by Brian Kirk
He quickened his pace and fixed a large smile to his face as he closed the distance, extending his hand.
“Welcome back,” Eli said. “I’ve been looking for you.”
“I know, sorry. It’s been one of those days. You know, with the Jerry situation and everything.” Eli was two inches taller than Alex, but appeared to be shrinking with age. They stood nearly eye to eye without Alex having to elevate onto his toes, which he was prone to do. Angela often joked behind his back that he should just wear platform shoes.
“Right, well, we have several issues to address. Is now a good time?”
Alex examined his watch as if it held his schedule. “Yeah, sure. Your office?”
“Why don’t we get some air?” Eli said.
They started out walking side by side silently. Then the quiet became tense. Alex could sense scrutiny in the silence. Has he found out about the test trials, somehow? What “issues” was he referring to? Every step felt like a lost opportunity to say something, every stark footfall a gavel strike sentencing his guilt.
He pulled out his iPhone and opened the email app in order to feign a distraction. He dropped a step behind Eli and let him lead the way, tension pulling his chest tight.
Eli walked out onto the courtyard, an extended stretch of dark-green grass walled in by hedgerows. Flowerbeds lined the perimeter and the concrete walkways that led up to a large water fountain featuring a young maiden pouring water from a stone vase. Eli always thought of the woman in the fountain as Miranda, finally at peace in her pool.
He walked to a bench on the far side of the fountain and gestured for Alex to sit, then joined him.
“What a mess,” Eli said, shaking his head.
Alex’s heart began to hammer. He nodded gravely. “I know,” he said, hedging his bets.
“Under normal conditions this is something I’d prefer to let slide, but given the circumstances, particularly with the review meeting pending, I just don’t know that I can.”
Alex continued to nod his head, watching the fountain recycle its water while his mind raced through his most rehearsed justifications.
“But this impacts you more than me,” Eli continued. “I want to hear what you have to say.”
When Alex first decided to solicit a buyer for his experimental medication, he knew he’d have to perform test trials to prove that it worked. The best course of action at that point would have been to pursue a grant to help fund his laboratory work. That would have eliminated the need for secrecy. But he knew it would also have driven a wedge between Eli and him. And Alex was not willing to relinquish his position as a potential successor to Eli at Sugar Hill. It was better, he had decided, to keep his good standing at the hospital and pursue placement with a pharmaceutical company on the side. But he always feared having to face Eli before his plans came to fruition. And he hadn’t yet considered how he would handle it. “Well, obviously I think it may be time we reconsider our approach,” he said, speaking hesitantly.
Eli crossed his legs and laced his fingers around his knee. “How so?”
“I mean in terms of treatment. I’m not sure the current plan is working.”
“Given recent events, I would tend to agree. So, what would you recommend?”
Alex sat up straighter. He turned towards Eli. Maybe this won’t be so bad after all. “Well, for starters, a different approach to therapeutics. We need medicine that does more than dull the symptoms. We need something that addresses the root of the problem. A medicine that—”
“Doesn’t exist,” Eli interrupted. He shook his head and sighed. “Medicine won’t fix Jerry’s condition. You know that. I’m surprised to hear you say so, given his history.”
Alex was nearly trembling with adrenaline. When Eli mentioned Jerry, however, it all drained away, leaving an acrid taste in his mouth and a ringing in his ears. “Well,” he said, mentally switching gears, “I’m just basing this off of a brief meeting with him this morning. His dosage is clearly off. He’s still displaying severe paranoid delusions. He…I understand that he assaulted an orderly? He’s never been violent before.”
“I suspect that he stopped taking his meds,” Eli said. “According to Manny he had been acting peculiar for a few days before the incident. We haven’t been able to get a straight answer from Jerry. I was hoping you could help get to the bottom of it. I’ve prescribed 20 mgs of Clozapine to be taken under supervision while we determine what caused the episode.”
