by Barbara Ebel
“Wouldn’t miss them if I could.”
-----
Annabel scurried to the emergency psychiatry facility and pressed the elevator button for the second floor. She smoothed out her short white jacket and straightened her student name tag. Although she had missed Dr. Keeton’s presence, rounds had gone well with Joshua and Bob and she had finished writing progress notes on all her patients, including her favorite inpatients, Haley and Lillie. Now to see Noah. She could not imagine what it must be like for him after being discharged from the hospital and no longer in medical school. It must be like winning a mega-lottery jackpot and then having the lottery association pull away your prize due to an electronic ticket error.
Upstairs, Annabel stopped at the small reception desk where a secretary and the one nurse’s assistant managing patients greeted her.
“Is Noah Goodman here yet?” Annabel asked.
“We just sent him down the hallway to Room 2. Here’s his chart if you need it.”
“Thanks,” Annabel said. She opened the chart to see if the outpatient lab work was there. Excellent, she thought. His lithium level for his bipolar disorder was within normal range. She expected him to be under control and without signs of mania or depression. Joshua and Selina had also put him on propranolol for tremors but that drug did not have a blood test. What she must do was evaluate if he was free of tremors but also free of any side effects from that beta-blocker.
Annabel closed the chart and realized how far she’d come. Brainstorming about the effect of her patient’s medication and possible side effects meant she was thinking like a seasoned physician. She smiled at her progress.
“Dr. Keeton should be here anytime,” she told the two women. “I’m going in to talk to Mr. Goodman.”
Annabel opened the door. Noah’s long frame was stretched out on the examining table which they rarely used in the outpatient rooms. He bolted upright and rubbed one eye.
“Sorry about that. I am so tired since my hospitalization. I think running around with mania before that caused me to deplete my energy.” He gave her a small smile and his mood seemed even-keeled. Noah wore neatly pressed gray trousers and a pale blue shirt; a warm jacket was thrown on the back chair.
“That’s okay, Noah,” Annabel said. “You can stay on the table if you’d like.”
She pulled a chair for herself from against the side wall to the front and placed it next to the one inside the doorway, leaving that one free for Dr. Keeton. The damn thing squeaked along the tile as she moved it … like a kid scratching his nails on a blackboard. She looked at the bottoms of the three chairs in the room. The two up front did not have rubber tips on them and she wished again that maintenance would take the trouble to do that odd job.
Noah nodded in the meantime, agreeing to stay on the exam table, and then Annabel noted he had no hand tremors. He then leaned back on the black padding with the palms of his hands.
“Dr. Keeton is on her way,” she said. “How have you been feeling?”
-----
Dr. Keeton pulled up the collar of her coat to block against the wind between the medical campus buildings and made her way over to the outpatient facility. She pressed the automatic door opener on the building and went inside where she greeted the security officer and the receptionist. As she went up the elevator, she heard an incoming text and checked her phone screen.
First she noted the text was from Edgar which made her mind flash back to Friday night and the glorious time they’d had. There would be more like that, she was sure. If there was a negative trait to this man, she had no indication of it yet. But that’s what love did - make one unaware of the flaws of their partner throughout the beginning stages of lust and attraction. The third stage of love – the ‘attachment’ phase – was when the blinders were taken down and the faults and idiosyncrasies of partners were discovered or acknowledged. She took a deep sigh. No matter, she would enjoy the love she felt for him. And in her estimation, it was not going to disappear anytime soon.
She gave the two women at the desk upstairs a friendly “good morning” and stepped over to the waiting room to call Edgar. His text asked her to call; it was important.
“Selina,” Edgar said when he answered. “Good morning. I know we talked last night. There have been events today that I should tell you about. Police matters.”
“My attention is all yours,” she said. She squinted her eyes and stood very still. Edgar has excellent judgment, she thought. ‘Police matters’ may have something to do with her patients.
