We approached the next door. The music was louder. I turned the knob. A moment later, the music shut off. I pressed, and the door started to open, then stopped and stuck. Something was holding it in place.
“Olivia, are you in there?” I said, hoping my voice wasn't carrying into the tunnel.
There were scuffling sounds.
“Open the door.”
There was a high-pitched giggle.
Now I was pissed. “I'm not playing around. Open up.”
I waited. Nothing but some intense whispering. Then, the squeal of furniture being moved. The door pulled open to reveal Olivia, bug-eyed, staring back at me, wearing a light-blue terry-cloth bathrobe. Her once pink slippers were soiled and wet.
Matthew stared at us from a mattress in the corner. About a dozen candles flickered at his feet, alongside a bottle of water. He was making a feeble attempt to push something under the bedding.
As I followed Annie inside, something crunched underfoot. I reached down and picked up a white tablet. There were two more on the floor along with a half-f blister pack. I picked it up. Ritalin, ten-milligram tablets.
I retrieved what Matthew had shoved under the mattress. It was a paper plate with a residue of crushed pills on it, and a length of plastic soda straw. Snorting Ritalin? That was a new one on me.
Matthew was sweaty, pupils dilated. Olivia was panting, like an overheated terrier. If she'd been any other patient, I'd have been evaluating the course of treatment, racking my brain for additional
support systems, reviewing our security procedures. Instead, anger boiled up inside of me. Olivia shrank away, cowering.
“What in the hell is the matter with you?” I cried.
She flinched. “I didn't do any,” she squeaked.
I felt like a parent, staring down my nose at an ungrateful child. I'd lost my professional distance, but at least I knew it.
I lowered my voice. “I don't think you realize how much you have at stake here. The only reason the judge let you come back to the Pearce instead of carting you off to jail is because you're in a secure unit. If the police find out you're getting out, taking drugsâ”
Now, Olivia's fear turned to petulance. She planted her feet and faced me. “So what?”
“They're not going to take you to reform school, you know. If you're lucky, it will be a detention center. Maybe even jail.”
“This is jail,” she retorted.
“Have you ever been to a real jail?” Annie asked her. Olivia stared down at the bedraggled ears of her bunny slippers. “Well, I have.”
Olivia gave her a sideways look. “What's the big deal?” Olivia folded her arms across her chest, but the sullen tone was tinged with curiosity.
Annie went on. “You won't like it.”
Olivia wiped her nose with her sleeve.
Annie asked, “How old are you? Fifteen?”
Olivia gave an indignant snort. “Seventeen.”
“That's how old I was.” Annie and I exchanged a look. “I didn't do drugs. But I did drink. A lot. I thought I could handle it.
“One night, I was out late with my friends, hanging out behind the high school. I'm driving home, like about the time it is now, when a cop pulls me over. Turns out it's my uncle Jack. He shines a flashlight in my face and growls, have I been drinking? I tell him no. I figure, all I've had is a few beers and over four or five hours. He'll never know. So he asks me to recite the alphabet.”
Olivia was hanging on Annie's words.
“Got up to G. Or maybe H. Then the letters got all mixed up. Surprised the hell out of me. So I say to him, âYou gotta let me sing it.' I
know
I can do it that way. I was so shit-faced, I couldn't even sing it.”
Olivia suppressed a giggle.
“He says, driving around like that, I could get myself killed. Besides, I'm underage. So I said to him, âWhat are you going to do? Arrest me?' And he says, âExactly!' I laughed. I thought he was kidding. But he was dead serious.
“He takes me in, books me, puts me in a cell with this other woman who's drunk, dirty. Puking her guts out. As the night goes on, they put more and more people in with us. The cell across from ours is full of menâdrunks and perverts. One guy is screaming and banging on the bars. Another one is exposing himself. The place stinks. Urine. Vomit. BO. The worst part is, there wasn't anywhere to go. Just a couple of cots and the floor. There I was, locked into this little space. I couldn't get away. I felt violated, just being there.” Olivia gaped at Annie. “It felt like anything could happen to me. I'd have died if I'd had to stay in that jail for another night.”
Olivia took a few moments to digest Annie's words. “What happenedâ” she started, when Matthew Farrell staggered to his feet. He pressed himself against the wall and started banging on it with the back of his head.
