Terminal Therapy

by Daniel Reinharth

“David,” Paula said. “Be nice. We can see that Andrea's in a very difficult position.”

  Andrea shifted in her seat until she faced Paula and me equally. “Thank you, Paula.”

  “I'm just being logical,” I persisted. “Dr. Rincon has a certain reputation.”

  Andrea looked at me again, but this time without smiling. “You have no idea what I have to do to please these people. My job depends on keeping everyone happy. It's especially difficult my being a woman.”

  “Men can be such pigs,” Paula said, encouraging her to keep talking.

  Andrea returned to neutral position. “Thanks again,” she sighed, then leaned forward. “I think I can trust the two of you. Don’t tell anyone, but I'm looking to start my own conferencing company. So networking and good PR are more important than ever for me.”

  I looked at Paula. She returned my poker face, apparently agreeing to use silence to draw more out of Andrea.

  “I'm surrounded by people who've had easy lives,” Andrea said. What about Jonathan Singer and Judith Klansky, I wondered.

  “They've had everything handed to them,” Andrea continued. “Money. Position. And still they complain. I don't come from the streets, but I have had to work hard to get where I am.”

  We all seemed to notice at the same time that the room had emptied out. My watch read 9 o'clock.

  “I know that we've all got to go,” Paula said. “But can you just tell us if you saw anything or anyone last night that might help? Such as why were Dr. Singer’s pills missing? How did they return to Ms. Carstens' pocketbook? And how did he end up in the water?”

  Andrea recoiled and shook her head. “No. Nothing. What-”

  “Who did you see in the back rooms?” Paula pressed.

  “Another time,” Andrea said, rising. “We don't want to miss the start of the conference.” She left the room before we could protest.

  CHAPTER SEVENTEEN

  I took advantage of our solitude in the breakfast room to grab Paula's hand and lead her out.

  “I don’t trust that woman,” she said, referring with a head gesture to Andrea Peterson.

  “I agree,” I said as we hurried to the opening talk. “But I’ll bet she knows things.”

  The conference room had a post-buzz atmosphere: conversations dwindling, people making final seat selections, rear ends wiggling into their most comfortable positions. I eyed empty spots in the back, but when Paula walked to the front I followed. Tracey Shanley, Mitchell Singer, and Andrea Peterson were at the podium, with Rafy Rincon off to one side.

  Tracey took the microphone. “Welcome, everyone. For the few here who don't know me, I'm Tracey Shanley. Associate Director of the Singer Institute. We're about to begin our conference, but let's start with a moment of silence, to show our solidarity with and best wishes for our beloved friend, colleague and mentor, Dr. Jonathan Singer.”

  I bent my head. As I waited, I noticed that our room had lost its battle against the Cape's natural humidity. I began to perspire.

  “Thank you,” Tracey resumed. “We all wish Jonathan a full and speedy recovery, of course. I'm confident that he would want our conference, his conference, to proceed. So that's what we'll do. Jonathan's a giant in our field. His work, which this conference represents, is also for the ages. Andrea Peterson, our conference coordinator, will make a few housekeeping announcements, and then Dr. Mitchell Singer will keynote. As leader of the Singer Institute in Jonathan's absence I'll be at your service at any time. Andrea.”

  Tracey motioned to Andrea and sat in the front row. Andrea expressed her sympathy for Jonathan Singer, then described the logistics of the conference, including schedules, personnel, and evaluations. She introduced Mitchell Singer, then sat next to me. I whispered a hello. Paula brushed perspiration off her forehead, and kept her gaze fixed on Mitchell.

  “Good morning everyone,” Mitchell began. “Thank you for your support at this difficult time. I'll keep you all informed whenever there are updates on my father's condition. As Tracey said, this conference represents my father's work, and his work will go on...even after he's gone, which I hope will be many years from now. Before the conference, however, he confided in me about his plans for the future of the Singer Institute. It was going to be his announcement, but under the circumstances...”

  He poured himself a glass of ice water, and drank it all. The silence in the room was total. I remembered that on the boat Jonathan Singer had mentioned an announcement.

