The Ninth Session

by Deborah Serani

  “Hello?”

  “It’s Paula again. Listen, I just remembered something important and wanted to let you know.”

  “Okay,” I said, plucking Luke’s file out again.

  “I, uh—it’s gonna sound a little bit crazy.”

  “No, go ahead, Paula. With the kind of days I’ve been having, I doubt it’ll shock me.”

  “When I was working with Lucas, I felt like—well, I think he was following me around sometimes.”

  I bobbled the phone hearing this but yanked it back up from its cord before it landed on the desk.

  “What made you think that?”

  “I could swear I saw him in the grocery store where I shopped a few times. I don’t think he lived nearby, so that struck me as odd.”

  “Did you talk to him about it?”

  “Actually, I didn’t. To tell you the truth, I never felt comfortable working with him.” Karne paused a moment before continuing. “He wasn’t authentic in sessions. Didn’t really reveal himself, y’know?”

  “Yeah, I know what you mean.”

  “Well, I hope you can help reach him in ways my work couldn’t.”

  “Thanks for sharing this, Paula. It is important.”

  Supervision

  Tuesday, June 20th

  “

  I just want to start by saying I got this ear-worm thing going on.”

  “A what?” Prader asked.

  “You know, a song or a phrase that gets stuck in your head.”

  “Never heard it put that way, Alicia.”

  I arched my eyebrows. “Well, I think we need to talk about it.”

  “So, what is it?”

  “Double, double toil and trouble.”

  “Shakespeare.” Prader said. “Macbeth?”

  “Yes.”

  “Fire burn and cauldron bubble. I believe that’s how the rest goes.”

  “Double double toil and trouble. Fire burn and cauldron bubble.” I closed my eyes as I recited. “Yes, that’s it.”

  “When did this ear-worm start?”

  “On the drive here.”

  “So you find yourself thinking about this prose as you come to supervision?”

  “Mhmm.”

  “You think this related somehow to your work with Luke?”

  I nodded. “In supervision Saturday, I told you he admitted to killing that young man.”

  “Oh yes, I remember it well.”

  I readied myself for the next disclosure. I squared my shoulders and looked hard at her.

  “In analysis this week, he told me killed his mother’s cat.”

  Prader said nothing, but blinked her eyes several times.

  “I was beside myself. Disgusted.”

  “We know abuse of animals is common in males with rage, abandonment, and attachment issues.”

  “I know. And I see now that Luke is disturbed. And his previous therapist just told me she thought he was following her around.”

  She pressed her hands down on the desk and leaned closer to me. “Why do you want to work this case, Alicia?”

  Her question didn’t surprise me. I wondered the same thing. But I had time to move through the shock of Luke’s narrative over the last few days. I knew the details and subtleties of the case, but Prader was only learning the facts through my recounting of the sessions.

  I was in the room with Luke, which is the most important part of all.

  She wasn’t there to feel, sense, or know the treatability of this case.

  “I know this sounds totally off. But I feel therapy might be able to help him.”

  “Didn’t you just say you were beside yourself?”

  “Well...yes, I am, but not because I’m afraid of him. It’s true what he’s done is terrifying, but—”

  “This patient’s a loose cannon!”

  “I don’t think so. At least, he’s not right now.”

  Prader leaned back in her chair.

  “Look, what he did was horrifying. No doubt about it. He’s antisocial and a psychopath, but he’s not a predator. He wants to understand his behaviors.”

  “I believe you. But not him,” Prader signed.

  “I really wanna try with this patient.”

  Prader looked downward a long time before any kind of assurance returned to her face. “I’ll continue to supervise you on this case, but I don’t have a good feeling about it.”

  “Good. Because, Dr. Prader, I can’t do it without you.”

  “The minute you feel unsafe or in danger, you’ll terminate treatment. Immediately, right?”

  “Absolutely.”

  “The prognosis is poor here, Alicia.”

  “I know.”

