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“And then I had this feeling like it was time to go back,” Mr. Ortiz said, “and I went back down the tunnel, and at the end of it was the operating room.”

“Can you be more specific?” Joanna said. “About the feeling?”

“It was like a tug,” he said, but the gesture he made with his hand was of a shove. “I can’t describe it.”

Joanna consulted her notes. “Can you tell me how the Virgin Mary looked?”

“She was dressed in white. She had this light radiating from her,” he said, and this time the gesture matched his words, “like diamonds.” She asked him several more questions and then shut off the recorder and thanked him for his time.

“I’m not really all that interested in near-death experiences,” he said. “My real interest is in dreams. Is your project involved with dream imagery at all?”

“No,” Joanna said and stood up.

Mr. Ortiz nodded. “Most scientists are too hidebound and narrow-minded to believe in dreams. Analyzing the images in your dreams can cure cancer, did you know that?”

“No.”

Mr. Ortiz nodded wisely. “If you dream of a shark, that means cancer. A rope means death. If you want to tell me one of your dreams, I can analyze it right now.”

“I have an appointment,” Joanna said, and escaped.

Is everybody a nutcase? she wondered, going back up to her office. Dream imagery. But once in her office, going over the transcripts of the multiple NDEs, she began wondering if dream imagery might be the key. Not Mr. Ortiz’s brand, of course, where images were assigned arbitrary meanings: a snake means sex, a book means an unexpected visitor. That was only a kind of glorified fortune-telling.

And Freudian dream analysis wasn’t much better. It tried to reduce everything to basic sexual desires and fears when dreaming was actually much more complex. Some imagery in dreams was lifted directly from the events of the day before, some from underlying worries and concerns, some from outside stimuli, like an alarm clock, and some from the neurochemicals generated during REM sleep, most particularly acetylcholine, which Richard had said was elevated during NDEs.

It was acetylcholine that made connections between the inputted data and long-term memory, connections the dreaming mind expressed sometimes directly and sometimes symbolically, so that the alarm clock’s ringing was transformed into a siren or a scream, and it, the Pop-Tart you had for breakfast, and the patient you were worried about all became incorporated into a single dream narrative. And it was possible, taking all those things into consideration, to analyze the content of the dream. Which was what Richard had been doing when he’d said the acetylcholine made the Titanic as likely an association as a hospital walkway, but he had been talking about the NDE as a whole, not the individual images within it.

Joanna hadn’t thought of analyzing those in terms of dream imagery, partly because the NDE didn’t feel like a dream and partly because some of the imagery — the light and the tunnel — was obviously direct manifestations of the stimuli. But that didn’t mean all of them were. What if some of them were symbolic interpretations of what was happening in the NDE?

Could that be why she kept remembering Mr. Briarley’s lecture on metaphors, because the images in the NDE were metaphors? She had focused all her attention on trying to find out what Mr. Briarley had said, but maybe the connection was in the NDE itself, hidden in what she was seeing and hearing.

She called up the transcript of her last time under and began going through it line by line. Some things were obviously direct representations of temporal-lobe stimuli. The lights from the Morse lamp and the deck lights and the light spilling out from the gymnasium and bridge obviously were, and she wondered if all the instances of white clothing — gloves, nightgown, steward’s white jacket — weren’t, too.

Some of the images were clearly taken directly from the Titanic — the lifeboats, the passengers out on deck, the deck chairs — and still others from her waking life — Greg Menotti and the red sneaker, and maybe even the blanket, though that could also be from the illustration on the cover of A Night to Remember.

Which left the details that couldn’t be attributed to the Titanic or the temporal lobe and therefore might be significant: Jack Phillips’s tapping out CQD instead of MGY, the mail clerk dragging the wet sack of mail up the stairs, the stairs themselves, similar to the Grand Staircase and yet lacking the cherub and Honour and Glory, the location of the gymnasium, the mechanical camel. If they were symbols, they were much more subtle ones than “snake equals sex.”

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