Blameless (20 page)

Diana sat down at her desk and tapped her pen on the pile of papers she had compiled for Valerie. Maybe the ectopic pregnancy hadn’t been the beginning of James’s slide, she thought. Maybe it had been Ethan. She had lost the baby in February, and it really wasn’t until that summer that James had started to slip. She opened a file and quickly found the notation she was looking for: James had met Ethan in May.

About a year and a half before his death, James went to a party where there was far too much high-quality cocaine and, as he told Diana, he had had far too little willpower. He and Ethan met around the coke mirror and stayed up all night doing lines and “relating.” Diana checked her notes again. It was subtle but clear, now that she knew what she was looking for. After becoming friends with Ethan, James had started to deteriorate. Before Ethan, James had stopped using drugs completely; after Ethan, his drug use quickly escalated to dangerous levels. And as James and Ethan spent more days at White Horse Beach and more evenings partying, James’s attitude toward work became more laissez faire; he complained that his boss was “leaning on him” too hard, and in July he confessed to Diana that he had been calling in sick a lot. “I never sleep at night,” he told her. “Ethan says you draw strength from being awake while the world rests.” When Diana pointed out that he didn’t seem to be getting the strength he needed, James had just hung his head. “I’m sorry,” he whispered. “I just don’t know any other way to be.” Not long after that, James had been picked up by the police, dazed and wandering along the Harvard Bridge at three o’clock in the morning.

Although James and Ethan’s relationship was obviously destructive, neither seemed able to stay away from the other. Diana immediately saw what Ethan got from James—money—but she had always been confused as to James’s payoff. One thing she knew for certain: James, or anyone suffering from a borderline personality disorder, would never get into a relationship without some clear advantage accruing to him. Maybe it
was
just for companionship, she thought. But she doubted it.

They fought all the time. Violent fights. One even landed them both in the emergency room. Diana would never forget that winter afternoon when Ethan had shown up for group wearing James’s favorite leather jacket, mimicking James’s accent and gestures. When James objected, Ethan punched him in the stomach and they had both been bloody and bruised, and her office in complete disarray, before they finally fought themselves out. It had been horrible, brutal, full of hate. Bruce had fainted.

Diana told both James and Ethan they would not be allowed back until they were willing to contract with the group that there would be no more violent outbursts. James agreed but Ethan stormed from her office and disappeared for a couple of months. James had improved after that—until Ethan returned.

Diana flipped through the folders, looking for her notes from that period to verify her memories. “Don’t coddle James so much,” she had written to herself. “Let him feel some of the consequences. Don’t allow your narcissism to maintain his pathology: Watch it.” Diana smiled sheepishly. Even then she had known that James’s idolatry had made her feel too powerful for her own good. That it wasn’t healthy for either of them. That it had the potential to lead her over the line.

She frowned as she reread her words. Here she was doing it all over again: acting like a mother who was blind to the guilt of her child, who always blamed “that wild crowd he runs with.” Ethan might be jerking her around with his messages, but what had happened to James wasn’t Ethan’s fault. And it wasn’t her fault either. It was James’s fault. James had done it. James was responsible for his own behavior.

Diana jumped from her chair and began to pace back and forth between the bookshelves, thinking about one of the last times she had seen James alive. It had been this past August, a few weeks after she had terminated with him—just after he had been released from the hospital for his Seconal suicide attempt. Coming home from a peer supervisory meeting, she had actually been worrying about whether James felt he had been abandoned yet again, and wishing she could help him through the difficult transition. She had been distracted as she pulled the jeep into the alley and was halfway to the door when he jumped out from behind the garbage cans.

“You’re still my doctor!” he had screamed at her, waving his arms. Then he had grabbed her shoulders, almost lifting her off the ground, shaking her. “You know you love me. You know it’s my baby you’re carrying! Mine!”

Somehow, although she never remembered quite how, Diana had managed to free herself. Terrified, she had rushed into the house and called the police.

But James was long gone by the time they arrived.

