His eyes met hers and he nodded, knowing she was waiting for that explanation. ‘I knew she wouldn’t let it rest. I wanted her to stop making me feel so awful, Doctor.’
His pale eyes were pleading with her.
Temporary insanity would do fine for a diagnosis but that wasn’t the end of the issue. It was just the beginning. What would happen to Arthur? A prison sentence for such a timid man would be hell. And then where? What would happen the next time he met a situation he couldn’t deal with? He couldn’t fight, at least, not in a confident way. He could only explode when the pressure had built up sufficiently. Would he then be a danger to someone else? Her job was to protect the public.
She knew he wasn’t wicked. He wasn’t evil. But he was damaged. And she wasn’t ready to release him to the authorities, although she knew she had already made up her mind.
She tried to flush him out. ‘Lindsay has said you can’t go home,’ she said. ‘And I understand your son, Saul, is in agreement with that.’
His eyes lifted for a moment and she saw a flash of red. He said nothing.
She needed to make him understand. ‘She could have died, you know, and then you would have been up on a charge of murder.’
Something a little more cognisant passed across his face. He hadn’t finished fighting yet. ‘It’s my house,’ he objected. ‘I paid for it.’
‘That’s something that will have to be decided through the courts and your solicitors.’ She felt he still hadn’t understood. Not fully. She needed to make him understand so addressed him directly. ‘Arthur, you know you will almost certainly have a prison sentence once I’ve completed my assessment.’
Fight over, he nodded and then looked up, a brightness in his eyes, hope not quite faded. ‘Maybe Saul will come to visit me?’
I wouldn’t hold your breath.
He followed this up with, ‘Has Lindsay forgiven me?’
There was no response to this except, ‘I don’t know, Arthur.’ She felt compelled to add, ‘But I wouldn’t hold out a lot of hope. She was badly hurt, you know.’
She thought he had absorbed this quite rationally, until he added hopefully, ‘I’ve written her a get-well card. Will that help, do you think?’
Her response was muted by the sharp summons of her bleep.
SIX
Wednesday, 17 June, 3.30 p.m.
The bleep was from Rita’s number and, when she connected, she was told that Dr Bracknell was waiting on the line to speak to her about Heather Krimble.
His response to her greeting was a jaunty, ‘Hi,’ his antipodean accent audible even in that one brief syllable.
He dived straight in. ‘I understand that you need some details on a patient of Laura’s, a Mrs Heather Krimble?’
‘That’s right. She’s been referred to me by her GP. Thirty-two weeks pregnant. She’s making a serious allegation against her obstetrician, and I understand this is not the first time.’
‘That’s right,’ he said. ‘I’ve been looking through her notes. She has quite a history of some very … imaginative … pregnancies.’
Claire smiled. His way of putting things made the episodes seem more like a fairy story than a serious psychiatric history with potentially serious repercussions.
‘You want me to give you a brief precis?’
‘Please – that would be really helpful.’
‘Right, then. Here we go.’ He cleared his throat, almost a drum roll for what followed.
‘She first came to Laura’s attention six years ago during her first pregnancy, referred by her GP, a Doctor Roy Barker, as she was claiming that her boss at work rather than her husband was the father of her baby and she wanted an HIV test. When questioned by Doctor Barker, she said she’d been having an affair with Mr Cartwright, who owned the printing works where she was employed. Doctor Barker reassured her but, as you know, HIV and hepatitis tests are routine anyway in pregnancy and they were negative. Trouble was her boss absolutely denied the whole thing. He said there was no affair, that he’d had nothing personal to do with Heather, that it was all fantasy. So … Doctor Barker asked Laura if she’d see her to try and find out the truth. That was the beginning of it all. She had some other delusions during the pregnancy – that the baby would reveal all when he was born and other stuff like that.’
