In the hall, he heard her crying.
* * *
AMFORTAS SKIPPED lunch and worked in his office, finishing the paperwork on some cases. Two of them were epilepsies in which the seizures were triggered bizarrely. In the first case—a woman in her middle thirties—the onset was induced by the sound of music, and the girl of eleven in the second case had only to look at her hand.
All the other workups dealt with forms of aphasia:
A patient who repeated everything said to her.
A patient who was able to write, but completely unable to read back what he had written.
A patient unable to recognize a person from facial features alone, the recognition requiring a hearing of the voice, or the noting of a characteristic feature, such as a mole or a striking hair color.
The aphasias were connected to lesions of the brain.
Amfortas sipped coffee and tried to concentrate. He couldn’t. He set down his pen and stared at a photograph propped on his desk. A golden young girl.
The door to his office flew open and Freeman Temple, the Chief of Psychiatry, bounded in with jaunty, lithe steps, springing upward on his toes a little as he walked. He careered to a chair near the desk and flopped down. “Boy, have I got a girl for you!” he said gaily. He stretched out his legs and crossed them comfortably while he lit a cigarillo and tossed the fanned-out match to the floor. “I swear to God,” he continued, “you’d love her. She’s got legs running all the way up to her ass. And tits? Jesus, one of them’s big as a watermelon, and the other one’s really big! It also happens she loves Mozart. Vince, you’ve gotta take her out!”
Amfortas observed him without expression. Temple was short and in his fifties, but his face had a puckish, youthful look with a constant merriment about it. Yet his eyes were like wheatfields stirring in a breeze, and at times had a deadly, calculating look. Amfortas neither trusted him nor liked him. When Temple wasn’t bragging of his amorous conquests, he adverted to his boxing matches in college, and he tried to get everyone to call him “Duke.” “That’s what they called me at Stanford,” he would say. “They called me ‘Duke.’ ” He would tell all the prettier nurses that he always avoided a fight because “under the law, my hands are considered to be lethal weapons.” When he drank he was insufferable, and the boyish charm turned into meanness. He was drunk right now, Amfortas suspected, or high on amphetamine, or both.
“I’ve been dating her girlfriend,” Temple rushed on headlong. “She’s married, but hell. So what? What’s the difference? Anyway, the one for you is single. Want her number?”
Amfortas picked up his pen and looked down at his papers. On one, he made a note. “No, thanks. I haven’t dated in years,” he said quietly.
Abruptly the psychiatrist seemed to sober, and he stared at Amfortas with a hard, cold squint. “I know that,” he said evenly.
Amfortas continued to work.
“What’s the problem? Are you impotent?” Temple demanded. “That happens a lot in your situation. I can cure it with hypnosis. I can cure anything with hypnosis. I’m good. I’m really, really good. I’m the best.”
Amfortas continued to ignore him. He made a correction on a paper.
“The goddamn EEG’s broken down. Can you believe it?”
Amfortas was silent and continued to write.
“Okay, what the hell’s this?”
Amfortas looked up and saw Temple reaching into a pocket. He extracted a folded sheet of memo paper and tossed it onto the desk. Amfortas picked it up and unfolded it. When he read it, he saw, in what appeared to be his writing, the cryptic statement, “The life is less able.”
“What the hell does that mean?” repeated Temple. His manner had now grown openly hostile.
“I don’t know,” said Amfortas.
“You don’t know?”
“I didn’t write it.”
Temple bolted from his chair and to the desk. “Christ, you gave it to me yesterday in front of the charge desk! I was busy and just stuck it in my pocket. What’s it mean?”
Amfortas put the note aside and continued with his work. “I didn’t write it,” he repeated.
“Are you crazy?” Temple grabbed the note and held it out before Amfortas. “That’s your writing! See those circles there over the i’s? Incidentally, those circles are a sign of a disturbance.”
Amfortas erased a word and wrote over it.
