli caught her eye.  “You can look at me, if you want.  But do I need to take off my clothes again?”

Dr. Silver smiled.  “No, honey.  But first things first.”  She turned to Jed.  “Are you Eli’s guardian?”

“No, ma’am--I’m just a friend.  Eli’s natural parents are both dead.  He has no adoptive parents, and no guardian.”

“Well, I don’t know how we . . .”  She looked to Dr. Goodwin.  “Maybe we should call Risk Management and ask them about getting a court order.  Have you spoken with Dave about this?”

Dr. Goodwin thrust his hands into his pockets, leaned against the closed door, and sighed.  “No, I haven’t.  So far we’ve been proceeding on the basis that there were emergent circumstances, given Eli’s extremely abnormal vital signs.  Of course, the longer things go on and he appears stable, the harder it is to justify intervention under that exception.”

“Well I don’t know, Tom, if I’m comfortable proceeding like this.  Maybe we should put this off and talk to Legal in the morning.”

Eli spoke, his voice emphatic.  “I’m in charge of what happens to me.”

Dr. Silver swung back around to him.  “But you’re not an adult.  You’re not legally able to give consent.”

“I’m much older than you, Dr. Silver.  Either I sign your paper, or I’m leaving right now.  That’s it.”

Dr. Goodwin stepped forward.  “Becky, let’s talk for a moment.  Please excuse us.”  They went out into the hall and stepped into an empty exam room adjacent to Eli’s.

Dr. Silver nervously brushed her hair away from her brow.  “Tom, I don’t understand any of this.”

Dr. Goodwin shut the door so that no one at the nurse’s station across the hall could hear.  “Becky, listen very carefully.  This kid just finished telling Dave and me he was born in Sweden back in the 1700’s, and that he’s neither eaten nor defecated since his genitals were cut off, and he was bitten by someone or something when he was twelve.”

“And you believe that?  Tom, come on.  That’s—” 

“Hold on, hold on.  I just examined him.  He is castrated.  I mean, that’s probably not even the right term—he’s got nothing down there at all.  Not even an urethral opening for urination.”

Dr. Silver began shaking her head, but Dr. Goodwin continued.

“You can see for yourself, if you want.  The guy in there, Jed, who’s been living with him for the last month or so says he’s drank hardly any water.  And get this—he found the kid wrapped up in a tarp and sleeping in a cave on his property.”

“That’s incredible, Tom.  It’s just—”

“I know it’s incredible, Becky, but so are the kid’s vital signs.  His heart beats four times a minute.  He doesn’t breathe when he’s asleep.  He doesn’t even maintain an internal body temperature.  And Jed told Dave the kid is telling the truth about the skin thing.  So I’m prepared to believe just about anything he says at this point.

“Now this kid is a flighty as hell, and understandably so.  He’s knows how strange he is, and he’s scared to death of being locked up in here and studied like a new species.  So I’m telling you, this is not the time to get bogged down in a lot of legalistic bullshit.  You mention a court order again, and he’ll run--I’m sure of it.  And then we’ll never have a chance to figure out what the hell’s going on.  Neither Dave nor I can allow that to happen--it’s too damn important.”

She had been staring at him like a deer caught in headlights; when he finished, she exhaled heavily, ran a hand through her hair, and looked down at the floor, her mind racing.  “I just don’t want to get sued over all of this, Tom.”

“Have the kid sign, and Dave will sign as his attending that the test is necessary under the circumstances.  I’ll sign it too, if you want.”

“All right—I’ll do it.”

“Good.  Because if half of what Eli has said is true, we’re dealing with someone who’s functioning on a completely different level than the rest of us.  And we can’t afford to screw this up.”

They returned to Eli’s room and Dr. Goodwin spoke.  “Eli, given what you’ve said about your age, and in the absence of anything to the contrary, we’ve decided that you can sign the form.  Dr. Cook will sign as well.  We’ve agreed that that should cover us for now.”

The anxiety on Eli’s face lessened a little.  “Okay.”

“I’m going to slip out now and see what’s cooking in Radiology.  Dr. Silver will explain the skin biopsy.”

After he had left, Dr. Silver explained how she would be removing a small core of Eli’s skin with a punch device after injecting a small amount of lidocaine to numb the spot.  Because it would be a six millimeter punch, Eli would also need a couple of stitches afterwards, and would wind up with a small scar.

