“All these agencies pay different fees for different treatments,” she continued. “And one of the reasons we charted so much was because we were basically writing up receipts. In the past, we would send copies of those receipts in, and the different agencies would pay the hospital.”
Nurse Washburn opened one folder and waved the sheets of paper under her chin like a fan.
“But now everything is computerized. That means we don’t have to send copies of anything. We just send electronic files from our computer to their computer. Then their computer authorizes money to be deposited in New Hyde’s accounts. But Equator Zero is kind of like automatic billing. Once the patient is in our system, New Hyde Hospital will bill for that patient’s care until the end of time.”
“At least you all won’t have to keep doing it yourselves every month.”
Nurse Washburn put the papers back into their folder, closed it, and set it neatly at the top of a stack. “No, Pepper. You don’t understand. Equator Zero will continue to charge for the care of a patient even after that patient is gone.”
“Discharged?” Pepper asked.
She put her hands on the paperwork again. One on Frank Waverly’s pile. One on Mr. Mack’s. “Deceased,” she said.
“But what about when they get caught?”
“If they ever get caught, they’ll call it a computer error. They’ll repay some portion of what they made in a settlement. But the amount they take in before they’re ever called out will be ten thousand times what they have to pay. Equator Zero makes patients profitable in perpetuity. That’s how Dr. Anand put it once. You all are worth more to them missing than present. More lucrative dead than alive.”
Pepper nodded appreciatively.
“Wow,” he said. “That’s devilish.”
“Dead souls,” Josephine sighed. “Good business.”
And quickly, instantly, Pepper saw himself trying to tell someone about Equator Zero. Nurse Washburn, Josephine, had just offered him quite a lot. He had the name of the program, he had the names of at least four dead patients (Kofi Acholi, Doris Walczak, Frank Waverly, Gerald Mack), and if he thought back a bit, he could probably list the exact dates when they died. Compare that to the dates on the bills recently submitted in their names and you had a report—verifiable, credible, simple, clear—that could force someone else outside the walls of New Hyde to take a goddamn interest. Pepper even saw himself using Coffee’s blue binder and trolling through the list of names and numbers of public officials that his friend spent so long amassing. And if those channels failed, maybe he could even try the reporter who’d written about Sue. Pepper wouldn’t change Coffee’s plan, just complete it.
Josephine tapped at the plastic pane, as if she was about to hand him his food order. She scanned the nurses’ station.
“I’ve got something here for you.”
Now one of the lines on the newly returned staff phone lit up. A bright red beacon on the cheap tan plastic phone. Josephine stopped searching for Pepper’s item and picked it up, didn’t even listen for a voice. “Be right there,” she said, then hung up again.
She walked to the formerly open end of the nurses’ station. There was a shatterproof plastic door there, running from ceiling to floor. Josephine slipped the red plastic key chain from a pants pocket.
Pepper walked toward the door of the nurses’ station, almost like he was the nurse’s escort.
“Stay where you are, Pepper.” Josephine didn’t sound scared like she might have a couple of months ago. She locked eyes with Pepper when she spoke, held his gaze until he nodded and backed away. She unlocked the door and stepped through, shut it again and locked it.
“That’s new regulations,” she told him. “I wasn’t trying to snap at you.”
Pepper put his hands up. “I didn’t take it that way.”
She nodded and, as proof of her comfort, she let him walk alongside her freely. He followed her. She began down Northwest 1, toward the front door. This was the only item on the unit that cost too much to move. Pepper passed the threshold of the hall, and Josephine put her hand out, just a millimeter away from his belly.
“No men on the women’s hall,” she said. “You know that.”
Pepper looked at the doors of the former conference rooms.
“But then how do you get male patients in and out of the unit?”
He pointed at the front door as proof of his clear logic. And Josephine didn’t fight him. She just shrugged and waved him toward her.
“That was easier than I thought,” he said.
“Maybe I don’t care because I’m leaving.”
“You got another job?”
