by Tim Downs
“Excited? Euphoric?”
“It was See & Say,” Natalie interrupted. “It’s like a book report. Did you ever feel ‘euphoric’ doing a book report? You must have liked school a lot more than I did.”
“I’m simply trying to understand the child’s emotional state at the time,” Armantrout said. He turned to Matt again. “You’re certain that Leah understood the nature of the presentation—that the event she described was supposed to be real and not fictional.”
“She understood,” Matt said. “I reminded her twice.”
“Yet she went ahead with the story anyway—and insisted it was true.”
“That’s right.”
“Did you object? Did you reprimand her?”
“No, not exactly.”
“Why not?”
Matt glanced over at Natalie. “Because Leah is a tenderhearted girl. I didn’t think it would help.”
“‘Tenderhearted’—what is that exactly?”
“She can be sensitive to criticism and blame. If you embarrass a child like that she can just shut down; that’s the last thing I want.”
“Why?”
“Because I’m trying to encourage their imaginations, that’s why.”
“It sounds to me like you may be encouraging them too much. Maybe a reprimand is just what Leah needs to bring her back to reality.”
Natalie’s teeth began to make a dull, grinding sound.
“Did anyone in the class challenge her story?” Armantrout asked.
“There was one boy,” Matt said. “He told her she was lying—that she made the whole thing up.”
“And how did Leah respond to this criticism?”
Matt paused. “She got angry. She began to withdraw.”
“Can you blame her?” Natalie said. “Someone called her a liar—wouldn’t you get angry?”
“Someone caught her in a lie,” Armantrout corrected. “I think that’s different. We need to keep in mind here that the story was patently untrue. Leah insisted that it was true, and when her claim was challenged she became angry.”
“There’s something else we need to keep in mind here,” Natalie said. “None of us know what Leah actually saw.”
Armantrout made a thin smile. “Well, we know it wasn’t an angel.”
“Do we?”
Matt looked at her. “What are you saying, Natalie?”
“I’m just saying that nobody knows. Leah says she saw a woman holding her hand out over a patient’s head, and for some reason she thinks the woman was an angel. If you had been there, Mr. Armantrout, what would you have seen?”
“Not an angel—I can tell you that.”
“You would have seen a woman holding her hand out over a patient’s head, just like Leah did—only you would have thought it was just a woman.”
“I don’t see your point, Ms. Pelton.”
“Leah wasn’t lying about what she saw—you just don’t agree with her about what it meant, that’s all.”
“I’m afraid it’s not that simple,” Armantrout said. “If we all saw a mouse but Leah insisted it was an elephant, there would be cause for concern. You’re quite right, Ms. Pelton, this is not about lying. This is about Leah’s ability to distinguish fantasy from reality—and how she responds when challenged.”
“What does that mean?”
“Mr. Callahan tells us that Leah became angry and withdrawn when a boy challenged her story. Unfortunately, if she’s going to keep telling stories about angels, she’s going to be challenged quite often. Will she always get angry? How angry? Will her anger response increase over time? Could her anger spill over into violent behavior?”
“Violent behavior? Now wait just a—”
Natalie started to rise from her chair, but Matt reached over and put a hand on her arm. “Hold on a minute,” he said to Armantrout. “Aren’t we getting ahead of ourselves here?”
“That’s what counselors try to do—get ahead of things. Right now Leah’s fantasy is probably nothing more than a harmless delusion triggered by exposure to religious mythology. But what about next year, and the year after that? What will happen when she reaches adolescence and her fantasies become fueled by psychosexual drives?”
“This is nuts,” Natalie said. “You’re treating Leah like some kind of deviant. The girl thinks she saw an angel! Joan of Arc did that and they made her a saint!”
“It’s interesting you should mention that,” Armantrout said. “A number of contemporary scholars have offered medical explanations for Joan of Arc’s visions. Some think they were caused by migraines; others schizophrenia. One historian believes she suffered from bovine tuberculosis caused by drinking unpasteurized milk.”
