Chapter Text
At first, he couldn’t comprehend what the problem was. It came about in waves, pushing and pulling a curtain of lucidity that occluded his own thinking with absurd ideas of ‘there’s nothing wrong, oh now I’m dying-, what was I worried about?’
It shifted again. Alex knew he didn’t recognize where he was, but he felt no concern or fear in wake of the surreal shift of calm relief. There was something burning, pulsing hot with occasional spikes of migraine-induced pain. He felt terrified, distinctly aware that something was wrong- and then he had no concern in the world beyond that of vague awareness.
Alex heard him speak and thought, ‘oh, he sounds like Tom’s dog,’ but hadn’t quite the clarity to remember what a dog sounded like. He hadn’t the memory or attention to think and recall who he was and where he was. Then the tide turned and riptide tore back the veil of calm innocence and left him contorted and heaving with his body unwilling to move despite his cries.
It was garbled, nothing like speech and Alex tried to tell him as such. It verbalized in broken scrambled grunts and groans, abstract relief damaging his recognition that something felt horribly wrong.
Alex felt his thinking return, the surreal babbling and illogical delusions fading. He thought, near horrified, ‘I can’t speak?’
Nothing intelligibly at least, although his loud warbling felt gangly and strange and his ears felt warped and shifting. The sounds coming out of his mouth didn’t correlate to the words in his head, single distinct words he knew he had said before, who are you?
Alex knew he (and under the taciturn stabbing somewhere behind Alex’s left eye, he realized hazily that he should be recognizing his pilot’s face or at least something resembling a face) wasn’t understanding the words spoken to him. He understood the soft tone, the lower cadence implying some sort of soothing meaning.
Alex relaxed under the progressive changes, although his understanding of what was happening still felt disjointed. Alex remembered being moved, the soft noises of an engine somehow crossing wires and jumbling about like animal cooing before hashing into more clustered indistinct sounds. On occasion, his pilot would say something that Alex didn’t know and in retrospect, Alex wasn’t sure if he had spoken at all or if Alex misunderstood the gargle of an engine to be a whisper in itself.
Alex knew enough to be concerned that there was blood on his arm, but couldn’t understand why. Alex knew his right arm wasn’t operating smoothly, instead, it jerked oddly with stifling disjointed movements then ultimately failed to move at all. Alex knew, in his discombobulated state, that there was a nagging suspicion that it was wrong. He stumbled on it, catching brief flickers of thoughts before it vanished under blank numbing silence before worried thinking shifted again. He struggled, for an unknown period of time between waves of delirium, that he should tell his pilot that there was something wrong with Alex’s arm.
Alex gurgled, reaching with broken janky movements towards the center console. It had knobs and slots and switches Alex all knew. He stared, saying something (he felt his mouth move and his throat rumble warmly which meant vibrations) with gurgling lazy movements that manifested into something Alex didn’t know.
In Alex’s eye, he knew numbers easily. In the seat of a helicopter, strapped down and secured in the co-pilot’s seat, he stared in astonishment at the panel of symbols.
He could perfectly recall numbers, remember how time worked and a handful of timezone calculations to know when Jack called back home. Although he retained a clear image in his mind, Alex couldn’t discriminate any of the information in front of him. Everything looked to Alex like pixels; colours and vibrating parts from where he sat too close to a box television and learned the world was made from primary colours and grey static.
The world shifted and Alex gurgled. There was no longer any foreground or background, instead, the picture of his vision merged into a single dimension of pixelated pieces all composing a bleeding picture, a photograph out of focus left underwater.
‘This is not good,’ Alex thought, recognizing that there was something definitely not right. He knew he was thinking but lost the internal narrator to the hazy undulating force of disoriented confusion. The world changed again distinctly, but he couldn’t grasp it. Time passed but he didn’t realize it, and after twenty minutes unknown to him he repeated more firmly, ‘this is not good.’
His grip on normal reality peeled back thinly, fragmenting into a pulpy wet tissue paper mess. The analog clock on the center console of the helicopter bore no resemblance to any symbols or numbers Alex knew- the border of plastic and metal confinement merged into shades of different colours compressed flatly into an indistinct abstract blur.
