There’s been a death in the family.
Danielle awakens from a deep, useless sleep—the kind that affords no rest and is punctured with grotesque forms and fractured events that have no link or purpose. When she opens her eyes, her heart beats erratically—a bird shot out of the sky. She feels an amorphous panic; wonders dully if someone is chasing her. The panic is quickly replaced with stark terror. They think Max is irretrievably mentally ill. Her first urge yesterday was to run to him and hold him in her arms. But she can’t do that—not yet. If Max sees her eyes, he’ll know what he fears is true—that she, too, thinks he’s crazy. She never, ever, wants him to feel that.
She lay awake much of the night agonizing over every word Reyes-Moreno said. Danielle still doesn’t believe what she told her, particularly the bizarre behaviors they attribute to Max—behaviors she’s never seen. No matter how she slices it, there’s no way Max could be what they say he is. But what if she’s wrong? The right side of her brain tells her that denial is always the first response a parent has to devastating news about a special-needs child. She must do her best to divorce herself from either knee-jerk disbelief or the paralysis of emotionalism. She has to get back into lawyer mode and uncover the core facts they’ve based their diagnosis upon. Once pointed in the right direction, she’s a better fact finder than anyone she knows.
She jumps up and yanks on jeans and an old, gray sweat
shirt. For the first time since they came to this dreadful place, she knows exactly where her compass is leading her.
Danielle crouches outside the rear wall of the Fountainview unit and swats mosquitoes from her neck. The night air is heavy, and tall grass forms a green nest around her. The steel back door stares at her, as if it knows of her intention.
She can’t believe she’s doing this. What if she gets caught? Even that begs the more basic question: What kind of a mother crawls around a psychiatric facility on her hands and knees in the pitch dark like some kind of card-carrying pervert? Danielle looks around. It would be just her luck if one of the security guards decides that now is the perfect time to make night rounds. She checks her watch. Ten fifty-two. There is only one night nurse on duty. At eleven, she usually sneaks a smoke in front of the unit until her maintenance man boy friend arrives and enthusiastically feels her up in a dark corner. If Danielle is lucky, they will disappear into the woods for the fifteen minutes they apparently require to consummate their hot, savage passion. She knows this because she has often crept to Max’s window late at night—just to watch him sleep. It took some of the sting out of the parsimonious visits allotted her by Maitland.
The locked door beckons, but Danielle is paralyzed. This feels like life or death. She can find out about Max or turn around; go back to her room; and never know why Maitland insists that her son is crazy. Yesterday, Danielle demanded—and Reyes-Moreno unequivocally refused to provide—the underlying data upon which they based Max’s diagnosis. She knows that filing a lawsuit will get her nowhere. The hospital legal machine will find ways to hide the precise information Danielle needs. She has seen it happen far too many times. At
that point, Danielle decided that she was entirely justified in getting it on her own.
Even so, she falters. She is desperate for information, but does her desperation justify breaking the law? But if she doesn’t find out what they’ve really based Max’s diagnosis on—the nuts and bolts of it—she’ll never know if it has any merit. That is intolerable.
Danielle slips a plastic card with the Maitland logo on it from the back pocket of her jeans. She swiped a spare earlier today from the nurses’ station. She takes a deep breath and inserts it into a shiny black box on the cold, metal door. She hears a distinct click.
She slips through the door like satin ribbon through a needle’s eye. Now that she has crossed the line, what she is doing seems perfectly natural, as if she has been breaking and entering all of her life. The soft, eerie lights, dimmed for the slumbering patients, give her goose bumps. She feels as if she has stumbled into a psychic’s murky parlor in an attempt to contact bodies long cold—a vain search for lost souls. She scans the silent hallway and darts into a small office. The first thing she does is to sidle underneath the security camera in the corner and point it skyward. She then places her flashlight on the computer desk and covers it with her red silk scarf. With a soft click, the flashlight’s wide eye lights the room in a soft rose. Office supplies crowd a corner; textbooks queue up in military formation on metal shelves.
