The Sacrificial Man (16 page)

“I’m glad.” He sounds doubtful, peering at me like I’m something in a petri dish. His glasses are half circles and his jacket corduroy. He’s the very caricature of a trendy physician. I’d laugh if there were not so much at stake.

“But the staff tell me you’ve been complaining of headaches and dizziness?”

“It’s nothing. Just the worry of being here, probably. I want to go home, now,” I tell him, biting back the ‘please’ that nearly escapes my lips. I will not beg. I don’t belong here. Freedom is my right.

“I’m sure you do, Alice.” Condescending. Using my first name without asking. To him, I’m a child asking for sweeties. I can hear the refusal already. “But although you seem well at the moment I think it would be wise to keep you here a while longer, just to be on the safe side.”

“But… ”

“It’s for your own good, Alice. You were in quite a state on Tuesday. Let’s see how you progress. The sedative from yesterday will have worn off now. I’ll prescribe something else to keep you stable. And some more painkillers for that headache.”

He’s not talking to me. The speech is for his own benefit, the routine drone of a doctor doling out pills. Prozac or some other serotonin cocktail.

I shall not take them. I won’t be tricked into madness, when sanity is all I have.

“Do you remember what happened on Tuesday, Alice?”

I think back, but my memory is a wasteland. I see outline but no details. What sedative did they give me, that I can’t catch the day in my mind? I hear broken glass, and I wonder if it was my patience or my sanity that was shattered.

On her way to the secure ward Cate asked a passing nurse where she would find Dr Gregg and was told his office was in the main part of the psychiatric hospital, near the Brain Injury Rehabilitation Unit. After she had thanked him, she headed to the crossroad of signs, scanning for BIRU. She dodged patients on the way, men and women who shuffled along or loped alarmingly, the very picture of madness. Alice wasn’t like that and, even after thinking about what Dr Gregg had said about egomania, she still wasn’t convinced that Alice was suicidal. Determined not to make any mistakes with this case, she wanted this decision explained to her. She’d made a mistake once before. She wasn’t going to let that happen again. This part of the hospital was open – no-one here was held against their will, and Cate found her way to a general staff room, with a coffee machine and several desks. Two nurses and a woman in a flowing skirt with a nervous laugh were chatting while they wrote in files.

Cate knocked on the open door and said, “I’d like to speak with Dr Gregg, please.” One of the nurses took her name and picked up a phone. Cate heard her tell Dr Gregg that Alice Mariani’s probation officer wanted a word.

“He’s on his lunch break,” the nurse said, replacing the receiver, “but he’s happy for you to go in if, you don’t mind that he’s eating.”

Cate was directed along the corridor to a door below a sign that announced, in gilt letters on a black board: DR CHARLES GREGG, Forensic Psychiatrist. Cate knocked and waited.

“Come in.”

Dr Gregg was seated behind an oversized desk, on which an open packet of crisps and a half-eaten sausage roll had been laid out on a serviette. He looked in his early fifties, silver peppered his brown hair and he wore half-moon glasses, his eyes framed by laughter creases. He stood, wiped his hand on the serviette, and offered it to her, “We meet at last, Miss Austin.”

“Cate,” she said, taking the hand briefly.

“Take a pew, Cate. And call me Charles. I hope you don’t mind if I carry on?” he gestured to his sausage roll, and Cate shook her head, “If I don’t grab something now I’ll miss my chance.”

The seat was fairly low and placed her on eye level with a framed picture of a smart looking woman with a helmet of dark hair, who must be his wife. There was also a picture of a dog, a giant St Bernard slobbering on a ball.

“I’m just on my way to see Alice Mariani. This is my second visit; I came yesterday to bring her belongings.”

There was a pause as Charles swallowed, “Yes, I noticed she was looking smarter this morning. You should have seen her on Tuesday. How did she seem to you yesterday?”

“Very well, I think. At first, I thought she looked strained but then, when she’d got herself dressed and we started to talk, I couldn’t see that she was any different from Monday.” Cate hesitated, “As you pointed out, I’m not medically trained.”

Charles finished his lunch and leaned forward on his arms. He lowered his head and peered over the half moons of his glasses, listening.

“So if you could help me out, Charles? I just don’t understand why she’s here. Do you really think she’s a danger to herself?”

“Today she seems calm. But on Tuesday she was far from stable. As I said on the phone, she was raging. That rage could have been projected, or turned on herself, but she was in a fury. Have you ever heard of Brian Blackwell?”

“Sounds familiar. Was he the guy who killed his parents and then went on holiday the next day with his girlfriend?”

“That’s right. There was some suggestion his mother abused him – he was seventeen and she still bathed him. After he murdered her, he moved her body to the bathroom. But I digress. I mention him because Blackwell’s charge was dropped from murder to manslaughter on the grounds of diminished responsibility. He had a narcissistic personality disorder. That’s how lethal the disorder can be. And on Tuesday, I wasn’t going to take any chances. Alice was furious and I believed she intended herself harm.”

“What about now? She seems as well as before. Does she still need to be here?”

“Staff have reported her as being angry, and several have picked up on her arrogance. The occupational therapist said she joined in with some of the team-building activities, but acted very superior and refused to cooperate with parts of the session. Alice is asking to be released, but when I had her sectioned she was very vulnerable. Let me get my notes.” He found the case file in grey cabinet behind him, and read the notes. The file looked battered, and its cover was torn. “The interview went wrong very quickly. I started by asking if her mother had a normal pregnancy and labour. It’s a routine question.”

