pediatricians, none of that mattered.
She had dropped off all committees, hadn't picked up a tennis racket in weeks, and couldn't remember the last time she and Jim had had sex.
Something was wrong, terribly wrong, with her son. And not only could none of the so-called specialists they had seen diagnose the boy's problem, but each seemed bound and determined to convince her that it fell in someone else's bailiwick. The violent episodes, occurring at first monthly, but now almost once a week, had enveloped Toby in a pall of melancholy and fear so dense that he no longer smiled or played or even spoke, except for occasional monosyllables in answer to direct questions-and then only at home. Situational depression, delayed autism, childhood schizophrenia, developmental arrest with paranoid ideation, acting out for secondary gain, the labels and explanations for Toby's condition were as varied-and as unacceptable-as the educators and clinical specialists who had applied them. The boy was sick, and he was getting sicker. He had lost nearly ten pounds from a frame that had not an ounce of fat to begin with. He had stopped growing. He had failed to satisfy the requirements for promotion to the fourth grade. He avoided interacting with other children. He had been given vitamins, antidepressants, Thorazine, Ritalin, special diets. She had taken him to Concord, and then to Boston, where he had been hospitalized for four days. Nothing. Not a single objective clue. If anything, he had returned from the medical mecca even more uncommunicative than before. Now, as she prepared to drag her son to yet another specialist-this one a young psychiatrist, new in town, named Brookings-Barbara Nelms felt the icy, all-too-familiar fingers of hopelessness begin to take hold. Toby's episodes at first seemed like horrible nightmares. Several times she had actually witnessed them happen-watched helplessly as her son's eyes widened and grew glassy, as he withdrew into a corner, drifting into a terrifying world he would share with no one. She had listened to his cries and had tried to hold him, to comfort him, only to be battered about the head and face by his fists. In the end, there was nothing she could do but stay close, try her best to see that he didn't hurt himself, and wait. Sometimes the episodes would last only half an hour, sometimes much longer than that. ' 518 Always they would end with her son mute, cowering, and totally drained. Perhaps this will be the day, she said to herself. Perhaps this man, Brookings, the first full-time psychiatrist in the valley, would have the answer. But even as she focused on this optimistic thought, even as she buttoned her blouse and smoothed the wrinkles she should have ironed from her skirt, even as she went to her son's room to fetch him for yet another evaluation at yet another specialist's office, Barbara Nelms knew that nothing would come of it. Nothing, perhaps, except another label. And time, she also knew, was running out. The drive from their house to the Ultramed-Davis Physicians and Surgeons Clinic took fifteen minutes. For most of the ride, Barbara Nelms kept up a determined conversation with her son-a conversation that was essentially a monologue. 'This doctor's name is Brookings, Toby. He's new in town, and he specializes in helping people with attacks like yours… We're going to get to the bottom of this, honey. We're going to find out what's wrong, and we're going to fix it.
Do you understand?'
Toby sat placidly, hands folded in his lap, and stared out the window.
'It would make it easier for Dr. Brookings to do his job if you would talk to him-tell him what it is you see and feel when you have the attacks. Do you think you can try and do that?… Toby, please, answer me. Will you try and talk to Dr. Brookings?'
Almost imperceptibly, the boy nodded. 'That's good, honey. That's wonderful. We all just want to help.
No one's going to hurt you.'
Barbara Nelms thought she saw her son shudder at those words. She swung her station wagon into one of the few spaces left in the crowded parking lot, locked her door, and then walked around the car to let Toby out. It was a promising sign that he had unbuckled his safety belt himself.
Instantly, hope resurfaced. Perhaps this would be the day. The only other time she and Toby had been in the Ultramed-Davis Physicians and Surgeons Clinic was for a brief follow-up visit with Dr. Mainwaring.
Toby's pediatrician worked out of an old Victorian house on the north side of Sterling. A directory, framed by two large ficus trees in the gleaming, tiled lobby, listed two dozen or so doctors, along with their specialties. Phillip R. Brookings, MD, Child and Adult Psychiatry was on the second of the three floors. 'Toby, do you want to take the stairs or the elevator?… Honey, I promise you, Dr. Brookings just wants to talk. Now, which will it be?… Okay, we'll take the stairs, then.'
