True to her word, Rita had a stack of charts for Michael to review when he returned to Holt Neuro the next morning.
"Did you enjoy your evening with Dr. Sykora?" she asked smugly as Michael still rubbed his forehead to awaken himself sufficiently to read the finely-printed files in his hands.
"Oh, definitely," Michael quipped back, "we had a grand time! Stitched a few foreheads, diagnosed and treated a case of pneumonia, re-set a broken leg—"
"Sounds like quite the party!" Rita shot back. "Oh, and Minnie has already called about her grandmother, and I told her about it. She said she'd be in after work today."
"Great!" Michael replied without really meaning it, "I'd better get as much done as I can before she arrives!"
"You do that, Dr. Holt," Rita agreed.
Michael adjusted the collar of his lab coat and commenced the work he loved in the field he knew best: helping people make sense of what was going on in their heads. By lunchtime, he had seen most of the pressing cases, performed two cranial operations, and was feeling the need to stretch his legs and get some fresh air. He hung his lab coat in his office and grabbed his overcoat off the hanger.
"Rita, I'm going to take a walk and get some lunch, okay? I'll be back in about an hour," he told his faithful assistant.
"I'll hold the fort till you get back, Michael," she promised.
No less than half an hour after Michael left, Rita was surprised to see a familiar face step out of the elevator and glance around her desperately: the Clinic patient from the day before, Karthey Devanne. The young woman's face was drawn with pain, and she had a hand plastered to her forehead. She ran over to Rita's desk.
"Rita?" she begged, blinking furiously, "Please, I need to see Dr. Holt; it's an emergency!"
Rita tried to overlook the breach of protocol. She smiled at Karthey, "Well, Karthey, it's good to see you again. I'm sorry, but Dr. Holt is away at lunch right now, and he's completely booked with other patients for the rest of the day. Holt Neuro doesn't usually take walk-ins, but I can schedule you an appointment later.
Karthey grimaced and hung her head, a sure sign, Rita knew, that something was definitely wrong, "Please," her voice was hoarse and desperate, "I need to see him right away! The headaches are back, and they won't go away!"
Just at that moment, who should return but Michael Holt, himself. He walked over to the desk.
"Karthey?" he asked.
She turned to him, grasping his arm desperately, "Dr. Holt, the headaches are back, and the pain relievers aren't working, and now—" she gulped and clenched her eyes shut as the pressure surged within her brain, "I can't see straight," she whispered, chin trembling as she fought back tears.
"Okay," Michael immediately resumed his persona as Dr. Holt, Brain Surgeon, and gestured to Rita, "Rita, take her back and let Trish know she'll need a CT scan, and I'll need to look at her MRI again. I'll be there in a minute." He turned back to the patient, "Karthey, we're going to get to the bottom of this. Where's your mom?"
"Martha dropped me off here," Karthey explained, "she said she'd be up as soon as she could find a parking space."
"All right," Michael was off down the hall toward his office.
Rita came around her desk and called after him, "What about your 1 o'clock appointment?"
"Move it!" Michael called over his shoulder.
Rita sniffed, "Well, come with me, Karthey."
"Okay," Karthey replied, gritting her teeth against the surging pain in her head.
By the time Michael returned to the room Karthey had after her scan, Mrs. Devanne had arrived. Karthey sat on the end of the bed.
"All right, Karthey," Dr. Holt began, coming over and beginning his customary inspection of her head, "do you want to tell me when the headaches and the blurred vision started?"
"Well," Karthey sighed, "pretty much as soon as we got home, the headaches began to come back, gradually. I took some Advil, and I wasn't sure at first if it would work, but it took this time, and the pain went away, just a little. Then, while Martha and I were watching a movie after dinner, I noticed that the picture seemed fragmented unless I closed one eye."
Michael paused, feeling no abnormalities or soft spots on her head, and looked at Karthey, "Fragmented?" he repeated.
"Yeah, like what one eye was seeing was sort of—I don't know—out of alignment with what the other eye saw. It was clearer if I closed one eye, but there was no way I was watching the whole movie like that!" Karthey sighed, "I tried to focus, to make my eyes see the same, but every time I tried that, it made my forehead hurt."
"And does it still hurt to focus now?"
Karthey closed her eyes and rubbed her forehead, "Yes; even in this normal light, my forehead hurts." She bit her lip, "and I think it must be getting close to the end of my last dose of Tylenol, because the pressure in the rest of my head is back again."
