Flashback

split, she kept reminding herself of the “higher good”—of Lorraine Budd recalling her high school friend from 1940- something and Ernestine spelling her nurse’s name and Louis Martinetti remembering his army days. “I don’t know.”

“You don’t know. Is it possible the front desk attendant maybe left for a few moments to go to the restroom or get a coffee, and while she did Clara slipped by?”

“It’s possible. But I really don’t know.”

“And where exactly were you when she got out the door?”

“At home.”

“You say your job is to monitor patients’ medications, correct?”

“Yes.”

“And you have a pharmacy degree?”

“Yes.”

“So you understand the medications that are prescribed to patients?”

“Yes.”

“Good. So if a patient is taking anything that might be harmful to themselves or others, you would know?”

“Yes.”

He opened up a folder and pulled out a sheet.

“Was Clara Devine on any medications that would cause her to become violent?”

Maybe. “No.” She heard the syllable rise easily out of her throat but imagined that her eyes were blinking red polygraph alerts.

“Are there any she was taking that could have such violent side effects?”

“No.”

He opened a file folder and removed a sheet. “The medication sheets on file at the nursing home lists Atenolol. What’s that?”

“A beta-blocker. It reduces heart rate, blood pressure.”

“What about Aricept?”

“That’s for her dementia.”

“No possible side effects?”

“No.”

“What about Paxil?”

“That’s for her depression and general anxiety.”

“How does it work?”

Brenda Flowers tried to protest the line and manner of questioning, but he persisted as if he were on some slightly manic autopilot.

Rene could see that Beck was enjoying his schoolroom inquisition, but she would not crack as she shot back the answers as if she were taking her orals back in pharmacy school. “Paxil is the brand name of paroxetine, a class of drugs known as selective serotonin reuptake inhibitors. It affects the activity of neurotransmitters in the brain, in particular serotonin and norepinephrine, which help regulate one’s mood.”

“You’ve done your homework, I see. So have I,” and he whipped out a file card from his folder. “Did you know that Paxil can cause delirium, irrational talk, and hallucinations, irritability and hostility, even manic reactions including ‘great excitement and psychotic rage, followed by depression’—all of which this drug is supposed to prevent? Is that not so, Ms. Ballard?”

“All drugs have side effects, and a small percentage may be adverse.”

“But are these not side effects that could have led to Mrs. Devine’s attack on Edward Zuchowsky?”

“That’s remotely possible.”

“Remotely possible? Well, did you know that England has recently banned the use of Paxil for children and teenagers under the age of eighteen because the drug has been linked to suicide, suicidal behavior, and violent outbursts? Did you know that?”

“I had heard that, yes.”

“And yet your home still prescribed the drug to her.”

“Clara Devine was seventy-six years old.”

He made wide-eyes. “Oh, so it only adversely affects people under eighteen? How is that possible? Brains are brains, no?”

“No. Childhood depression is different from adult depression, probably because children’s brains are still developing. So antidepressants may not have the same effects—beneficial or adverse—in children as in adults or geriatric patients. While it’s difficult to weigh the risk-versus-benefits of any medication, Clara Devine had been on the same doses of Paxil and her other medications for many months. So I’d say that it’s very unlikely that any of those meds caused such a dangerous impulse.”

“So you’re saying that nothing she was on could have accounted for her violent behavior.”

“Not to my knowledge.”

“But how would you know if you’ve been on the job for only eight weeks?”

“Because I saw her medical charts, and because there’s no report of psychotic rage, hostility, or combative behavior that would point to her killing of Mr. Zuchowsky.”

Beck rocked back in his seat and looked down at this list. “Once again, are you certain there were no drugs she was on that could have led Clara Devine to kill Mr. Zuchowsky—some kind of stimulant or antipsychotic drug that produced the opposite effect?”

In a flash she saw the nurses’ notes: “More alert.” “More verbal.” “Remembered his granddaughter’s name.” And Louis Martinetti’s swearing, “We’ll get them back is all.” And she heard her father’s exasperation: I can feel the holes.

Besides, she really didn’t know if Memorine had anything to do with the killing. That was the truth. And that’s what the purpose of this deposition was. Furthermore, this Cameron Beck was a royal prick. “Not to my knowledge.”

Beck snapped closed his file folder. “Thank you, Ms. Ballard. That will be all.” He stood up and shook her hand. “Good day.”

When they left the office, Ms. Flowers said, “Sorry about that. But he can get a little intense at times. You should see him in the courtroom. How do you feel?”

“Fine,” she said. Piece of cake? Rene felt as if she had just eaten a slab of suet.

30

FOR THE BETTER PART OF A WEEK, Rene pored through the various nurses’ reports of residents enrolled in the Memorine trials, hearing the nasal persistence of Cameron Beck’s voice—“any adverse side effects?” What she discovered was a marked increase in cognitive tests scores of nearly fifty percent of the subjects as well as improvement in their basic daily functions. In fact, Louis Martinetti had progressed twenty percent on his Mini- Mental State tests. That statistic particularly delighted Rene, as if the demon was being vanquished for both Louis and her father.

But in about a quarter of the reports, nurses had noted spells of “regressive behavior” and of “odd spells” when patients would become dissociated from the moment and lapse into past-time hallucinations—like Louis Martinetti thinking he was back in the army—or “childhood delusions.”

Flashbacks.

According to her time line, those residents were part of the first trial group.

“Her mood would suddenly change, like that,” Alice said when Rene asked about Clara Devine. “Suddenly she’d start talking in rhymes. Or she’d have conversations with people who weren’t there. That’s not unusual for dementia residents.” Then she added, “But the thing is these spells could last a long time, and they were pretty coherent. It was kind of weird.”

The notes also indicated that flashback spells had been observed in Mary Curley, who, like Clara Devine, was being treated with antipsychotic drugs and tranquilizers. So was Louis Martinetti.