Follow-up

I

When Amélia Ferraz’s history opened on Inês’s tablet, there were already three entries under recalibration.

Four years ago, uptake ninety-one per cent. Two years ago, eighty-four. Last autumn, seventy-six. Each line ended with a projected retention period, and each was shorter than the last.

Ageing neurons hold a mapping less well. Chapter one of the textbook.

The old woman sat in the white chair with her hands folded in her lap, her back not touching the backrest. She wore a dark grey coat of burel, the felted wool they make up in the Serra da Estrela, buttoned to the top.

“Here we are again,” she said, the way you’d speak of a relative who always turns up on time.

In the presenting-complaint field Inês typed: unclassifiable visual experience, fourth episode. She wrote that line a dozen times a day; her fingers did it on their own.

“Fourth time,” she said.

“Água mole em pedra dura…“ Dona Amélia began, and left the rest of the proverb where it was.

“The same colour?”

“The same.” She thought about it. “Not quite the same. It hasn’t got a name.”

“Can you describe it?”

“It isn’t seen.” Dona Amélia put out her forefinger and drew it slowly along her own forearm. “It happens. It moves, it’s warm. When I was small my mother used to plait my hair, her knuckles pressing on my scalp, one, then one. It’s like that. And when she sewed on a button — the thread pulls through and the cloth gives a little shiver. That shiver.”

Inês glanced at the buttons on her coat.

The Tecelã’s colour library held forty million coordinates, ultraviolet to infrared, down to the polarisation mantis shrimp use to signal one another. Inês ran the description against it. No match. Recommendation: affective-label recalibration.

Standard protocol, nine minutes. Inês pressed run. Dona Amélia closed her eyes like someone waiting for a gust of wind to pass.

When it finished, the system issued a report. Uptake sixty-eight per cent; projected retention four to five months. At the very bottom, in small grey type: memory reconsolidation events, 23. Inês had seen that line on every report she’d ever signed. It had never once been flagged red.

Dona Amélia opened her eyes and blinked twice.

“Much better,” she said.

Inês held the door for her. On the threshold she said, almost in passing, “You were saying, when your mother sewed on a button—“

The old woman turned and gave a small, polite smile.

“Did I say that?”

II

Four months later her daughter brought her.

Rita was in her forties. She stayed standing, and put an A&E discharge note on Inês’s desk. The escadinhas in Graça. Colles fracture, left wrist.

“She stopped halfway down,” Rita said. “Said the steps were happening. I was behind her. I nearly went down with her.”

Dona Amélia’s left wrist was in a plaster backslab. The coat was the same dark grey, but the top button was gone, leaving a small tuft of broken thread.

Projected uptake: fifty-nine per cent. Retention: two to three months. The recommendations field had one line more than before: if next retention falls below six weeks, refer to a Long-Term Maintenance unit (deep overwrite).

Inês knew what deep overwrite was. No more recalibrations one at a time: the error-prone perceptual channels were replaced wholesale with stable default mappings. Patients stopped seeing anything that oughtn’t to be there. Patients rarely described anything much at all.

“Will it be quicker this time?” Rita asked.

“Standard protocol is nine minutes.”

Inês was looking at the tuft of thread.

“I’d like to try something different this time,” she said. “Manual masking. I lock only the channels for space, depth and motion, so she won’t stop on the stairs again. The rest I leave alone for now.”

“What’s the rest?”

“The colour she talks about.”

Rita looked at her mother, then at Inês. “How long does that take?”

“About four hours.”

“Why not just fix all of it?”

“Full recalibration touches memory. Last time there were twenty-three reconsolidation events. This time there’d be more.”

That was true.

Rita waited four hours in the café across the road and drank three bicas.

Manual masking had to be drawn one channel at a time. Inês kept Dona Amélia talking throughout, on the grounds of monitoring her responses. The old woman said the colour came in the water the bacalhau soaked in — the third day’s water, after you’ve changed it twice. It came in the sheets on the line outside the window when the wind lifted them. It came when she touched the back of her own hand. Inês didn’t log any of it in the system. She opened a local file and typed it in sentence by sentence, and didn’t stop to fix the typos.

Near the end Inês asked, “Did your mother sew?”

Dona Amélia thought for a long time.

“I suppose so,” she said. “Women did, back then.”

On saving, the system asked for a reason for departing from standard protocol. Inês wrote: history of falls; motor safety prioritised.

Every word of it was true.

III

Seven weeks later Dona Amélia came alone.

The button was back on her coat. White thread, dark grey button, the stitches skewed into a crooked cross, the ends not quite trimmed.

“I did it myself.” She’d seen Inês looking. “It was there the whole time I was sewing.”

The mask had held. She hadn’t stopped on a stair since. But there was a figure on her record Inês had never seen before: unmapped channel activity, up 340 per cent since last visit.

The colour had spread. It was in the steam off the kettle, in Rita’s hands shredding couve for the caldo verde, on the ceiling at night. It used to come once or twice a month. Now it didn’t leave.

“Nights are the worst,” Dona Amélia said. “When the light’s off it’s still there. It isn’t a frightening thing. But it keeps happening, and I don’t know how long it means to go on happening. The Graça bells ring three and I’m awake. They ring five and I’m awake. I close my eyes and it’s on the inside of my eyelids.”

There were two bruise-coloured hollows under her eyes. Inês pulled up the actigraphy: over the last three weeks, an average of two hours eleven minutes’ sleep a night.

Dona Amélia took a sheet of paper, folded twice, out of her handbag and smoothed it on the desk. Informed consent: referral to a Long-Term Maintenance unit, deep overwrite. She had signed where the patient signs, a little shakily. Below was an empty box: countersignature of attending calibrator.

“Rita says you’ll sign.”

Inês didn’t touch the paper.

“If I don’t,” she said, “the system will pass you to another calibrator.”

“I know.”

“Then why come to me?”

Dona Amélia looked down at the button she had sewn on.

“Because last time you listened for four hours,” she said. “I thought I ought at least to tell you.”

Inês opened the local file, scrolled to the bottom, and closed it again.

She signed.

IV

The overwrite was booked for three days later, in the afternoon.

Dona Amélia came in the coat. Inês settled her, connected her, made everything ready, and then stopped with her finger over run.

“Tell me once more,” Inês said. “The colour.”

She went through the drawer for a long time and found a biro at the very back, then tore a strip of number tickets off the queue machine in the waiting room and turned them over.

Dona Amélia told her. It was shorter than the first time, and in places she stopped, as if feeling for a word that was no longer where she’d left it. She didn’t mention the plaits. She mentioned the button, and said she’d sewn it herself.

Inês didn’t correct her. She wrote it down sentence by sentence on the backs of the tickets, one full, then the next. She hadn’t written by hand in a long time, and the letters came out crooked.

When she’d finished, she pressed run.

Forty minutes. System report: uptake ninety-nine point six per cent; projected retention: permanent. Memory reconsolidation events: 1,412.

That line was red.

Dona Amélia opened her eyes and sat for a while, like someone waking from a very good siesta.

“Obrigada,” she said. “It looks a lovely day out.”

Inês saw her to the door. The old woman went down the three white calçada steps outside the clinic without a pause. The button on her coat sat crooked in the sun, a white end of thread sticking up.

Inês went back in, squared the tickets, folded them, and put them at the very back of the drawer with the biro. She locked the drawer.

The next patient’s history came up on the tablet. Recalibrations: one.

She pressed call. In the waiting room the screen chimed: A048.