by Torey Hayden
“Did Susan know she just made up Mrs. Jones?” Cassandra asked.
“Susan knew Mrs. Jones was in there, inside her, but mostly it just felt like it was someone else having those feelings, not her. Those were such scary feelings that she couldn’t bear to feel them. So she let Mrs. Jones have them. But, of course, this got her in lots of trouble, because no one else understood about Mrs. Jones and so they blamed Susan for the things Mrs. Jones did.”
Cassandra sat quietly, not looking at me.
“And I’m thinking maybe something like this has also happened to you,” I said. “Now that we’ve started talking about it, you can remember the things Uncle Beck did, but you’ve got a lot of really big feelings about what happened. I’m thinking maybe when you were little and you couldn’t do anything about what was happening to you, it just got too hard to live like that, and so you needed to make some other people inside you to help you cope with those feelings.”
Tears started to slide over Cassandra’s cheeks. She was sitting absolutely still, frozen even, all her muscles tensed.
“It was okay you did that, Cassandra. You were taking care of yourself. Sometimes when we are in difficult situations, we have to do things that we wouldn’t do otherwise, and that’s what was happening with you. You were strong and brave to do something to keep yourself safe. But now it’s time to stop doing these things. Those difficult times are over and those ways you kept yourself safe aren’t helpful in the life you lead now. So it’s time to see that Uncle Beck is just like this turd here. He doesn’t belong inside you. Now it’s time to flush him down the toilet.”
Cassandra’s needs had been so pressing that I didn’t get a chance to meet properly with Harry Patel and have the kind of discussion I’d wanted regarding my trip to Quentin. All I had managed was to catch him briefly in the hospital corridor that morning and pass on the shocking news that Lucia had been faking Drake’s ability to speak. Harry registered wide-eyed surprise, and then we were off in opposite directions.
Lucia phoned in the middle of the afternoon.
She was crying.
“No, no, that’s okay,” I said. “You’re not bothering me. No, of course, it’s okay to phone.”
“I cannot do it,” she sobbed.
My heart sank.
“I can’t tell Skip. He’s going to be so upset. His father’s going to … I’m sorry. I cannot do it.”
I let out a long breath of air. At least she’d phoned.
“I do not know what to do,” she said in a long, low moan. She was weeping noisily.
“Well, let’s look at the possibilities.”
“There are no possibilities. I do not know what to do.”
“Well, we sort of have to take a ‘where there’s life, there’s hope’ view, Lucia. There will be something we can do,” I said with a whole lot more optimism than I was feeling.
And so the conversation went. I talked with Lucia for almost an hour. She sobbed through most of it, her voice little more than a whimper when she did manage to speak.
It was obvious she was in enormous distress. Although she did not say outright that she was suicidal, it was not hard to imagine that. Nor was it hard to imagine the impact such distress might be having on Drake’s father, whom I now knew to be depressed and suicidal himself. What a situation.
And what to do about it? Truth was, I didn’t see any more options than Lucia did. The only difference was that I couldn’t say that. So I listened. I tried to keep my voice calm and reassuring. Over and over I said the same things—that there was a way through this, that I knew it was very hard for her but she could do it and, ultimately, that it would have to involve revealing the truth about Drake to more people.
I asked if it would be better if I talked to Skip or if Skip came to the city with her, and we all had a meeting here. No, she said. No. No. No. To everything.
So we just kept talking. Or rather I did, while she cried.
Slowly, we worked our way back around to the point where we had left off in Quentin. Lucia couldn’t cope with the idea of my telling Skip, so, in the end, she once again came to where she thought perhaps she could. Emotion spent, she talked, her voice quiet and flat. Yes. She’d try. And that’s where we finished up.
As soon as I got off the phone, I went in search of Harry Patel. He was in a session and, indeed, was booked right through five o’clock. So I asked his secretary to find out if he’d be willing to stay late and have a word with me then.