Olivia went over to him, examined his face, then raised her arm and pressed the inside of her wrist to his forehead. It was tender, caring gestureâthe kind of thing a mother does with a feverish child. “Is Mattie okay?” she asked me.
Mattie? He sank down to the ground. He was scratching at his arms. Now, he was rubbing his legs with jerky movements and swearing under his breath.
I squatted beside him. He pulled away, holding his hands up in front of his face. His forearms were covered with an angry rash. “Looks like an allergic reaction to too much Ritalin,” I said. Not
surprising. We'd started him on Adderall, also a psychostimulant. The combination could make a Ritalin overdose worse.
I took Matthew's arm. He tried to pull away. “I just want to take your pulse,” I explained.
“Pulse?” he gasped.
“Um-hmm,” I said holding his wrist. His pulse was racing.
“You want to abduct me,” he said, the words staccato.
Olivia crouched beside him. “No one wants to abduct you, Mattie.”
“X-ray me with infrared beams,” he continued.
Common reactions to Ritalin overdose were psychosis and paranoia. “I'm Dr. Zak, Matthew,” I said. “All I want to do is get you stabilized.”
“In-fra-red.” Matthew repeated the word, rocking on the syllables.
“We should get them back to the unit,” I said, hauling Matthew to his feet and dragging him out into the hall. Olivia tried to help support him on the other side.
Annie pulled the door to the tunnel open and stuck her head out. “All clear,” she called back to us.
We held onto Matthew and started back. The dripping from the ceiling had slowed. Our trip through the tunnel was quick and uninterrupted.
When we got to the unit, Annie left through a basement exit and the rest of us took the elevator to the first floor. A nurse who'd worked nights on the unit, on and off for years, greeted us. Her gray hair was disheveled and her uniform was rumpled, as if she'd been in bed for the last four hours but not sleeping. It's amazing how anxiety can wrinkle clothing. “Thank God you found them,” she said.
I sent Olivia to the common room to wait for me. I watched her walk off, struck once again by how waiflike she seemed, her clothes hanging on her thin frame. But something seemed off. Her gait was stiff-legged. I knew she was probably tired, but this wasn't a
tired walk. It was the walk of an old person with the beginnings of Parkinson's disease.
I passed Matthew Farrell over to the nurse. She clucked under her breath.
“Can you be sure he gets back to his room?” I asked. “Put him on five-minute checks. I don't care if he sleepsâhe probably won't be able to for a couple of hoursâbut I want him in his room. I'll beep Dr. Liu and ask him to come in and examine him. Oh, and one other thing. Once he's settled, can you have Ms. Temple's room searched? We're looking for drugs. Probably sample packs.”
Then I joined Olivia. She was curled up on the sofa. I turned on a light and brought a chair to sit opposite her. She blinked, put her arm up across her eyes, and turned away from me.
“Olivia, please sit up for a moment. I need to check something.”
“Turn off the light,” she whined.
I turned it off. Gray dawn barely made a dent in the gloom. But I could easily see her.
She sat up. “What?” The belligerence was back.
“Put your arm out,” I said.
She made a sour face but put her arm out anyway. I took her hand in mine and put my other hand around her biceps. Slowly I raised her hand, bending the arm at the elbow. The muscle ratcheted instead of contracting smoothly, jerking from one position to the next, like when you try to pedal but your bicycle chain has missing teeth.
Olivia sat up straight. “What the hell is that?” she asked, staring at her arm.
“Cogwheeling,” I said, giving her the medical term.
Olivia held out her arm and slowly flexed and bent it. “No shit.”
I watched her for almost a minute, looking to see whether she was also smacking her lips, drooling, or if her tongue was protruding from her mouth. Fortunately not.
“Can you make it stop?” she asked.
“Dr. Liu is going to come in and have a look at you. I hope so.”
She lay back down. I got a blanket and covered her. Then I called Kwan.
“This better be good. You've interrupted my beauty sleep,” he grumbled.
