Addiction

by G. H. Ephron

  20

  WHILE I was waiting for Kwan to come in, the night nurse brought me the incident report she’d completed on Matthew’s and Olivia’s disappearance. The “Resolved” box was checked. I signed it.

  I looked in on the orderly and nurse who were methodically disassembling Olivia’s room. They’d stripped the bed, turned over the mattress. The nurse was taking Olivia’s clothes out of the drawers and wardrobe and checking the pockets. The orderly was on a stepladder, looking behind each ceiling tile. When he saw me, he climbed down and handed me a half-dozen sample drug packets. Then he went back to his work.

  After that, I paced the unit, trying to stay awake. First to one end, then back to the other. As I passed the nurses’ station, I smelled coffee that was warming on a burner behind the desk. How good a cup would have tasted. My passes up and back were getting shorter. I needed a cup of coffee. I found myself standing over the pot, inhaling the aroma. I looked one way, then the other. There was nobody about.

  Just an inch, I told myself. What harm would it do? I poured myself a half a cup. I was about to take a sip when I heard footsteps coming down the hall. I downed the coffee in a single, scorching gulp. I was coughing and clutching the collapsed paper coffee cup when Kwan rounded the corner.

  “This is a pathetic thing. A grown man.” He clucked and shook his head. “You’ve done stupid things before, my friend. But giving up coffee on a dare—that takes the cake.” He pounded me on the back.

  I threw away the cup. It was one of the few times I willingly admitted that he was right.

  We went to check on Matthew Farrell. He was in his room. He’d shoved his bed against the wall and was counting linoleum floor tiles. While Kwan examined him, Matthew began on the ceiling tiles. When Kwan had finished, Matthew cataloged his results in microscopic printing on the back of the day’s menu. Then he started on the holes in each ceiling tile.

  Kwan quickly confirmed a Ritalin overdose, the effects of which were beginning to wear off. Eventually, he’d sleep.

  I caught a few hours of restless sleep on the couch in my office. When I came back down, Gloria was there.

  “I’ve got something for you,” she said.

  She handed me a brass key. I turned it over. I fished my keys out of my pocket. It matched the master key on my ring. “Where’d you get this?”

  “From Olivia’s bathrobe. When we moved her to bed, we checked her pockets.”

  “Probably her mother’s key,” I said.

  Gloria looked somber. “And I’ll bet you anything that last night wasn’t the first night they’ve gotten out.”

  I agreed. “Just the first time they got caught.”

  At least that explained how a pair of kids had effortlessly breached security on our unit without even tripping an alarm. I started for Olivia’s room.

  Gloria stopped me. “She’s still asleep, Peter.”

  I leaned against the desk. I was tired. I could feel the veins banging in my head like noisy heating pipes. I wanted to go home, get into bed, and forget all about Olivia Temple. She was a royal pain in the ass.

  Kwan and I met at Destler’s office at nine. Kwan came bearing a small Starbucks coffee. “It’s half decaf, half caf,” he told me. A peace offering. I took it gratefully.

  I sipped slowly, contemplating how abstinence makes the heart grow fonder. At twenty past, Virginia Hedgewick backed into the office. Her arms were loaded with a stack of newspapers and a box of doughnuts, which she set on a seven-foot-long teak credenza. She looked grim-faced when she turned to us. “Doctors aren’t supposed to die here. What next, I wonder?”

  “Was it on the radio?” I asked.

  “Dr. Destler called me with the news. Good thing he was doing one of his twenty-four-hour sleep overs.”

  Just then, Destler popped out of his office, looking as if he’d just stepped out of an ad for successful portly men. Blue suit, red bow tie, gleaming head. He looked clean and rested. I remembered. There’d been a fuss over how much money was spent renovating his office when he came to the Pearce—looked like the rumor that they’d installed a shower in the connecting bathroom was correct.

  With him was a well-dressed business type. I thought I recognized the man—a pharmaceutical-company executive or sales rep. But I couldn’t remember which or where from. They shook hands, and the visitor left.

