Fugue State

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by M. C. Adams


  Yes. The character witnesses. The friends and family who took the stand on my behalf, and the stress of the media spotlight that severed the ties between us. Her eyebrows rumpled in frustration. They gave their testimonies. Then they disappeared from the courtroom. Her stomach churned thinking of the row that would be left empty behind her today. Could she blame them? The trial was dreadful. Even her Texas-native parents stopped going to the courthouse after receiving death threats that her mother couldn’t handle. Alexa would skip her own trial if it were possible. Yet, she did blame them.

  He continued, “I think murder is off the plate.” His words jarred her back to reality. “There are still charges of manslaughter and criminally negligent homicide to deal with.”

  “Yes. We still have those.” Sarcasm seeped from her pores. Why must there be so many different words for kill? Much of the publicity the trial generated revolved around the definition of homicide in the Texas legal system, with variations spanning from capital murder to forms of imperfect self-defense, with or without adequate provocation. She frowned at the ugly words she heard so regularly and wondered how such terms came about.

  Alexa rolled her shoulders in tight circles in an attempt to break the mounting tension. Although Appleby touted good news, she still feared the jury’s critique of her character. I’ve seen enough scowls in that pulpit to know that the saints think I’m a sinner. Her eyes flashed at Appleby.

  “I’m relying on you to create a shadow of a doubt in the jurors’ minds. Convince them it wasn’t unnecessary force.” It had seemed like a daunting task for so long, but Appleby had made serious ground recently.

  “Relax. It’ll all be over soon enough.” His lips pressed into a tight line, and he turned his glance to the window.

  Walking into the courtroom, Alexa’s eyes scanned the audience. Her eyes glided across a haggard middle-aged woman with stringy black and gray hairs. She recognized this woman as the mother of Jamar’s youngest child. According to Appleby, Jamar had fathered two children with different mothers. One child was ten years old and shuffled between the mother and other family members. The older child was an adult son serving time in prison. Jamar also had a soft criminal record, in and out of jail since he was twenty. He had two counts of rape against him — but the most recent was over a decade ago. He had a few arrests for various drug charges, and one count of child molestation. Jamar had lived alone and never married. The woman didn’t seem to notice Alexa walk in.

  Alexa bit the inside of her lip as she took her seat in the front. She stole a glance at the jury, trying not to stare; she yearned to know their thoughts. Appleby had warned her not to make too much eye contact with them. He wanted the facts to speak for themselves. He was afraid they would be distracted by her looks and develop their own preconceived notions about her character. She had involuntarily made so many mistakes throughout the process. She turned away from the jury and considered adding “too much eye-contact” to her list of faults.

  She went over the list of errors she had created in her mind. That scandalous outfit that led both the bouncer and the police to think me a prostitute — bad idea. She winced. Don’t forget the cocktails that left my blood alcohol level at point oh-six, not far below the legal driving limit of point oh-eight. She rolled her eyes to herself as the voice in her head mocked the legal limit. I’m a whore and a lush. Check. Next? Oh, yes. Too deliberate with the knife when I turned on Jamar. According to the prosecution and Detective Marcum, a victim is typically much more precarious with their counter attack, stabbing away haphazardly without thought or recourse. They deemed her use of the knife “an unjustified use of force” in comparison to the superficial cut Jamar had made on her thigh. Finally, the first words the bouncer heard from her were, “Turn off the music.” The grimaces on the juror’s faces revealed their dismay. She didn’t sound like a victim to them, and Alexa didn’t know how to convey innocence. She behaved defensively and sometimes defiantly; Appleby kept her off the stand whenever possible.

  She wanted to tell them how painful the song lyrics were in her head, how those words tortured her even after her attacker lay dead. She wanted to remind them Jamar would have left her dead body in that alley. She fidgeted in her seat with frustration. Who knows what other mistakes I’ve made?

  The prosecutor stood. “I call Alexa DeBrow to the stand.”

