PRESENT DAY

Cameron is sitting back at the nursing station, working on a handwritten note about Spider-Dan.

Even though Dr. Beck didn’t tell us we needed to write a note,

Cameron always goes above and beyond. That’s how he is. Whenever we had a test, he would read and re-read the material over and over, highlighting every sentence in the textbook in a different color, and then he would do every single practice question he could get his hands on. Twice.

Cameron claims it’s because orthopedic surgery is extremely competitive, so his grades need to be stellar to get into a residency program. I don’t need to be as competitive, because I don’t want to be an orthopedic surgeon. I want to be… Well, I don’t know what I want to do in terms of a specialty. I know I want to be a doctor, and so far, that’s good enough. I figure by the end of third year, I’ll get it sorted out.

The only thing I know for sure is that I don’t want to be a psychiatrist. (Or an orthopedic surgeon.)

I used to think it was sexy that Cameron worked so hard. I liked how driven he was. I mean, every time I studied with him, I felt stupid, but I always ended up acing the exam because he would push me to go above and beyond. I don’t know when it stopped being sexy and started being annoying.

Maybe around the time he dumped me to study for the board exam.

Dr. Beck wanders over to join us at the nurses’ station, his hands pushed deep into his white coat pockets. My heart leaps when I see him. “Dr. Beck,” I say. “I need to talk to you.”

“Of course.” He smiles at me and those dimples poke out. Or in. Or whatever dimples do. “What’s up, Amy?”

I toy with the drawstring of my scrub pants. “So you know that patient in the seclusion room? Sawyer?”

“Yes…”

“I heard a strange noise coming from the room.” I crane my neck to look down the hall. “You said he was restrained, but it almost sounded like… like he was throwing himself at the door.”

Dr. Beck frowns. “I don’t see how he possibly could have gotten out of the restraints. We put them on both arms after he had dinner.” He looks over at Ramona, who is standing by a med cart in the hallway, emptying multicolored pills into a tiny plastic cup. “You secured both of Sawyer’s restraints, didn’t you?”

“Yes, of course, Doctor,” Ramona says.

“I just…” I shift between my sneakers. “That’s what it sounded like.

Like somebody was trying to get out.”

Dr. Beck stands there for a moment, a troubled expression on his face. “I appreciate you letting me know, Amy. We’ll proceed with caution when we enter the room in the morning.”

Hopefully, that won’t occur until after I’ve left in the morning. Dr. Beck was emphatic that Cameron and I would not be in any danger from the patient in seclusion, so I hope he waits until after we’re done and there’s more staff on the unit.

Dr. Beck looks down at Cameron, who now seems to be on page five of what promises to be an epic note. His tongue is sticking out of the corner of his mouth like it always does when he’s deep in concentration. I used to think it was cute.

“I didn’t say you had to write a note on your patient,” Dr. Beck says.

“I like to write them,” Cameron lies through his teeth. “It helps me organize my thoughts.”

Dr. Beck shoots me a look, and I could swear he rolls his eyes a bit. Gabby was right—I do like him. “Sure. Knock yourself out. Who did you see?”

“Daniel Ludwig.”

“Spider-Dan!” Dr. Beck claps his hands together. “My favorite patient!

A textbook case of schizophrenia. Isn’t the brain absolutely fascinating?”

“I completely agree,” Cameron—who has never disagreed with a professor once in the entire time I have known him—says.

“I’ve always been intrigued by what causes a normal brain to create such powerful delusions.” Dr. Beck’s face lights up as he talks. You can tell he’s one of those people who is extremely passionate about his career, and it makes me respect him more. “The basis of schizophrenia is thought to be an imbalance of neurotransmitters in the brain that occurs in just the right way to create the classic constellation of symptoms.”

Cameron nods vigorously. “It’s so fascinating.”

Dr. Beck smiles at him. “Cameron, can you please elaborate on the classical symptoms of schizophrenia?”

For a moment, Cam is caught off guard. But he quickly regains his composure. “Well,” he says, “he’s got both positive and negative symptoms.”

“Such as?”

Cameron looks down at the stack of handwritten papers in front of him, detailing everything about the patient from the moment he was born to five minutes ago. “He’s got positive symptoms like delusions of being Spider- Man, he hears voices, and he’s got disorganized speech. But he’s also got negative symptoms, like he won’t look you in the eye, he doesn’t have any friends, and he talks in a monotone.”

Dr. Beck nods, impressed. “Someone came prepared tonight.”

Cameron beams. Oh great, now that he got some positive feedback, he’ll be completely intolerable.

“He thinks that the webs in his hands are linked to urination,” Dr. Beck explains to me. “So he just stands over the toilet, trying to shoot out webs. And of course, it’s all made much worse by the fact that the medications he’s taking cause urinary retention.”

“Poor guy,” I murmur.

“You should go see him, Amy,” Dr. Beck says. “He’s got a classic case of schizophrenia, as I said. It will be a good learning experience.”

“I already saw a patient with schizophrenia.” It’s better than saying that the idea of interviewing a man who thinks he’s Spider-Man makes me uneasy. “William Schoenfeld.”

Dr. Beck considers this. “He’s interesting in a different way. His presentation is atypical for paranoid schizophrenia.”

“It is?”

“I’d say so,” Dr. Beck says. “He has the positive symptoms Cameron mentioned, such as hallucinations. And definitely paranoia. But not many negative symptoms. Also, he says he only started hearing the voices a few months ago, and it’s pretty rare for a man in his late twenties to have a first schizophrenic break. Usually, males present in their late teens or early twenties.”

I frown. “So what does that mean?”

“Could be an atypical presentation of schizophrenia, like I said.” He lifts a shoulder. “But there’s also a chance that his symptoms started a long time ago. Way before a few months ago. After all, many people with schizophrenia aren’t aware that they’re experiencing symptoms.” He drums his fingers on the table. “He could have been hearing those voices for years.”

I try to imagine what it must be like to spend years of your life hearing voices telling you to kill people.

“Anyway.” Dr. Beck waves a hand. “The medications are currently suppressing Schoenfeld’s symptoms. Go see Daniel Ludwig. I think you’ll find it very interesting.”

“I’d be happy to introduce you, Amy,” Cameron speaks up. Great. They’re both looking at me. I’m going to have to do this. “Sure,” I say. “Let’s go.”