Therapy

by Sebastian Fitzek

‘No, Viktor, it's the truth,’ said Anna coldly. She sneaked a quick glance out of the passenger window.

  Viktor ran a hand over his eyes. He sniffed. ‘Tell me it isn't true.’

  ‘I'm afraid I can't.’

  ‘You made it up. You're crazy.’

  ‘Yes, I'm afraid I am.’

  ‘Why are you torturing me? What's the point of your lies? Josy isn't dead!’

  ‘She's dead.’

  She says she's schizophrenic because it's easier than confronting the truth.

  The engine roared and Viktor looked up. He could see lights in the distance through the rain-streaked windscreen.

  ‘Don't worry, it won't take much longer.’ She reached for his hand.

  ‘Who are you?’ he screamed at her. ‘How do you know these things?’

  ‘I'm Anna. Anna Glass.’

  ‘Answer the question! What's your real name? What do you want from me?’

  The windscreen was awash with water because the wipers were still switched off, but Viktor could tell that the lights were getting closer. He knew exactly where he was. He and Anna were racing along a pier, heading towards the open sea.

  ‘Tell me who you are!’ he shouted. He knew he was about to die, but he felt like a schoolboy after a playground fight: wretched, tearful and snotty.

  ‘I'm Anna Glass. I killed Josy.’

  The lights were only two hundred metres away. A kilometre behind them was the beach, and ahead was the wide expanse of the cold North Sea.

  ‘WHO ARE YOU?’

  The hysterical edge to his voice was swallowed up by the roaring engine, howling wind and raging waves.

  ‘Anna. Anna Glass. There isn't much time. You should focus on what matters. You haven't read the final page.’

  Viktor shook his head and raised his hand to his nose. It was bleeding.

  ‘Suit yourself,’ she said. ‘I've helped you enough already, so I may as well read you the end.’

  She took the final page out of his hand.

  The car continued on its inexorable path towards the sea and Anna started reading.

  56

  Josy was dead. I didn't want to believe it, but I had no choice. I clung to her fragile, lifeless body and a scream rose in my throat, collecting in my mouth and pushing against my lips, but my grief was trapped by a gag of sticky oil. There was no need to hide anymore, no need to hide from Isabell; she had got what she wanted. Josy, my constant companion over the last few days; Josy, her own daughter, was dead.

  I stood up and crawled out of the tank. I opened the door, rubbed the oil from my mouth and called her name.

  Quietly at first, then at the top of my voice. Isabell. ISABELL!

  I left the shed and ran towards the porch.

  ISABELL! YOU KILLED HER!

  I stopped, alerted by a noise. It was coming from behind me. The floor was creaking in the shed. I turned round and saw her in the doorway. At that moment I knew what had happened: she had been there all the time. She had stayed, watching and waiting while I drowned her only child.

  Slowly, I walked towards her. Because of the oil in my left eye I could barely make out her features. The distance between us was down to a few metres when my vision suddenly returned. At last I could see clearly. At last I understood.

  She stretched out a hand, an oil-smeared hand, and I realized the extent of my error. From the very beginning, I had got it all wrong. And I only had myself to blame. The person in front of me wasn't Isabell. I was face to face with . . .

  Viktor and Anna locked gazes just as she started to speak the fatal words. And then it happened.

  The car soared through the air towards the sea and at that moment, the fog cleared and Viktor saw everything with perfect clarity.

  A radiator pipe. An overhead light. A small room.

  At last he understood.

  A metal-framed bed. A grey carpet. A drip.

  It all made sense.

  Anna Glass!

  The insight seared through his body and took possession of his mind.

  I was face to face with. . .

  The final piece of the jigsaw was in place: Anna. A-n-n-a forwards and a-n-n-A backwards. Anna in the looking glass. Anna Glass.

  ‘I'm you,’ he said. With that, the car faded from view and he found himself in a hospital room.

  ‘Yes.’

  It was the last time that the sound of his own voice would make him jump. He felt like a startled animal who had finally recognized its reflection in the mirror. He repeated the sentence to be sure that he wasn't mistaken.

  ‘I was face to face with . . .’

