by Brian Hodge
Fortunately, Sarah had taken pity on her, had made the first overture. Perhaps she smelled the frightful conflict that must have exuded from Adrienne's every pore and left her terrified to initiate further talk — but not too paralyzed to accept Sarah's invitation to go to The Coffee Plantation for lattes.
And within a week Adrienne had reaffirmed for herself that which archaeologists have always known: buried treasures are far more beautiful and valued the second lifetime in which they see the sun.
*
The apple slices were gone and Sarah had drunk the wine from the bowl by the time the sun was down, nothing but a defiant rose-red rime thinned across the horizon. The party was coasting, mellow, and Adrienne wondered if they would ever get around to singing "Happy Birthday" to Jayne.
"Remember the code blue I told you about, from a couple of weeks ago?" Adrienne asked.
"How could I forget a wandering desert madman?" Sarah ran a finger in the bowl and licked the traces of wine from the tip. "Such a classic, and it had to be you. You had to remind me, didn't you?"
Adrienne frowned. "You wouldn't have been feeling privileged if you'd seen him brought in. It would've almost made you sick. He'd beaten his hands to splinters, don't forget."
"Sorry." Sarah's face of contrition. "It was just so vivid, you know?"
"I know, I know. There is something about it, isn't there? But there's something about him…" Adrienne sighed and waved her hand in frustration. "On one level I'm completely baffled by this guy. He doesn't act quite as he should."
She was breaching all manner of ethical considerations in discussing Clay Palmer. Still, there wasn't a doctor or nurse she knew who adhered to expectations of patient confidentiality to the letter of the unwritten law. They all blabbed when they got home, and rationalized it by citing their discretion: What's a little sacrifice of confidentiality between bedmates?
"He sounded pretty distraught to me," Sarah said. "How's he supposed to act?"
"Anybody who's that problematic with aggression is going to resist counseling to some degree, if not exhibit outright hostility. I've never treated anybody like that who was very cooperative. Never."
"And he's not fitting that pattern?"
"No. He's not. But he should. His background is textbook. I had him pegged as growing up in an authoritarian home, and I couldn't have been more right. The poor kid's father was an ex-Marine, and used to make him run drills when he was five and six. When he had a paper route, the father wouldn't even break down and take over for him when he was sick — he'd follow him to make sure he still did the job, but he wouldn't help. That was the father's way of instilling a sense of responsibility."
Sarah's face soured. "Sounds like a real bastard."
Adrienne nodded. "It goes on and on like that. A lot of the patterns are the same from case to case, but it never seems to screw up any two people in the exact same way."
"But this one's different even beyond the variations?"
"I think so. It's odd — in spite of all my expectations to the contrary, he's been surprisingly cooperative. That's not to say he made it easy all along. He started out digging at me with a few barbs. Our first session he suckered me into one of the more cleverly segued propositions I've gotten."
She caught a tiny pinching between Sarah's eyebrows; perhaps she shouldn't have mentioned that. She had overlooked the subtle associations that might trigger in Sarah, the kind of thing she was usually sensitive enough to avoid. While Adrienne was as happy with her as she’d ever been with anyone, she knew that Sarah held deep worries that could not be easily soothed, for they were not entirely groundless. While everyone worries to some degree about their mate leaving them for someone else, here it was compounded by Adrienne's ability to vacillate between either sex. This Sarah could not do, and while she hid her anxieties well, still Adrienne understood that she held a clear advantage. Should she decide to return to a more traditional relationship someday, there was little Sarah could do to fight it. There were times this lay between them like a silent threat, barely acknowledged but biding its time.
Adrienne stroked the backs of her fingers along Sarah's leg and went on. "All along, I felt he really wanted my help but would be too proud or too threatened to admit it, even if he didn't have to come right out and say so. But he proved me wrong there, too. 'Help me.' Those were his exact words."
