by Judith Lucci
St. Germaine had hosted an amazing dinner party that included guests from Europe, as well as the locals. After everyone had left, he asked a very lovely lady to have a nightcap with him on his balcony. All seemed well until the lady murmured that she must leave to prevent gossip about them. Suddenly, St. Germaine lunged for the beautiful lady, grabbed her tightly around her shoulders, and tried to bite her neck while pressing her slender body against the ornate wrought iron balcony. Fortunately, for the lady, the balcony was rusty and gave way. She plunged to the ground and landed in azalea bushes, apparently unhurt, and ran through the Quarter for safety.
The incident was reported to the police the next morning, but when the police invaded St. Germaine's home, the Comte had disappeared. The police searched his home and only found tablecloths with large red splotches that appeared to be wine, although it was later determined to be part wine and part human blood. In his wine cellar, St. Germaine had stored hundreds of bottles of red wine with French and Italian wine labels, but a random testing of the cache proved them to be a mixture of wine and blood. Several cases of this wine had remained in the NOPD evidence room until it washed away in the Katrina waters a few years back, along with almost all of the evidence from the St. Germaine case. But, the evidence was clear that the bottles contained wine and blood.
As the air-conditioner continued to purr softly, Jack felt himself falling asleep and gave into the feeling. It had been a pretty rough day, and it wasn't getting any better. He deserved a few minutes of shut-eye. He continued to drift off until he was rudely awakened by a blaring horn of a presumably irate driver. After flipping the driver off, Jack shook his head to wake up and shake out the cobwebs remaining in his brain from his short nap. Jack also managed to convince himself that St. Germaine was a legend and only a legend, just another good old NOLA ghost story. But then reason and logic set in and he was forced to confront the number of unsolved murder cases and deaths where the bodies were discovered upon autopsy to have no blood or just a minimal amount of blood. The most recent case had occurred in 2009, but three other cases had occurred in the 1980s, shortly after Jack had joined the NOPD. Police records also had similar crime reports that dated back to the early 1900s. Unfortunately, a lot of those files had been lost in the flood waters of the storm.
The unsolved cases perplexed Jack beyond belief, and it pissed him off that he had been unable to solve the crimes. He also wondered about the hundreds of people who had disappeared in NOLA over the years, never to be heard of again. Of course, many of them were prostitutes and druggies, but they didn't deserve to disappear without a trace. There were also hundreds of bodies that had washed up on the shores of the mighty, muddy Mississippi, too decomposed to identify. Fortunately, now they could often identify the corpses via DNA evidence, but even that evidence had been lost in the storm. He was no closer to solving the St. Germaine legend than he had been in the 1980s and he didn't like that feeling. It irritated him beyond belief. Then he returned to his theory that St. Germaine was a serial killer who preyed on the vulnerable and down-trodden. He continued with that thought until his cell phone rang. Damn, he thought as he listened, here we go again.
Chapter 13
After lunch, Alex made several attempts to analyze pending malpractice claims. She was totally not into it and her attention kept returning to Angie and the night before. She called the O.R. and learned that Angela was in the recovery room. A little after 2:00 PM, her temporary secretary, Mona, checked in and Alex asked her to transcribe the depositions that were left over from yesterday. Unable to work, Alex decided to go off-campus to the psychiatric units to learn if the team had uncovered any possible suspects.
The heat was unbearable as she walked the distance between the main hospital and the Pavilion. Alex noticed the cordoned-off crime scene. The yellow-taped area showed her exactly where Angela had been assaulted, raped, and beaten. Several detectives were still trying to uncover any bits of evidence that could possibly exist. Alex wasn't surprised to see Commander François directing them. Jack waved as Alex passed. She looked at the shaded areas and shuddered when she thought of how dark it must have been last night and how scared Angie must have been. The crop of trees where Angela's body had been found was dense and the overhanging moss gave the area an eerie feeling, even during the day. It must have been awful for Angie. Alex said a quick prayer for Angela and her family.
