Ginger Weiss's blackout after the aortic transplant surgery becomes a crisis not because doctors discover a lesion, but because they find nothing at all. After a fugue following the aortic graft on Viola Fletcher, Ginger is admitted to Boston Memorial; the absence of a physical explanation leaves her facing a psychological illness that may end the surgical future she had nearly reached.

After the Fugue

On Friday, four days after the episode, Ginger remains a patient at Boston Memorial. George Hannaby had led her out of a snowy alleyway where she had regained consciousness, and she was admitted to the hospital. For three days, her colleagues subject her to an exhaustive investigation: an EEG, cranial X-rays, sonograms, pneumoventriculography, a lumbar puncture, an angiogram, and repeated procedures to cross-check the results.

The tests search for a wide range of possible causes, including tumors, cysts, abscesses, clots, aneurysms, abnormal intracranial pressure, and signs of infection or bleeding. The breadth of the workup makes the eventual answer more unsettling: this is not a case in which a hidden physical problem has simply escaped a cursory examination.

The Results

At two o'clock Friday afternoon, George comes to Ginger's room with the final test results and the consultants' opinions. His decision to deliver the news himself, rather than leave it to the oncologist or brain specialist overseeing her case, makes her fear that the findings are bad. She is sitting in bed in blue pajamas Rita Hannaby fetched from Ginger's Beacon Hill apartment, reading a paperback mystery and trying to believe that her seizures have an easily corrected cause.

Instead, the tests reveal no disease, injury, or congenital defect. When George explains that her fugue flights have no discernible pathological cause, Ginger loses the composure she has maintained since crying in the alley. She weeps quietly, with anguish. The blankness of the medical results does not reassure her: it removes the possibility that an identifiable bodily condition can be treated and cured.

Consequences for Ginger

The specialists' conclusion is that Ginger's problem is psychological, beyond the reach of surgery, antibiotics, or drugs intended to control a physical disorder. The narrative presents psychotherapy as the remaining hope for ending repeated fugue episodes, while stressing that its cure rate for such patients is low. A fugue may also indicate incipient schizophrenia, and the prognosis offered to Ginger includes a small chance of managing the condition and living normally alongside a dismayingly high risk of institutionalization.

The diagnosis strikes at the point when Ginger is closest to the career she has pursued: she is only months away from establishing her own surgical practice. Even if psychotherapy allows her to control the episodes, she will not be able to obtain a medical license. The distinction between a potentially correctable physical ailment and a psychological condition therefore becomes a reversal in her prospects: surviving the crisis does not mean she can return to the profession that has shaped her ambitions.

George's Care

After the diagnosis, George responds to Ginger's distress with practical gestures rather than further explanation. He takes tissues from the box on the nightstand, pours her a glass of water, and gives her Valium despite her initial resistance. He holds her hand and speaks softly until she gradually calms. His care offers immediate comfort, but it cannot resolve the uncertainty the tests have exposed or undo the threat to Ginger's independence and career.