Scared to Live (37 page)

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Fry hadn't realized there were loft apartments in Matlock. They certainly hadn't reached Edendale yet. But John Lowther's home was on the fourth floor of a converted mill complex on The Cliff, high above Matlock Green, overlooking a conservation area. Lifts had been installed, and an entry system with coded access from the communal areas. Yes, some of the original features had been retained in the conversion, but not too many. Enough to make 'period character' a selling point, probably. Judging by Lowther's place, the interiors had been given a very modern feel. This was open-plan living - a walkthrough from a study hall to the kitchen under exposed roof timbers and diagonal supports. The apartment was all chrome and glass, pastel shades and a tiny dining table set for two, looking as if it ought to be standing in an intimate corner of a fashionable restaurant. One problem, though. There was a high central ceiling, but if you wanted to walk close to the walls and look out of the windows, you'd better be a midget, or not mind a few bruises. The pitch of the roof was steep. Really steep. Fry stood in the middle of the living area and checked out the doors off the hallway. Two bedrooms, even. It was all

wasted on a single man, which John Lowther plainly was. She guessed he hadn't chosen the decor himself, either. 'There's nothing of immediate interest,' said Murfin. 'But we did find a bottle of tablets on his bedside table. Orphenadrine.' 'Never heard of it.' 'It's probably not important.' 'No . . .' Fry began to move away, then stopped and came back. 'What's the matter?' said Murfin. 'That phrase - "it's probably not important". Those sound like famous last words to me. You'd better check it out, Gavin.' 'OK, if you think so.' She had a feeling about this apartment. There was something she couldn't see. Inside any home, there were public places and private places. In the rooms where strangers might be expected to intrude, the contents were carefully chosen to present an image: highbrow books, artwork, the collection of expensive porcelain. But take a peek into the bedroom on your way to the loo, and you might find the truth behind the facade - the trashy novels, the S&M gear, the Prozac on the bedside table. Or in this case, perhaps, the Orphenadrine. Fry wondered what lurked behind the foliage in a house full of plants, what a conservatory stuffed with fuchsias and tree ferns ought to be telling her. On the way down to Matlock, she'd phoned in and asked them to check the details of Luanne's adoption with the authorities in Bulgaria. A link might emerge, or an inconsistency. Cooper walked in clutching a bottle of Buxton Spring water, as if he was taking a break at home in his own sitting room. 'What are you thinking about, Diane?' he asked. 'Henry Lowther.' 'Not pleasant thoughts, judging by your expression.' 'I was just wondering . . .' 'Don't keep it to yourself, then.' 'Well, Brian Mullen said the reason Luanne wasn't in the

house at Darwin Street on the night of the fire was because she was staying at her grandparents'. She wasn't sleeping through the night, and the Lowthers had taken the child to give him and Lindsay a rest, to let them get a night's sleep. That's what he said.' 'Sounds fair enough.' 'Mr Lowther didn't seem to know that, though.' 'What makes you think that?' 'Oh, I might be mistaken,' said Fry. 'It was only an impression, because of the way he hesitated when I mentioned it. And that was my own fault - I prompted him with Mullen's version of events, instead of asking him outright. I didn't think it was important at the time, you see.' 'Probably it isn't.' 'I expect you're right. Brian and Luanne were the only two members of the family who weren't at home when the fire started. But it must have been by chance, mustn't it?' 'So where do we go from here, Diane?' asked Cooper. 'I've no idea.' 'What leads do we have that can be followed up?' 'None that I know of.' 'Have we got any clues at all?' 'No.' Cooper tipped the last of the water into his mouth and tossed the empty bottle into a bin. 'We're really getting on top of this enquiry, then,' he said. Fry didn't react. Let him think she was mellowing with age, if he wanted to. Or that she just didn't care any more. 'You know, John Lowther reminded me a bit of that story you told me,' she said. Cooper looked round. 'Story?' 'The one about the woman who lived in a cottage near your farm when you were a child.' 'Old Annie?' said Cooper. 'Well, I can't see the similarity myself.'

'You said she didn't speak to anyone for weeks on end, then talked far too much when she was in company. As if she had to prove that she could still hold a conversation.' Cooper looked surprised. 'Yes, I did say that.' 'Also, you mentioned finding her frightening. A slightly hysterical tone to her voice, you said. That's what John Lowther reminded me of.' 'I know what you mean.' 'Well, there's a job for you to do, Ben. I'll call ahead and get the interview cleared with the hospital.' 'Hospital?' Fry explained to him. As Cooper prepared to leave, she listened to the silence of the apartment, well insulated and far enough away from the main road to deaden the sounds of traffic. 'We've got to find John Lowther,' she said. 'He could be a lot more dangerous than Brian Mullen.' Fry dialled the number of the bungalow in Darley Dale, where she had been only half an hour before. 'Mrs Lowther, where would your son go? What place might he be heading for right now?' She could picture the Lowthers looking at each other, deciding what answer to give. Fry half expected the phone to be handed to the husband, but it was Moira who spoke. 'When John wants to be alone, he likes to go up to the Heights of Abraham.'

