Keeping Faith

by Jodi Picoult

  "Did you ever interview Mrs. White in the role of a therapist?" Metz asks.

  "No, I was her daughter's psychiatrist."

  "Then can you say with absolute certainty that somewhere in this mother's twisted mind she wasn't trying to make you put her daughter on display?"

  Dr. Keller looks at Mariah, then at Faith sitting several rows behind her. "No," she says, her word soft as it falls into Metz's outstretched hand.

  "She was brought into the emergency room, bleeding from both palms," Dr. Blumberg says in response to Joan's question. "Traditional emergency-medical procedures failed to stop the bleeding, and I was called in for a consultation."

  "What did you do, Doctor?"

  He leans back in the chair. "I x-rayed her hands."

  "What did you find?"

  "No sign of trauma. Literally, a hole went straight through. No tearing of tissue, no mangled bones, nothing to indicate that this was a puncture wound of any kind, in spite of the slow and steady flow of blood."

  "Had you ever seen anything like this before, Dr. Blumberg?"

  "Absolutely not. It stumped me. I called in experts and colleagues, pediatric and surgical and orthopedic specialists, and we ruled out the medical possibilities one by one. Eventually I just treated the symptoms and sent the girl home, then went back to my office and started reading medical journals."

  "What did you discover?"

  "That, as many people know, this had happened in the past. And I mean in the way, way past. I was wary of believing it myself, but apparently several Catholic saints have exhibited stigmata, or spontaneous bleeding from the palms, side, and/or feet that is medically inexplicable, but also medically verifiable. And there is no physical cause for it."

  "When was the last documented case?" Joan asks.

  "Objection--Dr. Blumberg hasn't been ordained."

  "I'll allow it," the judge says. "Doctor?"

  "There was a man named Padre Pio, who died in 1968. But the most famous stigmatic would probably be Saint Francis of Assisi, who lived in the twelfth century. According to the reports I read, the wounds are quite real, quite painful."

  "What are the main characteristics you found in journals about stigmata?"

  "They can't be cured by ordinary remedies used to control bleeding or induce clotting. They last for months or years at a time, but unlike long-term natural wounds, don't fester."

  "How does that correspond to Faith's wounds?"

  "Very closely," the doctor says.

  "Did you officially diagnose Faith with stigmata?"

  Blumberg grimaces. "No. I was too skeptical. On her record I wrote that after weighing all medical possibilities, the conclusion I'd reached was that it was possible that Faith suffered from stigmata. But frankly, I'm still not comfortable with that diagnosis."

  "This past weekend, what was Faith's medical status?"

  "She was critically ill. She had been put on dialysis and had gone into cardiac arrest twice, her hands and side were bleeding again, and she'd slipped into a comatose state. My professional opinion was that she wasn't going to recover."

  "What is Faith's medical status now?"

  Blumberg grins. "Shockingly healthy. Kids tend to bounce back quickly, but this is truly remarkable. Nearly all her bodily systems are functioning at a hundred percent, or are well on the way to doing so."

  "In your opinion, Doctor, was Faith's heart and kidney failure intentionally caused by someone?"

  "No. There are too many medical personnel around in an ICU for that to happen. Not to mention that traces of medicine which might, for example, cause the heart to arrest were not found in Faith's bloodwork."

  "Were her hand and side wounds caused by someone?"

  He shakes his head. "As I've said, there was no indicative trauma. Just a tiny tunnel...right through the skin and muscle and bone and sinew." He holds up his palm. "There are more bones in the hand than anywhere else in the body, Ms. Standish. It's virtually impossible to puncture it without causing some trauma. Yet that's what I saw. Faith was just...bleeding."

  "Doctor, are you required by law to file reports of possible child abuse?"

  "Yes, any physician must."

  "Did you file this report after seeing Faith White a month and a half ago?"

  "No, I did not."

  "Did you file this report after admitting Faith White on Thursday night?"

  "No."

  "Was there any reason for you to file that report?"

  "Absolutely none."

  "Thank you," Joan says. "Nothing further."

  "Dr. Blumberg," Metz asks, "how many cases of stigmata have you treated?"

