Hush Little Girl

by Lisa Regan

  Kneeling in front of Emily, Josie waited for the next time Emily had to gulp in a breath, and said, “Emily, can we talk?”

  Another shriek pierced the air. Emily’s eyes locked onto Josie’s in a look of terror and powerlessness. She couldn’t stop it, Josie realized. The feelings were too big. There was no controlling them. There was only waiting until they petered out. Josie sat cross-legged in front of Emily and extended a hand, palm facing up. The shrill cries continued but in Emily’s eyes, Josie saw the little girl trapped inside the hysterical body. Emily’s fingers reached out and touched Josie’s palm. Leaning closer, Josie dipped her head. Gently grasping Emily’s fingers, she brought them up and guided them along the scar on her face. She started at the top, near her ear, and traced it down to under the center of her chin, then started again.

  “Emily,” Josie said softly. “You can survive the bad things. I promise you can.”

  After a long moment, Emily’s fingers worked on their own, running over the scar. Josie’s neck ached from staying in the same awkward position for so long, but Emily’s cries had receded to moans and the occasional hiccup, so Josie held herself still. Finally, a raspy whisper came from Emily’s throat. “One, two, three…” At six, she stopped and pulled her hand away from Josie’s face.

  Josie sat up straight and smiled. Emily clutched her stuffed dog to her chest. Her skin was pink and splotchy, eyes glassy. A look of complete exhaustion passed over her face. Josie said, “What happened, Emily? Why did you get so upset?”

  “I couldn’t help it,” said Emily.

  “I know.”

  “Sometimes I can’t stop the… distress. That’s what Mama calls it. Distress. Like bad, mad, and sad feelings all at once. They take over my body. I don’t want to have them, but I can’t stop them.”

  “What did your mom tell you to do when you feel distressed?” Josie asked.

  Emily started to rock slowly back and forth. “She says I have to ‘tolerate’ it. Holly says that means I have to let the feelings feel until they’re all done.”

  “That actually makes a lot of sense,” Josie said.

  “I don’t feel upset now.”

  “That’s good. Do you want to lay in the bed?”

  Emily nodded. Josie offered her a hand and helped her to standing. Josie tucked her beneath the covers. “Your things aren’t in your bag anymore,” she said. “Was that why you got upset? Did someone take them?”

  “I put them on the table next to my water cup. That lady was here but she fell asleep in her chair. I just wanted to see them. Then this other lady came with a cart filled with all kinds of cleaning stuff. She had a trash bag, and she wiped her hand across the table and right into the bag. I tried to tell her to stop, but the feelings came, and I—”

  Her chest rose and fell more quickly so Josie cut her off. “I understand. I’m very sorry, Emily.”

  “I asked the computer lady and the doctor to get you. You’re the police. Maybe you could get my things back.”

  Josie felt a little stab of pain in her chest. She couldn’t imagine finding the five small items in the hospital’s trash, and it would be hard to replace them. Why had they been so important to Emily in the first place? Lorelei hadn’t allowed television or electronics, but both girls had plenty of toys, books, and arts and crafts supplies. They obviously had not wanted for much. Josie made a mental note to mention it to the psychologist when he or she came to do their consult. To Emily, she said, “I can try to find them, Emily, but there is a very good chance I won’t be able to do so. This is a big hospital, and they have a lot of trash. Right now, we’re trying to find the person who hurt your mom and sister.”

  Josie sensed that Emily wanted to argue, but fatigue was taking over. Her eyelids drooped and snapped back open as she tried to stay awake. “Okay,” she said, resigned. “But can you stay in that chair and make sure nobody takes any of my other stuff?”

  “Emily, I would love to, but I have a lot of work—”

  “Can’t you do it on your computer? Like that lady? Just until they take me to foster care?”

  Josie looked at her watch. It was after one in the morning. The only work she’d be doing at this hour would be from her computer, chasing the leads she’d told the team about. She could have Noah bring her laptop to her. Josie smoothed the hair away from Emily’s forehead. Her skin was feverish. “Okay, I’ll stay for tonight.”