Barbara took his hand and led him up the stairs, half wishing he would react, make some attempt to pull away. He was plastic, emotionless.
Still, she could tell he was completely aware of what they were doing. A small plaque by the door to room 202 read P. R. BROOKINGS, MD, RING BELL ONCE AND ENTER. The waiting room was small and windowless, with textured wallpaper, an array of black-and-white photographs of mountain scenes, and seating for only four. At one side was a small children's play area, consisting primarily of dog-eared Highlights magazines, multicolored building blocks, and puzzles, none of which, Barbara knew, Toby would be interested in. She ached at the image of her son before it all began, huddled on the floor with his father, pouring excitedly over his Erector Set. No, Daddy, this way… turn it this way… See?
At precisely three o'clock, Phillip Brookings emerged from the inner office, introduced himself stiffly to her with a handshake and to Toby with a nod. He looked even younger than she had anticipated-no more than thirty- two or — three, she guessed, although his thick moustache made it hard to tell. As so often had happened over the preceding months, Barbara found herself wondering if she had aged so much, or if doctors were actually getting younger. 'So, ' he said, taking one of the two remaining empty chairs, 'welcome to my office. Toby, I appreciate your coming to see me, and I hope we can help you to feel better.'
He wore a button-down shirt and tie, but no jacket, and Barbara's initial impression, despite his youth, was positive. If nothing else, he had started off on the right foot by not talking down to the boy. She glanced over at Toby, who sat gazing impassively at the photos on the wall. 'Here's the medical history form you sent us, Dr. Brookings,' she said, passing the paper over. 'You have the other reports I sent you?'
Brookings nodded and briefly scanned the sheet. 'I think, ' he said,
'that if it is all right with Toby, I would like to speak with him alone in my office. What do you say, Toby?… We can keep the door open if you want, okay?'
He stood up and stepped back to the doorway of his inner office. 'Are you coming?'
'Go ahead, honey, ' Barbara urged. 'I'll be right here. Remember what I said. There's nothing to be afraid of.'
Slowly, Toby rose from his chair. 'Wonderful, ' Brookings said. 'Come in. Come in.'
Silently, but with every fiber, Barbara Nelms cheered her son on.
He was being more cooperative, more open to this man than he had been to anyone she had taken him to in some time. Perhaps, at last, he was ready. Perhaps… She watched as Brookings disappeared into his office.
From where she sat, directly opposite the doorway, she could see a roomy, comfortably furnished office with a large picture window, and plants arranged on the floor and hanging from the ceiling. Go on, darling Go ahead in. It's okay. It's okay. After a brief hesitation, Toby followed Brookings in. Then, after a single, tentative step inside the door, he stopped, his gaze riveted on the broad picture window across from him. 'Come in, Toby, ' Barbara heard Brookings say. 'I'm not going to hurt you.'
Barbara could see Toby's body stiffen. His hands, which had been hanging lifeless at his side, began to twitch. Dear God, she thought, he's going to have an attack. Right here.
Right now. 'Toby, are you all right? ' Brookings asked. Toby took several backward steps into the waiting room, his face chalk white, his eyes still fixed on the window. 'Honey, what's wrong? ' Barbara felt her muscles tense. No one but she and her husband had ever witnessed one of the attacks before. Frightened as she was, she sensed a part of her was actually grateful for what was about to happen. At least someone else would know what they had been going through all these months.
Instinctively, she glanced about for any objects on which Toby might hurt himself. Then, suddenly, the boy turned, threw open the outer office door, and raced out into the hall. 'Toby! ' Barbara and Brookings, who had come out of his office, called out in unison. The psychiatrist was across the waiting room and out the door before she had left her seat. Barbara reached the corridor just as he disappeared through the stairway door. Her pumps were almost impossible to run in.
At the head of the stairs she kicked them off and skidded down to the first floor, falling the last three steps and skinning her shin. As she limped into the lobby, Barbara heard the horrible screech of an automobile's tires and froze, anticipating the sickening thump of the car hitting her son. There was none. Instead, through the glass