  Her toes curled in her designer heels. She was expecting deliberations, not more questioning. Whatever is coming, I’m not ready for it. Reluctant to stand, she turned to Appleby in desperation. He held a blank expression. Having faltered time and again on the stand, she relied heavily on his coaching. With unexpected questioning, she feared another failure. Her nervousness could be misconstrued as guilt, while her attempt to defend herself came off as arrogance. She also feared the judge didn’t like her. He told her she had “an authoritative attitude that would not be tolerated in his courtroom” when she challenged the prosecutions questions. Challenged the questions? She twists my words in a manner that changes their meaning. Alexa had argued over the prosecutor’s use of the word drunk.

  “How drunk were you that night, Miss DeBrow?”

  “I wasn’t drunk.”

  “So you didn’t have anything to drink?”

  “I had two martinis.”

  “If you had two martinis, you weren’t sober. Agreed?”

  “I had two martinis.” She said each word more firmly than before.

  “Were you sober? Yes or no?”

  “I had two martinis. That is the only answer you get.” She had raised her voice.

  The judge banged her gavel and scolded Alexa’s behavior.

  His reproach sparked a silent fury.

  Alexa’s feet marched toward the stand, tension mounting within her subconscious. How am I supposed to behave? The fact that I am on trial for killing my attacker is ludicrous!

  As she took her seat at the front of the courtroom, she flattened the front of her Emilio Pucci skirt.

  “Dr. DeBrow, I’d like to remind you that you are under oath,” the prosecutor stated.

  Alexa’s eyelids fluttered in a state of disbelief. She said Dr. DeBrow — not Miss DeBrow, like every other day in court. She was startled to hear her own professional title, but only for a moment before she felt more at ease. Perhaps this new gesture is a sign of good faith that they are preparing to admit defeat? She’d wanted to request the judge that she be addressed as Dr. DeBrow because she thought her title would help to portray her as a more debonair and intellectual persona, further separating her from the role of a prostitute that the prosecution had contrived. However, when the judge stated Alexa conveyed an air of authority, she had decided not to ask. She adjusted her posture and sat more upright as the prosecutor began.

  The prosecutor was a dark-haired, older lady with oversized glasses. She shuffled through her paperwork as she addressed Alexa. “Your title as neuroradiologist has required extensive training, Doctor. Four years of college — at Dartmouth, nonetheless, followed by four years of medical school — where, I see you graduated at the top of your class.” The woman forged a counterfeit smile, before her eyes returned to the paper. “Then a year of internship in general surgery at the University of Texas, Southwestern, followed by four additional years of radiology residency there. You also completed a year of subspecialty training with a neuroradiology fellowship at Vanderbilt. Very impressive, Dr. DeBrow.”

  Alexa’s face grew warm. It felt good to have her positive attributes publicly acknowledged after all the negativity. The words created hope that the charges might be dropped, and she could return to being a respectable citizen again.

  But something in that woman’s eyes said otherwise. Something about the prosecutor’s sharp features and pursed lips said she was hiding something up her sleeve. Alexa’s optimism wilted beneath the woman’s gaze. How could she trust someone named Janice Finkle? How could she trust a woman with scattered gray hairs that she left uncolored, and scuffed up shoes that were obviously
too big? No. She would not trust the prosecution. Janice Finkle would probably ask for me to be stoned to death if it were legal.

  Ms. Finkle went on to list a series of medical board examinations that Alexa had passed, and additional training with competency exams and continuing medical education requirements. Finally, she mentioned more simple hospital training requirements, including basic life support and advanced cardiac life support, both of which required yearly certification, for which Alexa had been certified for over a decade.

  Finkle concentrated on Alexa’s brief surgical training. “Dr. DeBrow, I think we should all take comfort knowing someone with such vast medical training was present for Jamar Reading the night of August seventeenth. Dr. DeBrow, with a year of general surgery experience, can you tell us what a physician should do when they encounter a rapid arterial bleed?” The words exited her lips with a hiss.

  The question was as pointed as Finkle’s chin, and Alexa stole a quick glance at the jury. A dozen eyes stared at her quizzically.

