I walked through the door with several pairs of maternal eyes boring into my back. Some of them had probably been waiting for over an hour. I wondered why Towle didn't hire an associate.
Sandi showed me into the doctor's consultation office, a dark-paneled room about twelve by twelve.
"It's about the Quinn child, isn't it?"
"That's right."
"I'll pull the chart." She came back with a manila folder and placed it on Towle's desk. There was a red tag on the cover. She saw me looking at it.
"The reds are the hypers. We code them. Yellow for chronically ill ones. Blue for specialty consults."
"Very efficient."
"Oh, you have no idea!" She giggled and placed one hand on a shapely hip. "You know," she said, leaning a bit closer and letting me have a whiff of something fragrant, "between you and me that poor child has it rough growing up with a mother like that."
"I know what you mean." I nodded, not knowing what she meant at all but hoping she'd tell me. People usually do when you don't seem to care.
"I mean, she's such a scatterbrain--the mother. Everytime she comes here she forgets something, or loses something. One time it was her purse. The other time she locked her keys in the car. She really doesn't have it together."
I clucked sympathetically.
"Not that she hasn't had it rough, growing up doing farm work and then marrying that guy who ended up in pris--"
"Sandi."
We both turned to see a short, sixtyish woman with hair cut in an iron-grey helmet, standing in the doorway, arms folded across her bosom. Her eyeglasses hung suspended from a chain around her neck. She, too, was dressed in white, but on her it looked like a uniform. Her name tag proclaimed her to be Edna.
I knew her right away. The doctor's right-hand gal. She'd probably been working for him since he hung out his shingle and was making about the same amount of money she'd started out with. But no matter, lucre wasn't what she was after. She was secretly in love with the Great Man. I was willing to bet a handful of blue chip stocks that she called him Doctor. No name after it. Just Doctor. As if he were the only one in the world.
"There are some charts that need filing," she said.
"Okay, Edna." Sandi turned to me, gave a conspiratorial look that said Isn't this old witch a drag? and sashayed down the hall.
"Can I do anything for you?" Edna asked me, still keeping her arms crossed.
"No, thank you."
"Well, then, Doctor will be right with you."
"Thank you." Kill 'em with courtesy.
Her glance let me know that she didn't approve of my presence. No doubt anything that upset Doctor's routine was viewed as an intrusion upon Paradise. But she finally left me alone in the office.
I took a look around the room. The desk was mahogany and battered. It was piled high with charts, medical journals, books, mail, drug samples, and a jar full of paper clips. The desk chair and the easy chair in which I sat were once classy items--burnished leather--now both aged and cracked.
Two of the walls were covered with diplomas, many of which hung askew and at odds with one another. It looked like a room that had just been nudged by a minor earthquake--nothing broken, just shaken up a bit.
I casually examined the diplomas. Lionel W. Towle had amassed an impressive collection of paper over the years. Degrees, certificates of internship and residency, a walnut plaque with gavel commemorating his chairmanship of some medical task force, honorary membership in this and that, specialty board certification, commendations for public service on the Good Ship Hope, consultant to the California Senate subcommittee on child welfare. And on and on.
The other wall displayed photographs. Most were of Towle. Towle in fisherman's garb, knee-deep in some river holding aloft a clutch of steelhead. Towle with a marlin the size of a Buick. Towle with the mayor and some little squat guy with Peter Lorre eyes--everyone smiling, shaking hands.
There was one exception to this seeming self obsession. In the center of the wall hung a color photograph of a young woman holding a small child. The colors were faded and from the styles of clothing worn by the subjects, the picture looked three decades old. There was some of the tell-tale fuzziness of an enlarged snapshot. The hues were misty, almost pastel.
The woman was pretty, fresh-faced, with a sprinkle of freckles across her nose, dark eyes and medium length brown hair with a natural wave. She wore a filmy-looking, short-sleeved dress of dotted swiss cotton, and her arms were slender and graceful. They wrapped around the child--a boy--who looked around two or younger. He was beautiful. Rosy cheeked, blond, with cupid's-bow lips and green eyes. He was dressed in a white sailor suit and sat beaming in his mother's embrace. The mountains and lake in the distance looked real.
"It's a lovely picture, isn't it?" said the voice I'd heard over the phone.
He was tall, at least six-three, and lean, with the kind of features bad novels label as chiseled. He was one of the most handsome middle-aged men I had ever seen. His face was noble--a strong chin bisected by a perfect cleft, the nose of a Roman senator, and twinkling eyes the color of a clear sky. His thick, snow white hair hung down over his forehead, Carl Sandburg style. His eyebrows were twin white clouds.