As she drew in closer to Sarah's side, she remembered the apprehension that washed over her just before those words had left Clay's lips. She had watched him going through his emotional contortions, and there had surfaced within him a killing rage that thickened the air in the office. Every muscle had tensed and every doubt had surfaced: She had been wrong to trust him, been wrong to believe Ferris Mendenhall competent to prescribe an adequate dosage of lithium. She saw the wreckage that Clay could make of her office, and her. She saw her own obituary.
And as his seizure passed, there had swept through her an exhilaration she'd thought must surely be reserved for daredevil feats. Skydiving, ski jumping … anything where survival was left to fate.
This, more than anything, had taught her the addict's rush.
"There's something I'm not seeing yet in this guy," Adrienne murmured. "There's something in him that I'm missing."
"Then you'd better find it before long. You won't have all the time in the world with him."
"Tell me about it."
It was her one great fear in this case: Soon, word would come down to her that Clay Palmer was well enough to be discharged. He need not sit around until his hands healed and the casts were removed. While obligated to provide a certain measure of care, the hospital would fund the costs of a transient assault victim for only so long without squawking and demanding his release. He had insurance, a group employee policy, but the claim was being contested because, in leaving Denver, he had walked away from his job.
Of course, she had a certain measure of control, as well. His physical evaluation was out of her hands, but his psychological well-being was her responsibility. As long as she said he wasn't ready to be released, that might be enough to keep him around.
"What I'm most worried about," said Adrienne, "is if he decides he wants to go back home. There's no way I can justify any follow-up then."
"Have you thought about…?" said Sarah, almost teasing, dangling a possibility like tantalizing bait.
"What?" Adrienne met her eyes. "Come on, what?"
"Now think." Sarah nestled in closer as a chilled breeze began to blow in off the darkening desert. Adrienne curled one arm up around her shoulders and slowly ran her splayed hand through Sarah's tousled mane.
"Ow," Sarah said. "Your fingers are sticky and you're pulling my hair."
"Good." A cruel smile played over Adrienne's lips and she drummed her wine-tacked fingers. "What are you getting at?"
Sarah twisted her head around until she could bite Adrienne's hand, bearing down lightly with a grin until the hand relented.
"Don't tell me I haven't caught a little jealous pining in your eyes whenever the subject of my thesis comes up."
Adrienne pinched Sarah's nose. "If you'd decided on a subject, you mean."
"You know what I'm talking about. You love independent research, and the fact that it's going to consume my life before long digs at you, doesn't it?" She demonstrated by gouging her fingers into Adrienne's ribs, her most ticklish spot. "Right?"
"So what if it does? You're a presumptuous little bitch, you know that?" As she was running out of bodily places to torment, name-calling seemed a viable alternative.
Sarah grabbed both of Adrienne's hands and held them tight. "Then do something about it. What, the great healing motivator in my life can't see the obvious? If you're that intrigued by what makes him tick, run an end sweep around the hospital, go to the university psych department, and put in for some grant money so you can treat him as your first research subject."
"And what makes you think I haven't already moved in that direction?"
; Sarah flashed her sweetest smile. "Because if you had, you wouldn't have been so insufferably mopey about him five minutes ago. You would've been bursting." She arched her eyebrows, smug and satisfied, and leaned in nose-to-nose. "Right?"
"Right," Adrienne confessed.
She stretched out her legs to prop her feet on the railing beside Sarah's, and together they watched the darkness thicken across the desert, waiting for someone to come and tell them how antisocial they were being. It was a birthday, after all.
Six
Her weekend passed too slowly after that, her Sunday shift crawling except for the hour-long session with Clay, their fifth. She was a victim of her own growing obsessions, and they murdered time while leaving its bloated corpse in her way.
Monday morning she went back in on her own time and flagged down an impromptu meeting with Ferris Mendenhall. The man himself was easy enough to work under, but she had always hated his office. Bare of wall and devoid of personality, it always gave her the impression of having just been moved into, or about to be vacated, with the decor boxed away. She wondered what it meant, if Mendenhall had never felt himself long for this office, this position.