  ‘I was face to face with . . . myself.’

  No one said a word.

  *

  It was Monday November 26, and bright winter sunshine was slanting through the bars of room 1245 where Dr Viktor Larenz, former psychiatrist and world expert on schizophrenia, was being treated for multiple psychological disorders at the renowned Wedding Psychosomatic Clinic in Berlin. After four years of treatment, the patient, who had been taken off his medication almost a fortnight earlier, was experiencing his first moment of clarity since his daughter disappeared.

  The wind had dropped, the clouds were clearing and the storms that had shaken the city over the past few days had moved on. It was a crisp, sunny afternoon.

  57

  Nine days later, Berlin-Wedding Psychosomatic Clinic

  The lecture theatre was unusually empty. At the lectern, a small grey-haired character was holding forth to two men sat opposite him in the middle of the front row, surrounded by empty chairs. Most of the auditorium, which seated five hundred, was steeped in darkness, but a row of spotlights illuminated the stage. Contrary to normal practice, the doors to the theatre were locked.

  Professor Malzius, the clinic's director, was in the process of communicating highly sensitive information to Freymann and Lahnen, two of the best defence lawyers in Berlin.

  ‘Prior to his breakdown, Dr Larenz was an eminent psychiatrist with a successful clinic in central Berlin. I'm sure you're both aware of his myriad achievements, so I won't review them in detail now. Suffice to say, he was the author of numerous books and a regular guest on radio and TV.’

  The lawyers nodded and cleared their throats. Professor Malzius reached for the remote control and pointed it at the projector. They saw a portrait photo of a striking young doctor in his office, then the next slide appeared. It was still recognizably Dr Larenz, but this time in a lamentable state, curled up naked in a foetal position on a hospital bed.

  ‘He suffered a nervous breakdown following the disappearance of his daughter. He was admitted to the clinic on a temporary basis, but his condition worsened and he never recovered sufficiently to be transferred or released.’

  He clicked to another slide. It was a newspaper headline:

  STILL SEARCHING FOR JOSY

  Four Years Since Celebrity Psychiatrist's

  Daughter Vanished Without Trace

  ‘Four years ago last November, Dr Larenz's twelve-year-old daughter went missing. In the eleven months preceding her disappearance she developed a range of inexplicable symptoms. The cause of her illness, the nature of her abduction and the identity of those responsible remained a mystery . . .’ explained Malzius. He paused for a few seconds. ‘. . . Until now!’

  He was interrupted by one of the lawyers, a small man with curly blonde hair, who shot to his feet as if to say Objection, your Honour!

  ‘With all due respect, Professor Malzius, my colleague and I were hoping to hear something new. We're running out of time.’

  ‘Thank you, Mr Lahnen. I'm aware that you and Mr Freymann have an extremely busy schedule.’

  ‘Good. In that case you'll understand our concern. Our client is scheduled for transfer to the psychiatric wing of Moabit penitentiary in precisely thirty minutes. The preliminary hearing takes place tomorrow, which means we need to consult with our client today. Once he's released from this facility, the law will deem him well enough to s
tand trial for manslaughter or possibly murder.’

  ‘Indeed,’ snapped Malzius, irritated at being interrupted in his own auditorium by someone without a medical degree. ‘If you'll allow me to proceed with the briefing, you may find yourself learning something of relevance to his defence.’

  Lahnen pursed his lips and sat back down.

  ‘For four years the patient was unaware of his surroundings,’ continued Malzius. ‘He was living in an imaginary world, disconnected from reality. Then three weeks ago we took a radical, and dare I say groundbreaking step with regard to his treatment. I'll spare you the medical details and focus on the results.’

  Lahnen and Freymann nodded gratefully.

  ‘The first thing to understand is that Viktor Larenz suffers from two distinct conditions: Munchausen syndrome by proxy and schizophrenia. I assume you're more familiar with the latter, so I'll acquaint you with Munchausen's first. The syndrome derives its name from the notoriously boastful Baron Munchausen. Its sufferers lie about their health in order to gain sympathy from medical professionals and friends. By feigning physical symptoms, patients have been known to convince their doctors to carry out unnecessary surgery – appendicectomies, for example. They may also attempt to prolong the need for treatment by rubbing excrement or vomit into a wound.’

