Jonathan Kellerman - Alex 03 - Over the Edge

by Over the Edge

  The lights and noise came from a pair of hook and ladders, half a dozen ambulances, and a platoon of fire department and highway patrol cars. Half a dozen uniforms huddled around the Ford, and a strange-looking machine outfitted at the snout with oversized tongs made repeated passes at its crumpled passenger door. Blanketed bodies on stretchers were being loaded into ambulances. Some were hooked up to intravenous bottles and handled gingerly. Others, encased in body bags, were treated like luggage. From one of the ambulances came a moan, unmistakably human. The freeway was littered with glass, fuel, and blood.

  A line of CHP officers stood at parade rest, shifting their attention constantly from the carnage to the waiting motorists. One of them saw me and motioned me back with a curt hand wave. When I didn't comply, he marched forward, grim-faced.

  'Go back to your car immediately, sir.' Up close he was

  young and big with a long red face, a skimpy fawn-coloured moustache, and thin, tight lips. His uniform had been tapered to show off his muscles, and he sported a tiny, foppish blue bow tie. His name tag said BJORSTADT.

  'How much longer do you think we'll be here, Officer?'

  He stepped closer, one hand on his revolver, chewing an antacid and giving off an odour of sweat and wintergreen.

  'Go back to your car immediately, sir.'

  'I'm a doctor, Officer. I've been called out on an emergency and have to get through.'

  'What kind of doctor?'

  'Psychologist.'

  The answer didn't seem to please him.

  'What kind of emergency?'

  'A patient of mine just called in crisis. He's been suicidal in the past and is at high risk. It's important that I get to him as quickly as possible.'

  'You going to this individual's home?'

  'No, he's hospitalised.

  'Where?'

  'Canyon Oaks Psychiatric -just a few miles up.'

  'Let me see your licence, sir.'

  I handed it over, hoping he wouldn't call the hospital. The last thing I needed was a powwow between Officer Bjorstadt and sweet Mrs. Vann.

  He studied the licence, gave it back, and looked me over with pale eyes that had been trained to doubt.

  'Let's just say, Dr. Delaware, that I follow you to the hospital. You're saying that once we get there, they're going to verify the emergency?'

  "Absolutely. Let's do it.'

  He squinted and tugged on his moustache. 'What kind of car are you driving?'

  'Seventy-nine Seville. Dark green with a tan top.'

  He studied me, frowning, and said finally: 'Okay, Doctor, coast through slowly on the shoulder. When you get to this point, you can stop and stay put until I tell you to move. It's a real disaster out here, and we don't want any more blood tonight.'

  I thanked him and jogged to the Seville. Ignoring hostile stares from the other drivers, I rolled to the front of the line, and Bjorstadt waved me through. Hundreds of flares had been laid down, and the freeway was lit up like a birthday cake. It wasn't until the flames disappeared in my rear-view mirror that I picked up speed.

  The suburban landscape receded at Calabasas, giving way to softly rolling hills dotted with ancient gnarled scrub oak. Most of the big ranches had long been subdivided, but this was still upper-crust horse country - high-priced 'planned communities' behind gates and one-acre spreads designed for weekend cowboys. I got off the freeway just short of the Ventura County line and, following the arrow on the sign that said CANYON OAKS PSYCHIATRIC HOSPITAL, swung south over a concrete bridge. After passing a self-serve filling station, a sod nursery, and a Christian elementary school, I drove uphill on a one-lane road for a couple of miles until another arrow directed me westward The pungence of ripe manure clogged the air.

  The Canyon Oaks property line was marked by a large flowering peach tree shadowing low, open gates meant more for decor than security. A long, winding lane bordered by boxwood hedge and backed by shaggy eucalyptus led me to the top of a knoll.

  The hospital was a Bauhaus fantasy: cubes of white concrete assembled in clusters; lots of plate glass and steel. The surrounding chaparral had been cleared for several hundred yards, isolating the structure and intensifying the severity of its angles. The collection of cubes was longer than tall, a cold, pale python of a building. In the distance was a black backdrop of mountain studded with pinpoints of illumination that arced like low, shooting stars. Flashlights. I parked in the near-empty lot and walked to the entrance - double doors of brushed chrome centred in a wall of glass. And locked. I pressed the buzzer.

  A security guard peeked through the glass, ambled over, and stuck his head out. He was middle-aged and potbellied, and even in the dark I could see the veins on his nose.

  'Yes, sir?' He hitched up his trousers.

  'I'm Dr. Delaware. A patient of mine -James Cadmus -called in crisis, and I wanted to see how he was.'

  'Oh, him.' The guard scowled and let me in. 'This way, Doctor.'

  He led me through an empty reception room decorated in insipid blue-greens and greys and smelling of dead flowers, turned left at a door marked C Ward, unlocked the dead bolt, and let me pass through.

  On the other side was an unoccupied nursing station equipped with personal computers and a closed-circuit TV monitor displaying video oatmeal. The guard passed the station and continued to the right. We entered a brief, bright corridor checkered with blue-green doors, each pocked with a peephole. One door was open, and the guard motioned toward it.

