Learn to Have Been
June 2014
X
Nikki liked to study them. Their brains, yes, of course, but she thought it made more sense to take a look at the person first. Then when she sat down at the computer screen and the pictures started to form, she had the mental overlay of the expressions in their eyes when they went in or the tight ways they held their mouths as they filled out the forms.
You couldn't tell much from an MRI on first glance. Unless there was a lesion - those were obvious. But Nikki got the complicated ones because she had the best touch - the doctors sent them to her because she had a way of keeping them still and calm and the sequences went without a hitch.
Nikki stood when the two entered the imaging center's screening room. She introduced herself and the man smiled when he shook her hand. Yet he still looked nervous.
"I know someone named Nikki," he said. "I'm Rick Castle."
The woman at his side startled and gave him a look like that wasn't quite right, but the man flushed and hastily self-corrected.
"I should say, I named a character Nikki."
"About the same thing, isn't it?" Nikki answered. His resultant smile made her pleased; she liked to keep them at ease when they were fresh like this, new patients unused to the procedure and not sure what to expect.
She gestured for the two to sit down and the woman, Kate, handed over the paperwork they'd filled out in the lobby. The pre-screening forms were thorough, and so was Nikki. She went through each item and asked questions.
"You checked that you have metal in your body?" she asked. She wanted to be sure. "This was from an operation to correct a broken-"
"Knee. My knee. I have two screws," he blurted out. He looked proud of himself and Nikki concluded that this was more than a car accident. Brain injuries were never simple, and it looked like he was struggling to remember, to line the pieces up correctly.
"Screws are fine," she reassured them. "Surgeons specifically use non-magnetic screws and plates. It won't mess up the machine."
"Oh, good. I thought - what other option is there?" Rick babbled. "If I can't go in the machine, then..."
He trailed off and gave his partner a look; she brushed her fingers at his knee as if to warn him it was too much.
Nikki had seen some of that too in her fifteen years; the filter was gone in head injuries. The personality altered. She couldn't count how many daughters came with their stroke-victim parent and apologized profusely, He/she isn't normally so rude.
"Your weight on the form - this is an accurate amount?" she asked. She sized them up, both of them, and was reassured already that it was.
"It's correct," the woman answered. "They weighed him when he was - when - when he came in to the ER." She shut down after that, eyes withdrawing, her body held tightly in the chair.
"All right," Nikki said. "The scanner requires an accurate weight, so I ask to make sure. If the hospital weighed you, then that's perfect."
"Is it a long time in that tube?" the man asked.
Nikki gave him another quiet smile. "Not long. And we'll take breaks. Did Casey at the front desk walk you through the procedure?" she asked.
The woman nodded - Kate - and circled her fingers around the man's hand. He startled but clung to that one connection, his fingers blanching white around hers.
He had fine motor function; Nikki had seen him walk in the door - a little off-balance as he took his seat, but she saw from his chart that he was in physical therapy. It was helping; that was a good sign.
"All right then. We'll get started, okay? It's my voice you'll hear when you're in the scanner, and ma'am?, you can wait in the control room with me. You both ready?"
"No," he said, voice tight. But a kind of horror washed over his face and he shook his head, sheepish. "Yes. I'm ready. Let's get it over with."
Nikki stood and they followed, but she could feel their brittle and held-breath tension like walking through ice.
X
"You're doing so well," Nikki said into the mic.
Inside the scanner, Rick lifted his little finger from the squeeze ball to show he'd heard her, though he could have relaxed if he had wanted - they were between sequences. Nikki was inputting the next sequence even as she checked the images she'd just gotten, but there was a blur in the frontal lobe.
"Hey, Rick?" she said. "I need to do that scan over again. But in the meantime, you're allowed to breathe, you know."
There was a weak kind of laughter, and Nikki turned her head to the woman standing at attention in the room. She had her arms crossed over her chest and was gripping her elbows, something fierce on her face.
Nikki muted the mic. "Would you like to talk to him? We've had to redo each of the last three sequences, and I think he'd like to hear your voice."
The woman startled, jerked forward as if on a string. Nikki indicated the chair she'd drawn up beside her - as she had when they'd first started this - and now the woman sat down.
Nikki unmuted the mic and Kate leaned in.
"Rick?"
Over the speaker, they could hear the rush of breath he let out and the warning light went off on the panel in front of Nikki. He'd squeezed the emergency ball, the one they gave each patient to let the operator know if they had to get out.
Nikki pushed in. "Do I need you slide you out, Rick? Or was that-"
"Accident," he said, his voice sounding light. "Sorry, just an accident. Kate?"
"Yeah, babe. I'm right here."
He said nothing more to that, and Nikki glanced over to her, but the woman had settled back in the chair, her shoulders relaxed.
Oh-kay. Nikki set up the last sequence once more. "Rick? Are you ready to try this again?"
"Yeah."
"I'll talk to you after the clicks," Nikki assured him. She started the next sequence and glanced over at the woman sitting beside her, but Kate's eyes were sharp with anger, her body rigid in the chair.
X
"What can you see? Does it tell you?"
Nikki had already stood to open the heavy, sealed door between the control room and the scanner room when the woman finally spoke up. She turned around and saw that Kate was staring through the glass towards her partner, eyes flicking to the images on the computer and back.
"I can tell you that it's difficult to determine anything at all on first view," Nikki said calmly. "With a traumatic brain injury, you can sometimes see a lesion - clear as day - but that's not the case here."
"The neuro said it was a traumatic-"
"He's not wrong," Nikki interrupted. "But most issues aren't things someone like you or I can see at first blush."
The woman turned her head to Nikki and the anger that threaded through her whole body seemed to unravel. Now Nikki realized what it actually was. Not anger at all - fear. She had been - was - afraid.
"Hey, the doctors will take a look at the image we got here today, and they'll study it. I saw Rick's chart - he has a fantastic group taking care of him. You're in great hands."
The woman nodded and her arms dropped at her sides. "Can I - go in there now?"
"Of course," Nikki smiled. She unsealed the door and opened it up. On the other side, the bed of the scanner was releasing out of the tube. Nikki came forward and methodically withdrew the head coil, allowing the man to sit up.
He gave her a weak smile but his eyes shifted right past her to Kate. She said his name and came close, and Rick canted forward into her, his forehead hitting her shoulder.
Nikki didn't say a word, simply left them to slip out into the control room, give them a moment. She had expected the man to need the squeeze 'escape' ball, but he had kept it together. She glanced through the window, watched as the woman cradled him at his neck, her long fingers soothing in his hair.
She was saying something and he was nodding against her, and all traces of that bright and fierce fear in her body had disappeared.
Nikki looked down to the computer, her eyes trained on the images.
There were no lesions. That much was visible. But that meant the mystery continued.