Danielle sits in front of the monitor—her nerves singing—and watches as a large, white
M
gyrates on the screen. After a few moments, a message box appears.
Maitland Psychiatric Hospital.
A smaller box forms.
Password, please.
The cursor stands waiting in the empty box. Danielle enters the system without a glitch. When Marianne had raised the issue of Maitland’s security—she was unhappy with its laxness—Danielle
was surprised to learn that the nurses on the Fountainview unit cavalierly scribble the daily password on a Post-it and stick it under the counter at the nurses’ station. Marianne scoffed when she related how Maitland prided themselves on thinking that their security system was ironclad. She said they’d never get away with such carelessness in a big-city hospital.
Danielle smiles grimly as she types in the code. Hospital administrators, she is certain, worry about their employees mishandling the system, not the patients. Surely it had never occurred to them that a patient’s mother would jimmy the system.
She gives the keyboard a few intent taps and tries to ignore the horrific consequences if she is apprehended. She is an officer of the court who is committing criminal acts (a few felonies like trespass and hacking) with full knowledge of the legal ramifications. If her law firm finds out, partnership will be the least of her problems. If she is convicted of a felony, the bar will take away her license. She’ll be finished. There will be no way on earth to fund Max’s care. She shakes off these terrifying thoughts. Her watch warns her that she has only ten minutes to complete her task—assuming the frantic coupling outside is still rattling the trees.
Her nails are castanets on the keys. Prompts flash on the screen in mad succession as she negotiates her way through them like a bayou dweller in the Louisiana backwater. The blue glow of the monitor washes her with a purplish cast, and the small room is now nest-egg warm. The screen before her looks like some kind of daily log. Max’s name, unit and room number are at the top, as are his patient identification number and date of admission. Below are typewritten entries which, she surmises, are transcriptions from the handwritten notes of doctors, nurses and attendants. She makes out the initials of
Fastow, Reyes-Moreno and Nurse Kreng. Unfamiliar names flash before her—probably other members of Max’s “team.” Danielle reads the first entry; sits back abruptly; and rubs her eyes. Something is very wrong. She checks the name at the top of the page. Max Parkman. She reads it again. Twice.
Day 6
Pt. violent; agg. w/staff. Threat. pt. with physical violence; had t/b restrained; continue new med protocol; paranoid delusions; psychosis; 20mg Valium Q.I.D. Focus on Mo-son relatnshp/rage/denial. JRF
Danielle waits until the shock passes.
Paranoid delusions? Psychosis?
How could they decide that he was psychotic only days into this nightmare? She saw absolutely no evidence of this during her daily visits with Max. And what about “Focus on mother-son relationship”? That Fastow should even suggest something harmful in her relationship with Max is devastating. Her mind races back to the day Max was admitted. How had they acted toward one another? Of course he was angry and anxious with her; of course he lashed out at Dwayne when he was forced to go into the unit. He was scared out of his wits. Surely that’s perfectly normal on admission day. She reads on.
Day 12
Incident in cafeteria. Pt. lost control in serving line. Strikes child; curses server; throws tray. Restrained; taken back to unit; destruction to rm; isolation/heavy sedation
Post:
Pt. now episodically psychotic; suspect schizoaffective disorder and/or Cotard delusion (due to pt.’s depression and derealization). Episodes occur only late night. Pt. has no recollection following day. Tricyclics/SSRI’s not effective; consider electroconvulsive therapy. R-M
Danielle gasps.
Cotard delusion? Electroconvulsive therapy?
No one has said a word to her about any of this—not even Reyes-Moreno when she delivered the death-knell diagnosis. A wild thought flashes through her brain: Are they making these things up? She shakes her head. It’s too crazy. But why hasn’t anyone told her the details of what Max has been going through? How often had they shot him up with sedatives—other than the time they overdosed him? And thrown him into “isolation”? Reyes-Moreno only mentioned the one instance. Danielle sees Max lying on the floor in a padded room bleakly calling her name, his hands and feet bound by white canvas strips—to prevent telltale ligature marks or bruises. This sounds more like a sinister clip straight out of
One Flew Over the Cuckoo’s Nest
than the
modus operandi
of the most highly respected psychiatric hospital in the nation.
