“Temporary?”
“Tangible but temporary,” Dr. Ashland said, nodding. “That’s the interesting part. A human being and a block of ice cannot survive in the same environment. Not for long, anyway. The ice will melt or the human will freeze; we comprehend this inevitability from the moment we step outdoors in biting midwinter or pull a tray of cubes from the freezer. Ice is fundamentally alien to us, best seen from afar or across a semi-porous border. Inimical. Neutral but lethal. One or the other, frost or flesh, is not long for the world, ruined in increments by basic interaction with reality itself … but of course, that’s always the case, isn’t it?”
The detective nodded, the corners of his broad mouth dropping slightly as he feigned deep introspective insight. “Yeah. Interesting.”
“Yes,” said the doctor, stopping herself short. “Is there, perhaps, another topic I could discuss with you, detective? I’m passionate about any number of things, and ice—although it is quite interesting—isn’t really my formal area of expertise. I just think it’s pretty.”
“Hmm,” said the detective, nodding. “Yes. Your area of expertise, that’s … what? Anxiety disorders? Alternative therapies?”
“Correct,” said Dr. Ashland, putting on her brightest smile before taking another sip of bitter red tea. “Psychopharmacology, sleep disorders, and cognitive behavioral therapy, with a focus on natural remedies for extreme anxiety conditions. Do you mind if I play some music?”
The detective shrugged noncommittally. With the push of a button, the butterscotch shadows of Dr. Ashland’s office filled with the sounds of rapturous choral chanting, deep drums, and low piping.
Glancing around, spotting the hidden speakers tucked above the bookshelves, the detective sniffed. “This is also meant to be soothing? Pretty?”
“A bit,” said Dr. Ashland, hesitantly. “Uplifting, perhaps, is a better term; therapeutic in some instances. It’s a form of religious festival music recorded live in rural southeastern Myanmar. The people there know a fair bit about overcoming anxiety. And adversity.”
“Hmm,” muttered the detective. “About that. Can you give me an example of the sort of anxiety we’re talking about? I want to get an idea of what it is you do, in a general sense.”
“Of course,” she said. “Anxiety takes any number of forms and, in its severest manifestations, can be as violent or debilitating as any other mental or emotional instability. It’s the root cause, in my professional opinion, of most major atypical, therapy-resistant depression and addiction cases. Reactive attachment disorder, bulimia nervosa, or kleptomania with attendant substance abuse might be good examples of the sort of thing I help patients and their families cope with: stress disorders with no standard or reliable treatment options.”
“So,” he asked, “what are we talking about? You treat … stress? Negative reactions to stress?”
“In a manner of speaking, certainly. PTSD is a classic anxiety disorder, for example, and responds well to more unconventional therapies. Art, music, writing, even some interpretive dance.”
The detective smiled, crossing his arms. “How so?”
“I had a patient,” said Dr. Ashland, considering, “about whom I can divulge … some details of the case: she wasn’t a minor, and she had committed no crimes. She had severe misophonia, seemingly exacerbated by post-partum depression.”
“Come again?”
“Misophonia. It’s poorly understood. A rare neuropsychiatric disorder in which strong negative emotions are triggered by specific sounds. It’s been linked, theoretically, to everything from anxiety—which is why I was referred—to obsessive-compulsive personality disorder to synaesthesia to a malfunction of the limbic system. In short, hearing certain sounds fills the suffering patient with rage, directly triggering the flight-or-flight response complete with acute muscle spasms, sweating, nausea, pupil dilatation, and involuntary intestinal constriction in some cases.”
The detective grimaced. He wasn’t noticing the music as it increased in volume even as it slowed in tempo. The voices weren’t human; the words couldn’t be shaped by human anatomy.
“The sick part,” the doctor continued, “is that someone suffering from misophonia literally can’t help but listen for those sounds: the triggering stimuli cuts through any background noise like … well, like nails on a chalkboard. And the specific sounds that traditionally trigger full-on panic attacks for a true sufferer? Everyday and constant things: chewing, drinking, breathing, sniffling. Even the sound of clothes moving over skin or the faintest noise of foot-tapping.”