“I don’t want the injection.”

“It’s not going to hurt you.  It’ll make the biopsy less painful.”

“I don’t care.  I don’t want it.”

They locked eyes for a moment; then Dr. Silver yielded.  “Okay.  We’ll forego the lidocaine.”  She handed the form and a pen to Eli, and showed her where to sign.  Eli took them and then bent to the task; the better part of a minute passed as he carefully wrote out his name.  Dr. Silver looked on with interest.  When she took back the form and saw Eli’s handwriting, she began to believe in a way that she had not before; the script appeared foreign and very, very old.

She did a brief physical exam.  “You have beautiful skin, Eli--I’m sorry that I’m going to leave you with a scar.  Would you like me to do it on the back of your arm, or the inner part of your thigh?  It won’t be as obvious that way.”

“It doesn’t matter—I won’t get a scar.  And I won’t need stitches, either.”

“What do you mean, honey?”

“You’ll see.”

They chose a site on Eli’s upper arm.  He did not flinch when Dr. Silver pushed the small, circular blade down into his arm and pulled out a plug of tissue.  A small amount of blood oozed out, and Eli dabbed at it with a gauze 4 x 4 while Dr. Silver put the sample into a specimen bottle.  By the time she had finished, the wound had stopped bleeding.  She looked at the site, puzzled.

Eli looked at her and smiled.  “Watch.”

Intrigued by the conversation and by the fact that Dr. Silver was now sitting still and staring intently at Eli’s arm, Jed got up and came over to see.

Dr. Silver looked up and stared at Eli, dumbfounded.  “How’d you do that?”

Eli shook her head as she rolled her sleeve back down.  “I don’t know.”

“Do you always heal that quickly when you get hurt?”

“Yes.”
†

“There are several abnormal findings on this study, Dr. Cook.”  Dr. Oliverio paused and sipped some coffee in the darkened confines of the cave-like reading room.  “So abnormal, in fact, that I wanted to bring them to your attention before I dictate my report.”

“I appreciate that, Ted.  I wasn’t expecting to hear anything this soon.”

“Ah—it’s a light night in the ER, I guess.  You got lucky.”

“I could use a little luck with this patient.”

“I can see why.  So here’s the thing.”  He moved his mouse and began to pull up images that sliced through Eli’s chest from right to left.  “First, this little girl has an overarching problem with tissue density.  This is probably the most unusual finding, but I checked the calibration of the machine and it captured accurate data.”

“What’s the issue?”

“Her entire body—or at least, all of what we scanned—is outside normal human parameters for tissue density.  In short, she’s too light.”

“Too light.  Meaning . . . .”

“Meaning, overall she’s not as dense as you or me.  I calculated that across the spectrum, when I looked at the major tissue types—bone, muscle, and fat, she’s about 73 percent of normal density.”

“I’ll be damned.”

“How much does she weigh?”

“A little over fifty pounds.”

Dr. Oliverio squinted at one of the images as he spoke.  “And her D.O.B. is . . . May 30, 1990, so she’s twelve and-a-half.  Which means that she’s—”

“--grossly underweight.  And I checked her on a growth chart.  She’s less than the third percentile for age.”

Dr. Oliverio nodded, then removed his wireless glasses and tapped one of the stems on the screen.  “I think that would be consistent with what I’m seeing here.  And I can tell from the images that she’s skinny, but not emaciated.  Is that right?”

“That’s right.”

“Well, this is very strange, I have to tell you.  I’ve never heard or read anything like it.”

“All right.  What else?”

“The second most important finding concerns her heart.”  He changed the images to a transverse plane and began to scan down through Eli’s body, moving steadily lower until the top of the heart came into view.  “There’s a tumor located at the juncture of the right atrium and the superior vena cava.”

“The sinoatrial junction.”

“That’s right.”  He continued to move down and Dr. Cook began to see the abnormal density.  When it was at its largest, Dr. Oliverio stopped and used his mouse to draw a diagonal line through it from one side to the other.  “Its greatest dimension is about three centimeters.  Has someone run an ECG on her?”

“Yes—Dr. Goodwin is doing one now.”

“Good—because I’d be worried about an arrythmia or an AV block, given its size and location.”