  “As some of you know,” Mitchell resumed, “my father and I were estranged for a while. But we reconciled, and put our differences behind us. I even converted to his denomination of CBT.” He laughed, but then clutched the podium and looked down. Some in the audience smiled, sympathetic but subdued.

  “I have no idea what his previous intentions were,” Mitchell resumed, looking back up. “If indeed he had any. He’s never been one for long-range planning. In any case, he recently decided to pass on the reins of the Singer Institute to yours truly, whenever he thinks the time is appropriate. I feel humbled by the responsibility, and promise to do my best to continue his work.”

  He stopped speaking, but kept moving his facial muscles as though intending to say more but not able to do so. He sighed. “And now I'd like to introduce the conference's co-director, Dr. Rafael Rincon. He’ll make the first presentation.”

  Mitchell sat next to Tracey and smiled at her, but she stared at Rafy. I turned to Paula. “Wow,” she said. “We'll have to talk about this later.”

  Rafy rolled up the sleeves of his white dress shirt, and wiped his brow with a handkerchief. “Is it just me, or is it stifling in here?”

  Andrea stood up. “Sorry. I’ve been told that the air-conditioning is out. I'll see what I can do.”

  As my eyes followed her path to the exit door I was startled to see Lieutenant Hansen in the back of the room. He was holding his hat at his side, looking around. What was he doing here?

  Rafy spoke again, drawing my attention back to him. “I second everything that's been said about poor Jonathan. From the concern to the praise. What's been said about the Institute and this conference is also true of the ground-breaking study we planned together. He would want it to proceed. Today I have the privilege of announcing that we've secured the necessary funding. I vow to shepherd his work, our work, to its glorious conclusion.”

  He punctuated his last sentence by pumping his right fist in the air, as if trying to inspire the crowd at a revival meeting. Are you kidding, I thought. Audience reactions ranged from smiles to blank stares to head-shaking.

  Andrea returned with a muscular young man who plugged in electric fans on both sides of the room. The breeze helped immediately. She returned to her seat at the front and handed a scrap of paper to Mitchell. He read the note, turned around and nodded at Hansen. He then rose, and mouthed “got to go” to Rafy.

  “I hope nothing's happened to Jonathan Singer,” I whispered to Paula as Mitchell and Hansen left.

  “Bad news would probably have come from Carstens or Klansky, not Hansen.”

  “So why-”

  “Let's listen.”

  I was too mature to respond to the “shut up” glares of people near me. Instead I listened to Rafy discuss the mechanics of the aforementioned study. Recruiting psychologists, primary care sites, and patients with emotional problems. Study protocols for how the two specialties would cooperate to treat the patients. How the results would be measured and assessed in comparison to the results in a control group.

  Paula has told me that the riveting descriptions of whaling minutiae in “Moby Dick” prove that it's not necessarily what you write about; it's how you write it. If the same is true of speakers, Rafy was our Herman Melville. He used entertaining anecdotes and a flamboyant style to make research technicalities seem interesting. Well, almost.

  Tracey spoke next, delivering what was to have been Jonathan Singer's lecture. She discussed cognitive behavioral therapy (CBT), from its historical roots to its ba
sic principles--dysfunctional thinking and behavior, and how to fix them--to Singer's version of it. She next reviewed some of the scientific studies which launched CBT to prominence, and the Singer Institute's contributions to the field.

  At this point Mitchell Singer returned to his seat, and Hansen to his post in the back. Mitchell's rumpled shirt was now sweat-stained, clinging haphazardly to his body like badly applied wallpaper. Tracey lost her place in her talk, but recovered to close with a discussion of the study Rafy had described. From the the psychologist's and Institute's points of view. When she told us to enjoy our break and to be back by 10:45 AM sharp, Mitchell stood. He put both hands in his pockets.

  “Sorry, Tracey. Before you go, everyone, one announcement. Lieutenant Hansen of the local police”--he pointed him out, and Hansen nodded--“will be pulling some of you out individually for a brief chat. Just routine, he told me. I thank you all for cooperating with him.”

