The Fregoli Delusion (10 page)

“Now, the lieutenant is
understandably fixated on the bullet itself, because it’ll no doubt be a key
piece of evidence in his case, and while I’m retrieving it for him I’ll explain
why today is his lucky day.”

Harry had finished cleaning much
of the blood from the surface of the brain, and Easton now bent over it,
scalpel in hand. “What we have is a penetrating head injury, meaning that the
round penetrated the parietal bone, as I said, and entered the brain here,” he
pointed with the scalpel, “creating the primary wound track as it traveled
through in this direction,” he moved the scalpel diagonally above the surface
of the brain, “and coming to rest right here,” he pointed, “almost exactly a
centimeter from the surface. Up here,” he moved his scalpel back to the
entrance wound, “penetration of the parietal bone created numerous bone
fragments that generated secondary wound tracks, as I mentioned.” He moved the
scalpel. “See here, Hank? And here and here in particular. They helped shred the
artery right at the point of impact and also created additional damage to this
portion of the brain. Quite a little mess.

“But back to our round, and the
question of range of fire. I should mention, to begin with, that the entrance
wound and surrounding skin tissue, which we’ve recovered and preserved for
further reference, showed no searing, soot deposition, or powder tattooing,
only the typical abrasion ring I’d expect to see in these situations. I can
safely say that we’re dealing with a distant range wound, or in other words a
shot that was fired from a distance of more than two feet. It’s highly
unlikely, therefore, that the wound was self-inflicted. I should add that the
abrasion ring,” he glanced up at the gallery, “which is, you may recall, the
rim of flattened, abraded tissue around the entrance wound, was almost exactly
concentric, meaning the shot struck the head at an angle very close to
perpendicular.”

“In other words,” Hank supplied,
“his head was turned away from the shooter and in profile. He might have been
turning away to walk back to his bicycle, figuring their conversation was over.
Something like that.”

“Assume away,” Easton said.
“You’ll notice, as well, that there isn’t an exit wound. We’re not dealing with
a perforating injury, a through and through, but a penetrating injury, as I
already said, even though the round entered at the weakest part of the skull
where it would be met with the least resistance.” He bent over the brain and
began to extract the bullet. “You know where I’m going with this, right, Hank?”

“I’ve got an idea.”

“Then let me,” he worked his
forceps closer to the bullet, “add it all up for our guests. A penetrating
wound and not through and through, even though the bullet entered the skull at
its weakest point, a relatively small temporary cavity, which I haven’t
mentioned yet but is notable because of the relatively small amount of
shockwave damage to nearby brain tissue seen on the imaging, a reasonably
intact bullet, as we could also see from the imaging, with only some
deformation even though it did pass through bone, deflecting in a twenty-degree
angle, by the way, all of which is good for the lieutenant because the rifling
should be visible for analysis ... Harry?”

The diener extended a plastic
evidence bag. Easton pulled out the round and dropped it into the bag. Harry
sealed the top and held it up for Hank to see.

“In other words, a standard
velocity .22, if I’m not mistaken. As we always say, shot placement is
everything. It’s not necessarily the caliber of the round that’ll kill you but
the placement of the shot. In this case, I’d say the shooter couldn’t have
picked a better spot. More lucky than good, I suppose, but there you go.”

Harry took a pen and scribbled on
the tear-off receipt at the top of the bag. On the form printed on the side of
the bag he then wrote the victim’s name, a description of the evidence, date
and time of recovery, recovered by, and the first two lines of the chain of
custody table. Easton initialed the bag on the first line and gave the pen back
to Harry, who put his initials on the second line, tore off the receipt at the
top, and handed the evidence bag to Hank, who wrote his own initials next to
his name on the third line of the chain of custody table and held the bag up
for a closer look.

“Not bad.” He could see it was
indeed a .22 long rifle bullet. It was plain lead and not copper-plated, which
meant it was standard velocity rather than a high velocity load, as Easton had
predicted. A very common cartridge throughout the years. His eyesight wasn't
good enough to see the rifling marks, but Easton was again correct when he said
that the bullet was in good enough shape for the lab to complete an accurate
analysis. His lucky day, indeed.