An hour later, Dr Alexander Sinclair took off his white coat and put on a suit jacket, transforming himself from a clinical psychologist into a business executive. He sat down at his desk, opened a file and put on his glasses. 'You appreciate this is very exceptional, Detective Constable.' 'The circumstances are exceptional, too,' said Cooper. 'We wouldn't have asked you for this information otherwise.' 'Yes, so I've been persuaded by your senior officers. I'm

only agreeing to this conversation on the understanding that I'm acting in the interests of my patient, and no further.' Sinclair peered over the top of his glasses, a mannerism that Cooper hated. It made him look like a disapproving schoolteacher. 'We're extremely concerned for Mr Lowther's safety,' he said. 'Not to mention the safety of others that he might come into contact with.' 'Very well. There are some specific details of this patient's history that I can't go into, but I can answer general questions about his condition, which might help you.' 'Well, we already know that John Lowther spent three months in a psychiatric unit in Leeds.' 'That's correct.' 'Was he sectioned?' 'No, he admitted himself voluntarily, following a series of psychotic episodes.' 'What sort of episodes?' 'Mr Lowther was experiencing auditory and visual hallucinations.' 'Auditory - ?' 'He heard voices,' said Sinclair impatiently. 'And "visual" means he was seeing things.' 'Thank you.' He sighed and looked down at the file. 'At the time, Mr Lowther appeared to be suffering hallucinations of increasing frequency and severity. Admitting himself to the unit was a very sensible decision on his part. He had good insight at that point, so he knew that he was ill.' 'I'm not sure what you mean by insight, Doctor.' The glasses came off, making Sinclair human again for a few moments. His eyes were pale blue. He was probably capable of projecting a reassuring bedside manner, when he thought it was necessary. 'One puzzling feature of psychosis is that the affected

individual doesn't recognize the strange or bizarre nature of his own experiences. Even in the case of acute psychosis, a patient might be unaware that his hallucinations and delusions are in any way unrealistic' 'Yes, I see.' 'However, the level of insight can vary from one case to another. There can be quite good insight in some instances. Of course, this makes the psychotic experience even more terrifying. It means, you see, that the sufferer knows exactly what's going on. To put it bluntly, he knows he shouldn't be seeing demons and angels, or hearing voices - but he sees and hears them nevertheless. He can't stop himself. Try to imagine being aware that you're not in control of your own mind any more. You'd have to accept that some of your everyday perceptions are real, but others are illusory.' 'It's difficult to put myself in that position.' 'Of course it is. Believe me, when a patient is aware that he's losing control of his own thoughts, it strikes to the very core of self-belief, and can have an extremely destructive effect on his relationship with the world around him. It undermines the concept of identity, you see. I can imagine nothing more devastating, or more terrifying.' Sinclair put his glasses back on and peered at his visitor, assessing his reaction. Cooper was surprised by his sudden departure from the script, or rather from the notes in his file. For a few seconds, he'd spoken with real conviction. It struck Cooper that Alexander Sinclair had actually seen this happen to people he knew well - not just patients, but friends or family. Perhaps that was why he'd agreed to talk, despite the constraints of confidentiality. 'Can you tell me what John Lowther's auditory and visual hallucinations consisted of? Is it possible to say?' 'In general. He heard voices that commented on his behaviour, and told him to do certain things. That's why he

admitted himself. He was frightened of what the voices might make him do, and he wanted us to stop them.' 'And did you?' Sinclair smiled. 'Psychosis is only a symptom of mental illness, Detective Constable. The subsequent diagnosis was bipolar disorder. Mr Lowther was treated with anti-psychotic drugs until the episodes receded, and then we adjusted his medication until he was stable enough to be discharged.' 'So the medication made the voices go away?' 'Well Cooper watched him hesitate. 'But only as long as he kept taking the tablets?' he said. 'Of course. Anti-psychotic drugs work by changing the activity of chemicals that transmit messages in the brain. It's very important to take the medication regularly, and at the prescribed doses.' 'So when was John Lowther discharged from the unit?' 'In April. He was in good spirits by then. He said he was going to tell everyone that he'd been away on holiday. Somewhere nice, like the Caribbean. Except that it couldn't be the Caribbean, because he didn't have a sun tan. I dare say his family didn't let anyone know the truth either. That's perfectly usual. There's still a lot of stigma attached to mental illness, I'm afraid.' 'He'd have to be on anti-psychotic drugs for some time, I imagine.' 'Yes. But his records do show that he was worried about the side effects. Mr Lowther complained that he put on weight. And he twitched a lot, which he found distressing. Also, he said the medication made him impotent.' 'He was very restless when we saw him last week.' 'But no twitching?' 'No.' Sinclair fiddled with his glasses. 'Mr Lowther was prescribed Orphenadrine for the side effects, but he didn't like