“Is it impeding blood return to the right atrium?”

“I don’t think so.  It is not intracavitary.”

“Any ideas with respect to tumor type?”

“Hard to tell, but its posterior aspect is not as well encapsulated as the anterior and coronal surface.  In fact, it looks . . .”  he paused as he selected another image.  “. . . here.  See this?”  He pointed to a thin gray band of tissue that extended like a tendril from the mass, branched out, and engaged the spinal column immediately behind the heart.  “These finger-like projections are invading the neural foramina bilaterally at the T-3, T-4, and maybe even the T-5 levels.  I’m not an expert at pediatric cardiac tumors, but these suggest malignancy—some kind of sarcoma, perhaps.  Although it’s extremely unusual that the invasion of surrounding tissue has occurred only on the posterior aspect.  So I don’t know.”

“So it’s invaded the spine, and nothing else.”

“That’s right.  It’s hooked itself exclusively into her nervous system.  I see no invasion of the lung or of any of the adjacent vasculature.”

“Any recommendations?”

“Talk to Tom, but I’m thinking you’re going to want a surgical consult.  Someone top-drawer, too, considering how this thing has invaded the spinal cord.”

Dr. Cook sighed heavily; suddenly he seemed very tired. “Did you find any other abnormal masses?”

“We’ll come back to that in a minute.”

 “Okay.  What else?”

“Well, this person’s neither a boy nor a girl.  There’s no reproductive organs of any kind—no ovaries, no uterus, no fallopian tubes, no vagina, no testicles, no penis—nothing.  I cannot offer an opinion as to the patient’s sex, if any, at birth. The pelvis, however, has not undergone changes commonly seen when girls hit puberty.”

“He says he was born a boy.  And that at some point, his penis and testicles were removed.”

Dr. Oliverio frowned.  “Well, that would be consistent with what I see here.  Not sure why that would be done, but . . . .”

“I’m not sure, either.  We’re gonna try to clarify all that.”

“Good—it’d be interesting to know.  Shall I continue?”

“Yeah, please.”

“Okay.  The patient’s bladder is perfectly healthy, but completely empty--no urine whatsoever.  The urethra terminates just distal to Cowper’s gland.  How this person is urinating is unclear to me, and requires clinical correlation.  If you haven’t already, you need to ask him.”

“Working on that, too.”

“Good.”  Dr. Oliverio paused and gave him a look.  “You’ve got a very strange patient on your hands, Dave.”

He felt like laughing, but somehow the mood wasn’t right; instead, he nodded solemnly.  “That’s an understatement.”

Dr. Oliverio murmured something Dave couldn’t catch, and then continued as he pointed to several images.  “Okay.  The large intestine, small intestine, and rectum are completely void of fecal content.  Not sure why that’s the case, but usually you see a little retained stool or something coming down the pipe.  This kid’s as clean as a whistle.

“Now, when I saw that, I started wondering why he’s got no feces.  I’m thinking, maybe he’s obstructed.”  He used his mouse once again and pulled up a new series showing cross-sections of the stomach, viewed from above.  “The stomach’s not distended, but I think there may be thickening of the muscle at the pyloric valve because the pylorus is deviated upward toward the gallbladder.  In other words, I suspect he may have hypertrophic pyloric stenosis.  Is there any history of vomiting?”

“No.”

“Well, the diagnosis needs to be confirmed.  Studies to consider would be an ultrasound, or perhaps an upper GI with a barium swallow.”

“All right.  What else?”

Dr. Oliverio glanced at Dr. Cook and raised his eyebrows.  “The brain, my friend--the brain.”  With a few mouse clicks, he began clicking through images of Eli’s head, starting with his right ear and working deeper and deeper into his brain.  “There’s no particular order to this, but . . . the olfactory bulbs are enlarged bilaterally.  The cerebellum is slightly larger than I would expect for a twelve-year-old.  And most importantly, there are unusual structures located within the basal ganglia.”

“More tumors?”

“No, Dave.  They’re bilateral--just below the globus pallidus on both sides.  They’re too organized to be cancerous.”

“I can’t make heads or tails of these images, Ted.”

“Well, I’m not really qualified to be reading these, either, frankly.  You need to get a neuroradiologist.  There’s some very good people downtown I could recommend.  But I can tell you, these are very abnormal.”