And it pressed further, the tides of lucidity melting into a single unburdened mess. Alex slouched back, body stilling with occasional uncontrollable twitches. He thought but lost focus or recognition of what attempt he was trying the moment it began to operate. He had relied on hasty mental cues, ‘this isn’t good,’ ‘my arm isn’t working,’ but now they faltered so severe he found himself adrift. The pain wasn’t computing, glitching outside a mainframe and Alex forgot what a helicopter was or what the act of sitting felt like.
Something in his brain scrambled to operate, pushing stubbornly intermittent undisguised bits of knowledge that grounded him into reality. He drifted, unaware of what a body was, let alone what he was. There was no arm when the meaning became meaningless. There was no helicopter when his brain stopped whispering the word-.
And then something electrocuted him and forced him to gasp sharply as a knife stabbed hard into the left side of his skull. Then, he could see and notice the defined borders of the analogue clock and feel the seat and wetness of blood on his face and remember ‘I am not okay,’
It took until the sky changed colour for Alex to process through the measly task of informing his pilot that his arm was wrong. It took painstaking heartbeats and dissociative whispers to remember what an arm was, and then longer to move it. There was more blood then, Alex knew, but he never thought or considered his pilot may already know he was injured.
Then they weren’t moving, and Alex found himself baffled by the odd contraption that was a seatbelt. He looked at it and thought ‘what a bizarre thing’ before he forgot what he was and where he was. He didn’t know what he was supposed to do with it, or what it was.
Alex knew, that he had to do something, and it would result in him being able to move. He couldn’t figure what moving was, or what he was doing currently.
His pilot appeared and moved Alex but the memory of him doing such was not one Alex could conjure. He was sitting and then dissolved into the vastness of existence, and then cradled in arms that sent bright sparks of sensation. Alex squirmed, babbling noises he couldn’t understand but thought, apathetic and bewildered, ‘I sound like an infant.’
He heard himself speaking clearly in his head; no sound left his throat in an audible structure. Alex breathed air, tongue moving limply as he spoke out loud a collection of sounds on the developmental level of a baby. Alex had no idea he couldn’t speak properly until that moment, and he sat their flummoxed and baffled.
Alex was determined and stubborn on all levels, perhaps so ingrained in him even his cells operated with the devoted dedication of being petty. He inhaled forcefully, then punched it out with the repeated effort and confusing conclusion, ‘eventually it’ll make sense.’
He repeated it, feeling his throat vibrate and the warm rush of breath. The arms tightened and Alex thought, suddenly drowning with a euphoric sense of bliss and contentment, ‘see? I did it. I’m alright now.”
(And in reality, he spoke a collection of primal grunting noises like that of chimpanzees and apes; variations to the undulating groan “g-uhhh, uhhaaa, g-uhggg-hu!” )
Patiently, his pilot-turned-carrier responded with equal mystical noises and sounds that fascinated Alex deliriously. Had he ever heard such sound before? Surely they could not relate to meaning, it had to be a different sort of gibberish or noise in itself.
His carrier repeated it again, vibrating through Alex with how close he carried him, and after the fourth repetition, Alex considered maybe they wanted something in turn. Alex couldn’t remember or think about the structures of a sentence, or what made a question sound like one. Alex, confidence and knowing his throat worked with large inhalations, warbled back. His captor squeezed tighter and Alex felt equal parts befuddled and frustrated- Alex had responded, why was he not happy?
With every moment further, Alex drifted further. He lost the feeling in his limbs or perhaps lost the ability to comprehend what feeling and sensation were, and drifted further. He embraced it, mystified and forgetting from one second to the next, the silent whispers of immediate observation. Alex’s mind shifted, untethered by the perception of who he was as a person and embraced the collection of sensation without knowledge of himself to filter it. Alex was the moment-to-moment whispers of immediate existence, and he gazed upwards at the stream of colour and light and thought himself holy.
It felt peaceful, unburdened by things he no longer knew or could fathom. The world was bright but he was not one of the world. He couldn’t imagine objects or the tangible realm of life. He became unbothered and overwhelmed with the peaceful serenity of everything.
Alex was delirious when they arrived but didn’t understand. Somewhere, through the infrequent touches of sanity, he felt self-satisfied that he was in a hospital and that his self-diagnosis was right. There was something wrong with him, and he felt touched by the divine.