  Finkle continued, quoting an excerpt from Alexa’s initial police statement. “‘The blood spurted rapidly from his carotid, and he bled to death on top of me.’“ Finkle repeated her question. “Now, Dr. DeBrow, given your medical expertise, I would like your medical opinion. Can you tell the court what a physician should do when they encounter an arterial bleed?”

  A gasp slipped past her lips. They expected me to save that brute! Anger surged through her veins. Her jaw locked tight, afraid her words would incriminate herself. I killed that monster! she screamed in her head. My victory should be applauded! I was supposed to die that night! How she longed for someone to tell her they were glad that she killed him — glad because it meant she was the one who got to walk away that night. Glad that Jamar Reading had one less victim.

  She would have to keep waiting to hear those words. No one had spoken them yet, and she doubted she would hear them today. She clenched her jaw, fearing her lips would incriminate her.

  The prosecutor pushed forward with her attempt to crack Alexa. She referenced portions of the modern-day Hippocratic Oath that Alexa had sworn out loud as a medical student over decade ago, along with several statements issued by the hospital where she had been employed until yesterday that discussed the character and expectations of their physicians.

  Alexa’s hands balled into fists. How can they do this to me? How can they hold my medical training against me? Did they really expect me save that bastard? She glared at Appleby in a state of fury. They weren’t ready for this. She wasn’t prepared for this line of questioning. They needed a plan. She needed coaching. She needed to vomit. Her mind swam, her thoughts racing.

  Appleby’s eyes rested on his Blackberry, apparently lost in some other project.

  The prosecutor asked more deliberately now. “You were taught to heal the sick and save lives. Dr. DeBrow, why should we expect any less of you when Jamar Reading’s life was at stake?” Her condemnatory tone made the veins in Alexa’s throat throb. “Was it because he was a black man? Is that why you chose to let him bleed to death in the alley?”

  Now you’re calling me a racist? The media will love this. News reporters had successfully twisted her story into a racial conflict that highlighted the disparities between upper- and lower-class Americans. Both issues had gained attention of left-wing radicals who criticized Alexa under the spotlight of the television cameras.

  “What’s the first rule when dealing with an arterial bleed, Dr. DeBrow?”

  Hold pressure. The words echoed in her head.

  Finkle continued through narrowed eyes. “How is it that someone with such advanced training and education is incapable of carrying out the most basic medical treatment strategies? Why didn’t you hold pressure on Jamar’s gaping wound, Doctor? It’s your responsibility as a physician, Dr. DeBrow. Why did you let Jamar die when you alone were capable of saving him?” Her accusatory voice echoed through the courtroom.

  Alexa sat, silently appalled.

  Why is Appleby still enthralled with his Blackberry? She really needed him now. She stared him down while screaming Jacob! in her head over and over.

  “Dr. DeBrow?” asked the prosecution.

  She froze.

  “Miss DeBrow, answer Ms. Finkle’s question.” It was the judge now.

  But Alexa wouldn’t answer. She gritted her teeth and shook her head slightly back and forth. No. Not going to hang myself on your questions. She needed coaching. They shouldn’t be asking this of me. Why would I save him? Don’t they know I wanted him dead?

  Appleby’s head bobbed up from the Blackberry, and he seemed aware of what was happening in the courtroom. “I’d like to call for a recess in regards to the new line of questioning on my client.”

  Finally!

  Nods exchanged between the judge and prosecution. The judge banged the gavel. Alexa was afraid to move. Appleby had to walk to the front of the room and take her by the arm to coax her from her chair.

  CHAPTER 5

  Hold pressure. Hold pressure.

  The words echoed in her brain. Of course Alexa would hold pressure if a patient’s life were at stake. If it had been a family member, a friend, a stranger in distress, she would have stepped up to help them. But it wasn’t a patient that she found in the alley that night; it wasn’t even a human being she’d encountered. It was a monster. Jamar Reading was a monster. As he smashed her head against the alley cobblestones, Alexa had only one thought on her mind — not to escape, but to kill the man who hurt her. She was afraid to speak on the stand, fearing those words might escape her lips, and she would condemn herself.

