Instead, I intensified the pressure of my fingers. A sobbing sound rose from deep within his abdomen; his shoulders heaved, then slumped. He closed his eyes again, and his head swung pendulously before dropping to the table. He lay there, cheek to the metal, mouth gaping, breathing nasally and heavily. Nothing I said or did roused him.
He slept stuporously. I watched him and felt my spirits sink with each heave of his scrawny chest. I'd been prepared for psychosis, but for nothing this regressed. The standard battery of mental status questions - orientation to time and place, inquiries about distorted thought processes and scrambled perceptions - was irrelevant. On the phone he'd responded, if only minimally. He'd told Milo he'd called me; that meant some degree of consciousness. Now he was a zombie. I wondered if it was a transitory phase -the severe depression that sometimes follows a schizophrenic outburst - or something more insidious: the beginning of the end.
Schizophrenia is a baffling collection of disorders. Psychiatry's come a long way since the days when psychotics were burned as witches, but the roots of madness
remain a locked box. Psychiatrists control schizophrenic symptoms with drugs without really understanding why they work. It's palliative treatment that has little to do with cure. A third of all patients recover by themselves. Another third responds favourably to medication and supportive psychotherapy. And there exists a group of unfortunates who are resistant to any form of treatment; no matter what is attempted, they slide inexorably toward total mental deterioration.
I looked at the limp body splayed across the table and wondered which group would claim Jamey.
There was a third possibility, but it was a remote one. His symptoms - the tremors, the drooling, the sucking and blowing - bore the earmarks of tardive dyskinesia, nerve damage brought on by heavy doses of anti-psychotic medication. The disorder usually appears in older patients treated over a period of several years, but in rare cases acute dyskinesia has been noted after only minimal drug ingestion. Souza had told me that Mainwaring was continuing to medicate Jamey in the jail, and I made a note to learn more about the drugs he was getting and the dosage levels.
He started to snore loudly. As he sank deeper into sleep, his body seemed to retreat from my touch, going limp, almost liquid, as if his bones had melted. His breathing slowed. I kept my hand on his shoulder and talked to him, hoping some small bit of comfort would find its way through the stupor.
We stayed that way for the rest of the hour. I let go only when the cadre of deputies arrived and carried him back to his cell.
Sergeant Koocher told Sonnenschein to escort me out of the jail.
'I see what you meant by good luck,' I said as we walked. 'Getting him to respond.'
'Yup.'
'How often is he like that?'
'Most of the time. Sometimes he starts crying or
screaming. Usually he just sits and stares until he falls asleep.'
'Has it been that way since he got here?'
'He was pretty hyped up when they brought him in a couple of days ago. Like a duster. We had to keep him in restraints. But it didn't take long before he started to fade away.'
'Does he talk to anyone?'
'Not that I've seen.'
' How about his attorney?'
'Souza? Nah. He does the whole fatherly thing - puts his arm around him, feeds him juice and cookies. Cadmus shines him on. Totally out of it.'
We turned a corner and nearly collided with a group of inmates. At the sight of Sonnenschein's uniform they veered away sharply.
'I guess it's good for his case,' he said.
'What is?'
'His being so - decompensated.'
He noted my surprise at his use of the technical term and grinned.
'Psych major,' he explained. 'Got one more year for a B.A. Working here got me interested in it.'
'You're saying he's faking psychosis in order to be judged incompetent.'
He shrugged.
'You're the doctor.'
'What about your opinion? Off the record.'
He didn't answer right away.
'Off the record I don't know. With some clowns it's obvious what they're up to. The minute they get here they start putting on the Looney Tunes act. Only they usually overdo it because they're uneducated; everything they know about psychosis comes from TV and splatter flicks. Know what I mean?'
'Sure. Draft dodger mania.'
'You got it. Cadmus doesn't pull that kind of crap, but I heard he used to be some kind of genius, so maybe he's just playing the game a little smarter.'
'You said he screamed once in a while. What does he say?'
'Nothing. He just screams. No words. Like a deer that's been gutshot.'
'If you do make out something, could you write it down and show it to me the next time I'm here?'
He shook his head.
'No way, Doc. If I report it to you, I've got to report it to the DA. If I do it in this case, everyone will start to ask. After a while I'd be doing investigative freebies for everyone and neglecting my job.'
Okay,' I said. 'Just asking.'
'No harm in that.'
'Let me ask you something else then. Do you keep some kind of log - a record of the High Power inmates' behaviour?'
'Sure. Incident reports, unusual occurrences. Only screaming's not unusual. Some nights it's all you hear.'
We reached the elevator and waited for it to arrive.
'Tell me,' he said, 'do you like your work?'
' Most of the time.'
'It stays interesting?'
'Very.'
