Skull Session (45 page)

Yes, it had to be. A handprint.

61

T
HURSDAY MORNING, MO SAT AT his desk reviewing his conversation with Paul Skoglund. There was something different about him, Mo decided, beyond just the bloodshot eyes of overwork. Some quality of assertiveness or alertness. He had seemed to take charge of their conversation, leading, deciding, anticipating.

All in all, their talk about Lia had gone better than Mo had any right to expect. He found himself appreciating Paul more than ever. Part of it was the way he'd smiled when they talked about it. There wasn't any pity or condescension or one-upmanship in it. Just a moment of understanding, an
ain't life a bitch
smile. A good guy.

He wasn't sure how the sudden appearance of another Hoffmann son altered the picture. Paul thought it was important, and the history of violent pathology might connect to the business at Highwood, the dismembered and missing kids, or it might not. What did Paul think, he was living up there in the woods or something? Was Erik III, in his violent rages, Heather's Superman? Mo still couldn't escape the feeling that Paul wasn't telling him everything.

The problem in tracking Erik HI was that the last institution he'd been committed to, or at least that they'd found the papers for, no longer existed. None of the directories in the library reference section showed a Westford Psychiatric Treatment Center licensed in New York, and the Schenectady phone directory did not list a number. Westford must have gone out of business since 1983. Presumably its patients had been transferred to other institutions, and their medical records would no doubt have traveled with them. What about other records of a defunct mental facility? Some would be found in various files maintained by the state—licensed care providers, registered corporations. But would they offer information on transfers of patients?

There had to be a way to narrow the field of where to look. Long-term care for somebody like Erik Hoffmann III would have to be a speciahzed thing. You wouldn't want him in a bed next to a sweet grandmother with advanced senility, and you'd want staff trained to deal with violent behaviors. Plus Vivien would no doubt have looked for top experts in the field.

Mo thumbed through his phone book, dialed a number in Albany. He got routed through several departments before finding the right person in the records department and identifying himself. "I'm in a rush on an important investigation," he told the secretary. "Perhaps you could do me a favor? I need information on the Westford Psychiatric Treatment Center, in Schenectady. I believe it is now out of operation but was still in business in 1983."

"We maintain annual directories from prior years, sir. I have it here."

"I need the name of the director of the facility. Also of the chief of psychiatric services."

"Okay." Mo could hear her lips moving as she scanned the page.

"Oh, here. Dr. Bernard B. Andrews, executive director, Dr. Mona D.

Wright-Kerson, managing director, Dr. Morris K. Gunderson, director of psychiatric services."

"Perfect," Mo said, jotting the names. "Now, do those things have indexes? Are they cross-referenced by staff?"

"Let me see. Yes, it has a staff index."

"Fabulous. Can you do me one more favor? Get a copy of the current directory. Tell me where those people are now?"

Mo waited, listening to the air on the other end of the phone.

"Looking in this year's edition, sir, I don't see a listing for Dr. Bernard Andrews. I've got the other two, though."

"Okay. Where do they work now?"

He heard the flipping of pages, and she read off the names of two facilities.

Mo asked for Mona Wright-Kerson and was told that Dr. Wright wasn't available, but that he could leave a message. He wondered if Dr. Mona had gotten divorced since 1983.
Welcome to the club, Mona.
Dr. Gunderson was now director of the Isaac P. Cohen Center in Syracuse. Mo dialed and asked for the doctor and was shocked to find himself on the line with the man within moments.

"Dr. Gunderson, this is Morgan Ford, I'm an investigator with the New York State Police BCI. I'm hoping you can provide me with some information."

Dr. Gunderson spoke like a man accustomed to authority. "We need to be cautious about issues of legal authority and medical confidentiality. I can't promise I'll provide you with what you want."

"I'm trying to locate a person who may be associated with a series of violent crimes in upper Westchester County. Specifically, I am looking for an individual who was under your nominal care at Westford, around ten years ago. I want to know where he is now."

"That's correct, I was chief of psychiatric services there. But as to where a given patient is—"

"His name is Erik Hoffmann III. Mother and legal guardian is Vivien Hoffmann, from Lewisboro—"

"As to where a given patient is," Gunderson went on, "the laws of medical confidentiality prevent me from even acknowledging whether a person is or is not currently a patient at this institution. Without proper authorization."