  The doctor smiles. "Just this one."

  "But you feel qualified to give us an expert opinion here? Isn't it true that because you couldn't diagnose Faith's wounds, you made an educated guess?"

  "First let me tell you what I ruled out, Mr. Metz. I considered both direct and indirect trauma to the appendage. I examined the possibility of skin secretions, or nerves adjacent to the skin producing some substance, but the emissions were laboratory-tested, and they were indeed blood. Stigmata was the only diagnosis I could find that even came close to matching the clinical observations I made."

  "Can you say without a doubt that this is stigmata?"

  "Of course not, it wouldn't be my job. It's the pope's, I guess. All I can tell you is, Faith White was bleeding. And there was no medical explanation for it."

  "Is there a psychological explanation for it?"

  Blumberg shrugs. "In journals I read, there were attempts to replicate stigmata in patients under hypnosis. In a couple of very rare cases, psychiatrists managed to induce a kind of colored sweat...but no blood. There's no scientific proof that the imagination can produce stigmata apart from a religious idea."

  "Could the wounds have been produced during a sleepwalking episode?"

  "I doubt it. As I said, they looked nothing like puncture wounds."

  "Can you say conclusively that Faith's injuries were not caused by Faith herself, or by another person?"

  "It wasn't apparent," Blumberg says carefully. "I certainly couldn't come down with an absolute, but this clearly was not a case of child abuse. Mrs. White refused to leave her daughter's side, was extremely concerned about Faith's prognosis, and became very agitated when I hypothetically suggested a diagnosis of stigmata."

  "Have you ever seen cases of child abuse, Dr. Blumberg?"

  "Unfortunately, yes."

  "In any of those cases did the parent harm the child in front of you?"

  "No."

  "In any of those cases did the parent seem concerned about the child's prognosis?"

  "Yes," the doctor admits.

  "In any of those cases did the abusive parent herself bring the child in to be treated?"

  Blumberg clears his throat. "Yes."

  Metz turns on his heel. "Nothing further."

  Faith leans to the right. "Kenzie," she whispers, "I've got to pee."

  "Now?" the guardian ad litem asks.

  "Yeah. Like right now."

  Kenzie grabs the girl's hand and makes their excuses down the row of seated people. Outside the courtroom, she turns left toward the ladies' room. She waits for Faith to finish in a stall and come out and wash her hands. Then she smooths the girl's hair. "How you doing?"

  "It's boring in there," Faith whines. "Can we get a Coke?"

  "It's important that we stay inside. It won't be too much longer."

  "Just a Coke? Five minutes?"

  Kenzie stretches out the kink in her back. "All right. Five minutes." She leads Faith to the machines just inside the main lobby of the courthouse. People mill about: sequestered witnesses awaiting their limelight, attorneys on cell phones, uniformed men laying new mud mats on the floor. Kenzie deposits seventy-five cents and lets Faith push the buttons so that the can hurtles out of the chute.

  "Mmm. That's good," Faith says after taking a sip. She pirouettes, testing out her legs after sitting so long, and sto
ps abruptly when she looks through the glass doors of the courthouse. On the steps, on the snow-covered lawn, are hundreds of people. Some of them hold up placards with Faith's face posted; some of them wave rosaries in the air. Their shout of support swells like a tsunami as they catch a glimpse of her.

  She had not seen them coming in; Kenzie had taken her through a rear entrance simply so that she would avoid this. "Hold my drink, please," Faith says, handing Kenzie the Coke can.

  "Faith, don't--" she calls, but she's too late. Faith has already pushed open the doors to stand on the stone steps that lead into the courthouse. After a rousing cheer from her supporters, she raises her hands, and they cry out even louder. Stupefied, Kenzie finds herself unable to move. "Hello," Faith says, waving. She smiles as their prayers fall over her, accepting her due like a queen.

  "I've been treating Mariah White for seven years," Dr. Johansen says. "Ever since she left Greenhaven."

  "What was your opinion about her institutionalization?"

  "It never should have happened in the first place," the doctor says. "There were a variety of other treatments for depression that would have been just as effective."