He paused and she heard the sound of a page being turned. ‘Laura made the diagnosis of puerperal psychosis, temporary schizophrenia and treated her with a neuroleptic. When the baby – a little girl, by the way – was born, Heather Krimble went home to her husband. She didn’t return to work at Cartwright’s. There’s no more mention of him.’
Claire interrupted. ‘Was the child’s parentage ascertained?’
‘You mean a DNA test for paternity?’
‘Yes.’
‘Well, I assume it was done, Claire, but I can’t find a record. Anyway, Heather was treated and she gradually improved. She was discharged from Laura’s care two months after delivery but four months later the little girl died. Cot death. Tragedy, eh?’
‘Yeah.’
‘There was a lot of discomfort about this considering Heather’s previous psychiatric history. Doctor Barker wrote to Laura expressing his concerns, but she wasn’t able to shed any light on the baby’s death. There didn’t seem a connection between Heather’s allegations and the little girl’s death. Plenty of questions were asked but there was no evidence that the child had died of anything other than natural causes. There were a few brief counselling sessions but Laura discharged her. Her mental state appeared to have stabilized, though she never appeared to accept that her husband was the father of her child. I guess the subject was dropped.’
Claire sat very still, focusing on the psychiatrist’s words. This was true. This was what they did. They had enough work firefighting major problems. Subjects not considered pressing were just dropped.
‘Well, that was it,’ he said, ‘until pregnancy number two a couple of years later, when again Heather claimed that the baby was not her husband’s. This time her claims were even more bizarre – that the father was the window cleaner, a young chap named Sam Maddox. Incidentally happily engaged and just like Mr Cartwright before him, adamant he’d had nothing to do with the conception of her child. But Heather was sticking to her story that they’d had a long-term affair, that he was in love with her and was intending to leave his wife.’ Simon Bracknell spluttered, ‘Poor old bloody window cleaner hotly denied it, saying that he never even went inside the Krimble house, only did the windows from the outside – Heather was either out of the house or she stayed indoors. To cut a long and very imaginative story short, again there were lots of bizarre claims which continued right through the pregnancy. She was getting upset that the window cleaner wasn’t spending enough time with her, saying that he wasn’t showing enough interest in his own child. This time I did find a DNA report which proved that the baby, a little boy named Freddie …’ He laughed. ‘Cute name, that. Anyway, Freddie turned out to be her husband’s child.’ He laughed again. ‘Much, I’m sure, to the window cleaner’s relief.’
‘Yes,’ she agreed.
Simon Bracknell continued. ‘This time, after the baby was born, she was followed up even more closely by the community psychiatric team and treated. Oooh,’ he suddenly exclaimed, ‘looks like you’ve got a problem. Bit of self-harm here. A cutter. Very disturbed. And very upset post-delivery. Again treated with the usual neuroleptics and chlorpromazine.’
‘But not admitted.’
‘Seems not, which is why she’s stayed underneath your radar, Claire. They kept an eye on her in the community, but even though she had had one cot death there were no concerns about the second child. She’d never hurt him. But at two months old the little boy died, just like his big sister. It was put down as a cot death. Again, there were no signs that this was anything other than a second tragedy. Poor little Freddie. Heather was monitored in the community, counselled and eventually discharged.’ He paused. ‘Unlucky girl,’ he
said with typical antipodean understatement.
‘As you say,’ she responded drily, ‘unlucky girl.’
That was when he showed some curiosity. ‘And this time?’
‘She’s pregnant again and making another claim that the child is not her husband’s. Again, the GP believes this is not true.’ He didn’t need to know any more than that – for now.
‘Is it possible the problem lies not with Mrs Krimble but with her husband? She can’t bear the thought that he’s the father of her children so she substitutes?’
‘It’s certainly a possibility. I’m meeting her for the first time on Friday so maybe I’ll get some idea. Thanks, Doctor.’
‘Cut the formality, please. Call me Simon, for goodness’ sake. Look, if I can help in any way, I’d be happy to.’
‘Right. Thanks. Do you know how long you’ll be filling in for Laura?’