“Dustin Banks is at the house of Victor Blake. Marilyn Blake was found dead this morning by the housekeeper. Most likely by natural causes. Based on the stages of death, they’re telling me the body has been decaying for about a week.”
He stopped a second but she didn’t say anything. “Looks like Marilyn Blake lived upstairs and Victor lived totally separate downstairs. We haven’t been able to contact him to inform him of his mother’s death, unless he has known about it and didn’t report it. The stench upstairs is pretty awful, however, so I’m thinking he never went up there.”
Selina’s thoughts raced with multiple possibilities and red flags going off in her brain. “You said the estimated time of death is about a week ago?”
“Yes.”
She pieced together the timeframe of events. Victor’s outpatient clinic appointment was a week ago and group therapy five days ago. If his mother was dead, he gave no indication of it. His behavior during both visits was appropriate although Wednesday’s was more reclusive than Monday’s. She knew with disturbing certainty that Marilyn was the overseer of Victor’s prescription of risperidone, watching him and directing that he take it every single day.
Selina shuddered. If not treated, his disease - in its active infancy of potent psychotic behavior - may be festering like a pressure cooker ready to explode.
“Selina, are you there?” Edgar asked.
“I am. Victor’s appointment to see me is in two hours. He better show. He’s on medication which lets him function without psychotic episodes. His mother made doubly sure he took it.”
Edgar tapped his pen on the desk. “Not good. Maybe he’ll turn up at a movie theater or, worse yet, another crowded venue. But, Selina, I don’t like what else Dustin told me.”
“What’s that?”
“He has a reptile at his place. Not like a little garden snake, but a huge six-footer.”
Selina squinted her eyes. “What other bombshell news are you going to tell me?”
“Nothing,” he said. “But Victor Blake owning a snake like that, what does that mean?”
“You would expect a psychotic person to talk about strange creatures like he did but there is rarely merit behind their big talk. But since he really does keep an exotic, intimidating pet, he may be more off the deep end than we thought.”
“Selina, please be careful.”
“Thanks, I always am.”
“Selina?” he said and tapped his pen again.
“Yes?”
“I care about you.”
“Likewise,” she said. “Thanks for the info. I’ll talk to you tonight.”
She proceeded to Room 2, sat next to Annabel, and began asking Noah questions.
Chapter 30
Victor dressed in blue jeans, black sneakers, and a long-sleeved shirt with a motorcycle emblem on the back. The instant coffee he made tasted weak with too much powdered sugar so he stifled a sigh at his faulty drink. Since it was early Monday morning, he was well aware of his appointment with Dr. Keeton, but he forgot what time. Maybe 11 a.m., he thought. In the interim, other things needed to be done.
He sat crossed-legged on the floor to speak to Whatever whose dialogue with him had increased to a frenzy. Victor admired his triangular head with its dark brown spear-head pattern outlined in yellow. The snake was as splendid as a fine dog with a handsome coat of fur and markings. But he sure chatted a lot.
‘With my help, you have much to do today,’ Wha
tever said. ‘You decided never to go back to that awful job where the human beings ride through, hurling insults and strange behaviors at the window hole in the building. However, you can’t lie down about this. You must have the final say.’
‘Leave him alone about the job,’ the other voice said. ‘We all agreed he wouldn’t go back.’
‘Shut up. I’m only telling him to stop by. Even you with all your uppity wisdom would agree to that.’
Victor stood, dumped the contents of the mug in the sink, and opened the refrigerator. He cut off a chunk of cheese with green fungus and stuck it in his mouth as he fetched his jacket off the coat rack. After closing the house door, he uncurled the cap in his pocket and stretched it over his head.
‘One thing at a time.’ Whatever spoke with authority as Victor pulled into the fast-food parking lot. ‘No. Don’t park. Keep going straight and give your order at the drive-through line like those other creeps do.’
‘This is a waste of time, Victor,’ the antagonist said. ‘Just go inside and do what I tell you, not him.’
Victor stopped at the speaker box and someone shouted out. “Welcome. You can place your order.”
