"I felt that she had to trust me. I took a chance."
"A very dangerous one, according to Evan. Sarah has been aggressive with people before. You went in before she had her medication. He was extremely upset about that."
"What could she possibly have done? She's ten years old."
"That's not the point." Shelley paused. "Evidently there are problems between the two of you. I understand why. But the simple fact of the matter is that this is his hospital and his patient. You have to follow his rules."
Jess tried to keep down the sudden blood that rushed to her cheeks. She nodded, feeling like a scolded child. It was ridiculous, really. Shelley was right. And yet she felt betrayed.
"Tell me exactly what happened."
Jess related the previous day's visit, beginning with her arrival in Sarah's basement room. She tried to remember everything Sarah had said, each indication of her mental state, including her paranoia about the "white" people. Still, Jess had the frustrated feeling that she was unable to get across the thrust of events exactly the way they occurred. There were things that happened that would sound crazy if she repeated them now: the way the lights had blown out in the hall, the sudden jamming of the door locks, the way Sarah knew her medication was on its way long before there was any sign of Maria and the tray. Jess prided herself on her logical, orderly mind. Those things were not logical and she tried her best to dismiss them.
And yet she couldn't, damn it. They kept pushing themselves back in.
When she had finished, Shelley said, "She's all right, you know. Evan wanted it stressed, however, that she was in a very dangerous state and that it was touch-and-go for a while. Apparently she's had seizures before."
"Has she been tested for a lesion in the temporal lobe?"
"I'm sure they would have taken an EEG to rule that out."
"Her file had a lot in it about brain wave activity. Maybe they suspected some sort of damage, or tumor."
"I suggested it myself, actually, when Sarah was first assigned to state care. Though she was only a little over a year old, the symptoms indicated some physical trauma. We looked for swelling, collections of fluid, anything that might suggest an injury. We thought epilepsy, searched the readings very carefully. But there was nothing."
"She thinks she's in prison," Jess said. "They've got her scared to death."
Something must have shown in her eyes. Shelley leaned forward intently. "You've done more with her in your visits than that entire staff has in months. She had shut down entirely with me, saw me as some kind of enemy, which is one reason I haven't gone to see her the past few weeks. But she's connecting with you, you're building trust. That's good. That's one reason why we decided to bring you into this. Still, you have to be careful to view her as your patient and nothing more. Getting too attached can only be painful. There are bound to be setbacks."
Jess nodded. She had read about a case involving a young girl and a home care specialist; the child had been ill with a lengthy terminal disease, the sort that led to many highs and lows and false hopes. The specialist and the child spent most of the day together, and slept near each other at night. By the time she died the specialist had formed such a strong attachment that she refused to return to work, and in fact reported many of the same false symptoms of the disease. She described the death as if her own child had died.
"I want to ask you something," Shelley said. "This may be painful too and if you don't want to talk about it I'll understand. Earlier you mentioned your younger brother was autistic."
The use of past tense did not escape Jess's notice. Either Shelley had remembered from their previous conversation, or she had taken a guess. "And now you're wondering whether that has something to do with it. Whether I have some hidden agenda."
"The thought crossed my mind."
Maybe Shelley was right. She would have been a fool not to realize that her brother's death had pushed her toward child psychology in the first place.
Just because I'm interested in Sarah's case doesn't mean I'm looking for some kind of payback.
A familiar memory slipped up on her. Michael, standing on the sidewalk, the sound of the children in the playground, the noise of passing cars. She reached out to him but he did not see her. He did not see anything or hear her screaming.
"I was supposed to be watching him. We were near the park. My mother was at a pay phone and Michael stepped out into traffic. He was hit and killed instantly."
After countless looks of pity and murmurs of sympathy through the years she had learned to keep the whole thing to herself. But Shelley's reaction was not the one she had expected. Shelley simply looked at her and said, "And you blamed yourself for this."
"My mother had put him in my care. I knew what he might do. I should have stopped him."
"You were how old?"
"Nine."
"You must see," Shelley said gently, "how ridiculous that is."
"I was old enough for it to matter."
"Of course. But not old enough to be blamed for it."
Shelley said this as if it were a common truth. And Jess supposed that under normal circumstance it was, but she was not a normal girl. She knew what she was capable of and what she wasn't, and that was what had made it so difficult. Anyone could say that she had been too young, that her mother should never have left her alone with him. But that didn't change anything. It only shifted responsibility.
"And what happened then?"
"My mother started drinking more heavily, staying out at night. She treated me as if I weren't there. I suppose she blamed me too, in her way."
"Or herself, for leaving you to watch him."
"Maybe so." But now they were getting too far off the subject. She did not want to dig into the past any longer. Suddenly she felt as if there weren't enough air in the room to breathe.
"I've thought this case over very carefully. I've studied the facts and the data at hand and I do not believe Sarah is schizophrenic. She has some obvious adjustment problems and hostility toward the staff, but I won't know what else she needs until she's given a better chance to be lucid. I don't believe she should be locked up alone and I don't think she's a danger to anyone."
Jess listed off her reasons; Sarah had followed their conversation, been receptive to questions, showed short-term memory recall, scored well on cognitive tests. Her paranoia about the people in white seemed valid given the circumstances. And there were other, less tangible reasons; Jess might have called them gut instincts.
"Perhaps the antipsychotics are finally having an effect?"
"I just don't see it happening all at once like that. According to Dr. Wasserman she's been having breaks with reality for several years now, and the medications haven't done a thing. She's been so withdrawn and then so violent they've been forced to confine her to what is basically a cell. But I've seen little evidence of any of that."
Wasserman's voice, inside her head: she can be devilishly clever. Sarah playing possum. Could she be doing that again now? But she couldn't be this clever, Jess thought. How could you be psychotically disturbed and still plan such an elaborate game?
Instead of dismissing her, Shelley looked troubled. "I feel like I let her down," she said. "I should have been more involved the past few months, checked in more frequently. When Evan called I was ashamed because I hadn't looked in on her recently." She paused and her long, elegant fingers plucked absently at her sleeve.
"I've been distracted," Shelley said. "But of course that's no excuse."
"You could come with me to see her. It might do her some good."
"Sarah may associate me with the people in white coats. She'd see you with me and then in her mind you'd be one of them too."