Françoise was intrigued and asked, "What else did Anthony say? Anything specific to Angie?"
Alex was trying to remember. "He did say that Angie came to work for a paycheck and that she was afraid of the patients. That's about it. Do you remember anything else pertinent, Monique?"
Monique shook her head, while Robert remained silent.
Jack was rethinking the scenario. "Well," he finally said, "Anthony knew that she was afraid of him. It also sounds like he dislikes women in general from what he said to Rose, especially the bit about her being a slut. What do you all think?"
Monique responded quickly. "Short of giving you a long dissertation in psychobabble, it's possible that Anthony was transferring his feelings about Angie to Rose. It's hard to say, Jack. Anthony's paranoid. None of this is conclusive." Monique's voice was skeptical.
Jack looked irritated. "Of course, it's inconclusive. It's a theory. These are just possibilities, what ifs and wherefores, so to speak. What is conclusive is a DNA match on the hair follicles and other evidence pulled from the crime scene. I'll check on our boy with Alabama tomorrow. You never know." Jack was trying hard to be neutral.
Alex broached the next question. "What about Jim, Jack? Do you know he's former NOPD? I think he's on disability of some type now."
Jack heaved a heavy sigh. "I know Jim McMurdie well. Good cop, good guy. I rode with him when he was a rookie. He was a good man, an outstanding police officer. I'll never understand why he flipped. What about him, Monique? Do you think he could fit into this?"
Monique was clearly annoyed at Jack. She responded in an irritated voice, "Jim McMurdie is a good man. He's still a good guy. He's just sick. I haven't finished working him up yet. He's been on the unit for about three days and I've made a tentative diagnosis."
"Why was he admitted?" Robert asked.
Monique continued, "Mrs. McMurdie, Lynette, called me several years ago and told me that she thought Jim was having some psychotic episodes. Since Lynette's a registered nurse who worked at CCMC before their first child was born, I gave her telephone call credibility."
"I remember Lynette McMurdie. Didn't she teach critical care nursing over at LSU?" Robert asked as he searched his memory. "From what I can remember, she was a real knockout! A beautiful girl."
Monique said, "I don't know. She may have taught over there. I only remember her from the E.D. She and Jim met in the CCMC emergency department. But, you're right, Robert. She's gorgeous. Tall, fair skinned, with long, curly dark hair that she usually wears down. Anyway, …"
Robert nodded his head. "Yeah. That's her!"
Monique continued, "Lynette and I had lunch shortly after her phone call and she told me that Jim, out of the blue, started accusing her of having extramarital affairs. She said she was becoming a little frightened of him because he had become so irrational. She told me that the week before she called me, Jim had run outside their house and threatened a stranger who was out walking his dog. He apparently swore at the stranger, accused him of having an affair with his wife, and threatened to kill him if he ever saw him within eyesight of his house again!"
Alex was wide-eyed. "Humph. Wow, that's pretty intimidating. Bet that man never walked his dog that way again," she quipped, trying to lighten the mood. It didn't work. She paused for a moment, and then asked, "What did Lynette do?"
"Well, she tried to reason with him later. Her four-year-old had witnessed the scene and had been frightened by it. Lynette said that when she mentioned it to Jim later, he denied it ever happened. She believed he had no recollection of the event."
"Damn. How long ago was this?" Jack asked.
"It was several years ago. Anyway, I asked Lynette if Jim had been under any unusual stress or pressure and she—”
Jack jumped up from the table and exclaimed. "Damn, that's just about the time Jim was assaulted and beaten in the Quarter. From what I can remember, he was on foot patrol when he and his partner were jumped from behind by a gang of druggies, cop haters so they said. Anyway, Jim and his partner were badly beaten. They were hospitalized for quite a spell."
Monique looked at Jack and marveled at his ability to remember things, from the biggest things in his life to the tiniest details of a crime committed twenty years earlier. "You're exactly right, Jack. Jim was hospitalized for about two weeks with a head injury. He recovered nicely in the hospital. However, about three months after the beating, he experienced a sudden onset of dizziness, headaches, vomiting, ataxia, and left-sided weakness. He came to the CCMC emergency department for a workup."