  Destler gave me a disapproving frown. I hadn’t slept much, and I knew I looked it. At least Kwan balanced the equation.

  We followed Destler into his office. We sat across the desk from him in chrome and leather sling chairs, under the watchful eye of Wilhelmina Pearce. Destler had his seat pumped up high so he could look down on us.

  “A nasty business,” he said. “And you up there, rifling through your colleague’s files. I could take you before the board on this.” Destler stroked his chin thoughtfully. “You’ve both demonstrated questionable judgment, not to mention performed illegal acts—” Kwan started to protest. “I mean, some of you,” Destler amended. “It would be entirely appropriate to initiate an investigation, to relieve you of your duties, suspend your privileges.”

  The words were ominous, but his tone wasn’t making me squirm.

  “But I’ve decided against doing that for a number of reasons.” There was a long pause. He pressed his lips together until they disappeared. Apparently he wasn’t going to share his reasons with us.

  Destler’s eyes rested on a magazine lying open on his desk. It was an issue of JAMA, and it was open to the clinical note on Channing’s Kutril research. Parts of it were highlighted.

  I looked up at Destler. He was staring at me. His soft face had turned hard. “Dr. Temple’s Kutril study is complete,” he said. “The institute has met the requirements of the grant.”

  “You’ll see that her research gets submitted for publication?” I asked.

  “As you know, her methodology has been questioned.”

  That’s when I remembered who the man was that we’d seen leaving Destler’s office. It was an Acu-Med executive. A senior VP, in fact.

  “And Dr. Jensen’s research?” I asked. “I don’t believe he was as far along as Dr. Temple in completing the clinical phase.”

  “I’ve assured Acu-Med that the work will be completed. And submitted. The institute will meet its obligations. DX-200 is a very promising therapy.”

  “Promising and expensive,” I said.

  “Peter—” Kwan started.

  I wasn’t about to shut up. “Dr. Temple’s research should be published. If Kutril offers a cheap, effective treatment for psychological addiction …”

  Destler crossed his arms. “That’s a big ‘if?’”

  “You’re going to bury it, aren’t you?”

  “I’m not going to bury it,” Destler said, enunciating each word as if he were reading fine print off a cue card, “and I’m not going to suspend either of you. The Kutril study is … well, it’s over. Completed, as far as the Pearce is concerned. The work is well-intentioned but flawed.” The only thing keeping me in my chair was Kwan’s hand locked on my arm. “Ill-conceived. Poorly executed.” Kwan pressed hard. “And Dr. Temple must have realized as much. She must have been disappointed. Perhaps even distraught. Quite distraught. She had high standards. She must have seen this as a failure.” He closed the issue of JAMA.

  “Channing Temple did not kill herself,” I said, trying to keep control.

  “Whether she did or not is immaterial to this discussion,” Destler said dryly. “You are to back off the Kutril study. Do you understand? It’s in the best interest of all concerned.” Destler’s voice was quiet and firm. “The last thing I need right now is another brouhaha. The violent deaths of two physicians is a public-relations disaster. People will think we’re running a fly-by-night for the criminally insane. And you harboring a murderer isn’t helping the situation.”

  I rose to my feet, sending my chair crashing over behind me. “She’s not a murderer!” It was a good thing his desk was the width of a B
uick.

  Destler stood up also. “She was out and about last night, too, wasn’t she?” he asked, his chin disappearing into his neck as he pressed himself back, his head nestling up against Wilhelmina Pearce’s ample lap.

  Kwan righted my chair, and I eased back into it. I wondered how in the hell that news had reached Destler so quickly. Incident reports usually take at least a few hours to make their way through channels.

  “Dr. Destler,” I said, keeping my voice stony calm, “Olivia Temple is a patient at the Pearce, and our number-one obligation, public relations aside, is the well-being of patients.”

  Destler inched back to his chair and sat.

  I went on, “I need to see Dr. Temple’s research notes. Last night Olivia had another severe adverse reaction.”

