Confabulation

Gerald Fosse, sixty-three, retired elevator mechanic, Cleveland, Ohio, sits in the beige chair with his hands on his knees and describes the color of a foreman's necktie.

"Green," he says. "A green like, I don't know. Like the felt on a pool table. But cheap. The knot was loose."

Marta writes this down. The pen she uses is a Pilot G-2 07, blue ink, because the trial protocol requires handwritten notes in addition to the digital record, and Marta has filled eleven of these notebooks since January. The room sits on the fourth floor of the Bellmauer Clinic, Basel. Two chairs, one desk, one window facing the parking structure. The light changes quality at 3 p.m. when the sun clears the parking structure's roofline and comes in flat and warm, and Gerald always squints but never asks her to close the blinds. He tips his chin up and takes it on his face, the whole flat beam of it, the way he must have taken the spray from a cooling fan in an elevator shaft on a July service call.

It is 3:17 p.m. on a Wednesday. Session forty-one. Gerald is describing a fire he did not witness in a city he has never visited in a year he was not alive.

"The machines," he says. "The sewing machines. They were still going. Even after, even when the whole floor was. You could hear them. That sound, the needles, that kind of, what do you call it."

Whirr. The word Gerald cannot find.

"Like a hum," he says. "Like a dentist's drill but smaller. And all of them going at once, hundreds of them, and nobody sitting at them anymore."

Marta writes: 

Patient describes auditory detail consistent with industrial sewing machinery, ca. 1910. Specifies ongoing operation during crisis event. Detail noted for cross-referencing.

What she does not write: the sewing machines on the ninth floor of the Asch Building, the ones powered by a single motor on the eighth floor, ran on a belt-drive system. When the fire started, the motor kept running. The machines kept stitching fabric that was already burning. This is in the Cornell archive. Marta read the archive for her undergraduate thesis on occupational trauma psychology, University of Zurich, 2004.

Gerald says: "The doors. They opened the wrong way. Or they didn't open. One of them didn't open."

"Can you describe the doors?"

"They pushed in. You had to pull them. And one was locked. The one on the. On the. Left side, if you were looking from inside. The Washington Place side."

Gerald has never been to Washington Place. Gerald has never been to New York. Gerald serviced elevators in downtown Cleveland for thirty-one years, Otis and Schindler mostly, and he has a crushed left thumbnail from a counterweight guide rail in 2003 and knows every building on his route by its shaft: the smell of the grease on the cables, the pitch of the motor, the way the car settles at each floor, whether it sits level or a half-inch high or a half-inch low. Ask him about the Hanna Building on Playhouse Square and his hands start moving. He'll tell you the number 3 car has a governor that sticks in cold weather and the pit at the bottom of the shaft floods every spring and the sump pump was replaced in '07 with a cheaper model that cycles too loud and the tenants on the second floor can hear it through the wall. Ask him about a cable and he'll cock his head, listening for the singing note a fraying strand makes, the note you feel in your wrist before you hear it.

He should not remember a locked door in a building that burned in Lower Manhattan on a Saturday afternoon in March of 1911.

The drug is called Anamnex. A marketing team in Munich billed nine hundred thousand euros to name it. From the Greek anamnesis, the recollection of things past. It tested well in focus groups among women aged forty-five to sixty-five researching care options for parents with dementia. Like something you could buy at a pharmacy between the cough drops and the denture cream.

What the drug does: every time you recall a memory, your brain tears it apart and rebuilds it from scratch. Each rebuild is a little worse. Over decades, your mother's face becomes a category. Mother. The mole under her left eye goes. The way she held a cigarette goes. What you keep is the label.

Anamnex locks the pathway. The rebuild is an exact copy. Every time.

In Phase I trials, Anamnex restored memory function in eleven of fourteen early-onset Alzheimer's patients. A woman named Celeste Beaumont, Patient 3, recovered her wedding dress: the duchess satin, the Alençon lace with a small pull near the left shoulder that the seamstress promised to fix and didn't, September 1966. She recovered this on a Friday afternoon and held a glass of water and did not drink from it and her fingers went white on the glass and she said the words "Rue de Rivoli" and her mouth shaped them the way mouths shape the names of the dead. She also recovered every lie her husband told between 1968 and 2003. She filed for divorce after fifty-one years of marriage. She said: "I am not angry. I just can't forget anymore."

The trial team celebrated. Champagne in plastic cups in the break room on the fourth floor. The ceiling panels threw that white, institution-grade light that turns everyone's skin the color of grocery-store chicken, and someone had brought a sheet cake with buttercream roses, the roses already softening in the heat of the baseboard heater, their petals sagging into the frosting like wet laundry. Marta held her plastic cup and watched the bubbles rise and pop and rise and pop.

Gerald is Patient 7. He received the highest dosage: 400 micrograms, twice daily, for ninety days. The first six weeks were unremarkable. Gerald recovered memories consistent with his personal history. His mother's kitchen in Parma, Ohio. The smell of her cigarettes, Virginia Slims, menthol, and the sound of the radio she kept on the windowsill tuned to WMJI, oldies, and the window that stuck in summer so she'd prop it open with a phone book, the Yellow Pages, Cuyahoga County, 1978 edition, and the phone book got swollen with humidity so you couldn't close it if you wanted to and it smelled like wet paper and his mother's cigarettes and the oldies station played "Ain't No Mountain High Enough" every day at noon, every single day, and Gerald was eleven years old and thought noon existed so that song could play.

