The cab dropped him on the sidewalk outside the huge hospital complex. He could see an emergency entrance down the block, with a large red-lettered sign and an ambulance in front. Ricky felt a chill sweep down his back despite the oppressive midsummer heat around him. It was a cold defined by the last time he had been at the hospital, which corresponded to visits to accompany his wife, while she was still fighting the disease that would kill her, still undergoing radiation and chemotherapy and all the other attacks against the insidious happenings within her body. The oncologists’ offices were in a different part of the complex, but this still didn’t remove the sense of impotence and dread that resurfaced throughout him, no different from when he’d last been on the streets outside the hospital. He looked up at the imposing brick buildings. He thought that he’d seen the hospital three times in his life: the first time, when he worked in the outpatient clinic for six months, before going into private practice; the second time when it joined the dismaying array of hospitals that his wife trudged to in her futile battle against death; and this third time, when he was returning to find the name of the patient whom he’d ignored or neglected, and who now threatened his own life.
Ricky trudged forward, heading toward the entrance, curiously hating the fact that he knew where the medical records were stored.
There was a paunchy middle-aged male clerk, wearing a garish Hawaiian print sport shirt and khaki pants stained with what might have been ink or the remains of lunch, standing at the records storage bank counter who looked at him with a bemused astonishment when Ricky first explained his request.
“You want exactly what from twenty years ago?” he said with undisguised incredulity.
“All the outpatient psychiatric clinic records from the six-month period I worked there,” Ricky said. “Every patient who came in was assigned a clinic number and a file was opened, even if they only came in one time. Those files contain all the case notes that were worked up.”
“I’m not sure those records have been transferred to the computer,” the clerk said reluctantly.
“I’ll bet they have,” Ricky said. “Let’s you and I check.”
“This will take some time, doctor,” the clerk said. “And I’ve got lots of other requests . . .”
Ricky paused, then thought for a moment, finally picturing how easy it seemed for Virgil and Merlin to get folks to perform simple little acts by waving cash in their direction. There was $250 in his wallet, and he removed $200, placing it on the counter. “This will help,” he said. “Perhaps put me at the head of the line.”
The clerk glanced around, saw that no one else was watching, and scooped up the money from the countertop. “Doctor,” he said, with a small grin, “my expertise is all yours.” He pocketed the cash and then wiggled his fingers in the air. “Let’s see what we can find out,” he said, starting to click entries into the computer keyboard.
It took the remainder of the morning for the two men to come up with a viable list of case file numbers. While they were able to isolate the critical year, there was no corresponding way to determine by computer whether the file numbers represented men or women, and similarly, there wasn’t a code that identified which physician had seen which patient. Ricky’s six months at the clinic had run from March through the start of September. The clerk was able to eliminate files started before and after. Narrowing the selection down further, Ricky guessed that Rumplestiltskin’s mother was seen sometime in the three-month period, over the summer, twenty years earlier. In that time frame, new patient files at the clinic had been opened for two hundred and seventy-nine people.
“You want to find one person,” the clerk said, “you’re gonna have to pull each file and inspect it yourself. I can get ’em out for you, but after that, you’re on your own. It isn’t going to be easy.”
“That’s okay,” Ricky said. “I didn’t expect it would.”
The clerk showed Ricky to a small steel table off to the side of the records office. There was a stiff-backed wooden chair, where Ricky took up his position, while the clerk started to bring the relevant files to him. It took at least ten minutes to collect all 279 different files, stacking them on the floor next to Ricky. The clerk provided him with a yellow legal pad and an old ballpoint pen, then shrugged. “Try to keep ’em in order,” he said, “so I don’t have to file ’em back one by one. And be careful with all the entries, please, like, don’t get documents and notes mixed up from one file to the next. Of course, I’m not guessing that anyone will ever want to see these again anyways, and why we keep ’em is beyond me. But hey, I don’t make the rules.”
The clerk looked at Ricky. “You know who makes the rules?” he asked.
“No,” Ricky replied, as he reached for the first file. “I don’t. The hospital administration, most likely.”
The clerk guffawed, snorting contempt and laughter. “Hey,” he said, as he walked back to his own perch by the computer, “you’re a shrink, doc. I thought your whole thing is to help people make up their own rules.”
Ricky didn’t reply to this, but considered it a wise assessment of what he did. The problem was, he thought, that all sorts of people played by their own rules. Especially Rumplestiltskin. He picked the first file from the top of the first pile, and opened it. It was, Ricky thought abruptly, like opening a folder of memory.
