Do No Harm (20 page)

"Why do you think that is?"

"Maybe in light of what happened this morning, he views you as a savior."

"I barely interacted with him."

"Yes, but for all we know, you're the first person in his life to show him kindness in the face of opposition." Dash swept a stray dreadlock off his forehead. "He appears to be terrified of eye contact--he looks away almost constantly. That could be linked to insecurity resulting from his general unattractiveness--that he's afraid to be seen--but I think it's a bit more complex. I'm thinking his fear is linked to the nature of the crimes."

"How so?"

"He attacks women's faces. Their eyes." Dash smiled. "What do staring eyes represent?"

Despite the fact that Dash was nearly ten years David's junior, David didn't mind being treated like a resident. "Intense intimacy, usually hostility," David answered.

"Why hostility?"

"Because staring eyes presage an attack?"

Dash shook his head, dreadlocks swaying. "No. Because for those with low self-esteem, for those who are painfully insecure, staring eyes are the wellspring of shame. Think about it--Delilah blinding Samson, Oedipus putting out his eyes, Adam and Eve hiding themselves beneath fig leaves--all these acts took place after the real harm had already occurred. They are a reaction to the awful act, not the awful act itself. When we dream of shame, we're naked before others, caught with our pants down. A person who feels shame wants to turn away the eyes of the world, so they can't see his exposure, his vulnerability."

"Magical thinking. If you can destroy the eyes of those who look upon you, you can destroy shame. And your feelings of vulnerability and exposure."

"An oversimplification, of course, but yes." Dash shifted, and the couch creaked and groaned. "Clyde throws alkali in women's faces. It destroys their eyes so they can't shame him, destroys their beauty so they can't appear superior to him, destroys their mouths so they can't say bad things about him or laugh at him. The most efficacious way to keep someone from laughing at you is to make her weep."

"Well, he's certainly succeeded at that," David said.

"Yes. I'd guess that inflicting fear is one of his primary motivations. Replacing his own fear with that of someone else."

"I suppose it explains what seem to be motiveless crimes."

The first notes of Dash's laugh startled David in his seat.

"I've been on the stand enough to know there's no such thing as a motiveless crime," Dash said. "All violence is an attempt to achieve justice. All violence stems from perceived self-defense. Most crimes are an attempt to replace shame with pride." His smile gleamed white in his dark face. "Violent crime and state-condoned punishment are remarkably similar when you think of it. They both aim to avenge injustices."

"In Clyde's case, he must be avenging some injustice that has to do with the hospital. Or psychiatrists."

Dash shrugged, dreadlocks swaying. "Or nurses. His victims were two women in scrubs. He probably believes he attacked two nurses."

"Do you think he's a psychopath?"

"I don't. Psychopaths are glib and superficial. He seems to have deeply felt emotions. Rapidly fluctuating emotions. He went from cooperative to scared to angry like a Porsche going zero to sixty. I wouldn't be surprised to find some guilty rumination, depression, internal conflict, chronic feelings of emptiness--you know the symptom cluster."

David nodded. "Differential diagnosis. Not Otherwise Specified."

"NOS. The psychiatrist's crutch. Until I can get more out of him."

"I'd like to turn him over to LAPD a bit more sorted out. He certainly won't be in the most sympathetic hands."

"He seems to have some sort of bond with you. Maybe you should see if you can get him to open up. If you lead him to talk about the fear behind his crimes, rather than the crimes themselves, he might be more likely to talk. Zero in on his sense of injustice."

David stood, squeezing his fist so his knuckles cracked. "Well, I need to check in on him anyway. See if he's ready to ship out." He rested a hand on Dash's massive shoulder on the way to the door. "Thanks for the input."

Dash drew himself to his feet and glanced down. "Hey, David?"

One hand on the doorknob, David turned, an eyebrow raised quizzically. Looking at Dash's face, he could not locate the affability to which he had grown accustomed.

"Be careful."

A burst of noise sped David around the corner, where he saw the UCPD officers standing in the open doorway, one of them shouting for help. David saw Jenkins explode through the swinging doors of the lobby. Jenkins sprinted for Clyde's room, boots hammering, and swept inside.

David was already running down the hall, past the startled faces and the UCPD cops. He entered the room just after Jenkins. Clyde was thrashing violently on the bed in a seizure, limbs rattling the gurney rails to which he was bound. His eyes were rolled back, showing strips of white, and a line of drool ran down his cheek.

Pistol gripped tight in one hand, Jenkins charged the bed. David caught up to him a few steps from Clyde's gurney and placed a hand on his chest, which Jenkins quickly knocked away.

"It's under control," David said. "He's having a seizure."

Jenkins's eyes were still trained on Clyde. He swung his head slowly to face David, his pupils hard, black pinpoints, and in that instant, David had no doubt that he would have killed Clyde. David's adrenaline rush made his pulse beat at his temples. He met Jenkins's hard stare, the words coming like bullets from his mouth. "Step back from my patient."

Two nurses and one of the UCPD cops poured into the room, and Jenkins's eyes suddenly loosened. He took a step back, holstering his weapon. "Just making sure the suspect was secure," he said.

David turned back to the bed and grabbed one of Clyde's arms, which went limp in his grip, even as the rest of his body continued to seize.

"Back up!" David dropped Clyde's arm and took a step back himself. He turned to the others, registering a quick relief that Jenkins had left the room. "Stand back."

Clyde moaned, spittle flecking his lips, his head bouncing from side to side on the pillow.

"Nice try, Clyde," David said. "You can stop now."

Clyde seized for another moment, then stopped. His tufts of hair had been swirled upright, and when he raised his head, chin shiny with saliva, eyes dark and unblinking, he looked demonic. His grin was sharp and slick, a curved blade. He looked nothing like the frightened, cooperative man David had treated earlier.