  His expression shifted, became speculative. “Of course you can see her data. But I want you to see something else, too. Take as much time as you like. The only thing I ask is that you look at the documents here, in my office. And leave them here when you go.”

  I felt a wary uneasiness, certain that we were about to step into a very attractively baited trap.

  He continued, “I’ll ask Virginia to bring you the documents. Read them carefully, and think about the implications.”

  Destler picked up his phone, punched in three numbers, and waited. “Virginia …” he started, and gave her instructions. He listened for a few moments, then hung up.

  “I’ve just been reminded,” he said, pulling a black appointment book out of his top desk drawer and opening it, “I have another appointment to get to.”

  He swept the appointment book and the issue of JAMA into the drawer, closed and locked it. “I’ll leave you gentlemen to your work,” he said, standing and straightening his bow tie. Then he left the room.

  Kwan pronounced the appropriate verdict: “Bizarre. Truly bizarre.” Then he looked around warily and lowered his voice, “You don’t suppose this place is bugged, do you?” The same thought had occurred to me.

  Virginia Hedgewick staggered in carrying a storage box with a manila folder balanced on the top. Kwan leaped up and took them from her, consummate gentleman that he is.

  “A bit early for calisthenics, if you ask me,” Virginia said, smoothing her midcalf length skirt across her thick legs. She clucked disapproval as she gazed at the storage box. “This business of impounding files—in all my years, I can’t remember another time when we had anything like this. The only thing that comes close was that business with Robert Smythe-Gooding.”

  “You worked for him back then, didn’t you?” Kwan asked.

  “I was his secretary—that’s what they called us in the old days, before everyone got so damned politically correct. Very unfair, if you ask me. Heart wrenching. To see him brought down by that pipsqueak.”

  “What pipsqueak?” I asked.

  “Fellow’s long gone. He was a resident. Came in to assist Dr. Smythe-Gooding in his research. Ended up accusing him of plagiarism. Utter nonsense, if you ask my opinion. He’d copied a few sentences, maybe. But still, they shunted him aside. Didn’t want the accusations to become public. Too much at stake. Hospital reputation and all that.”

  Virginia eyed the file box she’d brought in, as if she didn’t like its smell. “Of course that’s all ancient history now,” she said, and left us to our work.

  Kwan opened the box, heaved out the files, and started going through them. I helped myself to the folder from the top of the box.

  “What on earth?” I muttered, as I leafed through. It looked like pages photocopied from a smaller journal. The handwriting was compact, precise, backward-slanting. I recognized it right away as Channing’s. The date on top of the first page was six months ago. The final entry was about a month later.

  Destler had a reason for wanting me to see this. It seemed very unlikely that these were pages Channing Xeroxed and gave him herself. Reluctantly, I started the first entry.

  Indian summer today. Hot and close. With the A/C off, this place is like an oven.

  I see you lying on the couch and I’m in my chair, pen ready. You’re upset. Ready to chuck it all. You’re letting it get to you. Letting yourself absorb the dark sadness. You are so vulnerable. So unsure of how to proceed. I want to make you strong.

  You are talking about your experiences now. I am half Listening, half not, mesmerized by the beads of sweat on your upper lip. I want to lick away the salty sweetness.

  I let my hand drift off the edge of the armrest, as if I don’t realize I’m touching your leg. Your skin is soft, smooth, pale and iridescent. My fingers stroke your bare skin. You are feeling it too. You let your legs fall apart. I let my fingers wander to the insides of your thighs. Your legs part further, your skirt pushes up. I can see you’re wearing nothing underneath. Surely you know. You agree, it is inevitable. I tell you, I want to make love to you. You act like you don’t heaz, but your back arches, your body tells me you want it too.

  I kneel. You have a dragonfly, just here in the hollow between your legs. It matches the other one. I touch it with my tongue. you moan, but not in protest.

  There was more, but I couldn’t keep reading. I felt queasy—violator and violated at the same time. Was this diary or fantasy? One thing was clear. It was personal, and I had no business reading it. If this were to fall into the wrong hands … it already had fallen into the wrong hands. I shuddered to think who else had pawed over Channing’s private thoughts. So this was the basis of those accusations of inappropriate behavior, boundary violations. Of course there had been no formal hearing. No charges brought. These were only words on paper. Never intended to be read by anyone but Channing herself.