I told him about finding Jensen dead, and Olivia and Matthew in Albert House. When he asked what I'd been doing, roaming around in the middle of the night in the first place, I told him I'd been looking for Channing's research files in Jensen's office. “There wasn't any other way to find out what I needed to help Olivia. And I'm worried that if I don't find Channing's work, someone's going to destroy it to keep it from being published. I was stunned when Destler told me he has the data.”
“Unbelievable,” he muttered.
Then I told him about Matthew's rash and Olivia's tremors.
He agreed, that it sounded as if Matthew was having a reaction to a Ritalin overdose. Of Olivia, he said, “I don't like the sound of that. If she weren't so young I'd be worried about something like tardive dyskinesia.”
It wasn't a pleasant prospect, a teenager with her tongue going in and out, arms shaking, doing the Thorazine shuffle. “I'm hoping it's only temporary,” I said.
“You're right about one thing. We really do need to see Dr. Temple's research notes. There's nothing about this kind of side effect in her report. If we keep Olivia on Kutril, I want some assurance that these symptoms are only temporary.”
“This is your lucky day. Destler says we can see Channing's research notes first thing this morning. Right after he talks to us about the novel approach we're using to treat Olivia's drug craving with Kutril.”
“Does this story have a happy ending, or should I bring my resume to Xerox?”
“Wouldn't hurt,” I said.
WHILE I was waiting for Kwan to come in, the night nurse brought me the incident report she'd completed on Matthew's and Olivia's disappearance. The “Resolved” box was checked. I signed it.
I looked in on the orderly and nurse who were methodically disassembling Olivia's room. They'd stripped the bed, turned over the mattress. The nurse was taking Olivia's clothes out of the drawers and wardrobe and checking the pockets. The orderly was on a stepladder, looking behind each ceiling tile. When he saw me, he climbed down and handed me a half-dozen sample drug packets. Then he went back to his work.
After that, I paced the unit, trying to stay awake. First to one end, then back to the other. As I passed the nurses' station, I smelled coffee that was warming on a burner behind the desk. How good a cup would have tasted. My passes up and back were getting shorter. I
needed
a cup of coffee. I found myself standing over the pot, inhaling the aroma. I looked one way, then the other. There was nobody about.
Just an inch, I told myself. What harm would it do? I poured myself a half a cup. I was about to take a sip when I heard footsteps coming down the hall. I downed the coffee in a single, scorching
gulp. I was coughing and clutching the collapsed paper coffee cup when Kwan rounded the corner.
“This is a pathetic thing. A grown man.” He clucked and shook his head. “You've done stupid things before, my friend. But giving up coffee on a dareâthat takes the cake.” He pounded me on the back.
I threw away the cup. It was one of the few times I willingly admitted that he was right.
We went to check on Matthew Farrell. He was in his room. He'd shoved his bed against the wall and was counting linoleum floor tiles. While Kwan examined him, Matthew began on the ceiling tiles. When Kwan had finished, Matthew cataloged his results in microscopic printing on the back of the day's menu. Then he started on the holes in each ceiling tile.
Kwan quickly confirmed a Ritalin overdose, the effects of which were beginning to wear off. Eventually, he'd sleep.
I caught a few hours of restless sleep on the couch in my office. When I came back down, Gloria was there.
“I've got something for you,” she said.
She handed me a brass key. I turned it over. I fished my keys out of my pocket. It matched the master key on my ring. “Where'd you get this?”
“From Olivia's bathrobe. When we moved her to bed, we checked her pockets.”
“Probably her mother's key,” I said.
Gloria looked somber. “And I'll bet you anything that last night wasn't the first night they've gotten out.”
I agreed. “Just the first time they got caught.”
At least that explained how a pair of kids had effortlessly breached security on our unit without even tripping an alarm. I started for Olivia's room.
Gloria stopped me. “She's still asleep, Peter.”
I leaned against the desk. I was tired. I could feel the veins
banging in my head like noisy heating pipes. I wanted to go home, get into bed, and forget all about Olivia Temple. She was a royal pain in the ass.
Kwan and I met at Destler's office at nine. Kwan came bearing a small Starbucks coffee. “It's half decaf, half caf,” he told me. A peace offering. I took it gratefully.