Michael pressed his lips and huffed out his nose, stepping away from the bed and sliding down the dimmer switch on the wall. "Karthey, if you don't mind, I'm going to check your eyes."
"All right," the girl complied.
Michael pulled out his ophthalmoscope and held Karthey's eyelid open. He peered through the window into her eyeball.
"Yep," he said finally.
"What do you see?" Mrs. Devanne asked anxiously.
Dr. Holt turned to the woman with a grim expression. "Karthey is exhibiting the early symptoms of mild papilledema."
Karthey furrowed her brow at the long, unusual word. "Papilla-what?" she inquired.
"It's a swelling of the optic disc at the back of the eye, typically caused by pressure from the brain on the optic nerve," Michael explained.
Mrs. Devanne shrugged, "That doesn't sound so bad when you explain it that way; is it serious?"
Michael nodded, "If whatever is going on in Karthey's brain is not resolved, she will certainly go blind."
The word hit Karthey like a shot. Her expression read sheer terror as she cried, "Blind! What can we do? I don't want to go blind! Please help us, Dr. Holt!"
Michael sighed; as much as he wanted to help, as much as he probably had the skills and the tools to help Karthey reach a definite diagnosis and possible cures, what he lacked was time and space. He knew that the longer he spent with her, the more his regular cases would continue to pile up. He thought carefully before answering, "I'll tell you what: unfortunately I have my own patients here to take care of, but I can refer you to a buddy of mine, Dr. Medino, who is a neurologist at Manhattan Memorial. The quickest way to get a consult with him is by going through the ER. When you do talk to him, tell him that I said you need two things: an MRI with contrast dye, so we can see how the fluid is flowing in your brain, and a lumbar puncture. Once that's done, have him send me the results, and give me a call if you have any questions about what he recommends, okay?"
Karthey was visibly disappointed that Dr. Holt would not be the one to help her, but at the same time she accepted there was nothing she could do about it. "All right," she replied. "Thank you, Dr. Holt."
Michael smiled as Karthey stepped off the table and prepared to change out of the gown. "Glad I could help you, Karthey," he said. As he watched her walk away, Michael couldn't help sighing to himself, "That should keep her busy for a few days." The whole situation was not as conclusive as he would have liked, but Michael held onto the fact that it was the best he could do under the circumstances.
His phone rang. Michael checked the screen; Kate Sykora was calling, and Michael was pretty sure he knew why. "Hey, Kate," he answered.
"Hi Michael," Kate's voice was quick; it sounded like she had something exciting to share, and only a short time to tell it. "Is Karthey still there?"
"Nope," Michael replied, "you just missed her."
"What? Where did she go? What happened?"
Michael laughed at Kate's tone and reassured her, "Nothing serious; I took a look at her and didn't see anything too incredibly alarming, so I sent her over to a colleague of mine at Manhattan Memorial; he should be able to take just as good care of her as I have."
Kate gasped, "Manhat-Michael!" she chided him, "You passed the buck, didn't you?"
Michael defended himself, "Look, Kate, I did as much as I could, but I have too many other patients to give Karthey the time she needs to get what she needs."
He heard Kate scoff, and knew she didn't believe he was doing the right thing. However, she put that situation aside and continued, "Oh, speaking of switching hospitals, I think I've finally found the truth behind Karthey's birth."
This was something Michael had been wondering if he would ever know. "Oh really? And what would that be?"
Kate launched into her story, "Okay, so the clinic where she was born is closed down now, but I checked hospital records from the nearby area, at about the time Karthey was born, and I called neurosurgeons who would have been on duty at the three or four likeliest hospitals at the time, and…I found him."
"Found whom?"
"The neurosurgeon who operated on Karthey! He said it had been a favor called in by a friend of his who worked at the clinic, and he had agreed to operate on a Baby Doe with an encephalocele, and almost as soon as he sent the baby back to the clinic, Jane Doe disappeared. He said he called his friend a week later and they had just found the mother dead in the street. She'd run off and left the baby."
"Separation anxiety, no doubt; so then it took about a week to register Baby Doe in the foster system, and you have a two-week-old orphan with a shunt no one knows about," Michael concluded. "That makes sense."
"Oh, it totally does!" Kate agreed enthusiastically.