And why don’t they even mention Asperger’s? Does psychosis now trump autism? Danielle can’t even begin to process the last sentence. Over her dead body will they strap Max down; put a piece of wood in his mouth; and electrify his brain. She shivers. She has to get him out of here—now.
Only a few minutes left. She quickly scrolls down to review a few more entries. Observations from play therapy. Educational and psychiatric testing attempted, but unsuccessfully completed due to soporific effect of sedatives and disordered thinking. Reiterations of Max’s suicidal ideations. She flips to the entry for today.
Team Meeting.
Pt. skilled at concealing symptoms fm Mo. Admits has not mentioned psychotic thoughts. Pt.’s violent tendencies real threat to himself/others; Pt. experiencing deep disturbances; auditory/visual/tactile hallucinations. Continues to threaten suicide.
Diagnosis:
Schizoaffective disorder, psychosis—
The screen blips off and the room goes dark.
Danielle freezes, hands poised over the keyboard. Someone must have discovered that the card is gone and is trying to flush her out by scaring the hell out of her. She jumps up and rams her hip into the corner of the desk. “Damn!” She puts her ear to the door; opens it a crack; and peers outside. The hallway is crushed charcoal. Danielle hears and sees nothing. She closes the door softly and ducks under the desk. Even if her heart is in cardiac arrest, her brain has not entirely deserted her. She turns off the power switch to the CPU. She doesn’t want someone to come in for a mop tomorrow and see Max’s information on the screen. She snaps off the flashlight; grabs the scarf; and shoves the card back into her pocket. She ventures into the hallway—no one.
Danielle creeps down the dark corridor, using her hand on the wall as her guide. When she reaches the door, she pokes her head cautiously outside the metal door and scans the landscape. Apparently no one is out to get her. The lights all over Mait land are out. There must have been a massive power outage. It is pitch-black, except for a few buildings that give off a greenish glow. Must be the emergency generators. Danielle slips outside and tiptoes to the corner of the building. She hears voices. The nurse runs from the trees, her white skirt billowing behind her—a neon sheet hung in a high breeze. Her priapic Lancelot is nowhere to be seen.
Danielle’s heart beats so fast that she feels nauseated and terrified all at once. She is clearly not cut out for a life of crime. Time to surrender or flee. When the nurse is out of sight, she sprints across the grass at full speed. Flashlight beams bop up and down around her, like costumed children searching for candy on Halloween night. Her dark jeans and dirty gray sweatshirt aren’t exactly camouflage, but they’ll have to do.
“Damned deer,” a voice growls from somewhere behind her. “Like rats. They’re everywhere.”
Danielle reaches a stand of trees and becomes one of them. The light bounces away, illuminating Fountainview. She clutches her chest and gasps. Even when it seems that the coast is clear, she clings to the tree and doesn’t move for a solid hour.
Olly olly oxen free.
Danielle waits in Maitland’s main conference room—the one with the chalkboard and the large U-shaped table. The meeting can’t start soon enough to suit her. This time she’ll be the one calling the shots.
Her first impulse after the bizarre discoveries last night was to march into the Fountainview unit and yank Max the hell out of there, but deeper reflection convinced her that this might be shortsighted. Her nocturnal felonies, while illuminating, now compound her confusion. She has no idea how to assess observations of a Max she doesn’t know. When Reyes-Moreno left another message this morning asking her if she had made the decision to move Max to their long-term residential facility, an idea flashed through Danielle’s brain. She told Reyes-Moreno that before she could consider such a step, she required a face-to-face discussion with the entire team.
