‘It’s the only island in the Tiber River,’ says Tom, reading from the on-screen text. ‘Linked – as we know – by the Fabricio Bridge, which joins it to the Field of Mars, and also by the Ponte Cestio.’ He jabs the monitor. ‘Now look here, another legend.’
‘Don’t get so excited; there is a legend in every corner of Rome.’
‘You may be right. This one concerns one of the last Etruscan kings. He was overthrown and his body dumped in the Tiber, a final act normally reserved only for lowlife sinners. Folklore has it that Tiber Island was created from a mound of silt and driftwood that formed over the body of the tyrant king.’
‘Nice.’ Valentina can’t resist a sick pun. ‘At least even after death he had his own form of king-dam.’
Tom might have laughed had he not been reading on. ‘Listen. For centuries the island was a dumping ground for the worst of criminals and the contagiously ill. Then when Rome was hit by a plague, some sibyl – which I think is a Latin adaptation of the Greek word sibylla , meaning prophetess – recommended that a temple was built there to Asclepius in order to stop the diseases spreading.’
‘Who?’
‘Asclepius, Greek god of medicine and healing.’
Valentina is impressed. ‘You knew that?’
‘I did. You remember the other night you said sex was the panacea for all ills?’
She blushes a little.
‘Well, Panacea was Asclepius’s daughter. While her name is used – and abused – much more in modern life, it was her father who dominated Roman and Greek times. The Rod of Asclepius is still a powerful astrological symbol and is the thirteenth sign of the sidereal Zodiac.’
‘What’s so special about it?’
‘It’s a staff entwined with a serpent.’
‘Oh God,’ she exclaims with high melodrama, ‘not more snakes and devils.’
‘It’s not what you think. Not Satanic. Asclepius was a brilliant physician, so brilliant that he reputedly brought people back from the dead. You’ll find his symbol is still used in America by the Medical Association, the Academy of Psychiatry and Law and the US Air Force Medical Corps.’ Tom suddenly thinks of more organisations, ‘In fact, the British Royal Army Medical Corps also use it, as do the Canadian Medical Association and even the World Health Organisation.’
‘Okay, I surrender under the weight of all those mighty medical bodies. But what’s your point? What’s the significance of the serpent and the staff in relation to our case?’
‘I’m not sure I can give you a perfect answer. But consider this: Asclepius left the legacy of a powerful cult that has influenced the most important medical minds in the world. The serpent and the staff are symbolic references to the oxymoronic fact that medicine is built on using drugs that in small doses heal but in big doses kill. In short,’ adds Tom, ‘in the modern world, doctors play god. They’re the ones with the everyday powers of life and death.’
39
Louisa Verdetti arrives at work exhausted.
She hasn’t slept.
The first thing she does is head to Valducci’s office and tell him everything about her overnight adventure with the Carabinieri.
The administrator says little as she explains about the body and possible links to the patient on their ward. ‘I’m sorry. I should have called you and informed you of the police request for me to accompany them.’
‘You should. You exposed both yourself and the hospital.’ He swivels in his black office chair and looks out of the window as he talks. ‘Are they likely to interview you formally?’
She shrugs. ‘I don’t know. I suppose so.’
He turns to face her. ‘It’s not an offence to help the police, but I do want to be kept in the picture. Is that too much to ask?’
‘Of course not.’
‘Okay.’
She starts to raise herself from her seat.
‘Before you go, I want to compare notes on our increasingly famous patient.’
‘ Scusi? ’
‘Diagnostics. You keep telling me she’s DID and I keep thinking schizophrenia, so let’s try to settle the matter so that when your police friends start asking, we’re on the same page.’
What he’s saying makes sense, although she’d really rather not do it right now.
Valducci senses her discomfort. ‘Louisa, if your diagnosis won’t hold water when analysed by a friend and colleague, then what hope have you in the stormy sea of external critique?’
‘I’m sorry. It’s just that I had such a bad night and I have a migraine.’
‘Then a contextual review of the symptoms of both schizophrenia and dissociative identity disorder will clear the fog for you. What diagnostic tools have you used so far?’
She’s annoyed that she’s being asked. ‘DES, DDIS, SDQ-20. We’ve been through the whole tick list on amnesia, depersonalisation and derealisation before making a final diagnosis.’
‘Good, then you’re well prepared. I want you to list unique symptoms that are not indicative of schizophrenia. Let’s start. Symptom one…’
She grinds her brain into first gear. ‘Identity confusion. Suzanna consistently has identity problems. These are obviously manifested in the form of her alters.’
‘Obviously,’ he answers sarcastically. ‘Schizophrenics also have a lack of a sense of identity and can’t see their role in society. So no uniqueness there. Point unproven. Next.’
‘Schneiderian symptoms and delusions. Again these are evidenced in the presentation of multiple personalities and even include bodily changes from alter to alter.’
‘Hmm, I’m not so sure they do. Any physical changes could be psychosomatically caused. Besides, schizophrenics are notoriously delusional – our wards are full of people who think they are being chased by aliens or are on the run from the government or the mafia.’
‘I suspect some of them might well be.’
Valducci almost laughs. ‘Point unproven. Next.’
‘Comorbid diagnoses.’
He stares at her. ‘You know your patient to be clinically depressed?’
‘No. I’m clutching at straws, but I strongly suspect it. It’s likely she-’
‘Not good enough. Besides, even if full depressive or manic syndrome coexisted with your dissociative syndrome, it still wouldn’t be unique. Schizophrenics have more than their share of mood episodes. Point unproven. Next.’
Louisa feels totally stressed. ‘Okay. We can do this all day. I throw up a DID symptom and you knock it down by matching it to schizophrenia, but that doesn’t resolve anything. Suzanna doesn’t have many of the things schizophrenics have.’
‘Such as?’
‘Catatonic behaviour.’
‘Good.’
‘Other psychotic symptoms.’
‘Such as?’
‘Well – her thinking isn’t characterised by incoherence.’
‘Good.’
Louisa dries up.
She’s out of ideas and her head is pounding. She rubs the back of her neck and hopes to massage a brilliant thought or remark out of her dulled brain.
‘More, come on!’
