I Know This Much Is True

by Wally Lamb

  She smiled. “Look. You know what your problem is? Can you calm down a minute and listen to something? You’re making the assumption that this is the worst place in the world for him to be and that’s not necessarily the case. And at any rate, there’s nothing you can do about it, anyway. You’re just going to have to take a leap of faith.”

  I sucked in a couple of deep breaths. Took a ten-second time-out. “You’re a real company gal, aren’t you?” I said.

  She laughed so hard, she snorted. “I’ve been called a lot of things down here, Domenico, but never—”

  “You are, though. You don’t look the part, but you’re walking the walk, talking the talk. You spout the party line just like the rest of them.”

  She shook her head. Kept smiling. “Now there’s a low blow,” she said.

  “Hey, look—”

  “No, you hey look. Let me have the floor for half a second. In the first place, paisano, I’m a woman, not a gal. Okay? If we’re going to be working together on this, you’re going to have to remember that distinction. ‘Gal’ sounds like someone’s horse, which I’m not. All right? And in the second place—”

  “Who’s your supervisor?” I said.

  She smiled, skimmed her hand across the top of her crewcut. “Why do you want to talk to my supervisor?”

  “Because if I have to get someone with a little authority to pick up the phone and call his goddamned doctor, then that’s what I have to do. I want him out of here today.”

  Her face remained unperturbed. “My supervisor is Dr. Barry Farber.”

  “And where’s he at?”

  “Dr. Farber’s at a conference in Florida. She’s delivering a speech there.” She smiled at the surprise on my face. “Gotcha again. Didn’t I, Domenico? Funny thing about professional women these days, isn’t it? The world is crawling with them.”

  “Who’s her supervisor?” I said.

  “That would be Dr. Leonard Lessard. One of yours.”

  “Hey, look,” I said. “I’d appreciate it if you just cooled it on the sarcasm, okay? I’ve got one or two things I’m trying to deal with here without you—”

  She tapped her finger again on the signature in front of me. “Dr. Lessard’s the Deputy Commissioner for Clinical Services. He’s the guy who ordered the transfer.”

  I stood up. Opened my mouth. Shut it again and sat back down.

  “I tell you one thing,” I said. “If my brother gets so much as a scratch while he’s in this place—”

  “He won’t,” she said. “I promise you. And you’re right, he is scared. And I can see you’re scared, too, which is probably why you’re being so obnoxious. But I want to tell you something. Are you listening, now? Can you really listen to me here, Domenico?”

  “Dominick,” I told her again. “My name’s Dominick.”

  “Dominick,” she said. She sat there waiting.

  “All right. I’m listening.”

  “You might be right,” she said. “Your brother might very well do better over at Settle than here at Hatch. Security’s tight here, by necessity; paranoiacs tend to have a hard time with all the watching and monitoring and security checks. But there’s a misconception about this place—that it’s the house of horror or the torture chamber or something. It’s not. Are there problems on the wards? Sure there are. Every day. Does anyone really want to be here? Uh-uh. Club Med it isn’t. But overall, the care is really pretty decent. Pretty humane.”

  I let go a laugh. “I don’t want to burst your bubble or anything, but this place is so decent and humane that last night I got my gonads pushed back up into my gut by one of your hired goons. I got real humane treatment down here. You want to know why I’m wearing these stupid pants you were laughing at before? Because I’m black and blue and swollen. I can hardly walk because of one of the compassionate guards you got down at this place. And I didn’t even get beyond the locked steel doors.”

  “I know, I know,” she said. “I saw the tail end of that. I’m sorry. That shouldn’t have happened, no matter how much of an asshole you were being. But just because one guard on the night shift thinks he’s Rambo, that doesn’t condemn this whole hospital. In the first place, the guards pretty much stay in the security areas unless there’s a problem. They don’t hang out in the wards; they have pretty limited contact with the patients, actually. And second, I know this place—especially Unit Two where your brother is. He’s in the best unit here. I may sound like a ‘company gal’ when I say this, but the people in Unit Two really do care. I mean it. And, like I told you before, Dr. Patel’s a real sweetheart. He’s lucky to have—”

  “Fine,” I said. “Great. But it’s a mistake.”

