“Where do you go?” Zachary asked Margaret. “You must know all of the places nearby.”
“There’s a diner two blocks down,” Margaret pointed the direction they should go. “Blue and white striped awning. They have good grilled cheese sandwiches.”
“Okay.” Zachary looked at Clarissa. “You want to walk or take my car?”
“Let’s walk.”
He nodded. The started down the sidewalk toward the diner. The road was fairly straight, and they could see the striped awning before they got to the end of the first block.
“You haven’t been sleeping?” Zachary asked.
“No. Not for long. Every night I think it will be tonight, that my body is so tired it has to give in. And I end up tossing and turning or sitting up… until my eyes finally close and I start dreaming. But I just keep dreaming about Quentin. And I wake up and I’m so sad for him. I know I shouldn’t be, he’s gone on to a better place, and all that. And I really do believe that. But I still feel so sad, so guilty.”
“Of course. That’s a totally natural reaction. I imagine the sleeplessness will wear off… like you say, your body will take over and insist that you sleep.”
Though that had never been a workable strategy for Zachary. He needed something to help him sleep. He didn’t like having to take meds to sleep, so he would go as long as he could without, but eventually he would break down and take something so that he could shut down his brain and get a few hours of unbroken sleep.
“I don’t know,” Clarissa said. “It started before Quentin died. It’s been going on for some time now…”
“When did it start?”
“I’m not sure exactly… a few weeks… a month or two… things just started falling apart in my life. I stopped being able to sleep. Started having nightmares. Couldn’t focus during the day. I feel like… like something bad is going to happen. All the time. But I don’t know what.”
They walked for a minute in silence. Reaching the diner, they found a seat, and both ordered the grilled cheese sandwich, then looked at each other like an awkward first date.
“What were your nightmares about before Quentin died?”
“Not all that different… the kids at Summit. Sometimes Quentin, sometimes one of the others. Dreams that they were hurt or dying, and no one would help me. Or dreaming that…” She tapped on the Formica table with a long, polished fingernail, “… you’re going to think it’s stupid.”
“No. I won’t. I have some doozies myself.”
“Sometimes that I am a resident there. That I am the one with autism. Or that I don’t have autism or anything wrong with me, and I am still locked up there and can’t get out or do anything but sit in my room or in therapy. It was really… terrifying. I know that’s silly. It wasn’t that there was anything bad happening to me, just that… I didn’t have any control over my life. No control over anything.”
“Yeah. That would be pretty frightening.”
And it was the truth of the situation for every one of those kids. If they did well, they could earn their big rewards. They could go to the fancy reward rooms and play video games, or crawl in the ball pit, or pick one of the quieter rooms. And that was the highlight of their lives. The rest of the time, they had no choice over where they could be, what they could do, no choices at all.
There were residents without autism there too. Youths who were too violent, runaways, who couldn’t fit in with families or whatever other living situations they had been in. Kids like Zachary had been. He couldn’t imagine being stuck in a more terrifying place than Summit. Things had been bad enough at Bonnie Brown and some of the other institutions or homes he had been in. But at least at Bonnie Brown, they didn’t give him electrical shocks. He’d been treated roughly. Had guards who figured it was okay to tune him up if he were misbehaving. But the thought of being wired like the residents at Summit, where anyone who had authority over him could punish him at any time, even from across the room, was daunting.
He’d seen Angel writhing on the floor. Trina, with her skin cooking under the electrodes. All of it court approved. Their parents signed off. The courts signed off. Everybody said it was perfectly okay to punish children and adults who had been judged incapable of controlling their own behavior. How was that fair?
“Mr. Goldman?”
Zachary roused himself and focused in on Clarissa, who was looking at him with questions in her eyes.
“Sorry. Did you ask me something?”
“No… just… I thought you were going to say something else, and then you kind of… drifted off.”
Zachary placed both of his palms on the table, trying to feel the cool, flat surface, to ground himself in the present with the sensations around him. It was a bright, friendly place. A sort of a fifties or sixties diner theme. Comfortable home cooking. He could smell their grilled cheese sandwiches on the grill; the waitress would be bringing them to the table soon.
“Do you know if anyone else you work with is having the same kind of symptoms?” he asked. “Sleeplessness, anxiety, depression…?”
“Like I said, we aren’t allowed to associate with each other. We’re not supposed to talk outside of the therapy sessions, only to sort out logistics, get reports filed, that kind of thing.”
Zachary waited. There were rules, and then there was what really happened when there were no snitches around to report the rule-breaking.
“I guess… yes, there are a lot of others who complain about having trouble sleeping. Or who drink too much. Or who take a lot of sick days. It’s kind of a running joke, taking all of your sick days in the first three months of the year… turnover is pretty brutal, we’re always having to train new staff. Dr. Abato likes to get people right out of school, when they haven’t already been trained in other methods. So that therapy sessions don’t get ‘contaminated’ with someone else’s program or ideas.”
“A lot of people quit? Or are fired?”
