Swig shook his head, but he hailed a tech standing across the hall. "Get Heidi Ott,
Kurt."
Kurt hustled off and we waited among the inmates. Patients. Did it make a difference what you called them? I started to notice lots of tardive symptoms-a tremor here, lip work there-but nothing as severe as Peake's. Some of the men seemed oriented; others could have been on another planet. Shuffling feet in paper slippers. Food stains on clothing.
Swig went into the nursing station, used the phone, glanced at his watch. He was back just as Heidi Ott came through the double doors.
"Hello, Heidi."
"Sir?"
"Because of the information you provided, Detective Sturgis has been trying unsuccessfully to communicate with Ardis Peake. Since you've got a track record, why don't you give it a shot?"
"Sir, I-"
"Don't worry," said Swig. "Your sense of duty is beyond reproach. The main thing is, let's get to the bottom of this."
"One thing before you go in there. You're sure Peake actually spoke to you-real words, not just grunts."
"Yes, sir."
"Tell me exactly what he said."
Heidi repeated the story.
"And this was the day before Dr. Argent died?"
"Yes, sir."
"Had Peake talked to you before?"
"Not about Dr. Argent.\
"What did he say?"
"Nothing much. Mostly mumbles. Yeah, no, nods, grunts. When we asked him questions."
Tug on the ponytail. "Nothing, really. That's why I paid attention to when he did start-"
"You were monitoring his speech."
"Yes, sir. Dr. Argent was hoping she might be able to increase his verbal output.
His behavioral output in general."
"I see," said Swig. "Any particular reason she wanted to do that?"
Heidi glanced at us. "Like I told these gentlemen, she said he was a challenge."
A faint, scraping sound grew louder, and we all turned. Paper soles on linoleum. A few of the men in the hall had drifted closer. Swig looked at them and they stopped.
Retreated.
He smiled at Heidi. "Looks like you've got the challenge, now."
She went in alone, stayed for twenty minutes, emerged, shaking her head. "How long do you want me to try?"
"That'll be enough," said Swig. "It was probably just an isolated incident.
Meaningless rambling. For all we know, he does that when he's alone. Thanks, Heidi.
You can get back to work. We'd all better get back to work."
As I drove off the grounds, Milo said, "What the hell turns a human being into thaf!"
"Answer that and you've got the Nobel," I said.
"But we've got to be talking biology, right? No amount of stress can do that." The air-conditioning was on, but sweat dripped offhis nose and spotted his trousers.
"Even in concentration camps people rarely went mad from suffering," I said. "And schizophrenia has the same prevalence in nearly every society-two to four percent.
Cultural factors influence how madness is expressed, but they don't cause it."
"So what is it-brain damage, genetics?"
"The highest risk factor is having a relative with schizophrenia, but only a very small percentage of schizophrenics' relatives become ill. Slightly more schizophrenics are born during winter and spring, when virus levels are higher. Some studies have implicated prenatal influenza. It's all speculation."
"Hell," he said, "maybe it's just bad luck."
He wiped his face with a tissue, pulled out a panatela, unwrapped it, and jammed it in his mouth, but didn't light up.
"I had a couple crazy relatives," he said. "Two aunts-my mother's cousins. Loony
Letitia had this thing for baking, did it nonstop. Cookies every day, hundreds of them. She ended up spending all her money on flour and sugar and eggs, started neglecting herself, trying to steal ingredients from the neighbors. They finally put her away."
"Sounds more like manic behavior than schizophrenia," I said. "Anyone ever try her on lithium?"
"This was years ago, Alex. She died in the asylum- choked on her dinner, how's that for a bad joke? Then there was Aunt Renee, stumbling around the neighborhood, looking like a mess. She lived till she was pretty old, died in some county facility."
He laughed. "That's my pedigree."
"I had a schizophrenic cousin," I said. Brett, two years my senior, son of my
father's older brother. As children we'd played together. Brett had competed fiercely, cheated chronically. During college he metamorphosed from a Young
Republican to an SDS honcho. By his senior year he was an unwashed, silent recluse who accumulated narcotics arrests, dropped out of sight for five years, finally ended up in an Iowa board-and-care home. I assumed he was still alive. There'd been no contact between us for over two decades. Our fathers hadn't been close....
"There you go," said Milo. "Tainted stock. Starkweather, here we come."
"Starkweather's only for the chosen few," I said.
"Bad little madmen. So what makes crazy people violent?"
"Another Nobel question. The main ingredients seem to be alcohol and drug use and a strong delusional system. But not necessarily paranoia. Psychotics who kill usually aren't trying to protect themselves from attack. They're more likely to be acting on some paranormal or religious delusion-waging war against Satan, battling space aliens."
"Wonder what Peake's mission was."
"God only knows," I said. "Dope and booze were obviously in play. Maybe he thought the Ardullos were mantises from Pluto. Or nineteen years of twisted sexual impulses finally exploded. Or a random circuit in his brain shorted out. We just don't know why some psychotics blow."
"Great. I'll never be out of work." His voice drifted off.
"In one sense," I said, "Peake's typical. Schizophrenic breaks occur most frequently in young adulthood. And long before Peake fell apart, he'd been showing signs of schizotypy-it's a fancy name for oddness. Low mental skills, social ineptitude, poor grooming, eccentricities. Some eccentrics stay mildly strange, others move on to full-blown schizophrenia."