The view from the conference room of Bogdanow, Federgreen was spectacular. It was on the second floor of a Back Bay town house, a small slice of a once-grand ballroom belonging to a once-grand Boston family. Floor-to-ceiling bay windows overlooked the Public Gardens. Even at this time of year, the strollers crisscrossing the park and walking along the edge of the lagoon were an entrancing sight. Diana’s eyes lingered on a large oak; its once emerald leaves, now a rusty brown, clung tenaciously to its limbs. She and James had shared a sandwich sheltered from the summer sun by that oak’s spreading green canopy.

But Diana had no time for irrelevant memories or entrancing sights. She turned her back to the windows and reached for the files Valerie had given her, Valerie’s words still in her ears. “I’m feeling pretty confident about our side of the case, but these medical records look bad to me,” Valerie had said as she led Diana to the conference room. “They’re just what Engdahl ordered: They read like Hutchins wasn’t that crazy. This doctor makes the suicide attempt sound like some minor mental aberration—like being depressed after a divorce. Or having insomnia. Is that possible?”

“It’s not possible.” Diana shook her head. “But it appears to be
Dr
. Pumphrey’s conclusion.”

“Look, the guy tried to commit suicide—a couple of times—and he had been in therapy for years.” Valerie handed Diana the medical records. “And this attempt was only last July, right? So he succeeded in killing himself less than three months later—that doesn’t sound too healthy to me.”

Diana nodded and glanced down at the file.

“See what you can find in there to buttress our contention that he was one sick cookie: errors, omissions, ways we can undermine the credibility of the other doctors—anything and everything. I can’t believe it’ll be all that difficult.”

“It’s so amazing to see this here,” Diana said, flipping through the pages. “Hospitals treat medical records like gold locked in Fort Knox.”

“Limited discovery.” When Valerie noticed Diana’s confused expression, she tapped the top file with the tip of her manicured finger. “Production of documents because of the speedy trial. Judge Hershey ruled that in order to proceed in such a short time frame, both Engdahl and I had to get copies of all evidentiary documents to each other immediately. Pumphrey’s notes and Hutchins’s medical records are part of Engdahl’s case—I have to give him copies of everything you just gave me.”

“You mean one side gets to see everything the other side’s going to use in court?” Diana was amazed.

“That’s the law,” Valerie said as she walked to the door. “I’ll check back with you later.”

Flipping through the hospital files, Diana was overwhelmed with remorse. She had terminated with James on July 25; he had swallowed an entire bottle of Seconal on July 31. Pushing away her guilt, she focused on the records. They were even more dense and complicated than she had expected. Considering that James had been in the hospital for only three days, it didn’t seem possible that so much could have been written about him. She quickly began sorting the papers into piles: intake interview, medical evaluations and tests, a neurological assessment, psychiatric consults, psychological test results, lab reports, daily rotation notes. She shook her head. Incredible.

She decided to start with the psychological information, figuring that held the most promise. Glancing quickly at the grandfather clock standing at the far corner of the room, Diana bent to her task.

She was familiar with most of the test results—she had copies of the same pages in her personal files—although a few were new to her. She was not surprised to discover that James had achieved an extremely high score on the WAIS, an intelligence test, or that his mode of aggression, measured by the Rosenzweig Picture Frustration Study, was extrapunitive—that he projected his anger outward, toward other people. Disappointed, she skimmed through the rest of the tests; but whether she was searching for proof of James’s illness, a discrediting bit of evidence, or Ethan’s “something,” there didn’t appear to be much of anything there.

The grandfather clock chimed, and Diana jumped in her chair. She squinted at the clock as it chimed nine more times, guessing that it was going to go off at least every half-hour, perhaps every fifteen minutes. She turned to the psychiatric assessment done after James had been stabilized in the medical unit. Pumphrey had administered the interview and, although he had recommended ten days of psychiatric evaluation, Diana now understood Pumphrey’s diagnosis: James had lied to him. The problem was proving it.

