Estivation

11 Nov

Linz Roe took a moment to think before explaining his request to the driver.

“I’ve accepted an internship there,” explained the Fort Vinea native in the rear of the cab. “I didn’t have much choice. It had to be there.” It was doubtful that listing Agama on his resume would advance him in his chosen field. But what alternative existed for him?

As the taxi rumbled down a rough jungle road, the athletic young doctor tried to shake loose his hopelessness about what lay ahead. The intern’s colorless eyes scanned the banyan forest outside. Candlenut, talipot palm, mimosa, palmetto, lavender, and toon trees seemed to be guarding an enigmatic secret of some sort.

He wondered what kind of superior the director, Dr. Elet Jalix, would turn out to be. And how soon he would learn about the supervisor’s favored treatment, estivation.

The main building of Agama Hospital resembled an old plantation mansion. Green shutters covered the square windows of the whitewashed outer walls. An elderly male nurse led the intern to the office of the head of the hospital.

Dr. Elet Jalix, a short man with a fringe of cottony white hair and silvery eyes, came forward to shake hands. He invited Linz to take a chair next to his desk. The older man carefully studied the younger one’s face. “I take it there was no alternative to Agama,” said Jalix, his voice sounding distant and hollow. “It has been over ten twelvemonths since I last had anyone here as my apprentice. Your acceptance of the position was a total surprise to me, Dr. Roe. I shall not embarrass you by asking for your reasons. Do you know anything about estival therapy and how it is administered?”

Linz considered a moment. “My textdisks barely mention the subject. I had to go back to the history of psychiatry on old bibliofilm to find material describing electronarcosis and soporization methods. There was nothing available on the clinical results of estivating mental patients for long periods of deep sleep.”

The director made a sour face. “That is understandble, because what I do here is out of favor with the highest medical authorities of Vinea. No one comes to study my accomplisments, or learn how to duplicate my estival treatment. That is due to the politics within psychiatry. My grandfather, the founder of Agama, pioneered the method. For him, estivation looked like the direction of all future therapy. For a few twelvemonths, it seemed that psychoanalysts everywhere were ready to apply my grandfather’s discovery.

“But that did not happen. Those who control psychiatric practice blocked and frustrated the spread of the estival method. They broke the hearts of both my grandfather and father. After both of them died, I inherited what was left. The number of patients coming here today is small, but I do my best to treat them through estival soporization. The results of the early years still come about. I win cures in eighty percent of the cases.” Jalix stared intently at his new intern.

“What sort of patients come to Agama?” inquired Linz.

“Mostly schizothymic persons who suffer severe disconnection from reality. I also have young hebephrenic patients with easily distracted personalities. But the overwhelming majority are schizoids, splintered and fractionalized in their minds and personalities. Estivation aims at the creation of inner fusion that repairs the unconscious conflicts in their suffering minds.”

“I understand that pharmaceutical prescriptions are not used here,” noted Linz. “Is that so for a specific reason?”

“That was a fundamental principle set by my grandfather. Never would he administer any chemical substance. I use only electrowave transmitters in treatment. Never are any drugs given to our patients.”

“That, then, is what makes human estivation so different from the processes we see today in medicine,” mused the intern. “I have read of the effects of exreme heat and dryness on many jungle creatures at the peak of summer.”

“Yes,” nodded Jalix. “We can observe this deep torpor in bees, earthworms, snakes, lizards, turtles, frogs, and the toads in our region. Elsewhere, it occurs in groundhogs, hamsters, woodchucks, tenrecs, and a variety of birds and fish. It is a suspension of the normal life processes, a protective kind of long, deep sleep.”

“And now it can be produced in human beings,” softly said Linz.

A short silence followed, until the director spoke again.

“You should see some of the patients at once. My head nurse will take you around and introduce them.”

Ruke Dulig was a bald giant, his head was a shiny globe. The nurse’s coffee eyes studied the intern’s rectangular face.

“Follow me,” said the towering man in white coat, pants, and neckband.

The first two patients proved typical schizoids: distracted, disoriented, and withdrawn. They ignored the unidentified visitor with Ruke.

“They are not responding to electronic pulse treatment yet,” said the guide once he had taken Linz back into the hallway. “The next patient is a beautiful young woman who paints pictures. She was estivated for two fortnights recently. It was her second trip into supor.”

“Is she improving?”

Dulig looked away. “That remains to be seen.”