“I don’t believe this,” Natalie muttered.
“Migraine sufferers are sometimes known to experience ‘auras’ before the onset of an attack; so are epileptics. Perhaps Leah’s visions are akin to that—an indicator of some underlying medical condition.”
Matt cut in. “Mr. Armantrout, I don’t see what all this has to do with—”
“I’m simply saying that we shouldn’t rule out a physical examination for Leah. What could it hurt? We need to keep in mind that this is Leah’s second imaginary angel sighting in only three days—if she does have some physical condition, it might be getting worse. I mentioned an MRI before; I think you should seriously consider it, Ms. Pelton. You work at UCLA, don’t you? You could easily arrange it. At least that way we could know whether we’re dealing with a physical or a psychological problem here.”
Natalie stood up. “Are we done here?”
“Natalie, wait—”
“Thank you, Mr. Armantrout, Mr. Callahan. I appreciate your concern for my daughter and I’ll take your suggestions under advisement. Now if you’ll excuse me.” She turned on her heel and hurried toward the door.
Matt was right behind her. He waited until they were in the hallway before he took her by the arm and said, “Natalie, hold on.”
She turned and glared at him. “I thought you said you were on my side.”
“I am.”
“Well, you sure have a funny way of showing it. You could have said a lot more in Leah’s defense.”
“Nobody was attacking Leah.”
“Oh no?‘Fantasies fueled by psychosexual drives’—what do you call that, a commendation?”
“We just want what’s best for her.”
She pointed back down the hall. “He doesn’t. He just wants to be a little demigod who gets to poke around in other people’s heads.”
“I agree with you,” Matt said. “Armantrout is an idiot—personally I can’t stand the guy. But he might have a point, Natalie. The school is going to expect you to do something just to show that you’re taking their recommendations seriously. Maybe you should consider that MRI—just as a compromise. I think it might get Armantrout off your back.”
“Have you ever had an MRI, Matt?”
“No, I haven’t.”
“The machine is huge—it fills a whole room. They put you on this rolling table and strap you down so you can’t move—that’s because the narrow little tunnel they put you in is so claustrophobic that some people panic. They lock your head in a kind of vise that holds it perfectly still, then they slide you into that tunnel and make you wait for fifteen minutes while these massive magnets buzz all around you. It doesn’t hurt at all—not one bit—but believe me, the minute you see that machine you think something must be wrong with you.”
Natalie’s eyes began to fill with tears. “I’ve made some big mistakes in my life, Matt, and my biggest fear is that my mistakes have already screwed up my daughter. I want her to have a normal childhood. I want her to think that everything’s okay—that she’s okay—and I want her to be able to see angels without somebody wanting to shove her head into an MRI. To tell you the truth, I’m jealous of Leah. I wish I could see an angel right about now—God knows I could use one.”
“Natalie—”
“Thanks for caring, M
att. But if you’re really on my side, the next time Leah mentions an angel, don’t tell anybody. Just call me—okay?”
21
Kemp parked his old Honda Civic in the UCLA Medical Center staff lot; the car sputtered and made one final death kick before it gave up the ghost. He checked his hair in the rearview mirror and took a thermos from the front seat—then he remembered something else. Can’t forget the notes, he thought, grabbing a leather folder beside him. I know an angel who needs them.
Last night’s installment had gone off without a hitch—with the slight exception of Emmet’s unexpected intrusion. Kemp recalled the blank look on the old man’s face as he took in the scene and then quickly backed out of the room. Did the old man have any idea what was going on? He was just a janitor, after all—just a minimum-wage drudge with no knowledge of medical procedure. It probably just looked like some kind of examination to him. Nothing to worry about, he told himself.