  'Here you go, Doc'

  The room was six-by-six, with soft white vinyl walls and low, flat ceilings. Most of the floor space was taken up by a hospital bed fitted with leather restraints. There was a single window high up on one wall. It had the filmy look of old Plexiglas and was barred with steel posts. Everything -from the commode to the nightstand - was built in, bolted down, and padded with blue-green vinyl. A pair of crumpled white pyjamas lay on the floor.

  Three people in starched white crowded the room.

  An obese blonde woman in her forties sat on the bed, head in hands. By her side stood a big, broad black man wearing horn-rimmed glasses. A second woman, young, dark, voluptuous, and sufficiently good-looking to pass for Sophia Loren's kid sister, stood, arms folded across her ample chest, at some distance from the other two. Both women wore nurse's caps; the man's tunic buttoned to the neck.

  'Here's his doctor,' announced the guard to a trio of stares. The fat woman's face was tear-streaked, and she looked frightened. The big black narrowed his eyes, and went back to looking impassive.

  The good-looking woman's eyes narrowed with anger.

  She shouldered the black man aside and stomped over. Her hands were clenched, and her bosom heaved.

  'What's the meaning of this, Edwards?' she demanded in a contralto I recognised. 'Who is this man?'

  The guard's paunch dropped a few inches.

  'Uh, he said he was Cadmus's doctor, Mrs. Vann, and, uh, so I - '

  'It was a misunderstanding,' I smiled. 'I'm Dr. Delaware. We spoke on the phone - '

  She looked at me with amazement and swivelled her attention back to the guard.

  'This is a locked ward, Edwards. It's locked for two reasons.' She gave him a bitter, condescending smile. 'Isn't it?'

  'Yes, ma'am - '

  'What are those reasons, Edwards?'

  'Uh, to keep the loon - to maintain security, ma'am, and, uh - '

  'To keep the patients in and strangers out.' She glared at him. 'Tonight you're batting oh-for-two.'

  'Yes, ma'am. I just thought since the kid - ' That's enough thinking on your part for one night,' she snapped. 'Return to your post.'

  The guard blinked rheumily in my direction.

  'You want me to take him - '

  'Go, Edwards.'

  He looked at me hatefully and shuffled away. The fat woman on the bed put her head back in her hands and began to snuffle. Mrs. Vann shot her a sidelong glance full of distain, batted her long dark lashes in my direction, and held out a finely
boned hand.

  'Hello, Dr. Delaware.'

  I returned the greeting and tried to explain my presence.

  'You're a very dedicated man, Doctor.' Her smile was a cold white crescent. 'I suppose we can't fault you for that.'

  'I appreciate that. How's - '

  'Not that you should have been let in - Edwards will answer for that - but as long as you're here, I don't

  imagine you'll do much harm. Or good, for that matter.' She paused. 'Your former patient's no longer with us.'

  Before I could respond, she went on:

  'Mr. Cadmus escaped. After assaulting poor Miss Surtees here.'

  The fat blonde looked up. Her hair was a stiff, platinum meringue. The face under it was pale and lumpy and mottled with pink. Her eyebrows were plucked flat, canopying small, olive drab, porcine eyes rimmed with red. Thick lips greasy with gloss tensed and trembled.

  'I went in to check on him' - she sniffled - 'just like I do every night. All this time he's been such a nice kid, so I undid the cuffs like I always do - give the boy a bit of freedom, you know? A little compassion doesn't hurt, does it? Then the massage - wrists and ankles. What he always does is he drifts right off in the middle of the massage and starts smiling like a baby. Gets a good sleep sometimes. This time he jumped up real crazy, screaming and frothing at the mouth. Punched me in the stomach, tied me with the sheet, and gagged me with the towel. I thought he was gonna kill me, but he just took my key and - '

  'That's enough, Marthe,' said Mrs. Vann firmly. 'Don't upset yourself any further. Antoine, take her to the nurses' lounge, and get some soup or something into her.'

  The black man nodded and propelled the fat woman out the door.

  'Private-duty nurse,' said Mrs. Vann when they were gone, making it sound like an epithet. 'We never use them, but the family insisted, and when big bucks are involved, the rules have a way of getting bent.' Her head shook, and the stiff cap rustled. 'She's a float. Not even registered, just an LVN. You can see the good she accomplished.'

  'How long's Jamey been here?'

  She came closer, brushing my sleeve with her fingertips. Her badge had a picture that didn't do her justice and, under it, a name: Andrea Vann, R.N.

  'My, but you're persistent,' she said archly. 'What makes you think that information is less confidential than it was an hour ago?'

  I shrugged.

  'I had the feeling when we spoke on the phone that you thought I was some sort of crank.'

  The frigid smile returned.

  'And now that I see you in the flesh I'm supposed to be impressed?'

  I grinned, hoped it was charming. 'If I look the way I feel, I wouldn't expect you to be. All I'm trying to do is make some sense out of the last hour.'