He knocked on the closed door of a private room. In seconds, a female in an orange bathrobe stood before them. Small and lithesome, with long carroty tresses, she gazed at the nurse, then turned to the stranger. Her dark terra cotta eyes peered with the indifference and lack of interest of an introvert, Linz noticed.

“This is our new doctor, Ostna,” gently said Dulig. “He wishes to meet you. Can we come in?”

Without a word, the patient stepped out of the way. The three went into the room, Dulig closing the door. Ostna sat down on a small stool, the visitors on a pair of settees.

“How are you feeling today?” the nurse said to her with evident concern.

She remained silent for a time, looking at Linz with sudden curiosity. “Am I to be your patient?”

Dulig decided to answer her. “Dr. Roe is an intern who is here temporarily. He will work directly under the supervision of Dr. Jalix, not on his own.”

Linz felt a slight constriction in his throat. He did not have enough time to stop and figure out why.”I am here as a student, Miss…I did not pick up your last name.”

“Gavin,” she told him. “My name is Ostna Gavin. I used to be an artist, but painting has become impossible since this illness came down on me.”

“When did that happen?” asked th intern.

“Last year, after my father’s death. I became extremely ill, unable to function at all. There were dark periods when a cloudy fog fell over me. It still strikes me periodically. Today, thankfully, is not one of them.” She turned to Dulig. “What does Dr.Jalix call them.”

“Phlegmatic episodes,” slowly said the nurse. “We should not be talking about your symptoms right now. There will be plenty of time for that.”

But Ostna went on, her dark eyes again on Linz. “This is one of my calm periods. I know that and can express how I feel. But it will not last. I know that for sure. A rhapsodic episode will hit me again sometime.”

“Rhapsodic episode?” questioned the intern.

She gave him a mischievous grin. “If you come in here at the right time, you will see what I mean, Doctor.”

Ruke Dulig suddenly sprang to his feet. “We must leave you, Ostna. You need undisturbed rest.”

The patient watched Linz follow the nurse out, exchanging looks with Ruke as he led the new psychiatrist into the corridor.

No question, there had been continual decline in the cure rate at Agama. It was evident in the statistical records of the hospital, Linz discovered. And the failure was greater than Jalix had indicated to him, he had no doubt about that.

Why were patients leaving without any improvement in their psychological conditions?

The head nurse opened the door of the records office where Linz had spent the early morning, reading at random. “The director wants you in the surgery immediately. He is about to send a patient into sopor. It will be Ostna Gavin.”

“Oh, I didn’t know. She said nothing when we visited her yesterday.”

They hurried down the long central corridor. “This is unscheduled,” quickly said the nurse. “The director saw her last night and made an instant decision to estivate. She was falling fast into an episode of disconnection, her mind shattering into fragments.”

“A psychiatric emergency?”

“It looks that way, Doctor,” answered Dulig. “Ostna was frenetic with excitement, impossible to control. I had to strap her down in a restrainer. Dr. Jalix feared she might injure herself, the way she was dancing and prancing about in her room. Her condition is one of hyperdrenia, he says.”

Linz noted a hint of doubt in the other’s voice. “Do you agree with that diagnosis, Ruke?”

The nurse’s face reddened. “It is not mine to decide, sir,” he managed to say before turning and walking away. The intern followed him.

The director, in a white gown, was busy with preparation in the surgery. He nodded to Linz, then spoke. “This patient is in a severe state of disconnect and excitation. I have decided she needs immediate soporization, or else the young woman may do harm to herself. Can you assist me in inserting the fabrilla conductors?”

“Yes,” answered the intern, “under your guidance.”

“Good. Let’s start at once.”

The two psychiatrists moved to a glass table upon which lay Ostna in a restrainer pouch. Jalix pointed to a white robe resting on a stool. Linz realized he was expected to put it on and proceeded to do so.

The artist’s face was brick red. Her hair seemed electrified, straight and stiff. Terra cotta eyes fixed on the intern, following his motions. Jalix bent over a small table holding the estival instruments. Picking up a pair of white pincers, he whispered to his assistant, “I will place the main conductor myself. It must touch the nerve correctly. Watch me carefully, for it will be your task to insert the minor fabrilla conductors.”

Linz observed how the conductor went into the side of the patient’s head. Neuilemnal sheath, neurological connective tissue, thought the apprentice. Each of these being pierced by the delicate nano-fabrilla, so thin as to approach invisibility.

All at once, Ostna closed her terror-filled eyes.