"Oddness," he said. "Take a walk in the park, walk out of a restaurant, there're some odd guys wanting spare change. Which one's gonna start wielding the cleaver?"
I didn't answer.
He said, "If Peake had any sort of thought system, he must have been in a helluva lot better shape than what we saw today."
"Probably. Though behind all the tardive symptoms there could still be some thinking going on."
"What does 'tardive' mean, exactly?"
"Late-onset. It's a reaction to Thorazine."
"Is it reversible?"
"No. At best, he won't get worse."
"And he's still crazy. So what good's the Thorazine doing him?"
"Neuroleptics are best at controlling delusions, hallucinations, bizarre behavior.
What psychiatrists call the positive symptoms of schizophrenia. The negatives-poor speech, flat mood, apathy, attentional problems-don't usually respond. Drugs can't put back what's missing."
"Well-behaved vegetables," he said.
"Peake's an extreme case, possibly because he didn't start out with that much intellect. His T.D.'s also very severe. Though he's not getting that much Thorazine.
Despite what Bollard told us about high-dosing, Peake's prescription has remained at five hundred milligrams, well within the recommended range. They probably haven't needed to high-dose him because he behaves himself. Behaves very little.
Psychologically, he's disappeared."
Milo removed the cigar, placed it between his index fingers, and sighted over the tobacco bridge. "If Peake was taken offThorazine, would he be able to talk more?"
"It's possible. But he could also fall apart, maybe even revert to violence. And don't forget, he was on Thorazine when he talked to Heidi. So he's capable of speech while medicated. Are you still taking this in-a-box stuff seriously?"
"Nah.... I guess I can't get away from the eye thing-hey, maybe I'm delusional and
Peake's a true prophet. Maybe Satan has dispatched the Pluto Mantises."
"Maybe," I said, "but would he inform Peake?"
He laughed, chewed the cigar some more." 'Bad eyes in a box.'"
"For all we know, Claire tried talking to him about his crime and sparked some kind of memory. 'In a box' could mean his own incarceration. Or something else. Or nothing at all."
"Okay, okay, enough of this," he said, pocketing the cigar. "Back to basics: check out Claire's finances and StargilFs. Go over Richard's file again, too. For the hundredth time, but maybe there's something I missed. And if you're not jammed, now's as good a time as any to go see Dr. Theobold at County. Maybe one of us will come up with something remotely resembling a factoid."
He grinned. "Lacking that, I'll settle for some juicy delusions."
I CALLED DR. Myron Theobold's office and got an appointment for ten-fifteen the next morning. By nine-forty-five I was clearing my head in the fast lane of the 10 East, enduring the crawl to the interchange, moving with the smog stream toward San
Bernardino. I got off a few exits later, on Soto Street in East L.A., drove past the county morgue, and pulled into the main entrance of the dun-colored metropolis that was County General Hospital.
Perenially underfunded and overstressed, County's a wonder: first-rate medicine for the tired and the poor, last stop for the hopeless and the addled. I'd done some clinical training here, taught occasional seminars, but it had been two years since
I'd set foot on the hospital campus. Outwardly, little had changed-the same sprawl of bulky, homely buildings, the constant parade of people in uniforms, the halting march of the ill.
One of those hot, overcast days that makes everything look decayed, but after
Starkweather, County seemed fresh, almost perky.
Theobold's office was on the third floor of Unit IV, one of the half-dozen no-frills annexes sprouting at the rear of the complex like afterthoughts. Dazed-looking men and women in open-backed pajamas wandered white-tiled halls. Two grim nurses escorted a heavy black woman toward an open door. IV's in both her arms. Tears marked her cheeks like dew on asphalt. In an unseen place, someone retched. The overhead pager recited names emotionlessly.
Theobold's secretary occupied a space not much bigger man Peake's cell, surrounded by gunmetal filing cabinets. A stuffed Garfield clung to the handle of one drawer. Empty chair. A note said, "Back in 15 min."
Theobold must have heard me enter because he stuck his head out of me rear doorway.
"Dr. Delaware? Come on in."
I'd met him a few years ago, and he hadn't changed much. Sixtyish, medium height and build, graying fair hair, white beard, large nose, close-set brown eyes behind aviator specs. He wore a wide-lapeled herringbone sport coat the color of iced tea, a beige vest checked with blue, a white shirt, a blue tie.
I followed him into his office. He was a psychiatry vice-chairman and a respected neurochemistry researcher, but his space wasn't much more generous than the secretary's. Haphazardly furnished with what looked like castoffs, it sported another collection of file cases, brown metal furniture, a storm of books. An attempt to freshen things up with a faux-Navajo rug had failed long ago; the rug's threads were unraveling, its color bands fading. The desk supported a turbulent swirl of paperwork.
Theobold squeezed behind the desk and I took one of the two metal chairs wrinkling the fake Navajo.
"So," he said. "It's been a while. You're still officially faculty, aren't you?"
"Courtesy faculty," I said. "No salary."
"How long since you've been down here?"
"Couple of years," I said. His attempts at cordiality were deepening the lines on his face. "I appreciate your seeing me."
"No problem." He cleared the area around the phone. Papers flew. "I had no idea you led such an interesting life- police consultant. Do they pay well?"
"About the same as Medi-Cal."
He managed a chuckle. "So what have you been up to, otherwise? Still at Western
Peds?"
"Occasionally. I do some consulting, mostly legal work. A few short-term treatment cases."
"Able to deal with the HMO's?"
"I avoid them when I can."