"I'm trying to be as ethical as I know how," Adrienne said, "and not bypass hospital hierarchy."
From across his desk, for the most part clean as a windswept plateau, Ferris Mendenhall eyed her. He was a lean man in his mid-forties whose white coat tended to flap upon his frame like a clipper's sail, and had no upper lip that she had ever seen. It remained hidden behind a drooping moustache that curled down with lazy bravado, a relic of a bygone age. If the sunburned pate visible through his thinning hair had been covered by a cavalry officer's hat, he might well have been dashing.
"This should be interesting," he said.
"How long would you estimate that Clay Palmer might be here before you start getting some real pressure to discharge him?"
"Clay Palmer…" Mendenhall leaned back in his chair and steepled his fingers. "This would be the patient with the broken hands?"
"Yes."
"Given that he came in under dual admission, so to speak, I'd say at least a few weeks." He frowned with his deep-set eyes; it looked perilously close to bureaucratic scrutiny. "Why?"
Adrienne took a deep breath. "I'd like your support with something as regards his case. Let me preface this by stating that he needs more help than he's likely to get here, unless somebody takes extra initiative. He's from Denver, and twice he was committed there for observation and, I assume, some rudimentary treatment" — this she realized she had said with disdain — "and it certainly didn't come close to meeting his needs. He needs more intensive therapy than he's had an opportunity to get."
Mendenhall rolled his chair back up to the desk. "This is not a county hospital for charity cases, and his insurance matter hasn't been resolved yet, although it doesn't look like the policy carrier has much ground to stand on. Still, if he needs months or years of therapy, refer him to County Services, where someone can deal with him on an outpatient basis."
"That's not good enough," she said, and shook her head. "For a couple of reasons. First, he isn't from here. If he were discharged, he'd have no place to stay. And even if he did, his dexterity's so limited by those casts that, he is, for most practical purposes, helpless. Which means he'd have no choice but to return to Denver, and honestly, I don't think he can even afford a bus ticket."
Mendenhall fiddled with his moustache, a sad Monday-morning look about him. "And reason number two?"
"I'm making progress with him. In our midweek session last Wednesday, he made a specific request that I help him. Send him elsewhere, and not only is he forced to start over with someone new, but the trust that I've established with him is completely shattered. Which can't help but impact the way he views the next therapist who tries to work with him." Adrienne scooted to the edge of her chair. "Ferris, it's my most sincere recommendation that discharging him anytime soon would be disastrous. Take one look through his file, and factor in what brought him here the night he was admitted, and you'll see that his violent outbursts have been getting worse over time. He's stabilized now, but he's still in a very precarious state of mind."
Mendenhall swiveled in his chair and stared for a moment at a file cabinet across the room. Upon it sat an iron casting of a Remington sculpture, horse and rider frozen in a moment of pure, perfect panic as, below, a rattlesnake hung poised in defiance. A curved symmetry rippled through the horse; it could either soar or collapse.
He swiveled back to her. "Unless his insurance carrier gets more cooperative, the administration will never allow him to stay here for any protracted length of time, and they are not swayed by arguments such as this, Adrienne."
She knew this, of course. Administrative logic was cold and precise and devoid of heart. There was compliance with the Hippocratic oath, yes, and they could not have turned Clay away at the door. Moreover, though, there was a bottom line. Too often the two pursuits were incompatible.
Nor was she entirely above it. Why else was she here, rather than at County? Every fourteen days she cashed her check from here and not once thought it too high a reward.
"I'm not asking for an indefinite stay," she said. "Before long, I may be able to work out a solution where Clay Palmer can be discharged and I can continue to treat him."
One of Mendenhall's eyebrows creaked upward. "And this would come about…?"