  Thirteen

  Josie sat beside Emily’s bed with her laptop open in front of her. One of the nurses had turned off the harsh overhead light, but it only succeeded in dimming the room slightly. Neither the light nor the noise of the Emergency Room on a Friday night just outside kept Emily awake. Curled on her side, her little stuffed dog clutched in her arms, she snored lightly. She hadn’t moved since Josie tucked her in nearly two hours earlier. Josie was supposed to be scouring databases and other internet resources for information on Lorelei and her life, but she couldn’t take her eyes off Emily.

  “She’s an old soul, isn’t she?”

  Dr. Nashat’s voice startled Josie. He stood in the doorway, smiling.

  “Yes,” Josie agreed. “You’re still here?”

  “Until seven a.m.,” he said. “The psychologist is here.”

  Josie looked back at Emily. “Surely, you don’t want to wake her now?”

  He shook his head. “No. Maybe you could talk to her while she’s here, especially since Emily seems to have bonded to you. I’ll ask her to come back later in the morning—at a more reasonable hour—for a formal consult. The social worker is coming back then, too.”

  Josie stood, left her laptop on the chair, and followed Dr. Nashat into the hall. She pulled up short when she saw Dr. Paige Rosetti standing outside. Her long wavy blonde hair was pulled back in a ponytail, and her thin frame was draped in a long tan linen dress accented by a white bolero sweater. Over one shoulder hung a messenger bag. Josie had gone to high school with Paige’s daughter and had had to enlist her help during a case the year before. They’d had a connection. In a moment of weakness, Josie had shared some of her deepest fears with Paige. In spite of the embarrassment she felt over that moment, Josie genuinely liked the woman. Noah and Gretchen had been after her for months to go to therapy to work through some of her unresolved childhood issues. Paige’s name had come up more than once.

  “Detective Quinn,” said Paige with a warm smile. “How nice to see you. I wish it was under different circumstances.”

  “So do I,” said Josie.

  “I’m sorry I’m so late. I was at Geisinger on another matter that needed my attention. It took far longer than I anticipated. Dr. Nashat said he didn’t want to wake the patient, but if you have a minute, I could take some initial notes and come back in a few hours, after the sun is up.”

  “Sure.”

  Paige looked around, as if for a place for them to sit. “Would you like to go to the staff lounge?”

  “I don’t want to leave Emily that long. Here.” Josie found the linen bin that Marcie had used earlier and pulled it over. “You can put your laptop here.”

  Paige laughed. While she removed her laptop from her bag and booted it up, they exchanged pleasantries. Josie asked about Paige’s daughter and Paige asked about Josie’s grandmother. Then it was time to get down to business. Josie described the case, the day, the circumstances of locating Emily and her unusual behavior throughout. Paige’s expression didn’t change as she listened, tapping away on her laptop the entire time. When Josie finished, she stopped typing and looked up, her brow furrowed. “Let’s start with her mother. You said Lorelei Mitchell?”

  “Yes,” Josie said. “Did you know her?”

  Paige folded her arms over her chest. “We went to the University of Pennsylvania together. Grad school. We were studying for our PhDs. She’s quite a bit younger than I am, but I took a break between getting my master’s degree and my PhD. That’s how we ended up in the program together.”

  Josie felt a spike of excitement.
“Were you friends?”

  “I wouldn’t call us friends, but I knew who she was. She went on to specialize in adolescent and child psychology, but she was primarily focused on areas that included oppositional defiant disorder, OCD, ADHD, that sort of thing. She was very interested in cognitive behavioral therapy.”

  “For non-psychologists, if you would,” Josie said.

  Paige laughed. “CBT is a form of therapy that focuses on changing behaviors that are based on cognitive distortions.”

  “Dumb it down a little more,” Josie said.

  Now Paige gave a full-throated laugh, head tossed back, mouth wide open. “Most therapy is based on sort of unpacking your past, right? Exploring your childhood or things that have happened to you in the past that shape you emotionally and cognitively.”