  “Studies say only a small percentage improve.” Prader considered her words before speaking again. “What makes you think he’s treatable?” she asked.

  “The death of his mother. She was the source of his torment.”

  “And she’s gone now.”

  “Yes,” I replied. “There haven’t been any more urges or rages since her death.”

  Prader concentrated quietly as she listened.

  “He’s come to each session on time, is verbal and thoughtful. He wants to reduce his symptoms.”

  “So, you believe his mother’s death neutralized the murderous urges? But how certain can you be?”

  “I’m not. But I put together an emergency plan.”

  “Hospitalization?”

  “Yes. And I’m available around the clock if he needs to call or see me.”

  “Good plan.”

  “And if I’m in any danger, I won’t hesitate to call the police.”

  “If that happens, Alicia, his disclosures remain with you. You cannot tell anyone anything.”

  “I know,” I said.

  “Can you live with that?”

  “I’ll have to. If I want to work the case, that’s the package deal.”

  “I don't know, Alicia,” Prader said, sensing the limitations. “And what if he is stalking you? How are you going to deal with that?”

  “Right now, all I want to do is stabilize the treatment plan. I’ll work every piece and confront everything as it happens.”

  “Use analysis to trace the origins of trauma. And help him link his rage and his actions.”

  “Of course.”

  Prader sighed. “Murderous rage. It challenges us to think in ways, we ourselves, aren't used to.”

  “Did you see many patients like this at Riker’s?”

  “Oh, yes. Many. But only a couple ever really made gains in therapy.”

  I nodded.

  “The crucial part, of course, will be to see if Lucas can tolerate therapy, learn to understand his feelings, and change his maladaptive behaviors.”

  “That’s my goal. Develop self-awareness and self-control. Maybe even empathy.”

  “No small feat,” she said with her left eyebrow raised.

  I shifted the supervision back to the Shakespeare parallel.

  “In Macbeth, Shakespeare used witches to represent the evil in the world. Witches subverted the natural order of things. They’re outcasts, living on the fringe of society, shadowy and ghostlike.”

  “Do you think your patient possesses these qualities?”

  “Yes, Luke definitely feels like an outcast with his family. And his mother accused him of failing her by not working in the family business.”

  “So, he subverted the natural order of things,” Prader said.

  “Yes.”

  “But the witches in Macbeth also prophesized, Alicia. They warned and cautioned Macbeth throughout the play.”

  “You’re right.”

  “Maybe the witch’s incantation is more of a warning for you.

  I considered her interpretation.

  “You’re saying my subconscious is warning me of danger?”

  “Yes,” Prader said.

  I closed my eyes a
nd allowed my mind to flow into a reverie.

  “Like I said, I started thinking of it driving here, but I can’t figure out why.”

  “Did anything else unusual happen before you came here today?”

  “No,” I said after thinking for a moment.

  “Well, let’s keep this Macbeth thread on the analytic table.” Prader looked at her desk clock. “We have to stop for now.”

  “Okay.”

  “And you can call me anytime day or night if things get dicey.”

  As I left the hospital and walked to the parking garage, I saw the sky was thickening with clouds. I headed across the lot, unalarmed the Saab, and threw my belongings into the passenger seat.

  As I lifted the vinyl hood and clipped its bearings into place, I did it again.

  Just like I did earlier in the morning.

  I jammed my thumb in the bracket.

  I forgot I did that earlier, until the pain reminded again.

  It was then I recalled the Macbeth prose, linking the ear- worm to my work with Luke. And all at once the symbolism made sense.

  By the pricking of my thumbs,

  Something wicked this way comes.

  Tuesday Night

  I

  finished work early and grabbed a late afternoon nap but awakened with a start, feeling something wet and cold on my face.

  “What the hell—” Within seconds, I realized it was Shasta. “You scared the shit out of me, Nicole.”

  She couldn’t read my lips, but she didn't have to.

  “You forgot,” she said flatly.

