"Needless to say, Dr. Scarpetta," Dr. Masterson began in his slow, precise way as he opened a thick file folder, "I am dismayed by Al Hunt's death."
"Are you surprised by it?" I asked. "Not entirely."
"I'd like to review his case as we talk," I said. He hesitated long enough for me to consider reminding him of my statutory rights to the record. Then he smiled again and said, "Certainly," as he handed it over.
I opened the manila folder and began to peruse its contents as blue pipe smoke drifted over me like aromatic wood shavings. Al Hunt's admission history and physical examination were fairly routine. He was in good physical health when he was admitted on the morning of April tenth, eleven years ago. The details of his mental status examination told another story.
"He was catatonic when he was admitted?" I asked. "Extremely depressed and unresponsive," Dr. Master-son replied. "He couldn't tell us why he was here. He wasn't able to tell us anything. He didn't have the emotional energy to answer questions. You'll note from the record that we were unable to administer the Stanford-Binet or the MMPI, and had to repeat these tests at a later date."
The results were in the file. Al Hunt's score on the Stanford-Binet intelligence test was in the 130 range, a lack of smarts certainly not his problem, not that I'd had any question. As for the Minnesota Multiphasic Personality Inventory, he did not meet the criteria for schizophrenia or organic mental disorder. According to Dr. Masterson's evaluation, what Al Hunt suffered from was "a schizotypal personality disorder with features of borderline personality, which presented as a brief reactive psychosis when he cut his wrists with a steak knife after locking himself in the bathroom."
It was a suicidal gesture, the superficial wounds a cry for help versus a serious attempt to end his life. His mother rushed him to a nearby hospital emergency room, where he was stitched up and released. The next morning he was admitted at Valhalla. An interview with Mrs. Hunt revealed that the incident was precipitated by her "husband losing his temper" with Al during dinner.
"Initially," Dr. Masterson went on, "Al would not participate in any of the group or occupational therapy sessions or social functions the patients are required to attend. His response to antidepressant medication was poor, and during our sessions I could barely get a word out of him."
When there was no improvement after the first week, Dr. Masterson continued to explain, he considered elec-troconvulsive treatment, or ECT, which is the equivalent of rebooting a computer versus determining the reason for the errors. Though the end result may be a healthy reconnecting of brain pathways, a realignment of sorts, the formatting "bugs" causing the problem will inevitably be forgotten and, possibly, forever lost. As a rule, ECT is not the treatment of choice in the young.
"Was ECT administered?" I asked, for I was finding no record of it in the file.
"No. Just at the point when I was deciding I had no other viable alternative, a small miracle occurred during psychodrama one morning."
He paused to relight his pipe.
"Explain psychodrama as it was conducted in this instance," I said.
"Some of the routines are done by rote and are warm-ups, you might say. During this particular session, the patients were lined up and asked to imitate flowers. Tulips, daffodils, daisies, whatever came to mind, each person contorting himself into a flower of his private choosing. Obviously, there is much one can infer from the patient's choice. This was the first time Al had participated in anything at all. He made loops with his arms and bent his head." He demonstrated, looking more like an elephant than a flower. "When the therapist asked what flower he was, he replied, 'A pansy.' "
I said nothing, experiencing a mounting wave of pity for this lost boy we had conjured up before us.
"Of course, one's first reaction was to assume this was a reference to what Al's father thought of him," Dr. Masterson explained, cleaning his glasses with a handkerchief. "Harsh, mocking references to young Al's effeminate traits, his fragility. But it was more than that."
Slipping his glasses back on, he looked steadily at me. "Are you aware of Al's color associations?"
"Remotely."
"Pansy is also a color."
"Yes. A very deep violet," I agreed.
"It is what you get if you blend the blue of depression with the red of rage. The color of bruises, the color of pain. Al's color. It is the color he said radiated from his soul."
"It is a passionate color," I said. "Very intense."
"Al Hunt was a very intense young man, Dr. Scarpetta. Are you aware that he believed he was clairvoyant?"
"Not exactly," I replied uneasily.
"His magical thinking included clairvoyance, telepathy, superstitiousness. Needless to say, these characteristics became much more pronounced during times of extreme stress, when he believed he had the ability to read other people's minds."
"Could he?"
"He was very intuitive."
His lighter was out again. "I have to say there was often validity in his perceptions, and this was one of his problems. He sensed what others thought or felt and sometimes seemed to possess an inexplicable a priori knowledge of what they would do or what they had already done. The difficulty came, as I briefly mentioned during our telephone conversation, in that Al would project, run too far with his perceptions. He would lose himself in others, become agitated, paranoid, in part because his ego was so weak. Like water, he tended to take the shape of whatever he filled. To use a cliche, he personalized the universe."
"A dangerous way to be," I observed.
"To say the least. He's dead."
"You're saying he considered himself empathic?"
"Definitely."
"That strikes me as inconsistent with his diagnosis," I said. "People with borderline personality disorders generally feel nothing for others."