David had known Clyde was faking as soon as his arm had gone limp in his grasp. Generalized seizures occur in all limbs, and sections of the body don't relax under pressure.

Clyde said, "Can't blame me for trying."

"Would you mind leaving us alone?" David said to the nurses and the UCPD officer. They complied, the officer shutting the door behind them.

David was alone in the room with the bound man. He stared at him from about three feet, breathing heavily, trying to process all that had just nearly occurred. Shirtless, Clyde lay on his back, restraints tying his ankles to either side of the gurney, spreading his legs. His white-gloved hands looked odd protruding from the restraints.

Despite Dash's claims, Clyde was having no trouble making eye contact at the moment. A small line of blood curved from the slit beneath his armpit.

David waited until he could speak calmly. "That didn't do much good. You opened up that cut under your arm with all your thrashing. Why are you faking a seizure? Did you want to harm someone when they came to help? We're trying to take care of you here."

"Bullshit," Clyde hissed. His breath was paradoxically rank and sweet--there was an almost medicinal scent to it. His right foot waved back and forth, a pendulum ticking off seconds. "You left me. You left me and didn't come back."

David pulled over a chair and sat, to put his head lower than Clyde's. Maybe Clyde would be more comfortable talking if David assumed a submissive posture. "I have other patients I need to see. Other patients who need help the way you needed help."

"I don't need you."

David drew closer. The blisters on Clyde's chest were resolving. Though still raw, they had either popped or ceased swelling. Again, David was amazed at how well Clyde's scrub top had protected his flesh from the alkali.

"I'm not here to harm you, Clyde. I'm here to see that you get the medical attention you need. That's why I brought in the other doctor. Why didn't you like him?"

The room had not been prepared for Clyde--David and Carson had dragged him in because it was the nearest unoccupied exam room, and David had given it only a cursory once-over. Now he stood and searched the room more extensively for unsafe objects, just in case Clyde managed to work an arm free. A lumbar puncture kit, stained amber by Betadine, leaned from the trash can. That meant there were needles, probably down in the trash liner. The unit of blood he'd spotted earlier remained on the counter nearby, among several packages of gauze. Clearly, it had been out of refrigeration for more than the admissible thirty minutes. He'd already removed the scissors; now he glanced in the drawers beneath the counter for scalpels but found none. An oxygen source box protruded from the wall. The flow meter was made of glass, but it was hard and small, like a test tube buried in the unit. It would be difficult to break.

"I hate you," Clyde said. "I fucking hate you." His lips quivered slightly. "The nurses came in here, told me you would leave me. They said you were saying bad things about me."

"I didn't say anything bad about you."

Relief washed across Clyde's face. "That's what I told them. I told them you were a great person, a great man, and you would never do that. I defended you."

David carried the trash can outside and set it by the door. "This has needles in it," he told one of the cops. "And could you please tell a clerk to call the blood bank, have them send someone down. We have a stray unit of O-negative that needs to be spoiled."

The officer nodded, and David returned to the room, sat, and faced Clyde. "I don't believe the nurses said those things about me. Do you think you're imagining some of the things they said?"

"No. No way." His breath whistled and wheezed. "If they take me away, will you come with me? You said you'd stay with me."

"I'll make sure you get the help you need," David replied evenly.

"You. I want you. You helped me. You helped cure me when no one else wanted to." Clyde's right foot continued its restless motion back and forth.

"I'm an ER doctor. I have to stay here."

Clyde strained against the restraints, and David noticed again the swelling of his hands. His wrists were chafed, one hand up over his head, one down by his side, like a playground monkey. David noticed an old stain on the cuff on Clyde's lower wrist. Probably semen. Sometimes they had to put guys on amphetamines in restraints, but they'd be hypersexual from the drug, so they'd turn on their sides to get at their penises and masturbate themselves bloody.

"Do you know why you're here?" David asked.

"Because I'm tied down. Where else am I gonna be?"

Concrete thinking. Pulling on a pair of gloves, David pressed forward into the Brief Mental Status Examination. "Clyde, do you know what month it is?"

His eyes beaded until they looked like small spots of oil. "Of course I do. You think I'm fucking stupid?"

David began applying Silvadene to the blisters on Clyde's chest, spreading the antibiotic cream with a fingertip. Clyde winced at his touch. David took care to lean back out of Clyde's space so he wouldn't feel crowded.

"No," David said. "I think you're sick. I want to help you."

Clyde laughed, a low snort. "They're running around the hospital scared of me. They have guards here because of me. I'm not sick. I know what I'm doing."

His vacillation between swaggering self-righteous criminal and emotional catastrophe was staggering in its range and rapidity. "What are you doing?" David asked.

"Making them sorry."

"Sorry for what?"

"For locking me up in the darkness. Not letting me out."

"Were you locked up? As a child? Were you kept locked up by your parents?"

"Noises and lights and snakes. They put the lights out on me. They put me alone. I just want . . . I just want them to be sorry. For the flashes and the noise."

Locked in the dark with snakes--it seemed too stereotypical to be real, like a serial killer's childhood case study. Perhaps the fantastic stories were an indication of delusions or hallucinations caused by LSD, PCP, or speed. Maybe even schizophrenia.

"Do other people think you have crazy ideas?" David asked. If the question was worded subjectively, Clyde would be more likely to answer it honestly.

"I don't . . . I don't know. I don't stay around people anymore." Clyde's speech was slightly slurred, as if he were speaking around a thick tongue. "Not people that can look at me back."

"You said you weren't taking any drugs. Are you sure about that?"

"I don't take any pills." The same defensive note David had encountered from him previously on the topic. David noted that he had changed drugs to pills. He seemed to be concerned with the issue of taking medicine, not illicit drugs.