you don't even suggest the notion of voluntary drug abuse. That kind of thing can only play right into the prosecution's hands and dilute the picture we're trying to paint.'
'Diminished capacity caused by paranoid schizophrenia. '
'Precisely. It's a difficult enough proposition for the layman to understand, without injecting needless complications.'
For good reason, I thought and refrained from responding. He stared at me, then began sifting through the papers on his desk.
'Is there anything else, Doctor?' he asked.
'Yes. Ms. Surtees's notes seemed more positive than anyone else's. Do you see her as an accurate reporter?'
He leaned back and put his feet up on the desk. There was a hole in the sole of one of his wing tips.
'Ms. Surtees is one of those well-meaning, maternal types who attempt to make up for what they lack in intelligence and education by becoming personally involved with their patients. The other nurses viewed her with bemusement, but she posed no problem for them. I wasn't pleased at her employment, but the family was distressed and felt one-on-one care was important, and I couldn't see her doing much harm. In retrospect, perhaps I was too permissive.'
Or impressed by dollar signs.
His jaws bunched as he chomped down on the pipe. He looked at me searchingly, requesting confirmation that he hadn't mishandled the case.
'So you don't have much faith in her credibility.'
'She's a baby-sitter,' he said brusquely, 'not a professional. Now, if that's all - '
'Just one more thing. I'd like to talk with Mrs. Vann.'
'Mrs. Vann is no longer with us.'
'Was she dismissed because of the escape?'
'Not at all. She left of her own accord, just a few days ago.'
'Did she say why?'
'Only that she'd been here for five years and wanted a change of scenery. I was disappointed but not surprised. It's difficult work, and very few last that long. She's a fine nurse, and I'm sorry to have lost her.'
'So you don't blame her for what happened.'
His eyebrows merged and created a mesh of creases in his forehead.
'Dr. Delaware, this is beginning to sound like an interrogation. My impression was that you came here to be educated, not to cross-examine me.'
I apologised for coming on too strongly. It didn't appear to mollify him. Pulling the pipe out of his mouth, he turned it upside down and knocked it angrily against the rim of an ashtray. A small cloud of grey dust rose, then sank, leaving a film of soot on the paper disarray.
'Perhaps you're not aware of the enormousness of our task,' he said. 'Convincing twelve untrained individuals that the boy wasn't responsible for his behaviour will be no mean feat. The issue of blame is yet another irrelevancy that will impede us. We're expert witnesses, not judges. Why persist in digressing?'
'From where I sit, what's relevant and what's digression aren't all that clear.'
'Believe me,' he said with visible exasperation, 'the issues aren't all that complex. The boy developed schizophrenia because of poor genetics. The disease disabled his brain and hence destroyed his so-called free will. He was programmed for disaster from birth, every bit as much a victim as the people he murdered. That's not speculation; it's based on medical data - the facts speak for themselves. However, because of the ignorance of the layman, it would be helpful to augment the argument with sociological and psychological theories. That is where, I strongly suggest, you should be directing your energies.'
'Thanks for the suggestion.'
'Not at all,' he said airily. 'I'll have that chart for you within a few days. Now let me see you out.'
We rose and left the office. The corridors of the hospital were silent and empty. In the front reception room a well-dressed couple sat holding hands and staring at the floor. In the woman's lap was an unopened copy of Vogue. A cigarette dangled from the man's lips. They looked up at the sound of our footsteps and, when they saw Mainwaring, gazed up hopefully, as if at a deity.
The psychiatrist waved, said, 'One moment,' and walked over to greet them. The couple stood, and he shook each of their hands energetically. I waited several moments for the conversation to end, but when it became clear that my presence had been forgotten, I slipped through the door unnoticed.
I HAD lunch at a cafe in Sherman Oaks and mentally replayed the interview with Mainwaring. For all his pharmacologic expertise, he'd given me no insight into Jamey, the person. That no doubt wouldn't have troubled him at all had it been called to his attention. He was a self-proclaimed biochemical engineer with scant interest in any organism above the cellular level. Years ago he would have been viewed as an extremist, but now he was au courant well in step with the new wave in psychiatry - a love affair with biological determinism at the expense of insight. Part of the motivation behind the shift was valid; psychotherapy, by itself, had proved minimally useful in the treatment of psychosis, and drugs had wrought remarkable, if unpredictable, symptomatic control.
But some of it was also political - through reasserting themselves as physicians, psychiatrists could distance themselves from psychologists and other nonmedical therapists - as well as economic, for insurance companies were reluctant to pay for something as ambiguous as talking
therapy but had no problem reimbursing for blood tests, brain scans, injections, and other medical procedures.
Psychology had its share of engineers, too - behavioural technologists, like Sarita Flowers, who steered clear of disorderly annoyances like feelings and thoughts and viewed the human condition as a set of bad habits in need of Skinnerian salvation.
Either perspective was a kind of tunnel vision, ad extremum, the blind worship of anything that could be quantified, combied with premature self-congratulation and a black/white view of the world. But there was a lot of grey space in the middle, and a patient could get lost there.
I wondered if that had happened to Jamey.
Arriving home at two, I called Souza and asked him to set up an appointment with Marthe Surtees.
'Ah, Marthe, a kind woman. I'll call the registry that employs her and see if I can reach her. Do you have anything to report, Doctor? I'm not asking for conclusions, only a feel for where you're going.'
'Nothing yet. I'm still asking questions.'
'I see. When do you envision yourself sufficiently prepared to write a report?'
'That's hard to say. Perhaps in a week or so.'
'Good, good. We'll be going to court for preliminaries at the end of the month. I'd like my armoury well stocked by then.'
'I'll do what I can.'
'Yes, I'm sure you will. By the way, we spoke previously about the possibility of some kind of drug intoxication. Have you reached any conclusions about that?'
'Dr Mainwaring was adamant that drugs had nothing to do with Jamey's condition, and he thought even raising the possibility would damage a dim cap defence.'
'Mainwaring's not an attorney. If I can show that Chancellor pushed drugs on the boy, not only wouldn't it hurt, but it would help.'
'Be that as it may. there's no evidence of drug abuse. The symptoms I noticed were probably tardive dyskinesia -
a reaction to the medications. He'd started to show them at Canyon Oaks. It's an atypical reaction after short-term treatment, but Mainwaring feels he's an atypical schizophrenic.'
'Atypical.' He thought out loud. 'Framed properly, that could work in our favour, make us less dependent upon precedent. Very well, keep probing, and let me know if anything else comes up. By the way, do you have anything scheduled later on today?'
'No.'
'Excellent. Heather arrived last night from Montecito, took a helicopter down at midnight in order to avoid the press. The children stayed behind, so if you want to speak to her, it would be a good time.'
'Sure.'