  “Hey, paisano,” she said. “It’s not a mistake. Let me walk you through it. Are you listening?”

  “Yeah, I’m listening,” I said. “Just don’t talk in initials. And don’t say stuff like, ‘He was a political appointee,’ or, ‘Oh, it’s Jimmy Lane fallout,’ when I don’t even know what you’re goddamned talking about.”

  She reached over and grabbed the candy bar I’d bought. Peeled off the wrapper at one end. Broke me a piece and took one for herself. “Okay, let me spell it all out,” she said. She glanced quickly at the intercom box on the wall. “Don’t quote me on any of this,” she said. “All right?”

  She explained her theory first: that the order to transfer Thomas to Hatch had probably come down from Hartford as a result of all the publicity his self-mutilation had caused. “I knew he was in trouble the minute I saw he’d landed on the front page of the Courant,” she said. “And then, when it went national—when it started showing up in papers like USA Today . . .”

  I told her about the Enquirer, Inside Edition, Connie Chung.

  “Shit,” she said. “The state hates that kind of negative publicity. You remember Jimmy Lane, don’t you? The psych patient who strangled that college kid up on Avon Mountain?”

  “In front of her girlfriends, right?”

  She nodded. “God, what a horror show that was. I don’t know if you remember this part of it, but Jimmy Lane was on a day pass from Westwood—on a hike with a supervised group—and he just wandered away from the rest of them. Just grabbed that poor kid. The guy had no history of violent behavior—nothing at all in his record to indicate that he might be anything but passive. He just snapped that day up there. That case set the department back years. Reinforced all the old stereotypes about the mentally ill—that they’re all psychotic killers, lurking in the shadows. That no one’s safe around them. It was a public relations nightmare. Remember all those letters to the editor? And the newspaper and TV editorials? I saw one bumper sticker: ‘Electric Fry Jimmy Lane.’ Good God, everyone in the state wanted blood. And when the insanity defense prevented a lynching, everyone wanted to lynch the system instead. And the system got pretty touchy about it. Pretty media-weary. See what I’m saying?”

  “He’s here, isn’t he? Lane? Didn’t he get sentenced to this place?”

  She ignored the question. “NGRI—not guilty by reason of insanity—became a real political hot potato because of that case,” she said. “So, to save face, the governor made some heads roll. He fired the commissioner. They retooled the entire department. And then, voilà, the PSRB was born.”

  “What’s that? The PSRB? You mentioned them before.”

  “The Psychiatric Security Review Board,” she said. “Very conservative and very media-conscious. They’re powerful, too. They wield what amounts to sentencing power.”

  Since the Review Board came into power, Sheffer said, lawyers had begun backing away from the insanity plea, even when it was legitimate. Psychiatric patients with charges against them were being advised to go through the criminal justice system instead: bite the bullet, go to a state prison, do one-half or one-third of their sentence, and then get out because of overcrowding, or on good behavior. “If the PSRB gets ahold of someone on the insanity plea,” Sheffer said, “they can keep him at Hatch indefinitely. Which they’
ve tended to do. That’s been the pattern so far.”

  “So what are you saying?” I asked her. “That they should arrest Thomas and send him to prison for what he did? That’s ridiculous.”

  “I’m not saying that. Not at all. If he did prison time, the psychological treatment would be minimal—a Band-Aid approach, and that’s only if he was lucky. And he needs treatment, Dominick. No doubt about it, your brother is a very sick man. But if it’s not a criminal matter, then the Review Board are the ones who are going to decide when he gets out of here. And like I said, they tend to be conservative. And jittery about the media. It reads better, you know? Freddy Kruger’s locked up and all’s well. Come out, come out, wherever you are. Have you seen today’s paper yet?”

  Had I? I couldn’t remember.

