Nichols set down his glass and held up his hands as if he were cupping something the size of . . . Well, a skull, actually.
"A live brain has about the same consistency as Jello. It sits inside the skull, which shields it, and it's also sheltered by layers of membranes that are called meninges. It's pretty well protected from most shocks you'd normally encounter day to day. But if your skull gets hammered really hard, then what happens—"
The doctor suddenly jiggled his hands around, very violently. "—your Jello-y brain is essentially being bounced around against your own skull. The worst damage usually happens to the brain tissue nearest the source of the trauma but you can have damage almost anywhere. Call it ricochet damage, if you will."
"All right. Assuming for the moment, though, that the damage is restricted to where he got hit, what's your diagnosis?"
" ‘Diagnosis' is way too strong a term, Mike. With this sort of brain injury, there's a lot of guessing at first—and would be, even if we were in the intensive care unit of a major up-time hospital. A lot of the diagnosis of brain injuries has to develop over time, since many of the symptoms are behavioral and—"
"James. Please. This is not a time for all the complexities and all the details and all the maybes and the we-don't-know-yets and all the caveats or any of that stuff. I need whatever you've got right now, down and dirty. Give me your best guess, if you don't like the word ‘diagnosis.' What is wrong with Gustav Adolf's brain?"
Nichols sighed. "I think his right temporal lobe is damaged."
"And that results in . . . ?"
"Assuming Gustav Adolf survives the next few weeks, he might make a complete and quick recovery." He took a deep breath. "What's more likely, though, is that it will take him months to recover, possibly years, and he may never recover completely. Probably won't, in fact, with that bad of an injury."
Mike sagged a little in his chair. "That's . . . about what I was afraid of. Would one of the symptoms be that he says things that make no sense at all?"
"Gibberish?"
"No, not gibberish. They sound like complete sentences, but it's as if all the words are scrambled. I'll give you an example. At one point when I looked in on him in the litter, he was awake and stared at me as if he had no idea who I was. Then he said—I think I'm remembering this right: ‘I ate my tree but the horse will not open the stirrup.' "
James ran fingers through his short, kinky hair. "Yes, that's a symptom of temporal lobe injury. One of the major functions of the temporal lobes is handling speech. What you're describing is a form of aphasia, which can manifest itself in many ways. People suffering from aphasia might be able to speak but not write, or write but not speak. Or they might be able to sing, but can't speak or write. Gustav Adolf's failure to recognize you is because the right temporal lobe is also involved in the visual content processed by the brain. Sound, too. Even if he recovers—this is just one example of what can happen—Gustav Adolf may have so much trouble with tonal recognition that music means nothing to him any longer."
Mike winced. The king of Sweden adored music.
"What else?" he asked.
James spread his hands. "There could be a lot of things, Mike. He might start having seizures."
"He hasn't had any so far," Mike protested. "I'm sure I'd have noticed or been told by one of his attendants if I wasn't there at the time."
"Doesn't matter. Seizures don't have to develop right away, with something like this. He might start having them a week from now, a month from now, a year from now—or never at all. And if he does start having them, they might last for a short while or the rest of his life. The brain's still a very mysterious organ, Mike."
"What else?"
"He's almost certainly going to have problems with memory retrieval. The problems may be mild, moderate or severe, and it's impossible to know ahead of time how long they might last. His behavior might become childish and/or irritable. He might have sudden unprovoked rages. He might sink into depression. He might find it difficult to concentrate on anything for very long. He might completely lose any sense of humor. His language skills could be chaotic. He might be able to speak but have no understanding of what he is saying. Or he might—for Christ's sake, Mike, how long do you want me to go on? Don't you get the picture yet? I repeat: the brain is still mostly a mystery. There's usually not much you can do with an injury like this except take care of the patient's bodily needs and wait and hope for the best. You want to know my diagnosis? Ask me in six months. Better yet, ask me five years from now."