Gunderson's implacable tone made it clear he wasn't going to be shaken. Mo's heart sank. This could be a major runaround, and probably all for nothing anyway.

"But frankly, Mr. Ford," Gunderson went on, "I don't know why you're asking me this. Your department should know all about it already."

"How so?"

"Because we sent you Erik Hoffmann's records. When he disappeared. For the missing persons investigation."

Mo rocked back in his chair. "I'm sorry. Please explain."

"The only patient ever to be lost from this facility. And the only reason I'm telling you this much is that confidentiahty was waived a long time ago. When he disappeared, his mother authorized giving your agency his records, to help trace him. I suggest, Detective, that you do your homework before wasting your own time and other people's. Now, if there's nothing else—"

"When was this?"

"Six years ago. I remember it well because it nearly wrecked my professional career—the patient's mother certainly did her best to see that it did." Gunderson's voice had some venom in it, barely concealed. "I'd ask what brings it up again, but, frankly, I'd just as soon not involve myself or this institution in any way. Good-bye, Detective."

62

"I
APPRECIATE YOUR SEEING ME today," Paul told Dr. Stropes. "For someone with a very busy schedule, you've been generous with your time."

"The pleasure is mine," Stropes said affably. "You've given me an excuse to expound on my favorite subject. And my so-called 'free' time today we both owe to the fact that a video conference we'd planned for this time had to be rescheduled."

They stood at the security desk in the polished marble lobby as the guard filled out a visitor's authorization for Paul.

Stropes was a tall man, not much older than Paul, with slightly stooped, narrow shoulders, intelligent eyes behind wire-rimmed glasses. He had skin the color of dark chocolate, with the shining, scrubbed look Paul invariably associated with medical people. He was dressed in dark slacks, a starched blue shirt with its sleeves rolled up, a boldly striped tie.

Stropes's office on the third floor was large and well-lit, separated from the hall by glass walls. Inside, it was furnished in tasteful natural woods and textured fabrics. A counter ran the length of one wall, holding two oversized computer monitors, keyboards, a pair of printers, stacks of paper and manila folders. A floor-to-ceiling window let in light from a small internal courtyard.

Stropes gestured for Paul to sit in one of the chairs in front of the counter and took a seat himself. "Only so much of my work is actually done in the lab. A lot of it is done here—the data entry, statistical analysis, graphic development, projections, computer modeling. I can access files from all over the country. One of the side benefits for me, of course, is that I can use the hardware for some of my personal projects. If I may ask, what prompts your interest in the arcane field of HD/HK?"

Paul had anticipated the question but still wasn't sure how he'd answer it. "I'm in education," he improvised, "and I'm fascinated by the study of cognition. I stumbled across a piece you wrote when I was doing some research in the MedLine database. I was thinking I'd write an article about the topic sometime."

"So you've come to the horse's mouth. Be forewarned, my work in this area is not—what's a nice euphemism?—'enthusiastically embraced' by many of my colleagues." He clapped his hands on his thighs. "But I'll tell you what I can. Let me start by asking a question: Are you pretty good with computers?"

"I'd say I have basic computer literacy."

"Well, these stations are connected to a mainframe Cray, which will handle pretty well anything. So in my spare moments, I get to play with some very powerful applications." Stropes slapped a key on the keyboard in front of him. "You've heard of Virtual Jack?"

"Virtual, as in virtual reality, I'm familiar with. What's Virtual Jack?"

"Well, Virtual Jack is a sort of a, a cyberspace robot, a computer program ofa human form in three dimensions that will operate on the screen in a way that's anatomically correct. The original was developed by a friend of mine, Norm Badler, at the University of Pennsylvania. Jack is quite an amazing fellow." Stropes moved the mouse and clicked it several times, opening up a succession of brightly colored windows on the screen. "In the medical field, a number of variations of Virtual Jack have been developed for specific purposes. What I've done is borrowed some ideas, invented a few new twists. This is my masterpiece, so far. I call him Hyper Jack." Stropes's grin broadened, a shy smile of pride.

Paul guessed that in the skeptical confines of the research center, he didn't show his masterpiece to many.

An outline ofa human figure appeared in neon blue against the almost black background of the screen. Within seconds, a tracery of lines filled in the outline, until the figure appeared to Paul as a three-dimensional wire sculpture ofa man, made of polygons like a geodesic dome. He stood on a checkerboard floor that tapered away into the distance.

