Jack eases me back down, which is just as well because I feel like I’ve been hit by a truck. All I want to do is go to sleep.

“Do you know who I am?” he asks.

I know the routine, so I answer everything he’s about to ask me. “Yes, you’re Jack Bradley, and my name is Abbie MacIntyre.” I swallow heavily and fight for the strength to continue. My voice is weak, and I can’t speak very fast. “It’s Monday morning, and I just collapsed in the OR. But I’m okay now.”

“Let me be the judge of that. Can you tell me if you had any symptoms beforehand? Dizziness? Chest pains? Corinne said you were blinking, as if you were having trouble focusing. You said your eyes were dry?”

I lay my open palm on my forehead. “Yes, but that wasn’t the real problem. I felt sleepy, and I was trying to stay awake. I’ve been sleeping a lot lately, taking frequent naps in the day. I have an appointment to see my doctor about it this afternoon. But I’m not pregnant. I had a hysterectomy years ago.”

“Okay. Good to know. How long has this been going on?” Jack asks.

I try to think. “Since my accident, I guess. I thought the fatigue was stress related, but lately I’ve been having some strange dreams that are more like hallucinations, and this is the second time I’ve passed out—although I didn’t actually pass out just now. I was completely conscious and awake. I could hear everything that was going on around me. I just couldn’t move my body or open my eyes or speak. It was total paralysis.”

“Okay . . .” Jack stalls for a few seconds while he mulls over everything. “And this started happening after your accident?”

“Yes.”

He turns to one of the other nurses. “Let’s get someone down here from neuro. Tell them who the patient is, that it’s Dr. MacIntyre.”

“Really . . . ,” I say, “I don’t want any special treatment . . .”

The nurse goes to a phone to make the call, and Jack touches my arm. “You’re not on anything, are you? Any medications? Alcohol? Illicit drugs? I need to know.”

I shake my head.

“Then tell me more about how you felt in the seconds just before you collapsed. Describe the experience to me.”

I pause. “Okay, but first, can you tell me what’s going on with the gallbladder patient? Is he okay?”

“We’ll check on that for you.” Jack makes eye contact with another nurse, who leaves the room.

I take a deep breath and think back to how I felt just before I collapsed.

“I was tired,” I tell him, “but that’s nothing new. Like I said, I’ve been sleeping a lot lately. But then I felt a tingling sensation in my head. I thought it would pass and that I was going to make it through the rest of the surgery, but then the patient’s blood pressure dropped, and alarms started going off. I felt a rush of adrenaline, and that’s when my knees gave out, and I couldn’t hold on to the instruments. My whole body just wilted. It was like all my limbs turned to spaghetti, and that’s why I fell. But like I said, I was conscious the whole time. I was fully aware of everything that was happening in the room. I could hear the resident and the anesthetist taking over, and then I felt myself being lifted onto the gurney. I heard Corinne tell you that I was blinking a lot and that I said my eyes were dry.”

Jack frowns at me. “Was it like . . . an out-of-body experience?”

Of all the doctors I know, only Jack would ask that question.

“No, I was very much inside my body, and my eyes were closed, so I couldn’t actually see anything, and yet I could see it in my mind. It was like I was trapped, and I wanted to break free from the paralysis, but I couldn’t.”

He nods at me. “You say your knees buckled when you felt the panic from the alarms going off?”

“Yes.”

A nurse returns with news about my patient in the OR. “Everything’s fine,” she says. “They’re just closing up now.”

“Thank God.”

Jack glances toward the door to the trauma room and pats my arm. “I’ll be right back. Just stay put, okay?”

Even though I have plenty to do in the hospital and another surgery scheduled in an hour, I don’t put up a fight because all I want to do is sleep. As soon as Jack is gone, I close my eyes and fall into a fitful slumber in which I dream that I’m skiing fast down a snow-covered mountain, unable to slow down because it’s too steep. I’m terrified I’m going to plummet to my death.

Then suddenly I’m being chased by a mugger in a city neighborhood. I dash into an alley, search for a place to hide, but there’s nowhere to conceal myself, so I just keep running, leaping over bags of garbage . . .

Someone touches my shoulder and shakes me hard. I wake with a gasp.

The head of neurology is standing over me, watching me intently. I’m surprised to see him, and I worry that I might have been moaning or talking in my sleep, none of which is terribly professional.