 “Refresh my memory on the basal ganglia?  And the globus . . . .”

“—pallidus.  Sure.  These structures are tied in tightly to the cerebral cortex and the thalamus and are involved in many important functions—motor control, eye movement, learning, cognition, emotional—you name it, basically.”

Dave nodded.  “Any idea what these things might be?”

“Not a clue.”

Dave shook his head.  “Anything else?”

“Nope.  But I’d love to see a PET scan or a functional MRI study on this patient.”

†

Dr. Silver had not been gone more than a few minutes when yet another physician came knocking at Eli’s door.  He was a tall, thin man whom Jed guessed to be in his 50’s, and despite the fact that it was now after 9 p.m., he was neatly dressed in a navy blue suit underneath his white doctor’s coat.  He also wore a bright red bow tie with white polkadots, which contrasted sharply with his black, unruly hair, giving him the appearnce of an absent-minded professor.  He offered them a broad smile and introduced himself as Dr. William Andrews, but hastened to add that they could call him Bill.  He stated that he was a neurologist, and specialized in epilepsy and sleep disorders.

He must have read Eli’s mind, because once the introductions were over he asked him with a wry smile whether he was tired of doctors yet.  Eli smiled back in spite of himself.  “I guess I am—a little.  I don’t like being in hospitals.”

“I don’t blame you.  Hospitals are not healthy places to be—they’re full of sick people.  But you don’t feel sick right now, do you?”

“No.”

“Then why are you lying there on that bed?”

“Well, I—I guess I thought I was supposed to.”

“Do you want to, or do you want to get up and move around?”

“I want to get up.”

“Good.  Because I’m tired, and I’d like to lay down.  Why don’t you take the chair, and I’ll take your bed.”

Eli gave a surprised laugh.  “Okay.”  Quickly she got out of the bed and after a stretch, sat in the chair that Dr. Silver had used.  Dr. Andrews took her place in the bed, but did not lie down; instead he sat facing Eli, casually crossing his leg and clasping his knee with both hands.

“Now Eli, I was told by Dr. Cook that there was some confusion about whether you are a boy or a girl.  Which do you prefer?”

“What do you think I look like?”

He thoughtfully rubbed his chin.  “Hmm. Well, at first glance, I would’ve said you are a girl.  Why?”

“Then you can think of me a girl.  Because that will make it easier for you.”

“It will indeed—plus, I won’t have to go correcting all the paperwork.  Are you sure you’re all right with that?”

Eli looked down.  “I’m not anything any more.  So it doesn’t really matter.”

“Well, you’re not nothing.  You’re a person, right?”

She brightened and looked up at him.  “Yes.  I am.”

“So why are you in the hospital?  I understand there is some concern about acting a bit like Rip Van Winkle.  Is that right?”

“Yes.  Sometimes I go to sleep for really long times.”

“When you say ‘really long,’ what do you mean?”

“Months.”

“Months.”

“Uh huh.”

“Meaning . . . what?  Two months?  Three months?  More?”

“Usually a couple of months.”

“And how many times has this happened to you?”

Eli thought for a moment.  “So many that I’ve lost count.”

“What brings on these sleeps?”

“I don’t know.  They just happen.”

“What brings you out of your sleeps?”

“I don’t know--I just wake up.”

“Are you able to remember anything that happens to you while you sleep?”

“Not really.”

“Have you ever seen a doctor before for this problem?”

“No.”

“When was the last time it happened to you?”

“It was around September.”

“When did you wake up?”

“It was in late November.  About . . . .”  She looked at Jed.

“. . . About four weeks ago, Eli.  You woke up on November 24.”

“Was anyone with you during that time?”

“No.  I mean, not until the end, when Jed found me.”

“Found you?”

“I went to sleep in a cave on Jed’s mountain.  He found me and brought me to his house and then I woke up.”

“You slept in a cave.”

Eli nodded.

He smiled.  “You got a thing against beds?”

Eli tried to smile back, but found it difficult.  “No—I just needed to be by myself.  In a place where I’d be safe.  I didn’t expect anyone to find me.”

“So you don’t have a family or anyone to look after you when this happens.”

“Not really.  Sometimes a friend, or something like that.”

“How do you feel when you wake up?”

“I’m very weak.  And I forget things, too.  Sometimes I can’t remember things in the past that have happened to me.”