Hours fled around him. Reading the files was a little like standing in a waterfall of despair. Each contained a patient’s name, address, next of kin, and their insurance information, if there was any. Then there would be some typed notes on a diagnosis sheet, which delineated the patient’s assessment. There were also suggested modes of treatment. In a clipped and quick fashion, each name was broken down to their psychological essence. The meager words in the files were unable to hide the bitter truths that lay behind each person’s arrival at the clinic: sexual abuse, rage, beatings, drug addictions, schizophrenia, delusions—a Pandora’s box of mental illness. The outpatient clinic at the hospital had been a vestige of 1960s activism, a do-gooder plan to help the less fortunate, opening the hospital doors to the community. To give back was the operative phrase of the times. The reality had been significantly harsher and substantially less utopian. The urban poor suffered from a vast array of illnesses, and the clinic had rapidly discovered that it was no more than a single finger in a dike sprouting thousands of leaks. Ricky had come to it while completing the final stages of his psychoanalytic training. At least, that had been his official reason. But when he first joined the clinic staff, he had been filled with idealism and the determination of the young. He could remember walking through the doors wearing his distaste for the elitism of the profession he was entering, determined to bring analytic techniques to the wide range of the desperate. This liberal sense of altruism had lasted about a single week.
In his first five days, Ricky had his desk rifled by one patient seeking drug samples; he’d been assaulted by a wild man hearing voices and throwing punches; he’d watched as one session with a young woman was interrupted by an outraged pimp, armed with a straight razor, who managed to slice both his estranged girlfriend across the face and the security guard across the arm before being subdued; and he’d been forced to send a preteen girl to the emergency room for treatment of cigarette burns on her arms and legs and still she would not tell Ricky who had put them there. He remembered her well enough; she was Puerto Rican and had soft, beautiful black eyes the same raven color as her hair, and she had come to the clinic knowing that someone was sick and that soon enough it would be she, as well, appreciating that abuse creates abuse in a way far more profound than any government study of clinical trials could ever understand. She had had no insurance and no way of paying and so Ricky saw her five times, which was what the state would allow, trying to pry information from her, when she knew that by talking about who was torturing her would probably cost her her life. He remembered it was hopeless. And he knew that if she survived, she was still doomed.
Ricky picked up ano
ther file and briefly wondered how he’d even managed to last six months at the clinic. He thought to himself that the entirety of his time there he’d spent feeling utterly and completely helpless. Then he recognized that the helplessness he felt at the hands of Rumplestiltskin was not all that different.
With that thought drumming his emotions onward, he tossed himself into the 279 files of the people he’d seen and treated all those years ago.
A good two-thirds of the people he’d seen had been women. Like so many married to poverty, they wore the rags of mental illness as obviously as they did the cuts and bruises of the abuse they received daily. He’d seen everything from addiction to schizophrenia, and he remembered how impotent the work had made him feel. He had fled back to the upper middle class from where he’d come, where low self-esteem, and the problems that accompanied it, could be talked into, if not cure, acceptance. He’d felt stupid trying to talk with some of his clinic patients, as if discussion could solve their mental anguish, when the reality would probably have been better served by a revolver and some guts, a selection, he remembered, a few had chosen, after coming to the recognition that one prison was preferable to another.
Ricky opened another file from that time, and spotted his handwritten notes. He pulled these out and tried to connect the name on the file with the words he had scrawled down. But the faces seemed vaporous, wavy, like distant heat above a highway on a hot summer day. Who are you? he asked himself. Then, he added a second question: What became of you?
A few feet away, the records office clerk dropped a pencil from his desk, and with a small cursed obscenity, reached down for it.
Ricky eyed the man for a moment, as the clerk bent back to the computer screen glowing in front of him. And, in that second, Ricky saw something. It was almost as if the way the man’s back was hunched over slightly, the nervous tic he had of drumming a pencil against the desktop, the narrow way he slumped forward, all spoke a language Ricky should have understood from the first minute, or at least in the way the man’s hand had clawed up the money Ricky offered him. But Ricky was only a tourist in this particular land, and that, he thought, explained why it had taken him some time to understand. He quietly pushed away from his table and stepped over behind the man.
“Where is it?” Ricky demanded in a low voice. As he spoke, he reached out and gripped the man’s collarbone tightly.
“Whoa! What?” The clerk was taken by surprise. He tried to shift about, but the pressure of Ricky’s fingers digging into the flesh and bone limited his movement. “Ouch! What the hell?”
“Where is it?” Ricky repeated, more sharply.
“What are you talking about? Damn it! Let me loose!”
“Not until you tell me where it is,” Ricky said. By now he’d lifted his left hand and also seized the man’s throat, beginning to squeeze. “Didn’t they tell you I was desperate? Didn’t they tell you how much pressure I was under? Didn’t they tell you I might be unstable? That I might do anything?”
“No! Please! Ouch! No, damn it, they didn’t say that! Let me go!”
“Where is it?”
“They took it!”