  ‘That's crazy,’ muttered Lahnen, frowning. His colleague looked similarly appalled.

  ‘Well yes, they're mentally unwell. The trouble is, diagnosis is very difficult. Munchausen's is more common than most people realize. Video surveillance has been used in some hospitals to help with detection, but it wouldn't have picked up on Larenz's problem. You see, Larenz suffered from Munchausen's by proxy, aka fabricated or induced illness or FII, which means he inflicted symptoms on someone else, namely his daughter.’

  Malzius paused to measure the effect of his words.

  ‘Larenz alone was aware that his daughter suffered from an immune system disorder, and he used his medical knowledge to murderous effect. Josephine, or Josy as he called her, had a hypersensitive reaction to paracetamol and penicillin, both of which he administered in increasing quantities. I suppose you could say it was the perfect crime. Larenz continued to prescribe paracetamol for Josephine's headaches and penicillin for her other mysterious symptoms, and everyone thought he was an exemplary father. His family and friends knew nothing of her allergies, so the regimen of drugs seemed medically sound. As it happened, Larenz was putting his daughter into anaphylactic shock. During the final stages, the doses were high enough to kill her.’

  The clinic director broke off to take a sip of water.

  ‘The endless round of doctor's appointments and consultations is another typical symptom of FII. In Larenz's case, the abusive behaviour was triggered by an incident that occurred when he, his wife and his daughter were on holiday in Sacrow. Josephine was eleven years old at the time and the father–daughter relationship was extremely close. All that was about to change. Josephine needed more privacy: she started closeting herself in the bathroom and she seemed more at ease in the company of her mother. There was a simple explanation: she had started to menstruate. Larenz was devastated by this milestone in his daughter's development. He couldn't cope with the idea that his little girl would soon become an independent adult. Not even his wife had noticed his pathologically possessive attitude to Josephine and so it didn't occur to her that he would deliberately poison their daughter to stop her growing up. He administered paracetamol and penicillin to make her vulnerable and dependent – typical FII. The syndrome is usually associated with mothers. It's the first time I've seen it in a male.’

  ‘Fascinating, Professor Malzius,’ said Freymann, seizing his chance. ‘Perhaps we could focus on the legal aspect. In your opinion, was Dr Larenz responsible for his actions? He poisoned his daughter over a period of nearly a year. That involves planning and premeditation, does it not?’

  ‘Not necessarily. Larenz is a pathological liar. He suffers from FII and he lied about his daughter's illness, but it's more complicated than that. Larenz believes his lies; he's delusional. And so we come to his second disorder: schizophrenia.’

  Malzius looked from Freymann to Lahnen.

  ‘His behaviour doesn't follow the usual rules.’

  58

  The doors to the auditorium were locked, so Dr Roth was obliged to brave the cold and peer through the outside windows. A few minutes earlier, Viktor had reached the end of his story, and Roth had hurried downstairs to find out where the lawyers had got to. He was secretly hoping that the professor was treating his visitors to one of his famously long-winded explanations: the usual difficulty was persuading him to stop. The lights in the auditorium were still dimmed and Malzius was in full flow. In fact, judging by the number of slides remaining, he and the lawyers would be busy for at least another fifteen minutes, enough time for Roth to achieve what he had to, provided that he was quick. He set off determinedly, stopping at the onsite pharmacy to collect some tablets, and arrived three minutes later at Viktor's door. He paused for a moment to recover his breath, smooth his hair and peer through the spyhole: no change. Viktor, still tied to the bed, was staring at the ceiling. Roth hovered outside, then made up his mind and inserted the cumbersome key into the lock. A quick turn to the right, and the metal door sprang open.

  ‘So you're back.’

  Viktor raised his head a little and craned his neck to see the psychiatrist walk into the room. Roth's left hand was thrust deep into his pocket, so Viktor couldn't be certain whether he was carrying anything or not.

  ‘Yes, I'm back.’

  ‘Have you decided to help me after all?’