"You might as well know it now" — she paused, with a curt nod — "I recently applied for an independent grant to study male aggression." Talking herself in deeper by the minute. Certainly she was committed now to taking action over the next day or two.
Mendenhall's face seemed to glaze with incredulity, each pore constricted, each hair a stiffened bristle. "You will not bring your personal agendas to this ward, and expect to be automatically accommodated."
"I don't see anything here as being mutually exclusive. While my first priority is the welfare of my patient, I'm not going to sit here and tell you that, in a case like this, I have no auxiliary interest in it at all." Adrienne leaned forward and relinquished Clay's file onto Mendenhall's desk, pecked it with a fingernail. "Just go through his file and see if you can find fault with a single thing I've said."
"I'll do that."
The skirmish was hers. Now, to press the advantage. And hope it was not too much, too soon.
"I'd like your permission for a simple test on Clay that may seem a bit out of the ordinary. I'd like to have his genetic karyotype run."
Mendenhall looked as if he had bitten into something sour. "What possible use could you have for that?"
"Specifically, to check him for a double-Y genotype."
Mendenhall began to laugh, short hitches of breath that rippled his moustache. "There's never been any conclusive correlation between a double-Y and aggressive behavior."
"I'm aware of that. But it's not been disproved, either."
Double-Y's possessed an extra male chromosome, an anomaly whose 1961 discovery had led to its carriers being regarded as "supermales." Subsequent studies caused a sensationalized fear of genetically predisposed criminals, but this was largely the result of sloppy research methodology: Subjects in influential studies in Great Britain and Sweden had been culled from mental institutions and prisons, rather than from the general population.
Mendenhall grabbed the file and shuffled to general patient data, scanned it quickly. "No indication of subnormal intelligence — hmm, to the contrary. Height only average." He closed the file and met her with quizzical eyes. "How could you possibly suspect he's a double-Y?"
"I don't," Adrienne said. "He does."
Mendenhall groaned and rubbed his crinkling forehead. "And he got this idea from where? Movies, or TV?"
Adrienne shook her head. "Neither. Clay has a collection of books about serial murders and criminal abnormality. He first read about the double-Y in connection with Richard Speck — "
"Amateur speculation. Speck didn't even have a doub
le-Y."
"Well, I gather most of the books Clay has, if not all, are more sensationalistic than scholarly in nature. But to be fair, I even looked it up in one of my old academic texts, and it was in error, too."
"Is he fixated on this?"
Adrienne nodded. "To an extent. He mentioned it in our third session and didn't much dwell on it, and once I'd explained that he shouldn't consider himself a candidate for it — because of his intelligence and height — I didn't think it was significant. But he brought it up again yesterday."
She silently cursed all scientists and exploiters everywhere who, with half-baked brains, trumpeted baseless conclusions that served only to inspire panic, like ripples across a calm pond. She no longer paid attention to the latest findings of dietitians who announced new reasons to scorn old foods. They would undoubtedly be contradicted soon enough, and hopefully go to their graves someday with all the obscurity they deserved.
How much more fundamental, if less widespread, was the fear generated by those who attached stigmas to abnormal variations of body and mind? Such deviations were so deeply borne that, to those affected by them, it was like giving them cause to loathe their own bodies.
"I think if we have his karyotype run and supply him with picture-perfect proof that he's not a double-Y," said Adrienne, "it'll help alleviate the anxiety he's feeling over it. And free him up for the things that do matter."
Mendenhall sat with pursed lips and frowning eyes, while the desktop held his gaze. "What kind of expenditure would this be?"
Always the cost; alleviation of misery was next in line. "If you want a dollar figure, I can't say. But negligible. It's a very routine, simple screen. We can't do it on the premises but we can keep it local: the Genetics Center of Arizona Associated Labs."
He progressed from pursed lips to gnawing at the inside of one corner of his mouth. "Find out how much. I can't give you the authorization until I know."