Diana was all too aware of how easily, and how well, James could lie. She knew for a fact that Ethan was capable of reciting complete fiction and passing a lie detector test, for his lack of a conscience—and therefore any physical manifestations of guilt—easily fooled the machine. And although she didn’t like to acknowledge too much similarity between James and Ethan, Diana had often wondered whether James would be an equally successful subject. Even though James had thoroughly fooled Pumphrey, that didn’t make him a psychopath. In his defense, Pumphrey was a new resident, completely unfamiliar with James. And probably equally unfamiliar with the deceptive nature of borderlines.

According to Pumphrey’s notes, James had been “lucid” and “charmingly forthcoming.” Diana had to smile at the description: James at his best—and most manipulative. James had denied any drug use, any past suicide attempts, said he was never troubled by insomnia, had no problems concentrating, and had just recently left a job he had held for almost two years. She nodded as she read Pumphrey’s diagnosis: moderate reactive depression, single episode. Unfortunately for their case, it was a reasonable diagnosis, given the information he had.

The clock chimed again, and again Diana jumped. She was relieved to see that it was ten-thirty—at least the damn thing wasn’t going to go off every fifteen minutes. She turned back to the records and then laughed out loud. Pumphrey had done a suicidality evaluation to determine James’s chance of attempting suicide again; on the basis of the test, he had concluded that James was low-risk. She pulled the test sheet from the pile: Finally she had something they could use to show an error in Pumphrey’s judgment.

She pushed away the psychiatric and psychological piles and skimmed through the rest of the reports. Her stomach churned with frustration. Valerie was right: These reports made James look good. She supposed they could use the suicidality evaluation to show how tests—and doctors—could be wrong. But she knew it was weak at best.

Diana stood up and walked into the bay. As had happened earlier, she was overcome with both exhaustion and a surprisingly strong anger. She clenched her fists and actually raised one, as if to punch it through the mullioned panes of the window. Stop it, she warned herself, pulling her arm down and opening her fingers. Now was not the time to lose it. Perhaps she could find something that would help their case—and there was always the remote possibility that Ethan actually
was
trying to help her.

Diana sat back down at the table and reached for the intake interview. James had overdosed on barbiturates and alcohol—Seconal and Scotch, to be exact. He had been brought in by ambulance, barely conscious, with a laceration to his head, apparently from a fall down the front steps of his building. His blood had been analyzed, assessed for toxicity, lethal levels established, and then his stomach had been pumped. After he was stabilized, they had run him through a battery of neurological tests.

Just as Diana was reaching for the neurological reports, Valerie walked into the room and asked if she had found anything. When Diana shook her head, Valerie sat down across from her. “What can I help you with?” she asked. “I’ve got about an hour.”

“See if anything jumps out at you,” Diana said as she pushed the intake and medical piles across the table, figuring they would be easier for Valerie to understand than the neurological. “You know your four prongs as well as I do.” Valerie began to read.

When the clock chimed eleven times, Diana stiffened but didn’t look up. Although she couldn’t imagine finding anything helpful in the neurological reports, nonetheless she flipped through the poor-quality copies; the originals had been on flimsy yellow or pink paper, and the contrast was very bad. She squinted at the words: a CAT scan, an MRI, an EEG. All showing normal brain activity. The neurological tests had been run because James had been admitted with a head injury; there had never been any real expectation that something was wrong. Just covering their butts, she thought. Something with which she should have been a little more concerned.

Alertness assessment: normal. Orientation to time, space and person: normal. Reflex assessment: normal both knees; normal left Babinski; no Babinski contraction of all five digits of right foot, no plantar reflex. See recommendation. Diana drew in her breath and read the reflex assessment results again.
No Babinski contraction of all five digits of right foot
.

“What?” Valerie asked. “What is it? Did you find something?”

Diana didn’t say anything. Her eyes flew to the bottom of the page where the recommendation was recorded. “Patient reports paralysis of five toes on right foot due to nerve damage suffered in motorcycle accident, 8/90,” she read. “Seek medical records to explore history and extent of previous injury.”