Adverse Effects Read online

  Copyright © 2020 by Dr. Joel Shulkin

  E-book published in 2020 by Blackstone Publishing

  Cover design by Alenka Vdovič Linaschke

  All rights reserved. This book or any portion thereof may not be reproduced

  or used in any manner whatsoever without the express written permission of the

  publisher except for the use of brief quotations in a book review.

  The characters and events in this book are fictitious.

  Any similarity to real persons, living or dead, is coincidental

  and not intended by the author.

  Trade e-book ISBN 978-1-09-402412-7

  Library e-book ISBN 978-1-09-402411-0

  Fiction / Thrillers / Medical

  CIP data for this book is available from the Library of Congress

  Blackstone Publishing

  31 Mistletoe Rd.

  Ashland, OR 97520

  www.BlackstonePublishing.com

  To Geiza, who helps me remember everything.

  Prologue

  The woman’s brown skin rippled like satin beneath Carl Franklin’s pale fingertips. Her hair billowed in a black halo against the bedspread. Slender fingers pulled the sheets free from the mattress as she moaned and jerked spasmodically. Her eyes bore into Carl’s as his fingers dug into the skin surrounding her neck.

  Carl’s stomach lurched when his hands tightened around the woman’s throat, blocking her screams. Even worse, the growing bulge in his pants confirmed he enjoyed it.

  “Stop,” he whispered, though it would do no good. The vision continued, relentless. Sitting in the living room of his luxuriant Somerville apartment, Carl gripped his armchair, trying to convince himself the rich leather felt nothing like the skin of her neck. “These aren’t my memories.”

  The woman jabbed her press-on fingernail at his eyeball. Carl tightened his grip. Twisted. Crushed her windpipe. The fight left her body.

  “That wasn’t me.” Carl spoke, though there was no one around to hear him—except for the voice in his head. He doubled over and pressed his fingertips against his skull. “I know who I am. I’m not a killer.”

  Bullets whizzed past. A soldier rushed at him. Carl slit the man’s throat and bolted. Burst through a door. Sprinted outside. Glanced over his shoulder. A mosque exploded behind him. Heat licked Carl’s back as he dived for cover.

  “I didn’t blow up any mosque.” Carl dug his knuckles into his temples. The windows shook as a train on Boston’s Green Line rattled past. “I’ve never left the country.”

  The scene changed. Carl was in an alley, and a submachine gun bucked in his hands. Dark-skinned boys screamed and fell at his feet.

  “Get out of my head!” Carl jumped from the chair and stumbled across his apartment to the bathroom. He yanked open the medicine cabinet and found the bottle. With a cry, Carl ripped off the cap and dumped two green capsules into his hand. He popped them into his mouth and swallowed them dry.

  “I’m Carl Franklin,” he said into the mirror. His rugged, handsome visage was marred by uneven stubble. His eyes were bloodshot, haunted. “I’m a successful accountant. I’m not a killer. Hold onto what you know.”

  While repeating the mantra, the mental fog lifted. The radiator clattered. A cold breeze blew through the crack under the toilet. His heart rate slowed. The images were gone. For now.

  Blinking and shaking his head, Carl stuck the bottle in his pocket and returned to the living room. He needed to call Dr. Silva.

  After Carl picked up the phone, he considered what he would say. How could he explain that he no longer knew what was real and what wasn’t?

  You can’t say that.

  The cold, hard-edged voice warning him off was his own—but it wasn’t. Two weeks ago, the voice had started telling him what to do. Where to go. What to say. Who to fear. Oh, God, why wouldn’t it stop?

  You know why. You were sick. In pain. You couldn’t pay the medical bills.

  “No, that’s not what happened,” Carl pleaded with the voice.

  They cured you. And, in exchange, you sold your soul.

  “No.” Carl flung the phone across the room. The images reappeared one at a time, like stars in a darkening night sky. He recoiled from the sting of his wife slapping him when she discovered the deal he’d made, the horrible things he’d done. His gut twisted at the blood pouring from his wife’s forehead after he shot her. “None of this happened. I know who I am.”