‘Tell him you want one of those breakfast sandwiches with eggs and bacon. It’ll be better than the moldy cheese you ate.’
‘No. Tell him you need an ice cream cone.’
“Both of you be quiet,” Victor said and swatted the air.
“Excuse me?” the attendant asked.
“Nothing,” Victor said. “Give me a bacon-egg biscuit and a vanilla ice cream cone.”
“That’ll be $3.99. Drive through.”
“Now, are you both happy?” Victor said as he drove forward.
He paid the unknown worker. In a moment, he took the brown bag and put it on the passenger’s seat. Then the attendant passed a full cone between the two windows and Victor wrapped his hand around it.
‘Tell him you’re Victor who works there and you want to talk to the manager,’ Whatever said adamantly.
“I know the manager,” Victor said. “I need to speak to him.”
The man, younger than Victor, heeded his request and stepped to the cooking area. The manager came and leaned out the window.
“Victor, what is it?”
‘Invert the cone and grind it into his hand,’ Whatever demanded. ‘Tell him to shove his job.’
‘You’ll do no such thing. The manager isn’t the problem,’ the antagonist countered.
“All right, all right, Whatever,” Victor shouted. He plunged the vanilla ice cream into his boss’s hand with the crispy cone part looking like a hat on a snowman’s head.
The manager raised his eyebrows up as he glanced back and forth between Victor and the pile of synthetic slop now drooling between his fingers. “What the hell is your problem?” he asked.
‘Tell him,’ Whatever said.
“I quit,” Victor said, “before I throw greasy oil out at the people rolling down their windows at me.”
Victor pulled his car away as the manager’s eyes grew wider and he stepped back inside to a safer environment. He didn’t blame some of his workers for disliking the drive-up window because a lot of strange characters rolled through. But his own former employee just took the top medal for craziness.
“Now are you happy?” Victor said to his voices as he pulled into the street.
‘Somewhat,’ Whatever said. ‘That was just a warm-up. Now we’re going to pay that bitch, Dr. Keeton, a visit. You do have an appointment.’
Victor simmered over Whatever’s comment as the sole of his foot pressed farther down than it should and he zipped through a yellow light. Dr. Keeton never came to my job and harassed me, Victor thought in defense of his doctor.
‘No,’ said Whatever. ‘Big deal. She did far worse. She manipulated you, me, and the other guy roaming around inside your head. That Dr. Keeton kicked us out of your mind like we were rubbish.’
Victor grimaced. But that was only temporary, he thought.
‘No it wasn’t. She pumps you with drugs that your own mother needs to monitor and she makes you see her regularly. You call that temporary?’
So that’s what his mother was supposed to be doing, Victor remembered. “Oh, all right!” he shouted aloud. “Snakes were part of my life before the psychiatrist.”
‘You’re damn right. I am your very best friend; the only one you have. How dare she treat me like deadwood? It’s me who fosters your well-being; it’s me who doesn’t treat you like you need a babysitter; and most importantly … I am the only one you can trust.’
‘He can trust me, too,’ the other voice interjected.
‘Go take a hike,’ Whatever yelled at him. ‘Right now I’m talking to Victor.’
Victor swerved into the emergency psychiatry parking lot. “Shut up. Both of you. You’re making my head explode!”
Silence ensued for a few seconds as Victor’s black sedan crossed two parking spaces and he suddenly stopped. He jumped out and slammed the door. He went to the side opposite his missing fender and kicked in that side, too.
‘Now we’re talking,’ Whatever said. ‘Let’s go in. You have business to take care of. Retaliate against that woman like your piece-of-shit car.’
Victor’s head pounded and his face reddened as he stomped across the asphalt and through the automatic front doors. “I need your help, Whatever,” Victor said in a fierce tone.
The guard walked out of the men’s room and recognized Victor as a patient as he hastened through the lobby. The woman at the desk looked up from her magazine. She knew he was headed upstairs to the outpatient clinic.