“I don’t believe you.”
“They did!”
“All right. Who exactly took it?”
“A man and a woman. Just about two weeks ago. They come in.”
“The man was well dressed, paunchy, said he was a lawyer? The woman was a real looker?”
“Yes! Them. What the hell’s this all about?”
Ricky released the clerk, who instantly pushed back from him. “Jesus,” the man said, rubbing his collarbone. “Jesus, what’s the big deal?”
“How much did they pay you?”
“More than you did. A whole lot more. I didn’t think it was so goddamned important, you know. It was just one file from way long ago that nobody’d even looked at for two decades. I mean, what’s the trouble with that?”
“What did they tell you it was for?”
“Guy said it was part of a legal case, involving an inheritance. I couldn’t see that, you know. The folks come to that clinic, they don’t got much in the way of inheritance, generally speaking. But the man gave me his card, told me he’d return the file when they were finished with it. I didn’t see the problem.”
“Especially when he handed you some cash.”
The clerk seemed reluctant, then he shrugged.
“Fifteen hundred. In new hundreds. Peeled ’em right off a wad, like some sort of old-time gangster. You know, I got to work two weeks for that sort of money.”
The coincidence of the amount was not lost on Ricky. Fifteen days’ worth of hundreds. He glanced over at the stack of files and despaired at the hours of the day he’d already wasted. Then he looked back at the clerk, narrowing his glare. “So the file I need is gone?”
“I’m sorry, doc, I didn’t realize it was some big deal. You want the guy’s card?”
“I’ve already got one.” He continued to stare at the clerk, who shifted about in his seat uncomfortably. “So they took the file, and paid you off, but you’re not that stupid, are you?”
The clerk twitched slightly. “What do you mean?”
“I mean, you’re not that stupid. And you haven’t worked in a records office for all these years without learning a little bit about covering your tail, right? And so, one file in all these stacks is missing, but not before you made sure of something, right?”
“What are you talking about?”
“You didn’t give up that file without copying it, did you? No matter how much the guy paid you, it occurred to you that maybe, just maybe, the someone else who just might come looking for it might have more juice than the lawyer and the woman, right? In fact, maybe they even told you someone might come in here searching for it, isn’t that right?”
“They might have said that.”
“And maybe, just maybe, you thought you could make another fifteen hundred or even more, if you had the thing copied, correct?”
The man nodded. “You gonna pay me, too?”
Ricky shook his head. “Consider the payment the fact that I don’t call your boss.”
The clerk seemed to sigh, measuring this statement, finally seeing in Ricky’s face enough anger and stress to believe the threat in its entirety. “There weren’t a whole helluva lot in the file,” he said slowly. “An intake form and a couple of pages of notes and instructions attached to a diagnosis form. That’s what I got copied.”
“Hand them over,” Ricky said.
The clerk paused. “I don’t want any more trouble,” he said. “Suppose someone else comes looking for this stuff . . .”
“I’m the only other person,” Ricky said.
The clerk bent down and opened a drawer. He reached in and produced an envelope that he handed to Ricky. “There,” he said. “Now leave me alone.”
Ricky glanced inside and saw the necessary documents. He resisted the urge to pore over them right there, telling himself that he needed to be by himself when he probed his past. He stood, slipping the envelope into his jacket. “This is it?” he asked.
The clerk paused, then reached down and plucked another, smaller envelope from the desk drawer. “Here,” he said. “This goes with it. But it was attached to the outside of the file, you know, clipped on. I didn’t give it to the guy. I don’t know why. Figured he had it, because he seemed to know all about the case.”
“What is it?”
“A police report and a death certificate.”
Ricky breathed in sharply, filling his lungs with the stale hospital basement air.
“What’s so important about some poor woman who showed up at the hospital twenty years ago?” the clerk abruptly asked.
“Someone made a mistake,” Ricky answered.
The clerk seemed to accept this explanation. “So now someone’s got to pay?” he asked.
“It would seem so,” Ricky replied, as he gathered himself to leave.
Chapter Eighteen
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nbsp; Ricky walked out of the hospital building, still feeling a tingling in his hands, especially in the fingertips that he’d dug deeply into the clerk’s collarbone. He was unable to recall a moment in his life when he’d used force to accomplish something. He thought he lived in a world of persuasion and discussion; the idea that he’d used physical strength to threaten the clerk, even if so modestly, told him that he was crossing some sort of odd barrier, or stepping past some unspoken point of demarcation. Ricky was a man of words, or, at least, had thought so until he’d received the letter from Rumple-stiltskin. In his pocket was the name of the woman he’d treated at a moment of transition in his own life. He wondered if he had reached another such point. And, in the same moment, he wondered whether he was standing at the edge of the road to becoming something new.
The Analyst Page 24