the idea of taking more tablets. So instead . . .' He hesitated again. 'You think he might have stopped taking his anti-psychotic drugs?' 'Yes, it's possible. Dealing with side effects is always a bit of a trade-off. It's a question of striking the right balance for each individual. Mr Lowther said once or twice that the effects of the drugs were worse than a few harmless delusions. He thought he'd return to his old self if he stopped taking the medication - he'd become slimmer, stop twitching, regain sexual function. It's a common response. Patients feel an overwhelming desire to go back to a time when they felt happy and safe.' 'Hold on a minute - "a few harmless delusions"?' said Cooper, picking out the most remarkable phrase in what he'd just heard. Sinclair fixed him with a sad gaze from his pale eyes. 'That would be the way it seemed to him, at this particular stage. I think Mr Lowther had probably forgotten the nature of his auditory hallucinations.' 'How is it possible to forget something like that?' 'It's a normal function of the brain to filter out negative experiences and retain the positive ones. This applies to psychotic episodes as much as to anything else.' 'I can't see anything positive in what you've described, sir.' 'Then I haven't described it properly. The fact is, not everyone finds psychosis a negative experience. While some patients suffer persecutory or self-blaming delusions, others develop grandiose fantasies or have an experience of deep religious significance. This can appear very positive and life-affirming.' 'Are you serious?' 'Absolutely. I've known some individuals describe a psychotic episode as a revelation, a wonderful and exciting new way of seeing the world - in fact, the sort of experience that people seek from hallucinogenic drugs. You know, a surprisingly large percentage of the population have undergone a psychotic

episode of some kind, without being disturbed by the experience. At the end of the day, a hallucination is merely the misattribution of internal events to an external source.' Cooper shook his head, trying to throw off a sudden, unwelcome burst of insight, a glimpse of how it might feel if the reality of his own world became suspect. He was sure he would find it disturbing. 'Could we get back to the question of John Lowther's condition, and how he was being treated?' 'Well, when Mr Lowther was discharged, he returned to the community. He has family members in Derbyshire. It's normal practice to ensure that the family are fully aware of the importance of maintaining medication. We can't be there standing over every patient personally, to make sure they take their drugs.' 'Who was supposed to do that? His parents?' Dr Sinclair frowned at the file. 'According to his records, there's a sister.' 'She's dead.' 'Oh.' 'And I think she might have been too preoccupied recently to worry about her brother.' 'Mr Lowther must have been due for a review,' said Sinclair. 'Perhaps his GP had examined him recently.' They looked at each other for a moment, conscious of the futility of trying to work out where and when the system had gone wrong. 'Basically, a dangerous psychotic was allowed out into society unsupervised,' said Cooper. 'No, no, you don't understand. Once a patient is discharged and living at home, clinicians are helpless. Even if we know they might be a risk to themselves and others, we can't force an individual to continue medication. Not at present.' 'But you'd like to be able to compel people to take their drugs?'

'Detective Constable, fifty thousand patients are detained by psychiatrists every year. If we can't compel people to continue medication when they're back in the community, all that happens is that some of them get very ill again and have to be detained a second time, or a third. It just goes on and on.' 'The revolving door approach. We see it often enough in the courts.' 'I'm sure you do,' said Sinclair. 'Besides, John Lowther isn't dangerous unless he has stopped taking his medication. And even then, he's only a risk to himself. You say his sister died? The trauma of her death might have disrupted his normal routine anyway. It would be easy for him to slip. I hope he hasn't gone beyond caring for himself.' 'Doctor, if John Lowther's psychotic episodes returned, would the hallucinations be as powerful as they were previously?' 'Possibly more so. To be honest, in my next consultation with him, I might have been moving towards a conclusion that he was suffering from a treatment-resistant condition.' 'What would you have done then?' 'Tried another drug. Probably Clozapine.' Sinclair took a tissue from a box on his desk and wiped a drop of sweat from his temple. 'There's one other thing that might be relevant. . .' 'Go on, sir.' 'At the time he was admitted to the unit, Mr Lowther was also suffering from night terrors.' 'You mean nightmares?' 'No, night terrors. Nightmares occur during REM sleep, terrors are experienced in stage four sleep. In practice, the distinction is that you remember nightmares, but you don't remember terrors. They're subconscious phenomena - but no less stressful, psychologically and emotionally.' 'And those might have returned, too?' 'It's possible.' 'In John Lowther's case, would his deteriorating condition be noticeable in the way he talks?'