Danielle looks at her watch. In a few minutes, she will have the chance to confront the entire collective. She has already decided that whatever they say, she will have Max discharged immediately and take him back to New York. Once there, she will contact Dr. Leonard and obtain a referral for a second opinion. There is no way she’s leaving Max here indefinitely without external—and irrefutable—confirmation of Maitland’s findings.
But what if the entries and Reyes-Moreno’s diagnosis are
true? Her superior ability to marshal the facts—which serves her so well as a lawyer—has completely deserted her. She tries again to order the conflicting scenarios that pummel her brain. If Max is truly psychotic, how is it possible that she never saw any of the signs? Surely Max would have said or done something of that ilk in her presence? Then she remembers the day she found Max’s diary and his intricate plan to commit suicide—of which she had been completely oblivious. She also recalls the chilling question he asked her at the beginning of this nightmare: “What do we do if they say I’m really crazy?” Maybe Max, as his condition worsened, did his level best to appear normal to her in the frantic hope that her answer would not be to condemn him to Maitland indefinitely. She flashes back to the entry that described Max’s psychotic behavior as exhibiting itself at night, which would explain their claim that by morning—when Danielle saw him—he had no recollection of those events at all. Danielle had attributed his utter exhaustion to the soporific effect of the medications, but it could have been the result of his nightly…episodes.
Equally perplexing is that, notwithstanding the devastating diagnosis and damning entries, Max does seems to be improving—at least during the few moments they have together each morning. Danielle can only attribute this to one variable: Fastow. As requested, he sent her the list of Max’s medications. They are all familiar to her, their side effects predictable. Maybe he is a psychopharmacological genius, as Marianne said.
She has picked up the telephone twenty times to tell Georgia about the diagnosis and to ask her to fly down again to give her moral support, but that would make it too real. She has an even stronger desire to talk to Marianne about everything, given the warmth of their growing friendship. But she is afraid
that Marianne’s medical education and psychiatric acumen—not to mention Max’s recent encounters with Jonas—will leave her friend no choice but to urge Danielle to accept Maitland’s diagnosis. This she cannot bear. Most of all, she wants to explore these issues with Max, but that is impossible—at least for now. If Max’s fear of losing his sanity has escalated so dramatically that he wants nothing other than to kill himself, then she cannot risk even a gentle probe into the darkness of his mind.
She tries to focus. The first order of business today is to find out how Maitland has the gall to demand that Max be surrendered for immediate, indefinite residential treatment—not the least of which is their intention to give him electroshock therapy without her knowledge, much less her consent. Her mind is already drafting the temporary restraining order to stop Maitland dead in their tracks on that one.
Danielle hastily researched ECT therapy on the Web last night. What she learned terrifies her: seizures are induced in the brain by brief bursts of high voltage and alternating current. This allegedly modifies neurotransmitters believed to cause severe mental illnesses. The risks include brain damage, seizures, cerebral hemorrhage, permanent memory loss—and death. The explanation concluded with the caveat that the use of this method—despite its return to popularity and the successes claimed—is still extremely controversial.
No shit,
she thinks.
“Ms. Parkman.” Reyes-Moreno’s kind smile is an oasis in the desert.
Danielle almost smiles back until she remembers the computer entry that questioned her emotional “lability” and her relationship with Max. Is she the one who wrote all that garbage, all those lies? “Hello, Doctor,” she says coolly.
The rest of the entourage, including Dwayne, files into
the room. As they take their places, Danielle reminds herself that there are all kinds of courtrooms in life, and all manner of adversaries.
Reyes-Moreno sits in the pole position at the head of the table. Fastow, on her left, regards Danielle with gelid, unpleasant eyes. His chair is not pulled up to the table, as if to broadcast his disengagement from and disdain for the proceedings. She still can’t stand the guy—no matter what kind of genius he may be. The other doctors take their seats and stare thickly at their files, sheep mourning their wool after shearing.
“Shall we begin?” Reyes-Moreno doesn’t ask the question as if she expects an answer.
“By all means.”
