The Reach

'Not yet.'

'There's a girl whose case I've been keeping an eye on for a long time,' Shelley said. 'Right now she's in the Wasserman facility downtown. She's severely medicated, completely withdrawn for the past several weeks, though she has shown the ability to communicate. The director of the clinic has asked for my help in the past, and we've had some success. We haven't been able to reach her this time.'

'Is there a diagnosis?'

'Dr. Wasserman believes she has a schizophreniform disorder.'

Jess felt the familiar early buzz of excitement that came with an opportunity. 'How old is she?'

'Ten.'

'Awfully young for that sort of illness to manifest, isn't it?'

'It is. Here's the nuts and bolts of it, Jess. I'm not sure the diagnosis fits, but Dr. Wasserman disagrees. We do agree, however, that she may be more responsive to someone younger, less polished, if you forgive the description. To be honest, we could have given this to a counselor on staff, but I wanted to give the experience to one of my own.'

'I'm glad to have it.'

'Good. You have a rare mix of intellect and empathy. I think you might appeal to her. I want you to test her-- Stanford-Binet, Weschler, Peabody, Rorschach. Let's hear any hypotheses you might have, suggestions for treatment. Then, if I like what you've done and Sarah shows progress, I'll allow you to present the case to the board of trustees.'

'It would be an honor, Professor.'

'You'll do just fine, I'm counting on it. But I want you to understand something. This is not some case study from a textbook. It is not a hypothetical situation. This is a very disturbed child we're talking about. She can be unpredictable, even violent. She's had an unusual history from the moment she was born. I know because I delivered her. I've been keeping tabs on her ever since.'

Jess tried to picture a younger Professor Shelley in hospital scrubs. She had heard that the professor had been a practicing physician, but had thought it nothing more than a rumor. Shelley was a very good teacher. It seemed to Jess that she had been born to it.

'This girl is . . . unusual. She's been in foster care and institutions since she was little more than a year old. I don't know if she's seen the outside world more than a handful of times in her life. Don't misunderstand me. Most of the time she is simply catatonic, and that may be all she'll be for you. But I want you to be on your guard.'

Shelley rose, signaling an end to their chat. A thread on her cardigan dangled down and trailed through the papers on her desk, at odds with the rest of her. She didn't seem to notice.

--2--

The Wasserman Children's Psychiatric Facility is located in the Boston neighborhood of Mattapan, in a section of town that has not enjoyed the improvements new money can bring. It sits on the edge of a 250-acre parcel of land that formerly housed the Boston State Hospital for the mentally ill, until that campus was shut down in 1979.

The location is an odd mix of desolate, abandoned wild-lands in the middle of urban sprawl. In this particular neighborhood and its cousins, Roxbury and Dorchester, it is not unusual to hear gunshots on a sunny Wednesday afternoon. Still, the facility is as pleasant as it can be considering the circumstances, a large brick building resembling an elementary school, set well back from the road and against a backdrop of wild grasses and shrubbery, with a wide lawn and a playground in the rear. The only details that set it apart from other buildings of its type are the wire mesh and bars on the windows, and the chain-link fence and guardhouse, where the man or woman on duty has a police baton and pepper spray within easy reach. There are many disturbed young patients here, some in their late teens, not all of them easily controlled.

Dr. Wasserman stood when Jess Chambers entered his office, and extended his hand. He was a bit younger than she had expected, mid to late forties, balding in front and mildly effeminate, wearing a forest-green turtleneck and corduroys, and delicate glasses with thin wire frames balanced upon a hawkish nose. His grip was moist and limp, and he had a slight eye tic that made it seem as if he were trying to wink at her.

'So glad you could come. Jean has told me all about you. You're quite a student, isn't that so? Lovely to know of the talented young people joining the profession.'

'Thank you.'

'Please, sit.'

Dr. Wasserman's office was in marked contrast to Professor Shelley's organized clutter. Everything was neatly in its place here, from the framed diplomas and awards on the walls, to the neatly labeled file cabinets. A polished-wood coatrack stood in the corner. The huge oak desk was bare except for an intercom, pen and pencil, notepad, file folder, a lamp, and a notebook computer. Too neat; to Jess, it hinted at a compulsive personality.

Wasserman sat down behind the desk and leaned forward on folded hands, as if imparting a secret. 'Jean has told me the course and fieldwork you've completed so far, and has assured me you are competent. So I'll skip by that and assume that you'll handle Sarah extremely gently.'

'Of course.'

'Now, there are some things you should know before we proceed further. One, Sarah has no relatives and no visitors. She rarely leaves the grounds. If you'd like to take her anywhere during your visits, and I mean anywhere, even inside this building, you must contact me first. Agreed?' 'Fine.'

'Secondly, she is on a strict schedule of medication. This schedule must be kept to the minute. We'll try to plan your visits at alternate times, but that will not always be possible.'

'What is she on?'

'Hmmm.' Wasserman pushed at his glasses with a finger, opened the file folder on his desk. He punctuated each word by tapping on the file. 'Let. Us. See. Neuroleptics, mostly. And sedatives. Sarah is extremely sensitive and can be devilishly clever. We had a new orderly here once who felt such a number of pills weren't necessary. Sarah managed to get out of her room. It took us hours to find her. She'd holed up in a ventilation shaft. Lucky she didn't make it out to the street.'

Lucky for who, Jess could not help thinking. 'I understood from Professor Shelley that you would tell me a little about Sarah's psychiatric background. It would help to know the case history. Perhaps if I could look at your file--'

'We'd prefer you to open your own file. Start fresh, so to speak. We're really looking for a new perspective from someone who has no preconceived notions of the case. I can tell you all you need to know for the moment. Feel free to ask me what you like.' Wasserman stood up abruptly and took a white lab coat from the rack near the window. 'Shall we take a quick tour?'

***

The Wasserman Facility was indeed a converted school building. 'We're a modest enterprise, privately endowed, but we do receive the occasional grant for research purposes. We have three psychiatrists on call, not including myself of course, four full-time counselors, and a number of support staff. Classrooms and evening quarters on the second floor, private rooms and conference areas on the third. This first floor is mostly staff offices, along with a small exercise facility and playroom. And then there's the basement, where the more difficult patients are given quiet time.'

It was like most facilities Jess had seen. White tile floors, prints of colorful paintings hung on cream-colored walls, along with the occasional cluttered bulletin board and posters of children's television characters. They passed a small room that contained the sad remains of someone's birthday party: sagging balloons tied to the door handle, trash bags spilling over with paper plates and napkins. The corridors were cool, clean if a little tired. Everything had the look of having been scrubbed too many times.

Jess was reminded of her mother's struggle to keep her brother out of places just like this. Her youngest memories of Michael were filled with a sense of nostalgia mixed with regret. The Chamberses did not have enough money for proper treatment, and after her parents' divorce an even larger burden was assumed by Jess's mother. Eventually they had moved from the little saltbox in Edgecomb to a trailer park on Indian Road in White Falls. During their years living there Jess was constantly confronted with reminders of a life that could be hard and cruel. Drunks, wife beaters, and abused animals were her constant neighbors.

They walked back down the hall, their footsteps echoing through the empty corridor. An open doorway