“Now bug out,” said Easton, “and
take our guests with you so we can get back to work.” He looked up at the
gallery. “Based on our virtual autopsy, I’m sure we won’t find anything else of
significance directly related to the death of the victim, and anything we
might
find we’ll bring to the lieutenant’s attention right away. I think his time
would be better spent following the evidence he’s now got in his hands instead
of standing around here as a redundant witness, don’t you?” Easton turned
around to Chalmers. “Doctor, if you’d like to get the trunk opened up, we can
move this thing along.”

Hank gratefully began to peel off
his gloves and gown. Evidence bag in hand, he left the autopsy theater, edged
around the janitor who was mopping the hallway floor with a strong-smelling
disinfectant, and went into the viewing gallery. Attorney General Perry was
alone, staring down into the theater, hands clasped behind his back. At the
sound of the door opening and closing, he turned and nodded at Hank.

“Sorry for the bluster earlier,
Hank. I was out of line. I apologize.”

“These things put a lot of stress
on everyone.”

Perry looked at the evidence bag
in Hank’s hand. “Our first break in the case, wouldn’t you say?”

Hank held up the bag so that Perry
could take a closer look. “Dr. Easton’s right. A standard velocity .22, which
explains why it didn’t exit the skull. We should be able to see enough of the
rifling to be able to find a match if it’s already in the system, or at the
very least match it down the road if we find the murder weapon.” He put the bag
in his jacket pocket. “It’s a break.”

Perry’s eyes wandered back down to
the dissection table. “I had no idea it would be so dehumanizing. I’ve never
been at one of these before. Never had to. Wasn’t ever in my career path. I
thought I was coming to pay my respects to H.J., or something.” He turned back
and met Hank’s eyes. “I don’t know what I thought. But that’s not H.J. down
there. It’s some piece of meat.”

Hank waited.

“I don’t know how you do it, Hank.
I’m a lawyer and a politician. I do my job in big offices, courtrooms,
government offices, board rooms, conference centers. We deal with autopsy
results all the time, sure, but not like this. How the hell do you do this for
a living?”

“You get used to it.”

“I can’t imagine that. Frankly, I’m
surprised you didn’t follow in your parents’ footsteps and make a name for
yourself in the courtroom. You must be a hard person to be able to deal with
this kind of thing every day.” He frowned. “Don’t get me wrong. I’m aware of
your incredible record as a police officer. I’m just trying to understand how
the hell you do it.
Why
you do it, given your background.”

Hank hesitated, then saw that the
man was struggling to deal with the horror of what he’d blundered into and was
genuinely desperate for help. “Someone has to do it, John. Someone who cares
about the outcome.”

“Of course, but surely you could
have been just as effective, or even more effective, as a prosecuting attorney.
Above all this.” He looked down into the theater and quickly turned his head
again.

“My mother,” Hank said, “God bless
her, likes to remind me on a regular basis of the difference between the law
and morality. Those of us inside the system, she always says, don’t have the
luxury of moral opinions about right or wrong. We serve a legal system that
operates within a well-worked set of rules. As civil servants, our job is to
apply the rules, catch the violators, and apply the penalties dictated by the
rules. Period.”

He took a breath, talking more to
keep Perry’s mind off what was happening below than anything else. “The people
who make the laws, politicians such as you, for example, can have a moral
agenda when it comes to amending laws or making new ones, but lawyers, cops,
and judges can’t, according to her. The law is what it is, she likes to say,
and it’s our job to deal with that. Know what I’m saying?”

“Of course.”

“Sure you do,” Hank said easily.
“You got your law degree from Harvard. But the thing I like to say in response to
my mother is that at street level, her point of view isn’t all that popular. At
street level, there’s a hunger for a different kind of morality. An eye for an
eye. A punishment that fits the crime. The street can be remarkably Dantesque,
that way. A hell in which you ultimately get back what you give.”

