funeral. Lou was accustomed to seeing the effervescent woman lodged behind her desk in the cramped Physician Wellness Office. But throughout all the tragic clients, disciplinary hearings, and budget crises, he had never seen her looking so deeply concerned.
“He’s waiting for you in his office,” Peterbee said as he approached her meticulous workstation.
“Mood?” Lou asked.
“Cat 5. I’m so sorry, Dr. Welcome.”
It was a poorly guarded secret that the staff at the PWO measured Walter Filstrup’s demeanor on the Saffir- Simpson scale, the one used by meteorologists to rate the power of hurricanes. The director seemed to enjoy his reputation and fostered it. Most days, Filstrup was a Category 2: strong winds. A couple of times that Lou remembered, he spiked up to a Category 4. But never in the two and a half years since the shrink was hired to run the PWO had he been labeled a Cat 5 by any of the staff.
“The only thing I have to fear, is fear itself,” Lou said, giving Peterbee a Winston Churchill
Okay, he was more nervous than he was willing to admit.
“I wish that were the case, Lou. I really do,” she responded. Peterbee puckered her face, possibly holding back tears.
“Hey,” Lou said, “we both know I’ve been through worse.”
“Just don’t let anyone change you. Since you got here, you’ve made a huge difference in the lives of a lot of people.”
“I can only be me,” Lou sang to the tune of the Sinatra song.
The PWO somehow managed to squeeze four cubicles, a reception desk, small conference room, supply closet (where they also kept the printer and fax machine), and Filstrup’s office into 850 square feet of space. Teeth on full clench, Lou knocked on the director’s closed door, imagining his dentist, Dr. Moskowitz, poised by one of the space-age chairs in his dental office, licking his chops as a couple of crowns drew ever closer.
“Come on in,” he heard Filstrup say. The man sounded bright and unburdened.
Filstrup’s office was, as usual, cluttered and uninviting. His bookshelves overflowed with medical textbooks, and his desk was lost beneath dictations, articles, and client’s charts-an absolute HIPAA nightmare. By contrast, the psychiatrist himself was neatly and nattily dressed in a favored blue suit, crisp white dress shirt, and solid gray tie. He was a trim, modestly built man. His horseshoe head of hair was a chestnut brown, his glasses gold wire- rimmed, and his face without distinctive features.
Filstrup took off his glasses, cleaned them with a tissue, and rubbed at his eyes. “Sit down, Lou,” he instructed. His deep baritone was belied by his size.
Lou removed papers from the Aeron chair, set them down on the carpeted floor, and took the seat himself.
“So, how are you holding up?” Filstrup asked.
There was no detectable anger in his voice, which was a source of some surprise. Where was the rage? That crimson forehead?
“I’m doing okay, Walter,” Lou said, “given the circumstances. How about you?”
“I’m doing all right-given the circumstances,” Filstrup said.
“Walter, let’s cut to the chase,” Lou said. “I’m assuming you asked to meet with me to discuss the situation in Kings Ridge.”
Now almost smirking, Filstrup snapped open up a case file that Lou assumed belonged to John Meacham. Lou watched as his boss flipped unhurriedly through the pages.
“We talked about this case when I took over as director for the PWO. Do you remember?”
Lou managed a microscopic nod.
Walter Filstrup had assumed the helm of the PWO from Dr. Abigail Stevenson with all the grace and patience of a deer trapped in a living room. His first act was to demand that the two assistant directors review, in front of him, all the active cases. The ADs were Lou and a passive little psychiatrist named Ollie Comer, who had been there since the program’s inception twelve or thirteen years ago, and was on the tail end of a profound, protracted burnout.
The discussion surrounding John Meacham was not pretty. During the pitched battle over Lou’s choice of treatment, Comer, who was not in recovery, and had actually been Lou’s monitor following his release from rehab, said not a word.
“John Meacham should have been seeing a psychiatrist,” Filstrup said now, echoing his position from that unpleasant day after he had taken over the operation.
“You say it like it’s a fact, Walter,” Lou countered, as he did then, “as though there isn’t another option that would have worked.”
“For a case like John Meacham, there isn’t,” Filstrup shot back.
Now Lou had to once again clench his jaws to keep himself from a useless, inflammatory, snide retort.
When Filstrup took over the PWO, John Meacham was doing just fine. He was attending AA meetings daily, sometimes twice a day, abstaining from any alcohol or other drugs, and not surprisingly, given the work he was doing on himself, keeping his anger issues in check. Twelve steps to remaking a life-and John Meacham had taken them all, and would keep on taking them, Lou firmly believed.
“Alcoholism is a disease, not a moral issue, Walter. We’ve been through this before.”
“No, you’ve been through this with me. And I haven’t agreed.”
“You haven’t listened. I know what I do here works. I have successful case after successful case to prove it.”
“Why? Because you were once a drug addict yourself? That gives you all the authority here? It’s been my opinion, Lou, that your past experiences don’t help your judgment. They cloud it.”
“John didn’t need psychotherapy, if that’s what you’re getting at,” Lou said. “He needed to get sober and to keep going to meetings, and that’s what he was doing.”
“Until he killed seven people. I can’t think of one of your cases that shouldn’t have involved some degree of psychotherapy,” Filstrup said. “I conducted a thorough review of your clients, including ones from before I joined the PWO. You recommend a comprehensive mental health course of treatment less than ten percent of the time in your substance abuse cases.”
“Because that’s not the way we’re going to get their licenses reinstated,” Lou said, feeling heat beginning to scorch the back of his neck. “Psychotherapy can drag on and on, when recovery is no farther away than attendance at meetings and adherence to the principles of AA, the first of which is that you can’t drink. There may be other approaches and programs that will get drunks sober, but this is one that I know works. That’s why I haven’t gone out of my way to recommend any others.”
“So John Meacham is a success by your standards?”
Lou took in a sharp breath.
“No,” he managed, no longer able to cull the strain from his voice. “Obviously, something went terribly, terribly wrong with John. But I was monitoring him, Walter. He was doing everything required of him. He was happy and productive. We never got a positive on his urine tests. This wasn’t about alcohol.”
“My point exactly, Welcome. This is a straightforward mental health issue. It always was.”
Cap’s portmanteau popped into his head. The boxer was right, and so was Filstrup. And so, for that matter, was he. Meacham was crazy at the moment he fired those shots-absolutely insane. But something had created the insanity, and it was nothing that Freud or Jung or any therapist could have couched out of him.
“We have an obligation to protect the public from doctors who pose a danger to their patients,” Filstrup was saying.
Lou shook his head in dismay. “No, Walter,” he said, “that’s what the board of medicine is for. Of course we need to pay attention to that, too, but we also have an obligation to our docs. Sometimes we’re all they have-the
