I have to admit, Dr. Frankenstein’s laboratory had come to mind when Zugg first hypothesized as to the reason Paul Liu and Kevin Lee had been abducted. I had pictured massive Van de Graaff generators and operating tables being hoisted toward the night sky while lightning bolts flashed and werewolves bayed at the moon…but that was fiction. As difficult as it was to believe, at Edgewood Hospital, here in the middle of Long Island suburbia, reality had replaced fantasy.
“Ready for the best part?” Lido said.
Ambler and I shrugged. I couldn’t imagine how he could top what we had just seen.
Lido approached a wall mounted X-ray viewer and flipped on the light. The illuminated x-ray clipped to the viewer was of Rat’s deformed skull. Zugg had been right on the money.
Sixty-Three
Lido’s sense of the macabre had not been sufficiently sated, so we left him below ground to nose around the operating room while Ambler and I hoofed it back up to Pilgrim State to debrief Dr. Marsh.
Marsh looked nothing like I expected. He had WASP-fro hair. How’s that for a portmanteau? He was wearing plaid pants and was puffing on a pipe. Oddly, he reminded me of an aging porn star, reminiscent of the days when adult films were shot in 8mm.
Marsh and Hector were huddled over a pair of folders, reviewing notes, when Ambler and I arrived. We sat down at the conference room table and waited a moment while the good doctors completed their current stream of thought. This was my first contact with Marsh. I reached across the table and shook his hand.
Marsh turned the folders around so that we could examine the photos they contained. The first folder contained pictures of the man who had been posing as the late Dr. John Maiguay. The photos spanned several years chronicling him as he progressed from a young boy into a teenager. His cleft lip scar was clearly visible in the early photos; the one’s taken before he developed facial hair. With the dark mustache in place, it was almost impossible to detect his birth defect. I recalled the first time I’d met him, the minutest hint of a scar just peeking out from behind his mustache and commenting to myself that only a very observant eye would notice it. He was the lucky one—the photos of Rat were impossible to bear.
Here too, the photographs had recorded his development as he progressed from a young boy into a teen. As Zugg had foretold, Rat’s abnormalities were congenital. The early photos were the hardest to look at, the child’s face with the enormous cyst on the forehead occluding his eye. It was more than I could handle. I closed the folders and pushed them back across the table.
“Their names are James and Terrance Ryan,” Marsh said.
“Ryan?” Ambler queried, no doubt surprised, as I was that the boys did not have Asian names.
“That’s right, James and Terrance Ryan, twin brothers, the sons of Patrick and Mayra Ryan. Patrick Ryan was a veteran, born and raised on Long Island. As a vet, he had his military benefits to pay for the care of his boys.”
“Which one is which?”
“James is the one that’s been impersonating the deceased Dr. Maiguay. Terrance is the one with the extreme deformities.”
“Then their mother was Asian?”
Marsh nodded.
My mind once again flashed back to my initial encounter with the man posing as Dr. Maiguay. I recalled thinking that his features were a curious blend of Oriental and occidental—now it made sense. “You seem to be very familiar with this case.”
“Detective, I was employed here at Pilgrim State for almost thirty years. I started as a staff psychiatrist right out of medical school and worked here until I retired a few years back—in charge of the facility for the last twenty. You have no idea what I’ve seen over the years.” Marsh took a moment to wet his lips. “I haven’t come across a more difficult case study than the one involving Terrance and James. One of the most tragic stories I’ve ever encountered.”
I honestly didn’t know that I had the strength to hear Marsh’s story, but I knew I had to. “I’m sure this is difficult for you, Doctor. We don’t need all the gory details, a high level overview will suffice.”
“That might be best,” Marsh said.
It was getting very late and I was beginning to feel physically and emotionally spent. Whatever it was that had kept me going had run out. We had recovered Paul Liu and had two suspects in custody. It was only a macabre sense of curiosity that kept me in my chair while my queen sized sleigh bed and pillow cried out for me. I was dying for a good night’s sleep and would be happy enough to wrap up the details in the morning—or so I thought.