  The smile turned crooked and, in the process, somehow grew more amiable.

  'Let's get off the ward,' she said. 'The rooms are soundproofed, but the patients have an uncanny way of knowing when something's up - almost an animal type of thing. If they catch on, they'll be howling and throwing themselves against the walls all shift.'

  We went into the reception room and sat down. Edwards was there, shuffling around miserably, and she ordered him to fetch coffee. He screwed up his lips, swallowed another gallon of pride, and complied.

  'Actually,' she said, taking a sip and putting the cup down, 'I did think you were a crank - we get plenty of them. But when I saw you, I recognised you. A couple of years ago I attended a lecture you gave at Western Peds on childhood fears. You did a nice job.'

  'Thanks.'

  'My own kid was having bad dreams at the time, and I used some of your suggestions. They worked.'

  'Glad to hear it.'

  She pulled out a cigarette from a pack in the pocket of her uniform and lit it.

  'Jamey was fond of you. He mentioned you from time to time. When he was lucid.'

  She frowned. I interpreted it:

  'Which wasn't very often.'

  'No. Not very. How long did you say it's been since you last saw him?'

  'Five years.'

  'You wouldn't recognise him. He - ' She stopped

  herself. 'I can't say more. There's been enough rule bending for one night.'

  'Fair enough. Can you tell me how long he's been missing?'

  'A half hour or so. The orderlies are out in the hills with flashlights.'

  We sat and drank coffee. I asked her what kinds of patients the hospital treated, and she chain-lit another cigarette before answering.

  'If what you're asking is, Do we get lots of escapes, the answer is no.'

  I said I hadn't meant that at all, but she cut me off.

  'This isn't a prison. Most of our wards are open - the typical stuff: acting-out adolescents, depressives past the high-risk period, anorexics, minor manics, Alzheimer's, cokeheads, and alkies on detox. C Ward is small - only ten beds, and they're rarely all full - but it creates most of our hassles. C patients are unpredictable - agitated schizos with impulse control problems; rich psychopaths with connections who weasled out of jail by checking in for a few months; speed freaks and cokers who've taken it too far and ended up paranoid. But with phenothiazines, even they don't act up much - better living through chemistry, right? We run a tight ship.'

  Looking angry again, she stood, adjusted her cap, and dropped her cigarette into cold coffee.

  'I'm gonna have to get back, see if they found him yet. Anything else I can do for you?'

  'Nothing, thanks.'

  'Have a nice drive back, then.'

  'I'd like to stick around and talk to Dr. Mainwaring.'

  'I wouldn't do that if I were you. I called him right after we discovered Jamey was missing, but he was in Redondo Beach - visitation with his kids. Even if he left right away, that's a long drive. You'll be stuck here.'

  'I'll wait.'

  She adjusted her cap and shrugged.

  'Suit yourself.'

  Once alone, I sank back down and tried to digest what

  I'd learned. It didn't add up to much. I sat restlessly for a while, got up, found the men's room, and washed my face. The mirror bounced back a tired visage, but I felt full of energy. Probably running on reserves.

  The clock in the reception room said 4:37. I thought of Jamey wandering in the darkness and grew taut with anxiety.

  Trying to put him out of my mind, I sat back and read a copy of the hospital throwaway, The Canyon Oaks Quarterly.. The cover article was on the politics of mental health financing - lots of talk about HMOs, PPOs, PROs, and DRGs. The gist of it was to urge families of patients to lobby legislators and insurance carriers for more money. Briefer pieces dealt with anticholinergic syndrome in the elderly - old people misdiagnosed as senile because of drug-induced psychosis - the fine points of occupational therapy, the hospital pharmacy, and a new eating disorders programme. The entire back page was an essay by Guy Mainwaring, M.D., F.A.C.P., medical director, entitled 'The Changing Role of the Psychiatrist'. In it he asserted that psychotherapy was of relatively minor value in dealing with serious mental disorders and best left to non-medical therapists. Psychiatrists, he stressed, were physicians and needed to return to the medical mainstream as 'biochemical engineers'. The article ended with a paean to modern psychopharmacology.

  I put the paper down and waited restlessly for half an hour before hearing the rumble of an engine and the sizzle of gravel under rubber. A pair of headlights beamed through the glass surrounding the front doors, and I had to shield my eyes from the glare.

  The headlights went off. After my pupils had adjusted, I made out the waffled contours of a Mercedes grille. The doors swung open, and a man charged in.

  He was fiftyish and lean, with a face that was all points and angles. His hair was grey-brown and thin and brushed straight back over a generous crown. A widow's peak marked the centre of a high, wide brow. His nose was long and sharp and slightly off-centre; his eyes were restless

  brown marbles set deeply in shadowed sockets. He wore a heavy grey suit that had cost a
lot of money a long time ago, a white shirt, and a grey tie. The suit hung loosely, trousers bagging over dull black oxfords. A man unconcerned with frills and niceties, a perfect match for the Bauhaus building.