Claire's Head (10 page)

Claire had had no idea that he knew all the words to “The Walrus and the Carpenter” (for all that he kept books of Charles Dodgson's mathematical puzzles piled at his bedside for nighttime reading). Where and when had he learned the words? She'd certainly never heard him recite the poem before. In fact, she had no memory of him reciting any poetry to them during her childhood, even though he admitted to a love for the rollicking rhymes and raucous northern adventures of Robert Service's Yukon sagas.

Now here her father stood, just under six feet tall, heavier than in the photographs from his youth, leaning over the table, his fingertips resting lightly, as if for balance, upon its surface. His smile was suffused, it seemed, with sadness (but then it was a sad story he told, of all those self-sacrificing oysters) as he offered them this love song, this distraction, this gift of himself.

At eight-thirty in the morning, Claire climbed avenue des Pins, past the grey stone weight of university buildings, through heat, weaving among the summer students and nurses, until she reached rue de l'Université, which rose steeply from Sherbrooke below and dead-ended, on the other side of Pine Avenue, part-way up the mountain. She turned right onto the little dead-end stretch of University and stepped into shadow, pinned in on the left by the tall stone walls of the Royal Victoria Hospital, and by the Neurological Institute on her right. Ambulances were parked some four metres ahead, near where an elevated passageway linked the two buildings. Inside the Neurological Institute, she found Dr. L'Aube's room number on the wall directory. First floor. To
the left. Fourteen steps later, she entered his reception area. She'd hoped she might reach him before his appointments began – at nine, she'd assumed, but no, he'd started at eight-thirty.

“I spoke to you by phone,” Claire told the receptionist, tipping back her sunglasses. “About Rachel Barber. The journalist who's been missing since she was here in March. The doctor didn't call me back. So I came from Toronto. I'll only take a few minutes of his time. I'm free any time until four today.” She was booked on the five o'clock express train back.

The receptionist, bottle-black-haired, bare-armed, solid in her swivel chair, looked vaguely disgruntled.

“He has appointments, but have a seat in the waiting room, I will see,” she said.

“Five minutes,” Claire said. “I just need to know for certain if she spoke to him and if so, what they talked about.”

In the doorway of the waiting room, she sniffed the air, testing the stuffiness, the currents of circulation. Waiting rooms often gave her headaches. Being confined in one was like submitting to a plot to reproduce your symptoms in order to confirm, before you saw the doctor, that you really had them. This room was better than most: bigger, high-ceilinged, with tall and no doubt leaky windows. The chairs arranged around the perimeter made it feel a little like a dance hall. The magazines were only a few months out of date, not archaeological. And there was a telephone, whose real dial tone droned when Claire lifted the receiver: they were not, glory be, sealed off from the outside world.

Two women sat side by side in chairs pushed against the wall opposite the windows, one older than the other, the older one wearing a wide-brimmed straw hat. Neither spoke. Claire sat in
a chair facing the door, at a right angle to the women. There were four chairs, in total, against the opposite wall, four beneath the windows, one on the other side of the telephone table. The walls were easily twelve feet high. The voice of the receptionist came to her, intoning now in English, now in French.

A middle-aged man in a white coat, eyebrows thick as shrubbery, appeared in the doorway, tilting from the waist as he spoke. “Elaine Stephanopolos.” Both women stood.

“Excuse me,” Claire said, rising also.

“Not yet,” the doctor said. “I will be with you shortly.”

A woman in red sandals towed two small children into the room.

Claire spoke to the receptionist again. “I have mentioned you,” the woman said. “He says he thinks he remembers the name.”

“I have a photograph.”

If Rachel had been here, what would she have done? In March, had her migraine of the night before resolved itself by the time she arrived at the Neurological Institute?

Dr. L'Aube had led the two women past the receptionist back into the main hallway, which branched in two directions. The reception area lay in the corner where the corridor turned. Claire left the waiting room. To her right, the hall, lined with closed doors, led back to the main entrance. The left-hand corridor, also lined with closed doors, terminated in a large room filled with spanking white medical equipment. Vessels for bodies, lacking only those bodies.

