Delirious

by Daniel Palmer

Rachel cleared her throat. It was an unconscious response that Charlie interpreted as a willingness to compromise. A good sign. He listened as Rachel typed something on her keyboard—a Google search to retrieve the exact text of the law, he hoped.

  Rachel read Section 36B into the phone. When she got through sub-point A, Charlie smiled. He listened carefully as she reread the passage at his request.

  “The patient has communicated to the licensed mental health professional an explicit threat to kill or inflict serious bodily injury upon a reasonably identified victim or victims and the patient has the apparent intent and ability to carry out the threat, and the licensed mental health professional fails to take reasonable precautions as that term is defined in section one.”

  “And the patient has the apparent intent and ability to carry out the threat,” Charlie repeated, emphasizing that the law required a showing of ability along with the threat.

  “Yes. That is what it says.”

  “Well, I don’t have that ability, Rachel,” Charlie said.

  “How can you prove that to me, Charlie?”

  “I can prove it by going to the hospital, as you suggested. I can get evaluated. They can make a diagnosis. Perhaps offer some recommendation or treatment. The proof is when I call you from the ER.”

  This time Rachel’s lengthy silence was not punctuated by her quiet breathing. She was deep in thought, perhaps even holding her breath. Charlie did the same. He knew her answer meant everything.

  “Which hospital?”

  He could have used InVision to locate the nearest emergency room, but it wasn’t necessary. He knew exactly where the closest ER was to him. How could he not? His mother was a patient there.

  “Mount Auburn Hospital. Fifteen minutes away.”

  “I’m calling the ER in twenty. If they don’t know who you are, the next call I’m going to make is to Simon Mackenzie.”

  Charlie tried to thank her, but the line was already dead.

  Chapter 22

  Rachel Evans stared at the phone on her desk but could not bring herself to reach for the receiver. When she finally did, she made a surprise move and pulled her hand away before picking it up. She knew she had to make the call to Mackenzie’s office; it had been her intention to do so all along. At least by offering Charlie the impression of a deal, she felt confident he would heed her advice and go to the nearest hospital. It wasn’t a technique scripted out of any training manual she had studied, but Rachel wasn’t a rising star at Walder-man for her linear thinking, either.

  Charlie was a good talker; she had to give him credit for that. Without missing a beat, he had capitalized on a potentially viable loophole in the law with decisive precision. Intellectually, she understood why Charlie opposed her contacting Mackenzie, but instinct made Rachel suspicious more was at stake than his sterling corporate reputation. Even so, she still felt guilty for deceiving him and wondered if more harm than good would come from her contacting his former boss. The law, however, demanded she take action, but that didn’t make it any easier.

  Rachel distracted herself from making the call by examining Joe’s extensive case file. Perhaps something in it would help to shed light on Charlie’s erratic behavior. She would feel better making the call if armed with even a cursory hypothesis to work from. Yet everything about Charlie’s situation presented her with a truly unique conundrum. What she gleamed from Joe’s file suggested only that the dice of DNA had come up lucky seven when Charlie was born.

  The only references pertaining to Charlie that Joe had made in therapy had to do with his understandable frustration at his brother’s ongoing apathy. Perhaps Alison Giles’s sudden illness was a factor, or maybe the stress of moving in with Joe had extracted too great an emotional toll on Charlie. The timing wasn’t quite right, though, she concluded. Charlie had come to see her before he knew about his mother being hospitalized. Nothing in Rachel’s notes from her last session with Joe, the make-up appointment for the one he’d missed, hinted at Charlie’s stunning decline. In fact, she had noted that Joe seemed to be enjoying having his brother around.

  Indeed, the lack of any warning signs troubled her greatly. Charlie was fine one minute and falling apart the next. Not unheard of, Rachel reminded herself, but certainly unusual. Either his case would prove to be a rare anomaly or perhaps, she excitedly considered, the spark of some startling new discovery in neuroscience. Whatever the outcome, Charlie was in desperate need of help, and Rachel’s trickery, though ethically suspect, should ensure just that.

