“Who?” he asked, glancing uncomfortably at the patients around us and signaling to me, perhaps, that it was inappropriate for us to be seen interacting like this.
I didn’t care.
“Jason Edwards,” I said. “My patient—the one who showed up with no court order, no medical records, no written documentation of any kind. I want to know his psychiatric history, his family background, whether he’s ever been hospitalized before … and I want to know about the events that landed him here—what crime he was charged with.”
“We’ve been through this before,” Wagner reminded me. “I don’t have any more information than you do.”
“Bullshit,” I replied. A few heads turned in our direction and I lowered my voice. “You wouldn’t have accepted him here otherwise. You can’t commit a patient to a state psychiatric hospital without a court order, and you know it. Now, there’s something you’re not telling me about this case, and I want to know what it is.”
He sighed, as if what I was demanding wasn’t relevant to my patient’s treatment, as if we’d been through this charade a thousand times before. He glanced down at his watch. “I have a meeting in half an hour.”
“Well then,” I pressed, “you’ve got twenty-five minutes to talk to me.”
Wagner appeared to consider his options. He’d been avoiding me lately; I was almost certain of it. I watched him deliberate a moment longer, then he shook his head with an air of resignation. “Fine,” he said. “You want some background on this case? Come with me.”
I followed him down the hall, feeling the eyes of patients and staff upon us as we exited the dayroom. It irritated me, those stares. I wanted to turn around and tell them to mind their own damn business, that I was the only one acting responsibly here. Instead, I focused my attention on the back of Wagner’s sport coat, something beige and polyester that made a soft swishing noise with the pendulum movement of his arms as he walked.
When we were both inside his office, he shut the door and went around his large oak desk to a tall wooden cabinet against the far wall. He pulled open the top drawer and fingered his way through a series of files before finding the right one. I took a seat, inwardly reflecting on how ugly this office was with its rigid, unyielding furniture, its decrepit gray carpet, its complete lack of any natural light, its pretentious but cheaply framed diplomas hanging slightly askew on sickly yellow walls. I wondered how he could stand it, or whether he even noticed.
“The case surrounding Mr. Edwards’s presence at Menaker involves the death of an individual named Amir Massoud,” he said.
I waited for him to go on, but he seemed to need further prodding. “They knew each other?”
“They were in a relationship,” Wagner replied, tossing a newspaper article on the desktop in front of me. I bent to study it.
MAN STABBED TO DEATH IN SILVER SPRING TOWN HOUSE the headline said. My eyes scanned the lines of text, taking in the story.
Twenty-five-year-old Amir Massoud was fatally stabbed within his Silver Spring townhome in Montgomery County, Maryland, on the evening of May 12. Police report no signs of forced entry. The victim’s domestic partner, 25-year-old Jason Edwards, was taken into custody for questioning, as the incident is suspected to have been the result of a possible domestic dispute. Mr. Massoud was a graduate student in civil engineering at University of Maryland. He is survived by his father and two siblings. Funeral services are scheduled to be held at National Memorial Park in Falls Church, Virginia.
“He was convicted?” I asked Wagner, picturing the quiet, thoughtful face of the patient I’d been interacting with over the past several weeks. We all have the potential for violence, I know—particularly when it comes to crimes of passion—but I was having difficulty imagining Jason wielding a knife in a homicidal rage. It didn’t coincide with the impression I’d formed of him.
Charles studied me from across the desk. “Not exactly.”
Of course not, I realized. Jason was in the same category as most of the other patients here—either deemed psychologically incompetent to stand trial, or the more difficult to obtain judicial finding: not criminally responsible by reason of insanity.
“Did he come to us directly from the court system, or was he transferred here after spending time at another facility?”
“Lise,” he began, “there’s more to this case than you’re prepared to handle.”
“What do you mean?” I asked. His denigrating tone annoyed the hell out of me, but I tried not to give him the satisfaction of showing it.
“Simply that there are broader forces at work here than you can imagine. Suffice it to say that Jason is only tangentially involved.”
“I don’t understand.”
“I know,” he replied. “But unfortunately any further information I provide would be difficult to integrate with what you already know.”
He talks like a true administrator, I thought, constructing his sentences with the careful design of conveying as little useful information as possible. I scowled at him. “What in the hell does that mean?”
He shook his head. “I know this puts you in an awkward situation.”
“It puts me in an impossible situation,” I corrected him. “I mean”—I raised an exasperated hand into the air and let it fall like dead weight into my lap—“what am I not understanding here, Charles? Is this political? Are you protecting someone? Jesus, we have a responsibility—a professional and moral duty—to act in the best interest of our patients.”
“I feel that I’m doing that.”
“Do you?Do you really?” I asked.
He regarded me impassively, his features unyielding. “I’m sorry I can’t tell you more.”
“One thing is becoming clear to me,” I said, standing to go. “You’re allowing yourself to be manipulated by outside influences that have nothing to do with the medical management of this patient.” I went to the door, put my hand on the knob, but turned back to look at him one last time before I left. “Your judgment is compromised,” I told him.
He had the audacity to turn those words back on me, as if somehow he were the righteous one. “So is y—” he started to respond, but I slipped into the hallway and shut the door behind me before he could finish.
