Panophobia
Dr. Sarah Ryerson was eating a sandwich in the doctor's lounge when the 911 operator notified Puritan Falls Hospital that an ambulance would be bringing in two patients involved in a single car accident on Old Bridge Road. She quickly finished her late-night lunch and headed toward the emergency room, mentally preparing herself for what might be a life-and-death situation.
As the EMTs rolled the gurney through the outer door, one called out, "Elderly patient male, no pulse or respiration."
Although all attempts were made to resuscitate the man, he was declared dead shortly thereafter. Unlike most auto-related deaths, there was no blood. In fact, other than a small laceration on the forehead, the old man had no visible injuries.
"Looks like a heart attack," the doctor announced. "Where's the other patient?"
"Rock is with him in the waiting area. They're watching cartoons."
"Cartoons?" the doctor echoed.
"Yeah. The other patient is a kid about four or five years old."
Sarah went out to the waiting room that, given the lateness of the hour, was empty except for Rock and the young patient. Although Rock was obviously enjoying the cartoons, the child did not seem to be interested.
"I'm Sarah," she told the boy. "What's your name?"
When the child remained silent, Rock said, "We haven't been able to get him to talk."
The doctor was not surprised. A car accident was often a traumatic experience, especially for one so young.
While the physician was discussing the boy's condition with the paramedics, Officer McMurtry walked into the emergency room.
"Shawn? I'm surprised to see you on duty this late," Sarah said. "Sometimes I think we have a one-person police force."
"I'm filling in for Sergio. He's out sick with a stomach virus. How's the little patient doing?"
"He seems all right, but I haven't had the chance to examine him yet."
"What about the other one?"
"DOA. Apparent heart attack. My guess is that's what caused the accident."
"I don't suppose you recognize either of them."
"No. Why?"
"The man had no identification on him."
"What about the car? Can't you run the tags?"
"Already did that. The car was reported stolen in Falmouth four days ago."
The young boy, who had apparently overheard Shawn's last comment, announced, "There are roughly thirty thousand automobile-related deaths each year in the United States alone."
The adults were surprised not by the fact that the child had finally spoken but by what he had to say.
"I wonder where he heard that," Shawn said.
Sarah was instantly concerned. His was not the vocabulary or sentence formation skills typical of so young a child.
"Why don't we go back to the examination room now?" she asked the boy. "You can watch television after I've had the chance to look you over."
"In the past fifteen years," the boy continued, "more than two hundred children have died as a result of falling television sets. It is estimated that three children are injured by a television every hour, and one child is killed every two weeks. Furthermore, eighteen thousand adults are injured by them every year."
"That kid must be some kind of a genius!" Shawn exclaimed as Rock wheeled the gurney out of the waiting room. "A regular Albert Einstein or Good Will Hunting."
Sarah frowned. If she were asked to compare the patient to a movie character it would be to Dustin Hoffman in Rain Man.
* * *
After the doctor examined the child and found him to be in perfect health, she was faced with the dilemma of what to do with him. Without knowing his or the deceased patient's identity, she could not contact the boy's family. Shawn McMurtry had exhausted all the usual avenues open to law enforcement and came up with nothing.
"I suppose we will have to contact the department of youth services in Boston," the police officer concluded.
"It's 3:00 a.m.," Sarah argued. "They boy ought to get some rest. I'll find a bed for him here at the hospital for tonight, and you can call DYS in the morning."
"Good idea. Maybe by that time someone will notice the child is missing. If not, I'll talk to Stan about contacting heart doctors both in this area and around Falmouth. The old man had a heart attack; he might have been seeing a doctor to treat a heart condition."
The little boy, who seemed to have a keen sense of hearing, said, "Over seven hundred thousand people die in America every year due to heart attacks. It is the number one killer of women and is more deadly than all forms of cancer combined."
"How does he know this stuff?" Shawn exclaimed with wonder.
Sarah lowered her voice to a whisper and said, "I believe he's autistic."
"Do you have any experience with people suffering from that condition?"
"No," the doctor admitted. "I was considering having Lionel come over and examine him in the morning."
"It looks like we're going to have a lot to do tomorrow. Want a coffee?"
"Sure. There's a vending machine in the doctor's lounge."
The boy, who had yet to fall asleep, sat up on the gurney.
"At least forty people have been crushed to death by vending machines that tip over."
Morbid little kid, Shawn thought as he took out his cell phone to call the station.
"According to recent studies, eighty-three people have died when their cell phones exploded without warning."
As one of the hospital orderlies took the child to an empty room, Sarah and Shawn headed for the doctor's lounge.
Half an hour later, after Shawn left to patrol the quiet streets of Puritan Falls, Sarah went to check on her young patient. Surprisingly, he was still awake and fully alert.