  No sooner had Rachel closed Joe’s folder than her hand grasped the phone’s receiver. It took a moment to route her call through SoluCent’s main reception, but eventually she was put through. A cheery, mature-sounding woman answered on the first ring.

  “Simon Mackenzie’s office, may I help you?”

  Rachel felt her throat tighten. It wasn’t until she actually made the call that she fully understood Charlie’s vocal opposition to the idea. If the industry was as gossipy and close-knit as he had implied, her call was tantamount to a lynching.

  “Yes, I was wondering if I could speak with Mr. Mackenzie,” Rachel said.

  “I’m afraid Mr. Mackenize is out of the country on business and won’t be returning until sometime next week. May I take a message?”

  Rachel thought a moment, and a thin smile escaped her lips. Technically, her responsibility was to avert any immediate threat to persons named. Mackenzie was in no immediate danger, as he was traveling on business. What harm could come from her giving Charlie a chance for a proper medical evaluation? Perhaps she could spare him from the indignity he justly feared. Rachel decided to phone Mount Auburn Hospital in ten minutes to check in on Charlie and take it from there.

  “No message,” Rachel said. “I’ll just try back later if needed.”

  “Thank you for calling. Have a pleasant afternoon.”

  Rachel hung up the phone, feeling quite good about herself. Yes,

  she was feeling quite good indeed.

  Chapter 23

  The automatic doors of Mount Auburn Hospital opened as Charlie approached. It was midafternoon on a Thursday, and on any other day he’d turn right and walk the all too familiar fluorescent-lit linoleum hallway toward Ellison 5 and his mother’s ICU bedside. This time he had to pause to scan a wall placard in front of him, looking for the directional arrow that would point him toward the ER. The ER was in the opposite direction of Ellison 5, and while walking along that corridor, he bumped into June Hollie, the nurse in charge of the ICU and one of Joe’s favorites.

  “Are you lost, Charlie?” June asked with a warm smile.

  Charlie froze and stared blankly back at June. “Yes … I guess I’m just wandering the halls, thinking,” he managed to say.

  She squeezed his arm gently; her eyes felt kind and practiced.

  “Of course,” she said. “I just took a bit of a walk myself.”

  “Actually, I’m glad I bumped into you,” Charlie said. “I was wondering if you got my message.”

  “About your mother’s responsiveness?” June asked.

  “Yes,” Charlie replied. “It’s just that I thought the last time I was here, she was moving her arm. And it seemed voluntarily to me, at least whenever I touched her. I pinched her even and was certain there was movement after that, too. Did you notice the same?”

  June kept her eyes locked on his. Her compassion and empathy were visible, as though she were a part of the family and not a paid professional.

  “We’ve kept a close watch. And we’ve tried the same things you reported,” June replied. “I’m sorry, Charlie. But we didn’t notice any movement at all.”

  Charlie nodded. “Perhaps, it’s just that I wanted there to be,” he offered.

  “That can certainly happen. Will we be seeing you soon? I’ll tell Judy and Samantha to be on the lookout.”

  He nodded again, more eagerly than he had intended. A lengthy visit to the ICU felt like a blessing compared to what he was about to
go through.

  “I’ll be up soon,” he said.

  June squeezed his arm again, smiled politely, and walked past him, on her way to Ellision 5, the ICU, and Alison Giles’s bedside. With a deep, anxious sigh, Charlie turned and made his way for the emergency room.

  The waiting room of the Mount Auburn ER was mostly empty. A boy sat with his arm encased in ice, tears welling in his eyes, while his worried mother sat stoic by his side. On another chair a man in his late fifties watched a soap opera airing on the wall-mounted T V. He wore a tattered olive green army jacket that seemed to come straight out of the “to be tossed” bin at an Army-Navy store. Whatever his ailment, it wasn’t visible to Charlie, and he showed no eagerness to be seen by hospital staff.