The Pavilion loomed in front of Alex and she couldn't believe how ominous the building appeared, even in the daylight. The psychiatric hospital was a two-story converted storage building, painted grey in color, with most of the windows barred or shuttered, either to protect against the summer heat or to keep patients from looking out – or, more likely, jumping out. Alex wasn't sure which. Probably more to keep patients from jumping out of the windows, she finally decided. Some of the bars in the windows shined brightly in the Louisiana sun. They were a gun metal color. Everything was grey. How depressing. It was all absolutely, totally depressing, Alex thought to herself as she entered the building.
The foyer of the Pavilion presented as much as the outside, grey and dreary. A pair of metal benches with grey, fake leather cushions, were on either side of the door and a bank of elevators stood to the right. The walls were painted grey. Alex wondered what had happened to hospital green. That used to be the color in hospitals. The doors to the stairway and several other areas were locked. Good, Alex thought to herself, as she tried to open them.
The silence in the foyer was deafening. Alex could hear herself breathe. As she looked around, she thought about all of the sick, deranged, and criminally insane patients who had crossed through this space. Deathly quiet. It was as if the walls were waiting for her to say something.
She pushed the elevator button and it slowly crept down towards her, making a slow rattling noise. Geez, the elevator sounds like someone rattling chains, she thought to herself. There was nothing normal or comforting about this place, she thought, as the metal albatross rolled to a banging stop and the door crept open. The elevator was unmanned. There was no operator on board. Usually, the elevator would be manned by a psych tech or mental health worker to usher people up and down the floors of the old storage building -- for safety reasons, of course. As she began the slow ascent to the inpatient units, she wondered if the lack of an elevator operator was also part of the budget cuts. She sighed sadly to herself.
Alex rang the bell for admission into the closed unit. She was easily admitted and was escorted by a large man, presumably a psych tech. As they walked down the hall towards the day room, Alex was surprised by the silence. It was as silent as a tomb on the unit. Deathly quiet and dark, the sun shuttered out by long drapes.
She spoke to two psych techs, one from the day shift and one from the evening shift counting sharps. Sharps were globally defined as anything that patients could use to harm themselves. Hopefully, most sharps, along with cell phones, were confiscated on admission, but psychiatric patients who wanted to die were ingenious at finding things to kill themselves. Razors, scissors, glass perfume bottles, aerosol cans, and any other instrument the patient could use were kept in the nurses' station. Patients were allowed to use their razors during admission but only under the supervision of a staff member.
A quick conversation with one of the psych techs alerted Alex that all sharps were accounted for, except for one razor. The tech had laughingly informed her that one sharp was always missing -- nothing to worry about. "We are always missing at least one," he'd joked.
Alex didn't share his macabre sense of humor over the missing razor. In fact, she was concerned at the tech's nonchalance and casual dismissal of a dangerous instrument. Alex asked him where the staff and patients were. He directed her towards the Community Room on the North Hall, where the patients and staff were holding a group meeting.
Alex walked down the hall trying to remember what a therapeutic community was when her cell phone rang. Mona was calling her to tell her that the 3 o'clock executive meeting was
canceled. Alex felt a tinge of impatience as she continued down the hall. She knew Don had not wanted to meet and figured that Favre had probably talked him out of it. She shook her head in disgust.
Finally, she remembered the definition of a therapeutic community. It was a model of behavioral health care that allowed psychiatry, nursing, social work, and patients to work together to establish a trusting environment at the hospital. In an effort to establish a psychiatric milieu, each group had an equal voice in the operation of the unit. The therapeutic community addressed issues and concerns that affected patients and staff. Alex paused outside the door and listened for a few moments.
Today's discussion was centered around the attack on Angie. The group leader was attempting to get patients to verbalize their feelings about the attack and share any knowledge of how it happened. About 20 faces stared at her as she entered the community room. Alex scrutinized the group, looking for a friendly face, but there were none. Only suspicious faces stared back at her
She was surprised at the mixture of patients. Both genders and all ages were represented. Some patients looked acutely ill, psychotic in fact. A few had tardive dyskinesia, usually caused by the effects of long-term phenothiazine or anti-psychotic therapy. These patients were easily identifiable by their pill rolling mouths and shuffling gaits. One little, old, white-haired lady looked like Mrs. Santa Claus. She sat attentively in the circle, her hands clasped around her 1950s vintage pearl pocketbook. She smiled sweetly at Alex and nodded. Finally, a friendly face. She spotted Monique in the group and gave her a faltering wave.