  "Was there any way Mariah could have prevented herself from being hospitalized?"

  "No. Her husband believed it was the best option. Her mother was in Arizona at the time, unaware of the proceedings. Mariah was heavily medicated, and so removed from reality that she couldn't stick up for herself."

  "What was your opinion of Mariah White's mental state upon release from Greenhaven?"

  Dr. Johansen frowns. "I found her to be emotionally fragile, but receptive to learning coping skills. And, of course, she was very preoccupied with her pregnancy."

  "Did she exhibit signs of psychosis at that time?"

  "No."

  "No delusions, no hallucinations?"

  "Never. Even when Mariah was hospitalized, it was for depression."

  "Dr. Johansen, what is your opinion of Mariah's mental state today?"

  The psychiatrist stares at his client as if divining her thoughts. "I think she's getting stronger and stronger," he says solemnly. "As evidence of that, you need only consider that she's waived doctor/patient confidentiality here in court, in an effort to retain custody. And look back to August: When presented with virtually the same trigger situation that once made her suicidal, she reacted this time in a much healthier manner. She pulled herself together, took care of her daughter, and went on with her life."

  "Doctor, in your mind is there any possibility that this woman would harm her daughter?"

  "No."

  "In your therapy over the past seven years, has there ever been an admission, inclination, or thought of Mariah harming her daughter?"

  "Absolutely not."

  "Has Mariah spoken to you about the current circumstances surrounding Faith?"

  "You mean the visions and the media? Yes."

  "Does Mariah believe that her daughter is, indeed, a visionary?"

  Dr. Johansen is silent for so long that Joan starts to repeat the question. "Mariah believes her daughter is telling the truth," he says. "For whatever that's worth."

  "How do you go about getting someone committed to a mental institution?" Metz begins.

  "It's a court process," Johansen says. "A psychiatrist evaluates the person, and the judge reviews the files."

  "So several people are involved in the decision."

  "Yes."

  "Does the system work?"

  "Most of the time," the psychiatrist says. "In the cases where you can't trust a person's own judgment on the matter." He stares pointedly at Metz. "However, in this particular case the system didn't work. Mariah White was severely depressed and overmedicated, and her own wishes were not respected."

  "If the judge had believed that Mrs. White didn't need institutionalization, would the court order have been passed?"

  "No."

  "If the psychiatrist had believed that Mrs. White didn't need institutionalization, would the court order have been passed?"

  "No."

  "If the next of kin, Colin White, had believed that Mrs. White didn't need institutionalization, would the court order have been passed?"

  "No."

  "I see. So you're suggesting that these various people should have set aside their observations and taken the opinion of a woman who cut open her wrists a week earlier?"

  "That's not--"

  "Yes or no, Doctor?"

  The psychiatrist nods firmly. "Yes, that is what I'm saying."

  "Let's move on. What did you prescribe for Mariah White when she first left Greenhaven?"

  Dr. Johansen looks down at his notes. "Prozac."

  "Was this a continuous prescription?"

  "For a while. But after a year she went off it, and she functioned beautifully."

  "You considered her emotionally stable?"

  "No question in my mind," Johansen answers.

  "Has Mariah White asked for a refill of that prescription?"

  "Yes."

  "When?"

  "Three months ago," the psychiatrist says. "August."

  "Right after her husband left? Then she wasn't as stable as you thought--right, Doctor?"

  Dr. Johansen straightens. "The same exact thing that threw her for a loop seven years ago happened again, Mr. Metz. This time, instead of attempting suicide, she called me up and said, 'I need help.' Any psychiatrist in the country is going to view that as a mark of mental stability."

  "Are there side effects to Prozac?"

  "Occasionally."

  "Such as?"

  "Sometimes fluoxetine may cause headaches, chills, nervousness, insomnia, drowsiness, anxiety, dizziness. Also hypertension, rashes, nausea, diarrhea, weight loss, chest pain, and tinnitus."

  "What about hallucinations?"

  "Yes," Dr. Johansen admits. "But quite rarely."

  "And suicidal ideation?"