"Ah, but this was part of his magical thinking, Dr. Scarpetta. Al blamed his social and occupational dysfunction on what he believed was his overwhelming empathy for others. He truly believed he sensed and even experienced other people's pain, that he knew their minds, as I've already mentioned. In fact, Al Hunt was socially isolated."
"The staff at Metropolitan Hospital described him as having a very good bedside manner when he worked there as a nurse," I pointed out.
"Unsurprisingly," Dr. Masterson countered. "He was a nurse in the ER. He would never have survived in a long-term care unit. Al could be very attentive providing he didn't have to get close to anyone, providing he wasn't forced to truly relate to that person."
"Explaining why he could get his master's degree but then be unable to function in the setting of a psychotherapy practice," I conjectured.
"Exactly."
"What about his relationship with his father?"
"It was dysfunctional, abusive," he replied. "Mr. Hunt is a hard, overbearing man. His idea of raising a son was to beat him into manhood. Al simply did not have the emotional makeup to withstand the bullying, the manhandling, the mental boot camp that was supposed to prepare him for life. It sent him fleeing to his mother's camp, where his image of himself became increasingly confused. I'm sure it comes as no surprise to you, Dr. Scarpetta, that many homosexual males are the sons of big brutes who drive pickups with gun racks and Confederate flag bumper stickers."
Marino came to mind. I knew he had a grown son. It had never occurred to me before this moment that Marino never talked about this only son, who lived out west somewhere.
I asked, "Are you suggesting that Al was homosexual?"
"I'm suggesting he was too insecure, his feelings of inadequacy too great, for him to respond to anyone, for him to form intimate relationships of any nature. To my knowledge, he never had a homosexual encounter."
His face was unreadable as he gazed over my head and sucked on his pipe.
"What happened in psychodrama that day, Dr. Masterson? What was the small miracle you mentioned? His imitation of a pansy? Was that it?"
"It cracked the lid," he said. "But the miracle, i
f you will, was an intense and volatile dialogue he got into with his father, who was imagined to be sitting in an empty chair in the center of the room. As this dialogue intensified, the therapist sensed what was happening and slipped into the chair and began playing the part of Al's father. By now Al was so involved he was almost in a trance. He could not distinguish the real from the imagined, and finally his rage broke."
"How did it manifest itself? Did he become violent?"
"He began to weep uncontrollably," Dr. Masterson replied.
"What was his 'father' saying to him?"
"He was assaulting him with the usual brickbats, being critical, telling him how worthless he was as a man, as a human being. Al was hypersensitive to criticism, Dr. Scarpetta. This was, in part, the root of his confusion. He thought he was sensitive to others, when, in truth, he was sensitive only to himself."
"Was Al assigned a social worker?"
I asked, continuing to flip through pages and finding no entries made by any therapists.
"Of course."
"Who was it?" There appeared to be pages missing from the record.
"The therapist I just mentioned," he replied blandly.
"The therapist from psychodrama?"
He nodded.
"Is he still employed by this hospital?"
"No," Dr. Masterson said. "Jim is no longer with us-"
"Jim?" I interrupted.
He began knocking burnt tobacco out of his pipe.
"What is his last name and where is he now?" I asked.
"I regret to say that Jim Barnes died in a car accident many years ago."
"How many years ago?"
Dr. Masterson began cleaning his glasses again. "I suppose it was eight, nine years ago."
"How did it happen, and where?"
"I don't recall the details."
"How tragic," I said, as if the matter were no longer of any interest to me.
"Am I to assume you are considering Al Hunt a suspect in your case?"
he asked.
"There are two cases. Two homicides," I said.
"Very well. Two cases."
"To answer your question, Dr. Masterson, it isn't my business to consider anyone a suspect in anything. That's up to the police. My interest is in gathering information about Al Hunt that might assist me in verifying that he had a history of suicidal ideations."
"Is there any question about that, Dr. Scarpetta? He hanged himself, didn't he? Could that be anything other than a suicide?"
"He was dressed oddly. A shirt and his boxer shorts," I responded matter-of-factly. "Such things often lead to speculations."
"Are you suggesting autoerotic asphyxiation?"
He raised his eyebrows in surprise. "An accidental death that occurred while he was masturbating?"
"I'm doing my best to obviate that question, should it ever be asked."
"I see. For insurance reasons. In the event his family might contest what you put down on the death certificate."
"For any reason," I said.
"Are you really in doubt as to what happened?" He frowned.
"No," I replied. "I think he took his own life, Dr. Masterson. I think this was his intention when he went down to the basement, and that he may have taken his pants off when he removed his belt. The belt he used to hang himself."
"Very well. And perhaps I can clear up another matter for you, Dr. Scarpetta. Al never demonstrated violent tendencies. The only individual he ever inflicted harm upon, to my knowledge, was himself."
I believed him. I also believed there was much he wasn't telling me, that his memory lapses and vagueness were patently deliberate. Jim Barnes, I thought. Jim Jim.
"How long was Al's stay here?" I changed the subject.
"Four months, I believe."
"Did he ever spend time in your forensic unit?"
"Valhalla doesn't have a forensic unit per se. We have a ward called Backhall for patients who are psychotic, suffering the DTs, a danger to themselves. We don't warehouse the criminally insane."
