I shook her hand. "Frank Clevenger."
"I’m sorry if the ward clerk put you off," Mossberg said.
"No problem," I said. "I’m forty minutes early. I know something like that can turn a locked unit inside out."
She laughed. "Why don’t we take a few minutes together in my office, then I’ll get Billy for you."
As we walked through the unit, we passed patients as young as four or five years old and others who looked closer to seventeen or eighteen. They seemed perfectly normal as they spent the weekend chatting in the hallway or playing board games in their rooms or watching television in the lounge. But I knew from my own rotation in child and adolescent psychiatry, back when I was a resident at New England Medical Center in Boston, that only the sickest young people get access to inpatient units, the ones at risk of committing suicide or homicide. Managed care insurance companies indiscriminately shunted the rest to outpatient treatment. The patients here were on multiple psychoactive medications. Any one of them could fly into a rage or be overwhelmed by hallucinations, without warning. Their minds had already veered into chaos — whether due to trauma, abuse or addiction to drugs or alcohol. They might never live normal lives, no matter how much help they got. Kids are less resilient than people think.
I thought of the murderous violence Billy had witnessed in Russia and the trauma he had, no doubt, suffered in the orphanage. Was it at all surprising that a boy whose world had been destroyed would come to be destructive? Wasn’t it obvious that the ruinous potential of fire would feel as warm to him as returning home after a long journey? Would he not be drawn to revisit his private terrors by looking into the eyes of a neighbor’s terrified pet? And then this more disturbing thought came to mind: Would watching his baby sister struggle for her last breaths speak to him of his own emotional suffocation?
We walked into Mossberg’s office, an eight-by-ten-foot space piled high with books and medical journals. "Please," she said, pointing to a chair next to her desk.
I navigated my way to the chair, careful not to knock over any of the stacks of reading material. I moved a bunch of
New York Times
newspapers, two volumes of Tennyson’s poetry, and a copy of Harry Crews’s
A Childhood
off the seat, and sat down. Once I did, I was nearly face-to-face with the only thing hanging on Mossberg’s walls: a three-by-four-foot painting of a dog with electric blue fur, a white snout, and big, pointy ears. Sitting amidst rolling green hills and blue-black oak trees, the dog had a questioning expression on its face and big, golden eyes that stared into the room, seemingly waiting for something.
"Interesting painting," I said.
"Blue Dog? She helps the kids talk. Sometimes they tell her things they can’t tell me, and I just listen in."
"She looks like she’s heard a lot of stories," I said.
"Those big ears," Mossberg said. She smiled.
I felt comfortable in Mossberg’s space, and with her. The ability to inspire that kind of feeling in people is essential — and rare — in psychiatrists. One in fifty might have it. "You like pearls," I said, nodding at her.
"I like the lesson they teach," she said. She reached to her neck and rolled one of the pearls between her thumb and forefinger. "The grain of sand is an irritant, but the oyster turns it into something beautiful. An oyster without a grain or two of sand doesn’t have much potential. Same with people, if you ask me."
"Agreed," I said. "I feel like I’m sitting with a friend."
She smiled. "Maybe you are," she said. "I know of your work. You’ve had fascinating cases."
Every so often I bump into someone who’s read one of the profiles of me that ran in publications ranging from the
Annals of Psychiatry
to
People
magazine when I was taking one forensic case after another, each more chilling than the last. But that was a different time, and I was a different person, and I didn’t want to get into any of it with Mossberg. "I gave up my forensic practice a couple years back," I said. "I wouldn’t normally be involved in Billy’s case. I’m interviewing him as a favor to a friend in law enforcement."
She didn’t take the hint. "I’ve never heard of anything like the case of that psychotic plastic surgeon," she led. "Where was it? Lynn, Massachusetts? The state hospital?"
"Right," I yielded.
"Dr. Trevor Levitt."
I really wished she would stop.
"No. Lucas," she said. "Trevor Lucas. He had taken hostages. Nurses, patients, and so forth."
"Yes."
"And you negotiated their release," she said.