'Good to hear. I've really enjoyed my psych classes, especially the abnormal stuff, been thinking about going on for a master's or something. But it's a lot more school, a heavy-duty decision, so I've been asking the psychiatrists who come here if they like what they do. Last one I asked -Cadmus's other doctor - looked at me funny, like it was a trick question, like what did I really mean by that.'
'It's an occupational hazard,' I said. 'Overinterpreting.'
'Maybe so, but I got the feeling he just didn't like cops.'
I thought of what Souza had said about Mainwaring's being tagged as a defence expert, said nothing.
A few seconds passed.
'So,' said Sonnenschein, 'you really do like it.'
'Can't think of anything I'd rather do.'
'Excellent.' He smiled, then grew grave. 'You know, you spend some time up here, see these guys and hear
about the things they've done, makes you want to understand how people get like that, know what I mean?'
'I sure do.'
The elevator doors opened. We boarded and descended in silence. When they opened again, he'd forged his face into a stoic mask. I wished him luck with his studies.
'Thanks,' he said, stepping out and using his hand to keep the door from closing. 'Listen, I hope you figure out what's going on with the kid. If I could help you, I would. But I can't.'
I stepped into the sally port. Beyond the blue bars I saw two men in the entry room. Their backs were to me as they stashed their guns in one of the lockers. I collected my ID and stepped out as they walked up to the trough. One of them was Cal Whitehead. The other was a big man, too, heavy and droopy, with pale skin, thick black hair, and startling green eyes under shaggy black brows. The hair was clipped short around the back and sides, except for long, unfashionable sideburns, and left thick on top. A wave of it swept across his forehead. His face was broad with thick features - a prominent, high-bridged nose, fleshy ears, and full, soft lips - its boyishness marred by the acne scars that pitted the flesh. His clothes were baggy and rumpled - brown corduroy jacket with button flaps and a half belt in back, tan double-knit trousers over scuffed desert boots, brown rayon shirt, and mustard-coloured tie.
'Hey, it's the psychiatrist,' said Whitehead.
I ignored him and looked at the other man.
'Hello, Milo.'
'H'lo, Alex,' said my friend, with obvious discomfort.
An awkward silence took root and sprouted, interrupted finally by a bark from behind the glass. Milo unclipped his LAPD ID card from his lapel and dropped it into the trough. Whitehead did the same with his sheriffs ID.
'How've you been?' I asked.
'Fine,' he said, looking at his shoes. 'Yourself?'
'Fine.'
He coughed and turned away, rubbing a big, soft hand over his face, as if washing without water.
The awkward silence blossomed. Whitehead seemed amused.
'Hey, Doc,' he said, 'how's your patient? Ready to spill his guts and save us a hassle?'
Milo winced and flashed me a knowing look that faded instantaneously.
'Don't tell me,' taunted Whitehead, 'he's totally zonked out, right? Pissing down his leg, eating his own shit, and un-a-ble-to-teU-right-from-wrong.'
I started to walk away. Whitehead moved his bulk between me and the door.
'Yesterday you had nothing to say, mister. Today you're an expert.'
'Cool it, Cal,' said Milo.
'Yeah, I forgot,' said Whitehead, not budging. 'He's your buddy, so when he pulls the dim cap shit, it's okay.'
The door to the sally port slid open.
'Come on, Cal,' said Milo, and I saw his hands clench.
Whitehead looked at me, shook his head, smiled, and stepped aside. He pivoted, stomped into the port, and Milo followed him.
The bars slammed shut. Whitehead moved immediately to the left and began kibitzing with the deputies in the booth. Milo stood by himself on the other side of the port. Before I left, I tried to catch his attention, but he'd fixed his gaze on the grimy floor and never raised his eyes.
SOUZA'S STEAK bled as he cut into it, forming a pinkish puddle around the meat that spread and coated the white bone china plate. He inserted a chunk of sirloin in his mouth, chewed slowly, swallowed, wiped his lips, and nodded.
'He was that way when I saw him early this morning,' he said. 'Stuporous.'
We were alone in the dining room of his law building. The room was hushed and dim, an Anglophile's fantasy. An oval Victorian table of mahogany polished to a mirror glow stretched nearly the length of the room, ringed by matching chairs upholstered in floral brocade. An oversized stone mantel liberated from some draughty Hampshire manor dominated one wall. Above it a collection of hunting prints surrounded a framed heraldic crest Silk Persian rugs spread over dark parquet floors. The walls were carved, waxed, knotty pine panels hung with antique Punch caricatures and more hunt scenes. Fluted pedestals in each corner supported marble busts of men of letters. Heavy drapes of the same brocade that
covered the chairs had been drawn over tall, arched windows, and the sole source of light was a Waterford chandelier suspended above the table's centre.
'One of the deputies told me he was agitated when he first came into the jail but has been withdrawing steadily,' I said.