  “Forgot what?” I tried to push Shasta off, but she kept nuzzling her snout all over me, jumping on the bed.

  “Dinner. You forgot me and the kids were coming for dinner,” she signed.

  “It’s not that I forgot. I just didn’t remember,” I signed to her.

  Nicole and I had similar features, pale freckled skin, brown eyes, and long chestnut hair, but I was a bit taller. I took advantage of my height and weight at that moment and hip-checked her onto the bed as I walked by.

  “Ow.” Nicole said aloud.

  I took my index fingers and dotted them down my cheeks, the sign for crybaby.

  “Any news from the police about Soraya's break in?”

  “Yes,” she said speaking, hoisting herself off the mattress. “But the kids can hear us, so let's sign.”

  Talking in sign away from the kids was a wise choice. Though Rebecca and Seth were only five years old, they were skilled Coda’s. Able to play and be busy, they also listened and monitored the environment, knowing when to offer help if needed. In fact, just as silence fell between Nicole and me, they appeared.

  “Aunt Alicia,” Rebecca said, poking her head into the doorway, “Where are those animal puzzles?”

  “Gimme a kiss first.”

  Rebecca gave me a peck on the cheek.

  “They’re in the closet by the front door, honey.”

  As she dashed away, Seth ran up and jumped into my arms. “I can’t find Elvis?”

  “Check the loft. But it’s hot up there. Bring him down and play here.”

  Seth jumped down and headed for the stairs like a bat out of hell.

  “Don’t pull his tail,” Nicole yelled out.

  My niece and nephew were treasures. Since Ryan and I never had children, they were as close to our own. Early in our marriage, Keith and Nicole were great about letting us be a part of the twins’ life. We were their god-parents, their Friday night babysitters. We also went to soccer games, karate practices, and dance recitals. That is, until Ryan got ill.

  When Ryan died, only Rebecca and Seth gave me any semblance of joy. Being with them was like a magic elixir. A medicinal tonic. As I watched Rebecca settle into her puzzle and Seth bound up the stairs, I drank the moment in.

  Nicole knocked into me on purpose, breaking the spell as she walked Shasta into the living room. Once there, she removed her leash and vest and put them on the couch.

  It was rest time. Shasta walked over to Rebecca, scooted herself to the floor, and stretched out by her legs.

  “Don’t eat my puzzle,” she said to the dog.

  Shasta looked away and groaned. Then her body twisted and seized.

  “She’s doing that coughing thing again, Mom,” Rebecca signed.

  “I know. She did it earlier this morning. Probably too much swimming in the pool,” Nicole signed back. “I’ll call the vet.”

  Nicole and I made our way into the kitchen.

  “What’s the update on Soraya’s house?” I asked.

  “Obviously, she’s upset. She asked if Keith would set up some cameras like we have at our house.”

  “How are the kids?”

  “We didn’t tell them anything about the break in. Just some stranger danger talk. Stuff like that,” Nicole signed.

  “Good idea.”

  “Detective Scott told Soraya that there weren’t any fingerprints left.”

  “No other clues?”

  “No.” Nicole changed the subject. “So why did you forget our lunch today?”

  “Just busy with work.”

  “You do three things. Over and over and over. You go to work. You go to supervision. And you make time for me and the kids. It’s not enough, Alicia,” Nicole signed.

  I nodded, knowing she was right.

  “You need more than just that,” she signed. “By the way, how’s that difficult case of yours going?”

  “If only I could tell you about it,” I signed. “But, all things aside, I do need to get out more.”

  Nicole moved closer and hugged me. I wanted to shut down and push her away, but I didn't. Instead, I let her hold me and I wrapped my arms around her tightly.

  Suddenly, a series of heavy thumps pounded above us from the attic.

  Then a high pitch scream filled the air.

  It was Seth.

  Nicole felt his frenzied steps within her body at the same time I heard his voice. We both ran from the kitchen.