I could feel my pulse in my temples. "Not all of them," I said. "Lucas butchered a few of them before I declared victory and had my picture taken for the papers. It’s a minor detail people tend to forget."
"I’m sorry," she said. "I do recall reading about an elderly woman. Her body had been disfigured — with a knife."
I didn’t respond.
"And if I remembered correctly, Lucas performed some sort of crude
neurosurgery
on another hostage?" She shook her head. "It was very brave of you to go onto that unit in the first..."
My brow was damp. I wiped it with my shirtsleeve. "These memories are very painful to me. I don’t talk about them."
Mossberg leaned back in her chair, then sat there, watching me intently. "I see," she said, a therapeutic strain of kindness in her voice.
I knew what she was thinking. I would have been thinking the same thing: That not being able to talk about a memory means your mind is still enslaved by it. But I wasn’t ready to do the work of freeing myself, and I hadn’t come to Mossberg for that kind of help, anyway. I had come for clues to help solve the murder of an infant girl — and to make sure that her twin sister stayed alive. I sat straighter in my chair. "What can you tell me about Billy Bishop?" I asked her pointedly.
Her eyes narrowed, and she pressed her lips together, as if finalizing her diagnostic impression of me. If she was as sharp as I thought she was, she’d get it right: something just shy of full-blown post-traumatic stress disorder. A few moments passed. "Very well," she said. "I’m sorry to intrude. I tend to wander places I haven’t been invited."
"No offense taken," I said. "I understand."
She nodded. "About Billy..." she said, reorienting herself. "I can tell you he’s a very dangerous person. He seems to be a young man without conscience. I’m not surprised that he lashed out at his sister."
"Why do you say that?"
"Certainly not because of anything he’s told me," she said. "He’s happy enough to talk about Nantucket, Manhattan, sports, television, and anything else unrelated to the Bishop baby’s death — or to his life in Russia. He avoids those topics like the plague."
"I can understand that," I said.
"Of course you can," she said. She paused to underscore her point.
"Let’s stick to Billy," I gently reminded her. "I promise to work on my own avoidance another time."
"You’re right. I lost my head." She winked. "My main concerns about Billy," she continued, "come from the psychological testing we conducted yesterday, shortly after he arrived on the unit."
Psychological testing involves a variety of evaluations, including the Minnesota Multiphasic Personality Inventory, the Bender Gestalt Intelligence Test, and the Rorschach series of inkblots. The goal of the testing is to determine whether the examinee suffers from any major mental illness, as well as to assess his core character traits, how he thinks about himself, and how he responds to the world around him.
"He cooperated with the testing?" I asked.
"Not really. The deception scale shows he gave untruthful answers to many of the questions. He was trying so hard to appear absolutely healthy psychologically that he didn’t endorse a single sign or symptom of psychic distress. He rated his mood at ten out of ten. He insisted that he saw only happy scenes in the inkblots. No blood. No monsters. No storms. He said he ‘always’ gets along with people and that they do nothing to irritate him."
"So did the testing yield any useful data?" I asked.
"It did." She picked up a set of sheets from her desk and turned a page. "First things first: Billy is highly intelligent. His IQ tested full scale at 152. He’s in the extremely gifted range. In his case, that’s good news and it’s bad news."
"What’s the bad part?"
"The bad part is that his intelligence seems to exist in a moral vacuum. It may just make him a more cunning predator. On the projective sections of the test, his responses were highly egocentric. He saw people almost exclusively in terms of what they could do to satisfy his needs." She flipped a few more pages. "Billy was asked, for example, to tell a story about a drawing of a police officer chasing a man. The man is holding a fistful of money. Billy’s only comments were, ‘I wish I had that money. He’d never catch me.’ When the examiner coaxed him to say more about the scene, all he added was, ‘I want a gun like that someday, too.’"
"He didn’t say anything about what the man had done wrong?" I asked. "He didn’t offer any thoughts about what would happen to him if he were caught?"
She shook her head. "Nothing related to law, morality, or punishment." She looked at the report again. "A drawing of a baseball player lying on the ground between bases, clutching his knee, yielded, ‘I didn’t want to play baseball this summer, but my father made me. It’s a stupid game.’"