Victor careened forward, bypassed the elevator, and ran up the staircase.
‘She is expecting you today,’ Whatever said.
As Victor pushed the door open with a thud against the wall, it was like his thick snake had wrapped itself around him. Caressing him. Speaking intimately into his ear. Bonded forever.
‘You, however, have the element of surprise.’
Catching his breath, Victor stopped abruptly at the desk. “Which room is Dr. Keeton in?”
“Mr. Blake,” the receptionist said nicely. “You’re early. She’s in Room 2. You can …”
Victor jerked away from the counter, his sneakers laying down rubber as he ran to Room 2. He threw open the door. A guy around his age sat on the black table but right next to Victor on the left was his doctor and that female medical student.
‘Rodents are my victims,’ Whatever shouted at Victor. ‘Today Dr. Keeton is your victim. Fling her off that chair.’
For one second, Selina gasped from the intrusion and started to rise. “Victor,” she said, “your appointment is …”
Victor grabbed her shoulders and flung her to the floor. With more momentum than the rest of her body, her head snapped back and a crack sounded on the tile floor.
‘‘That will teach her she can’t boss you around. None of them can.’
Victor picked up Selina’s chair and stood above her for a second as Dr. Keeton, barely aware, brought her arms up in self-defense. It did no good. He rammed the chair down into her body and then swung it back up.
As Victor swung down again, he aimed the front feet of the chair into her upper torso. He smiled as the two sharp rounded front ends made contact, one on her neck and one on the upper right side of her chest. He drove the chair in as hard as he could.
The bright red blood from the hole he made in her neck spewed out like a geyser. Her arms dropped to her side and her facial expression wore no more surprise; only the fading ebb of consciousness.
Annabel leaped out of her chair. Noah swung his legs around to the end of the table and jumped off. And in the heart of the room, Victor kept pushing the chair with the lethality of a .45-caliber Glock.
Annabel felt her heart squeeze with such rapidity and force she thought it was going to explode out of her chest. The room was a horror scene. Blood covered much of Selina’s body and the floor all around her. Victor stopped
driving the chair into Selina and jerked his head her way. She gasped as his eyes landed on her and she feared for her life.
The distance to the door was short; Annabel darted and yelled up the hallway. “Call 9-1-1! Get the police! Call over to the ER for help!”
Noah glanced at the open door and at Victor. He decided to take his chances with the other psychiatric patient because he had lessened his grip on the chair and it hung loosely from his hands. As Victor stared down at Selina, Noah lurched up his leg and kicked him in the back, sending him stumbling forward.
Annabel ran to the front desk and confirmed the two women were calling for help. “Victor attacked Dr. Keeton,” she shouted. “We’re all in danger.”
She had a quick thought and without thinking it through, she pulled her cell phone out. With trembling hands, she spun to Edgar Banks’ contact info and pressed ‘call.’
Edgar sat at a red light in his patrol car. His hands-free phone rang and he saw Annabel Tilson’s name pop up on the dashboard screen. “Miss Tilson, this is a surprise. I spoke with Selina earlier so you all must now be aware of Victor Blake’s developments.”
“Edgar,” Annabel said, her voice pressured and tense, “it’s Dr. Keeton. Get over here right now.”
“Where?”
“Second floor. Psych emergency building. Victor’s gone mad.”
“I’m on my way.” Edgar turned on his siren and blinking lights and cut through the red light.
-----
The receptionist and nursing assistant ran out the outpatient clinic door while Annabel placed the call to Edgar. With the call over, she glanced back down towards Room 2. She vaguely heard a scramble and then Victor and Noah, arms swinging, plummeted into the hallway.
The facility doors crashed open and two paramedics from the hospital raced in with a stretcher and two medical bags. Annabel made eye contact with both of them; with her expression of fright and Victor and Noah grappling on the floor, she didn’t have to say a word. The two paramedics raced ahead; one of them grabbed Victor, the other subdued Noah and they succeeded in pulling them apart.