  Her phone rang again. While she spoke to the person on the other end, she unfolded a copy of the Daily Record, thumbed to an inside page, and pointed:

  COMMIT 3 RIVERS SELF-AMPUTEE TO FORENSIC HOSPITAL.

  My stomach muscles clenched. Jesus Christ, I thought. Here we go again. At least he wasn’t front-page news anymore. He was front-page second-section news. Maybe Thomas’s fifteen minutes were almost up.

  The article implied that if my brother hadn’t gone into shock when he amputated his hand, he might have started hacking away at other people. It made him sound like the kind of psychopath who did belong at Hatch. It made a case for it. The reporter quoted some talking head from Hartford about public safety—about how patients’ rights “coexisted” with the rights of the community to a safe environment, but that the latter was priority number one.

  It was bullshit: Thomas as a public menace. I knew it and so did any doctor who’d ever worked with him. But I was beginning to get what the deal was. With Sheffer’s help, the situation was beginning to clarify itself like one of those Polaroids that develops in the palm of your hand: my brother’s being locked up at Hatch was about public relations. Order restored. They’d slammed the door on him, and now this Psychiatric Review Board was going to throw away the key. Okay, I sat there thinking. Now I’ve got it. Now, at least, I have a hand to play.

  “I’m sorry, Dominick,” Sheffer said, after she’d hung up the phone. “I know I’m throwing a lot at you here—a lot more than the state of Connecticut wants me to, actually.”

  “Who cares what the state of Connecticut wants?” I said.

  “Well, for starters, I have to,” she said. “Unless you’re interested in supporting me and my daughter. Look, let me back up a little—tell you a little bit about the legality of what’s already happened and what you can expect now. Okay?”

  “Yeah,” I said. “Okay.”

  Thomas had been admitted to Hatch on something called a Physician’s Emergency Certificate, which the surgeon at Shanley Memorial had put into motion.

  “That’s the fifteen-day paper, right?”

  “Right,” she said. The hospital now had fifteen days to observe the patient—to determine over a two-week period if he was dangerous to himself or others. “The fifteen-day paper’s airtight, Dominick,” she said. “There’s no way in hell you’re getting your brother out of here today. It’s out of your hands. Thomas is going to be here for fifteen court-ordered days, minimum.”

  “This sucks,” I said. “This just sucks.” I got up, walked back over to the window. The patients in the rec area had gone inside. “There’s no way to fight this fifteen-day thing?”

  “There is, actually, but it’s a long shot. A waste of time, probably. Your brother or you could request a ‘probable cause’ hearing. Then the hospital would have to prove that Thomas is dangerous to himself. But think about it: all a judge has to do is look down at his stump. There’s the proof of probable cause, right? You want my advice?”

  I was still looking out the window. “Go ahead,” I said.

  “Just ride out the fifteen days. Let us take care of him, observe him, see how well he starts coming around now that he’s gotten back on his meds. This is probably going to be the safest place for him.”

  “Oh, yeah, right,” I said. “In with a bunch of psychotics with violent histories.”

  “That’s not fair, Dominick, and it’s not accurate, either. There are all kinds of psychiatric patients here—not all of them violent by a long shot. Sooner or later you’re going to have to face the fact that the person who’s most dangerous to Thomas is Thomas. But he’s on close watch. For the next forty-eight to seventy-two hours, there’s going to be an aide within ten feet of him, twenty-four hours a day. If he’s suicidal, someone’s going to be there.”

  “He’s not suicidal,” I said.

  “Well, all right, suppose he were.”

  “So then what?” I said. “What happens after the fifteen days?”

  She said Unit Two’s evaluation team would file a report with the probate judge. She’d have input into it. And Dr. Patel, and Dr. Chase, and the head nurse of the unit. The recommendation would be that he should be discharged, or transferred to another facility, or kept here under the jurisdiction of the Review Board.

  “Okay, let’s say the judge hands him over to this Review Board. What do they do?”

  “They commit him.”

  “Where?”

  “Here, I said. At Hatch.”

  “For how long?”

  Her eyes fell away from mine. “For a year.”

  “A year!”