“How do you sleep otherwise?  I mean, daily sleep.”

“I sleep during the day, because I have to stay out of the sun.”

“Okay.  But once nighttime comes and you wake up, do you feel rested?”

“Yes.”

“You’ve never had a problem getting a good night’s sleep, even though you find it necessary to sleep during the day.”

“That’s right.”

“Do you ever get headaches?”

“Never.”

“Ever had a seizure?”

“No.”

“Have you ever suffered a head injury?”

She thought for a second or two.  “I’m not sure.  I’ve hit my head a few times, but  I was okay.”

“Hard enough that you lost consciousness, or had to go to the hospital?”

“That’s never happened.”

“You seem rather pale.  Is that just because you avoid the sunlight?”

“I don’t know.”

“Dr. Cook told me you have some rather unusual vital signs.  Has someone already checked your pulse and blood pressure tonight?”

“Mmm hmm.  Dr. Goodwin.”

“Okay, then I’ll forego that.  Your temperature—it goes up or down depending on your surroundings, right?”

“Yes.”

“That’s extremely unusual.  If the temperature goes down, do you feel cold, or vice-versa?  In other words, do you notice it?”

“I do, but it doesn’t bother me.”

“Explain what you mean by that.”

“I guess what I mean is that I could walk around outside right now dressed like I am and I wouldn’t care.”

“So why do you have a winter coat, then?”  He nodded at Jed.

“Because Jed was worried about me, and I didn’t want him to.”

“I understand.  Let me ask you:  have you ever done that—gone outside underdressed--and then gotten frostbit?  Walked around in the snow, for example, thinking you weren’t cold, and then discovered a problem with your feet?”

“That never happens.”

“Okay.”  He stood.  “Why don’t you come sit on the bed for a minute.  I want to take a look at you.”

After Eli had complied, he used his foot to press a pedal on the bed near the floor.  There was a hum and the bed began to rise, startling Eli.

“Sorry about that.  I just want you a little higher, that’s all.”

“It’s okay.”

“There we go--that’s better.”  He stood directly in front of Eli.  “I want you to look right at me.”  Eli complied; then he pulled a small black stick with a round mirror on one end out of his pocket and held it up to the right of his face.  “Now I want you to watch this, okay?”

“Okay.”  He moved it from right to left as Eli tracked it; then held it steady, off to Eli’s right.  “Now, I want you to keep your head toward me, but watch for my stick with your eyes and  tell me as soon as you can see it.”  Slowly he began to move it inwards. 

“Now.”

“Okay, good.  Now let’s do the other.”

“Now.”

“Super.  Do you wear glasses or contact lens?” 

She smiled.  “No.  Never.”

“Have your eyes ever been evaluated?”

“No.”

“Hmm.  Well, I’d like to.  And I’d like to dilate your pupils with some eyedrop medicine that will make it easier for me to see inside your eyes.  The medicine doesn’t hurt, but it takes awhile to wear off, so you’ll want to avoid bright lights for a few hours.  Would that be okay with you?”

“If you think it’ll help me, I will.”

He obtained the medicine in its dropper bottle and some tissues, and with her cooperation, put a few drops in each of Eli’s eyes.  Eli blinked, them dabbed the excess bright yellow fluid out of the corners of his eyes. 

“It takes a few minutes for it to work, so let’s do some other things while we wait.  First, I’m going to say three words for you to remember.  Repeat them after I’ve said all three.  Shirt.  Brown.  Honesty.”

“Shirt, brown, honesty.”

“Again?”

“Shirt, brown, and honesty.”

“Now, I want you to keep those words in mind, because I’m going to ask you for them again in a few minutes.”

“Okay.”

“Count from one to five.”

“One, two, three, four, five.”

“Now count backwards from five to one.”  Eli complied.

“Spell ‘world.’”

“W-O-R-L-D.  Or V-Ä-R-L-D-E-N, in Swedish.”

“Oh yes!  I forgot you’re from Sweden.”

“Mmm hmm.”

“You lived in Sweden for a long time, too, I hear.”

“That’s right.”

“At some point, I’d like to speak with you about that, but not tonight.  Deal?”

“We’ll see.”

“That’s it?  That’s all I’m going to get?  A ‘we’ll see’?”