“Sounds bad,” he said, raising one eyebrow.
“If you’ve ever lived with someone who snores, you know how annoying a single repetitive sound can be. Now, imagine that you can’t help but hear it. Can’t stop focusing on it. All day, every day. Imagine that hearing it is enough to drive a pregnant woman to walk eight blocks in a snowstorm with a week’s groceries all because someone in the back of a crowded bus is chewing gum.”
“Sounds real bad,” he corrected.
Dr. Ashland took a sip of tea. “It is. And we have no idea how common it is, nor how to treat it. Not really. For my patient, the disorder was so intense that she became physically angry—dangerously angry, on a level that you as a homicide detective might understand—at the sound of her child nursing. When she privately intimated this to her own mother, the woman was involuntarily committed. My patient lost custody of her infant son along with her job, her home, her savings, and her marriage. She was on suicide watch when I was contacted.”
The detective whistled. “And you helped her?”
“Yes,” she said. I cured her, she thought, uplifted her and saved her. “With what you’re hearing now,” she said.
“This … music?”
He hadn’t noticed yet.
“Just one element,” Dr. Ashland said, “of traditional folk remedy for treating severe anxiety after childbirth, practiced in secret amongst certain nomadic, matriarchal ethnic groups in rural Thailand and Laos. It also involves certain fungi, herbs, and other ingredients fairly common to that area.”
The detective nodded. “Fine, fine. You have a background in psychopharmacology. I take that to mean drugs? Mental state … or,” he searched for the term, “mind-affecting drugs?”
“Indeed,” said the doctor, nodding.
A single crimson drop of blood ran from the detective’s left nostril; he wiped it away without noticing. He opened his mouth and closed it again. The pupil of his right eyes was a pinprick, the dark iris contracted to the tiniest pucker.
She took another sip of the piping-hot tea, biting back a sickened grimace. “While I don’t claim to know the full length and breadth of the literature on all modern psychoactive chemical treatments, I flatter myself to imagine that I’m considered something of a local expert. I know what the Chinese and Koreans are prescribing; I know why we aren’t doing the same, even if the reasons are profoundly foolish. And I can offer … let’s say, robust resources to my patients when less-invasive procedures fail to meet their needs.”
“Meaning … what, precisely?”
“Is this about drugs, detective? Street drugs?”
He dismissed her question with a wave. ”What do you mean, ‘robust’?”
Dr. Ashland took another long sip of the red tea, feeling her throat begin to get scratchy. She calmly picked a facial tissue from the desk and dabbed at both eyes before blowing her nose. “To say too much would violate confidentiality clauses. I mean robust.”
The detective folded his arms. “How so?”
“My patients are, as you say, particularly troubled. Troubled youth, primarily. They need robust treatment—willing or no, and most of them aren’t.”
“Ordered by the courts,” the detective said.
“Or sentenced to my care by parental fiat and quite possibly more dangerous for the distinction. Especially the rich kids, if you don’t mind me saying so. They’re often the worst cases … the craziest ones,
if I’m being informal.”
The detective shook his head, letting the comment pass. He knew how dangerous the children of the wealthy could be.
Dr. Ashland continued. “Many of these patients do not respond well, or at all, to traditional medications, and although I’m loath to overprescribe drugs when psychotherapy will do, my patients are often somewhat more resistant to talking than they are to being strongly dosed-up. If I may speak frankly.”
The detective frowned. “So you mean … what? That you pursue nontraditional medications for your patients? It’s what you’re famous for.”
“That’s one way of phrasing it,” Dr. Ashland said, taking a final, deep draw of her tea. “The best medicine, detective, is the one the patient will take. You could have the most efficient, reliable, highest-potency antipsychotic on the market—the very best gram for gram, dollar for dollar—but it won’t do a damn bit of good to anyone if a psychotic person won’t take it or forgets to take it or takes it just until he thinks he’s ‘cured’ or stops taking it because it gives him stomachaches or worse. Hell, stomachaches would be a blessing, considering some other common side effects of particularly potent psychoactive drugs.”