"He showed no interest in how the man had been injured?" I asked.
"None whatsoever," Mossberg said without looking up. "A third example: When he was asked to describe what was happening in a picture of a man leaving a room, obviously angry, with a woman in tears looking after him, he said, ‘She should stop crying. She’s loud, and it’s hurting his ears. He should go back and
make
her stop.’"
I cringed at that narrative, remembering how Tess, the surviving Bishop twin, had cried out while North Anderson and I were with Darwin Bishop in his study. Could little Brooke Bishop’s wailing have annoyed Billy enough to seal off her windpipe? "Did you question Billy directly about the loss of his sister?" I asked.
"In a general way," Mossberg said. "I asked him what had happened to Brooke."
"And?"
"He said she had stopped breathing."
"Did he show any emotion when he answered?" I asked.
"No."
"Did you sense he was suffering any guilt?"
"He insists he had nothing to do with it," she said.
"But you don’t believe him," I said.
"Well... no. Of course not."
"Why not?" I asked.
Mossberg looked at me askance. "I hadn’t heard anyone express doubt that Billy committed the crime. Mr. Bishop’s wishes were for a secure setting where his son could be held — away from the glare of the media — until trial. I assumed you would be helping to craft an insanity plea."
"Did Bishop say that? He expects Billy to stand trial for murdering Brooke?"
"Very clearly," Mossberg said. "Am I missing something? Is there confusion on Nantucket about whether Billy killed his sister?"
I took a deep breath, let it out. "Less than you might expect," I said.
Laura Mossberg walked me down the hall to Billy’s room, a space about the size of her office, but furnished with a smaller wooden desk, a desk chair, and a platform bed. Billy was lying facedown on the mattress, apparently asleep. He was wearing blue jeans and a white T-shirt. A young man about college age sat outside the room, reading a textbook.
"We have Billy on one-to-one observation, around the clock," Mossberg explained. "I should tell you that this unit wouldn’t normally provide services to someone with a history of violence like his. We admitted him at the request of our CEO. Mr. Bishop is a major donor to the medical center."
That didn’t surprise me. Darwin Bishop’s influence obviously reached far and wide. "I won’t need more than half an hour with him," I said.
"Feel free to ask for me when you’re finished," she said. She started back down the hallway.
I walked into Billy’s room. He rolled onto his back, flipped his straight, dirty blond hair out of his eyes, and stared at me. He obviously hadn’t been sleeping. "You would be
who?
" he demanded.
"Frank Clevenger," I said, staring back at him. "I’m a psychiatrist."
Billy’s ice blue eyes sparkled. He was sixteen and looked like a prototype adolescent, at the edge of boyhood and manhood, with fine features that promised to become handsome. The lines of his nose and jaw were almost feminine, suggesting fragility, but in another year or two, as his wiry body filled out, his broad shoulders adding impressive bulk, that hint of femininity would be the very thing that reassured women they could immerse themselves in him, rather than fear him — this Russian-American, bad-boy billionaire’s kid. That is, if he wasn’t in prison for life. "My dad sent you," he said.
"Not exactly," I said. "Your father gave me permission to see you. I’m working with the Nantucket Police Department."
Billy sat up, smiled. "He gave me your name before I left home," he said. "Trust me. He sent you."
The bravado in his voice reminded me of Billy Fisk, the teenager I had lost to suicide. I pictured Fisk sauntering around my office during his first visit, talking trash about how much respect he got on the streets. It took me months, and fifty or so meetings together, to get him to back off the tough-guy routine and talk to me about who tough his life had been. I should have taken things even slower. Because I had lost him somewhere on the journey into his pain. I closed my eyes, remembering the call I’d gotten that he had hung himself.
"Still with the program, doc?" Billy asked.
I opened my eyes. "I’m fine," I said. I noticed Billy’s forearms were marred by faded, haphazard scars where he had slashed at himself. "And maybe you’re right. Maybe your father sent me, after all." I pulled out the chair from under the desk, turned it toward the bed, and sat down.