Just then, Michael heard a door close and Minnie Tanner's anxious voice, "Dr Holt?"
Michael kept his back turned just long enough to hide the fact that he was rolling his eyes. "Kate, I've gotta go," he said.
Luckily, Kate caught his tone and understood. "All right; see you later," she replied.
Michael hung up the phone and turned to face the young Asian woman. "Yes, Minnie, what can I do for you?"
"Dr. Holt, do you have a minute?" Minnie asked. She latched onto his arm and began pulling him back down the hall to her grandmother's room. Michael checked over his shoulder and, sure enough, faithful Rita had just peeked around the corner to see Minnie dragging him away. She did not move to stop them, but Michael was sure he felt her death glare as the longer he indulged Minnie meant less time seeing scheduled patients.
As they approached the room full of comatose patients, Minnie explained, "I think my grandmother is out of her coma."
Michael stopped in his tracks and pulled his arm out of Minnie's grasp, "Minnie—" he protested, but she cut him off.
"No really! Come see!" She forged ahead, continuing, "I think she responds when I talk to her. My brothers and even my husband think she's a vegetable; that's why they never come, and they think I'm silly for coming." The two of them entered the ward as Minnie finished, "I still hear the alarm, it's so quiet in here with all the other comatose patients, but I think since no one else seems to hear it, I should just forget about it. Look at her, Dr. Holt!" Minnie's tone was desperate—yet hopeful. She gazed at her unconscious grandmother, "I think she can understand what I say, even though she can't respond."
For the first time since entering the room, Michael realized that Minnie had been right all along: there was an insistent beeping emanating from somewhere around Lianne Set's bed. "Wow, Minnie," he shook his head, "you're right; that would get annoy—" His voice faded as he realized there was something odd about the beeping; it wasn't completely consistent, like an alarm; but there was a definite pattern to it. Michael frowned in concentration, and Minnie noticed it.
"What is it?" she gasped quickly, evidently fearing the worst.
Michael did not answer her question directly, but asked his own. "Wait a minute," he remarked, "Chiang-Yun Set was a telegraph operator, wasn't he?"
Minnie raised her eyebrows in puzzlement, "Grandfather?" she clarified, "Yeah; why?"
Michael immediately dove for the pen and small notebook he always carried in his lab coat pocket. "That's not an alarm," he told Minnie Tanner, furiously jotting down the series of dots and dashes according to the pattern he heard. "That's Morse code," he announced triumphantly, showing Minnie the paper.
Minnie tilted her head, "It is?" she asked incredulously. She listened closely, her eyes following the dots and dashes on the page as her ear matched them to the beeping sounds she heard. Her eyes widened, "It is!" she cried. She handed the notebook back to Michael. "What does it mean, Dr. Holt?"
Michael quickly grabbed his smartphone and looked up the Morse code alphabet. Soon, the message was translated. He read it to Minnie: "I hear you, Mouse."
Michael wasn't sure what the message meant, or if he had translated it correctly, but the effect on Minnie was so swift and sure there could be no doubt. Her hands flew to her face, and her knees buckled. "Grandma!" she shrieked. Before Michael could stop her, she grabbed her grandmother's hand. "It's me! Your Minnie-Mouse! I'm here! I hear you too, Grandma!" She turned her eyes toward the notebook in Michael's hand. "May I keep that?" she asked him.
Michael shrugged and handed it to her, "Sure; do you need my help, or can you decode it yourself?"
Minnie shook her head, "Oh no, I can do it; now that I know it's Morse code, I can talk to her." She stopped and pressed her lips, "Will you try to contact my brothers for me?" she asked, "I know they will come once they learn she's still alive."
Michael tried to keep a smile on, even though he knew he was late making his rounds. "Sure, I can get someone on that," he responded.
"Thank you so much, Dr. Holt," Minnie's voice was genuine as she clasped his hand gratefully.
Michael didn't quite know what to say; there were no words for how and why a comatose patient would suddenly awaken and begin communicating in Morse code. Minnie Tanner stayed there at her grandmother's bedside till Michael finished both his rounds and his paperwork. He poked his head into the room. "Minnie?" he called to her, "It's about time to close up. You can come back tomorrow. Your brothers will be here, too. Rita called them."
Minnie finished the last sentence from her grandmother, grabbed her things, and ran to the door. "Oh, thank you, Dr. Holt!" she cried. "See you tomorrow!"