  The idea that she would ever try to save him was outlandish. Why would anyone try to save a monster? She left the courtroom disheartened and disheveled.

  Appleby escorted her into the hallway. She caught Jimmy Thornton’s glance as she exited the courtroom. She hadn’t noticed him in the audience. She turned away from him trying to avoid his questioning stare. Thankfully, Appleby tugged her aside.

  “Try to relax, Miss DeBrow. This is her attempt to try you for criminally negligent homicide; it’s a step down from manslaughter. Take comfort in that.” He sat her on a bench far away from the crowd while he paced a few steps away and made calls on his Blackberry.

  Too flustered to relax, her mind raced. Why is Jimmy here? Jimmy Thornton was more intimately involved in the ordeal than Alexa cared to admit. He had been there the night of the incident. After she had spoken with the police that night and given her statement to detective Marcum, the detective had accompanied Alexa in the ambulance to the hospital so she could have her injuries evaluated. She hadn’t known which hospital to choose. She wanted to go somewhere where no one would know her, but she had so many connections in the medical field that any decision risked stumbling into someone she knew. She chose St. Joseph’s Hospital on the east side of town. It was a small private hospital near the Country Club, and the farthest option she knew from Community Northwest.

  Nonetheless, when a physician arrived at the hospital emergency room in the middle of the night covered in blood, it made quite an impression, and word got around. One doc called another, and it wasn’t long before Jimmy Thornton showed up at the hospital.

  So much for HIPAA, Alexa thought when she saw him. The Health Insurance Portability and Accountability Act legally required confidentiality between a patient and their healthcare provider. It had been thrown out the window in her case.

  Seeing Jimmy outside the courtroom brought on another flashback of the night’s events. She relived the moment he had walked into her hospital room. She was alone. No family. No friends. No one to comfort her during her time of distress. She cringed with embarrassment, knowing how it must have looked to Jimmy. She hadn’t called anyone because she wasn’t ready to explain the situation.

  Jimmy scanned her up and down, fumbling for an explanation for his arrival. “Jeb Gunderson, one of the ER docs, told me you were pretty banged up and a-a-lone. I, um, I wasn’t sure if you ne
eded something.” He didn’t ask her what happened. Yes, word got around, indeed.

  “I have some stitches in my left thigh, and in the back of my head. I’ll be fine, Jimmy.”

  He frowned as if unsatisfied with her response.

  She continued, “They made me get a head CT.” He raised a questioning eyebrow. Alexa shrugged. “They said if I had the CT, they would let me sleep.” She had initially declined the head CT, deciding for herself she had suffered a concussion, and doubting she had suffered any treatable head injury. She had not wanted the unnecessary radiation that accompanied the scan, but the neurologist who examined her required continuous, in-hospital monitoring for forty-eight hours if she refused the study. That meant no sleep, and Alexa’s tired body begged for rest.

  “Can I see your CT?” Jimmy asked. He shared her background in neuroradiology.

  She nodded and waved him out of the room. Her head ached, and she rolled over on her side and closed her eyes in an attempt to shut out the pain. She thought about what her head CT might reveal, carefully weighing the possibilities. She stretched out the hand tethered to the IV, and her fingers moved over the focus of pain in the back of her head. I could have a skull fracture — perhaps one of the parietal or occipital bones. She ran her hand over a tender lump near her hairline, a hematoma. She felt the prickly sutures the ER doc used to unite the scalp laceration. The bones don’t feel displaced.

  She contemplated the intracranial injuries she could have sustained. I could have a head bleed. She scrutinized her risks for an intracranial hemorrhage. An epidural bleed occurred just deep to the skull and above the thick meningeal covering that surrounded the brain. But epidural blood most commonly accompanied skull fractures on the side of the head where the middle meningeal artery lived, not the back of the head where her injury lay. She could have subdural blood trapped beneath the thicker dura and the more delicate meninges that covered brain. But subdural bleeds arose more commonly in the elderly due to a combination of stretching veins and atrophic brains. Both scenarios could require surgery, but neither fit her mechanism of injury.

 

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