“It is now your job to place the subodinate lines, my boy,” said Jalix. “I will oversee how they are positioned. But the rest of the work will be yours.” He handed the intern an unused pair of pincers.

Linz felt a lump of pain in his throat as he obeyed.

Ruke Dulig wheeled Ostna on a gurney back to her room. She was in estival coma, not due to become semi-conscious for half a day or more. Linz visited her quarters several times, eager to be present for the early period of partial awakening. The patient was strapped down with pneumatic belts, preventing abrupt turning or rolling over. Her breathing was slow and weak, barely perceptible.

Sitting near by, Linz rose as soon as he caught a muffled murmur. The estivated Ostna had opened her unmoving eyes of orange-brown terra cotta. She remained torbid and benumbed, the intern noted. This was a state of partial reactivation. Though she moved, she was insentient, her brain befogged with sleep.

Linz remembered that he was to summon the director by remote signal button when Ostna opened her eyes. As he was about to do so, she began to murmur unconsciously.

“Father…father! Why did you die so suddenly…The words I said to you…evil…forgive me…”

The two men listened as if hypnotized by the estivated patient’s ramblings.

In a short while Ostna fell back into the full, silent state of sopor. Linz invited Ruke to go with him to his quarters in the staff residence hall. “I want to discuss what we’ve heard from her. We have to help relieve the pain as best we can.”

The pair, once seated opposite each other, went over the secrets the patient revealed while unconscious. “She has from the beginning been classified as a schizothymic,” said Linz, “but that is a gross misdiagnosis. The germ of her malady originated in puberty, when her father passed away. She has unresolved guilt that still festers in her unconscious from that period. She must be re-categorized. Estival treatment will have no value for her at all. It could even affect her negatively.”

He drew a deep breath, then went on. “Perhaps most of the patients treated at Agama Hospital have been mistakenly diagnosed. I wonder whether estivation is damaging their true conditions?”

Almost trembling with emotion, Ruke spoke from the heart.

“It is terrible. The  situation is horrible. Her father caused her lifetime suffering. How could he shame her so, parading his mistress in front of his daughter?”

“Many men keep mistresses,” muttered the intern. “The tragedy here is that Ostna confronted him directly before he died, and he compelled her to feel as though she were responsible for his death. It drove her into an unresolved internal conflict.”

The two thought quietly for a time. “If only we could rescue her somehow,” murmured Ruke.

Each evening Linz poured over his notes on Ostna. He continued assisting Dr. Jalix in the surgical unit whenever estival fabrillas were placed in patients’ brains. Whenever possible, he studied the hospital records in secret. Gradually, his darkest suspicions were confirmed. Misdiagnosis and useless surgery were the rule, not the exception, at Agama. Dissociative schizoidal was the common label put on patients. All specific disorders were combined and treated with estivation.

But what could a powerless intern do? Linz foresaw that Elet Jalix would never accept the evidence he had collected. Estivation had become a precious family legacy to the director. How could the man throw out a prized medical tradition? But some attempt had to be made to convince Jalix to stop the harm he was causng the patients, however futile it promised to be.

The bungalow where the head of the hospital made his home was a short walk from the main building. Linz went there shortly after dusk, in the green twilight from the sunken daystar. Palms, cinnamon and cinchona trees towered over the cottage. From a distance came the screams of wild monkeys and tamarins. A large green quetzal flew up into the darkening turquoise sky as he passed and climbed onto the porch. He had to knock only once before a menial opened the door.

“Tell the director that Dr. Roe is here to see him,” said the unexpected visitor.

Jalix heard this and came swiftly from the study where he had been reading a bookdisk. He welcomed the intern and took him into the study where he had been studying. From behind his candlewood desk, the older man peered at the younger. “What are you here for?” inquired the estivator.

“Let me get to the point at once, sir. I have come here on behalf of one of our patients, Miss Gavin. She should be transferred elsewhere for conventional psychochemical treatment. Further estivation will not improve her condition, because her diagnosis has been in error.”

For a moment, it appeared as if the director might rise to his feet. Blood rushed to his face, reddening it. “What are you talkng about, my boy?”

Linz boldly stared down the angry gaze from the other. “She is described and treated as a schizoid suffering distractive dissociation. But I believe it is something completely different.”

“And what is that?” said Jalix, glaring at his insubordinate intern.