‘Looks like it’ll be for the long haul.’
He was giving nothing away but prolonged sick leave didn’t sound too good for Laura. Claire didn’t ask. The jungle drums of NHS colleagues would reach her sooner or later.
‘Maybe we’ll meet up one of these days?’ he added hopefully.
‘Yeah,’ she said, tacking on a banality to avoid sounding unfriendly, ‘it’s a small world.’
‘Certainly is,’ he agreed, and that was the end of the conversation.
But she had learnt useful facts.
Heather had plenty of history and Laura’s notes had given it colour and some flavour. Soon it would be time to meet her.
SEVEN
Friday, 19 June, 3 p.m.
Clinic 5, Outpatient Department, Greatbach Secure Psychiatric Hospital.
33/40
Claire’s primary emotion, as she made her way down to the clinic, was curiosity. It is difficult not to form a picture of a patient when you know pieces of their history, even if her current view was lopsided as the facts she had learned so far about Heather Krimble had all come from independent sources. Now it was her job to try and make some order of these reports, using Heather’s version. Then, possibly, she would start to separate fact from fiction, psychosis from neurosis, sift out any hint of deliberate malice and behind that any motive for lies manufactured purely to bring Charles Tissot’s lucrative career crashing down around his ears. A doctor is taught to trust a patient’s account, to believe their stories and not to question their version. A psychiatrist has a different method. Their patients may not be lying deliberately. They may believe their own untruths. They may not. But every statement has to be measured and weighed. Doubted, tested and finally evaluated. Fact, fiction or a subtle blend of both?
A psychiatrist needs to look into their patient’s eyes as well as their brain, and for that you need insight plus concentration. As she sat behind her desk and opened the set of brand-new notes, she was focusing her mind and anticipating that first stare. How much of a clue would there be to the turmoil writhing underneath? Would the iceberg principle apply? One-tenth visible? The other nine well hidden. If hidden, how deeply? Well below the consciousness? Too deep to probe without the use of hypnotics? How aware was Heather of the fact that her stories were denied by others? A psychiatrist needs to be able to drill deep into the mind like a geologist, taking his sample not only from the surface but also from the underlying rocks. Then analyse it before dividing it into various categories. Not igneous, sedimentary, metamorphic, but truth, deliberate lies, delusions.
The mind is stripped down as a mechanic does an engine, observing the processes as they work. Only then can the visible symptoms be classified, a diagnosis made before treatment is instigated. Whatever Heather Krimble had on show, it was time for Claire to make her own assessment.
She looked at the blank page, already feeling her pulse quickening. This was why she had chosen psychiatry for her career. For what is life if not a challenge? So she sat and let her mind explore. Charles had portrayed the woman she was about to see as a vindictive madwoman. But why should Heather feel vindictive towards him? She hadn’t even known him. The two men she had previously accused had at least had some ongoing contact with her. But Tissot? Of his own admission, they had only met briefly on that one occasion. How would she explain this?
And underneath her professional interest was a female perspective. What would she be like?
Her notes were sketchy so far, written on loose sheets. She’d made a rough aide mémoire while Simon Bracknell had been on the line but Claire had had little experience of this condition. She had only treated one case of erotomania before – an elderly man convinced a ballerina with a local company was obsessed with him. He’d sent her flowers night after night, believing that every time in the corps de ballet she turned towards him or tilted her head in his direction (no matter that her fellow corps members were making identical moves), it was nothing to do with the choreography but a secret signal to him alone in the auditorium, picking him out, in the dark, from the entire crowd. And when the dancer pirouetted or performed an arabesque, it was to entice him. It had been an extraordinary case. The treatment had been difficult and protracted, the seventy-four-year-old very hard to convince. She probably never had achieved this. His conviction had been too deeply rooted, too intransigent. Her suspicion was that the Heather/Charles case may well turn out the same.