Marsh took a moment while he packed more tobacco in his pipe. Thank God he didn’t light up. “Ryan met his wife and married overseas—the Philippines I believe.” He reviewed the folder before continuing. “Mother’s name was Mayra de la Cruz.” He shut the folder and looked me in the eye. “The Philippines is the Third World. Have you ever been to a Third World country, either of you?”
“I’ve been to Haiti,” Ambler said. “It’s not pretty, children running around naked, hungry people living in shacks. It’s very bleak.”
“That’s right, inadequate nutrition, disease, lack of medical care—all adds up to a high level of birth defects. Do you understand where I’m going with this?”
We did, and I’m sure he could read in our eyes that we didn’t need to know the gruesome details pertaining to Terrance Ryan’s congenital birth defects.
“You can leave out the details concerning the boy’s physical deformities, Dr. Marsh,” Ambler said. “We’re more concerned with their behavior and anything that would help us to understand why they became deviant.”
“These boys never had a chance. By the time they were brought here for care, they had already endured their mother’s suicide and years of rejection and ridicule. Their father blamed them for their mother’s suicide. He was a very traditional Irishman with strong opinions. He didn’t make their lives easy.”
I didn’t want to assume, but could understand why Mayra de la Cruz had taken her own life—the pain she must have endured as a foreign woman trying to bring up two deformed children with no support from family or friends. All the same, I had to ask. “Do you know if the mother left a suicide note?”
“No,” Marsh said. “I only know about the suicide because it was disclosed during the intake procedure.”
“And their father is dead?”
“I can only assume so. He was in a bad way when he brought the boys here.”
“Bad way?” Ambler asked.
“Out of work—I suspect he was a lush. He dropped the boys off and never came back. Despite our best efforts, the boys endured a living hell while they were here.”
“How long was that?”
“Almost ten years as I remember. They were discharged when they reached their majority. They took advantage of outpatient services for a while after that—eventually we lost track of them.”
“And Maiguay was a physician here?” Ambler asked.
“Yes, he worked in the infirmary for many years. The man had a good heart.”
“How so?”
“Well, just the fact that he devoted so many years to this facility. The state doesn’t pay all that well, you know. He passed up many lucrative offers, just so that he could take care of Pilgrim’s resident population—he was one of the only kind souls the Ryan boys knew. Finally though, economics won out and he accepted a position at Lenox Hill in the city.”
“How long ago was that?”
“Just before I retired, three to four years ago.”
Ambler and I looked at each other, presumably arriving at a similar conclusion at the same time. The real John Maiguay never made it to his new job at Lenox Hill. Somehow James Ryan must have stayed close to Maiguay, learning enough medicine to pose as a physician and take his spot at Lenox Hill. The real John Maiguay, the devoted physician that cared so deeply for these unfortunate twins never made it out of The Pine Barrens, and was likely the twins’ first victim.
“It’s not hard to see why they tu
rned out the way they did. Still, James must have been a brilliant child in order to pull off the elaborate scheme that he did.”
“Oh yes, James was bright alright, extremely bright. Both boys had above average IQs, especially Terrance.”
“But I thought he was mentally impaired,” Ambler said.
“Terrance, mentally impaired? Why would you say that?” He flipped open one of the folders and began looking through it. “He was tested a number of times—consistently scored over one hundred sixty on the Wexler Adult Intelligence Scale.”
“I knew it,” Ambler shouted. “He’s a goddamn faker.”
“What do you mean he was faking it?” Hector asked.
“Terrance was psychologically evaluated shortly after he was apprehended. We were led to believe that he had very limited intelligence, likely as a result of his congenital deformities. We were told he had limited executive functioning.”