“That’s what I thought. Eli, that dosage is too low.”
Eli sat still, staring at the lady watering the fountain. “You know how I feel about antipsychotics. But I won’t interfere with your recommended treatment plan. Unfortunately, we can’t continue to offer vocational training while he’s unstable.”
It was Eli who had set up the vocational program at Sugar Hill. It helped provide purpose and offered structure to outpatients still struggling with mental illness, two essential components for recovery and quality living. And it was Eli who’d suggested that Alex enroll Jerry in the program, had, in fact, held the landscaping position open with him in mind, knowing how much he liked to be outside.
Alex had been hesitant at first, unsure that Jerry was capable of handling any level of responsibility, given his condition at the time. But he’d agreed to give it a shot. More out of an obligation to Eli than any optimism that it would help Jerry’s well-being. But it had, almost immediately.
Jerry had come alive while performing remedial tasks in the courtyard. He had made friends with the other workers, even some members of the hospital staff. In just a few weeks his malaise had lifted and he had become nearly self-reliant, getting up by himself each day and preparing for his shift. After a couple of months, Alex had been able to help him find an assisted-living center where he moved in on his own. He had become happy, coherent, and even displayed some of the characteristics of his old personality.
In many ways, Eli had helped bring his brother back. It was a gift Alex was not quick to forget.
“I know,” Alex said. “I was afraid of that.”
“I don’t believe that medication is the only answer, though, Alex. I worry about a complete relapse. I would be reluctant to strip him of a constructive outlet. I can help find a temporary position for him with a work-release program for more severe cases. Once we get him stabilized, he’s welcome to return to work here.”
“I’ll think about it,” Alex said. I’ve got some more pressing problems at the moment, he thought. “First, I’m going to have him released and brought home. Rachel can watch over him and make sure he’s taking his meds.”
Eli nodded and said nothing. Alex’s wife was not a nurse.
The silence threatened to become uncomfortable again, so Alex broke it. “I met with our new patient, Crosby. We’ve got our work cut out with that one.”
Eli seemed content to sit forever in silence. Alex couldn’t bear it. “I hear that you had a run-in with him yourself,” he said, and immediately wished he hadn’t.
Eli arched his eyebrows. “What did you hear?”
“Nothing, just that there was some sort of a confrontation. That he threatened to tackle you.”
Eli appeared fascinated by the fountain. His mouth was clamped shut.
Alex waited, waited—the gurgling water echoing the sound of his rising blood pressure—then continued, “And that you got in the way of an orderly attempting to subdue him. The man’s dangerous, Eli. I know your stance on the use of force, but you can’t put so much trust in these patients. The man attacked a group of people with a hunting knife, for Christ’s sake. And you’re…” old, he almost said, “…coming up on a critical review meeting. Think how it would look if you facilitated an assault.”
It was true, Eli knew. Had he been involved in a physical conflict with Crosby, it would give the board an excuse to reassess hospital protocol. It would support th
eir argument for tighter restrictions, fewer patient liberties, more medical intervention. It would undermine much of the progress he had made to bring a more humane approach to the hospital. And it would likely hasten his exit. Something he was becoming less convinced was such a bad thing anyway.
So long as Alex can carry the torch, he thought, which he had begun to question recently as well. He needed to be sure.
“Perhaps you’re right,” Eli said and rubbed his eyes. “I don’t need to be as involved in patient care. It’s past time I turn those responsibilities over to you and concentrate more on hospital operations.”
Alex pressed his lips together to keep from smiling. When they’d walked outside, he thought it was to discuss his dealings with Philax Pharmaceuticals. Now it seemed as though he was cementing his position as the next Chief Medical Director of Sugar Hill. When he inhaled it inflated his chest, and he liked the way it made him feel. “You’ve set the guidelines, Eli. I’ll just be following your lead. I hope that I’ve proven myself capable of continuing your ideals.”