When I returned to the seventh floor to see Harry after five, I found him in the little kitchen area behind the secretarial office. The floor was empty and the office staff had already gone home.
“Kitchen area” was a sophisticated name for what was simply a small room behind the reception area that contained a table and chairs, a half-sized sink, some counter space, a coffeemaker, and a microwave. Harry had a minuscule teapot out—barely big enough to hold one large mug’s worth—and he was heating a Pyrex bowl full of water in the microwave.
“Very difficult to make tea around this place,” he muttered, peering into the microwave. “Too many coffee drinkers.”
“Couldn’t you just do it in the coffeemaker?” I asked. That’s what we did downstairs, if we wanted tea. Put a teabag into the coffee carafe and let the hot water drip through.
Harry made a face of exaggerated disgust, the sort of look you’d expect on the face of a wine connoisseur if you’d just suggested he might enjoy some of that nice boxed wine you’d opened two months ago and kept in the cupboard above the stove.
“I want tea,” he replied. He lifted a small canister off the counter. “Here. Like this. My sister sends it to me. This is proper tea.”
The canister was made from woven wickerlike material, but I couldn’t tell what it was called, as most of the writing was in Bengali. The microwave dinged. Harry poured the water into his tiny teapot.
And then at last we sat down at the table to talk.
I told Harry all the details of the meeting out in Quentin. I told him, too, about the phone call earlier in the afternoon. And I admitted the one thing I didn’t understand about myself in all this: the degree of shock I felt at this case. I was accustomed to dealing with both the victims and the perpetrators of child abuse. Indeed, I could listen to Cassandra telling about the hideous experiences with Uncle Beck, and while I was horrified for her sake, I was not shocked myself. Yet, this case did shock me. This was the boy’s mother, and she had willingly sacrificed her own child to protect herself and her husband. She was willing to hurt a four-year-old to keep adults safe. I just kept thinking of what Drake had been needlessly subjected to—medical examinations, psychological interventions, the time here on the unit—and I was shocked.
I wanted to run my feelings by Harry to get his opinion, not only because I was perplexed about why this should affect me so strongly when I could accept much worse abuse cases as part of a day’s work, but also because I feared it would interfere with my ability to work with Lucia, if I didn’t pay attention to it. Intellectually, I was all right. Intellectually I could recognize the degree of fear and confusion Lucia must have felt to do what she had done, and I could respond in a rational way. However, if I wanted to be genuinely compassionate toward her, I needed to appreciate why it brought up such subjective feelings in me.
So we talked over that issue a little while. Harry, as always, was slow and meditative in his words, taking long pauses to stare into his cup of tea, as if to read information from the pattern of the tea leaves. He talked about the psychiatric perception of motherhood, about Jungian archetypes, about how we connected all these things with our own experiences, and from there he digressed into a discussion of how mothers were portrayed in mythology. I don’t know if he ever really answered my concerns specifically, and truth was, the theories that underpinned Harry’s perspective as a psychiatrist were to me just that—theories—which made them no more substantial to me than the myths he was recounting. Nonetheless, it was a helpful conv
ersation. I think what I’d really needed was simply to acknowledge those feelings aloud, to express my concerns about responding appropriately to this case, because once I had, I felt better about it, even without answers.
At last the conversation came specifically to Lucia and the problem at hand. Harry and I explored the things she had done to cover up Drake’s disability. We also discussed Drake himself and what could be done to help him. I had contacted the Mayo Clinic for a new report, but still had not received it, so we didn’t know the full extent of his physical problems, but it was obvious that for him to prosper, he was going to need special support to acquire a nonverbal method of communication, and he had already lost a crucial four years of doing this.
Harry’s brow furrowed in a thoughtful expression. “The more I think on all this, the more I’m wondering if Lucia isn’t suffering a kind of Munchausen’s by proxy,” he said.