He saw Perry frown, trying to make
sense of what he was saying.

“As a cop, I’ve spent my career in
the middle of it all, dealing with the street’s version of what’s right and
what’s wrong, while at the same time trying to work within the rules as a cog
in the legal system. I’m pulled in both directions every day. To be there, to
do this job for a living, I
have
to have a tough skin. I realized very
early in my life I could do it. Things that bothered other people didn’t bother
me. To put it in a nutshell, I do this not only because I want to, but also because
I
can
.”

The door opened and Exler stuck
his head inside. “The press is waiting for a brief statement, Mr. Attorney
General, then we should get you back to the airport.”

Perry held out his hand to Hank.
“Thanks very much.”

“You’re welcome,” Hank said,
relieved to have been rescued from a conversation that was making him feel very
uncomfortable.

“Give my regards to your mother,”
Perry said, squeezing his hand tightly.

“I will, sir.”

Perry glanced once more at the
window behind him. “Do what you have to do.”

12

Karen didn’t like psychiatrists
very much.

As a teenager, she’d been
interviewed by several psychiatrists responsible for her mother’s care back
home in Fort Worth, and they weren’t exactly her favorite category of people.
One had made an effort to be kind and understanding, others were formal and
impersonal, and one in particular had been an aggressive son of a bitch who
thought she was hiding more than she was telling and was determined to
intimidate it out of her. Even at that age, though, she’d had enough insight
into human behavior to understand that the nice one was putting on an act to
make her feel relaxed and cooperative, and she’d had enough self-possession to
stand up to the bully and tell him to go fish.

As she fought her way through
heavy downtown traffic toward the office of Dr. Sally Caldwell, she remembered
that the supposed objective of most of the interviews had been to collect
whatever information they could about her mother’s behavior before her
institutionalization.
We know about her leaving home last month, when they
found her on the highway, but were there other times before that when she
disappeared? Maybe just for the day? Times when you didn’t know where she was?
And what would she say when she came back? Did she cry very often? Did she yell
at you and hit you? Did she blame you for everything? Did she say you should
have been a boy instead of a girl?

A few of the interviews had been a
bungled attempt to explore her own feelings about her mother’s illness. They
were short and sweet. No matter how fake nice they were, or how aggressive,
there was no possible way she’d say a word about what was going on inside
her
head. It was none of their goddamned business.

She was sitting through the third consecutive
red light at the same intersection. Irritated, she flicked on the Crown Vic’s
flashing grill lights and mounted the sidewalk, knocking aside a metal garbage
can as she maneuvered into an alley. She drove down the alley between the
dumpsters, crates, and abandoned store fixtures to the next block over, where
she blipped her siren, forced her way back into traffic, and bulled into the
far lane. Someone blew their horn behind her and she threw a glance into the
rear view mirror, hoping to see a raised fist or middle finger, but was
disappointed.

She killed the lights and took a
deep breath.

Celebrity psychiatrists were even
worse than the regular kind, as far as she was concerned. Not only were they
psychiatrists, which was bad enough, but they were attention-seekers who loved
to show up on television hawking their latest book or self-help video or some
such waste of time and money. And Dr. Sally Caldwell, unfortunately, was a very
hot commodity in the celebrity-psychiatrist racket right now.

In her mid-fifties, Caldwell was originally
from Milwaukee. Her hometown origin still lingered in her accent and played
well on television, lending her a certain charm that appealed to people. Karen
had glanced through Caldwell’s book on body language and thought she’d covered
it off fairly well, but she’d looked at another on weight loss and self-esteem
and found it to be completely self-serving. Karen had her doubts as to how
useful Caldwell was going to be on something as off-beat as this Fregoli thing.