  Rebecca, though, rolled her eyes, patted Shasta on the head, and continued doing her puzzle.

  “He’s such a troublemaker,” she said to the dog.

  By the time we reached Seth in the hallway, his cheeks were flushed, and his face was streaked with tears. He was dripping with sweat.

  “What? What?” Nicole signed.

  Seth’s hands moved so fast I couldn’t read them. Then he pointed upstairs and threw his hands around his mother.

  I shook Nicole’s shoulder. “What’s wrong?”

  Nicole picked herself up and slung Seth on her hip. She spoke to me as she brushed away his falling tears. “Seth said Ryan was talking to him upstairs.”

  “Uncle Ryan was talking to you, honey?”

  Seth nodded slowly under his sobs.

  “What did he say to you?”

  “He—he sc-ared me.”

  Nicole rubbed his chest and gave me a sideway glance.

  “How did he scare you?” I asked.

  “I was l-looking for Elvis. I couldn’t find him. I thought he went into the closet. So I went in there and then I saw Uncle Ryan.”

  “Uncle Ryan was in the closet?” Nicole signed.

  “Mhmm. Uncle Ryan told me Elvis wasn’t in the loft. He said Elvis was outside. He told me to look out the window.”

  “And did you?” I asked.

  “Mmmhmm. He’s by your car, Aunt Alicia.”

  “Let’s go upstairs and you can show Mommy and me.”

  “Noooo. I’m never, ever going up there again.”

  As Nicole comforted Seth, I walked to the side door and peeked through the blinds. There, by my car, was Elvis stretching in the grass.

  Dumbfounded, I opened the door and whistled for him to come in. I turned my attention to Seth as the cat trotted in.

  “It’s okay if you opened the window in the loft, Seth. It gets really warm up there.”

 
“I didn’t open it,” Seth replied.

  “You didn’t do anything wrong, honey. Elvis likes to jump from the roof to go outside,” Nicole signed.

  “I didn’t open it Mommy. It was open when I got there,” Seth said, insistent.

  “Well, it’s okay if you did open it,” I said, reaching to tousle his hair.

  Without warning, Seth smacked my hand aside.

  “No hitting,” Nicole signed.

  Seth slid off her lap and clenched his fists. “I told you. I didn’t open it. I. Didn’t. Open. It,” Seth said screaming.

  And with that, he dropped to the floor in frustration, breaking apart Rebecca’s puzzle with his kicks and punches. Within seconds, both kids went into meltdown mode, and Elvis bolted out of the room.

  Death had a way of distorting life.

  I was familiar with how the real and imagined collided. Seth was still deeply grieving, finding Ryan’s loss unbearable.

  I went upstairs to the loft to close the window before Elvis got out again. It was wide open to the sills. The heat was oppressive, even with the ceiling fan on. It was amazing Seth was able to stay up there as long as he did.

  The closet door was open with many of Ryan’s clothes scattered on the floor. By the armoire were several pairs of shoes—and on the bed was his favorite Mets jacket. Several of the photo albums were out too.

  “Oh, Seth,” I said gathering Ryan’s things, “I miss him too.”

  Before a wave of grief surged, I opened the armoire, put the items back, and placed the photo albums in their assigned spot. I hung the clothing back on the rod, trying to ignore the beads of sweat that streaked down my back.

  It took several tries, but I scooted the shoes with my feet back to into the closet and propped the jacket back on its rung on the door.

  Seeing there was nothing else to put away, I went to close the closet door. But when I sealed it shut, a dank, cloying scent filled my nose. It was the smell of decay—of the old, the unused, and the obsolete. And the odor knotted itself in my throat.

  I coughed several times but couldn’t clear my lungs. With no breath moving in or out, I started to choke. The roasting heat didn't help. I became weak. Light-headed. And nauseous.

  Desperate for air, I stumbled toward the open window and gasped violently, but my vision blurred, and my hearing muted.

  As I fell to the floor, the closet door opened.