“Danielle.” Her green gaze is straight and true. “I understand that you have asked to meet because you have certain questions about the validity of our collective diagnosis.” She raises her hand slightly before Danielle can say anything. “I also understand that you are reluctant to sign the necessary papers which would commit Max to our care for another year.”
“That is correct.” Her words are frozen bullets. “I want a detailed explanation of how the team concluded that my son is schizoaffective and psychotic.”
Reyes-Moreno nods sympathetically. “Danielle, I’ve given you the reasons for our diagnosis. Perhaps you were too upset at the time to process it completely. Is there something you don’t understand? We’ll be happy to explain it to you.”
“No, Doctor,” she says. “What I want is a copy of Max’s file—with every notation and observation upon which you base your diagnosis.”
Reyes-Moreno’s smile shrinks. “I’m afraid that won’t be possible.”
“Why not?”
“I hope you understand that we are not unwilling to accede to your request, but are simply unable to do so.” Her eyes are calm, but firm. “As an attorney, surely you are aware that Max’s file is protected by the physician-patient privilege. While we are required to explain Max’s diagnosis to you, we are not at liberty to reveal our underlying observations. Of course, if you feel that you need documentation to confirm our diagnosis, I urge you to go through the appropriate legal channels.”
Danielle’s voice is lacquered lava. “I certainly will.”
So they want to play hardball—fine. She’ll file suit and obtain Max’s documents—and more—through discovery. “Then what, if anything, will you and your ‘team’ now reveal to me that explains this extraordinary diagnosis of my son?”
“We are here to answer any questions relating to Max’s medication protocol, future treatment possibilities or the nature of schizoaffective disorder.” She gives Danielle a sharp look. “Frankly, we are very concerned about your reaction to Max’s diagnosis. We want to help you accept it so that Max can begin long-term residential treatment. To that end, I would like to schedule a few sessions with you this week.”
Danielle frowns. “With me? Why?”
Reyes-Moreno gives her those calm, green eyes again. “To ensure that before you go, you can help Max deal with his illness within the context of your relationship.”
Danielle ignores the intimation of her imminent departure.
“Do you have a specific question about my relationship with Max?”
“It is something we believe requires further exploration.”
“But you won’t tell me why.”
Reyes-Moreno shows the first break in her demeanor—a slight fissure in her countenance. “Not at this time. We can
discuss it further when we present Max’s treatment protocol in a few weeks.”
Like hell we will,
thinks Danielle. It is clear that she won’t get anything more out of this tribe, not that she expected them to reveal their outrageous observations to her. She doesn’t give a damn about Maitland’s sterling reputation. It isn’t enough. She will make a graceful departure so she can get Max out of this place. “Doctors, I want you to know that I am grateful for all you have done.” Danielle nods at Reyes-Moreno and the others. All nod back, happy china dolls.
There, she’s laid the groundwork. She is reasonable. She is grateful.
“I mean no disrespect when I tell you that I simply cannot agree with your conclusions,” she says. “As such, Max and I will be leaving this afternoon.” She places both palms on the table in front of her and stands. This indicates that the meeting is over and, although they have not reached a viable settlement, they will part on friendly terms.
“Danielle.” Reyes-Moreno’s voice is curt. “We know that you disagree with our diagnosis. What you do not seem to understand is that you are in denial of the gravity of Max’s condition.” Her unwavering gaze locks upon Danielle. “I simply cannot permit you to take Max out of this facility when we have concluded that he may well commit suicide the moment he walks out of these doors—not to mention his increasing psychosis and demonstration of serious violence with others. I will not expose this hospital to legal claims—which would be well-founded—arising out of the release of your son.” She pauses. “Nor will I jeopardize Max’s mental health and his life, or someone else’s, by releasing him into your custody.”
Danielle’s eyes widen. “What are you saying—that I’m the one to blame here? That Max isn’t safe with me?” Her voice is an invitation to battle, steely and removed. “Or maybe it’s
just that no one has had the mettle to question a diagnosis rendered by the superlative doctors of Maitland—” she looks pointedly at each face around the table “—even when no basis for such a diagnosis exists.”