  Her hands flew up in defense. “Don’t kill the messenger, paisano. He’d be here for a year, and then his case would come up for annual review.”

  I sat there, slumped in the chair, my arms bracketed around my chest. “A year,” I said again. “How the hell am I supposed to look him in the eye when I see him today and say, ‘Okay, Thomas, here’s the deal. They got you for the next 15 days and maybe for the 365 days after that’? How am I supposed to tell him that?”

  “Dominick?” Sheffer said. “That’s another thing.”

  “What is?”

  “Visiting. You can’t see him yet.”

  Visits were restricted, she said, because of the maximum-security status. Thomas and she would work up a list of potential visitors—up to five people. A security check would have to be run on everybody on the list. We’d have to wait until we were notified. It would take about two weeks to get clearance.

  “Two weeks? In two weeks, he’ll be out of here!”

  She reminded me that that was not a given. Suggested I lower my voice a little.

  “So you’re saying that for two weeks, he just twists in the wind down here. He can’t even see his own brother? Jesus, that’s great. He probably will be suicidal by then.”

  She shrugged an apology. “There’s nothing I can do about it,” she said. “Except fill in the gaps as much as possible. Act as your liaison.” She smiled. “Which I’ll be very happy to do. You can call me whenever you want to. Whenever you need to. You guys can communicate through me until your clearance comes through.”

  I nodded, resigned. I felt suddenly, profoundly, sleepy.

  She spent the rest of the time describing Thomas’s surroundings, his daily routine: what the rooms were like, how they ran things at mealtimes, how patients had access to computers and arts and crafts and college extension programs. I couldn’t really listen. In the past thirty-six hours, I’d spent all my anger and outrage. I was running on empty.

  On our way out, we bumped into this Dr. Patel. Middle-aged woman: salt-and-pepper hair rolled into a bun, orange sari underneath her lab coat. “A pleasure,” she said, extending her hand. Dr. Patel said she was in the “information-gathering stage” of her treatment of my brother. She’d call me after she’d read through all his records and she and Thomas had had two or three sessions. Perhaps I would be willing to share some personal insights that might augment his medical history?

  Sheffer escorted me back toward the main entrance; it felt like I was sleepwalking. “I’ll go in and see him right after you leave,” she promised. “I’ll tell him you were down here tryin
g to visit him. Anything else you want me to tell him for you?”

  “What?”

  “You know something? You look like you need to get some serious sleep. I asked you if there was anything you wanted me to tell your brother for you.”

  “No, I guess not.”

  “You want me to tell him you love him?”

  I looked at her. Looked away. “He knows I love him,” I said.

  Sheffer shook her head and sighed. “What is it with you guys and the ‘L’ word, anyway?” she said.

  She was overstepping her ground again, but I was too tired to resist. “All right, fine,” I said. “Tell him.”

  We shook hands. She told me to call her anytime. Asked me where I was headed.

  “Where am I headed now?” I shrugged. “Home, I guess. I guess I’ll just go home and disconnect the phone and crash. You’re right. I haven’t slept for shit.”

  “Oh,” she said. She looked around, waved to the guard at the door, and spoke a little lower. “I thought maybe you were going to check things out at the doctor’s.”

  “What for? You told me Ehlers isn’t even his doctor anymore. That it’s out of my hands.”

  “I didn’t mean Dr. Ehlers,” she said. “I meant a medical doctor. Get those bruises of yours looked at. Have a few pictures taken while you’re still swollen.”

  I looked at her, my face a question.

  “In case, you know, you needed some documentation. A little leverage for later on. A bargaining tool with the state of Connecticut. . . . Of course, you didn’t get that idea from a company gal like me. I’d never suggest something like that.”

  Halfway toward the entrance, I turned around to look. She was still standing there. A jowl-faced guard and a metal detector stood between us. “See you later, Mr. Birdsey,” she called. Gave me a thumbs-up. “Shalom! Arrivederci!”

  10

  1962

  Thomas and I have been to three different states: Massachusetts, Rhode Island, and New Hampshire. Four, counting Connecticut.