Ghost Notes

*The room is unfamiliar. I don't know how I got here.*

The words filtered through the earbud nestled in James Mitchell's left ear, delivered in his own voice with clinical precision. He stood before a mirror in what appeared to be a hospital staff bathroom, fluorescent lights casting harsh shadows across his face. Wine-colored scrubs hung slightly loose on his frame, as if they'd been chosen for someone else.

*You're experiencing an episode of Korsakoff-Wernicke encephalopathy. The condition affects your ability to form new memories. Trust no one. Your life depends on following these instructions precisely.*

The man staring back from the mirror wore exhaustion like a familiar coat. Dark circles shadowed eyes that seemed to be searching for something just out of reach. His name badge read "Dr. James Mitchell, ST3 General Surgery," complete with the NHS logo and a photo that matched his reflection with unsettling accuracy.

His fingers drummed an unconscious rhythm against the porcelain sink – index, middle, ring, pinky, in a pattern that felt more like muscle memory than nervous habit. Something about the movement felt wrong, as if his hands were reading from the wrong sheet music.

*Your shift starts in twenty minutes. The schedule has been loaded into your phone. Follow your calendar notifications. Act normal. People's lives depend on you maintaining your cover until we can extract you safely.*

The bathroom door swung open with a gentle creak. A nurse entered, her shoes squeaking against the linoleum floor. "Morning, James," she said, nodding as she passed. "Ready for another exciting day in theater?"

"As ever," he replied, the words emerging automatically. His voice sounded different without the earbud's mediation – rougher around the edges, less precise, with a cadence that didn't quite match the methodical speech patterns of his recorded self.

The hospital day unfolded like a well-rehearsed performance. His phone buzzed at regular intervals, each notification a stage direction guiding him through the complex choreography of medical practice. Ward rounds. Pre-op assessments. Patient consultations. Each interaction felt simultaneously foreign and familiar, like sight-reading a complicated piece he'd somehow played before.

In the surgical assessment unit, James examined a patient with suspected appendicitis. His hands moved with practiced efficiency, palpating the abdomen, noting tenderness in the right iliac fossa. The medical terminology flowed effortlessly from his lips, yet something about the rhythm of his speech felt off-key, as if he were reciting lines written in a language he'd learned but never truly inhabited.

*Remember your training. Upper right quadrant pain radiating to the right iliac fossa suggests classic appendicitis presentation. Trust your hands. They know what to do.*

"Dr. Mitchell?"

The voice came from behind him, causing him to turn. A woman in dark blue scrubs stood in the doorway, her posture radiating quiet confidence. Dr. Sarah Chen, according to her badge. There was something intense about her gaze that made him instinctively glance at his left hand. No ring adorned his finger, but a pale indentation marked the skin where one might have rested.

She noticed the gesture and smiled, a hint of understanding softening her features. "Took me nearly eight months after my divorce before I stopped checking for mine," she said. "Time heals all wounds, right?"

The words triggered a flash of memory – calloused fingertips sliding over metal strings, a wedding band catching the stage lights, the low throb of an upright bass resonating through his chest. But the image dissolved like smoke before he could grasp its significance.

"Right," he mumbled, though something about her statement rang false, like a note played in the wrong key.

*Focus. Don't let them distract you. Each interaction is a potential threat to your cover.*

Throughout the day, these discordant moments accumulated like wrong notes in a familiar melody. The way his fingers tapped out rhythms on patients' charts. How the beeping of medical equipment resolved into syncopated patterns in his mind. The strange comfort he found in the basement break room, where the humming of the vending machines created a low, steady drone that reminded him of something he couldn't quite name.

During quiet moments between surgeries, he found himself drawn to the hospital's chapel. The space was always empty during these hours, and something about the acoustics made his footsteps echo like the walking bass lines that kept surfacing in his thoughts.

*Your condition is deteriorating,* his recorded voice warned as he sat in one of the chapel's hard wooden pews. *You'll need another treatment soon. Go to the pharmacy at exactly 1800 hours. Ask for the package left for Dr. Mitchell. Don't deviate from the schedule.*

The afternoon brought an emergency laparotomy. As James scrubbed in, another memory surfaced – not of surgical procedures or medical training, but of standing in a dimly lit club, the weight of an instrument against his chest, four strings humming with possibility. The memory felt more vivid, more real than any of the medical knowledge that seemed to flow automatically through his hands.

The operation proceeded with the precision of a well-rehearsed performance. His surgical team worked in perfect rhythm, passing instruments, adjusting lights, monitoring vitals. It was almost like performing, this synchronized dance of skilled professionals. Each movement flowed into the next with a timing that felt more musical than medical.

As he closed the final suture, James realized he hadn't checked his phone for instructions in over two hours.

*You've done well today,* the voice said later, as he stood in the same bathroom where his day began. *But we need to maintain the illusion. Take the medication. Record your message for tomorrow. The cycle must continue.*

The small pill bottle from the pharmacy felt heavy in his hand. He studied its label in the harsh bathroom lighting. The pharmaceutical name was correct for treating Korsakoff's syndrome. The prescription appeared legitimate, down to the smallest detail.

But something caught his eye – a tiny imperfection in the reflection of the fluorescent lights on the bottle's surface. For a fraction of a second, the pattern broke down into pixels, like a digital image rendered just slightly wrong.

James removed the earbud and held it up to the light. The technology was sophisticated, but now that he was looking closely, he could see it wasn't standard medical equipment. It was something else entirely – something designed not to help him remember, but to make him forget.

His fingers moved across the smooth surface of the sink, no longer drumming randomly but playing out a distinct pattern – the opening bars of Mingus's "Goodbye Pork Pie Hat." The motion felt natural, authentic, like coming home after a long absence.

He pulled out his phone and opened the calendar app. Every slot was filled with detailed medical appointments and procedures stretching back months, yet when he tried to recall any specific surgery from the previous week, the memories slipped away like water.

In his pocket, he found a creased photograph. It showed a quartet on stage – piano, drums, saxophone, and bass. The bassist's face was in shadow, but James recognized the way the man held his instrument, the way his fingers pressed against the strings. He turned the photo over. On the back, in handwriting that matched his own, was a message: "Remember who you are."

*The room is unfamiliar. I don't know how I got here,* the earbud voice began again, but James was no longer listening.

He reached into his other pocket and found a small brass key with a tag attached. The tag bore an address and a time: 23:00. Below it, in the same handwriting as the photo: "Jazz Club – Final Set."

In the mirror, Dr. James Mitchell straightened his scrubs one last time. But the man who walked out of the bathroom moved with a different rhythm, his steps falling into the gentle swing of a walking bass line.

The room was unfamiliar. He didn't know how he got here. But he knew where he was going, and the music in his head was getting louder...