  "On occasion. However, you must remember that I've seen this particular patient on this particular drug at a dosage of twenty milligrams P.O. for over a year. I know how her body reacts to it. Were this a new prescription, Mr. Metz, you might be right. But not in the case of Mrs. White."

  "Was she off the drug, Doctor, for a period of several years?"

  "Yes."

  "Aren't there adverse effects associated with its discontinuation?"

  "Yes."

  "Such as suicide attempts, psychosis, delusions, and hallucinations?"

  "Again," Johansen cautions, "you're talking about a minute percentage of people."

  "But might she have had some adverse effects to discontinuation?"

  "None that she reported, Mr. Metz."

  The lawyer turns. "Dr. Johansen, what's the likelihood of someone who undergoes successful treatment of depression having a recurrence of the illness?"

  "I don't have statistics."

  "But it happens fairly often, doesn't it?"

  "Yes. But usually the well-adjusted ones know to return to a psychiatric professional, at that point, for help."

  "I see. So basically you're telling us that someone who's crazy once has a good shot at going crazy again."

  "Objection!"

  "Withdrawn," Metz says. "Nothing further, Doctor."

  Joan is out of her seat before the words leave his mouth. "I'd like to redirect," she snaps. "I'd like to qualify the terms 'mental disorder' and 'depression.' Are they one and the same?"

  "Of course not."

  "What was Mariah's diagnosis?"

  "Suicidal depression," Johansen says.

  "Have you ever heard of Munchausen Syndrome by Proxy?"

  "Yes."

  "Does it stand to reason that a person diagnosed and treated for suicidal depression would seven years later develop Munchausen Syndrome by Proxy? Is that a direct relationship?"

  Dr. Johansen bursts out laughing. "No more than saying that because you eat breakfast in the morning, you're likely to be wearing underwear."

  "Thank you, Doctor," Joa
n says. "I'm through here."

  What Millie decides as she sweeps up to the witness stand is that she's held her tongue long enough. As long as Joan intends to make her a character witness for Mariah, she wants to get her two cents in. She settles in the chair and nods at the attorney, ready to begin.

  "Mrs. Epstein, how often do you see Faith?"

  "At least every other day."

  "How often do you see Faith interacting with Mariah?"

  "Again, just as frequently."

  "In your opinion, is Mariah a good mother?"

  Looking every inch the proud parent, Millie beams. "She's a wonderful mother. She works twice as hard as any other parent because she's so intent on doing the best possible job."

  "How has Mariah dealt with the media surrounding Faith these days?"

  "How would you?" Millie says. "She's pulled Faith out of school; she keeps her hidden from their cameras. She does whatever she can to give her a normal life." There. That's her obligation to Joan, the material they've rehearsed ad nauseam. But she continues to speak, causing Joan to stop in her tracks and glance up, surprised at the change in script. "You all think that Mariah's the one who has to measure up. But whose fault is this, really?" With a trembling finger, she points to Colin. "He's the one who did this to my daughter before. He had her committed. Well, he should be the one committed, for not being able to keep his pants zipped--"

  "Mrs. Epstein," Joan says firmly. "If you could just please stick to the questions?" She clears her throat and gives Millie a very pointed look.

  "No, I think now that I'm up here, I'd like to talk. Who wouldn't be depressed if your husband starts sleeping around behind your back? I don't know why--"

  "Ma'am," Judge Rothbottam warns, "I must ask you to control yourself."

  Joan walks toward the witness stand during this digression, smiling tightly. "Cut it," she says through clenched teeth, and turns away, muttering something about loose cannons. "Mrs. Epstein, there are a variety of reasons to legally support a change of custody. To your knowledge, has Mariah ever sexually abused Faith?"

  "God, no."

  "Has she ever hit her daughter?"

  "She doesn't even smack Faith on the bottom when she's being wise."

  "Has Mariah ever emotionally abused Faith?"

  "Absolutely not!" Millie says. "She's completely supportive."

  "Does Mariah work outside the home, or in any other way spend most of the day away from her daughter?"

  "She's with her every minute." Millie looks sourly toward the judge. "When she's allowed to be."