“I think more quit than are fired. Even though the rules are strict, there aren’t a lot of people breaking them flagrantly enough to be fired. Everybody wants to keep their jobs. Wants to do the best they can to help these kids. They need us.”
“Everybody talks about kids,” Zachary observed. “But a lot of the residents are adults, aren’t they? And not all just eighteen or nineteen.”
“Oh, I know. But that’s how we think of them. As our kids. Even if they’re older than us. Because they’re like children. They need us to look after them. To care for them.”
“You get pretty attached to them.”
“Yes. We’re everything they’ve got. It’s like a parent-child relationship. And I guess that’s how we see it, even if they are older. A lot of the really old residents aren’t doing any therapy. They’ve advanced as far as they can, and they’re just… living out their lives. So I didn’t really work much in those units. Now and then to cover when they were understaffed. But there’s not a lot to do, other than making sure they are fed and washed.”
“What do they do with their time? Do they just sit around all day?”
“It depends on their level of functioning and what their interests are. Some do puzzles or have a hobby. Something that their families keep them supplied with. As long as they don’t have anything that can be used as a weapon, Summit is pretty open to whatever pastimes they choose.”
“What did you think of Quentin?”
She couldn’t hide the fact that she was startled by his sudden change of direction. But the waitress chose that moment to bring them their plates, so Clarissa had time to change gears and think about her answer.
“I don’t know… in what way? He wasn’t a happy boy. He was homesick, even after two years. Signed for his mom a lot.” She tapped her cheek with her forefinger. “And you know that he came to Summit because he was violent.”
“But the shocks took care of that.”
She gave a little shrug. “They seemed to, mostly,” she admitted. “I hate the ESDs, but they do seem to
work.”
“Lovaas, the guy who wrote about ABA?”
“Yeah…?”
“Did you know that he recanted later? That he said that shocks didn’t work in the long term. The children became inured to them over time. And he said what they had learned in ABA didn’t generalize over other environments.” Zachary paused. “Is that the right word? Generalize?”
“Yes,” Clarissa agreed faintly.
“Dr. Abato thinks the solution to getting used to the pain is just to increase the shocks. Increase the pain level to get control over them again.”
Clarissa frowned as she took a bite of her sandwich. Zachary nibbled at his own, but had no appetite. It was perfectly done. Just crispy enough. The cheese melty, the butter salty, but he couldn’t eat it.
“But he can’t do that,” Clarissa said. “There’s already controversy over whether the phase-two ESD we are using right now is acceptable. It works for most of the kids, and the court won’t rule against us using it because the parents say they have nowhere else to go. But another device? A stronger one?”
“The kind they use to control adult prisoners,” Zachary informed her. “That’s what he said. And I guess if they’re already in use in other circumstances, maybe it won’t be impossible to get it approved.”
“I don’t think they could ever get it approved for use with our kids.”
“Do you want to leave Summit?” Zachary asked after a lengthy pause in the conversation.
“I do… and I don’t… I want to help children, and it’s a good job with good pay and benefits. But it’s eating me up. I can’t sleep. I can’t think. It’s not making me happy.” She pushed around the remaining corner of her first half-sandwich. “It didn’t make Quentin happy.”
“I think you need help.”
“Me? Help with what?”
“Someone to talk to about your symptoms. You should talk to a psychologist. A therapist. Someone.”
“It’s nothing. It’s just stress. Being upset over Quentin’s death.”
“I don’t think so. I think it’s more like PTSD. And you said it started before Quentin died.”
She picked up the bottle of Heinz ketchup on the table and spilled a pool onto her plate. “This better be real Heinz, and not just a Heinz bottle refilled with generic stuff.” She dabbled the second triangle of her sandwich in the ketchup and took a bite. Since she didn’t complain about it being generic, Zachary assumed that she found it acceptable. She pretended for a couple of minutes to be completely engrossed in the meal, then finally looked up at him again.
“PTSD?” she repeated. “How could it be? PTSD is for war veterans. People who have been through traumatic events. Not ABA therapists!” She made a wide shrug.
“I don’t know. I know about PTSD… but not all of the kinds of events that can cause it. But what you’re describing… it sure sounds like PTSD to me.”
“I don’t get flashbacks,” she said, a slightly derisive note in her voice. “What would I flash back to? A therapy session? They can be pretty raw, but I don’t think it counts as a war.”
Or war crimes.
Zachary wasn’t so sure. What he had seen that day had been pretty traumatic to him. And Clarissa was a young girl, seeing that and worse every day for months. After a few hours of seeing the shocks used, Zachary had been ready to curl up in a ball and shut the rest of the world out. He knew that Angel and Trina would both be haunting his restless dreams along with Quentin. And Zachary was tougher and more experienced than Clarissa.
“I still think you should talk to someone,” he said. “Get some help. And maybe a prescription to help you sleep.”
Chapter Sixteen
I
have a question,” Zachary said suddenly. He was still poking at his barely-touched sandwich, while Clarissa was nearly done with hers. The afternoon sun shone through the diner window.
“What is it?” She looked anxious about what he might ask her. And he could ask her a lot of uncomfortable things. But most of them didn’t need asking, unless he was trying to make her feel worse than she already did.