Dr. Desmonde, once again her unflappable self, signaled her in.
Alex entered the community room and Monique introduced her.
"Group, this is Alex. She is a nurse and the attorney for the medical center. Alex is a friend of Angie's and she wants to help us understand what happened." Dr. Desmonde looked carefully at the group, gauging their reaction to Alex. She was unsure what their response would be to a stranger and an attorney in their presence. She waited calmly for their response.
After a short silence a male patient angrily retorted, "I ain't saying nothing else. Why does she need to be here? She ain't part of this here. I ain't never seen her before!"
Dr. Desmonde looked nonplussed and replied, "Anthony, Alex is Angela's friend. She's here because she cares about her. She wants to know who hurt her. She's not here for any other reason."
Anthony continued to look angry and uncertain as he muttered, "Yeah, yeah, sure. What other BS you got for us, doc?"
Alex, unsettled for a moment, responded. "Dr. Desmonde is right, Anthony. Angie's my friend. Her twin sister, Bridgett, works with me. I'm concerned about her and what's happened to her." Alex eyed each member of the group. The silence seemed endless, an eternity. Of course, Alex remembered, silences in psychiatry were meaningful. Right? It probably wasn't an uncomfortable silence, it was simply a long silence, but for sure uncomfortable for her. Each patient looked at her speculatively. Some of them seemed skeptical and uncertain of her presence. Others looked interested in having her there. Alex met each of their stares with a straightforward look.
Finally, a female patient spoke to her in a friendly voice. "Hi, Alex. I am Penny. I am a schizophrenic, so they say. So, I guess I must be. Anyway, I'm doing good now. It's okay with me if you stay." Penny looked around the room and then addressed the group, "She looks okay to me." Penny nodded her approval of Alex. "Whatdaya say? Can Alex stay?"
A dozen heads nodded affirmatively over what Alex perceived as a long period of time.
Only Anthony seemed unsure. He snarled at her and said, "Why in the hell would she want to be with us? We're castoffs, crazies, don't nobody want to be with us." His eyes glittered angrily at her.
Alex looked directly at Anthony and replied calmly, "Anthony, I admire your courage and your ability to voice your objections. I want to stay because I want to hear your thoughts on what happened to Angie. You know people around here. You may have information that could be useful in helping us solve this terrible crime. Angie didn't deserve what happened to her. She worked here because she cared about you." Each group member seemed content with what Alex had said. Only Anthony continued to stare at her suspiciously.
"Yeah, so you say." Anthony's voice was mocking her. "Angie got a paycheck for comin' here. She may have cared some, but the money was why she came. She's okay, I guess. But, don't hand me no bullshit. She didn't care that much. Besides, she was scared. Angie was scared of us. I know that. All of us do." Anthony looked around at the group, grinning as he spoke. His look was sinister. Several of them nodded their heads in agreement with him. He glared at Alex and growled, "I'm sure that whoever hurt her knows, too. Anyway, we know we cooperate with you or we stay here longer. I'm in for now." Anthony, still mistrustful, gave Alex a shifty look, glared at her, and then looked at the floor.
Alex said simply, even though her heart was beating full force, "Thanks, Anthony. I'll take what I can get. Don't let me interrupt. Just continue as if I wasn't here." Alex felt frenzied, uncertain. She turned to Monique, her eyes pleading with her to take up the reins of the group therapy meeting. Monique nodded at the group leader to continue. Alex was definitely out of her comfort zone and she knew the patients on the unit knew it.
The group leader continued the meeting. "Now, group, before we were interrupted, we were sharing our feelings about what happened to Angie. Rose, I believe you were talking."