As she walked, she looked from side to side, from one room door to the next. The swivel of a seasoned staff member. She was leaving just as she got good at the job. “I found something a little less … unpredictable,” she said.
“Bomb squad?” Pepper asked.
“Close!” Josephine laughed. “I joined the Army.”
“Get out of here!”
“Better pay,” she said. “Sad as that is. And I already feel like I’ve had some war training.”
“That’s kind of insulting,” Pepper said. “But I see your point.”
They reached the secure door. Josephine looked through the plastic and spoke loudly to someone on the other side. “Got to wait for the doctor to let you in!” she shouted. She shrugged as if to say, Regulations.
“Hey!” Pepper said. “What was it you had for me? A going-away present?”
“You’re not leaving yet.”
Josephine heard how harsh that sounded. “I mean that’s got to be settled by the new unit head,” she added. “But I don’t think it’ll be too long. Really. You know who’s been telling the new doc that you’re not ill? Miss Chris!”
“She just doesn’t like me,” Pepper said.
“That’s true, but she wouldn’t lie. She means it.”
Pepper waved her off. He didn’t want to start expecting good news. Nothing made waiting worse. At the very least, he hadn’t been removed from the unit and taken to a lockup, so the original case of assaulting the officers probably had not been brought before a judge yet. Josephine walked back toward the nurses’ station. Before Pepper joined her, he pressed his face to the door’s window. On the other side he saw two paramedics, one man and one woman. They looked at him for a moment, standing straighter and widening their eyes. He realized they hoped he was the doctor and was about to let them in.
Pepper didn’t bother trying to explain. Instead he stared at the third person out there. A big man. Not tall but wide. The polite term is heavyset. (The clinical term is hyperobese.) A black guy. Maybe. Or a Latin guy? Pepper couldn’t say for sure. Late twenties or early thirties, his hair was kind of a wild puff and his head was down. The EMTs watched Pepper, but this heavyset guy was more interested in his own toes. He had his arms crossed. He looked thoughtful, morose, like that presidential painting of JFK. Almost identical except this guy wore a bright blue windbreaker and weighed about three hundred pounds. Pepper knocked on the little window hard enough to shake this big guy from his daze.
He looked up at Pepper. Pepper returned the stare.
Then someone tapped his back.
Pepper turned and found Dr. Barger. The man didn’t smile now like he often had in Book Group. And his shirt, once open down to the chest, was buttoned to the top. He wore a tie and a frown.
“Dr. Anand had a lighter touch with patients,” Dr. Barger said. “But I’m going to expect more from you.”
Pepper waited to be recognized.
“Now, I want you out of this hallway,” Dr. Barger said. “It’s for the female patients only.” The doctor looked at him blankly. He didn’t recognize Pepper at all.
Pepper decided not to try to remind the man of the good old days in Book Group. What would be the point?
“Go,” Dr. Barger commanded.
Pepper saluted.
“Yes, Captain!” Pepper said.
He returned to the nurses’ station where Josephine had already let herself back in. When Pepper appeared, she was already moving charts and peeking into drawers.
“Go over there,” Josephine pointed. At the end of the station, opposite the long door, was a window the size of a dinner tray. Josephine opened one last drawer, pulled something out, and came toward him. Inside the nurses’ station there was a small plastic knob that she used to slide the plastic window open.
“Don’t see much mail coming through here,” Josephine said. “But you got a postcard last week.”
“Why didn’t you give it to me when it first came?”
“I couldn’t have a conversation with you,” Josephine explained. “You were just, out, you know, from the meds.”
Pepper nodded and opened his hand to her, right outside the window.
“Plus, I liked looking at the picture on the front,” she said. Josephine handed the postcard through. “It’s by a man named Vincent Van Gogh. Have you ever heard of him? He was a painter. A real genius.”
Pepper let the postcard lie in his large palm with the image facing him. It was in color. Bright yellow and orange. Van Gogh’s Vase with Twelve Sunflowers. The image so vibrant that Pepper felt the warmth of the sun that fed those flowers. Pepper traced a finger over each one. He lifted the card now and turned it over.