"Can't you sleep?" she asked.
There was no response.
"Are you comfortable? If not, I can adjust the bed."
"The odds are three million to one that a person will die falling out of bed."
"Why are you so interested in death?"
The boy seemed not to hear her question but looked straight ahead, his eyes vacant.
Sarah was a good doctor, but she was trained in tending to the illnesses of the body, not the mind. As such, she knew she was hopelessly unequipped to deal with the special needs child.
* * *
As Dr. Ryerson led Lionel Penn to the boy's room, the psychiatrist told her, "I don't know how much I'll be able to help. We don't yet have any medical tests that can diagnose autism."
"Stop apologizing for the fact that you can't work miracles," Sarah teased her good friend. "I already know you can't walk on water, raise the dead or part the sea."
The sound of Lionel's laughter preceded the two doctors into the patient's room.
"There have been at least two hundred documented cases of people laughing to death," the child said, his only form of greeting.
"Well, that's a good sign," Lionel told Sarah. "One of the indications of autism is that children are unable to form meaningful two-word phrases."
"He's well beyond that," the medical doctor confirmed.
"Hello there, young man. My name is Lionel Penn. What's your name?"
Since the psychiatrist had no more luck than anyone else did at communicating with the child, he was forced to direct his questions to Sarah.
"Has he smiled or shown any facial expressions since he was brought in here?"
"No, but then he's been through a lot," the emergency room physician reasoned. "I wouldn't expect him to."
"What about hand gestures? Has he pointed at anything, waved to anyone, reached out for something with his hands?"
"Not that I'm aware of."
Lionel reached into his pocket and took out a pen to jot down a few notes on the patient's record.
"On average, a hundred people choke to death on ballpoint pens each year," the boy said, although he had not seemed to be following the psychiatrist's movements.
Dr. Penn stared at the boy and pursed his lips.
"I wonder if ...," he mumbled, his voice trailing off.
"What is it?"
"Has everything he's said been related to death?"
"Yes, it has," Sarah replied after recounting the boy's various comments.
Lionel turned his attention back to the child.
"I'm going to fly to New York this weekend," he said, although there was no truth in the statement.
"Plane crashes claim an estimated thirteen hundred lives each year, and twelve percent of the passengers who survive the impact will later die of shock."
"I want to take in the Red Sox-Yankees game there."
"There have been an estimated eight hundred and fifty deaths of people playing or watching baseball, either professional or amateur."
"My favorite color is blue."
The boy said nothing.
"I love to swim."
"Every day roughly ten people die from unintentional drowning."
"I'm thirsty. I wish I had a can of Red Bull."
"Energy drinks contain as much as two hundred milligrams of caffeine, which is enough to trigger a heart attack in a person with a pre-existing heart condition."
A faint smile crossed Lionel's ruggedly handsome face.
"I don't believe this boy is autistic," he told Sarah after leading her out into the corridor where they could speak in private.
"Something is wrong with him," she insisted.
"Like you said, he's been through a lot. I think he's terrified, and this is the way his fear manifests itself. Some people who suffer from phobias have panic attacks; others shut down and tune everyone out."
"He's got a phobia? What is it? The fear of dying?"
"Not exactly. Fear of death is something we all have to some extent."
"Then what is he afraid of? Water? Airplanes? Energy drinks?"
"Everything. It's not common, but he might be suffering from panophobia, or sometimes referred to as omniphobia, which—to put it in simple terms—is the fear of everything. If I were to tell him about my boat, he would no doubt conjure up images of sinking ships or people drowning. Likewise if you were to talk about the last meal you had, he would automatically associate your comments with food-related deaths."
"Is his phobia treatable?"
"Well, he's young, and children are often resilient. If the cause of his fear can be determined through therapy, there's a good chance he can live a normal, productive life."
"The first step is to find out who the child is and where he came from," Sarah said. "There's not much we can do for him if he's placed in the foster care system."
* * *
When Shawn McMurtry returned to the hospital shortly before noon, Detective Stan Yablonski accompanied him. Both men looked to Sarah—in layman's terms—"a little green around the gills."
"Are you here as patients?" she asked.
"No," Shawn replied. "It's about the boy."
"Have you learned anything?"
Stan reached into his breast pocket and took out a fax he had received from the National Center for Missing and Exploited Children.
"Is this him?" he asked.
Sarah looked down at the photo of a five-year-old boy and instantly recognized her young patient.
"Yes. Who is he?"
The pallor of the two policemen became more noticeable, and Sarah feared one or both of them might pass out.
"His name is Jory Lindall," Shawn answered. "He went missing from a school playground in New Bedford back in 1954."
"Fifty-four? There must be some mistake. That was more than sixty years ago!"
"Of course there's a mistake," Yablonski said. "I'm here to try and straighten it out."