Munchausen syndrome by proxy is a strange and complex psychiatric disorder whereby people seek attention through the suffering of someone else. A carer—usually a parent or a medical worker—does things that harm the individual in his or her care, including fabricating, exaggerating, or inducing symptoms. This is done to get attention, sometimes just straightforward attention from people the carer perceives as powerful and authoritative, such as the medical community. Other times it is done more elaborately, so that the carer him- or herself appears valiant or important. In such instances, an affected individual may set fires in order to rescue the people inside a building or in some other way endanger people with the intent of garnering attention for being heroic in saving them.
I hadn’t considered that possibility with Lucia—that she might, in fact, be purposefully avoiding appropriate intervention for Drake in an effort to get continued attention for his “specialness”—and I have to admit, the possibility of that made what was happening seem even more odious to me.
Leaving the seventh floor that night, I felt worse than when I’d arrived. That Lucia and her husband were so weak that, rather than stand up to Mason Sloane, they would make their son suffer for them was bad enough. The thought she could be doing it for attention was literally nauseating to me.
Chapter
32
The staff at the rehabilitation center where Gerda was held assessment meetings on patient progress every two weeks to establish if goals were being met and if changes were necessary. The patient was included in the meetings where possible, as were immediate relatives. Joy Hansen phoned Monday morning to ask if I would come to the assessment meeting being held that afternoon for Gerda.
When I arrived in the conference room at the nursing home, a man I didn’t recognize was sitting at the far end of the table. Tall and big-boned, with thinning mousy-colored hair, he looked to be in his mid-fifties. While he wasn’t precisely what I’d describe as elegant, his well-cut, expensive clothes and his groomed appearance gave him a refined air.
I glanced questioningly at Joy, as I sat down beside her. “Son,” she scrawled on the edge of her notebook.
A few minutes later, Gerda was brought into the room by wheelchair. She was wearing a short pink fleece robe and had a fresh, well-scrubbed look to her to a point that her skin looked vaguely translucent, like that of a Madame Tussaud’s waxwork. Her long, yellowed hair had been brushed out to flow over her shoulders, which made her look quite beautiful in a faded way, although it occurred to me at that moment that this was not a usual style for an eighty-two-year-old, and Gerda herself would probably never choose to wear her hair like that. Unable to manage her hair herself and unable to communicate to any of the staff how she preferred to wear it, she might actually be finding her appearance embarrassing and we would never realize it.
“Hello, Gerda, we’re here for your review,” said the staff nurse. Then they started off around the table, each one of them who worked with Gerda—the nurses, the physiotherapist, the occupational therapist, and so on—giving their reports.
These were crucial meetings, and from the perspective of a professional, I knew the value of the patient’s presence. Not only did it enable the patient to participate, it also protected important patient rights to information. Nonetheless, I found it uncomfortable sitting through the meeting with Gerda present. Despite the concept of giving her access to the decision process, it was, in reality, lip service. She couldn’t speak in a communicative way. Simple as that. So her future was being decided right in front of her, and however much she might not want the outcome, it was unlikely she could do anything about it. Being present only allowed her to see it happening. It didn’t allow her to change it.
Unfortunately, there was no realistic alternative. No one present was being calloused or uncaring. The simple truth was that we weren’t in control either. Her circumstances themselves—age, health, income, support network—would decide everything.
Including Gerda, however, lent an aspect of humiliation to the proceedings that I was uncomfortable with. She was reduced to the status of a child in front of us. Inadvertently people slipped into the third person during the discussion, talking about her in front of her, not as a means of exclusion but simply because she was not of decision-making status. And I was left thinking how sad this was. Perhaps there was no other choice. I was realistic and experienced enough to appreciate that. It was sad, nonetheless, and it would be wrong to lose awareness of that.