His pilot and carrier and his figure he recognized through abstract impressions that bore resemblance Alex didn’t know, wrapped Alex in a blanket and covered Alex’s eyes. Alex found it comforting; the gentle careful touch something that pierced the veil.
Alex curled into a ball, pressed firm to his figure’s side although some moments Alex forgot the figure was there at all. In the darkness, Alex did not miss the light or throb that accompanied colours. He breathed a warm muffled sensation his brain struggled to recognize and ultimately never did. Alex wondered, unconcerned and filled with childish awe, if this was where he died. He wanted to know the final step, to feel his body truly separate and connect with the billions of spiritual parts; absent of sight, sound, touch, smell, taste, pain, or fear- Alex desired the freedom of the body and the release from life entirely.
When Alex arrived in the intensive care ward in Chioggia, Italy, it was in the center of an energy spiral on par to the death spiral of a ravenous crocodile. Chioggia, only a handful of miles south of Venice, connected to the mainland of Italy and held a harbour of ships with a questionable origin. Malagosto normally housed much more extensive medical facilities, but instances of specialized damage were relocated to different establishments.
Alex thought, that he felt horribly exhausted of all energy and devastatingly weak. He felt it drain from an unknown fjord, leaking free and leaking him thoroughly deflated of any stubborn determination. Medical personnel swarmed about him, relocating him to two different gurneys and three stabilization devices as fluorescent lights and sharp sounds drove him to near insanity.
They moved quickly, poking and prodding him with increasing demands. Each cumulative obligation added to the stockpile of disoriented frustration and mild fear. Alex couldn’t understand or muster the energy to lash about in panicked movements, he felt every bit a chained tiger in a cage, impaled with barbs and tazed with cattle prods.
Eventually, he slumped limp and unconscious on his settled gurney. Two medical personnel examined his eyes and marked subjective measurements for pupil dilation, acknowledging that both were uneven and his need for an MRI was dire. His clothes were removed, dried blood swiftly cleaned and one nurse dragged a hospital gown over him, mindful of the extensive bruising and fresh injuries.
When Alex woke hours later, in the morning of a different time zone, he felt surprised he was still alive. Curled alone in a quiet cubicle in an unknown hospital, his aching head propped on a thin pillow with his right cheek and eye squeezed closed against overwashed cotton. Devoid of energy, he collapsed in a humanoid outline against the mattress with little ability to shift further. He thought, that he felt a bit like a wooden carving, but one melted and charred and despite his dismal ability to think, he couldn’t determine how his body was positioned; he couldn’t feel where his body began or where it ended.
His head pulsed with tormenting pain that pushed and tugged a whirlpool and monsoon of theatrical proportions. Every minuscule shift in position triggered further flares, a bubbling twist that drained what little energy Alex could gather. Unable to speak, his eyes sustained a crescent unveiling of his eyelids that did little more than give him a monotone vision.
He could hear anything beyond the excruciating rhythm of his heart which contracted so overwhelming in force it shook his bones and jerked his muscles with its volume. He wanted to wail, to groan a quiet murmur and shriek of a newborn animal unable to communicate beyond that of blatant misery.
Absent of higher thinking, Alex couldn’t fathom many things. He didn’t know where he was and lacked the ability to pull open the archives of his memory to remember how he got there. He could sense somewhere near his feet the presence of two people, but couldn’t examine further or contemplate the meaning behind it.
Alex didn’t know medical anatomy even with a functioning brain, but he once watched the telly with Tom and remembered the signs and piercing shrieks of a broken heart monitor. Granted, currently, he couldn’t think or actively dwell with purpose on anything beyond outright observation and subconscious recollection. It didn’t take an 89% on his biology A-levels to look at the blue-tinged image of his brain, and know ‘oh, that white spot isn’t good.’
He felt heavy and wrong, signals and neurons defective under the smouldering circuitry of compressed networks and internal bleeding. Alex lay there, a defective pile of deteriorating meat that somehow retained a consciousness. He felt inanimate, untethered and removed from reality with no ability to comprehend the external world. He was still there, Alex knew it was still him- but without the clear precise edges or outlines that thinking gave him. He felt, emotional and unbothered and somehow pure and suffocating.