  Dr Roth strode wordlessly to the window and gazed into the darkness. It had been snowing since early that morning, and the flakes had settled, covering the ugly concrete forecourt in a blanket of snow.

  ‘Have you got what I asked for?’

  ‘I'm still not—’

  ‘Come on, Dr Roth, you heard what happened, and you know that I'm right.’

  Privately, Roth agreed, but he didn't want to put his career on the line without reminding Viktor of the risk he was taking on his behalf. He hesitated.

  ‘I'm counting on you, Dr Roth. We don't have much time. They're already half an hour late.’

  ‘All right, Dr Larenz, I must be mad to agree to this, but I'll do as you ask. You trusted me with your story, and after this we'll be quits. Don't ask me to do anything more.’

  Roth left the jar of pills in his pocket, withdrew his left hand and deftly loosened the straps. Viktor rubbed his wrists and ankles gratefully. ‘Thanks. That was kind of you.’

  ‘No problem. Look, we've got ten minutes at most, then I need you back in the restraints. Do you want to go to the bathroom and freshen up?’

  ‘No. You know what I want.’

  ‘You want your freedom.’

  ‘Yes.’

  ‘Out of the question. You know I can't do it.’

  ‘Why? I thought once you'd heard the full story—’

  ‘Have I heard the full story?’

  ‘Of course. I told you everything.’

  ‘I'm not convinced you did.’ Dr Roth shook his head and breathed out heavily through his nostrils. ‘I think you're hiding something. Something important. You know what I'm talking about, don't you?’

  ‘Do I?’ said Viktor with a roguish smile.

  ‘What's so funny?’

  ‘Nothing.’ Viktor grinned. ‘I was wondering how long it would take you to ask.’

  59

  Professor Malzius cleared his throat, took another sip of water and continued his lecture in the monotonous drone otherwise reserved for those who had the dubious pleasure of being a doctor, patient or student at the clinic.

  ‘Larenz's schizophrenia allowed him to inhabit a different reality. In the early stages of his condition, he was anchored in the normal world, but after a while the delusions became his life. Because of his schizophrenia, he wasn't aware of what he was doing to his d
aughter. It was a kind of defence mechanism: the delusions allowed him to continue administering paracetamol and penicillin in the belief that Josephine needed the medication. He didn't have to pretend to be a devoted father, he truly believed it, and everything he did was geared towards making her better: he gave up his job and threw himself into the search for a cure. Josephine was seen by every imaginable specialist – with one glaring exception: Larenz omitted to take her to an allergist. As Josephine's condition worsened, so too did his delusions. His relationship with Isabell deteriorated and he persuaded himself that she was to blame for Josephine's ill health. In fact, he even went so far as to accuse her of killing his daughter, when all the while he was the culprit, albeit without knowing it.’

  ‘In other words, manslaughter, not murder,’ broke in Freymann, a thickset giant of a man. He was wearing a double-breasted navy blazer with distinctive buttons. A gold chain led from his belt to the timepiece in his pocket, and a paunch had started to form above the waistband of his grey trousers.

  ‘The legal ramifications are your concern,’ said Malzius, taking a tone more commonly used with ill-mannered children. ‘My task, as I understand it, is to outline the facts – and those are the facts, to the best of our knowledge. But if you want my opinion, Dr Larenz can't be held responsible for what he did. He certainly didn't intend to kill his daughter; he only wanted to stop her growing up. And it wasn't premeditated: Josephine didn't die because of the poison; she drowned.’

  He reached for the remote control and forwarded to the next slide. It showed the Larenzs’ villa in Schwanenwerder.

  ‘Dr Larenz's house – a truly magnificent place.’

  Freymann and Lahnen shifted in their seats and nodded impatiently.

  ‘At the time of the accident, Larenz's schizophrenia had reached an advanced stage. He believed that he and his daughter were on holiday on a small North Sea island called Parkum, when actually they were in the garden at home. The fateful hallucinations began when he became convinced that Isabell, who was at work that day as usual, was at the front door. As I mentioned before, he already perceived Isabell as a threat to his daughter and, on hearing her voice, he picked up Josephine and took her to the boathouse.’