  Do you? Sick laughter echoed in his head. Are you sure Carl Franklin is real?

  “I have to be. I won’t be someone else.”

  But you are. You always were. The voice amplified, reverberating in his skull. And you must follow his orders.

  He saw a man with no face, only cruel, menacing eyes. Commanding. Controlling.

  “He doesn’t exist!” Carl’s head swam. The faceless man followed him as Carl stumbled toward the kitchen, losing his balance and cracking his head against the table.

  The stench of sour ale from the half-finished beer bottles scattered around the room assaulted Carl’s nose, making his stomach heave. Blocking out the smell, he opened the refrigerator and grabbed what remained of a six-pack. He popped open a bottle and chugged the beer.

  You can run, but you can’t hide. Every word echoed like a concussion grenade. Sooner or later, you’ll have to admit what you did.

  “Never!” Carl grabbed and gulped down another beer. The bottle slipped from his grasp. Crashed. Splattered him with glass shards. He clenched his fists and howled. “I know who I am!”

  But you don’t. Do what he wants, and you will.

  Carl stumbled to the window and gazed out at the frozen swimming pool below. In a few months, when the ice melted and the flowers bloomed, his neighbors would lounge on deck chairs, listening to reggae music and living the good life. How lucky they were to be free of doubt. They’d never wonder if everything they knew was a lie.

  You don’t have a choice.

  Drops fell from overhanging icicles. Looking at the light snow dusting the courtyard, at squirrels foraging for whatever acorns they’d missed before winter struck, Carl felt calm at last. At peace. He did have a choice.

  Hold on. Let’s not do anything stupid.

  Carl backed up a few steps to get a running start, and then jumped and crashed through the window, plummeting eight stories. His last thought was clear: I know who I am.

  Chapter One

  “Now I know who I am,” Jerry Peterman said, wiping a tear from his eye. He glanced at the medical licenses and psychiatric board certifications arranged on Cristina’s office wall and turned back to her, beaming. “I’m remembering more every day. It’s like someone opened the floodgates. I don’t know how to thank you, Doctor.”

  As the affable security guard gushed about his recovered memories, brushing his thinning hair over his bald spot and then rubbing his thick palms together while he talked, Cristina Silva’s heart swelled with pride. Nine months earlier, Jerry had been a lost lamb, afraid and unwilling to talk about what little he remembered before the ten-year gap in his memory. Those years had disappeared, as had his confidence. But now he was ready to rejoin the world, and he couldn’t stop thanking Cristina and praising her psychiatric skills.

  “You’re embarrassing me,” she said, scribbling on her notepad. She sat on an easy chair opposite Jerry, who was perched on the couch. “Jerry, you’ve done the hard work, finding mementos to trigger your memories, doing relaxation exercises, staying healthy.”

  “Sure, all that stuff helped, but none of it would’ve mattered if you hadn’t hooked me up with Recognate. Working bank security these days is going great and
I even joined a bowling league—did I tell you that? Still, I keep worrying that one day you’ll tell me I can’t get the pills anymore, and everything will go back to how it was.”

  “Don’t worry about that. When the study ends, you can keep taking Recognate as long as you need it.”

  “But will it keep working? What if I wake up one day and—just like before—I have no idea who I am?”

  Cristina’s skin grew cold. She glanced at the desk photo of a couple in their fifties: attractive, and professional, with Latin features like Cristina’s own. Her slender nose and frame perfectly matched the man’s, while her dark eyes and curly hair mirrored the woman’s. Her parents had died two years ago to the day. Valentine’s Day. The day their life ended—and hers began.

  Brushing away her thoughts like cobwebs, Cristina turned back to her patient. “Jerry, please don’t worry. Even when subjects in earlier studies stopped taking the drug, they experienced no withdrawal or memory loss. I’m just glad it’s worked so well for you.”