“Not the Terrance I knew,” Marsh said. “He was brilliant despite everything he was going through. If either of these boys was capable of committing a complex crime, it’s Terrance. Despite his small size, he completely dominated James. He was physically abusive. He used to slice his brother’s scalp with glass, beat him, and burn him, but smart enough not to leave any marks on the face or arms. He got away with it for years and James never turned him in.”
“Why do you suppose that was, Dr. Marsh? Why do you suppose James put up with physical abuse? He was bigger, stronger—it just doesn’t make a hell of a lot of sense,” Ambler said.
“It makes all the sense in the world. You see, all the physical size in the world won’t help you when you’re intimidated, and in this case, the simple answer is that James was afraid of his brother.”
“James was afraid of Terrance?”
“Oh certainly,” Marsh said, “Almost everyone was.” He took a pack of cigarettes out of one pocket and retrieved a lighter from the other. “Anyone mind if I smoke?”
I wasn’t a fan of smoking, but I wasn’t going stop him. We were finished with Marsh’s debriefing. He lit the cigarette. The first whiff of it sent my mind flying. “I’ve got to go. Thank you for your time.” As I left the room I wondered why I hadn’t made the connection before.
Sixty-Four
John Doe, the apartment over the restaurant, and the tunnel staircase, they all reeked from cigarette smoke, and then it hit me, so did Ryan. I don’t know why it hadn’t dawned on me before, but it all hit home the moment Marsh lit his cigarette. Terrance Ryan, the man known as Rat, needed to be looked in on, and he needed to be looked in on now.
Ambler had stayed behind to wrap things up. Gus was sitting next to me as the chopper lifted off and headed back to Manhattan.
I took the time to brief him on the meeting Ambler and I had taken with Marsh and Hector. Needless to say, I had his full and undivided attention.
“You have to wonder, why didn’t they torture Paul Liu the way they tortured John Doe?”
“Because, Gus, he was the right one. In Paul Liu, they’d had found their holy grail, the one human being that could be used to repair Terrance Ryan’s congenitally deformed skull. It was their prize and they needed to keep it, keep Paul Liu in good condition until they could perform the surgery.”
There was a lot that I had to presume, but presume I would for I needed to make all the pieces fit within my mind before I reached Lenox Hill. Marsh had stated that the twins had been discharged from Pilgrim State upon reaching their majority. He also said that they had been outpatients for a short time, but soon after, disappeared. The word, disappear, meant different things to different people. To a man like Marsh, it meant that they stopped making appointments and coming to the hospital. To me, it meant that they had simply dropped out of sight.
I would never be able to imagine what life was and had been like for someone like Terrance Ryan. His deformities had forced him to retreat underground, to shun society, and lurk within Manhattan’s shadows and the tunnels that connected Pilgrim State and Edgewood Hospitals. He must have learned early in life to intimidate and to use his intellect to his best advantage, in order to survive against the never-ending pain he was forced to endure as a result of his appearance. Torture and manipulation had become the tools he relied on for survival.
The promise of a new day must exist in the human mind in order for an individual to go on day after day. There must be hope, and to create hope, Terrance had fantasized about and attempted to carry out his warped plan to alter his appearance by replacing his congenitally deformed skull with a healthy one. I could only imagine that his plan was years in the making, learning medicine, learning surgery, dreaming, scheming—in his sick mind, somehow it all made sense. As for his brother James, he was either equally deranged, or so completely dominated by Terrance, that he could not escape his brother’s evil.
The trip back was over in the blink of an eye. As Lido and I stepped from the chopper, the whomp of the chopper blades subsided, and for a brief moment I was acutely aware of how quiet and serene the city was in the middle of the night. For a few brief seconds, all was still. There were no cries for help, no alarms, and no gunshots. Manhattan was peaceful and serene, bathed in the tranquility of night. And then, just as quickly, status quo returned.
