best hope was to get her into the central area of the spectrum, not too low or too high, able to interact and make relationships, adapt and change.' She picked up a pen and scribbled a note to herself on a yellow Post-it pad. 'I'm afraid to say, however, that Kelly is still very passive and preoccupied. Stuck, if you like, or cocooned; either unable or unwilling to relate.'
She peered over her glasses again, as if to underline the seriousness of what she was saying. 'Young children are deeply affected by witnessing violence, Mr. Stone, particularly when the victims of that violence are family members. Kelly's grandmother has been describing to me her previous cheerfulness and energy.'
'She used to be such fun to be with,' I said. 'She never laughs at my jokes now.' I paused. 'Maybe they're just not very good.'
The doctor looked a little disappointed at my remark. 'I'm afraid her current behavior is such a contrast to how she was previously that it indicates to me that the road to recovery is going to be even longer than I at first thought.'
Which meant even more expensive. I was ashamed at even having the thought, but there was no getting away from it.
'What sort of time scale are we looking at?'
She pursed her lips and shook her head slowly. 'It's still impossible to answer that question, Mr. Stone. What we're trying to repair here is not something as simple as a fractured limb. I appreciate that you would like me to give you some sort of schedule, but I can't. The course of the disorder is quite variable. With adequate treatment, about a third of people with PTSD will recover within a few months.
Some of these have no further problems. Many take longer, sometimes a year or more. Others, despite treatment, continue to have mild to moderate symptoms for a more prolonged period of time. I'm afraid that you really must prepare yourself for a long haul.'
'Is there nothing I can do to help?'
For the second time, Dr. Hughes smiled briefly. It was fleetingly triumphant rather than warm, and I got the feeling I'd fallen into some kind of trap.
'Well,' she said, 'I did ask you here today for a specific reason.
Kelly is here, in one of the rooms.'
I started getting up. 'Can I see her?'
She, too, stood up. 'Yes, of course. That is the object. But I have to say, Mr. Stone, that I'd rather she didn't see you.'
'I'm sorry? I '
The doctor cut in. 'There's something I'd like you to see first.' She opened a drawer in her desk, pulled out several sheets of paper and pushed them across the desk. I wasn't prepared for the shock they gave me. The pictures Kelly had drawn of her dead family looked very different from the happy smiling photograph I had in my backpack.
The one of her mother showed her kneeling by the bed, her top half spreadeagled on the mattress, the bedcover colored in red.
In another, her five-year-old sister, Aida, was lying on the floor between the bath and the toilet, her head nearly severed from her shoulders. The nice blue dress she'd been wearing that day was spattered chaotically with red crayon.
Kev, her father and my best friend, was lying on his side on the floor of the den, his head pulped by the baseball bat that lay next to him.
I looked at the doctor. 'They're the positions I found them in that day exactly? I hadn't realized?'
I'd found her in her 'hidey-hole,' the place where Kev wanted the kids to run to if there was ever a drama. She'd never said a word to me about it, and I'd never thought that she might have witnessed the carnage. It was as though the events were recorded in her memory with the clarity of a camera.
Hughes looked over her glasses. 'Kelly has even remembered the color of the comforter on her bed that day, and what was playing on the radio as she helped set the table in the kitchen. She has talked to me about how the sun was shining through the window and reflecting on the silverware. She recalls that Aida had lost a hair band just before the men came. She's now just replaying the events immediately preceding the killings, in an effort, I suggest, to achieve another outcome.'
I was relieved that her flashbacks didn't go any further, but if the treatment worked she would surely begin to recount what had occurred afterward. When it did, I would have to involve the Firm to sort out any 'security implications' that might arise; but for now, they didn't need to know that she was ill.
The psychiatrist interrupted my thoughts. 'Come with me, if you will, Mr. Stone. I'd like you to see her and explain a little more about what I hope we can achieve.'
She led me a short way down the hall. I couldn't make sense of any of this. Why wasn't Kelly allowed to see me? We turned left and walked on a while, stopping outside a door that had a curtain across a small pane of glass. She poked it very slightly aside with a finger and looked through, then moved back and motioned for me to do the same.
I looked through the glass and wished I hadn't. The images of Kelly I kept in my memory were carefully selected shots from before she got sick, of a little girl quivering with excitement at her birthday party on the replica of the Golden Hind, or shrieking with delight when I finally kept my promise to take her to the Tower of London and she got to see the Crown Jewels. The real-life Kelly, however, was sitting on a chair next to a nurse. The nurse seemed to be chatting away, all smiles. Kelly, however, wasn't replying, wasn't moving. Hands folded politely in her lap, she was staring at the window opposite her, her head cocked to one side, as if she was trying to work something out.
There was something deeply scary about how still she was. The nurse wasn't moving much, either, but Kelly's was an unnatural kind of stillness. It was like looking at a frozen image, an oil painting of a young girl in an armchair, next to a film of a nurse who happened to be sitting still, but who would move again in a second or two.
I'd seen it before. It was four years ago, but it could have been four minutes.
I was on my hands and knees in her family's garage, talking gently as I moved boxes and squeezed through the gap, inching toward the back wall, trying to push the images of the carnage next door behind me.
Then there she was, facing me, eyes wide with terror, sitting curled up in a fetal position, rocking her body backward and forward, holding her hands over her ears.
'Hello, Kelly,' I'd said very softly.
She must have recognized me-she'd known me for years-but she hadn't replied. She'd just carried on rocking, staring at me with wide, scared, dark eyes. I'd crawled right into the cave until I was curled up beside her. Her eyes were red and swollen. She'd been crying and strands of light brown hair were stuck to her face. I tried to move it away from her mouth.
I got hold of her rigid hand and guided her gently out into the garage.
Then I picked her up in my arms and held her tight as I carried her into the kitchen. She was trembling so much I couldn't tell if her head was nodding or shaking. A few minutes later, when we drove away from the house, she was almost rigid with shock. And that was it, that was the stillness I saw now.
The doctor's mouth came up close to my ear. 'Kelly has been forced to learn early lessons about loss and death, Mr. Stone. How does a seven-year-old, as she was then, understand murder? A child who witnesses violence has been shown that the world is a dangerous and unpredictable place. She has told me that she doesn't think she'll ever feel safe outside again. It's nobody's fault, but her experience has made her think the adults in her life are unable to protect her.
She believes she must take on the responsibility herself-a prospect that causes her great anxiety.'
I looked at the frozen girl once more. 'Is there nothing I can do?'
The doctor nodded slowly as she replaced the curtain and turned to head back up the hallway. As we walked she said, 'In time, we need to help her gently examine and review the traumatic events that happened to her, and learn to conquer her feelings of anxiety. Her treatment will eventually involve what are best described as 'talking therapies,' by herself or in groups, but she's not really ready for that yet. I will need to keep her on antidepressant medication and mild tranquilizers for a while yet, to help lessen some of the more painful symptoms.
'The aim eventually will be to help Kelly remember the traumatic events safely, and to address her family life, peer relationships, and school performance. Generally we need to help her deal with all the emotions she's having