I sipped slowly, contemplating how abstinence makes the heart grow fonder. At twenty past, Virginia Hedgewick backed into the office. Her arms were loaded with a stack of newspapers and a box of doughnuts, which she set on a seven-foot-long teak credenza. She looked grim-faced when she turned to us. “Doctors aren't supposed to die here. What next, I wonder?”
“Was it on the radio?” I asked.
“Dr. Destler called me with the news. Good thing he was doing one of his twenty-four-hour sleep overs.”
Just then, Destler popped out of his office, looking as if he'd just stepped out of an ad for successful portly men. Blue suit, red bow tie, gleaming head. He looked clean and rested. I remembered. There'd been a fuss over how much money was spent renovating his office when he came to the Pearceâlooked like the rumor that they'd installed a shower in the connecting bathroom was correct.
With him was a well-dressed business type. I thought I recognized the manâa pharmaceutical-company executive or sales rep. But I couldn't remember which or where from. They shook hands, and the visitor left.
Destler gave me a disapproving frown. I hadn't slept much, and I knew I looked it. At least Kwan balanced the equation.
We followed Destler into his office. We sat across the desk from him in chrome and leather sling chairs, under the watchful eye of Wilhelmina Pearce. Destler had his seat pumped up high so he could look down on us.
“A nasty business,” he said. “And you up there, rifling through
your colleague's files. I could take you before the board on this.” Destler stroked his chin thoughtfully. “You've both demonstrated questionable judgment, not to mention performed illegal actsâ” Kwan started to protest. “I mean, some of you,” Destler amended. “It would be entirely appropriate to initiate an investigation, to relieve you of your duties, suspend your privileges.”
The words were ominous, but his tone wasn't making me squirm.
“But I've decided against doing that for a number of reasons.” There was a long pause. He pressed his lips together until they disappeared. Apparently he wasn't going to share his reasons with us.
Destler's eyes rested on a magazine lying open on his desk. It was an issue of
JAMA
, and it was open to the clinical note on Channing's Kutril research. Parts of it were highlighted.
I looked up at Destler. He was staring at me. His soft face had turned hard. “Dr. Temple's Kutril study is complete,” he said. “The institute has met the requirements of the grant.”
“You'll see that her research gets submitted for publication?” I asked.
“As you know, her methodology has been questioned.”
That's when I remembered who the man was that we'd seen leaving Destler's office. It was an Acu-Med executive. A senior VP, in fact.
“And Dr. Jensen's research?” I asked. “I don't believe he was as far along as Dr. Temple in completing the clinical phase.”
“I've assured Acu-Med that the work will be completed. And submitted. The institute will meet its obligations. DX-200 is a very promising therapy.”
“Promising and expensive,” I said.
“Peterâ” Kwan started.
I wasn't about to shut up. “Dr. Temple's research should be published. If Kutril offers a cheap, effective treatment for psychological addiction ⦔
Destler crossed his arms. “That's a big âif?'”
“You're going to bury it, aren't you?”
“I'm not going to bury it,” Destler said, enunciating each word as if he were reading fine print off a cue card, “and I'm not going to suspend either of you. The Kutril study is ⦠well, it's over. Completed, as far as the Pearce is concerned. The work is well-intentioned but flawed.” The only thing keeping me in my chair was Kwan's hand locked on my arm. “Ill-conceived. Poorly executed.” Kwan pressed hard. “And Dr. Temple must have realized as much. She must have been disappointed. Perhaps even distraught. Quite distraught. She had high standards. She must have seen this as a failure.” He closed the issue of
JAMA.
“Channing Temple did not kill herself,” I said, trying to keep control.
“Whether she did or not is immaterial to this discussion,” Destler said dryly. “You are to back off the Kutril study. Do you understand? It's in the best interest of all concerned.” Destler's voice was quiet and firm. “The last thing I need right now is another brouhaha. The violent deaths of two physicians is a public-relations disaster. People will think we're running a fly-by-night for the criminally insane. And you harboring a murderer isn't helping the situation.”
I rose to my feet, sending my chair crashing over behind me. “She's not a murderer!” It was a good thing his desk was the width of a Buick.
Destler stood up also. “She was out and about last night, too, wasn't she?” he asked, his chin disappearing into his neck as he pressed himself back, his head nestling up against Wilhelmina Pearce's ample lap.
