armrest. Engaged in the conversation, Nate relaxed in the navy blue chair across from Susan’s. The table between them held two palm-prosses, the one she had been using to type in notes about her meeting with Sharicka Anson’s parents and the one Nate had been using to proofread the day’s endocrinology entries. Currently, both lay closed as they talked about Monterey.
“Okay,” Susan said. “We’ve established we’re a normal six-year-old girl safely buckled into our car booster. In the front, Daddy is driving. For some reason, he has his seat belt undone.”
“Why?”
“That’s what we’re trying to establish. The car won’t start without his belt buckled, so we have to assume it was buckled at one time.”
“So he unbuckled it.”
“Yes.”
“Why?”
Susan wondered if Nate was deliberately playing stupid to try her patience. “Why indeed? That’s still the million-dollar question.” She heaved a slow, deep sigh. “We know from history he’s either an excellent father or is just remembered that way to honor his memory. For now, let’s assume it’s true. That presumes he kept his seat belt buckled until some point when he unbuckled it.” Worried Nate might insert another “why” and she would have to strangle him, Susan continued. “And about that same time, the car was involved in a deadly crash. The two events are clearly connected.”
Fatal crashes had become much less frequent in the last decade since the outfitting of vehicles with sensors, monitors, alarms, and internal navigation systems. However, many people still drove older cars or overrode systems that became as much nuisance as help. The current airbag designs were safer for children at the expense of adults, except around the driver’s seat. Cars no longer started without a driver breath analysis, all seat belts in place, and a fingerprint key, so she had no reason to believe Monterey’s father had been drunk or high or medically incapacitated. At the least, those would have shown up on the black box.
Nate finally did something more than question. “I think we can discard the possibility that the father unbuckled because he anticipated the crash. Unless we have reason to believe he intended to kill both himself and his daughter?”
Susan shook her head. By all reports, father and daughter had shared an intense bond. He adored her, and the feeling was mutual. Monterey’s extreme reaction to his death confirmed that description. “Now, a conversion reaction is the involuntary loss of a bodily function, such as speech, that has no biological explanation.” Nate nodded matter-of-factly as Susan continued. “If we dissect a conversion reaction, there is always logic at its core. Often, it’s a strange logic, but logic nonetheless.”
Nate sat up straighter. “Now you’re getting into the realm of primary and secondary gain.”
Susan stiffened at his use of medical terminology, then laughed. “I keep forgetting you’ve read all those medical texts and edited thousands of charts. Sometimes I lose track of the fact that I’m not discussing this with my usual sounding board, my dad.”
“I’ll take that as a compliment,” Nate said. “Your dad’s a brilliant man.”
Susan could only agree. She had a great respect, as well as affection, for her father. “Primary gain: Not speaking somehow lessens her anxiety about either the crash itself or the loss of her father. Secondary gain: Admission to the hospital and focus on her muteness allow her to avoid mourning her father, talking about the details of the crash, and gains her the full attention of mother and staff.”
“How does not speaking decrease anxiety?”
Though simple and obvious, the words sent Susan’s thoughts in another direction. Her own mind distorted the question to how not eating with others/never dating would decrease anxiety. She sat bolt upright. “Oh, my God! My dad’s having a conversion reaction.”
Nate stared. No one outside of Susan’s head could have followed that conversational leap. “What?”
“Sorry. I just had an epiphany about something that’s made me curious for about twenty years now.”
Nate guessed, “There’s overlap between Monterey’s case and your father’s?”
Susan nodded. “I’ll deal with that later. With him.” The realization opened her to a new line of thought. “Nate, there’s the obvious. If Monterey can’t talk, she doesn’t have to relive the accident verbally. She doesn’t have to talk about her father. But what if there’s more? What if words coming out of her mouth caused the accident in the first place?”
“Voice feature to change the radio station? Perhaps the sudden switch startled him?”
Susan felt certain that was not the answer. “Something that caused her father to unbuckle his seat belt, as well as distracting him. Something like . . .”
Nate caught on quickly. “A request for something beyond his normal reach.”
“A dropped toy or some food, perhaps.” The logic seemed infallible. “She has something important to her. Playfully or accidentally, she tosses it into the front seat area. She asks for it back. Dad unbuckles and is reaching for it, loses sight of the road for a moment, and the crash happens.”
Nate continued the thread. “Monterey blames herself and can’t process the emotions of an event this traumatic. So she expresses the psychological conflict through mutism.”
Susan nodded broadly. “And it would also explain something I’ve noticed in the chart but didn’t give much credence to.”
Nate waited patiently this time.
“I’ve noticed there’s a difference in what her female nurses chart compared to the males. In the males’ notes, she’s nearly comatose, while the females document some episodes of nonverbal communication. I’ve experienced that myself, while the resident who had her before me, Aiken Mallory, could not get her to respond to him in any way.”
Nate drew himself up to his full height. “Why don’t they just assign her female doctors and nurses?”
“Patterns are always easier to see in hindsight, and you have to make the assumption first. I’m going to suggest all female nurses for Monterey at rounds tomorrow.” Susan looked Nate over carefully, and another idea came to mind. “And I’m going to suggest a visit to meet you.”
“Me?” Nate clearly did not follow again. “What good would that do? According to you, I’m indistinguishable from a regular, boring male.”
Susan smiled broadly. “Except for one very important difference.”
Nate guessed, “My circuitry?”
“You can’t die in a car crash.”
Susan Calvin broached the subject with her father over a dinner of stew that she ate alone as they talked. “Dad, I used to love the big family meals with Mom.”
John dodged her gaze. “I thought we were talking about what you did at work.”
“We are,” Susan assured him around a mouthful of whole grain roll. “I have a patient who hasn’t spoken since the car accident that killed her father. And a father who hasn’t dated or eaten since the car accident that killed his wife.”
“I eat,” John protested.
“Not that I’ve seen. Not for years.”
John shrugged. He reached across the table, snagged a carrot from Susan’s stew, and took a bite. “Happy?”
Susan rolled her eyes.
John chewed and swallowed before explaining. “It’s not that I can’t eat with people anymore. It’s just that food doesn’t taste right since the accident, and I never know if something’s going to hit me the wrong way while I’m with a friend or an important client. Why spend a fortune on gourmet cooking that tastes like cardboard or plastic or dish soap? Eating in groups also makes me think of your mother, and that makes me sad. Grief is entirely normal.”
“Grief is normal,” Susan confirmed. “But it’s not supposed to keep people from participating in normal life experiences forever. Don’t you think that, after twenty years, you should have gotten over it enough to do something as ordinary as eating in public?”