"But the resemblance is uncanny," Shawn pointed out. "It's possible he might be the missing child's grandson."
"You think the old man who was driving the car might be Jory Lindall?"
"It's a long shot," the detective replied, "but it won't hurt to make a few inquiries. Mind if I see the boy?"
Sarah took the two men to the child's room. Stan was astonished by the similarity between the patient and the photograph.
"Hello, son," he said, holding the picture in front of the boy. "Do you know who this is?"
The child's eyes did not move but stared straight ahead as though he had not heard a word the detective said.
"I'm going to contact the Center and see if they can send me some more detailed information on Jory Lindall," he said to Sarah and Shawn. "Maybe they can put me in touch with his mother, if she's still alive."
The detective's statement caused an immediate and surprising change in the child's behavior.
"No, Mommy! No!" he shrieked. "Please, don't!"
The patient became so agitated he had to be restrained. Sarah asked the nurse to bring her a sedative, but the little boy, after one final, piercing scream, passed out on the bed.
* * *
"Has there been any further change in the child's condition?" Lionel asked when he met Sarah for dinner that evening in the hospital's cafeteria.
"No. A neurologist from Mass General examined him earlier. He said the boy is in a catatonic state. He's going to want to consult with you on his psychiatric condition."
"I don't know how much help I'll be. I only saw the boy for a few minutes. But I do think he's afraid of something."
"I agree with you. You should have seen him this afternoon. The way he screamed for his mother—he seemed absolutely terrified."
"Could it be he wasn't screaming for her as much as he was screaming for her to stop something?"
"You think she might have abused him?" Sarah asked.
"I don't know. But maybe she's the reason he seems so afraid."
"If only we knew who he was, we might actually find some answers instead of just more questions."
"Shawn and Stan have any luck?"
"They're still waiting to hear back from the Center for Missing and Exploited Children."
"You don't suppose that the patient is really Jory Lindall?" the psychiatrist asked.
"Not unless he's somehow managed to discover the fountain of youth," Sarah teased. "Or maybe he was abducted by aliens, taken to outer space or another planet and returned to Earth still a five-year-old boy."
"I think you missed your true calling, Dr. Ryerson," Lionel parried. "Rather than being a doctor, you should be writing for The National Tattler."
Laughter, often thought to be the best medicine, helped ease the tension the two doctors felt.
"The food here leaves a lot to be desired," Lionel said, as he finished the last of his bland meatloaf. "If you're not busy tomorrow night, why don't we have dinner at the Sons of Liberty?"
Before Sarah could reply, her pager sounded.
"Duty calls," she said.
After leaving the cafeteria, Sarah and Lionel encountered Stan Yablonski and Shawn McMurtry in front of the ground floor elevators.
"Sorry if I interrupted your dinner, but I thought you'd like to see this right away," Stan apologized as he handed a manila file folder to the emergency room physician.
"Is this possible?" she asked after reading the first few pages in the folder.
"What is it?" Lionel asked.
"These are reported sightings of children fitting Jory Lindall's description," Sarah replied.
"There have been more than two dozen instances during the period from 1954 until as recently as 2013 where reputable people confirm having located the missing child," Stan explained.
"Look at the last page," Shawn instructed the physician. "It gives a very detailed description of the missing boy."
Sarah read many of the key points aloud.
"Blood type A positive. A dime-sized birthmark on his left shoulder. A three-inch scar on his right thigh. A mole approximately one-half inch ...."
The doctor momentarily stopped speaking. She closed her eyes and returned the file to Yablonski.
"It's him. Right down to the mole."
"That's what all those other people claimed," Stan said.
"Maybe we're missing something here," Shawn declared. "I once saw on an episode of Law & Order a girl who was in her twenties but had a disease that made her look much younger."
"You're talking about Turner Syndrome, which is a chromosomal disorder that only affects females, not males."
"What about Gary Coleman? He looked extremely young for his age?"
"That's because he suffered from an autoimmune kidney disease that, in combination with the corticosteroids and medications he took, stunted his growth and gave his face a childlike appearance. To my knowledge, Shawn, there is no medical condition that would give a man over sixty years of age the appearance of a five-year-old. There are no real-life Benjamin Button situations."
"What do we do if the boy is Jory Lindall?" Lionel asked. "Every biologist in the world is going to want to examine him. He'll never have a moment's peace."
"Before we worry about what's to become of him," Stan said, "we'll have to prove beyond a doubt that he is Jory Lindall."
"Does he have any living relatives?" Sarah asked. "If so, we can do a DNA test."
"Both the parents are dead," Shawn replied, "but he's got an older sister living in a nursing home in Florida."
"If you can get me the name of the place, I'll contact the head doctor and ask him to send me a buccal swab," Sarah offered.