'That's an accurate assessment. The entire history has been one of deterioration. At the time of his commitment to Canyon Oaks he displayed long stretches of lucidity - days at a time. Anyone talking to him during those periods would have wondered what he was doing there. He was a brilliant boy before the... troubles, and his facility with the language was damn near awe-inspiring. He'd use his intellect to try to convince others that he'd been wrongfully committed. He was so good that even I found myself questioning the wisdom of the decision once or twice. But eventually, if you spent enough time with him, the psychosis emerged.'
'In what way?'
'A misplaced word here, a jumbled thought there. The pairing of topics that bore no logical relation to one another. He'd begin a sentence and trail off into silence or add details that didn't fit. Attempts to question him about it made him acutely upset, often to the point of hysteria -jumping to his feet; making outrageous accusations; screaming. Eventually the lucid periods diminished, and he became more confused, less predictable. It became impossible to hold a normal conversation with him. Profoundly paranoid is the phrase Dr. Mainwaring used. Now' - he shook his head and sighed - 'apparently it's got even worse.'
'By less predictable, do you mean violent?'
'Not really, though I suppose unrestrained, he might have been able to do some damage. He'd flail out, jump up and down, clutch his face, tear at his hair. He may have been mildly assaultive on one or two occasions, but before the escape he had never hurt anyone. No one ever considered him homicidal, if that's what you mean.'
'This morning he was drooling and trembling and
making sucking motions with his mouth. Have you seen that before?'
'I noticed it for the first time yesterday. Of course, I haven't been in close enough contact with him to be certain he hasn't been that way before. What do these symptoms mean?'
'I'm not sure yet. I'll need a detailed record of any treatment he's received - medication, electroconvulsive therapy, psychotherapy, everything.'
His eyebrows rose.
'Are you implying some kind of toxic reaction?'
'At this point I don't know enough to imply anything.'
'Very well,' he said with some disappointment. 'I'll set up a meeting with Mainwaring, and he can fill you in. Be sure to let me know if you feel there's brain damage of any sort. It could prove useful.'
'I'll keep you posted.'
He looked at the untouched meal on my plate.
'Not hungry?'
'Not right now.'
After lifting a glass of ice water to his mouth, he sipped and put it down before speaking.
'The severity of his condition has got me thinking, Doctor. I'd originally considered petitioning for a delay based upon incompetence to stand trial but decided against it. At that time I felt the chance of success was nil. He was disturbed but still verbal with occasional flashes of brilliance; a psychiatrist talking to him at the wrong time might have mistakenly assumed malingering. In a highly publicised case judges tend to play it conservative; few of them have the gumption to cope with the hue and cry certain to result from a delay. Now, however, I don't know. If he maintains this level of deterioration or gets worse, even the prosecution psychiatrists may agree he's incompetent. What do you think?'
'Have you yourself suspected him of malingering?'
He'd begun cutting another piece of meat, and the question stilled his knife and fork and caused him to look up.
'No, not really. I know he's quite ill.'
'But not so ill that he couldn't pull off eight murders that required careful planning.'
He put the utensils down.
'You come right to the point, don't you, Doctor? No matter, I like that. Yes, you're right. We're not dealing with one cathartic explosion of bloodlust; the slashings were carried out with a perverse kind of care and attention to detail. That suggests detachment and the ability to think analytically, which poses a problem for the whole notion of an insanity defence. But I believe I have a way of dealing with that problem, which I'll come to later. In any event, what's your opinion regarding a petition for delay?'
'What would a delay mean in practical terms?'
'Involuntary commitment until such time as he's judged competent, which in this case may be if, not when. But would the boy's interests be best served by such a move? The commitment would have to be at a state hospital, and those places are horrors. He'd end up on a back ward, which might be a death sentence in itself. If I take the case to trial and the diminished capacity defence is successful, there'd be more flexibility in arranging his subsequent care.'
I knew what he had in mind. Another private hospital, where the family's money would play a major role in influencing treatment and discharge decisions. There Jamey could be put away long enough for the furore to die down and then quietly released as an outpatient in the care of his guardians.
A chilling scenario ran through my head. Would he end up yet another psychological time bomb let out on the street with little more than a prescription for Thorazine and an appointment with a therapist because some expert had misread beh
avioural suppression as significant improvement? If so, the gradual fade to noncompliance was depressingly predictable - pills not swallowed, appointments not kept - as were its consequences: the inexorable return of the demons. Confusion, pain. Night walks. The sudden lashing out fuelled by paranoiac fury. Blood.
Up to this point I'd been able to involve myself in Jamey's case - to sit across from him and feel compassion -because I'd disassociated myself from the crimes of which he'd been accused, denying the possibility that he'd butchered eight human beings. But even Souza, it seemed, assumed he was guilty, and listening to him talking strategy and discussing flexibility of care was forcing me to confront the consequences of my involvement.
Jonathan Kellerman - Alex 03 - Over the Edge Page 11