There is silence. The eyes of the brain trust are glued to their folders.
Cowards,
she thinks. One of the interns starts to say something, but Reyes-Moreno inclines her head ever so slightly. He stops, a well-trained puppy.
“Ms. Parkman.” Reyes-Moreno’s green eyes are unrelenting; the voice a soft hammer. “We invite you to obtain a second opinion; however, I urge you to do so immediately. It is your refusal to accept what we are trying to tell you that is causing your son more damage, perhaps, than his underlying mental illness, which is grave enough in itself.”
Danielle’s anger ignites. “Are you telling me that I don’t know my own child? That I’m so innately selfish that I would fail to admit the truth so I could cause my son additional harm?”
Reyes-Moreno looks at her as if she is a deadly virus just identified under her microscope. “Frankly, we find it extremely disturbing that you have failed to observe the warning signs. This a progressive disorder, as you must be aware.”
“What warning signs?” All she can think of are the lies in the entries—that she is a bad mother, that Max’s “psychotic behavior” is something Danielle has blithely ignored. Redrises into her throat, but she manages to keep her voice level. “Max has been seen by reputable psychiatrists long before he came here. Not one of them has ever suggested that he might be violent in any way—much less schizoaffective. And no one—except you people—has conspired to strap my son down, shove a piece of plastic into his mouth and shoot 450 volts of electricity through his brain.” She points her index
finger at Reyes-Moreno. “Forget about lawsuits, Doctor. You’re going to jail.” She marches to the door.
“Max is not just suicidal. He is dangerous.” Reyes-Moreno’s words are black bullets.
Danielle turns and stares at her. The remainder of the team freezes. “What?”
The eyes are snapped whips. “Max has completely lost touch with reality. He is convinced that the Morrison boy has been torturing him. More specifically, he believes that there is a voice in his head that keeps him advised of Jonas’s secret plot to harm him and, ultimately, to have him done away with.”
“That’s absurd!” Danielle strides across the room and stands directly in front of Reyes-Moreno. “Do you people honestly expect me to buy this? What are you trying to accomplish with these monstrous lies?”
Reyes-Moreno’s eyes are wide, alarmed. “I have no idea what—”
“You know exactly what I’m talking about.” Danielle puts her hands on her hips. “So now Max believes that boy wants to kill him? Just how do you know that? Did he whisper it to you in a secret session? In a moment of some profound psychological breakthrough?” Her patience is gone. She leans forward and slams both of her open palms flat on the table directly in front of Reyes-Moreno. The crack of sound causes the doctor to recoil. Danielle leans so far forward that her face is inches from Reyes-Moreno’s. “Why don’t you tell me what in the hell is going on here, Doctor? I won’t call it a conspiracy if you won’t call it the truth.”
Reyes-Moreno pulls back just as Dwayne stands up and grabs Danielle by the arms. The doctor stands, obviously shaken. “Danielle, you need immediate psychiatric treatment.”
Danielle twists away with a harsh laugh. “Like hell, lady. By the time you people are through with me, I’d be foaming at the mouth and baying at the moon.” Danielle shoots her a scathing look. “You have my son formally released from this execrable excuse of a hospital immediately, do you hear me? And if I don’t have his goddamned records in one hour, I’ll have an injunction slapped on you people so fast your heads will spin.” Danielle then leans very close to Reyes-Moreno—so close she can see the lines on her lips. “Am I making myself clear?”
Reyes-Moreno doesn’t flinch. “You won’t reconsider?”
Danielle’s voice is ice-blue. “No.”
Reyes-Moreno sits down, pulls a document from her file, and hands it to her. “I’m sorry to say that we anticipated your reaction.” Danielle snatches the paper from her and scans it. “Our temporary restraining order against you was granted by the judge this morning,” the doctor says calmly. “I hope you understand how much we regret that your actions and attitude required that legal action be taken to protect Max.”