  “I get it,” Josie said.

  “CBT is different. It assumes that your behaviors are based on distorted thinking or behaviors, and it tries to help you change them. It proposes strategies and coping mechanisms to meet those behaviors exactly as they are in your life.”

  “Was Lorelei good at it?”

  “I don’t know,” Paige answered. “We lost touch after the PhD program. I had been splitting my time between Philadelphia and here while I completed the program. Lana and my husband were here in Denton—this is where we lived—so once I got my PhD, I came back permanently. Lorelei stayed in Philadelphia. I’m surprised to learn she’s even here. I thought she’d be working for a large hospital by now, maybe teaching, speaking at conferences. She was very ambitious.”

  “Her license was revoked twenty years ago,” Josie said.

  “Oh my. Do you know what for?”

  “I haven’t found out yet. What can you tell me about Emily?”

  Paige glanced down at her notes. “It sounds like she has obsessive-compulsive disorder. I’m no expert, but the counting, the hoarding, the meltdown—those are pretty classic signs.”

  “What do you mean?”

  Paige closed her laptop. “People think of OCD as this disorder in which the person who has it is simply excessively clean, or that they insist on symmetry, right? Someone will say, ‘oh, I have to straighten that painting out because it’s bothering my OCD,’ or ‘I keep my house so clean because I have OCD.’”

  “I’ve heard people say things like that, yes,” Josie agreed.

  “OCD has nothing whatsoever to do with cleanliness.”

  “Really?”

  “Really. It’s about certainty. A person with OCD usually has some form of intrusive thoughts or obsessions. Typically, they don’t make sense. For example, if I don’t step on my bathroom floor tiles in a certain order every time I’m in there, my friend might die. Or if I don’t repeat the same phrase fifty-two times in my head, then my house might burn down. OCD is illogical that way, but the main thing to understand is that the obsessive thought will cause the person anxiety. In terms of the examples I just talked about, you would not want your friend to die or your house to burn down, right?”

  “Right.”

  “So you have to do something to relieve that anxiety you’re feeling. That’s where the compulsion comes in.”

  Josie said, “The compulsion is stepping on the tiles in a certain order or repeating the phrase.”

  “Yes! Exactly. If you believe that stepping on your bathroom tiles in a certain order is going to prevent your friend’s death, then doing that is going to relieve the anxiety you have which comes from worrying about your friend dying. The problem is that even if you step on those tiles in the perfect order, there’s always this little voice in your head that is nagging and asking, ‘Are you sure you stepped on those tiles in the right order?’”

  “It makes you go back and do it again and again,” Josie said. “Because the more your mind asks the question, the more uncertain you become.”

  “Precisely. So you keep carrying out the compulsion. It’s all very ritualistic, and it takes so many different forms. It sounds like Emily has some intrusive thoughts and compulsions surrounding counting and hoarding. The problem is that no matter how many times a person with OCD carries out their compulsion, that anxiety is never going to go away because it’s based on distorted thinking. That’s why trying to reason with them or talk them out of their thoughts or compulsions won’t work. Their brain is misfiring. Telling someone with OCD not to think obsessive thoughts or engage in the compulsive behaviors would be like telling a diabetic patient to produce more insulin.”

  “You said hoarding,” Josie noted. “But she had five very random little objects. That hardly seems like hoarding.”

  “Hoarding doesn’t always mean collecting hundreds or thousands of objects. What Emily was doing is a form of hoarding. Those objects are meaningless, aren’t they?” Paige argued. “Most people would think they were trash. In fact, obviously housekeeping thought they belonged in the garbage. Yet she was hoarding them—keeping them—because to get rid of them would cause too much anxiety and stress. This is the distorted thinking. The brain is misfiring. Those items took on some significance to Emily, making it very difficult for her to part with them. The voice in her head was likely saying something like, ‘if you throw that away, something bad will happen.’ It’s very nonsensical. That’s why cognitive behavioral therapy works so well to change the behaviors and thinking.”

  “What about the meltdown?” Josie asked.