"Sure thing," McMurtry said and then he and Yablonski headed back to the police station.
"I'll give you a call about dinner tomorrow," Lionel told Sarah and then he, too, left the hospital.
Moments after parting from her friends, Dr. Ryerson was called to the emergency room to set a broken leg.
* * *
For the next few days, Jory was kept in intensive care. Under other circumstances, Sarah would have referred him to the Boston Children's Hospital, but she wanted to wait for the results from the DNA test. As of yet, she, Lionel Penn, Shawn McMurtry and Stan Yablonski were the only people who knew about the child's unusual circumstances. The four of them would decide what steps to take after they confirmed or disproved he was the missing Jory Lindall. When the two policemen showed up at the hospital late one afternoon, Sarah suspected from the look on their faces that the DNA proved a positive match.
"I've yet to learn anything about the old man he was with when he came to the hospital," Stan informed the doctor. "I've run his fingerprints through AFIS and checked his DNA against the national database and came up with nothing. We know he wasn't Jory's father or either of his grandparents. They're all dead. Of course, there's always the possibility he was the man who kidnapped him."
"We can't keep Jory's identity a secret much longer," Sarah said. "We're going to have to tell someone."
"His sister suffers from dementia," Shaw explained. "I doubt she remembers she even had a brother."
"I think we should let the Center for Missing and Exploited Children decide what to do with him," Yablonski suggested.
"I doubt they've had experience with this type of thing," Sarah argued.
"And we have?"
As the doctor and the two policemen weighed the pros and cons of their available options, an anxious voice came over the hospital intercom: "Dr. Ryerson to intensive care, STAT!"
"That's about Jory. He must have taken a turn for the worse," Sarah said and then began running toward the elevator.
Two highly agitated nurses were in the hall outside the boy's room.
"Sarah!" one cried. "I mean Dr. Ryerson."
"What is it?"
"It's the boy. He's gone!"
Sarah naturally assumed the patient had expired, but when she turned the corner and entered the private room, she saw that the bed was empty.
"Where's the body?"
"We don't know," the calmer of the two nurses explained. "The child has disappeared!"
Security was called and an Amber Alert issued. The hospital doors were sealed and every room was searched. There was no sign of the missing boy.
"He couldn't have gotten very far," Sarah suggested. "He was catatonic."
"Someone could have abducted him," Shawn replied.
When no sign of the child was found, the head of security played back the video taken by the camera in the intensive care unit. Other than Dr. Ryerson and the nurses assigned to take care of the child, no one had gone in or out of Jory Lindall's room all day.
"He couldn't have gone out the window," McMurtry observed, stating the obvious.
"I'm beginning to doubt Jory Lindall was ever here," Stan said.
"What are you saying?" Shawn asked.
"Maybe he still looked five years old because he died back in 1954."
"No," Sarah insisted. "I examined the boy. He was no ghost."
"I don't mean to debate the matter with you," Stan argued, "but he wasn't human either. People grow old and eventually die. They don't stay five years old."
McMurtry had the final word: "Well, whatever he is or was, he's obviously missing—again!"
* * *
A month after the young patient disappeared from Puritan Falls Hospital, Keira McEnroe and her boyfriend were spending the day at Cedar Point amusement park in Sandusky, Ohio. The two teenagers had just gotten off the Millennium Force roller coaster and were heading toward the next ride.
"My hair must be a mess!" the girl exclaimed as she rifled through her handbag, looking for a comb.
"Why make a fuss over it? It'll only get messed up again when we go on the next ride."
As she combed her hair, Keira noticed a little boy, around kindergarten age, standing by himself as crowds of people pushed by him.
"Are you lost?" she asked, kneeling down so that she could talk to him at his level.
There was no reply. The child simply stared ahead as though he was unaware Keira was there.
"Are you parents here with you?"
"Don't waste your time; he's not answering."
"Look at him! He looks frightened. I'm not going to walk away and leave him here alone."
"Then tell one of the park employees to call security. Let them handle it. That's what they're paid to do."
Ignoring her boyfriend's advice, Keira continued to question the child.
"Are your parents on one of the rides?"
"It is estimated that there are four point five amusement ride-related deaths per year," the child said.
Unsettled by the child's comment, Keira stood up and turned to her boyfriend.
"Maybe you're right. Let's find a security guard. I think the boy might be autistic or something."
None of the people on the Cedar Point security force or in the Sandusky Police Department would ever determine what that "something" was. For even Lionel Penn with his vast knowledge of phobias could not comprehend that abject fear—such as that felt by a five-year-old child being brutally murdered by his own mother—can sometimes be so tremendous that it becomes all-encompassing and will continue to live on even after he is gone.
I agree with the great Franklin Delano Roosevelt: We have nothing to fear but fear itself ... and black cats!