Alex existed in a remote space so far and distant from what normal informational processing once provided. Alex understood that something devastating had happened, but didn’t have the ability to ponder the complications or ramifications and instead lay there with an emotional surge of curiosity and apathetic bemusement.
It felt strange, with no more language in his skull to define the terms or sketch the gridwork for Alex’s interests and hobbies. Alex felt like colours, but had no name or terms for daily schedule or habits; he had no words for who he was so ultimately was he anything to exist?
He lost the clock that constantly ticked, the looming dread of deadlines or foreign threats. He couldn’t remember the day before or his childhood experiences- and he drifted in the fluid feel of simply being. He lost his tethers, his body and form and drifted larger than life and he thought the world a beautiful thing.
Alex felt and intrinsically knew, that despite the horrific wake of an obvious disaster, he knew that he was okay. He no longer had a body he could touch or move, he was light and connected to the expansive vast world of life and knew he would be alright.
Outside, it was very different.
Alex lay there on a large bed like a newborn, unable to make sense of the various sensory stimulation in the physical environment around him. Every touch or question invoked a response interpreted as painful. Alex, with incorrect pupillary responses and near shut eyelids, reacted with infantile moans and fluttering muscle tremors to every question, touch, or caress on his skin.
His doctor, an Italian man with an unshaved patch below his left jawline, returned in rapid medical jargon his reported findings and a rough approximation of what precisely the state of his patient.
“He’s stabilized,” the man said, fluttering frantically between complex terminology and layman language. “No imminent medical crisis and his reactions are not correlating to potential deterioration into an unconscious state.”
Alex had no ventilator nor was he intubated. He breathed on his own with shaky jolting movements, ribcage fluttering and exhales occasionally manifesting as muffled groans. Intravenous lines administered medications and fluids to replenish the drastic lack of blood volume and other deficiencies. An arterial line snaked below the thin blanket of his bed, wriggling into Alex’s vessels to measure his blood pressure in instances of a sudden drop.
Horrifically, ignoring the shaved portion of Alex’s skull where heavy synthetic dressings closed the open wound of severe brain impalement, a thick rod pierced through Alex’s skull like a torture device. It led to a computer, frantically monitoring shifting pressure within Alex’s skull to recognize the presence of an aneurism. Cauterization of cranial vessels was never so certain after trauma.
Yassen Gregorovich had his eyes on the EEG machine, displaying jolting lines from various electrode sites splattered across Alex’s head in shaved patches. He hadn’t the knowledge for diagnosing damage but knew how to read an X-ray.
“This device,” Yassen said, nodding to the EEG. He elaborated no further, the doctor scrambling to explain its presence.
“It has many uses!” the man defended nervously, clearly aware of who he was speaking to. “We can determine nonconvulsive status epilepti- a seizure. And anesthetic if we need to repair more inside his brain. It helps us know if he hemorrhages again, or more cerebral ischemia.”
Yassen understood very little of that but knew enough to recognize the device meant nothing good. He asked flatly, “and if he has a seizure?”
“It’ll alarm,” the doctor said, then hastily added, “but it will ah, change colour! You see how it is blue and purple? If it changes to red, it means his brain is sending signals.”
A shifting change in colour was bad, presumably, it had something to do with wavelengths and energy then. Yassen changed his focus, looking at the thick rod piercing the top of Alex’s head in mockery of a unicorn.
“Ah, the intracranial pressure- it is the pressure within the skull,” the doctor struggled to explain. He beckoned with one hand towards the various lines feeding into Alex’s body, some replenishing blood and others filled with saline and medications Yassen didn’t know. The doctor explained, “we have sealed his skull and that is to monitor the volume inside his skull. If it increases, then there is more bleeding that can damage the brain.”
“Because you failed your duty to repair the damage,” Yassen summarized.
The doctor looked horrified, then scrambled to explain. “No! No sir- we repaired the vessel but there is more in the brain than only blood! We had to remove damaged tissue and had to isolate cerebrospinal fluid from where it had been punctured. Our surgeons are still confused by what managed to impale him-.”
“A television antenna,” Yassen informed him bluntly. Alex on his bed groaned quietly, body shuddering in reaction to a small waft of air circulation.
