“Besides,” Shaden added, “the Ansons are going away next weekend. It’s today, or they have to wait two weeks.”
The nurses seemed so earnest and eager, and both had excellent reputations on the unit. Susan sighed. “I do believe Sharicka is making an honest effort. But do you really think she’s ready?”
Shaden made an important point. “If she were on some of the older antipsychotics, no. They can take weeks or months to really work. But she’s on hefty doses of Antoladol and Vilyon.”
Susan knew the second-generation neurotransmitter stabilizers did act quickly. Some psychiatrists started at subtherapeutic doses and worked their way up slowly, but Sharicka was already at the maximum dose for her size. Her previous R-1 had raised it, not knowing that Sharicka had been hiding her medications. “You’re sure she’s swallowing them?”
Shaden could have taken that as an insult. It implied, and quite rightly, the nurses had not acted thoroughly and properly in the past. Providers assumed people took their medication; and, under most circumstances, would not bother to check. It was a patient’s prerogative not to fill a prescription or take a medication, even one he required to live. But an underage mental patient in a locked unit ought to have better than usual attention paid to such details. “Sharicka is taking great pains to prove to us the meds are going down her throat.”
Susan doubted she wanted the specifics. “I’ll talk to the Ansons,” she promised, “but I’m not going to push them. If they decide they can’t handle her, we wait at least a week before presenting the possibility again.”
Shaden bobbed his head, clearly finding the conditions reasonable. “I’d like to come with you.”
Susan bit her lower lip. She was not the sort of person to squash conflicting opinions, and he was Sharicka’s most frequent caretaker. Although he had a soft spot for the girl that did not always seem logical, he was a competent professional with far more PIPU experience than she. The Ansons had run into people like Shaden many times. They would understand his point of view. Just maybe, Shaden would learn to value theirs as well. “All right. When do you want to do it?”
Shaden smiled. “They’ve had a solid forty minutes together. How about now?”
“Now suits me fine.” Susan swallowed her misgivings, turned toward the door, and they headed for the conference room together.
Chapter 17
Saranne handled unlocking the metal door and escorting Sharicka back to the ward, while Susan and Shaden remained with the Ansons. They looked different to Susan somehow: less morose, more animated and alive. Lucianne’s eyes had a faintly hopeful glimmer, and Elliot’s face bore just a hint of a smile. He stepped forward, his hand outstretched. “Good afternoon, Dr. Calvin.” He took her hand and shook it, nodding at the nurse as he did so. “Shaden.”
“Good afternoon, Dr. Anson,” Shaden replied respectfully.
Susan addressed the mother, still sitting on the chair where Sharicka had recently perched in her lap. “Hello, Dr. Anson.”
Susan shut the door as the others took seats around the table; then she joined them. The couple sat together, doctor and nurse across from them. Lucianne spoke first, “Sharicka says you ‘fixed’ her. I hope she doesn’t mean . . .”
They all chuckled, though somewhat uneasily. The idea had to flash through more minds than just Susan’s that Sharicka should never bear children. It chilled her to even consider the cruelties someone like Sharicka could inflict on a helpless infant. “Sharicka will always be Sharicka,” Susan said. “I’m concerned we’re all prematurely optimistic, but I have to admit she does seem to have become honestly committed to improving her life and the lives of those around her.”
Shaden nodded vigorously. “She credits Dr. Calvin with inspiring her to do her best. She’s taking her medications like clockwork, and she hasn’t acted impulsively in days. She’s even made some real friends among the other patients.”
Though Susan could not deny the truth of those statements, she wished Shaden would tone down his rhetoric. The Ansons had seen the many cycles of Sharicka, and they knew better than to pin their hopes on a few days of cooperation — or so she hoped. She had read enough books, had studied enough couples and parents, to know human emotions lived in the moment. She had seen mothers in supermarkets ready to fricassee their young one moment and buying them ice cream the next. Nature had endowed children with the ability to bring out the best and worst in adults from moment to moment, and love tended to drive humans to illogical faith and actions.
Lucianne sucked in a deep breath, releasing it gradually through pursed lips. “You say she’s committed to improving her life. But, given her” — she glanced at Shaden, then back to Susan — “her diagnosis, is that even possible? Can she even understand morality? The difference between right and wrong?”
“All sociopaths understand the difference between right and wrong, especially ones as intelligent and well- raised as Sharicka,” Susan replied. “I’ll bet she could recite the rules of your household, and the reasons for them, in her sleep. What they lack is empathy, compassion, guilt, remorse.”
Susan took the discussion into the realm of Lucianne’s understanding, childhood special education. “You know how children with a nonverbal learning disability rely on spoken words and explanations? They can’t intuitively grasp nonverbal communication. They don’t ‘get’ tone of voice, figures of speech, gestures, personal space, facial expressions, humor, and so forth?”
Lucianne and Elliot both nodded, and the mother added, “If you catch it early, those things can be taught with repetition, verbal explanations, physical outlines, and behavioral rewards. It works for higher-functioning autistics, too.”
Susan appreciated that they had not only followed her example but improved upon it. “If you start young enough, you can internalize the lessons to the point where at least some of those skills can seem almost normal. Kids with NLD can eventually use idioms correctly. They may not tell jokes, but they know one when they hear it and laugh in the appropriate places. Their own faces may be expressionless, but they learn to recognize other people’s moods by rote.”
“Right.” Lucianne cocked her head in consideration. Color formed in her cheeks and gradually spread to light her entire face. “Are you suggesting we might be able to teach Sharicka . . . remorse and compassion?”
Susan did not know. Historically, the success rate for treating people with sociopathy was abysmal. However, that had changed in the last few years with the creation of the second-generation neurotransmitter stabilizers. Since antisocial personality disorder could not technically be diagnosed before age eighteen, the literature about treating children for it was nonexistent. She wondered if they had just stumbled upon a brand-new treatment for juvenile conduct disorders. “I’m not sure,” she admitted. “Until now, Sharicka hadn’t shown any insight into her problem. Now that she acknowledges it, and has expressed and acted upon the intention to change, I think we might have a chance.”
Elliot laced his fingers on the tabletop. “She does seem . . . different,” he admitted. “More like . . . our Sharicka. The one who used to fall asleep watching a movie in my lap. The one who loved ‘hangaburs’ and ‘pockasickles’ for dinner and begged for just one more story at night.”
Lucianne smiled at the memory. For the first time since Susan had met her, she looked like a typical mother misty-eyed over a child’s scribbled drawing of her. “Do you think . . . now that she’s really taking her medication . . . ?”
Susan felt torn. “I think . . . she is really trying, yes.”
“She loves your family,” Shaden cut in.
Susan did not like his phraseology. It made it sound as if Sharicka stood apart, that they had never really accepted her as a full-fledged member. “She loves