The postmark read: Amsterdam, the Netherlands.
In the space for a message he found two words, in large print (and a punctuation mark):
“LOOCHIE LIVES!”
Pepper’s heart leapt so hard, he almost didn’t survive.
It’s fair to say Pepper haunted the oval room. He didn’t know where else to go. His room seemed sort of lonely, but the lounge—and that big, blaring television—just seemed to promise a different kind of isolation.
Instead he stayed in the oval room, right by the phone alcove, while Josephine returned to logging the paperwork that New Hyde Hospital hoped to flip into fraudulent profits. She continued, rather than walking off the job in protest because she needed the paychecks that would come for another week. Frankly, she was more concerned with how she’d pay for the elder-care home she’d found for her mother. (She couldn’t leave Mom in the house alone, after all, while the Army deployed her to the other side of the world.)
Pepper didn’t bother her again. He hovered near the phone alcove, and every few minutes he slipped Loochie’s postcard out of the breast pocket of his pajama top and looked at it. Van Gogh’s painting and Loochie’s note, which was more beautiful? (Okay, the painting, but not by much.) Loochie was out there in the world. He felt so happy it almost made him nauseous. He wondered where she was. Still in Amsterdam? Back in the United States? Maybe even somewhere else by now.
But really, it didn’t matter where Loochie had gone. Didn’t matter if she’d ever face hard times again. (Of course she would, like anyone.) For now Loochie was something she hadn’t been through six years of on-and-off institutionalization. Loochie was alive.
Beside the phone alcove, he watched some of the other patients emerge from their rooms. He watched Northwest 1, the new women’s hallway, and the female patients who turned in the wrong direction, too. Disoriented by the rearrangements. Facing the front door rather than the nurses’ station and getting totally rattled until they saw Pepper, eyes so bright he shined like a lighthouse. He waved and they set course toward him.
He greeted each one, then sent him or her to the lounge. As those men and women ate breakfast—those who’d survived the terrible night—the food on their trays tasted damn near gourmet.
And finally the new admit finished his intake meeting. Dr. Barger and his team had kept the first room, right next to the secure door, as a meeting space. But since the new patient was a man, Dr. Barger escorted him all the way down Northwest 1 to the nurses’ station. Dr. Barger told the new admit to wait there for Josephine, who had run to the bathroom. (Though the doctor remembered her name as Karen.) Then Dr. Barger returned to his team in the intake room.
The new admit hadn’t responded to Dr. Barger, or anyone else during the meeting. He waited at the nurses’ station now in the same pose as Pepper had seen before. Head down, arms crossed, he didn’t take in the surroundings at all.
Pepper knew what he was going to do even before he began. He slipped Loochie’s postcard into the breast pocket of his pajama top. There, it fortified him, like any good talisman.
Pepper approached the new guy slowly. What to say now? How to break the ice, one dude to another? Pepper didn’t want to look stupid. Suppose he spoke and this guy only glared at him, or tried to bite off his nose, or laughed at him. It seemed so ridiculous to be nervous about saying hello to a stranger after what he’d been through at New Hyde. But there it was, even here, just some mundane social anxiety. Pepper rested one hand on Loochie’s postcard. This made it look like he was about to recite the Pledge of Allegiance. He felt himself calm.
Now Pepper walked closer and extended his hand. “What’s your name?”
The new admit left Pepper’s hand hanging there. Kept his arms crossed.
“Anthony,” he finally said.
“People call me Pepper.” He lowered his hand.
Anthony grinned to himself. He kept his head down, but spoke loud enough to be heard.
“Is that because you give everybody the squirts?”
Pepper laughed. Anthony grinned, then returned his gaze to the floor.
At the Vincent Van Gogh Museum in Amsterdam, there’s a bit of text printed on the wall of the second-floor landing. It explains Van Gogh’s ambition as a painter; that Van Gogh viewed his work as a kind of “love letter” to humanity. He hoped to be a great artist, but not simply to bring praise upon himself, his talent. (Though that would’ve been nice, dammit.) He hoped to reflect the world’s own glory, with love. An artistic impulse, but one not exclusive to artists. For instance, Coffee. For instance, Dorry. And now, Pepper. The aspiration is so rarely rewarded, or even understood, that most people don’t even try. But wherever it’s found, whenever it’s displayed, it’s an act of genius.