Kemp was feeling good tonight. After working out a few bugs in a shaky opening night performance he felt like he was beginning to hit his stride. He had the system down now: Each morning the four partners would meet in the Century Plaza suite to hammer out that evening’s episode, and each night the angel would faithfully present it to his captive audience. By now Kemp knew precisely how much to adjust the propofol, and exactly how long it would take to move Hayden into and out of her semiconscious state. Last night he remembered to hang a freshly laundered lab coat in the closet—can’t have the angel looking frumpy, after all. Tonight he even thought to bring a spare bulb for the examination light just in case of a burnout. Attention to detail—that’s what separates the professionals from the amateurs.
There were other touches he was adding too. Last night he took the time to speak with each of the other nurses just before beginning his hour-long session to avoid appearing absent any longer than necessary—especially Natalie, to prevent any more awkward interruptions like the first night. He wished there was a lock on the door, but that was something no hospital allowed—can’t have stubborn patients locking themselves in their rooms. As soon as the session was over Kemp readjusted the propofol and immediately took his half-hour break, strategically making contact again with each of the nurses and using the break time to allow Hayden to slowly sink back into her coma.
By now the system was a thing of beauty—an elegantly choreographed dance, a perfectly synchronized symphony. He had the whole thing down to a science now, and science was something Kemp was very, very good at.
He was getting pretty good at this angel thing too; he was feeling the part. It had all seemed a little awkward that first night, but by the second night the words came more quickly. He had more confidence; he improvised freely, throwing in a personal comment or insight whenever it seemed like an improvement on the notes. Kemp imagined that this must be what Liv Hayden felt like when she was in the middle of shooting a picture—when she began to inhabit a role to the point that she was no longer pretending to be a character—she was the character. I could get used to this role, Kemp thought. It fits me.
Kemp took the elevator to the sixth floor and headed immediately to Hayden’s hospital room, but when he opened the door he saw something he didn’t expect—he found Dr. Smithson examining his unconscious patient. Kemp took a quick look at his watch—awfully late for rounds, he thought. The neurologists usually left hours ago.
Smithson looked up as he entered the room.
Kemp nodded a cursory greeting. “You’re working late.”
“I like to be thorough,” Smithson said. “So how is our patient doing?”
“You’re the doctor.”
“So are you,” Smithson said. “I’m curious about something, McAvoy. You’ve managed to let everyone around here know you’ve got your MD, but I’ve never actually heard you refer to yourself as Dr. McAvoy. Why so modest?”
“It could lead to misunderstandings,” Kemp said. “A patient might be tempted to give my opinion more weight than he should. We wouldn’t want that to happen, now would we?”
“No, we wouldn’t—but there’s no reason we can’t talk doctor to doctor, is there? So tell me, Doctor: What’s your evaluation of Ms. Hayden’s condition?”
Kemp shrugged. “You’ve only kept her comatose as a precautionary measure. Her vitals have been stable—no indications of intracranial hypertension.”
“Then you think I should bring her out of it.”
“What’s the hurry? The only risks in keeping her under are the usual ones for anesthesia: impaired gastrointestinal motility, suppressed immune response, a minor risk of infection or pneumonia. The risks are minimal; I’d give her another few days.”
Smithson smiled. “I’m bringing her out of it the day after tomorrow.”
“Then why did you ask my opinion?”
“I wanted to see what you’d say. I’m going to start backing off on the propofol late tomorrow.” He paused. “Then I plan to give her a dose of Versed.”
Kemp did a double take in spite of himself. “Versed? Why?”
“It helps with anxiety. I think it might help with her emotional readjustment, considering the trauma she’s been through. Is there some reason I shouldn’t?”
“There’s just no reason for it. You might use Versed to help jump-start a coma, but not when you’re bringing her out of it. The only effect it would have is to—”
Kemp stopped.
“What, Dr. McAvoy? What effect would it have?”
“It’s unnecessary medication, that’s all. It carries the same risks as all other anesthesia.”
“Which you said were minimal.”