Every detail came back with its grain intact, its edges preserved, the whole scene arriving at once the way vomiting brings up a meal you forgot you ate. Then, in week seven, what came up was someone else's meal.

"I can smell it," Gerald says. This is how it starts now. Every session. The same three words. His nostrils widen, the alar cartilage flaring, the thin muscles in his nose dilating for air that carries no information. The room smells like recycled air and Gerald's deodorant, Speed Stick, Ocean Surf, and the vinyl upholstery of the beige chairs. His hands tighten on his knees. His pupils dilate.

"I can smell the cloth. The burning cloth. It smelled, it's not like a campfire. It's not like wood. It's. Cotton and linen and there's something else, a chemical, they treated the fabric with something, the shirtwaists, to make them hold their shape, and when that chemical burns it smells."

He stops. He looks at her.

"Sweet," he says. "It smelled sweet the way antifreeze smells sweet. Your mouth waters and your stomach heaves and they're both right."

Marta writes it down. Her handwriting, normally a tight, German-school cursive, has loosened over the weeks. The letters lean. The loops open.

The clinical team meets on Fridays at 9 a.m. Dr. Wenger presides. Marta handles the patient interviews.

"The Triangle fire is one of the most-documented industrial disasters in American history," Dr. Wenger says. "It's in the cultural water supply. Every labor history course, every safety training video, every documentary on PBS. Mr. Fosse doesn't need to have read the Cornell archive. He just needs to have lived in the United States for sixty-three years."

Marta says: "He described the doors opening inward. He specified the Washington Place exit was locked."

"Wikipedia," Dr. Falk says.

"He described the color of a foreman's necktie."

Dr. Falk shrugs. The shrug involves his eyebrows, his shoulders, and one palm turning upward, a gesture so practiced it has its own musculature. "Brains are excellent art directors. Give them a fact and they'll dress the set."

Marta does not say: he described sewing machines still running after the operators fled. This detail appears in a single eyewitness account, an article by William Shepherd for United Press, phoned in live from Washington Place while he watched from the street. The detail about the machines is not in the Wikipedia article. It is not in any PBS documentary. It is in the Cornell labor history archive's primary source collection, in a 1977 compilation called Out of the Sweatshop, edited by Leon Stein, and Marta was one of the graduate students who read it. In 2004. The image of sewing machines stitching nothing does not leave once it moves in. It furnishes a room in your skull and stays.

She does not say this. She writes, in the case report: 

Confabulation consistent with cultural exposure to widely available historical material. No anomalous features noted.

She goes home. The apartment in Kleinbasel, across the Rhine, four rooms she has lived in for four years without hanging anything on the walls. The overhead light in the kitchen is a single bulb in a white ceramic fixture and the bulb is the wrong wattage, too dim, and every surface in the room goes soft and brown at the edges. Oak floors that creak in a specific pattern when she walks from the door to the kitchen. The kitchen window looks out onto a courtyard where someone keeps a bicycle chained to a drainpipe and the bicycle has not moved in the four years Marta has lived here. The chain has rusted into the drainpipe. The tires have cracked open and the inner tubes show through, gray rubber turning white in the weather. Pasta. Tomato sauce from a jar, Barilla, arrabbiata. She eats standing up. The sauce gets on her fingers and she licks it off and the sauce is too hot and the roof of her mouth goes slick and raw. A glass of Dôle, a Valais red that her father shipped her a case of in November. Six bottles left.

Her mother is in a care facility in Lucerne called the Residenz am See. Same building where her grandmother died. Different floor. The disease runs in families. The gene variant is called APOE4, and Marta carries one copy, tested during her residency, in a genetics lab on the third floor of the University Hospital of Basel, on a Thursday, alone, and the results arrived in an envelope and the envelope sat on this same kitchen counter for two weeks before she opened it, and the paper inside was a single sheet and the relevant line was highlighted in yellow and the highlighted line said APOE ε4/ε3 heterozygous, which means elevated risk, which means maybe, which means her mother's floor and her grandmother's floor and her own future floor may all be in the same building.

The laptop opens. The Cornell archive fills the screen. The same eyewitness account she read in 2004. The sewing machines. The bodies. The doors. Gerald's voice runs through the sentences, his flat Midwestern delivery, the way he pauses before sensory details the way a television buffers, the tendons in his wrists surfacing under the skin when the memory arrives.

The laptop closes. The dish, the fork, the saucepan. The sponge is the yellow kind, Scotch-Brite, and the abrasive side has worn down to a thin green fuzz and the dried sauce comes off in flakes and the water in the sink turns orange. Bed. No sleep. The dark and the courtyard and the sounds of Kleinbasel at night: traffic on Feldbergstrasse, the tram on Klybeckstrasse, the drunk who sings opera on his way home from the bar on Thursdays, and tonight is Thursday, and tonight the drunk is singing something from La Bohème, the part about the cold hands, and Marta lies in the dark with her own cold hands pressed between her thighs for warmth and listens and does not sleep.