Soon enough Pepper would be released, but until then what would he do? Sit in his room and wait, or might there be more he could offer? Like now, with this new guy, so overwhelmed, so clearly scared, helpless. Pepper touched Anthony’s arm lightly.
“I like to greet the new admits,” he said. “You should see a friendly face first.”
Pepper raised his free hand and waved as if to take in the entire world. He smiled at Anthony.
“Let me give you the tour.”
AUTHOR’S NOTE
MY WIFE GAVE birth to our first child, a son, in May 2011. We were overjoyed and exhausted. We’re both writers and each of us had books due to our publishers by the end of the summer. That gave us about three months to complete our manuscripts. We were scared shitless and figured it was impossible. But with a new kid we needed money more than ever. My wife and I made a deal. We’d give each other two hours out of the apartment every day, seven days a week until September arrived and we had to return to our teaching gigs. (We ain’t making a living on the writing alone!) We stuck to the schedule religiously and the pages piled up. Did we make the deadline?
Hell, no.
But we created decent routines. Leaving home for only two hours meant that I couldn’t travel far. I ended up working at the Twin Donut on Broadway and 180th Street. Nine tables, no elbow room. If it was packed I’d go down to the Dunkin’ Donuts on Broadway and 178th. Between my two offices sat the Port Authority, George Washington Bridge branch. When the coffee ran through me I used its wretched but reliable public bathroom. I wrote this novel in those donut shops out of necessity, not design. But this book wouldn’t be what it is if I’d written it anywhere else.
Each day I had the privilege to hear, see, (and sometimes smell), a cast of characters as broad and beguiling as anything out of Dickens or Days of Our Lives. I’m talking about the old women trying to hand out Spanish-language e
ditions of The Watchtower inside the Port Authority, the fruit and vegetable sellers lining the sidewalks between 179th and 180th, the bus drivers on their coffee breaks, the mothers rationing donuts out to their already amped-up kids, the Chinese women selling bootleg DVDs out of their handbags, the addicts panhandling cars coming off the George Washington Bridge, the twitchy men lined up for far too long at the urinals inside the Port Authority bathroom, the old Dominican men who spoke in shouts so loud that my iPod could never drown them out, the cops and the high-school kids, the tourists and the meter maids, the dude in his fifties who just came through the Twin Donut carrying a handful of knit caps and chanting, “Good hats, good hats, five dollars.” All of them, and more, are in this book. A few even inspired some secondary characters at New Hyde Hospital. If I’d worked on The Devil in Silver someplace secluded and serene, I might’ve forgotten how bonkers and beautiful people can be. So thank you, Twin Donut, Dunkin’ Donuts, Port Authority, and all the folks I watched file through. You people nearly wore my reclusive ass out! Also, I love you.
The same can be said (the love I mean) of my wonder-editor, Chris Jackson. This is our third book together, and by now I really can’t imagine how I’d write a good book without him.
Thanks also to Julia Masnik for being so bright, warm, and really damn funny when I called in to my agent’s office.
Thanks to the John Guggenheim Memorial Foundation and the MacDowell Colony for their support.
While I had personal experience visiting psychiatric units around New York City, this book demanded research to learn how the units run, and what kinds of systems keep them operable (if not always working). Dr. Monique Upton and Dr. Jennifer Mathur were kind enough to answer my many questions. Thanks also to Nina Bernstein, whose insightful reporting on the story of Xiu Ping Jiang inspired portions of Sue’s story. I’m in their debt. Any mistakes or simplifications about how the mental-health system runs are mine.
My wonderful wife and closest ally, Emily Raboteau, gave me great help with this book. She also gave me our son, Geronimo, who is a badass. Little man, I knew you were dope ever since you were semen!
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