In Caldwell’s waiting room, Karen
badged the receptionist and cooled her heels while The Famous One finished up
whatever the hell it was she was currently doing that was So Damned Important.
In the waiting room with her were a woman who wouldn’t meet her eyes and a
teenaged girl who wore some kind of private school uniform. Karen had not
missed the interest the girl had shown in Karen’s sidearm, which peeked out
when she brushed back her jacket to return her badge to her belt. As Karen
paced back and forth the woman spoke quietly to the girl, who picked up a
magazine from the table beside her instead of responding.

An inner door opened and the
receptionist appeared.

“Detective Stainer? Please come
this way.”

Karen followed her through a
doorway into an inner office. Dr. Sally Caldwell sat at a large glass desk that
held only a large flat panel computer monitor and a china tea cup and saucer.
She looked up from her monitor, flashed Karen a smile, and stood up. As she
came around the desk, hand extended, Karen saw that Caldwell was half a foot
taller than she was, perhaps five foot ten, and large framed, carrying more
weight than Karen but without looking heavy. Her hair was colored platinum
blond and cut in a shoulder-length bob style with a medium curl. She wore an
expensive-looking blood-red jacket-and-skirt combination with white pantyhose
and black pumps, all of which apparently tried to suggest a little-girl
innocence.

“Detective Karen Stainer,
Homicide,” Karen said, flashing her badge.

“Very glad to meet you.” Caldwell gave
her a quick, soft handshake. “Won’t you please sit down?” She led the way to an
arrangement of leather chairs in one corner of the office. “The tea’s fresh.
Would you care for some?”

Karen shook her head. “I won’t
take much of your time. I understand you made a house call on Brett Parris last
night after his day of fun. We've done the disclosure authorization thing,
right? So I need you to explain the situation to me. I need to know how
reliable he is as a witness. Whether or not I can trust what he said he saw
yesterday morning.”

They sat down. Caldwell crossed
her legs and nodded sympathetically. “I understand your concern. It was a very
upsetting situation for Brett.”

“How was he doing last night when
you saw him?”

“He was agitated, of course. I was
there for nearly an hour.”

Karen had spent more time with the
guy yesterday than that, so the fact that he was agitated wasn't exactly a news
bulletin. “Was he freaked out? Delusional? Was he doing the guys-in-disguise
thing with you?”

“He was agitated, as I said. He
was rational, otherwise. You must remember that he's a paranoid schizophrenic,
so the first thing I assessed was his behavior in that context. He wasn't
displaying any symptoms such as hallucinations or thought disorder, he spoke
fairly coherently despite being upset, and his attention stayed reasonably
focused on us throughout. He was mostly upset because he insisted he'd seen
Richard Holland and no one would believe him.”

“You said ‘us.’ Do you mean you
and his father?”

“No. Brett's APRN was there with
me.”

“APRN.”

“Advanced practice registered
nurse,” Caldwell explained. “Mona Jensen. She's a PMH-APRN, actually.
Psychiatric mental health APRN.”

Karen was uninterested in the
alphabet soup. She knew what a psychiatric nurse was, and found it informative
that Brett Parris had retained one. Probably to help look after his home care.

“Fine. You and the nurse. And he
seemed okay, you say. Other than being wound up about whether or not people
believed him. Did you sedate him?”

Caldwell shook her head. “We
talked him through it. Mona works with him every day, so there was a basis for
breaking through the anxiety and bringing him back to a state of relative calm
without sedation.”

“Okay, fine.” The fact that Brett
hadn’t needed to be sedated was good news. “So what’s the deal with this
Fregoli condition of his?”

“Fregoli syndrome is actually
quite rare,” Caldwell said. “It’s a form of delusional misidentification
syndrome, or DMS, where the patient believes they’re being persecuted by
someone who disguises himself as other people. It’s named after Leopoldo
Fregoli, an Italian actor who was famous a hundred years ago for being a
quick-change artist.”

“Okay. He has these delusions that
other people are Richard Holland, and he’s paranoid Holland’s stalking him. As
I understand it, Holland bullied him when they were in school.” She leaned
forward. “What I need you to do is help me with how this thing works. Does he
get it all the time? Just sometimes? Does something trigger these delusions, or
are they random?”