Robert was absorbed, his medical mind working. "It sounds like he was having a stroke secondary to the beating. This is sounding like a very sad story," Robert said, lamenting over the Jim McMurdie story.
"Yes," Monique said, "It is a very sad case. On neurological exam, there was evidence of left dysmetria and decreased sensation to touch on the left side. Jim had no history of hypertension or any other risk factors for stroke. His head CT scan revealed a left cerebella hemorrhage with massive effect. He had edema present near the fourth ventricle. He also had some mild atrophy of—”
Jack interrupted in an irate voice. "Yo. Wait a damned minute! Don't forget I'm here. Talk my language!" Françoise was once again furious because he couldn't understand the medical jargon. "Talk to me, not above me!"
Alex intervened, "Basically, Jack, Jim had a stroke. It also sounds like parts of his brain weren't working based on the atrophy of—”
"What in the devil is atrophy?" the commander barked at them. "Dammit, talk to me, too. I'm sitting here. You medical people are a pain in the…" Jack stared darkly into his Irish coffee, irritated that his friends were talking above him. He hated that worse than anything.
Monique smiled and patted his hand. "Sorry, Jack. Atrophy just means parts of his brain hadn't been used lately. You know the old saying that if you don't use it, you lose it? Anyway, the jealous accusations of extramarital affairs started after his injury."
Robert was intrigued. "This is fascinating, Monique. Do you think that his head injury caused his psychosis?" Robert leaned forward eagerly in anticipation of Monique's answer.
"I think it's possible. There is research to support the premise and—”
Françoise interrupted rudely. "I don't think it's fascinating. I think it's generally shitty. A policeman gets injured in the line of duty, has a stroke, and goes wacko. What the hell is fascinating about that? I don't admire the science of it. I just see the loss of a good, honest cop. Sorry." Françoise's voice was bitter as he continued to stare darkly into his Irish coffee.
Robert looked apologetic. "Sorry, Jack, I just—”
Françoise interrupted, "Save it for the medical books, Bonnet, I’m not interested.”
There was an uncomfortable silence. Alex surveyed her nails and made a mental note to call for a manicure tomorrow.
Robert took a long swig from his Irish coffee and wished he'd ordered another one.
Monique and Jack stared at each other.
Finally, Monique began again. "Jack, the entire Jim McMurdie story is pure speculation. May I finish?" Her voice was calm, cool.
"Yes, of course, Monique. I just feel differently. McMurdie's a good man, was a fine cop. Now it sounds as if he could be implicated in this crime. It's unfair, it sucks, to say the very least. Of course, finish." Jack's voice was diffident as he raised his shoulders.
"Okay. Anyway, after I talked to Lynette the first time, she called again and reported that Jim was becoming increasingly depressed and irritable. His mood swings were frequent, and he'd begun drinking more than usual. She said she was becoming more frightened of him. She told Jim he had to go for help or she would leave."
"How did that go? Did he come to see you?" Alex asked.
"Yes. He came three times. He was quiet, withdrawn, and cooperative. He seemed to know he had irrational behavior, but didn't know why. He did better for a while and he and Lynette got some marriage counseling. Things were better. I pu
t him on a course of psychotropic drugs that seemed to help, when he took them…"
"Only a short period … what happened?" Robert remained absorbed in Monique's story.
"Typically, he stopped taking his medicine. I guess there was some sort of incident at work and the internal affairs division of the New Orleans Police Department put him on involuntary leave. Then Jim experienced extreme melancholia. He was acutely depressed."
"Why was he admitted to the pavilion last week? What was the reason?" Jack asked.
Monique shook her head sadly and answered. "Lynette and Jim were shopping for baby furniture at the mall when Jim saw a man he believed Lynette was having another affair with. He went berserk and attacked the man. His attack was vicious. Jim was psychotic and delusional at the time. Finally, the security guards at the mall subdued him and he was TDO to us. It's extremely sad."
The group digested this information slowly. Finally, Alex asked, "How badly was the man hurt?"
"Pretty bad. He'll recover, though." Monique threw her hands up in frustration. "The worst part is that Lynette, who is seven months pregnant, took their daughter to her parents' home in Baton Rouge. At this point, she's refused to be a part of Jim's therapy."