The automatic doors slid open. Lido and I raced into Lenox Hill’s emergency room. The quiet was gone, medical personnel were rushing about, a stricken older man was moaning, a woman was sobbing—the world was back to normal.
We took the elevator to the floor where the psychiatric patients were housed, identified ourselves, and rushed to Terrance Ryan’s room, Rat’s room.
It was empty.
Sixty-Five
“This is bad.”
The policeman who had been assigned to watch Ryan was lying face down on the floor with a hypodermic needle sticking out of his neck. The sharps container had been ripped off the wall and torn apart. The needles are supposed to be broken off before the syringes are disposed of, but someone had gotten lazy. Lido helped the officer up and he started to come around.
I was eye level with the bed. One of the leather restraints that should have secured Terrance Ryan was saliva soaked and had been gnawed through. I couldn’t imagine that he had been flexible enough to bend over and chew through the leather restraint, but in that instant I knew that was exactly what had happened.
“What hit me?” the officer said. He leaned forward and rubbed the back of his head.
“Don’t move,” Lido said. “There’s a hypodermic needle sticking out of your neck.”
The officer winced.
“Any idea how long you’ve been out?”
He shook his head.
“Stay with him. I’m going to take a look around.” There was no need to buzz for a nurse. I heard footsteps racing down the corridor.
“No hero shit, right?” Lido said.
“I’ll be right back.”
I dashed out of the room and scanned up and down the hallway—nothing. I began going door to door, from one patient room to the next, checking every bed to make sure Ryan wasn’t in one of them, playing possum. I finally came upon an on-call room and yanked the door open. A man was lying face down on the floor, clad only in boxers. He had a pulse, so I left him and raced back to Lido.
A doctor was already attending to the police officer. The hypodermic was out of his neck and the doctor was dressing the injection site. A nurse was assisting.
“There’s a man unconscious in the on-call room down the hall. We need to mobilize security. The man who was in this room is a suspect in a murder investigation and is trying to escape. I need all the exits sealed immediately.”
“Help them,” the doctor said. “I’ve got this.”
The nurse raced out of the room.
“We’d better hit the ground floor. I’ve got no idea how fast hospital security moves.”
The doctor was shaking his head. “Unless it’s time for a coffee break, you’re on your own.”
We raced to the
elevator, pacing, while we waited for it to hit our floor. We jumped in and began planning strategy. “He may be gone already. It’s New York City. If he’s hit the street, he can vanish in a hundred directions.”
I could see that words were stuck in Lido’s mouth. We went three floors down before he spoke. “Unfortunately, we have to split up. I’ll take the main entrance and coordinate sealing off the building with hospital personnel.”
“I’ve already called it in. I’ll cover Emergency.”
He grabbed me and kissed me before the doors opened. It was unexpected, but not unwelcome. I felt myself slipping away. We were both so tired. I wanted to rest in his arms and leave the world’s problems behind me, but in the next instant, the doors parted, and we reluctantly split up.
When I hit Emergency, it was no different than the way I had left it. The old man was still moaning and the woman was still sobbing. I could see an ambulance pull up just outside. Within a moment, the ER doors burst open. A pair of paramedics rushed in pushing a gurney. Emergency room physicians rushed over to them. The place was in pandemonium.
I checked everyone in the room. I wasn’t sure how Ryan would be dressed, but there was no camouflaging his face, and for that reason, I considered it an unlikely route of escape. Ryan would seek an exit that would afford as little attention as possible. I tried to think as he would. I knew that he was most comfortable below ground. Lenox Hill had a basement, probably a hell of a basement, filled with supplies, emergency equipment and generators, but that would only provide him a place to hide—egress to street level would be difficult.
I was standing in the center of the ER’s entrance, turning in a circle, trying to will the answer into my head, when from the corner of my eye, I noticed that outside, the doors on the back of the ambulance opened and closed. I hit the street.
The Brain Vault (Stephanie Chalice Thrillers Book 3) Page 21