Chapter 11 (#ulink_7401b1e8-470c-52d7-aa97-2dc9dacb17da)
That night I couldn’t sleep. I lay in bed staring at the wall, the images of newspaper articles I’d tracked down online that evening popping into my head like the small explosions of flashbulbs from a 1930s-era camera. For hours I’d hunched in front of my PC’s monitor, the index finger of my right hand clicking away, moving up and down along the mouse’s roller as my eyes darted back and forth across the paragraphs. It had been hard to concentrate. At the far end of the hall outside my apartment someone was yelling—the person’s voice wild, hysterical, chaotic. I was reminded yet again of the thin artificial separation between institutions like Menaker and the vast, untethered world beyond, and wondered how many souls had been misassigned to each. I got up, paced the room, considered calling the police. But already I could hear other voices—calm and authoritative—in the hallway, and I realized that someone must have beaten me to it. The yelling escalated for a moment, followed by the ensuing sounds of a brief struggle. Others in the complex—my neighbors—might be opening their apartment doors and poking their heads through the thresholds for a quick peek at the action. But not me. I saw enough of this type of thing at work. My days were filled with it. I had no desire to witness it here, in the ostensible shelter of my personal life.
After the noise abated, I went to my computer again and sat down. Amir Massoud had indeed died on the night of May 12, 2010—stabbed to death in the front hallway of his townhome. He’d died at the feet of his domestic partner, Jason Edwards. The knife, bearing Jason’s fingerprints, had been lying on the floor next to the body when police arrived. I could imagine the blood on Jason’s shirt, his pants, his palms, already beginning to dry into something lifeless and irreparable. I could imagine the first arriving officers taking in the scene in a glance and, with hardened faces and practiced efficiency, pulling their weapons and ordering Jason to show them his hands, to move away from the body and to lie facedown on the floor while they pinned him down with a knee to the back of the neck. His arms would have been twisted behind him, his wrists ensnared in the uncompromising steel of the cuffs. In my mind, I could see him being led out to the street, the officer grunting, “Watch your head,” as Jason lowered himself into the back of the vehicle. I could envision him sitting at some table amid lime-green walls in the station’s interrogation room, could hear him being grilled by the detectives, could even imagine him breaking down under the emotional strain and confessing to it all. I could envision all that, but what I could not picture was the actual murder. I could not imagine the hand of my patient wrapped around that knife as he plunged it into his lover’s chest. I closed my eyes, concentrated on forming that image, but it simply wouldn’t develop. What appeared instead was the expression on his face the first day I’d met him.
During my medical training, I’d seen that look from time to time. It was in the faces of some of the terminally ill cancer patients I’d treated as an intern: a surrender, an overwhelming fatigue, a desire to let go, to be done with it all, and yet the realization that there was something beyond their control that was holding them here still. They resented it, I knew, the indignity of that lingering existence. Jason had borne that look the first time I met him, and there were days when I noticed it still, as if he were stuck in some purgatory from which he might never be released.
I switched off the computer and went to the bathroom, studying my reflection in the mirror. There were dark lines beneath my eyes and the corners of my mouth seemed to droop into an unhappy countenance. My face looked puffy and swollen, like I’d been crying, although I had not. The water was cold as I splashed it on my face with cupped hands filled from the faucet, harboring the hope that when I returned my gaze to the mirror I’d look different—somehow refreshed and unburdened.
I did not.
I climbed back into bed and lay there in the dark. An argument in the apartment next to mine could be heard through the thin walls. I sandwiched my head between two pillows, tried to ignore it, and felt like I was eight years old again, listening to my parents bicker in the other room.
“HE’S GOT NO place else to go,” I could hear my mother saying, her voice low and meek in response to my father’s domineering presence. He was a man used to exerting his will over others, and it infuriated him when he perceived resistance to a course of action on which he’d already decided.
“Well, living with us is not the answer!” he exploded, and I could hear something strike the common wall shared by our adjacent bedrooms. A shoe, I thought. It was just a shoe—not my mother’s head.
There was silence in the house, and despite my fear I pulled back the covers, crossed the room, and padded out into the hallway. The brass knob of my parents’ closed bedroom door was cold in my hand.
A quick sound of footsteps on the other side, and suddenly the door was yanked open, the doorknob wrenched from my grasp. My father stood in the threshold, glaring down at me. “What do you want?” he demanded, the sentence feeling more like an allegation than a question. Beyond him, I could see my mother sitting on the side of the bed, a forgotten article of clothing folded in her lap.
“I … I heard something hit the wall,” I replied, too stunned to try for anything but the truth. “I just wanted to make sure you and Mom were okay.”
“We’re fine,” he told me. “We were just having a little discussion about your uncle Jim. Your mother thinks it’s a good idea for him to come live with us.”
“I like Uncle Jim,” I said.
My father got down on one knee in front of me, looked me straight in the eye. “Let me tell you something about your uncle Jim that your mother is too chickenshit to mention. Your uncle Jim is crazy. He’s been in and out of institutions for years now, had his brain poked and prodded by all those quacks over at the psych hospitals in Baltimore, Springfield, and Ellicott City. And what good has it done him?” he asked, casting a challenging look over his shoulder at my mother. “He’s still as crazy as the first day I laid eyes on him. And now”—he turned his smoldering gaze back on me—“she wants him to come live with us. You think that’s a good idea, Lise? Do you?”
I stood there, a deer in the headlights, not knowing how to respond.
“Leave her alone,” my mother told him from where she sat on the bed. “She hasn’t done anything. You don’t need to yell at her, too.”
“I’m not yelling,” my father said, standing up and turning away from me. He raked a hand through his thinning hair. “I’m just trying to be the voice of reason here.” He crossed the room, put his hand on the nightstand. “He attacked a lady. Did you know that, Lise?” I shook my head, but he went on without waiting for a reply. “He attacked a lady in broad daylight. And now he’s got criminal charges against him.”