At least this time, I know I was dreaming. I have no illusions that I was actually skiing down a snowy mountain or running from a thief who wanted to hurt me.

I try to sit up, but I feel weak and groggy. “Dr. Tremblay . . . how long was I out?”

“About ten minutes,” he tells me. “How are you feeling now?”

“Rotten,” I reply, leaning up on my elbows. Then I decide it would be best to rest my head on the pillow before adding, “And exhausted. Like my body is made of lead. I’m just so tired.”

He ponders that and nods with understanding. “Dr. Bradley told me what happened. He described your symptoms to me, but I’d like to hear it from you. Can you tell me everything you remember, leading up to the moment you collapsed? And anything else you think is relevant about your health.”

“Of course.” I explain my fainting episode again and the level of awareness I had, along with the strange dreams I’ve had at home over the past few weeks. And my car accident.

Dr. Tremblay listens attentively.

I also mention that I’ve put on a few pounds.

When I’m finished telling him everything, he asks, “Are you aware that you were dreaming just now?”

“Yes. Was I moaning? Or tossing and turning?”

“No, but your eyelids were fluttering. You’ve been in a state of REM since the moment I entered the room.”

He raises an eyebrow, and I understand why he’s telling me this—because we both know it’s not normal to enter the REM phase so quickly after drifting off. It should take anywhere from eighty to a hundred minutes.

“So . . . what do you think is going on?” I ask him, and I feel inadequate because I don’t know the answer myself. I’m a physician. Shouldn’t I know what’s wrong with me?

Dr. Tremblay glances away briefly. “I can’t be absolutely sure without performing some tests,” he says, “but I suspect that what happened to you in the OR just now was cataplexy.”

Cataplexy. I know that disorder, and it’s not something I want to hear.

“What you’ve just told me,” he continues, “about the dreams you’ve been having and your increased fatigue and sleeping during the day is consistent with the condition of—”

“Narcolepsy,” we each say together.

I stare at him with wide eyes, suddenly feeling very alert.

He nods, knowing that he doesn’t need to explain to me that narcolepsy is a neurological condition that causes disruptions in sleep patterns and excessive sleepiness during the day. The afflicted person can sometimes nod off involuntarily.

Another symptom is sleep paralysis—which is normal for most people during a state of REM, probably because our brains want to prevent us from acting out our dreams. But with narcolepsy, this paralysis can occur when the person is falling asleep or waking up, and it can be accompanied by vivid hallucinations that seem real.

Cataplexy is an add-on I really don’t need as a surgeon. It’s a loss in muscle tone while the person is awake. It’s usually triggered by a strong emotion, like panic. Even laughter can bring it on. Some episodes can be barely perceptible, with only a slight muscle weakness—a drooping eyelid, for example—but a more severe attack can result in a full physical collapse, like what just happened to me in the OR when the alarms started going off.

“But why?” I ask him. “I was fine before. Is this because of my accident?”

All the anger I have felt toward Alan pales in comparison to the blistering fury I feel now, because if I have acquired this condition because of his drunk driving escapade on his way to see his secret lover, I will never be able to forgive him. This isn’t something I can get over eventually, like the heartbreak from his affair. This is my whole future.

I’m a surgeon. How can I operate if I might drop instruments or fall down without warning? How can I handle sudden stressful situations if I have cataplexy? My career will be over. My life will never be the same.

If there was ever any chance of forgiveness, it’s slipping away now, fast as blue blazes.

Dr. Tremblay speaks plainly to me. “Narcolepsy is a mysterious condition, Abbie, and it may have any of several causes. It could be autoimmune in nature, or it may be genetic. Symptoms can take a while to fully manifest, so we can’t be sure it was your accident that caused this, at least not yet.” He holds up a hand. “But let’s not jump the gun. I’d like to do a full physical to rule out other things, then send you to a sleep clinic for some tests before we attach a diagnosis to this.”

I shut my eyes and nod my head, because I know how this works. We can’t presume anything at this stage. We need clinical test results and analysis to be sure.

“When can we do that?” I ask as I glance at the clock on the wall. “I have another case in less than an hour.”

He gives me a sympathetic look. “You’ll have to reschedule or get another surgeon to cover for you. And I advise you to stay out of the OR until we have this figured out.”