  “What is it?” Kwan asked.

  I hesitated. The last thing I wanted to do was expose Channing’s intimate thoughts to yet another person who barely knew her. “Destler somehow got his hands on some pages from Channing’s personal journal. Remember those rumors of impropriety? Wouldn’t surprise me if they’re based on this.”

  “Diaries?”

  “I think she was recording what she thought, not what she did. I know she’s been writing a daily journal since she started working with Daphne. It’s basically the same thing Olivia was doing when she wrote those e-mails to her mother—working through thoughts and feelings that disturbed her. Still, it makes it look like …” I didn’t want to say what it looked like. Others had already done plenty of that. “If the press got hold of this—” I started. The thought was terrifying. Reporters crawling all over the place, interviewing former patients, crucifying a dead psychiatrist who conveniently wasn’t there to defend herself. It occurred to me, this was exactly what Destler intended me to think.

  I made a mental note to tell Drew to gather up the rest of Channing’s journals and put them somewhere secure or destroy them. I put the journal pages back into the folder. I hated leaving them there for Destler and his cronies. But I had no choice. There were probably other photocopies and the journal itself was somewhere, too.

  “No fair, you took the easy job,” Kwan complained. “Are you going to help me go through these?”

  I turned my attention to the purple file folders Kwan had taken from the storage box—they looked a lot like the files I’d seen in Jensen’s open file drawer. It took the better part of an hour to go through them all. Most of the adverse events reported were minor. Nausea, blurred vision, drowsiness. We did find two subjects who’d experienced seizures. Channing had given them Neurontin to raise their seizure threshold, and continued treatment without any further problems.

  Then Kwan found a subject who’d had tremors. “But this guy’s fifty-three years old,” Kwan said, offering me the file. “At that age, tremors may not be an adverse event. They could be a sign of aging. At any rate, he dropped out of the study, it says, for personal reasons.” The file hung in midair, Kwan not letting go, me not pulling it away. “Damn,” Kwan said. “Isn’t her trial supposed to be targeting younger addicts?”

  I rummaged in the box and
found the file containing the ads they’d run to recruit subjects. “Between twenty and forty,” I read. “A fifty-three-year-old shouldn’t be in this study at all.”

  Was this something else that Destler wanted us to see? That in her zeal to complete the study on time, to get the results she wanted, Channing had accepted subjects who should have been out of bounds?

  “I wonder if there are others,” I wondered aloud. Kwan was already leafing through the files. Within minutes, he’d assembled three additional file folders, all subjects over forty.

  If she was including overage subjects, I wondered if there were more irregularities? No doubt, this was precisely the line of inquiry Destler hoped I’d get sucked into.

  I contemplated the pile of file folders. Four inappropriate subjects were sufficient to cast doubt on any study. I told Kwan, “It doesn’t make sense. It shouldn’t have been that hard to recruit people who fit the protocol—why stray?”

  “Maybe she thought she was just bending the rules.”

  “Kwan, you know she wasn’t a rule bender.”

  “Maybe she was stressed out. Was she drinking? Or taking something to help her deal with the pressure?” Kwan asked.

  “Ativan.”

  “A lot or a little?”

  “Don’t know.”

  I felt as if I had the good Channing perched on one shoulder, the bad Channing on the other. One was straitlaced, too good to be human. The other was unethical, drug addicted, and power hungry. Somewhere between lay the truth.

  “If she was going to cheat, why not go all the way and alter the ages?” Kwan said.

  Why not indeed, I thought. “You know, it would be easy for someone who wanted to discredit the Kutril trials to take a legitimate subject record and change the date of birth. It’s not something that can be easily checked. And with Channing out of the way, who would know? If that’s what happened, a cheap, effective treatment for psychological addiction goes up in smoke along with Channing’s reputation.”