  Charlie announced himself to the intake nurse. Mindful that Rachel might follow through on her threat to call, he made certain she wrote down his name before taking the forms and clipboard she handed him to the waiting area as instructed. Even without a heavy influx of patients, the wait lasted past the end of the soap opera and a good fifteen minutes into the start of another. The man in the olive green army jacket hadn’t moved and didn’t seem the least bothered by his wait. A nurse had called the boy into the ER, his mother in tow. A few others arrived, none seriously injured, and took their seats with the requisite forms to complete. Nobody sat near Charlie or the olive green army jacket man. They were the poisonous ones, Charlie thought. The men without cuts or visible trauma, loners in the ER, who seemed to be viewed by the other patients with a caution one might reserve for a wild animal.

  Thirty minutes had passed before a nurse emerged from the waiting room and called his name.

  “Charlie Giles?”

  He needed a moment for his name to register. The idea that he was actually going to be a patient in the hospital had yet to sink in.

  “That’s me,” Charlie said, standing.

  “Follow me,” the nurse said.

  Charlie walked a few paces behind. She pulled back a thin white sheet hanging from a semicircular rod, like that in a hotel shower, and directed him to take a seat on the empty bed.

  “How are you feeling today?” she asked. “Your chart indicates you were referred to us by your psychiatrist. You didn’t list your physician’s contact name. Can you tell me your psychiatrist’s name?”

  “She’s not really my psychiatrist,” Charlie said. “She’s more of a friend, I guess you could say, who also happens to be a mental health professional.”

  “Okay,” said the nurse, her tone warning him not to try additional avoidance tactics. “Then can you tell me why your friend suggested you come in today?”

  He hated how she emphasized the word friend. Charlie took a deep breath and gathered his thoughts, hoping that she would nod her head, as if what he would say was commonplace.

  “I’ve been experiencing lost time,” Charlie said.

  She looked at him. “Lost time?”

  “I may have done things that I can’t remember doing,” Charlie explained.

  “I see,” she said. “That can be very scary.”

  Though her body language didn’t offer any solace that a quick diagnosis was to come, Charlie was grateful that she didn’t seem judgmental, or worse, act afraid of him. The willingness to listen to a total stranger who made outlandish, perhaps committable statements was beyond his comprehension. If the roles had been reversed, he would have dismissed the person as crazy. But her compassionate attitude suggested she was willing to listen and, above all, to believe.

  She asked a few more questions and jotted down additional information on a PC tablet. Charlie was uncomfortable that his personal information was now the official property of the Mount Auburn patient database. If Rachel had not threatened to contact Mackenzie, Charlie would never have come.

  The vital tests were quick. She checked his blood pressure, heart rate, and gave him a brief eye exam, presumably looking for drug use. In minutes she had completed her checklist.

  “I’ll tell the doctor to hurry. I can see you’re anxious to get this over with.”

  They made eye contact. It was as though she could look right through his armor and tell that he was truly scared.

  “I appreciate that,” Charlie said.

  “It won’t be long. I promise.”

  The nurse slipped outside the curtained enclosure with a quick wave good-bye.

  Charlie looked down at his watch. He wondered if Rachel had kept her promise to call. Perhaps, he thought, it was all a bluff to get him to seek the help she thought he needed. For the first time since this nightmare had started, he began to believe that she was right.

  The curtain was pushed aside, and an Indian woman entered.

  “I’m Dr. Asha John,” she said, extending a hand to Charlie. Dr. John’s handshake was strong, the nails on her hand cut short. She had wavy dark hair past her shoulders and wore a white coat over a pair of green hospital scrubs and white tennis sneakers. A pair of tortoiseshell glasses hung around her neck from a gold chain lanyard. Charlie stared at her name tag longer than he had intended.

  “My husband is an American. I took his name,” she preemptively explained.

  Charlie reddened, then nodded.

  “So tell me, Mr. Giles. What is troubling you today?”

  Charlie repeated what he had told the RN.

  “And these episodes … How many do you think have occurred?” Dr. John asked.

  “If I could answer that, I wouldn’t have lost that time, would I?”

  Her expression revealed nothing. “Have you had any severe headaches since this began?”

  “No.”

  “What about fevers? Vomiting? Drowsiness?”