The white-haired psychiatrist’s face turned crimson. He sprang to the door and yanked it open. “You’d better make an appointment with me,” he snorted. “You’re a goddamn hostile, angry man and you’re fucking crazier than a loon!” Temple slammed the door behind him.
For a time, Amfortas stared at the note. Then he went back to work. He had to finish this week.
* * *
IN THE afternoon, Amfortas gave a lecture at the Georgetown University Medical School. He reviewed the case of a woman who from birth had been unable to feel any pain. As a child she had bitten off the tip of her tongue while chewing food, and had suffered third-degree burns after kneeling for minutes atop a hot radiator to look out of a window at a sunset. When later examined by a psychiatrist, she reported not feeling pain when her body was subjected to strong electric shock, to hot water at extremely high temperatures, or to an ice bath that was greatly prolonged. Equally abnormal was the fact that she showed no changes in blood pressure, heart rate or respiration when these stimuli were applied. She could not remember ever sneezing or coughing, the gag reflex could be elicited only with great difficulty, and corneal reflexes that protect the eyes were totally absent. A variety of stimuli, such as inserting a stick up through the nostrils, pinching tendons or injections of histamine under the skin—normally considered forms of torture—also failed to produce any pain.
The woman eventually developed serious medical problems: pathological changes in her knees, hip and spine. She underwent several orthopedic operations. Her surgeon attributed her problems to the lack of protection to her joints that was usually given by sensation of pain. She had failed to shift her weight when standing, to turn over in her sleep, or to avoid certain postures which produce inflammation of the joints.
She died at age twenty-nine of massive infections which could not be controlled.
There were no questions.
* * *
AT THREE thirty-five, Amfortas was back in his office. He locked the door and sat down and waited. He knew he couldn’t work just now. Not now.
Occasionally someone would rap at the door, and he waited for the footsteps to go away. Once there was a rattling of the doorknob, then pounding, and he knew it was Temple even before he could hear his low growl through the wood of the door: “You crazy bastard, I know that you’re in there. Let me in so I can help you.” Amfortas kept silent and he heard no movement for a time on the other side of the door. Then he heard a guarded, soft “Big tits.” And another silence. He imagined that Temple had his ear to the door. At last he heard his springing footsteps creaking away on double-thick soles. Amfortas continued to mark the time.
At twenty to five he telephoned a friend at another hospital, a neurologist on the staff. When he reached him, he said, “Eddie, this is Vincent. Has my CAT-scan result come in?”
“Yes, it has. I was just about to call you.”
There was a silence.
“Is it positive?” Amfortas asked at last.
Another silence. Then, “Yes.” It was almost inaudible.
“I’ll take care of it. Goodbye, Ed.”
“Vince?”
But Amfortas was already hanging up.
He took a sheet of department stationery from a right-hand drawer of his desk, and then carefully composed a letter addressed to the Chief of Neurology.
Dear Jim:
This is difficult to say, and I’m sorry, but I need to be relieved from my regular duties effective this Tuesday evening, March 15. I need all the time I can get for my research. Tom Soames is very competent, and my patients are secure in
his hands until you can find a replacement for me. By Tuesday, my reports on old patients will be finished, and Tom and I agree on the new ones seen today. After Tuesday, I’ll try to be around for consultation, but I really can’t promise. In any case, you’ll find me in the lab or at home.
I know this is sudden and will cause you some problems. Again, I’m very sorry. And I know you’ll respect my desire not to say any more about my decision. I’ll have my desk cleaned out by week’s end. The ward’s been terrific. So have you. Thanks.
Regretfully,
Vincent Amfortas
Amfortas left his office, put the letter in the Chief of Neurology’s box and walked out of the hospital. It was almost half past five, and he quickened his steps toward Holy Trinity. He could make the evening Mass.
The church was crowded and he stood in the back and followed the Mass with an agonizing hope. The broken bodies he had treated through the years had imbued him with a sense of man’s frailty and aloneness. Men were tiny candle flames, apart and adrift in a void that was endless and terrifying and black. This perception brought humanity into his embrace. Yet God eluded him. He’d found His cryptic traces in the brain, but the God of the brain only beckoned him toward Him, and when he came close He held him out at arm’s length; and at the last, there was nothing to embrace but his faith. It hugged the candle flames together in a oneness that soared and illumined the night.