“Yes, but—”
“I think what you were about to point out is that Versed has an amnesic effect—it erases memory.”
“It’s just unnecessary, that’s all—in fact it’s useless. Versed’s amnesic effect is limited; there’s no telling what she’ll remember and what she won’t.”
“Is that a problem?”
“Look, you asked my opinion and I’m telling you. All anesthesia involves risk, and prescribing a powerful sedative that may or may not have the intended effect is unprofessional. In fact, it’s unethical.”
“Thank you for your opinion, Doctor. Now perhaps I could get your opinion on something else.” He opened Liv Hayden’s chart and took out a folded computer printout. “These are Ms. Hayden’s electroencephalograms from the last few days—I was reviewing them just before you came in. There was really no reason to bother, since there haven’t been any complications or concerns, but like I said—I like to be thorough.” He unfolded the printout and spread it out on the bed. “Notice these sections—here and here. Ms. Hayden’s EEGs indicate that she’s been in a deep coma since her arrival a week ago—except for these two brief periods of time. According to the time code, each incident occurred in the middle of the night—one last night and one the night before. Each incident occurred while you were on duty.”
Kemp looked at the printouts. “Are you saying she regained consciousness?”
“It would have been more like a semiconscious state. Tell me, did you notice anything different about Ms. Hayden during those periods of time?”
“Like what?”
“Any change in her vitals? An increase in blood pressure or pulse rate?”
“Her vitals are all charted. You can check for yourself.”
“I already did. Were there any changes in her verbal or motor response? Any spontaneous eye movement?”
“I would have noticed that.”
“Yes, I’m sure you would. Just one more question, Dr. McAvoy . . . why exactly did you leave Johns Hopkins?”
Kemp just stared at him.
“You’re right, Dr. McAvoy, there’s no reason at all to give Ms. Hayden Versed. All it would do is block some of her memory—as any anesthesiologist would know. That’s why I suggested it, and when I did you just about had an aneurysm. Why is that? You don’t want her to forget anything from her time here, do you? What is it you
want her to remember so desperately? Your phone number? Your address? Your declarations of love?”
“Don’t be absurd. That would be unethical and illegal.”
“Yes, it would—and I’m wondering if you’re the sort of guy who would go that far.”
“Are you accusing me of something?”
“I don’t know,” Smithson said, “but I’m sure going to find out. I plan to put in a call to Johns Hopkins on Monday—they should get back to me in a day or two. I’m going to see if they can tell me what sort of person you really are. Have a nice night, McAvoy. If you’ve got any last messages for your girlfriend here, you’d better deliver them fast. She’s coming out of it on Sunday.”
22
Kemp allowed the door to the suite to slam shut behind him and immediately headed for the coffee. It was only their fourth day in the Century Plaza suite but the room was a complete disaster now; it looked like the Gulf Coast the day after Hurricane Katrina. The addition of a partner the size of Tino didn’t exactly help things.
The three men stopped writing and looked up.
“Hey,” Wes called out. “How’d it go last night?”
“Slick as a proctologist’s glove,” Kemp said. “What did you expect?”
“Did you make it through all the material?” Tino asked.
“Every line.”
“No problems then?”
“No problems.” Kemp paused. “But I’m afraid I’ve got some bad news.”
Biederman got up from the sofa. “What bad news? What’s going on? What happened?”
Kemp stared into his coffee cup; it looked like a layer of dirt had settled in the bottom. “I talked with Hayden’s neurologist last night. He plans to bring her out of her coma on Sunday.”
“Sunday? That’s tomorrow!”
“What does that mean for us?” Tino asked.
“It means we’ve only got one more shot at Hayden and that’s it. Tonight’s our last chance; later today they plan to start backing off on her propofol. I might be able to squeeze in a few extra minutes with her tonight, but that’s all. If there’s anything else we want our angel to say to her, he’d better say it tonight.”