She set off back towards the entrance, past notices tacked to bulletin boards advertising neurological conferences, a bipolar
clinic, an epilepsy study that needed volunteers. When she retraced her steps and re-entered the main vestibule, she realized, with a start, that she'd stepped into a brain.

On first impression the room looked merely like a near-spherical womb of honeyed wood. Peering closer, she saw that the dark lines of dendrites wriggled towards neural cells across the panelled ceiling, and the amber walls were speckled with dots that rose in greater and greater concentration to a line marking the edge of brain tissue like the crest of a wave. The wooden radiator casings were stacked cervical vertebrae. The effect of the whole was deliriously quaint: a moment of mid-twentieth-century neurological knowledge preserved architecturally, in wood. Claire read the plaque that said the room had been built to the specifications of Dr. Wilder Penfield, the Institute's founder, the pioneering Montreal neurosurgeon who had done some of the earliest brain mapping.

Anyone standing in the middle of the room became part of the brain, a live neural connection.

Yet this brought Claire no closer to Rachel. She left the vestibule and was halfway down the hallway's left-hand branch, keeping her eyes peeled for Dr. L'Aube's office, when a man in a white lab coat, younger than Dr. L'Aube, burst out of a doorway, directly opposite the closed door with Dr. L'Aube's nameplate upon it.

“Excuse me,” Claire said.

He stopped, waylaid in midstride, parts of him (hands, one leg) still in motion, flinging themselves away from his body. His name tag read Dr. Michael Tagliacci. “What can I do for you today?” Words spilling into one another.

“Are you a colleague of Dr. L'Aube's?”

“I am.” A tenor voice, light as a cello.

“Are you a migraine specialist?”

“That, too.”

“I'm looking for someone. My sister. I don't think she's here now. She's missing. She's a journalist. I think she talked to Dr. L'Aube back in March, the day before she vanished. Maybe you'll recognize her. Her name's Rachel Barber.” She handed him a colour Xerox of the photograph, Rachel in the kitchen of her apartment in New York.

He took it. His whole trajectory shifted. “Let's sit down for a minute.” He checked his watch, reopened the door to his office and ushered Claire in, beckoning her towards an armchair in front of his desk, simultaneously lifting a stack of books from the chair with his other hand. A room four metres by three. Electric guitar propped in the corner by the door. Walls jammed with books, shelves crammed with teetering piles. Desk surface, 155 centimetres wide, half-buried under paper and a desktop computer. At the front of the desk: a plastic model of a brain. A room arranged for work, not meeting patients.

Dr. Tagliacci dropped the colour Xerox onto his desk, tugged back his sleeve, and glanced at his wristwatch once more, wedging the phone receiver between his neck and shoulder. “Hey, Mike here. Give me ten.” He set down the phone but remained standing, gathering strands of black hair into neat strips running back from his forehead. “Canadian, from New York?”

Claire nodded.

“It was a magazine piece of some sort, wasn't it? Name again?”

“Rachel Barber.”

“I spoke to her.”

“Here? In this room?”

He nodded.

“Do you know if she also spoke to Dr. L'Aube?”

“L'Aube's the clinician. He tends to get pretty jammed up. He sees the patients, I'm primarily a researcher. Of course he researches, too. He heads up the team but we work closely together. Presumably he passed her on to me.”

He sat. He handed her a business card and she, inscribing her home phone and e-mail on the back, gave one of hers to him.

“She's missing,” he said.

“She hasn't been directly in contact with anyone since she left here.”

“Shit, eh? You're not accusing us of abducting your sister.” His grin vanished. “Sorry. That was in terrible taste. You've gone to the police?”

Claire nodded. “Can you possibly tell me what you talked about when she was here?” She pulled out her notebook and uncapped her pen, taking him in a little more now: good-looking in a way that might have appealed to Rachel; cleft chin; a manner that seemed both smooth and congenitally nervous.

“So she left here —?”