He wore a short white coat over a blue oxford shirt, burgundy print tie, and dark gray trousers of a subtle check. His shoes were black calfskin loafers. Very proper, very tasteful. But clothes didn't make the man. He would have looked patrician in double knits
"Dr. Delaware? Will Towle."
"Alex."
I stood and we shook hands. His grip was firm and dry. The fingers that clasped mine were enormous and I was conscious of abundant strength behind them.
"Please, sit."
He took his place behind the desk, swiveled back and threw his feet up on top, resting on a year's back issues of the Journal of Pediatrics.
I responded to his question.
"It is a beautiful shot. Somewhere in the Pacific Northwest?"
"Washington state. Olympic National Forest. We were vacationing there in fifty-one. I was a resident. That was my wife and son. I lost them a month later. In a car crash."
"I'm sorry."
"Yes." A distant, sleepy look came on his face; it was a moment before he shook himself out of it and came back into focus.
"I know you by reputation, Alex, so it's a pleasure to get to meet you."
"Same here."
"I've followed your work, because I have a strong interest in behavioral pediatrics. I was particularly interested in your work with those children who'd been victimized by Stuart Hickle. Several of them were in the practice. The parents spoke highly of your work."
"Thank you." I felt as if I was expected to say more but that was one subject that was closed. "I do remember sending consent forms to you."
"Yes. yes. Delighted to cooperate."
Neither of us spoke, then we both spoke at the same time.
"What I'd like to--" I said.
"What can I do for--" he said.
It came out a garbled mess. We laughed, good old boys at the University Club. I deferred to him. Despite the graciousness I sensed an enormous ego lurking be hind that white forelock.
"You're here about the Quinn child. What can I do for you?"
I filled him in on as few details as possible, stressing the importance of Melody Quinn as a witness and the benign nature of the hypnotic intervention. I ended by requesting that he allow her to go off Ritalin for one week.
"You really think this child will be able to give you information of substance?"
"I don't know. I've asked the same question. But she's all the police have got."
"And your role in all of this?"
I thought up a quicky title.
"I'm a special consultant. They call me in sometimes when there are children involved."
"I see."
He played with his hands, constructing ten-legged spiders and killing them.
"I don't know, Alex. When we star
t to remove a patient from what has been determined to be an optimal dosage we sometimes upset the entire pattern of biochemical response."
"You think she needs to be on medication constantly."
"Of course I do. Why else would I prescribe it for her?" He wasn't angry or defensive. He smiled calmly and with great forbearance. The message was clear: Only an idiot would doubt him.
"There'd be no way to reduce the dosage?"
"Oh, that's certainly possible, but it creates the same type of problem. I don't like to tamper with a winning combination."
"I see." I hesitated, then continued. "She must have posed quite a problem to merit sixty mgs."
Towle placed a pair of reading glasses low on his nose, picked up the chart and flipped through it.
"Let me see. Ah, yes. Hmm. "Mother complains of severe behavioral problems." " After thumbing through a few more pages: " "Teachers report failure to complete school assignments. Difficulty in maintaining attention span for more than brief periods." Ah--here's a later notation--"Child struck mother during argument about keeping room clean." And here's a note of mine: "Poor peer relations, few friends." "
I was certain that the argument had something to do with giving away the giant walrus, Fatso. The gift from Daddy. And as for friends--it was easy to see that M and M Properties wouldn't truck with that kind of nonsense.
"That sounds pretty severe to me, don't you think?"
What I thought was that it was horse shit. There'd been nothing resembling a thorough psychological evaluation. Nothing beyond taking the mother at her word. I looked at Towle and saw a quack. A nice looking, white-haired quack with lots of connections and the right pieces of paper on his wall. I longed to tell him so, but that would do nobody--Melody, Milo---any good.
So I hedged.
"I can't say. You're her doc." Faking the comradely grin was an exercise in moral self-control.
"That's right, Alex. I am." He leaned back in his chair and placed his hands behind his head. "I know what you're thinking. Will Towle is a pill pusher. Stimulants are just another form of child abuse."
"I wouldn't say that."
He waved away my objection.
"No, no, I know. And I don't hold it against you. Your training is behavioral and you see things behaviorally. We all do it, settle into professional tunnel vision. The surgeons want to cut everything out. We prescribe and you fellows like to analyze it to death."
It was starting to sound like a lecture.
"Granted, drugs have risks. But it's a matter of cost-risk analysis. Let's consider a child like the Quinn girl. What does she start out with? Inferior genes-both parents somewhat limited intellectually." He made the word limited sound very cruel. "Lousy genes and poverty, and a broken marriage. Absent father-although in some of these cases the children are better off without the kind of role models the fathers provide. Bad genes, bad environment. The child's got two strikes against her before she leaves the womb.