"Was Al ever on this ward?" I asked again.
"It was never necessary."
"Thank you for your time," I said, getting up. "If you would simply mail a photocopy of this record to me, that will be fine."
"It will be my pleasure."
He smiled his broad smile again, but he would not look at me. "Don't hesitate to call if there's anything further I can do."
It nagged at me as I followed the long, empty corridor to the lobby, but my instinct was not to ask about Frankie or even mention the name. Backhall. Patients who are psychotic or suffering the DTs. Al Hunt had mentioned interviewing patients confined to the forensic unit. Was this a figment of his imagination or confusion? There was no forensic unit at Valhalla. Yet there very well may have been someone named Frankie locked up on Backhall. Maybe Frankie had improved and was later moved to a different ward while Al was a patient at Valhalla? Maybe Frankie had imagined he had murdered his mother, or maybe he had wished he could?
Frankie beat his mother to death with a stick of firewood. The killer beat Gary Harper to death with a segment of metal pipe.
By the time I got to my office it was dark out and the custodians had come and gone.
Seating myself at my desk, I swiveled around to face the computer terminal. After several commands, the amber screen was before me, and moments later I was staring at Jim Barnes's case. Nine years ago on April twenty-first, he had been in a single-car accident in Albemarle County, the cause of death "closed head injuries."
His blood alcohol was.18, almost twice the legal limit, and he had nortriptyline and amitriptyline on board. Jim Barnes was a man with a problem.
In the computer analyst's office down the hall, the archaic, boxy microfilm machine sat squarely on a back table like a Buddha. My audiovisual skills have never been extraordinary. After an impatient search through the film library, I found the roll I was looking for and somehow managed to thread it properly into the machine. With lights out, I watched an endless stream of fuzzy black-on-white print flow by. My eyes were beginning to ache by the time I found the case. Film quietly creaked as I worked a knob and centered the handwritten police report on the screen. At approximately ten forty-five on a Friday night, Barnes's 1973 BMW was traveling east on 1-64 at a high rate of speed. When his right wheel left the pavement, he overcorrected, hit the median strip, and became airborne. Advancing the film, I found the medical examiner's initial report of investigation. In the comments section a Dr. Brown had written that the decedent was fired that afternoon from Valhalla Hospital, where he had been employed as a social worker. When he left Valhalla at approximately five P.M. that day, he was noted to be extremely agitated and angry. Barnes was unmarried when he died, and he was only thirty-one years old.
There were two witnesses listed on the medical examiner's report, individuals Dr. Brown must have interviewed. One was Dr. Masterson, the other an employee at the hospital named Miss Jeanie Sample.
Sometimes working a homicide case is like being lost. Whatever street seems even remotely promising, you follow it. Maybe, if you're lucky, a back road will eventually steer you toward the main drag. How could a therapist dead nine years have anything to do with the recent murders of Beryl Madison and Gary Harper? Yet I felt there was something, a link.
I was not looking forward to quizzing Dr. Masterson's staff, and was willing to bet he would already have warned those who counted that if I called, they were to be polite-and silent. The next morning, Saturday, I continued to let my subconscious work on this problem while I rang up Johns Hopkins, hoping Dr. Ismail might be in. He was, and he confirmed my theory. Samples derived from Sterling Harper's gastric contents and blood showed she had ingested levomethorphan shortly before death, her level eight milligrams per liter of blood, which was too high to be either survivable or accidental. She had taken her own life, and had done so in a manner that under ordinary circumstances would have gone undetected.
"Did she know that dextrom
ethorphan and levomethorphan both come up as dextromethorphan in routine tox tests?" I asked Dr. Ismail.
"I don't recall ever discussing such a thing with her," he said. "But she was very interested in the details of her treatments and medications, Dr. Scarpetta. It is possible she could have researched the subject in our medical library. I do recall her asking numerous questions when I first prescribed levomethorphan. This was several years ago. Since it is experimental, she was curious, perhaps somewhat concerned…"
I was barely listening as he continued explaining and defending. I would never be able to prove Miss Harper had deliberately left the bottle of cough suppressant out where I would find it. But I was reasonably certain this was what she had done. She was determined to die with dignity and without reproach, but she did not want to die alone.
After I hung up, I fixed a cup of hot tea and paced the kitchen, pausing every so often to gaze out at the bright December day. Sammy, one of Richmond's few albino squirrels, was plundering my bird feeder again. For an instant we were eye to eye, his furry cheeks frantically working, seeds flying out from under his paws, his scrawny white tail a twitching question mark against the blue sky. We had become acquainted last winter as I stood before my window and watched his repeated attempts at leaping from a branch only to slide slowly off the coned top of the feeder, his paws grabbing wildly at thin air on his way down. After a remarkable number of tumbles to terra firma, Sammy finally got the hang of it. Every so often I would go out and throw him a handful of peanuts, and it had gotten to the point where if I didn't see him for a while, I experienced a tug of anxiety followed by joyous relief when he reappeared to clean me out again.
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