  “OCD provokes a fight or flight response. While you or I might only have a fight or flight response to something like being assaulted, someone with OCD will have that response to something that seems very minor—like these objects being thrown away. Again, it’s the brain misfiring, telling her that losing those objects is a life-or-death situation when it’s not. Believe me, she can’t control it. Stress and trauma, like the kind she experienced in the last twenty-four hours, will always make the obsessive thoughts and compulsions worse. OCD can be difficult to manage in the best of circumstances, let alone after a traumatic event. To be honest, she was lucky that Lorelei was her mom. She would probably be much worse without Lorelei to—”

  Paige broke off and looked at the floor. Lines creased her face. Neither of them needed to say it. Emily was now a lot worse off without Lorelei. Clearing her throat, Paige changed direction. “The trick with cognitive behavioral therapy and OCD is exactly what Emily told you: if you can tolerate those feelings, eventually they decrease and even go away. For example, if she was afraid to touch a railing, you’d make her touch it over and over again and just sit with the feelings until her brain righted itself and realized that touching that railing isn’t going to make something bad happen. The worst thing you can do is give in to the compulsions.”

  “So I shouldn’t be digging through the dumpsters out back for a stone, sequin, feather, birthday candle and milk bottle cap?”

  Paige smiled. “No, I would not recommend it.”

  “What else do you remember about Lorelei?”

  “Not much other than that. As I said, we went our separate ways after the PhD program. I went into private practice here. I had no idea she was even in Denton. When did you say her license was revoked?”

  “Twenty years ago.”

  “How strange,” said Paige. “That must have been devastating for her. She was extremely passionate about her work.”

  “Do you remember if she had any family or friends she was close with?”

  “No, I don’t, I’m sorry.”

  “Have you ever heard of a Dr. Vincent Buckley?”

  Paige shook her head. “That name doesn’t sound familiar.”

  Josie thanked her for her time. Paige agreed to return in the morning to speak with Emily directly. Josie returned to the dimly lit room where Emily’s snoring continued unabated. She was grateful that the girl was getting some rest. Soon enough, she would wake again to a world that was completely shattered.

  Fourteen

  It took a couple of hours of searching, and Josie had to subscribe to the Philadelphia Inquirer, but she
found an article about Lorelei from twenty years earlier. The headline read: Pennsylvania Psychologist Loses License After Preventable Murder–Suicide. Josie gasped and sat up straighter in the guest chair. She glanced over at Emily to make sure she was still asleep, and read on.

  The Pennsylvania Board of Psychology has revoked the license of Dr. Lorelei Mitchell after a long-time adolescent patient killed his mother in her home and then later attacked Dr. Mitchell at her office before killing himself. The patient had a history of oppositional defiant disorder and schizoaffective disorder with paranoid delusions. He was also being evaluated for bipolar disorder at the time of this tragedy. The patient’s estranged father had filed a complaint with the disciplinary board following the incident. After a review of Dr. Mitchell’s chart, the board deemed the tragedy “foreseeable and preventable”, given Dr. Mitchell’s credentials and experience with adolescent patients dealing with these and other similar disorders.

  “It’s unthinkable that something like this could happen,” said the patient’s father. “Dr. Mitchell holds herself out as an expert in ODD, schizophrenia and bipolar disorder, and yet she failed my son. She treated him for years. She knew him well enough that she should have seen this coming and had him locked up so he couldn’t hurt anyone.”

  Dr. Mitchell, who is still recovering from her extensive injuries, had no comment.

  “Good lord,” Josie muttered under her breath.

  That could explain the thirty-four stab wounds. Josie thought about the trajectory of Lorelei’s life: losing her mother at nine; managing to become a successful psychologist only to be nearly killed by a patient; losing her license, and now, she and her daughter had been savagely murdered, leaving her other daughter alone, just like she had been. Sometime during her life, Lorelei had met someone and had his children. Had he abused Holly? Josie thought of the antipsychotics in the kitchen cabinet. Or had it been Lorelei?