"Is it any wonder then that soon we're seeing all the telltale signs--antisocial behavior, noncompliance, poor school performance, unsatisfactory impulse control?"
I felt a sudden urge to defend little Melody. Her genial doctor was describing her as some kind of total misfit. I kept silent.
"Now a child like this--" he took off his glasses and put down the chart--"is going to have to do moderately well in school in order to achieve some semblance of a decent life for herself. Otherwise it's another generation of P.P.P."
Piss-poor protoplasm. One of the quaint expressions dreamed up by the medical profession to describe especially unfortunate patients.
Playing straight man to Towle wasn't my idea of a fun afternoon. But I had a hunch it was some kind of ritual, that if I held out and let him smilingly browbeat me he might give me what I came for.
"But there is no way a child like this can achieve with her genes and her environment working against her. Not without help. And that's where stimulant medication comes in. Those pills allow her to sit still long enough and pay attention long enough to be able to learn something. They control her behavior to the point where she no longer alienates everyone around her."
"I got the impression that the mother was using the medication in a haphazard way--giving her an extra pill on days when there were lots of visitors at the apartment complex."
"I'll have to check that." He didn't sound concerned. "You have to remember, Alex, that this child does not exist in a vacuum. There's a social context here. If there's nowhere for her mother and her to live, that isn't exactly therapeutic, is it?"
I listened, certain there was more. Sure enough: "Now you may ask, what about psychotherapy? What about behavior modification? My answer is: What about them? There is no chance of this particular mother developing the capacity for insight to successfully benefit from psychotherapy. And she lacks the ability to even comply with a stable system of rules and regulations necessary for behavior mod. What she can deal with is administering three pills a day to her child. Pills that work. And I don't mind telling you, I don't feel a damn bit guilty about prescribing them, because I think they're this child's only hope."
It was a great ending. No doubt it made a big hit at the Western Pediatric Ladies Auxiliary Tea. But basically it was all crap. Pseudoscientific gibberish mixed in with a lot of condescending fascism. Dope up the Untermenschen to make them good citizens.
He had worked himself up a bit. But now he was perfectly composed, as handsome and in control as ever.
"I haven't convinced you, have I?" He smiled.
"It's not a matter of that. You raise some interesting points. I'll have to think about it."
"That's always a good idea, thinking things over." He rubbed his hands together. "Now, back to what you came for--and please forgive my little diatribe. You really think that taking this child off stimulants will make her more susceptible to hypnosis." "I do."
"Despite the fact that her concentration will be poorer?"
"Despite that. I've got inductions that are especially suited for children with short attention spans."
The snowy eyebrows rose.
"Oh, really? I'll have to find out about those. You know, I did some hypnosis, too. In the Army, for pain control. I know it works."
"I can send you some recent publications."
"Thank you, Alex." He rose and it was clear that my time was up.
"Pleasure to meet you, Alex." Another handshake.
"The pleasure is mine, Will." This was getting sickening.
The unasked question hung in the air. Towle snagged it.
"I'll tell you what I'm going to do," he said, smiling ever faintly.
"Yes?"
"I'm going to think about it."
"I see."
"Yes, I'll think it over. Call me in a couple of days."
"I'll do that, Will." And may your hair and teeth fall out overnight, you sanctimonious bastard.
On the way out Edna glared and Sandi smiled at me. I ignored them both and rescued Milo from the trio of munchkins that was climbing over him as if he were playground equipment. We made our way through the now-boiling mob of children and mothers and reached the car safely.
5
I told Milo about the encounter with Towle as we drove back to my place.
"Power play." His forehead creased and cherry sized lumps appeared just above his jawline.
"That and something else that I can't quite figure. He's a strange guy. Comes across very courtly-almost obsequious--then you realize he's playing games."
"Why'd he have you come all the way out there for something like that?"
"I don't know." It was a puzzle, his taking time out from a frantic afternoon to deliver a leisurely lecture. Our entire conversation could have been handled in a five-minute phone call. "Maybe it's his idea of recreation. One-upping another professional."
"Hell of a hobby for a busy man."
"Yeah, but the ego comes first. I've met guys like Towle before, obsessed with being in control, wi
th being the boss. Lots of them end up as department heads, deans and chairmen of committees."
"And captains and inspectors and police chiefs."
"Right..."
"You going to call him like he said?" He sounded defeated.
"Sure, for what it's worth." "Yeah."
Milo reclaimed his Fiat and after a few moments of prayer and pumping it started up. He leaned out of the window and looked at me wearily.
"Thanks, Alex. I'm going to go home and crash. This no-sleep routine is catching up with me..."
When the Bough Breaks Page 6