  Jerry sighed, visibly relieved. His emotional stability was still erratic. “It definitely worked. You’ve given me back my life. Do you know what I remembered last night? I ran the Boston Marathon twice. Once in a bunny suit!”

  “Yes, you already told me.” Cristina couldn’t help smiling. “Twice.”

  His face flushed. “Sorry.”

  “Don’t be. I love your enthusiasm.” Cristina’s watch beeped. She glanced at it before opening a desk drawer and removing a slim rectangle wrapped in ruby paper. She smiled and handed it to him. “This is for you.”

  His eyes widened as he accepted the gift. “A Valentine’s Day present?”

  “More of a token to recognize how far you’ve come. Open it.”

  He ripped off the wrapping paper to reveal a book bound in black leather. He ran his fingers over the cover. “It’s a journal.”

  “I think it would be a good idea for you to record both new experiences and regained memories.” Leaning forward, Cristina tapped the book cover. “And it’s also so you don’t need to worry. If for some reason you lose your memory again, you’ll have an anchor to quickly pull you back.”

  Jerry looked at the journal, then at her, eyes brimming with tears. “Thank you. I’m not sure when’s the last time someone gave me anything.”

  “Whatever you remember, write it down.” She smiled and turned to her computer. “You’re still at the same address?”

  “Huh? Oh, yes.”

  She glanced at him. “Is something wrong?”

  “No, it’s nothing. It’s . . . Uh . . .” He studied the floor. “Would you have dinner with me?”

  Cristina’s face flushed. Unintentionally attracting affections from clients was as much an occupational hazard of working in mental health as getting burnt was when being a firefighter. The clinical term was transference.

  Cristina swallowed. Jerry had come so far. And she certainly did not want to damage his still-fragile psyche.

  “I appreciate the offer, but because this is a professional relationship with boundaries, I want to be certain that you understand what can and cannot happen between us.”

  His face fell. He stared at the floor again. “I know. I’m sorry.”

  “Hey,” she said, lightly tapping the journal until he reestablished eye contact. “I’m proud of you. It took a lot for you to ask. Use that newfound courage and keep taking risks. There’s someone out there for you. Promise me?”

  His mouth twisted before a hint of a smile played at his lips. “Okay, Doc.”

  “Good. You have my cell number if you ever need a shot of encouragement.” She winked. “And since you’re a preferred patient, I won’t even charge you a co-pay.”

  He laughed.

  Cristina finished typing and printed Jerry’s prescriptions before handing them over. “This should hold you for two more months. Be sure to make an appointment with me before you run out. I want to hear more about your college road trip to New Orleans.”

  After Jerry left, Cristina leaned back in her chair and scanned her notes. So many of her patients foundered no matter what she did. However, her patients like Jerry—those enrolled in the Recognate trials—had experienced dramatic recoveries nothing short of miraculous. And without suffering a single adverse effect.

  What a shame the manufacturer had declined so many of her referrals to the trials. ReMind Pharmaceuticals used unusually narrow inclusion criteria for this open trial, but once the results went public, Recognate would be available to everyone. Not only would it help those with total amnesia, it could benefit anyone needing a memory boost.

  As she closed Jerry’s chart and set it aside, Cristina amused herself with the thought that Recognate was so effective that if ReMind marketed it directly to the consumer, it could cut her patient roster down enough to potentially put her out of business. But there was no sign of a mass patient exodus happening soon. Her patients depended upon her. And Cristina loved helping them find themselves. It got her out of bed each morning and gave her a strong sense of purpose.

  Her watch beeped again. She shut it off and glanced at the desktop photo. This time she surrendered to impulse and traced the outline of the man’s face, imagining the feel of rough stubble under her fingertips. She did the same with the woman’s—almost but not quite smelling the scent of Angel perfume.

  “Soon I’ll remember everything,” she whispered as she stroked the photo. “I won’t lose you again.”