Eli gave him a small smile.  “Mmm hmm.”

He made an exaggerated sigh.  “All right—I’ll take what I can get, I suppose.  Can you spell ‘världen’ backwards?”

“N-E-D-L-R-A-V.”

“What year is it?”

“2002.”

“What season?”

“Winter?”

“What month?”

“December.”

“What day of the week?”

“Wednesday.”

“Okay.  What were those three words again?”

“Brown, shirt, honesty.  A brown shirt shows honesty.”

He smiled.  “Yes—brown is a very sincere color, don’t you think?”

“I like brown.  My mother had brown eyes.”

“Just like yours.  Although I would say that your irises are tinged with some green, too.  You have very pretty eyes, Eli.”

“Thanks.”

“What was your mother’s name?”

“Anna.”

“What was her last name?”

“I don’t remember.”

He paused.  “I thought your name was Eriksson.”

“I just borrowed that from a friend because I knew I’d need one to see a doctor.  I’m really only ‘Eli,’ now.”

“Never use ‘only’ with your name, Eli.  Where are we now?”

“A hospital.”

“What’s the hospital’s name?”

“Um . . . Culpeper something.”

“What state are we in?”

“Virginia.”

“What city?”

“Culpeper.”

He pulled out a pen.  “What is this?”

“A pen.”

“And this?”  He tapped his watch.

“Watch.”

“Name as many animals with four legs as you can.”

“Cats and dogs.  Mice and rats.  Cows, oxen.  Pigs and goats.  Horses.  Lambs, deer.  Squirrels, chipmunks, raccoons and, um, skunks.   Beavers.  Turtles and lizards.  Hippos.  Elephants, lions, tigers, bears, cheetahs, giraffes, zebras . . . wolves and foxes, jackals and hyenas, wildebeests and gazelles.  And, uh . . . guinea pigs.”

“Close your eyes and touch your nose.”
 
“Now stick out your tongue.”

As Eli complied he produced a tongue depressor, which he briefly inserted into her mouth, making her cough.

“Sorry about that--just part of the exam.  Are you right-handed or left-handed?”

“Right.”

“I want you to hold your arms up like this.”  He held his arms up as if to fly but with his hands curled into fists toward his chest.  Eli mimicked him.  “I’m going to try to push your arms down, and I want you to resist me.”

“Okay.” 

In his chair, Jed smiled.

“You’re a good little resister.  Now I want you to put your elbows down but keep your fists, as if you were going to punch me.”  He took ahold of her forearms.  “Now try to keep me from pulling your arms down.”

“Okay.”

“You’re stronger than you look.”

Eli nodded; Jed could tell from the look on his face that Eli was enjoying the attention.  Dr. Andrews continued to test the muscle strength in his arms, wrists and hands.  “Your strength is excellent.”  He held out the index and ring fingers of one hand and told him to grasp them and squeeze.  When Eli did, he paused.

“You can do much better than that, can’t you?”

“Yes.”

“Squeeze harder.”

“I don’t want to hurt you.”

“Don’t worry about me.  I want you to try harder.”

Eli looked at him and swallowed; then slowly, steadily complied.  When the first sign of discomfort appeared on Dr. Andrews’ face, he stopped.

“Okay, okay.  Thank you.”  He looked at him.  “Just how strong are you?”

Jed spoke.  “He beat me at arm wrestling.  Easily.”

“Is that true?”

Eli nodded reluctantly.  “Yes.”

“Do you know why you’re so strong?”

“Not really.”

“Let’s check your lower extremities.”  In about a minute, he had tested all of the major muscle groups of Eli’s hips, legs, ankles and feet.  “All just as strong.”

When Dr. Andrews had finished checking his reflexes with a rubber mallet, Eli looked down and closed his eyes.  “It’s getting kind of bright in here.”  Dr. Andrews checked his watch; then went to the door and used a rheostat to lower the light in the room.  “Is that better?”

“Yes, thank you.”

“Let me have a quick look at your eyes, now, and I think we’ll be done.”  He took an opthalmoscope tethered to a rack on the wall by a black, curled cord, turned it on, and shined it on the back of his hand.  He stepped up in front of Eli and asked her to look at the scope rack on the wall behind his left shoulder; then brought the scope up and shined it in her left eye.