Caldwell spread her hands. “As I
mentioned, it’s a rather rare condition, and unfortunately we don’t know a lot
about it. Part of our efforts over the years has been to try to separate it
from other DMSes such as Capgras syndrome, where the patient believes that a
number of people known to him have been replaced by identical imposters. Both
Capgras and Fregoli are included in the category of schizophrenia. That may not
mean much to you, Detective—”

“I know about schizophrenia,”
Karen interrupted shortly. “Just tell me how the Fregoli delusions work.”

“Sorry. I do tend to get into
lecture mode quite easily. The point I was making is that we don’t have a solid
understanding of Fregoli syndrome as a whole, because there are still so few
cases, and we can’t say definitively what causes it. If we understood its
origins we could probably better predict a patient’s behavior and how to treat
it. In a low percentage of cases, the patient had some other drastic condition
such as Alzheimer’s dementia, epilepsy, or a stroke, but not in most. Brain
scans have shown some kind of atrophy or damage in perhaps half the known
cases, often on the right side of the brain, but not in others. The only
consistent factor we can point to right now is an underlying psychosis. In
Brett’s case, he has already been diagnosed as a paranoid schizophrenic, as I’ve
said, and he’s being treated as such, which is how it works with Fregoli
subjects. We treat the underlying disorder and it seems to keep the Fregoli
symptoms under control.”

“So he’s on meds for schizophrenia
and that controls this other thing.”

“Correct. But like most psychotic
symptoms, his Fregoli-related delusions come and go. If he skipped his
medication that would likely trigger a recurrence of the symptoms, which I
understand happened on a regular basis when he was away at school. But he
assures me he’s very conscientious now about following his regimen, and Mona
confirms it.”

Karen chewed on the inside of her
cheek for a moment. “Here’s the thing. Brett Parris says he saw Richard Holland
running away from our crime scene moments after Jarrett was shot. I know damned
well the state’s attorney can’t use him as a witness because he’d get torn to
shreds on the stand by the defense because he’s a schizophrenic with all this
other bizarre stuff going on. Everybody tells me he’s just blowing smoke when
he says it was Holland he saw and that I should ignore it, but I look into the
guy’s eyes and I listen to the sound of his voice when he tells me it was
Holland, and I believe him, damn it. I think he’s telling the truth. I mean, I
think that’s really who he saw. So here’s my question. Could you tell last
night whether he was telling the truth or whether it was another one of these
Fregoli delusions?”

Caldwell shook her head. “Not to
any degree of certainty that would be useful to you in your investigation.
Generally speaking, these patients are absolutely convinced by their delusion
and can appear completely truthful. I’ve examined Brett several times under
such conditions and it’s remarkable how certain he is.”

Hiding her disappointment, Karen
took out a business card, put it on the table, and stood up. “If you think of
anything else you think I need to know, I’d appreciate if you'd call me. My
cell number’s there. I can be reached twenty-four seven.”

“I can’t make any promises.”

“Sure.” Halfway to the door, Karen
stopped and turned around. “Let me ask you something else. Has Brett Parris
ever shown any signs of being violent, or talked about wanting to kill
someone?”

“Not at all,” replied Caldwell.
“You may be laboring under the false belief that paranoid schizophrenics are
intrinsically violent. If anything, they mostly want to be left alone, which is
very true in Brett's case. If you’re thinking that he might have killed Mr.
Jarrett, I’d tell you you’re wasting your time. It’s not in him. Not under
any
circumstances.”

“All right.” Karen reached the
door and turned around again. “There’s a girl out in the waiting room. I’m
guessing she's your next patient.”

Caldwell said nothing, looking at
her.

“She showed a real interest in
this when I put away my badge.” Karen moved her jacket to show her gun. “I’m no
psychiatrist, but that sort of thing kinda jumps out at me. I thought you might
be interested.”

“Thank you, Detective,” Caldwell
said coolly.

Karen stared back. “You’re
welcome.”