  As we filed out for our recess Paula squeezed my arm. “Let's go find Hansen,” she said. “Maybe there’s a break in the case.”

  CHAPTER EIGHTEEN

  Paula and I caught up to Hansen in the room with the pool. He was rubbing the back of his neck, maybe figuring out his next move.

  “Lieutenant Hansen,” Paula said. “May we speak to you first?”

  “Why? Can you help me?”

  “Yes. I think we can. I was right, wasn't I? Jonathan Singer didn't just fall off the boat. He was pushed.”

  “You said the same thing at the hospital last night. Have you learned anything to back that up since then?”

  “Not exactly. But I can tell you more about the people here.” She looked around the room, and pointed in the distance. “Let's go sit over there. We can talk without being overheard.”

  “If you say so.”

  I chose to ignore his obvious sarcasm. Paula led us to the other end of the pool, where we sat around a table. Between the humidity and the sunshine streaming through the skylights, I quickly felt as if I were sitting in a greenhouse. I took a napkin from my pocket and wiped the sweat from my neck and face.

  Paula seemed cooler than I was for a change. She re-addressed Hansen. “You know, you should take us seriously. David has already solved two murders.”

  “Oh, really?” Hansen said.

  “Yes, really. David, tell him.”

  “I'm no detective-”

  “Come on,” Paula said. “This is no time for false modesty.”

  “Well, I was unfortunate enough to be involved in murders at my workplace on Long Island, and at my parents' place in Centreville. Which is also in New York.”

  “A lot more than involved,” Paula said. “The police would never have solved those cases without him.”

  Hansen frowned. Hmm. Paula was usurping my role as the impolitic one. She continued:

  “If you don't believe us, talk to the police detectives yourself. Tell him, David.”

  That tactic seemed all right to me. “You could speak to Detective Louis Paulsen. Manhattan’s one-three.”

  Hansen, doubtlessly amazed by my use of police lingo--stolen from Paulsen--actually took out his notepad and wrote the name down.

  “So tell us, Lieutenant,” Paula said. “What do you know now that you didn't know yesterday?”

  Hansen sighed. “It won't be a secret very long. Someone made an anonymous call to us. Accused Mitchell Singer of pushing his father off the boat.”

  Paula slapped the table, causing Hansen and me to jump. “No way,” she said. “Mitchell would never have done that to his father.”

  “Well-”

  “But it does prove my point. Something more than a simple accident is going on here.”

  “Listen, Ma'am.” (Paula winced, and I restrained a grin). “I hear what you're saying,” Hansen continued. “But I'm not convinced. I'm not convinced that there's been foul play. And I'm not convinced that Mitchell Singer is automatically innocent.”

  I couldn’t help nodding.

  “On the other hand,” Hansen added. “It's my job to investigate. Right now I'm reconstructing everyone's movements on the boat last night. Tell me about yours.”

  We recounted our movements, and what we'd seen. Paula and I also told him what we'd learned about the people we'd met. Hansen took intermittent notes--mostly when Paula spoke. When she took a breath he looked at his watch and stood up.

  “It's time for you to return to your conference,” he said. “And for me to interview the others.”

  “So you'll keep us informed?” Paula asked. Hansen just grunted as he walked away.

  “That went well,” Paula said.

  “I don't know. It doesn't seem wise to annoy the police right from the start.”

  “Don't worry. The main thing is not for him to like us. It's for him to take us seriously.”

  I could have argued that antagonizing him might drive him away. That we needed him more than he needed us. But this time I actually recognized an argument I couldn't win. “Let's load up on snacks,” I said. “Then get back to the conference.”

  “Sounds good to me. I'll get a cold drink to cool myself off, then coffee to bring along.” Ah, a point of agreement. Snacks first, back to being a couple next?

  #

  We walked into the refreshments room. Shanley, Rincon, and Peterson were facing each other in the center of the room, hands on hips, faces flushed. Shades of the triangle formation in “The Good, The Bad, and The Ugly!”--no aspersions intended. The few others in the room cowered at the periphery.

  Rafy was addressing Tracey. “Are you accusing me of stealing the research study?”