Eli’s nod was slight. He placed a hand on his stomach as though from a pang of indigestion. “I’ll tell Angela that I’m placing you in charge of patient care. We’ll need to be aligned as we prepare for our review meeting. You know the battle we face with the board.”
It was a board member who had put Alex in contact with the Philax representative in the first place. He was intimately familiar with the battle over the appropriate use of antipsychotic medicine at the facility and the board’s desire to take a more active approach. Not to mention their willingness to accept money from pharmaceutical companies. Had he sold his experimental medicine to Philax, he would not have been the only one positioned to benefit financially.
Alex smiled and gave a conspiratorial nod to Eli. “You know I have your back,” he said.
They both turned and faced the fountain, admiring the pretty lady forever filling her pool.
Chapter Twelve
For Jerry, some days the world made sense; its great cosmic mystery could be explained in the life cycle of a chrysanthemum. The seed gets nutrients from its environment, grows and blossoms into a flower, unveiling its vibrant beauty, disseminates its pollen on the wings of the honeybee, then wilts and returns its essence to the earth, enriching the soil for chrysanthemums to come.
Some days, though, the world is a roiling stew of insanity. A cacophony of discordant voices, of contradicting ideas, of irrational impulses, of impossible images. During such days, the flower becomes a creature of dark complexity—a carnivorous species with nefarious fangs and acidic saliva, waiting to devour whatever wanders too close. The flower, then, is both a thing of beauty and an instrument of death. It simply depends on perspective—an unstable, unreliable, inconsistent filter for assessing reality. Reality became even more unpredictable when the filter malfunctioned, when it was removed.
The absence of the filter allowed Jerry to see the duality in all things. It offered a view behind the veil. A stark look into the raw chaos of the cosmos where life operates on a subatomic scale, a swirling soup of photons coalescing into the image of expectations. An indifferent energy field of infinite possibilities made material through the force of the collective unconscious.
The world is illusion; we only pretend it’s real. That was the purpose of the filter, to make the mystery appear mundane. To make it safe to smell the flowers.
The pills provided an artificial filter, a murky lens through which the world assimilated itself into its familiar form. But it was nothing more than a false representation of the way the world should look, according to the makers of the medicine. Not the creator of the world.
Still, Jerry didn’t know which was better. The chaotic view behind the veil or the predictable sights supplied by the fabricated filter. These were his thoughts when Alex walked through the door, and Jerry saw both a beloved sibling and a hostile stranger. Then a shadow emerged from behind Alex, and Devon walked into the room.
“What do you say we go home?” Alex said. He was holding a small, scuffed suitcase containing Jerry’s few personal belongings. He set it beside the door and smiled. His smile wavered the longer he stood there waiting. “Come on, Jerry, let’s get you out of here.”
Jerry blinked his eyes and stood, holding out his hands as the room swayed underfoot. He struggled to keep his head from sagging and to move his feet forward. That was one thing about the fabricated filter. It produced a heavier world.
“That’s it. Take your time,” Alex said, placing a hand against Jerry’s back and guiding him towards the door.
“Will you escort him out?” Alex asked Devon. “I’m going to load up the car.”
“Not a problem,” Devon said, circling behind Jerry as Alex stormed out the door.
When the footfalls had faded, Devon grabbed Jerry by the arm, digging his fingers deep, pinching the median nerve against the bone.
“Don’t think I forgot about you,” Devon growled into Jerry’s ear. “Think you can get away with biting me? No, sir. Not a chance. I’m gonna hunt your crazy ass down like a rabid dog.”
Jerry turned his head and looked up into Devon’s face. The filter revealed a pudgy black man in a crisp blue shirt, but he feared what was behind the veil. He tried to speak, but his tongue was a dead thing, decaying in his mouth.
