Sleeping Beauty (42 page)

“They might strike the caretaker or kick them. Biting and scratching are also common.”

“Have you yourself read other physician accounts of these types of encounters?”

“Yes, many.”

“I see.” Ben pinches his ample chin between his index finger and thumb, like he’s deep in thought. He inhales and exhales loudly through his nose. “Dr. Charmant, if Ms. Beau had confessed at her first meeting with Dr. Pickering and you that she had, indeed, exhibited hypersexual behaviors during previous KLS episodes, would you have then formally diagnosed her with KLS without a sleep study? In short, would you still have done a sleep lab evaluation if you had known?”

“I was not her attending physician, so I was in no capacity to make that call.”

“My apologies. If you had been her attending physician, would you still have done a sleep lab evaluation of Ms. Beau?”

“Yes.”

“Why?”

“Because hypersexual behavior can have other medical causes.”

“Such as?”

“Brain trauma, bi-polar disorder, Alzheimer’s, to name a few. It was important to gather as much data as possible while she was experiencing the episodes in order to rule out other disorders.”

“Very good. Now, were you able to ascertain how Ms. Beau would know, besides the hypersexuality displays, when she was getting closer to entering a KLS episode?”

“Yes, she would have cataplexy attacks–fainting spells–leading up to her episodes.

“And what was her treatment for those cataplexy attacks?”

“She was taking sodium oxybate.”

“Is this a medication commonly used for cataplexy attacks?”

“Yes, it’s standard of care for cataplexy.”

“Isn’t it true that the only approved medical use for sodium oxybate in the Unites States is for the treatment of cataplexy?”

“That’s correct.”

“If you had been certain at that time of her first office visit that Ms. Beau suffered from KLS, would you have recommended that she discontinue the sodium oxybate?”

“No, I would not have recommended that.”

“Can you tell us why?”

“The sodium oxybate might still have relieved the cataplexy symptoms that she suffered before the onset of a KLS episode.”

“What was Ms. Beau’s dosing regimen of sodium oxybate?”

“She took five grams every night.”

“Is this an unusually high dose for the treatment of cataplexy?”

“No, it’s a typical dose for her height and weight.”

“Dr. Charmant, several witnesses have already educated the court about Klein-Levin Syndrome. Can you tell us about the similarities between behaviors exhibited by a person taking a medically justifiable dose of sodium oxybate, and a person suffering from the onset of a hypersexuality display?”

“Both might exhibit a decrease in social inhibitions, extreme drowsiness, and the possibility of suffering from amnesia afterwards.”

“When was the last time Ms. Beau had taken a dose of sodium oxybate?”

“Her intake paperwork the morning of her visit to the sleep lab indicated she took her regular dose the night before.”

“Would the effects of the sodium oxybate have worn off by the time you saw Ms. Beau in the sleep lab?”

With a struggle the formidable Ms. Gaelic extracts her large bottom from the confines of her chair. “Objection, Your Honor,” she says. “Dr. Charmant is not a pharmaceutical expert.”

Ben eyes her incredulously. “Since when is a medical doctor not considered an expert on the topic of pharmaceuticals?”

There are scattered titters in the courtroom. “Overruled, Ms. Gaelic,” says the judge. “And perhaps later,” she adds drily, “you can advise the court regarding who would be more qualified than a medical doctor to comment on legal medications.”

Dozens of people, include several jurors, are openly laughing now. I see Brendan’s jaw twitch, clearly not amused.

Charmant’s attorney turns back to the witness stand. “Doctor?”

“Yes, it would have worn off by the time she came to the sleep lab. The half-life of sodium oxybate is thirty minutes to one hour, meaning that a five gram dose over four hours would be completely eliminated from the system within twelve hours.”

“Was Ms. Beau fully coherent and aware when you saw her at the sleep lab that first morning.”

“Yes.”

“And did you ask Ms. Beau to bring her medications with her the morning she saw you in the sleep lab?”

“I did.”

“Why did you do this?”

“She wasn’t sure of her medication or dosages when Dr. Pickering and I took her medical history in the clinic, and it was important that we get an accurate inventory of all of them before the testing.”