  Wow. They didn't seem to notice Paula and me. Nor did they seem to care that they were arguing in public.

  “She didn't say that,” Andrea said. “But it is interesting. I thought the two of you had reached some sort of understanding.”

  “What's that supposed to mean?” Tracey asked.

  “I saw the two of you together in the back of the boat last night. Poor Dr. Singer's not even dead, and you’re already dividing up the spoils.”

  “It wasn't like that at all!” Tracey said. “My main interest, my only interest, is what's best for the Institute.” She turned to Rafy. “And you should understand that, too.”

  “Should I?”

  “Well, if it wasn't dirty politics,” Andrea resumed, “it must have been dirty something else. I know what's always on Rafy's mind.”

  “That’s absurd,” Rafy replied. “You don't know what you're talking about. But I suppose that to a slut everything's about sex.”

  And to Freudians, I thought-

  “You bastard! Who's calling who a slut?” Andrea snapped. She stomped away, bumping into a table. Glasses fell over, spilling juice and coffee. Silverware clanked and dishes rattled. Chin thrust forward, she completed her exit without turning around.

  “She'll go far in life,” Rafy said.

  “You bastard,” Tracey echoed. She made a fist, then took a deep breath and unclenched it. As she left the room she nodded at Paula and me.

  Rafy surveyed the scene, as though taking a head count. His hands moved to his neck, as if straightening a tie he'd forgotten he'd removed, then fell to his sides. “The show's over, everyone. Just a little difference of opinion among friends. Time to get back to the conference.”

  We all murmured our assents. After Rafy left, Paula and I grabbed orange juice, cookies, and grapes. We knew our priorities. I couldn't wait to hear her take on the scene we'd just witnessed.

  CHAPTER NINETEEN

  The next two talks were basic but instructive, focusing on studies proving the benefits of CBT in depression and anxiety. These disorders, which afflict 10-20% of primary care patients--my patients--diminish not only the quality of life, but also the life span of people suffering from conditions such as heart attack, cancer, and emphysema. Lieutenant Hansen appeared at the door in the back every twenty minutes. He pulled out Tracey, then Andrea, then a couple of other people I didn't know but who
must also have been on the boat.

  When class was dismissed at 12:15 PM I turned to Paula. “I'm sure you're hungry, but let's go to the hospital first-”

  “Perfect. We can check on Jonathan Singer’s condition-“

  “Yes.”

  “-while we grill Carstens and Klansky,” Paula added. “Using stealth technology, of course.”

  I grinned. “I always suspected that you were a truth-seeking missile.” Paula grinned back.

  “Just remember,” I added, “that so far, despite our suspicions, there's no proof that it's anything but a tragic accident. If they’re innocent they deserve our support.”

  “I think we’re past the suspicion stage,” Paula replied. “But as far as supporting them, it’s a deal.”

  I wanted to discuss the Shanley-Rincon-Peterson argument, but Paula said she'd rather think and relax this time while she drove. I tried, but couldn’t do either. So I settled on the extremely important task of counting the number of ice cream parlors between the hotel and the hospital. Would you believe four?

  We arrived at the hospital at 12:30 PM. After signing in as Singer's visitors we took the elevator to the second floor, where the Intensive Care Unit (ICU) was located. The first room on our left was labeled “Conference Room.” It was small, with sky-blue walls. There were half a dozen comfortable chairs and several tissue boxes. And I knew the room's purpose.

  It was for meetings. For doctors to discuss patients or medical topics with each other, or for doctors to meet with the families of ICU patients. And considering that ICU patients are all critically ill, and that many of them will die, such meetings are not usually happy ones. General status. Risks and benefits of invasive medical procedures. Discussions of when to conclude that the situation is hopeless. A time to treat, a time to stop treatment, a time to withdraw treatment. All these discussions cloaked in medical gobbledygook, delivered to families whose minds are numbed by sorrow, fear, and anger.

  I shuddered, remembering the ghosts of family meetings I'd participated in. I hoped that Jonathan Singer and his loved ones would be spared the worst.