Joy presented her findings, and then it was my turn. Only Joy had thought to include me; to the other staff I was still someone of indeterminate status. Which was fair, given I was not being paid and gerontology was not my field of specialization. And even more fair, given I really had nothing to add to the official assessment. While Gerda was now speaking spontaneously to me on a regular basis, it remained coded in memories. She was communicating. Indeed, it surprised me how much could be conveyed through this odd, symbolic form of speech. I knew now not only about her homestead childhood; I knew also the emotional territory of a lonely, marginalized child. And I knew as well, from her interactions with Drake, of her interest in other lonely, marginalized children, of her ability to recognize them, of her efforts to reach across the great gulf of age and disability to respond to them, to want to know what was happening to them. Yet there was nothing I could add to an official report on her rehabilitation. Gerda communicated in this way simply because the stroke had left her unable to communicate in the way the rest of us do, and while it was communication, she still could not make a telephone call or speak to a doctor or notify someone of an emergency situation.
I said my piece. Gerda’s eyes were on me as I spoke, and if there exists telepathy in this world, it was happening then. I could hear her silent pleading. I could feel her desperation not to go down the road she was headed on. Her desolate sorrow echoed in my head. Nonetheless, I had to say what I had to say.
When the meeting ended, the decision was made. Gerda would move on to full nursing home care.
Afterward, when Gerda had been wheeled back to her room and most of the staff had returned to their duties, her son, Edward, came around the table to where I was sitting with a cup of coffee.
“I want to thank you for your efforts,” he said. “I’ve been told you’ve been coming specially to see my mother.”
I nodded. “You’re welcome. I’ve enjoyed it.”
“I wish we could have come up with something else for her,” he said. “I know she won’t like it.”
“No,” I replied.
Edward gave a faint shrug of his shoulders. “But she’s always been difficult.”
“In what way?” I asked.
“Mother is very passive-aggressive.”
This seemed an extraordinary thing to say, so I asked, “How so?”
“She’s always been one of those people who never does anything with her own life, but she also resents anyone else trying to do anything with theirs.”
“Did you find this?” I asked.
“Yes, definitely. We all did. You should have met my father. He
was extraordinary. Quite a go-getter.” Edward smiled and sat down in the chair next to mine. “Funny how families are. How, if you look at them. You know. When you get older. When maturity gives you a more distant perspective. You do wonder at the workings of them. At how things ever turned out as they did.”
I nodded.
“My father was, in his own way, very sophisticated. At least for those times. He was from Philadelphia, which was a long ways from here. In more ways than one. His family wasn’t rich, but they’d still managed to help him get a good education. He was cultured, was my dad. Well versed in things like Greek mythology and botany. Music and art. Loved his art, did my father. And opera. He knew opera, can you believe that? Out here? My mother, on the other hand, never went past eighth grade. They met—it was during the Depression, so nobody had jobs—my father was unemployed and working piecemeal at whatever he could find and he got a temporary job at the sawmill and that’s how he met her, because her father worked at the sawmill as well. He rented a room at their house and that’s how they started courting. And know what? My dad married her, and then he spent the whole rest of his life as a manual laborer. I mean, here was a guy with two years of college. He could tell you about all the great artists living in Florence during the Renaissance and explain how all that creativity came about because of the Medici family’s money, and then he’d tell you what all those pictures they painted meant. Yet he just stayed out on that ratty little farm they had, raising pigs and chickens to supplement the pittance he got paid at the mill. He had a strong personality, my father did. Influenced both Anna and me. Gave us such a love of culture.” He grinned in a rather admiring way.
“Whereas my mother never bothered to learn anything. If she told us things, it was stuff like how they had to scrape grease from the frying pan to put across their bread when she was little because they didn’t have enough money for butter, or how she raised a bum lamb once; it followed her everywhere, just like in the nursery rhyme. That was all she knew about, that very inward-looking down-home stuff. Yet she controlled my father. He refused to move off the farm. He refused to go anywhere, even into town. Kept saying it would kill her. Kill her to live somewhere else than here, just because she was born and raised here. But in the end, it killed him. Had a heart attack two days before he was supposed to retire. Just too much hard work.”