Alex thought about this for a moment and said, "Can't say I blame her. She's probably frightened to death of him. I would be. Has he ever attacked her?"
"No, he's verbally abused her, consistently verbally abused her, but he hasn't attacked physically – at least not yet, but it is within the realm of possibility." Monique's voice was low.
Jack was once again annoyed. "What kind of bullshit response is that? It's within the realm of possibility that I will attack each one of you at this table. Now tell us what you really think, Monique. I'm sick of this psychobabble."
Monique bristled and her face flushed as the blood poured to it. She managed to hold her temper. "Yes, I think it's highly probable. I think Jim has Othello Syndrome. If he'd attacked Lynette, my diagnosis would be final."
Robert was the first to respond. "Othello Syndrome … like Othello as in Shakespeare's Othello?"
Monique nodded her head. She turned to Jack and explained. "Yes, Othello Syndrome is named for the tragic character in Shakespeare's play in which jealousy played a major role in the character’s commission of spousal homicide. While the Othello story occurred in the context of a marital relationship in the play, Othello Syndrome can be applied to any generic situation involving sexual or other intimate partners. As you can imagine, there is no clear demarcation as to what comprises ‘normal’ jealousy versus ‘morbid’ jealousy."
Robert was clearly intrigued, although he was smart enough not to say so and incur Jack's wrath again.
Alex could tell. She could still read his face and anticipate what he would say. She wasn't disappointed.
"How does Othello Syndrome first appear? Is it rare? I've never heard of it. How do they diagnose it? How does the patient present?" Robert fired a barrage of questions at Monique.
"Othellos appears much like Jim's psychiatric illness has evolved. The forensic literature suggests that Othello Syndrome has appeared as delusional jealousy, sexual jealousy, erotic jealousy, and delusions of infidelity."
"How is it diagnosed? Are there criteria?" Robert asked again, his medical mind working.
"Well, sort of. Othello is often subsumed in the DSM diagnostic criteria described under delusional, paranoid disorder. There can be non-bizarre delusions of unfaithfulness, as well as auditory or visual hallucinations. Sometimes it's hard to pick up the hallucinations, if they're not clearly evident." Monique stopped for a minute to think. She continued, "Also, if bipolar syndrome is present, the mood swings may be brief or inconsequential to the relative length of the delusional disturbance. I think that's what's going on with Jim. It's hard to group human behavior into tight little boxes. Frustrates me to death, especially when people try to do it." Monique was beginning to look tired, the wear and tear of the day etched on her face.
"I think you're right," Robert surmised. “The diagnostic criteria sounds very much like Jim to me. What do you think?” Robert asked Monique.
"Yeah. It's very possible. There are two things that prevent me from confirming a diagnosis of Othello. Only one has any scientific or medical merit.”
The group looked at her expectantly.
Françoise was trying hard to be patient. "Well, Doc, spit it out," Jack said carefully.
"First of all, the spouse is usually the threat in Othello. Jim hasn't physically harmed Lynette yet – although there are many cases reported where Othello patients attacked neighbors, children, and other unknown persons. Certainly, Jim fits into this mold." Monique stopped, as if examining Jim mentally.
"What's the second reason you haven't made a final diagnosis?" Alex asked Monique, gently.
Monique gave Alex a forlorn look. "It's because I don't want to. The syndrome doesn't respond very well to traditional psychotherapy or medication. It has a very poor prognosis. It's a devastating illness."
There was a long silence at the table as the four friends contemplated Jim's dilemma.
"Yeah, this really sucks, big time," Jack concurred, obviously distraught.
"Is there scientific evidence connecting Jim's head injury with the Othello?" Robert asked.
Monique nodded affirmatively. "Yeah. The best evidence suggests that Othello symptoms follow an injury of some type. As a matter of fact, there's currently a NIH research team working on identifying typical Othello lesions in the brain."
Commander Françoise, who had been thinking, looked hard at Monique. His face appeared to be carved of stone. "Monique, how dangerous are these people?" His look was ominous.