"What's valuable about this simulacrum is that he is subject to all the same constraints of motion as a real person. Each line of the grid he's made of is mathematically quantifiable. If he lifts his leg or bends his arm, it's within the real limits of skeletal arc and muscular contraction or extension. He has virtual weight and mass. The forces that Jack can bring to bear are all accurate models ofa living human and available for me to visualize and measure."

Stropes's enthusiasm grew as he talked: "As I said, each line, and each area enclosed by the lines, is a quantifiable unit. That means I can get a true measure of what any movement means. I can see it in graphic form on the body of Jack, or I can see it in a numerical readout up here. For example, when he bends his arm, say like this, the biceps must contract to lever up the forearm. I can visualize the amount of contraction by looking at Jack's arm, shortening here, thickening here, or I can see on the readout that in moving the arm through a 135-degree arc the biceps shortens from ten inches to seven-point-two inches. I can do this with every muscle system in the body. The program can also calculate the speeds of movement caused by any amount of muscular contraction, and the foot-pounds of force required to produce any speed."

On the screen, Jack did knee-bends, jumping jacks, squat thrusts. Flashing figures in a column of boxes at the right of the screen analyzed the movements of each muscle group.

"This is the skeletomuscular Jack, but there are several other views of him. First is the internal Jack—his organs, and the biochemical processes occurring within the organs."

As Paul watched, the hollow interior of the blue image filled with colored structures. He recognized lungs, heart and circulatory system, spinal cord and peripheral nerves, other organs. The heart pulsed regularly, the lungs expanded and contracted.

"For me, the important part is what each anatomical system does. Let me give you an example. Jack is right now an adult human male, five feet eleven, 175 pounds, he's fit and active. Let's look at him in two different modes of activity." Stropes touched the mouse and the screen split in two, with an identical version ofJack on each side. Now, inside the neon blue outline of his body, his heart, organs, brain, and muscles showed in varying intensities of blood red.

"I'm going to look at his blood flow. On the left is Jack at rest. You can see that his heart and lungs are pulsing slowly—about seventy heartbeats and ten breaths per minute. You can also see by the intensity of the color of his organs and muscles where his blood is going. The figures over here tell the exact story: At rest, he's pumping about 5,900 milliliters of blood per minute. About 750 go to his brain, 250 to the heart, 650 to his muscles, 500 to his skin. The biggest recipient of his at-rest blood flow is his internal organs, which are getting 3,100 milliliters a minute."

Stropes tapped the mouse again, and the Jack on the right-hand screen changed. He did a quick round of calisthenics, then began to run at a good clip, arms pumping, the floor scrolling behind him. His heart fluttered, the lungs squeezed faster. The organs dimmed, while the large muscles exploded with crimson.

"On the right side, now, you've got a normal human being at maximum exertion. Heart rate increases to 184 per minute, breathing increases proportionately. Blood flow has skyrocketed to four times resting rate—to 24,000 milliliters per minute. But what's really fascinating is
where the blood is going.
The heart muscle is receiving four times what it was at rest, 1,000 milliliters. The organs are receiving far
less
than they were at rest—only 600, about a fifth. But the muscles have gone from 650 to 20,900 milliliters."

The Jack on the right side of the screen, pulsating with motion, was almost painful to watch.

"But blood flow is only part of it. I can graphically illustrate the level of glucose or oxygen consumption at different levels of exertion. Also the levels and locations of adenosine triphosphate, creatine phosphate, glycogen—each of the major 'fuels,' you might say, of muscular exertion. And then I can project what Jack's body would
have to do
if it were to go hyperkinetic or hyperdynamic. To throw a 200-pound sofa across the room requires specific brain and body chemistry. I program this system to show me what that activity level would look like in a variety of ways."

Stropes had gotten himself worked up as he spoke, moving around in his chair, gesturing dramatically. Paul couldn't help catching some of his excitement. "So have you got a program of Jack in a hyper mode?" he asked.

"I do. It's not a pretty sight, if you find regular Jack a little nerve-racking, but it's instructive. Here." Stropes entered several commands, and again the screen unified so that there was only one Jack on it. "Here we go. Heart rate 260. Breathing rate 140. Blood flow twice the normal maximum at 50,000 rriilliliters. Internal organs receiving the barest maintenance flow, about 300, skin losing a httle. Heart muscle gaining big. And muscles exploding with blood, oxygen, glycogen, ATP, getting 45,000 milliliters. I can calculate the power and speed of every muscle, every limb. The figures are staggering. But those are the figures you'd need to have the strength and speed indicated by hundreds of well-documented reports."