And the case histories she’d spent the previous evening reading up on appeared to reinforce that idea. But at least she understood the main principles of erotomania: an unshakeable but deluded belief that a person, usually someone of higher social status or more attractive, was secretly in love with the subject. Charles Tissot certainly fitted that bill as did, though to a lesser extent, the boss of the printing company where Heather had worked. But the window cleaner? Younger. Perhaps he fitted the ‘more attractive’ criterion.
But as she prepared to call her in, Claire reminded herself that the accused this time was Charles Tissot.
She gave a final glance around her clinic office. Shared by all who needed it and less personal than her upstairs domain. Health posters Blu-tacked on to neutral walls. A desk, a computer, three chairs, little else. Anonymous.
She stood up. It was time to meet her patient. She walked out into the waiting room and scanned the upturned faces that turned to regard her, like sunflowers. Some she knew. Others were strangers. A couple of rows from the back, two women were sitting side by side, their heads almost touching. They were similar enough both in looks and style to mark them out as sisters. Both were neatly but quietly dressed in tailored trousers and loose shirts, one cream, the other pale green. Both had thin light brown hair cut in a fringed bob. She picked on the one in the cream shirt who had first looked up at her approach.
‘Heather Krimble?’
She was wrong. It was the other one, the woman with the slightly shorter hair and the green shirt who stood up. She was small and slight, with a pale complexion, and her face was sweating. Anxious brown eyes met hers. And, of course, as she straightened up, there was the biggest clue of all: a swollen belly.
Her pregnancy looked less advanced than eight months, hardly showing a bump in the loose-fitting shirt, but she was obviously conscious of it. Her hands were placed protectively over it as though she recognized the vulnerability and uncertainty surrounding the child inside. Her eyes were tawny brown, almost feline, with flecks of yellow. Her expression was bland but wary as an antelope. She wore no make-up and had a resolute air, squaring her shoulders and turning towards her as though facing her fate.
Claire smiled and extended her hand. ‘I’m Doctor Roget,’ she said.
Heather’s eyes flickered over her, her expression guarded, with some suspicion just stopping short of hostility. After the briefest of pauses, she nodded. ‘Hello.’
Claire’s eyes moved to the second woman as she too stepped forward. ‘I’m Ruth,’ she said briskly, ‘Heather’s sister.’
As Claire turned her attention on Ruth, her own questions proliferated. What was her take on this? A shared delusio
n? There were few clues in the sister’s face. Ruth was slightly less attractive than her sister. But she improved her appearance with mascara and pale pink lipstick, unfortunately clumsily smeared just outside her mouth. She was more confident, almost belligerent as she squared up to Claire with something approaching a challenge. Her expression, if not overtly hostile, was guarded, on full alert, like her sister’s. But Claire sensed doubt too. She was not quite comfortable facing the psychiatrist with this latest story. On the other hand, there was a certain set about her mouth, combined with honesty in her eyes, which gave Claire confidence that she would not flinch from the truth. As she saw it. But balancing that, her body language was unmistakable – affection and protection towards her older sister. Claire nodded in the direction of the consulting room. ‘Shall we go?’
Heather walked by her side, head turned towards her, smiling, questioning. Making friends? Or carefully appraising? Ruth remained two steps behind, with a heavier and more determined tread. Almost fatalistic. Claire ushered them both into the consulting room, observing her patient. Heather appeared placid now and a little smug, patting her pregnant stomach periodically as though to congratulate it or else reassure herself that it was still there.
Not a fantasy.
When Heather sat she pressed her knees together primly. Her stare, unblinking and very direct, could have been classed as unnerving except there was some confusion, a slight pucker between her eyebrows, as though she was unsure quite how she had ended up here. Already, Claire was finding her difficult to assess. Take your time, she told herself.
She opened Heather’s notes to the page where she had left her loose sheets, already thinking that on the surface it would seem that Charles Tissot had little to fear. Heather’s past history appeared to be letting him right off the hook. Shame.
The Deceiver Page 6