“Like what?”
Dr. Ashland narrowed her eyes. “Would you take a drug that made you impotent, detective? Fat? Incontinent? Gave you narcolepsy or seizures? Would you recommend it to a friend? How many thirteen-year-olds do you know who would take it? How many seventeen-year-olds? How many of your own colleagues would continue with their dosage even if strongly recommended by a doctor?”
He opened his mouth and simply shook his head. The droning sound was beginning to affect him.
“Of course,” said Dr. Ashland, “that’s only part of the problem. Patients, in general, don’t like taking meds. A common and debilitating symptom of schizophrenia, for example, is the sincerely held belief that doctors or the government or both are trying to put harmful alien compounds or substances into your body … which, when we consider what a lot of these drugs do to a patient, isn’t actually so crazy.”
The detective waved away the observation. “So you’re willing to experiment. I’ll accept it’s for the benefit of the patient. How far do you go?”
Dr. Ashland sighed, setting down the last dregs of her tea. “The long-arc history of drug manufacture, legality, and prescription is utterly maddening, detective. Bayer used to market heroin as a children’s cough suppressant; Parke-Davis legally sold cocaine over-the-counter up until 1922—during Prohibition!—before moving on to both PCP and ketamine. Other end of the spectrum, nitrous oxide was first isolated in 1772, but it wasn’t used as a surgical anesthetic until midway through the 1860s because people were too busy treating it as a common recreational drug. We’ve nearly universally got our heads on backward when it comes to drugs, treatment, therapy, and addiction.”
“You think some of your patients could benefit from cocaine.”
“I think,” said the doctor carefully, “that people who were prescribed cocaine by their doctor probably very rarely missed a dose. And if it provided effective treatment in some instances, I wouldn’t be surprised. Indigenous peoples have used Erythroxylum coca as medicine for millennia.”
The detective frowned. “What do you know about Modos121?”
“I’ve heard the name,” admitted Dr. Ashland, biting back the taste of tea, now congealing in her mouth—some of it was trying to crawl back up her throat. “It’s a street drug, yes? Relatively new. Recreational, similar to ecstasy. Has elements of a nootropic. Homebrewed, like methamphetamines.”
“Not quite.”
“But it has a recipe? Yes. One that could be found on the darknet, simple enough that a cunning young person could make some given a basic chemistry background, a ventilated basement with a drain, and a Bunsen burner.”
The detective nodded.
“Let me guess. This Modos also has some relatively obscure chemical component known to be found in a rare or markedly uncommon anti-anxiety medication that I prescribed to a patient or have been known to prescribe.”
The detective nodded. “Something like that.”
“And you’re here as a homicide detective investigating whether I have any connection to a mysterious death. A death related to one of my patients and to this drug.”
The detective didn’t nod this time. He didn’t have to.
“None of my patients or former patients have died recently,” she mused, “that I know of. So I’m guessing that you think one of my patients is the culprit. Possibly killing people with this drug and possibly because of this drug.”
“I’m not at liberty to say,” said the detective.
“Well, then. I have one more photograph, very much like these that I don’t put up on my wall. It’s not something that I show to everyone.”
Stepping behind her desk, she pulled a thin manila envelope from her top drawer and handed it to the detective.
“You asked me before who sculpted the ice in these images, and I said no one. And that’s true. Yet you saw the hand of an artist because there was what you perceived to be irreducible complexity in that image; it looked like something. See a sculpture, assume a sculptor.”
“Sure.”
“This photograph, detective, is of an actual ice sculpture.”
He pulled the glossy photograph from the envelope, curious, taking in the image with his breath held. After a moment, he glanced back up at Dr. Ashland. “It’s … what, a melted swan?”