“Crazy-acting motherfucker,” Devon spoke through the side of his mouth, relaxing his grip as they ventured into the hallway. He smiled as a nurse passed by. “You’re weak, is all you are. Weak in the mind. You ain’t gonna get no pity from me, you biting-ass bitch. I’m gonna pay you back.” He gripped his arm again and every few steps would grind the nerve against the bone.
They approached the doorway to the doctors’ parking lot and Devon waved at the station nurse.
“Aw, you leaving us, Jerry?” she asked.
His half-lidded eyes hid the pain. When he tried to speak, all that came out was spit.
“Well, don’t be a stranger.”
Devon opened the doors and pushed Jerry through. “You may be getting out of here, but I’m gonna come pay you a visit. You can believe that.”
Alex was waiting in his car by the curb, the engine idling. His wife was holding open the rear passenger door. Devon walked Jerry up to the car and helped him inside.
“There you are, Dr. Drexler. Need anything else?”
“No, that’s all, thanks.”
“Anytime.” Devon gave Jerry a final pat on the arm. “See you around, partner,” he said, and closed the car door.
Jerry’s arm continued to throb, but after a couple of minutes he couldn’t remember why. The motion of the car rocked him in his seat, and every time he blinked, it seemed like he was somewhere different. A highway. A parking lot. A sidewalk. A hallway. A door. Like pictures in a slideshow. That was another problem with the filter—it often lacked fluidity.
He was with a woman now. She held him gently by the arm as he shuffled forward. A curtain of glossy, black hair concealed her face. He swayed as he walked and his arm pushed pleasantly against her breast.
He blinked again and was now staring at a plate of food—a fried chicken leg, mashed potatoes soaked in gravy, a small pile of green beans. He heard voices and tried to lift his head, but it was too heavy. It was like a cinder block attached to a flower stalk.
“Now that he’s home it should get better,” he heard a voice say.
Home, Jerry mused, looking around, recognizing the familiar interior for the first time. The threadbare floors, the ticky-tacky walls, the hand-me-down furniture with sagging seats and scuffed surfaces, matching only in their uniform lack of design. Was this his home, this transitory outpost for wayward wanderers? This box that had been lived in by dozens of others and would surely be lived in by dozens more.
He hadn’t chosen to live here, had he? Of all the places he could live in all the cities and all the towns
and villages and yet-undiscovered places on this orbiting rock, why here? Whose choice had that been, if not his? In this infinite existence of limitless potential, why was he assigned to this particular reality and what was the point? Better yet, how could he break free?
Chapter Thirteen
When Alex was a kid he used to imagine what it would be like to have dinner at his big brother’s place after they grew up. It was nothing like this. Huddled around a small square table listing a bit to the right. Its faux wood top warped from water spills and spotted with shadows cast by dead moths lying in the light fixture above. The peach-colored carpet was a leopard skin of stains and reeked of mildew, and he could hear Jeopardy playing at full volume through the paper-thin walls.
Jerry didn’t seem to mind his living conditions, however. He hardly seemed awake, for that matter, with his half-lidded eyes staring blindly at his plate of food. The higher dose Alex had prescribed appeared to be working. Drowsy was better than delusional, as far as he was concerned.
At least Rachel’s attitude had improved. She hadn’t even made a remark when Alex picked up dinner from Popeye’s, only realizing the correlation to the name of her flattened dog after placing the steaming bag of food in Rachel’s lap. Sympathy always brought out the best in her.
“He shouldn’t require too much of your time,” Alex said, talking to Rachel in front of Jerry as though he weren’t there. Glancing at his unfocused eyes made it clear that he wasn’t really. “If you don’t want us to see, why don’t you just cut out our eyes?” Alex speared a stack of green beans and used it to scoop up a bite of mashed potato. “Just check in every couple of days to see how he’s getting along and show him a familiar face.”
Rachel began to nod her head, cutting into her chicken breast after excising the skin. She displayed the intense concentration of someone being assigned a secret mission from the director of the CIA. “How long do you think it’ll be before he’s able to return to work?”