Monique's eyes met Jack's head on. "Incredibly dangerous. Jack, these patients are very, very dangerous. Othello patients harbor hostility towards others secondary to their delusional jealousy. This hostility can result in serious physical violence, including homicide. Some Othello patients murder out of morbid jealousy. These patients can be extremely violent to themselves and others."
"Are these patients dangerous only to themselves and people they know or are they dangerous to anyone?" Jack was pressing Monique for information she didn't want to give.
After a short silence, Monique acquiesced with a faraway look in her eyes. She looked out the floor-to-ceiling restaurant window as she said, "Individuals suffering from Othello Syndrome pose a significant risk to society in terms of potential violence, both in domestic and generic circumstances. Jealousy in its most severe form, the Othello delusion, plays a major role in completed homicides and spousal murders. In this situation, we know he was delusional. He attacked several men prior to admission."
Robert looked carefully at Monique and asked her gently, "Do you think Jim could have attacked Angie?"
Monique replied slowly, "I don't know. I don't believe rape is part of the syndrome. At least, I've never seen it reported anywhere in the evidence. I think that's a significant factor when we look at Jim. Otherwise, he could easily fit the picture of the attacker. He's known to be delusional, morbidly jealous." Monique stopped for a moment to think and then continued, "And he presents as classically evolving Othello Syndrome. Who knows?" She shrugged her shoulders, looking very tired. She added, "I'm wasted. Can we continue this tomorrow?"
Jack felt his phone vibrate in his pocket. As he struggled to get it out and read the text he said, "You guys timed this just right. Gotta go folks, sorry to leave such great company, but I've got another murder in the Quarter. Third one today." He shook his head. "Damn, this is getting old."
Monique glanced up and said, "Does the police commander always have to show up at every crime scene?"
Jack glared at her. "We've had this conversation. We’re all tired, and, yes, this police commander will always show up at crime scenes and that isn't changing.”
Monique looked tired and rejected. It was a good thing she had her car. She'd be damned if she was getting in Jack's car. Of course, she was insta
ntly ashamed for having these thoughts. It was because of Jack's sense of commitment that she loved him so.
"Let's continue this tomorrow. Of course," Alex said, "we're all beat. Monique, don't be too upset. It may not even be a Pavilion patient. It could be anyone, right, Jack?"
Jack grinned at Alex. "Yep. You bet, Al. Proof is in the pudding and the pudding in this case is hair follicles, semen samples, and bite marks. "Yo, gotta go. Later,” he said as he kissed Monique goodnight.
As Alex, Robert, and Monique walked towards the door of the Palace, Monique said, "I just don't get it. Why in the hell do police rush to a murder scene? They certainly can't help the victim. It's ridiculous."
"Well," Robert opined, “I think it has to do with testosterone and conditioning. And, in this case, a certain police commander who, trust me, will never change.”
Alex nodded in agreement.
Monique sighed in resignation. "Yeah, that's why I love him," Monique admitted.
After hugging each other good night, Alex and Robert congratulated Monique again, who waved them away, suggesting that the romance was “old hat” now.
Robert offered Alex a ride and she accepted gratefully. During the ride home, the couple enjoyed a companionable chat. They talked about their happiness for Jack and Monique, as well as how difficult it was going to be for Monique to adjust to being a police commander’s wife, if the romance got that far.
After reaching her house, Alex invited Robert in for coffee, but he looked at his watch and told her he had to get back to CCMC. He wanted to check on Angie and several other patients whose surgery he had supervised in the O.R.
Robert walked Alex to the door of her beautifully restored home, remarked how well manicured the lawn was, kissed her briefly on the cheek, returned to his silver Mercedes, and drove off.
Alex felt very alone after Robert left and wished for a few minutes that he had joined her for some decaf. But, when she realized how exhausted she was, she was glad that he hadn't. The day had been two days long. She was worn out from thinking about Angie, the crime, and the patients in the Pavilion. Besides, the celebration dinner had been wonderful, but a bit stressful at times. Too bad this had to happen to the couple now. Her thoughts kept returning to Jim McMurdie, but for some reason, her intuition told her he didn't do it. After assuring herself that there was no concrete evidence to implicate him, she went into her kitchen, poured herself a glass of milk, found some chocolate cookies, and took them into her bedroom.
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