  Cristina pulled her hand away, opening her top desk drawer and removing a bottle of green pills and a water bottle. She popped two capsules in her mouth and chased them with a splash of water. She closed her eyes and tried to remain patient, waiting to discover what she would remember next.

  Chapter Two

  After finishing her last patient progress note of the day, Cristina leaned back at her desk and massaged her scalp. While psychiatry wasn’t as physically grueling as emergency medicine or surgery, the emotional investment of dealing with intractable depression and uncontrolled mania was incredibly taxing. If it weren’t for the success with her Recognate patients, she wasn’t sure she could get through the day.

  A light knock on her office door brought Cristina out of her reverie. She looked up to see her office manager leaning against the jamb. Devi Patel’s petite frame was bundled in a ski parka.

  “I pulled the referrals for tomorrow and called to confirm your appointments.” Devi’s voice lilted with a trace of an Indian accent. “If it’s okay with you, I’m going to head out.”

  “Of course, it’s okay. It’s already six thirty.” Devi had been hired six months ago, after Cristina’s first office manager quit unexpectedly. Filling the position so quickly had been lucky. To have someone so dedicated and skilled with technology was a double blessing. Cristina certainly didn’t want to deal with another employee burning out and urged Devi to leave. “You should’ve gone home an hour ago.”

  “I could say the same for you.” Devi flipped a strand of straight black hair away from her eyes and pursed her lips. “You’re not going to pull another all-nighter, right?”

  “No. I just need to review my notes one more time. My report to ReMind is due in a few weeks, and I don’t want to leave out anything that could jeopardize their study.”

  “You? Miss something?” Devi laughed. “Sherlock Holmes didn’t have the eye for detail you have. And I’m not just saying that because you’re my boss.”

  “Well, thank you.” Cristina blushed. She eyed the pink cashmere scarf wrapped around Devi’s neck. “Fancy. Big plans tonight?”

  “My boyfriend’s taking me to dinner at L’Aromatique for Valentine’s Day.” Devi furrowed her brow. “You don’t have plans?”

  “Uh, no, unless you count snuggling with my cat.”

  The holidays seemed to bring more pain than joy, and Valentine’s Day was the worst—a bitter remin
der of what she’d lost two years ago.

  Push that feeling away, she thought. I need to be complete before I can share myself with anyone else. And I certainly do not need to unload my crap on my assistant.

  Forcing a smile, Cristina shrugged. “It’s fine. I’ll get another chance to celebrate the day in a few months.”

  “What do you mean?”

  “In Brazil, they celebrate Valentine’s Day in June. It’s called Dia dos Namorados—Lover’s Day. I’ve been thinking of taking a trip to Rio this summer, so . . .”

  An image sparked in her mind so abruptly that Cristina stopped talking: a teenage Cristiano Ronaldo look-alike held her hand, leading her through a street packed with taxis and tourists. Cristina’s other hand clutched a bouquet of red roses. The smell of black beans and seasoned beef wafted from the entrance of a nearby restaurant. The handsome boy caught her eye and pointed up. Towering overhead atop a cliff was at a statue of Christ with outstretched arms.

  “Dr. Silva? Are you okay?”

  Cristina jumped. She turned, wide-eyed, and found Devi staring at her.

  “I’m fine,” she said, feeling anything but. She’d gotten used to new memories appearing a few hours after taking Recognate, but this one had been different. It was so vivid and felt more real. Yet her mind told her that it wasn’t true. It couldn’t be.

  While growing up, Cristina’s parents had often talked about taking her to see Rio de Janeiro, where her mother had been born. They had even taught Cristina Portuguese and made her watch every movie about Brazil they could find. But they never made that trip.

  Cristina recognized the statue in the memory from photos of Corcovado. It was Christ the Redeemer, a famous landmark in Rio. But it was something about the boy that struck a chord. It was more than his resemblance to a famous soccer player. He meant something to Cristina. At least, that’s how it felt.

  Realizing Devi was still eyeing her, Cristina forced a chuckle. “A little headache. It’ll go away.”