Alex turned her head towards the patient identified as Rose. She looked to be in her thirties, was waif thin, and had long, stringy brown hair. Alex thought Rose looked afraid of her own shadow. She wondered if she'd been abused at some point in her life. Rose literally seemed to shrink and almost became invisible as the group stared at her.
"I … I … feel so awful for Miss Angie." Rose's voice was soft and hesitant. "She was nice to me. We talked last night, just before Jim started that fight in the day room." Rose looked around at the group and saw them staring intently at her. Her voice faltered and she began to cry. Then, she said, "Angie and I could have talked longer, but Jim ruined our conversation." She gulped, her thin shoulders heaving in despair as she burst into sobs.
Anthony's voice was hoarse with anger and resentment. "Why are you crying, Rose? You are such a little crybaby bitch. Ain't nobody hurt you yet. You're such a cowardly little piece of crap. You're a slut, just like all the women. You remind me of my …." Anthony's voice had become louder and louder as he screamed at Rose, his face livid with rage. Suddenly, he stood up and lunged towards the frail, pale woman, who seemed to shrink away from him. He was going for her neck.
"Oh, no! No! No," Alex could only exclaim. She was unable to move, paralyzed in her chair.
In a flash, Donna Meade, the nursing manager of the general psychiatry unit, a behavioral health tech and Dr. Desmonde wrestled 6 foot Anthony to the floor, pinning his arms behind him. Donna Meade left for an instant to ring the "all staff alarm" red button located by the door. The ASA was to psychiatry what a code blue was on general hospital units. It announced a psychiatric emergency and requested that all available staff report immediately to the location. Within seconds, two additional male psych techs and a second RN appeared with the syringe of Haldol which, after a nod from Dr. Desmonde, was administered into Anthony's upper arm. The two psych techs lead Anthony away to the seclusion room while the rest of the patients stared.
It was then that an acute realization hit Alex. These people, these patients, had their own culture, their own pecking order. They had their own leaders and power structure. Anthony was the power structure. Now that he was down, no one was going to say much or offer any significant help.
Alex felt safe for a brief moment. Then she realized, with a sinking feeling, that she was in a very dangerous situation. Suppose the other patients acted out? Didn't that happen often? She tried to remember from her nursing school days. Didn't one patient incident spark other patients to act out? Like an avalanche? Of course they did.
She felt her heart rate pick up quickly and the hair on her arms stood up. She felt chilled. Yes. That is what happens. That's exactly what happened last night in this very place! Alex looked around furtively.
Several patients were agitated, rocking back and forth in their chairs in perfect rhythm. Another patient was plucking invisible particles from the air. Alex felt her heart fill with panic. Just to her left was another large man. He suddenly began screaming and pulling at his hair. Then he stood up and started pitching empty chairs against the window, hollering that he had to get out and save his baby.
Donna Meade looked at the patient, calmly touched his arm, and said in a soft, steady voice, "Jim, stop throwing the chairs. You're okay now. You're in the hospital and nobody's going to hurt you. Please, you're upsetting the other patients." Donna's voice was calm and quiet. She slipped her hand into the crook of Jim's arm just as he was about to toss another chair at the barred windows. He immediately replaced the chair on the floor.
Jim gave Donna a confused look. Then recognition seemed to appear on his face. "Oh, oh, oh! I gotta get outta here. I gotta go. I'm sorry, Donna. I didn't mean to cause no trouble." Jim's eyes were terrified and were full of tears. He looked ashamed of his behavior. The huge man was literally cowering before the staff and the patients.
"I know, Jim. You just couldn't help it. Let's go to the quiet room and rest awhile." Donna continued to hold his arm gently.
Then, to Alex's amazement, the large man allowed the petite Donna Meade to walk him back to his room.
Donna motioned to Monique that she needed some medication and then said to Jim in a quiet voice, "I want you to rest for a little while. We'll talk about this later."
Alex shifted her eyes from Jim and glued them on Monique. If Monique left her in the community room, there'd be no staff member at all to subdue any patient outbursts. In fact, they had been lucky that Donna had been able to quiet Jim. It would have been impossible for Alex, Donna, and Monique to wrestle the enormous man to the floor.