“And why was that?”

“Because part of the sleep lab testing involves a urinalysis and a drug screening that’s used to diagnose certain sleep disorders.”

“I see, thank you. Dr. Charmant, who suggested that Ms. Beau undergo sleep lab testing?”

“Dr. Pickering ordered it.”

“Who arranged for you to be the physician in charge at the sleep lab that day?”

“Dr. Pickering asked me to oversee Claire’s testing.”

Ben takes a few steps back from the stand and folds his arms as if to say to the jury:
See? No planning, no intent to harm, nada. They got nothin’
.

“Dr. Charmant, when did you first become aware of your physical attraction to Ms. Beau? Was it during her first office visit at the Children’s Hospital?”

“Not immediately.”

“By the time she left that same day?”

He tilts his head, thinking. “I wouldn’t call it ‘attraction.’”

“What would you call it?”

“I thought she was a clever, tough woman who was anxious to receive a diagnosis for the symptoms she’d been experiencing, and who’d had a lot of difficulties in the last year getting a diagnosis.”

“You say that she was ‘clever and ‘tough.’ In what way?”

“I saw her in an exam room first, and assumed–incorrectly as it turned out–that her electronic medical record was in error, and that she was nineteen and not twenty-nine. I also called her by her first name and asked her if her parents were with her.”

“And she corrected you–on all three counts?”

The right side of his mouth curls the tiniest bit. “Forcibly. And rightfully,” he adds.

“So you admired her for her pluck?”

“Yes.”

“Were you attracted to her by the time of her sleep lab evaluation?”

“Not beforehand, no.”

“After she arrived?”

“I still wouldn’t have used the word ‘attraction.’”

“Fine,” says Ben sarcastically. “When did your ‘admiration of her pluck’ turn into something else?”

The spectators around me giggle while I seethe.

“Counselor…” warns the judge.

I feel like getting up and walking out, I’m so pissed. “What is he
doing
?” I hiss at Rev.

Rev shakes his head. “It’s brilliant!” he whispers. “Watch…”

Chapter Thirty-Two

“My apologies, Your Honor,” says Ben in that buttery, smooth voice of his. “Dr. Charmant, how would you describe how you felt about Ms. Beau at that time?”

“I felt awkwardness towards her because of how the initial clinic visit in the hospital had gone. I knew that she wasn’t happy about Dr. Pickering assigning me to her sleep visit.”

“When you saw Ms. Beau for the first time in the sleep lab, did you notice anything different about her?”

“Well, she looked very different from when I saw her two days before at the hospital. I remember that I thought she was dressed in very flattering clothes.” He shrugs. “She’s a beautiful woman. My mind registered this fact. That was all.”

“Did you tell her that you thought she looked different?”

“No, it took me a few seconds to realize who she was. She noticed my expression, and I explained to her that I didn’t recognize her at first, that was all.”

“And where did this happen?”

“Right after I showed her into the sleep lab bedroom.”

“Was it then that you complimented Ms. Beau on her beauty or her clothing?”

“Never. To my knowledge she was not aware of my opinion of her clothing choices or her appearance.”

“Once you were inside the bedroom, the camera records you looking at Ms. Beau for several seconds without speaking.”

“Yes,” says Brendan.

“You were still looking at Ms. Beau, correct? Looking at her, but not speaking?”

“That’s correct.”

“Was it during that time that your mind was registering that she was a beautiful woman in pretty clothing, and you were literally speechless?”

“No.”

“Then how would you explain the reason for the silence?”

“Like I said before, I felt very awkward around Claire because of how poorly I’d handled her initial office visit in the clinic. I could tell from the way she spoke to me that wasn’t happy that I was the one overseeing her visit.”

“At the time that your mind registered that she was a beautiful woman in pretty clothing, did you ever consider discontinuing the doctor-patient relationship with Ms. Beau?”

“No. I did not have any inappropriate feelings towards her, nor did I feel that I was unable to continue overseeing her care.”