“O Lord, I have loved the beauty of thy house.…”
Here was all that could matter, for nothing else did.
Amfortas glanced over at the lines for confession. They were long. He decided to go the next day. He would make it a general, he thought: a confession of the sins of all his life. There would be time at the morning Mass, he thought. There was rarely a line at that hour.
“And may it become for us an everlasting healing.…”
“Amen,” prayed Amfortas firmly.
He had made up his mind.
* * *
HE UNLOCKED the front door and walked into the house. In the foyer he picked up the bag and the Post and then carried them into the little living room, where he turned on all the lamps. The house was a rental, fully furnished in a cheap, drab, mock-colonial style. The living room railroaded into a kitchen and a tiny breakfast nook. Upstairs were a bedroom and a den. It was all that Amfortas needed or wanted.
He eased himself down into an overstuffed chair. He looked around him. The room was, as usual, untidy. Disarray had never bothered him before. But now he felt an odd impulse to straighten it up, to organize and clean the entire house. It was something like the feeling before a long trip.
He put it off until tomorrow. He felt weary.
He stared at a tape recorder on a shelf. It was connected to an amplifier. There were earphones. Too tired for that as well, he decided. He didn’t have the energy for it now. He looked down at the Washington Post on his lap, and in an instant the headache was tearing at his brain. He gasped and his hands flew up to his temples. He stood up and the newspaper scattered to the floor.
He lurched upstairs and into his bedroom. He fumbled for the lamp and turned it on. By the bed he kept a medical bag, and he opened it, removing a swab, a disposable syringe and an amber-colored vial filled with a fluid. He sat down on his bed, unbuckled his pants and pushed them down, exposing his thighs. And in moments, he’d injected six milligrams of Decadron, a steroid, into the muscle of his leg; the Dilaudid wasn’t enough anymore.
Amfortas fell back on the bed and waited. The amber-colored vial was clutched in his hand. His heart and his head pounded out different rhythms, but then after a while they melted into one. He lost track of the time.
When at last he sat up he saw that his trousers were still at his knees. He pulled them up, and as he did, his eye caught the green and white ceramic on his bedstand, a fluffy duck in little girl’s clothing. A legend read HONK IF YOU THINK I’M ADORABLE. For a moment he stared at it sadly. He buckled his belt and went downstairs.
He went into the living room and gathered up the Sunday Washington Post. He thought to read it while he heated a frozen dinner. When he’d turned on the overhead kitchen light he stopped in his tracks. On the breakfast nook table were the remains of a morning meal and a copy of the Sunday Washington Post. The paper was disarrayed and in sections.
Someone had been reading it.
4
DIVISION OF CONSOLIDATED LABORATORY SERVICES
Bureau of Forensic Science
Laboratory Report
March 13, 1983
TO: Alan Stedman, M.D.
cc: Dr. Francis Caponegro
Your Case #50
FS LAB #77-N-025
Victim (s): Kintry, Thomas Joshua
Examiner: Samuel Hirschberg, Ph.D.
Laboratory: Bethesda
Age: 12
Race: B Sex: M
Date Received: March 13, 1983
Suspect (s): None
Evidence Submitted By: Dr. Alan Stedman
One bottle of blood and one bottle of urine for alcohol and drug screen.
Results of Examination:
Blood: 0.06% ethanol weight/volume
Urine: 0.08% ethanol weight/volume
Blood and Urine:
Negative for significant quantities of cyanide and fluoride; negative for barbiturates, carbamates, hydantoins, glutarimides and other sedative-hypnotic drugs. Negative for amphetamines, antihistamines, phencyclidine, benzodiazepines. Negative for natural and synthetic narcotics and analgesics. Negative for tricyclic antidepressants and carbon monoxide. Negative for heavy metals. Positive finding: succinylcholine chloride, 18 milligrams.