“She checked out of the Hotel du Parc the next day. March 16. She was supposed to go to Toronto afterwards but she cancelled her plans. She said she was coming to Montreal to interview a neurologist for an article on migraines. She left Dr. L'Aube's name on a piece of paper on the desk in her apartment.”

“No other leads?”

“Nothing yet.”

“So we're it – well, we talked about migraines.”

“Can you please be more specific?”

He pulled in his chair, straightening himself, the mauve cuffs of his shirt extruding beyond the arms of his lab coat. Stubble spread across his cheeks, around his jaw, under that firm chin. “We talked about developments in serotonin-based research.”

“Okay, but more.”

“You know migraine results from a deficiency in regulating serotonin? Used to be thought of as a vascular problem, but it's actually a neurological problem.”

Claire nodded.

“During a migraine, blood flow increases in the brain stem and other cortical areas. Medications such as sumitriptan or other triptan drugs can lessen migraine symptoms but don't seem to affect blood flow in the brain stem. Two areas of the brain stem, the dorsal raphe nucleus and the nucleus raphe magnus – tell me if you want me to slow down or explain anything – contain large amounts of the neurotransmitter serotonin. This is what our research here is concentrating on. We're trying to measure, using PET scans and fMRI's, the serotonin levels in various areas of the brain throughout a migraine. There are also sex-based differences in serotonin distribution. Men have more in the left frontal lobe, women's is more evenly distributed. Women don't retain brain serotonin levels as well as men without eating foods containing tryptophan, which the body converts to serotonin. Serotonin levels drop precipitously during a migraine attack, as much as 60 per cent. We're trying to fix where
the serotonin activity occurs, what triggers the drop, all getting back to the fundamentals of what exactly initiates migraine.”

“Give me a sec,” Claire said, scribbling. “Did she say who the piece was for?”

“Probably. I don't remember. L'Aube might. It's true we never heard back from her but that's not unusual with journalists.”

“Was there anything particular in what you said that seemed to catch her attention, that she might have wanted to follow up on?”

“We talked a little about drugs, too. The failure of current triptan drugs to cross the blood-brain barrier and thus affect what's going on in the brain stem. That's the goal, ultimately.”

“To cross the blood-brain barrier.”

He nodded.

“How close are you to that?”

“Well, first we have to understand the mechanism.”

“Did you give her any other leads? People to contact?”

“There's the guy at Sunnybrook in Toronto. Some good people in the UK.”

He gave her names and she wrote them down. “Did she happen to mention that she gets migraines?”

“She mentioned it. Not auras but pretty frequent, severe, kind of drug resistant by the sound of it.”

“Would you happen to know if she had a migraine when she came to see you?”

“At one point she said so but she wasn't obviously incapacitated.”

“Did she seem in any way upset or on edge?”

“No, but she wanted something I wasn't prepared to give her. We do these studies, examining serotonin levels in patient volunteers during the course of a migraine. You have to have not taken any drugs in the last twenty-four hours and we put you through a PET scan. She said she hadn't taken anything and was willing. But she wouldn't be in town for any kind of follow-up, and that's part of the study. And there's a preliminary interview. We're not set up for walk-ins. Though she was very persuasive.”

“So what happened?”

“I told her, under the existing protocols, I couldn't use her in the study. That was pretty much it.”

“When was this?”

“Around three, four in the afternoon. Hang on, I'll check the date.” He picked up the phone and dialled. “Pierre, a quick one. Got a woman here whose sister's disappeared. Journalist, here in March. Yeah, I talked to her. You spoke to her by phone. Okay. It's in your book?” He looked at Claire. “March 15. Three p.m.” Hung up the phone. “You get them, too, don't you?”

Which took her aback. “Yeah. Do you?”

“No, go on, hate me. You seem to know the language. There's a physiological predisposition that runs in families, as I'm sure you know. Mother? Grandmother?” Claire nodded. “Yours as bad as your sister's?”

“Not quite as bad.”

“The usual tyramine-based triggers – chocolate, red wine, et cetera, et cetera?”

“Other ones, too.”

“The drugs work for you?”