“Jesus Christ!”  Dr. Andrews stumbled backward and bumped into the ECG machine, which rolled rapidly backward and banged into a portable supply cart; then he dropped the scope as he struggled to keep from falling down. 

Jed leaped to his feet.  “Doctor?  Are you all right?”  He quickly went to the wall switch and turned up the lights, then came to the doctor’s assistance.

Dr. Andrews had managed not to fall, but was standing rigidly near the wall and staring at Eli, who had covered his face with his hands and was beginning to cry.  Jed stepped between them, picked up the opthalmoscope, and handed it back to the doctor.  “What happened?”

He looked at Jed, his face pasty.  “She’s got . . . cat’s eyes.  I mean, they reflect.  And it scared the hell out of me.”

Jed looked at him for a few more seconds, then at Eli; then he went to Eli and embraced him.  Eli continued to cry, but after a short time he stopped covering his face and embraced Jed.

“I’m sorry--I’m sorry.”  His voice was muffled against Jed’s shirt.  “I want to go home now.  Please, take me home.”

Dr. Andrews spoke.  “Eli, I didn’t mean to do that.  I wasn’t expecting it, that’s all.  I’ve never seen that in a person before.  I’m very sorry.  Please accept my apologies.”

Eli continued to cry, but then spoke in between his tears, his voice high and full of tension.  “It’s all right.  I just—I’m trying to get help, but I know I’m a freak.  You won’t be able to change me.  No one can--it’s too deep.”

Dr. Andrews came to the bedside as Eli’s crying tapered off and he slowly pulled away from Jed.  This time it was Dr. Andrews who produced a crisply folded handkerchief and offered it to Eli.  “Eli, don’t say that.  All of us here are committed to helping you.  And if you leave now, we’ll have dilated your pupils for no good reason.  I’m almost finished with my exam, and I promise I won’t act like that again.”

Eli’s crying resolved into some sniffles as he wiped his eyes.  Slowly, haltingly, he agreed to let him finish.

“Good.”  He straightened his bow tie and his stethoscope, which hung askew from the breast pocket of his white doctor’s coat, and then rechecked the light on the opthalmoscope to make sure it hadn’t broken.  Jed went back over to the door and turned down the lights again.

“Before I check them, Eli, let me ask you:  can you see in the dark?”

“Yes.”

“I mean, more than normal?”

“Yes.  I see really good in the dark.”

“Okay.  Well, that doesn’t surprise me.  Because you have what’s called a tapetum lucidum—something that’s never been reported in a human, as far as I know.”

“What’s that?”

“It’s latin for ‘bright tapestry.’  It’s a layer of special cells that lie behind or adjacent to the retina and reflect light back.  Mind if I have another look?”

“Go ahead.”

“Thanks.  I think I’ll turn the light on this scope down a bit, though.”  He proceeded to check Eli’s eyes.  “They look good.  The disk margins are nice and sharp.  And you do, in fact, have tapetum lucidum, like I said.  Amazing.  Jed, do you mind . . . ?”

“Sure.”  Jed brought the lights up to about halfway.

Dr. Andrews hung the scope back on the wall.  “Well, I’m done, Eli.  Thanks for being so cooperative.”  He shook Eli’s hand.  “You’re an exraordinary youngster, and it’s been a true privilege to examine you tonight.”

Eli nodded.  “You’re welcome.  So what happens next?”

“Well, there’s lots to think about in your case.  I think we’re in some uncharted territory, because as far as I know, no one has ever had a sleep disorder quite as profound as yours.  But I’m thinking that I’ll want you to schedule a visit to my sleep clinic so we can do a little monitoring while you snooze.  Get a feel for what’s going on up in that old noggin of yours.”  He gently ruffled the hair on Eli’s head.

“You mean I’ll have to come sleep here in this hospital?”

“Well, not exactly.  The sleep clinic’s not here, it’s part of my office in Fairfax.  And don’t worry, you’ll have your very own room, and you’ll be quite safe.”

“I’m not sure I want to do that.”

“You don’t need to decide tonight.”  He gave Eli and Jed a card.  “I know you had an MRI tonight.  I’d like to take a look at your scan.  Dr. Cook has your cell number, right, Jed?”

“Yup.”

“Good.  Let me do that first, and then I’ll call.  How’s that sound?”

“Okay.”

Continued next week