Samuel Hirschberg, Ph.D.
Toxicologist
5
“There is a doctrine written in secret that man is a prisoner who has no right to open the door and run away; this is a mystery which I do not quite understand. Yet I too believe that the gods are our guardians, and that we men are a possession of theirs.”
Kinderman thought of the passage by Plato. How could he help it? It haunted this case. “What’s the meaning of it?” Kinderman asked the others. “How can this be?”
They sat around a desk in the middle of the squad room, Kinderman, Atkins, Stedman and Ryan. Kinderman needed the activity around him, the steadying bustle of a world where there was order and the floor would not vanish from beneath his feet. He needed the light.
“Well, of course it’s not a positive identification,” said Ryan. He scratched at a muscle in his forearm. Like Stedman and Atkins, he was working in his shirtsleeves; the room was overheated. Ryan shrugged. “Hair can never give you that, we all know that. Still…”
“Yes, still,” echoed Kinderman. “Still…”
The medulla of the hairs were identical in thickness, and the shape and size and number per unit length of the overlapping scales of the cuticles were exactly the same in both the samples. The hairs that had been taken from Kintry’s hand had fresh, round roots, implying a struggle.
Kinderman shook his head. “It couldn’t be,” he said. “It’s farblundjet.”
He looked down at a photo they had taken of the woman, and then into the cup of tea in his hand. He poked at the lemon slice with a finger, bobbing and stirring it around a little. He still wore his coat. “What killed him?” he asked.
“Shock,” answered Stedman. “And slow asphyxiation.” Everyone stared. “He was injected with a drug called succinylcholine. Ten milligrams for each fifty pounds of body weight causes instant paralysis,” he said. “Kintry had almost twenty milligrams in him. He wouldn’t have been able to move or cry out, and after ten minutes or so he couldn’t breathe. The drug attacks the respiratory system.”
A cone of silence descended upon them, cutting them apart from the rest of the room, from the busy, loud chattering of men and machines. Kinderman heard them, but the sounds were muted and far away, like forgotten prayers.
“What is it used for,” Kinderman asked, “this—what did you call it?”
“Succinylcholine.”
“You love to say that, don’t you, Stedman.”
“It’s basically a muscle relaxant,” said Stedman. “It’s used for anesthesia. You mainly find it used in electroshock therapy.”
Kinderman nodded.
“I might point out,” the pathologist added, “that the drug leaves almost no margin for error. To get the effect that he wanted, the killer had to know what he was doing.”
“So a doctor,” said Kinderman. “An anesthetist, maybe. Who knows? Someone medically qualified, right? And with access to the drug, this whatever. Incidentally, did we find a hypodermic syringe at the scene of the crime or, as usual, only some Crackerjack prizes that the rich kids are constantly throwing away?”
“We didn’t find a syringe,” Ryan answered stoically.
“It figures,” Kinderman sighed. The search of the crime scene had yielded them little. True, the mallet bore the marks of impacting on the nails; but only smeared fingerprints had been found, and blood antigen tests of the saliva on the cigarette butts showed the user had blood type O, the most common of them all. Kinderman saw Stedman checking his wristwatch. “Stedman, go home,” he said. “You, too, Ryan. Go away. Go on. Go home to your family and talk about Jews.”
Parting amenities were exchanged and Ryan and Stedman escaped into the streets with nothing more on their minds now but dinner and the traffic. As Kinderman watched them, the squad room came to life again for him, as though it had been touched by their ordinary thoughts. He heard telephones ringing, men shouting; then they passed through the door and the sounds were gone.
Atkins watched as Kinderman sipped his tea, deep in thought; saw him reach inside his cup, extract the lemon slice, squeeze it and then let it plop back into the cup. “This thing about the newspapers, Atkins,” he brooded. He looked up and met Atkins’ steady gaze.
“It’s got to be an error, Lieutenant. It must be. There’s some explanation. I’ll check at the Post again tomorrow.”
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