The doctor twitched and nodded quickly. “Ah, yes. We removed what we had to, but even then we cannot consider the new volume of fluid to replace the removed tissue mass! It’s to monitor all pressure changes or potential rupture of other portions due to fluid intake.”
Yassen thought that this entire ordeal was far too messy.
“What are the outcomes?” Yassen asked sharply, turning away from Alex to stare at the various image reports of the boy’s brain. The doctor, similarly, spun to address the images.
“Well, we have systemic antibiotics administered, it’s standard to do so with any cranial catheters. After five days, the risk of contracting meningitis or ventriculitis increases drastically.”
“Meningitis,” Yassen echoed flatly.
“Ah, yes, sir. But he doesn’t need to be intubated since the damage didn’t affect lower cortical functions. That removes the risk of pneumonia or lung damage, but if we must sedate him there are other complications…”
“You have permission for any treatments necessary,” Yassen said. “Any medications or procedures are permitted.”
The doctor gaped, closed his mouth, and swallowed heavily. He scribbled something on a nearby notepad, the word levetiracetam which meant nothing to Yassen.
“Yes sir,” the doctor croaked nervously. He cleared his throat, tapping the brain image once more around the section of overwhelming white. “As you can see, the...television antenna pierced his skull in two places. Since the protrusions broke and remained lodged, he experienced little blood loss but the internal hemorrhaging…”
“Explain it to me,” Yassen said.
“Well, the MRI, the magnetic resonance imaging and CT scan confirmed the precise areas of injury. The antenna damaged the left temporal lobe, beside his ear, sir. That section of the brain is often known as the communication and language center of the brain. Burst vessels in this area both cut off the blood supply to localized tissue, suffocating it, sir. The increased pressure since the object was not removed similarly...ah, compressed the brain’s ability to deliver blood to the tissue.”
“The pressure cut off blood circulation,” Yassen summarized, gazing at the white blob. “The affected area has died.”
“Yes but- sir, you must understand. The brain is an incredible organ, often able to recover miraculously. Neural pruning or adjacent tissues developing new networks to compensate for the loss of function-.”
“I don’t care about that,” Yassen said coldly. “He moved erratically.”
“His right side? An area of compression touched the left premotor cortex and the left secondary motor cortex, potentially the posterior parietal association pathway…:
The doctor trailed off in thought. Yassen shifted just enough to remind the man of his presence, spurring the doctor into action.
“My apologies, sir,” the man said. “I...I have notes from the Step-Down Unit to move him into the specialized neurotrauma ward. It’s expected he experiences distortions in motor movements on his right side, as well as visual distortions and other brain functions.”
“What brain functions?”
“I, sir you’ll have to forgive me I’m not specialized in brain trauma, I’m only ICU inpatient-,”
Yassen moved with the speed of a cobra. He snatched the doctor’s coat, clasping the collar of his undershirt in a tight grip that nearly bruised the underlying skin. Yassen repeated, unfaltering, “ what functions?”
The man struggled, blurting nervously; “the- the left temporal lobe-. I...visual perception! And auditory input- the left side is...auditory placement of words I think-.”
“Difficulty speaking?” Yassen tested flatly.
“I think that’s right temporal...Sir, sir don’t-.”
Yassen released him grudgingly. The door opened to a new doctor, one with a cleanly shaved beard and more alert eyes. The ICU doctor bolted out, leaving Yassen with the new man who coincidently held a steel travel mug wafting the smell of coffee.
“Well, he’s a bit scared,” the new man said interested. He took one look at the brain image on the wall and approached with both eyebrows lifted. Humming quietly, he took a sip from his travel mug then flipped through paperwork and lab readings Yassen didn’t know.
“I’m the new doctor for…” the man trailed off, glancing at the name with a precursory look, “for Mr. Hunter here. The interesting case you’d got. Blunt trauma but no unconscious state. Acquired injury but diagnostically not a traumatic brain injury- technically a hemorrhage. Damaged sections removed from an impaled foreign object, what a mess.”
Yassen took note of the new doctor, one that looked much more competent and much less afraid. Yassen asked him cooly, “your prognosis?”
“Nothing definitive until we have some testing done. We’ll get that finished once we have twenty-four hours to monitor him. He’s young and neuroplasticity is a miracle for boys his age.”