“When did you first recognize that you were attracted to Ms. Beau in a way that went beyond the natural inclination for a normally-functioning brain to recognize a beautiful woman when she’s standing three feet in front of you?”

“Not until a couple of weeks later when we ran into each other at the beach.”

“So you never did anything prior to Ms. Beau’s appointment in the sleep lab or during her time in the sleep lab that would have given her the idea that you were physically attracted to her?”

“Never.”

“Approximately fifteen minutes after her arrival, something unexpected happened. Can you tell us about that?”

“A few minutes after I introduced her to the testing room, she lost consciousness.”

“Was Ms. Beau hooked up to electrodes when that happened?”

“No, I hadn’t had a chance to apply any electrodes at that point.”

“What happened after she lost consciousness?”

“I caught her before she hit the ground, and carried her to the bed.”

“Did it occur to you to treat this as an emergency?

“No.”

“Why not?”

“Because Claire had a history of cataplexy attacks preceding KLS episodes. Physically she was fine. Her airway was clear, her heartbeat and breathing were steady and regular. She just needed a few minutes to regain consciousness.”

“While Ms. Beau was unconscious did you ever touch her?”

“Yes, I just told you I carried her to the bed and checked her airway and heart.”

“And after that?”

“While she was unconscious I marked her scalp and parts of her face and neck. I also applied one EKG pad to the skin beneath her collarbone.”

“Why?”

“Sleep study data is collected through electrodes attached to the scalp and the face. An EKG monitors heart activity. By marking the spots for the electrodes while she was temporarily unconscious, I was doing something I would need to do regardless.”

“You mean if you’d waited until she’d awakened, you would’ve needed to make the same placement markings?”

“Yes.”

“And how did you accomplish this–making the placement markings–on Ms. Beau’s scalp and skin while she was laying down?”

“Mostly from a standing position.”

“Was there any point at which you found it necessary to get on the bed?”

“Yes, there were parts of the right side of her scalp and face I couldn’t easily reach from a standing position. At that point I did get on the bed.”

“Were you on the bed marking Ms. Beau’s scalp when she began to regain consciousness?”

“I was on the bed, but I was applying one of the EKG pads.”

“Just under her collarbone, correct?”

“Yes.”

“Did you find that you needed to lift the fabric of Ms. Beau’s bra in order to apply this EKG pad?”

“A very little, yes.”

“Is this typical when applying EKG pads?”

“Yes, it’s typical when doing this for female patients.”

“What did you do when you realized that Ms. Beau was waking up?”

“I stood up immediately.”

In my seat behind the defense table, I fight a juvenile giggle, thinking of Ben’s marathon practice sessions during which the response to this very question was carefully crafted. In the end, “I stood up immediately” was chosen over the much less desirable “I got off immediately.”

“When Ms. Beau regained full consciousness, where were you?”

“I was standing next to the bed.”

“Doing what?”

“I was giving Claire instructions on how the testing would proceed.”

“Did she appear alarmed at that time?”

“Not initially.”

“When did Ms. Beau begin to exhibit agitation?”

“About two minutes after she began to regain consciousness.”

“How did you become aware that she was agitated?”

“When I tried to leave the room, she asked me not to leave her alone.”

“And to what did you attribute this sudden anxiety?”

“I wasn’t certain.”

“What did she do? In what way did you become aware that she was agitated?”

“The look on her face for one. She looked fearful. And then she tried to stand up while she was still partially paralyzed.”

“And what did you do then?”

“I urged her to lie down on the bed before she fell down.”

“Did she follow your advice?”

“Yes.”

“At that time, did you give her a glass of clear liquid to drink?”

“Yes, I gave her a glass of water.”

“Why?”

“Cataplexy attacks are often preceded by an extremely dry mouth. Patients often complain about this before the attack and afterwards. I was simply anticipating that she would be thirsty once she was able to move and sit up.”

“Dr. Charmant, other witnesses have testified that sodium oxybate has a strange taste. Would you agree with that?”

“Well, I’ve never tasted it, but I understand that it tastes like table salt dissolved in water. I’ve had other patients say that it’s like drinking saline solution.”

“Would you describe it as a pleasant flavor?”