“No, it’s nothing to be concerned about. Just… some of the logistics of the shock devices they’re using at Summit.”
“Um… okay. What about them?”
“They’re bulky, with the backpacks, and pretty complex with all of the wires and electrodes… how many?”
“Six.”
“Six electrodes that have to be attached. The residents just let you put them on every day? Or put them on themselves? How does that work?”
“Kids that are pretty compliant, it’s not a problem. Some of the more reactive patients, it can be difficult. With the worst cases… they keep them on at all times. You always have at least one electrode attached, so then you can… shock them… if they are fighting against having the others attached. Each electrode is like a cattle prod or stun gun, with the positive and negative poles close together, so each one operates independently.”
“And they keep them on all the time? How? When they are sleeping?”
“Yes. When they’re sleeping. I don’t imagine it’s too comfortable sleeping with the backpack on, but they get used to it.”
Zachary couldn’t imagine trying to sleep with such a device attached. From what he understood, children with autism often had sleep issues. Those would be magnified a hundred times by having to sleep with ten pounds of batteries in a backpack and six electrodes attached to their bodies.
“What about hygiene? Do they bathe? Shower?”
“Shower,” Clarissa confirmed. “They have to keep one arm electrode attached and hold that arm out of the water.”
Zachary closed his eyes to picture it. “How do they do that?”
“Sometimes they need help. It is pretty hard to wash with one arm out of the shower. Or for them to understand why they need to. Some of them are dyspraxic—not very well-coordinated.”
“And by help, you mean… one person holding on to their arm to keep it out of the water, and maybe another one doing the washing?”
Clarissa stared off into space. Zachary watched her curiously. In spite of the fact that he’d dealt with his own PTSD for thirty years, he’d never watched someone else having a flashback. He waited for her to return to herself.
Clarissa looked back at him, blinking and looking like she was just coming out of a fog.
“What?”
“You don’t have flashbacks?” Zachary asked.
“No.”
“What was that? Where did you just go?”
“Nowhere. I was just thinking about something else. Daydreaming.”
“Who was in the shower? Who were you remembering?”
Clarissa shook her head. “They’re so defenseless. And with the electrodes… to never be free of them… it’s just so sad.”
“Yes.” Zachary finally pushed his unfinished sandwich away from himself. “It is.”
Kenzie didn’t have time to get together for supper. Things had been busy at the coroner’s office and she had other evening commitments. She didn’t tell Zachary what those commitments were and, after dancing around the issue and not being able to get to a satisfactory answer, Zachary forced himself to let it go. If he acted like a jealous boyfriend, demanding to know where she was going and who she was seeing, they would never be able to move their relationship forward. He’d lose the friendship and the resource that she was to him.
But she did agree to a phone call while she was on break, eating a vending-machine dinner at her desk. So he uploaded the information he wanted her to look at and waited for her call.
When the phone rang, Zachary had been trying to calm himself with a game of solitaire, and nearly launched the phone across the room in his surprise. He tapped the green button to answer and put it to his ear.
“Kenzie? Hi.”
“Hi, Zachary. I don’t have much time, like I said, but I’ve got a few minutes for you.”
“I want to go over the coroner’s report again.�
��
“I see that. Is something bothering you?”
“No, just… now that I’ve been there, and seen how they operate, I want to review it again, see if I can pick up anything else.”
“Okay. What first?”
“His mother said that one of the things that he did when he was anxious was picking his skin.”
Kenzie made a noise of acknowledgment. “Yes… I can see that. Pretty obvious from the photos. We discussed it the first time.”
“I know. So I didn’t look at his skin very carefully to begin with. I figured all of the scabs and scars were from him picking at his skin.”
“Uh-huh.”
“But now I’m wondering if any of the damage was done by the electrodes.”
“What electrodes?”
“From their skin shock therapy. It’s one of the aversives that they use. Their preferred one, so that they can give the same punishment consistently every time.”
“Uh… okay. And you think they might have caused some damage to the dermis?”
“I saw a girl today who was burned by a malfunctioning unit. Blisters. Second degree electrical burns. So I wanted to know if any of Quentin’s injuries might have been burns, or started as burns and he picked them as they scabbed. Would you be able to tell that?”
“From these photos? Probably not. Where would the electrodes have been located?”
Zachary described the locations of the arm and leg electrodes. “And apparently two on the torso, but I’m not sure of the positioning. I couldn’t see those ones.”
Kenzie hummed as she looked through the pictures on her screen. They hadn’t done any really close shots of the skin on his arms and legs, where he had picked at his skin. But they were good quality digital photos and could maybe be enlarged enough that Kenzie could see the details she needed.
“I really couldn’t say one way or the other,” Kenzie said. “The best spots to look at are his torso, where he couldn’t pick his skin as easily through his clothes. Mostly, he picked at his arms and a little on his legs. There are a couple of places on his stomach and back where I could be looking at burns from the electrodes. But it’s pretty hard to tell from the photos.”
His Hands were Quiet Page 16