“How did she respond?”

“She seemed perplexed, and then told me that she was adopted when she was a child, so didn’t know much about the details of her birth.”

“Understandable.”

“So I moved on to the next section that is standard in psychiatric assessments, and asked about early experiences, starting with school.”

“Yes?” Cate leaned forward.

“She said that she was a good pupil, but never very popular, that she always felt different.”

“Different in what way?”

“I asked her that. She suggested she was ostracised because of her extraordinary beauty and intellect. Of course, this arrogance fits with my initial diagnosis. It seems she only had one friend, her inferior in many ways, according to her. And then she became agitated and tearful.”

“That can’t be unusual.” Cate herself saw many people in tears and every probation office had a box of tissues on the desk.

“No. But I have previous medical records, from her GP, detailing some work conducted when she was a teenager. Her mother had concerns about Alice’s unhealthy relationship with a friend, which was exclusive and probably sexual, and she was eventually referred to a clinical psychologist. I wanted to ask Alice about this, and it was when I pressed this point that she became destructive, throwing things and grabbing for my notes. She was shrieking again and again ‘I won’t go to prison!’” The torn file had been sellotaped, but Cate could still see the tear. “She was in a rage, grabbing and breaking anything she could, including the vase.”

Something shifted in Cate’s brain. Alice was refusing to go to prison. She remembered the broken glass on the floor. Snapdragons. The flowers were the same, but the vase had been swapped from the expensive blue to chunky yellow. She felt she was missing something, but what? She tuned back in to what Dr Gregg was saying, “We’ve got a new approved social worker at the hospital, so I called her to Alice’s house. She agreed with me that Alice needed sectioning. There was no way she would have come in voluntarily.”

Cate glanced at her watch. She was already late for her meeting with Alice. Then a thought came to her, something triggered by what Dr Gregg had said before. “You said Alice looked a fright on Tuesday. What did you mean?”

“She was wearing grey, baggy trousers, a well-worn t-shirt speckled with paint and, if you’ll forgive me, she wasn’t wearing a bra. She looked scruffy, and her hair was tangled and greasy. Very different to how she looks now.”

“What about her face?” asked Cate.

“She looked awful. Dark shadows under her eyes, a clear sign of sleeplessness, and a yellow pallor. She looked ill.”

Cate thought of the purple and grey makeup on the mahogany dresser, in shades she had never seen Alice wear. “And of course she had marks on her arm?”

“Superficial ones, yes.”

Finally, it all clicked into place. It was the vase that had been changed, not the flowers. Why would a vase be changed if the flowers were not dead? Like a dawning light, Cate knew what had happened. She spread her right hand, clawing the nails and scratched her lower arms, digging hard until red welts appeared on her skin. “Were her arms marked like this?”

Dr Gregg was about to protest, but she wouldn’t be stopped. Cate could suddenly see very clearly, and the vision was startling; she knew what had happened. She reached into her bag, removed some pewter shadow, peered in the tiny mirror within the case and smeared it under her eyes.

Dr Gregg was saying, “Cate, you don’t need to do this… ” but she didn’t stop. She knew she was right. Ignoring him, she rubbed until her eyes looked bruised and tousled her hair on to her forehead. Cate peered into her pocket mirror, at the dishevelled, hectic face that stared back at her, and marvelled at how easy it could be to lose one’s sanity. She showed him the marks on her arms, her chaotic face, “Did she look like this?”

Dr Gregg stared, his mouth slack. Perhaps he was thinking that she was mad. Then he sat back and carefully closed the file. “If you are right, then I must commend our patient’s acting skills.” He sighed, “But why would she want to put on an act?”

Cate thought about what Alice said yesterday, about her fear of going to prison. “To get a hospital order rather than a prison sentence. She went too far and you sectioned her, but I think she was leading you to recommend a hospital order. Isn’t it possible?”

“Maybe. But there’s something else you should know. That psychologist who saw her when she was just sixteen believed that she was exhibiting signs of a personality disorder. He even identified narcissism. She was already ill, all those years ago. Because of her age a firm diagnosis wasn’t made, but I think the notes show remarkable foresight. The episode on Tuesday, rather than being skilled acting, may in fact be a manifestation of a long-established case of narcissistic personality disorder. If she’s genuinely sick, and we mistake it for acting, she won’t get the help she needs. And that could be fatal.”

I’m sitting on the bed with a tray balanced on my lap. The food is unappetising: pale chips and sticky beans, a child-sized carton of milk. I’m dissecting the beans with a blunt knife when Cate Austin throws the door wide. She has my full attention. Her neck is bunched muscle, her jaw set and her face and hair are a mess. She speaks before I have a chance to swallow.

“Why didn’t you tell me you’d been treated for mental illness before, Alice?”

Her voice is fast over an undercurrent of resentment. I dab my lips with the paper napkin and push the tray aside. “I can’t eat this rubbish.”

“I’ve just been to see Dr Gregg.” Cate looks hard at me, demanding a reaction. “He told me that you already had a diagnosis, dating back to when you were sixteen. A personality disorder. You lied to me.”

“You’re wrong, Miss Austin. I was too young to be diagnosed. I’ve never said a word that wasn’t true.”