“She is a cycloid caught in unending cyclothymia. Cycles of hyperdrenia are followed by depression. She swings between periods of sanguinity and phlegmatic moods. It is sometimes referred to in the text tapes as bipolarity or dysthymic disorder. Estivation does no good at all. In fact, it is probably a very negative influence.”

Jalix gave him a searing look. “Do you realize what you are saying? Such accusations are destructive of all that has been done here for three generations. If what you are saying is true, then I must shut down Agama Hospital immediately.”

“But I am certain that my conclusions can be proven true,” argued Linz. “So far, Ostna Gavin has been the focus of my observations. But it seems logical that the other patients have similarly been maltreated through their estivation.”

The director glared at him. “What are you saying? If Ostna is let go, all the others will have to be released or tranferred as well.”

“It will be for their good, sir.”

All of a sudden, Jalix reached for a drawer of his desk and pulled it out. The object he removed looked like a small vaporizer bottle. Rising from his chair, the small man circled around the desk, startling Linz with unexpected speed. Before he could move or act to defend himself, the younger man was sprayed with somniferous scopolamine. That was the end of the fateful confrontation.

Summoned by a phone call, Ruke Dulig hurried over to the bungalow. Why had the head psychiatrist commanded him to bring a wheel barrow with him?

The director led him into the study where Linz Roe lay slumped in a chair. “He experienced a complete breakdown while we were discussing professional matters,” said Jalix. “He must be taken back to the main building at once, before he awakens. Who can say what will happen then? The man went berserk right before my eyes. It was totally unexpected , of course.”

“I’ll bring him in the wheel barrow,” mumbled the astonished nurse.

Jalix stepped closer. “You must help me in the surgical unit,” he commanded. “Only immediate estivation can prevent further deterioration of the poor fellow’s mind. I will come as soon as I can. For now, it is your task to transport and prepare him.”

Dulig answered with a nod, then turned and went for the handcart. His head whirled with a legion of disparate thoughts. From what the intern had told him earlier, he could deduce much about the inevitable conflict with Jalix that may have erupted that evening. “What next?” he asked himself.

With Linz curled up in the wheel barrow, the nurse hauled him out of the bungalow. Jolted and bounced by the irregular ground, the passenger’s body kept striking the sides and the bottom of the cart.

Ruke could barely make out the psychiatrist’s unconscious, irrational muttering. “Misconduct…criminal malpractice…” It was clear to the listener that these words referred to the case of Ostna. Everything now depended on him. Whatever he decided to do could not be changed.

Linz, coming out of coma, dreamed he was lying in a road vehicle. Opening his eyes, he realized it was true.

Above him was the dark metal roof of a carryall rumbling at rapid speed on a rough, jungle road. Moving his head to one side, he realized a startling fact. There was a body enclosed in a cloth pouch to his left. Through the transparent plastic window covering the head, a face was visible. It took only a second for him to recognize who it was.

Linz recalled the interruption of his last session with Dr. Jalix. What had happened after the small man had risen from his chair to silence him?

Ostna slept on, in the depths of estivation.

Was there anything he could do to save her from long or permanent coma? It was clear that Jalix, having harmed her like so many other patients, now intended to destroy both her and the one who had uncovered the crimes of the hospital.

The carryall began to slow down, then turned off the roadway. When it came to a stop, Linz heard a front door open, then close. Someone was coming to the back of the vehicle.

The intern closed his eyes. This might be his only chance to break away. The rear door of the carryall was opened and linz immediately jumped up, throwing himself out and springing upright. He charged directly into the solid body of the nurse.

“Stop. Dr. Roe,” shouted Ruke, grabbing him by the shoulders. “You do not understand. I am taking you two away. To where you will be safe. Where Jalix has no power.

“Remember, you discovered that estivation is a fraud. With your assistance, I was helped to understand what the director was really doing. You proved for me that he created the pain I have witnessed for years. If I had not taken the two of you away, that fiend would have placed both of you in permanent coma.

“Now, if you are able and willing, come and sit with me in front. We will soon reach Fort Vinea, where the police and the health authorities can hear what we have to tell them. This therapy may have had some good effects in the early years under the grandfather, but today the dire negative  results are clear to see.”

Linz, staring at the bald giant, broke out in a smile. “I see you have everything in hand, my friend. In a short while, Ostna should come out of her present state. She will be another witness against the evil you witnessed back at Agama Hospital.

Ruke smiled as he envisioned a recovered, happy Ostna.

The two had a quick, adoring look at the patient still in deep sleep, then climbed into the front cab and continued their escape.

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