  “No to all,” Charlie said.

  She placed her long, delicate fingers along the sides of Charlie’s neck and began pressing them against his skin, as though playing keys on a piano.

  “My throat feels fine,” Charlie said.

  “Yes. I’m sure it does,” Dr. John said. Then she moved her fingers higher and felt up by his ears and across his cheeks with the same pressing motion.

  “Can I ask what you’re looking for?”

  “Well, Mr. Giles, normally I would have to phone the psychiatrist on call, seeing as I’m not trained in that specialty. However, patient volume is light today. I’d like to rule out some other possibilities if I could before making that call.”

  “Such as?”

  “Encephalitis, for one.”

  “Encephalitis?” Charlie had heard of the condition before but wouldn’t have been able to identify the symptoms.

  “It’s an inflammation of the brain,” she said. “It’s brought on by a viral infection. It has been documented to change behavior in some patients, alter personalities. It could explain your lost time. Do you have any viruses you know about? Herpes, for instance?”

  “No,” Charlie said.

  She continued to feel around his cheeks. “I’m checking your parotid glands for any sign of the mumps. It’s rare for mumps to cause encephalitis, but less so than mosquitoes. At least around these parts.”

  “Why do you think it might be encephalitis?” Charlie asked.

  That stopped her examination. “Right now, Mr. Giles, my job is not to figure out what might be causing this,” she said. “My job is to figure out what isn’t. I’d like to rule out several possibilities. It’s going to take some blood work. I’d like for you to stay here. At least until the blood work is done and I’ve had a chance to contact our staff psychiatrist if needed.”

  “How long will that take?” Charlie asked.

  “A few hours,” she said. “No more than three.”

  Charlie thought. It was strange that something as dire-sounding as encephalitis would seem like a blessing. It felt curable, at least. Even though he hadn’t been entirely truthful about all his symptoms, he’d been honest about his lost time. Perhaps Rachel’s first suggestion was correct: something was physically wrong with his brain. Waiting a few hours for an explanation fo
r the madness of the past several weeks was a small price to pay. He couldn’t do anything for

  Gomes now. The police would find him soon enough. But perhaps

  something could still be done to save himself. “Do you want me to wait right here?”

  “That’ll be fine. I’ll get one of the nurses to draw your blood.” “Bring it on,” Charlie said. For the first time in days he felt a small

  glimmer of hope. A swelling brain felt a lot less scary than a mind he

  couldn’t control.

  Chapter 24

  It took a few minutes of gnawing before Charlie realized that he was biting down on his knuckle. It was a habit he’d developed as a kid, around the same time his father had stopped taking medication for psychosis and started behaving erratically. Few in his class had teased him about it. Without peer pressure to stop it, the habit had become part of Charlie’s makeup. His classmates had seen it as a sign of his competitive nature, a visible barometer of the intensity that propelled Charlie to excel in all facets of school life—academics, athletics, and popularity.

  It wasn’t until after a particularly stressful exam in college that he stopped. In study group, he had actually broken skin and begun sucking out his blood. A woman had noticed a thin line of red dripping down his chin and had screamed loudly. The embarrassment had brought the habit to an immediate and long overdue end—until now.

  Charlie rose and paced around the small enclosed examination area. The equipment was for the most part familiar: a blood pressure machine, bins of sterile instruments, bandages, a small oxygen tank, and several intercoms and buttons for alerting staffers to emergent situations. He sat down on a swivel stool that he’d pulled out from underneath a desk fastened to the wall. The bed was making him uncomfortable. It felt more appropriate for the truly infirm. He kept the curtain drawn and listened to the sounds of patients crying out in pain, of doctors and nurses consoling and healing. Charlie pictured each measure from the first Charlie Christian tune that he’d memorized. The mental exercise was at least helping him to relax. Perhaps, he thought, when he held a piece of paper in his hands, something that had been generated from lab tests, produced by computers, validated by technology, he would embrace the idea that he could be seriously ill. Until then, this whole experience served one important purpose—to keep Mackenzie in the dark about the kill list.