“A melted angel. A cherub with tiny wings, crafted to pirouette as it urinated vodka for partygoers. This photograph was taken near the very end of an incredibly lavish birthday event on a private island as most of the guests were departing. The man they were celebrating took his own life not six months later, hoping to avoid prison for fraud.”
He handed the image back. “I don’t get it.”
Dr. Ashland nodded. “Most people see only a lump; I suspect you constructed the image of a swan from that oozing pile only because I told you that it was an ice sculpture to begin with.”
The detective frowned.
“I like to keep this photograph here because it contrasts so perfectly with the beauty you see around you. Most people,” the doctor said, “think that the human mind is like a crystal vase: formed intricately and explicitly for its purpose, whatever that purpose might be. When such a delicate thing breaks—and it often does—there are a lot of different things you can say about it afterward.”
“Like what?”
“Well, there are the helpful things and the no-so-helpful things, aren’t there? If a glass vase breaks into a very small number of big pieces, we can say ‘well, maybe we can glue it back together.’ And if it breaks into a lot of very small pieces, we can say ‘stand back because it can cut you.’ But it’s not very useful to say ‘those pieces look like a duck.’ In my professional opinion.”
“You may have lost me, doctor.”
“But the human mind isn’t a vase. It’s just water, really—blood and tissue, sugar and protein and wet electricity—temporarily frozen, caught in a state of nature. There is no sculptor. We just are. When a mind breaks, psychiatrists always want to hold up a shard and say ‘sociopath’ or ‘sex addict’ or ‘monster.’”
“But those,” said the detective, “aren’t useful definitions. In your professional opinion.”
“That’s correct. They don’t have the courage to say ‘this one is broken, let’s get rid of it’ or ‘this one can be repaired, so let’s fix it.’ Or even ‘this can be repurposed. We can make something beautiful out of these shards. Reduce, recycle, reuse.’ Ice sculptures, and other crap just like them, allow us to pretend that we’re in control; let us pretend that there’s order in a chaotic universe. And they are very dangerous because of that. Good day, detective.”
“You haven’t really answered all of my questions, Dr. Ashland.”
“I’m well aware. I am also aware that you don’t have a warrant. You will not find the girl yo
u’re looking for. She is in a state of nature, and unlike most of us, she understands that. No hand shaped her nor crafted her, detective, unless the gods are much stranger and much crueler than you or I can begin to imagine.”
He frowned. “Where is she?”
“Would that I knew,” she sighed. “Come back with a warrant, and we’ll go through my files until I can prove to you that I can’t locate her, either. Until then, have a lovely afternoon.”
The detective left, wobbling slightly, seeming not to notice.
Dr. Ashland turned off the music and steadied herself against her desk, taking deep breaths. Another press of the remote dimmed the lights; a third click locked the door. She waited.
After a minute, she vomited twice in rapid succession.
She crumpled to the floor unceremoniously, leaning against her desk and kicking off her heels. Wiping her mouth with the back of her hand, she pulled her laptop to the floor and opened a private chat program.
It was already running; the most recent post was hers.
+3+: Trouble. Be back.
Dr. Ashland considered and began typing.
+3+: 9, I have just had the unfortunate experience of killing a man. He was dressed as a police detective although I am uncertain as to his true masters. I learned what I could, but it was not much. Asking about Modos.
A moment passed and words appeared.
+8+: We are pleased. 9 is informed. You are absolved.
+5+: How was it killed?
Dr. Ashland relaxed; she finally let go of a breath she didn’t know she was holding.
+3+: I gave him a long earful of Wood Mother’s Calling Song; he’ll take his own life no sooner than 20 minutes from now. I would expect him to drive off the road or eat his gun within 40–45 minutes at the most. He is unlikely to contact anyone.
+7+: it is well
+5+: You took precaution?
Dr. Ashland felt her fingertips, still numb. How much was shock? She couldn’t say.
Tomorrow's Cthulhu: Stories at the Dawn of Posthumanity Page 8