Kwan righted my chair, and I eased back into it. I wondered how in the hell that news had reached Destler so quickly. Incident reports usually take at least a few hours to make their way through channels.
“Dr. Destler,” I said, keeping my voice stony calm, “Olivia Temple
is a patient at the Pearce, and our number-one obligation, public relations aside, is the well-being of patients.”
Destler inched back to his chair and sat.
I went on, “I need to see Dr. Temple's research notes. Last night Olivia had another severe adverse reaction.”
His expression shifted, became speculative. “Of course you can see her data. But I want you to see something else, too. Take as much time as you like. The only thing I ask is that you look at the documents here, in my office. And leave them here when you go.”
I felt a wary uneasiness, certain that we were about to step into a very attractively baited trap.
He continued, “I'll ask Virginia to bring you the documents. Read them carefully, and think about the implications.”
Destler picked up his phone, punched in three numbers, and waited. “Virginia ⦔ he started, and gave her instructions. He listened for a few moments, then hung up.
“I've just been reminded,” he said, pulling a black appointment book out of his top desk drawer and opening it, “I have another appointment to get to.”
He swept the appointment book and the issue of
JAMA
into the drawer, closed and locked it. “I'll leave you gentlemen to your work,” he said, standing and straightening his bow tie. Then he left the room.
Kwan pronounced the appropriate verdict: “Bizarre. Truly bizarre.” Then he looked around warily and lowered his voice, “You don't suppose this place is bugged, do you?” The same thought had occurred to me.
Virginia Hedgewick staggered in carrying a storage box with a manila folder balanced on the top. Kwan leaped up and took them from her, consummate gentleman that he is.
“A bit early for calisthenics, if you ask me,” Virginia said, smoothing her midcalf length skirt across her thick legs. She clucked disapproval as she gazed at the storage box. “This business of impounding filesâin all my years, I can't remember another
time when we had anything like this. The only thing that comes close was that business with Robert Smythe-Gooding.”
“You worked for him back then, didn't you?” Kwan asked.
“I was his secretaryâthat's what they called us in the old days, before everyone got so damned politically correct. Very unfair, if you ask me. Heart wrenching. To see him brought down by that pipsqueak.”
“What pipsqueak?” I asked.
“Fellow's long gone. He was a resident. Came in to assist Dr. Smythe-Gooding in his research. Ended up accusing him of plagiarism. Utter nonsense, if you ask my opinion. He'd copied a few sentences, maybe. But still, they shunted him aside. Didn't want the accusations to become public. Too much at stake. Hospital reputation and all that.”
Virginia eyed the file box she'd brought in, as if she didn't like its smell. “Of course that's all ancient history now,” she said, and left us to our work.
Kwan opened the box, heaved out the files, and started going through them. I helped myself to the folder from the top of the box.
“What on earth?” I muttered, as I leafed through. It looked like pages photocopied from a smaller journal. The handwriting was compact, precise, backward-slanting. I recognized it right away as Channing's. The date on top of the first page was six months ago. The final entry was about a month later.
Destler had a reason for wanting me to see this. It seemed very unlikely that these were pages Channing Xeroxed and gave him herself. Reluctantly, I started the first entry.
Indian summer today. Hot and close. With the A/C off, this place is like an oven.
I see you lying on the couch and I'm in my chair
,
pen ready. You're upset. Ready to chuck it all. You're letting it get to you. Letting yourself absorb the dark sadness. You are so vulnerable. So unsure of how to proceed. I want to make you strong.
You are talking about your experiences now. I am half Listening, half not, mesmerized by the beads of sweat on your upper lip. I want to lick away the salty sweetness.
I let my hand drift off the edge of the armrest, as if I don't realize I'm touching your leg. Your skin is soft, smooth, pale and iridescent. My fingers stroke your bare skin. You are feeling it too. You let your legs fall apart. I let my fingers wander to the insides of your thighs. Your legs part further, your skirt pushes up. I can see you're wearing nothing underneath. Surely you know. You agree, it is inevitable. I tell you, I want to make love to you. You act like you don't heaz, but your back arches, your body tells me you want it too.
I kneel. You have a dragonfly, just here in the hollow between your legs. It matches the other one. I touch it with my tongue. you moan, but not in protest.