“I don’t have a salesman’s sample case with me,” Carver said. “And I sometimes think I might be going mad, so I must be sane.”
“Uh-hm. Which patient did you want to discuss with the doctor?”
“Paul Kave. I’ve been hired by his family to try to locate him. I really could use Dr. Elsing’s help.”
At the mention of Paul she uncrossed her arms and sat forward. The Kave name was magic in places where money changed hands. Dr. Elsing wouldn’t like it if Beverly pissed off Adam Kave, even indirectly.
She lifted her pale green phone delicately, as if it might be coated with something that would burn her fingers. Then she pecked out a number with a long pencil to protect her painted nail, and explained the situation briefly to Dr. Elsing.
“He’s with a patient now,” she said to Carver, replacing the receiver. “He’ll talk to you in about twenty minutes, if you’d like to wait.”
“I’d like,” Carver said.
He limped across the soft green carpet and sat down in a leather Danish chair that sighed as it took the brunt of his weight. Beverly glanced with disinterest at his cane, then got busy with paperwork. The maimed were the maimed, physically or mentally. Infirmities were all the same to her, whether she could or couldn’t see them.
Ten minutes later an unbelievably obese girl in her teens wedged herself through the reception-room door and said hello to Beverly. Beverly smiled and said hello back, calling the girl Marie. Marie had a face that was all flesh-padded sweetness. She said a shy “hi” to Carver and sat down as far away from him as possible. The chair popped and groaned beneath her. Then she picked up a Seventeen magazine and started leafing through it, and Carver ceased to exist.
Some seventeen it must be for Marie, he thought. Grossly overweight and seeing a psychiatrist. Fate was a sadist.
Then it occurred to him that Chipper would never see any kind of seventeen, and he felt less pity for Marie. He looked at the four-color, glossy ad for skin cream on the back cover of the magazine, then looked at Beverly, who was engrossed again in making entries in a large ledger book with pages that crinkled as she leafed through them.
“We can talk in about five minutes, Marie,” a man’s voice said. It was a soothing voice that came down softly on the crisp consonants. If voices had color, this one would be green.
Dr. Roland Elsing was standing by a light-oak door that had just opened. He was a medium-height man in his late forties, with a balding pate and a moon-shaped face that had deeply etched lines, like bloodless incisions, running symmetrically from the sides of his nose to the corners of his thin lips to form a sort of triangle. They were the kind of lines people with poorly fitted dentures developed. He wasn’t dressed the way Carver imagined psychiatrists clothed themselves; he had on a windowpane check sportcoat, wrinkled charcoal slacks, and brown shoes with thick and wavy gum-rubber soles and heels. Practical shoes, made more for comfort and hiking than for impressing wealthy clients who wandered in with phobias and fat wallets. Emmett might be wrong about this guy.
“Mr. Carver?”
Carver leaned on the cane and stood up.
“Come in, please.” No flicker of eye movement to the cane. Elsing opened the door wider to make room for Carver to pass.
The soft green decor was carried into the office. There were tall, glass-lined bookcases along one green wall, with books and papers stuffed into the shelves in a jumble. The doctor’s desk was dark mahogany. The thick brown drapes behind it were closed. A pale ceramic bust of someone who looked like Beethoven sat on top of one of the bookcases, gazing down on the scene with blank eyes. There was a tiny beige sofa in the room, a love seat. Also a comfortable-looking chocolate brown easy chair. Though it was afternoon, a brass gooseneck lamp with a green-tinted shade glowed on Elsing’s desk. It was a restful room, unnaturally quiet. Almost made you wish you had mental anguish so you could come here now and then and pass the time. It was impossible to hear the street sounds down on Commercial.
Elsing smelled like tobacco. He motioned for Carver to sit in the comfortable chocolate brown chair, then sat down behind his desk heavily, as if his feet had been hurting. That might explain the sloppy, comfortable shoes. The pipe rack holding half a dozen well-used wood pipes explained the tobacco smell. The doctor bowed his head, then looked up and smiled expectantly. Carver figured in another couple of years the crown of Elsing’s head would be as bald as his own. Tough shit.
“You wanted to talk about Paul Kave?” Elsing said. Right to business; time was something not to be wasted, and the way not to waste it was to take control of the conversation immediately.
“That Beethoven?” Carver asked, pointing to the ceramic bust.
“Uh, yes it is.”
“I wondered.”
“Mr. Carver-”
“Paul’s family’s hired me to try to find him before the police do,” Carver said.
“Paul’s my patient, Mr. Carver. Naturally I respect the confidential nature of that relationship. There isn’t much I can, or will, tell you about him.”
“Have the police talked to you?”
“Yes. I told them no more than was necessary.”
Carver felt himself getting irritated despite all the greenness. “Doesn’t the Hippocratic oath take a backseat to murder?”
“Of course. And I cooperated with the police. But I don’t think Paul killed anyone. This entire affair is some sort of tragic confluence of circumstance, and I don’t want to add to the misdirection.”
Carver felt like giving the good doctor a lesson in admissible evidence, but he didn’t want to lose him. “Then we’ll speak only in generalities, Dr. Elsing. Tell me about schizophrenia. The kind Paul Kave suffers from.”
Elsing’s lips curved into a momentary smile. The lines swooping from the sides of his nose deepened. “You make it seem so easily categorized,” he said in his soft, soft voice. “There’s a lot not known about schizophrenia, Mr. Carver. It usually strikes its victims when they’re young, between the ages of fifteen and twenty-five, and it lasts for decades. It gets progressively worse if not controlled. Seldom better. It’s still one of medicine’s most elusive mysteries. And an illness that’s prompted a great many public misconceptions. Read the papers about the search for Paul Kave and you’ll see what I mean. Schizophrenia isn’t at all as most of the media assume.”
“What causes it?”
“That we don’t understand precisely. One theory is that it has to do with dopamine, a chemical that passes between nerve endings in the brain. In a so-called normal person, stress causes the dopamine levels to drop. This lessens the intensity of the signals that pass between nerves. Not so with schizophrenics. Their brain activity is heightened tremendously by stress. The chemical imbalance causes various symptoms, among them imaginary voices, irrational thoughts. The world can seem like an ominous madhouse to an advanced schizophrenic.”
“So it’s really a physical illness that causes mental problems.”
Elsing shook his head slowly, as if to say it was impossible to give Carver a course in psychiatric medicine in five minutes. “The chemical imbalance triggers certain reactions, Mr. Carver. And as I said, this is one of several theories. We do know that three million people, more than one percent of the population, will at some time suffer from the disease during their lives. It would behoove us to learn much, much more about it.”
“What sort of treatment was Paul’s?”
“Analysis and, when he was entering a bad period, medication.”
“What kind of medication?” Carver asked. He saw Elsing notice his piqued interest and wasn’t sure if the doctor would answer. The muted ringing of a phone filtered in from the outer office; Beverly caught it on the third ring.