The Jack on the screen was a seething blur of crimson as he ran on the flowing treadmill of the computer desert. There was a desperate, tormented quality to his motion. Frenetic.
Hysterical.
The endless empty plane of Jack's universe poured away behind him as he struggled, going nowhere. It was as if he were striving to break out of the screen, out of the confines of his digital self, into a more real world. Paul had to look away.

"Somethin', ain't it?" Stropes hit another key and Hyper Jack started doing jumping jacks with a hideous, fanatical intensity. "I can show you what he'd look hke in other activities, lifting something heavy, throwing things—"

"No. No thanks." Paul shook his head. "I get the picture." He found his own pulse racing, his breath hard to catch. Why was Hyper Jack so disturbing? There was something about his isolation on that geometric desert under that empty computer sky, the futility of his simulated exertions. Jack looked hke he had terminal Rimbaud's disease, Paul thought, was flailing to get out of his bleak world. A tic built in him. He started to reach out, twist the invisible doorknob, then suppressed it, only to be surprised by a facial tic that tugged his cheek uncomfortably.

Stropes was looking at him with concern, and Paul struggled to clear his head. "Is this possible? Wouldn't his heart fail? Could the circulatory system really handle that much blood flow?"

"Those are just the questions I've had to ask. The answer is a provisional yes—under very rare, very particular circumstances. Let me show you one more Hyper Jack—that'll help me explain." Again he worked the keyboard with practiced strokes. In place of the full figure of Jack, the screen filled with a close-up of Jack's head, a hollow shape created by a three-dimensional grid of neon-blue lines. "Here's Jack's head. Now I'll fill in his brain. I gather you're fairly familiar with the anatomy of the brain?"

"I've done a bit of reading."

"Okay. So we've got the main structures: in green here the brain stem, in purple the cerebellum, in blue the cerebrum, and so on. One of my primary concerns is the HPA axis."

"The hypothalamic-pituitary-adrenal axis. Fight or flight."

"Exacdy. The basic process of alarm looks hke this. This red, walnut-shaped thing is the hypothalamus. When the senses tell it that there's a threat or a source of challenge or stress, a cascade of neurochemical processes begins. First, an electrical signal is sent to the hypothalamus, which squirts out CRF—corticotropin-releasing factor. This travels straight to the pituitary gland, often called the master gland because it tells the other glands what to do." On the screen, a series of tiny, brilliant white dots left the hypothalamus and traveled forward in Jack's cranium to a peanut-size gland. "The CRF kicks in the pituitary, which secretes ACTH, adrenocorticotropic hormone, into the bloodstream. Within a second, this reaches the adrenal glands, which pump out cortisol. Cortisol converts norepinephrine into epinephrine, and the body enters its fight-or-flight response.

"It's a very ancient survival mechanism that kicks the organism into overdrive. The heart pumps much harder and faster, the lungs take in more oxygen, the liver releases more sugar, the muscles become more active, the pupils dilate, the body begins to sweat."

"But everything you've described is the normal process ofarousal," Paul said. He tapped the monitor, where Jack was becoming stimulated by the digital chemicals in his bloodstream. "What happens in the hyper mode?"

"Okay. We know the level of arousal is dependent upon the intensity of the threat or challenge input that's given. Obviously, if kitty knocks a flowerpot off the window still, your heart beats a bit faster. If three large guys come at you with lead pipes, your body really gets cranked. So if you've gone into hyper mode and you're peeling back steel plate with your bare hands, it's going to require a measurable amount of strength. I've calculated backward from what Jack's muscles and lungs and heart
have
to do to make him hyper, and calculated the level of excitement of each part of the HPA axis. What I've found is that a normal brain can't do it—can't produce the intensity of electrical stimulus and the quantity of arousal chemicals needed. But let's assume a few minor, entirely possible, deviations from normal anatomy. First, let's add a variant of epilepsy that, triggered by emotional stress, shoots a drastically increased electrical charge to the HPA axis in the brain. Second, slightly change the size and shape of the HPA components and the glycogen storage capacity of the liver. The necessary combination of factors would occur only very rarely in any given human population. Probably, as Wilkes said, the needed variations in brain activity and structure are inherited."