Yassen knew field medicine, and he knew the realm of Malogosto medicine. He remembered administering field amputation, torture and stabilization to extract information without threat of death. Yassen knew how the body worked and which organs were actually necessary. The brain, he knew never to damage or injure. A hostage with a concussion reduced or negated accurate information. A hostage struck unconscious meant failure.
“His survival?” Yassen asked after a slight pause. SCORPIA said to never strike the head, and skull wounds bleed excessively. Yassen did what he could to bandage the injury and stabilize the metal prongs still lodged in the boy’s fractured skull. The entire helicopter flight was a lesson in why skull damage was so deadly to a mission’s integrity. The boy fluctuated between delirious comments and uncoordinated jerking, combined with right-sided slumping and progressively more incoherent gurgling. The sight was not pretty, and it had alarmed Yassen deeply. Sayle was not pleased with the failure of his operation and Yassen knew the man to be compromised. A moment of timing, perhaps only minutes, and Yassen executed Sayle with a bullet through his body as Alex collapsed to the ground in a pile of blood.
Alex recognized Yassen distantly, but only for a few seconds before slowly he deteriorated. Yassen carried him to the helicopter, secured him, and called ahead for intensive care.
He never considered leaving Alex Rider alone on the rooftop.
The doctor examined the images from Alex Rider’s scans for a longer period of time, making notes in shorthand Yassen couldn’t determine the meaning for. After a brief moment where the doctor took notes of current readings on Alex’s machines, the doctor sighed and turned to face Yassen properly with a small regretful smile. He offered one hand and introduced himself. “I’m sorry for my delay. And you’re...one of those special cases?”
In special cases, they liked to subtly call SCORPIA agents coming in with medical anomalies. Sometimes even Malagosto couldn’t treat neurotoxins or sustain full-body sedation for nine days. Sometimes hostages were bartered for and required medical treatment outside of Malagosto’s ability before the exchange.
“Yes,” Yassen said with no further information. He addressed the doctor and said; “you will do everything within your abilities for this boy.”
“Yeah, I had a feeling you’d say that,” the doctor exhaled in a rush. He aged ten years, looking at the MRI and CT report. Much to Yassen’s increasing dread, the doctor muttered a quiet prayer. Yassen spared a look to the bed, where Alex curled limply on his side with doltish chewing, drool sliding sluggishly from the flaccid half of his face. His eyes, still open but asymmetric pupils stared forward dully with a blank stupor.
“I’ll do everything I can for Mr. Hunter,” the doctor promised with the beginnings of sympathy. “He was brought in quickly, and with brain trauma all seconds matter. You did a wonderful job providing all the care you can, and at this time I’m confident that there will be no limitations to basic brainstem issues, it seems localized to the only the temporal lobe.”
“The previous doctor was unable to comment further.”
“He’s used to traffic accidents and broken legs,” the neurologist dismissed with a grimace. “This is...well, pediatric open brain trauma leads to a great selection of problems. There’s more evidence for the development of adverse behavioural outcomes. I’d have to find the evidence, but it’s standardized brain changes for internalizing and externalizing problems with emotional shifts- aggression, impulsivity, the normal.”
Yassen couldn’t fathom Alex Rider being more impulsive. He felt the well of dread deepen to limits he never knew. He asked, voice steady, “what other forms of behavioural changes?”
“There’s...well, there’s the potential for new-onset psychiatric disorders. Personality changes, conduct or oppositional defiant disorders. Did he have any symptoms prior? Any history with disregard for authority figures?”
Yassen thought clear and loudly in his mind, ‘oh dear.’
“Behavioural impairments may resolve in the first year after injury, as well as other side effects,” the doctor hurried to assure him. “Almost half of the children develop attention regulation difficulties after traumatic brain injuries and other limitations to inhibitory control. This will all be checked with our neurocognitive testing after, but I would warn you to be patient with him. He’s gone through a traumatic event, he needs a careful hand.”
“A careful hand,” Yassen repeated. He knew how to be a careful hand. It took a careful hand to aim a gun and pull the trigger, to hold the leash on a dog or the reins of a horse. It took steady hands to pull teeth from a screaming man’s mouth or pluck nails from a shaking hand. Yassen said, “I can do that.”