Praying for Sleep

  They waded through the chill, slimy water and gazed at the lake. It wasn't their levee that had given way; it was the sandbags by the dock--the ones that Owen had assured Lis he'd stacked high and solid. The rising lake had pushed them over and the water was backing into the creek behind the garage. Amid eddies and whirl-pools, the stream was filling the yard.

  "What do we do?" Portia shouted. Her voice was harsh and unsettling; despite the quick-moving current, the flood was virtually silent.

  There wasn't much they could do, Lis decided. The water was flowing in through a twenty-foot gap--too large for the two of them to dam. Besides, the garage was in a low-lying area of the property. If the level of the lake didn't rise much more, the house and most of the driveway would be safe.

  She said, "We leave is what we do."

  "Fine with me."

  They waded into the garage and climbed into the Acura. Lis slipped the key into the ignition. She paused superstitiously--concerned that the flood had shorted out the battery or ruined the starter. She looked at Portia then turned the key. The engine kicked to life and purred smoothly. Backing out carefully, Lis eased the car through the flood up the incline of the driveway.

  They were nearly out of the dark pool surrounding the garage when the car shuddered and the front wheels, the drive wheels, dug through the gravel and into the slick mud below, where they spun uselessly, as if they rested in ruts of ice.

  This, Lis recalled, had been her second concern.

  He eased his BMW around the curve on Route 236 and sped out of Ridgeton through the cutting rain.

  Richard Kohler now descended through the hills and swept to the right, heading due east once again. There it was. Perfect. Just perfect! He laughed out loud, thinking that the scene was far more impressive than he'd remembered. He pulled into the back of the lot, parked and shut the engine off. He unzipped his backpack, extracting Michael Hrubek's file--the one he'd started to read earlier that evening.

  This battered folio had been penned by sixty-five-year-old Dr. Anne Weinfeldt Muller, a staff psychiatrist at Trevor Hill Psychiatric Hospital.

  Trevor Hill was a renowned private facility in the southern part of the state. Michael had been Anne Muller's patient for merely five months but her insights into his plight, and his improvement under her care, were inspiring. It was, Kohler reflected, a true tragedy that no one would ever know how effective Muller's treatment of Michael Hrubek might have been.

  Like Kohler, Anne Muller divided her time among various hospitals and happened to have come across Michael at a small state facility where she worked with severe schizophrenics. Impressed by his intelligence and struck by his unusual delusions, she campaigned to pry open the doors of expensive Trevor Hill and have Michael admitted as a pro bono patient. The hospital administrators--preferring patients that were more "mainstream" than Michael (that is, able to pay their bills)--had resisted her efforts at first but had finally acquiesced, largely because of her own prestige and talent and pigheaded manner.

  His first day had been spent in a restraint camisole. Then he'd calmed and the feared garment had come off. Kohler glanced again at Muller's notes, jotted in the first week of the young man's commitment: Pt. is hostile & suspicious. Afraid of being struck. ("You hit me on the head, you're one dead fucker, make no mistake.") No apparent visual hallucinations, some auditory . . . Motor activity is extreme, restraint at times necessary. . . . Affect flat or inappropriate (Pt. began sobbing when noticed book of American history; later Pt. laughed when asked about maternal grandmother and said she was "one dead fucker") . . . Cognitive functioning good but flights of ideas indicate purely random thinking at times. . . .

  Although the many state hospitals in which Michael had been committed undoubtedly blended together into a grim stew of memories, Trevor Hill might very well have stood out pleasantly in his mind. In state facilities, patients wore filthy clothing and sat in drab rooms with blunt crayons or Play-Doh for entertainment. Many of the men and women had the indentations of lobotomies on the crowns of their heads and were regularly third-railed by electroconvulsive-shock technicians or sent into insulin comas. But Trevor Hill was different. There were far more orderlies and doctors per patient than in the state hospitals, the library was full of books, wards were sunny and windows unbarred, the grounds landscaped with trim paths and gardens, and rec rooms stocked with learning toys and games. ECS was used occasionally but medication was the major tool of treatment.

  Yet, as with all schizophrenic patients, getting the right drug and dosage for Michael was a major task. One young resident at Trevor Hill had naively asked him what medicines he'd taken in the past and the patient answered like a diligent medical student. "Oh, lithium. Generally, chlorpromazine and its derivatives are contraindicated for me. I'm a schizophrenic--make no mistake about that--but a big component of my disease is manic-depression. You may know that as bipolar depression. So, lithium has generally been my drug of choice."

  The impressed resident prescribed lithium and under the drug's effect Michael went berserk. He threw the ward's television through a window, leapt out after it and got halfway through the main gate before being tackled by three burly orderlies.

  After this incident Dr. Muller took over treatment personally. She put Michael on a loading dose of Haldol--a dosage larger than he would ultimately need but intended to stabilize him fast. He improved immediately. Then began the fine tuning, balancing the drugs' effectiveness against the side effects of weight gain, dry mouth, the uncontrollable moving of the lips that antipsychotic drugs cause, the nausea. His regimen included, at various times, Thorazine, Stelazine, Mellaril, Moban, Haldol, and Prolixin. Thirty milligrams of this, one hundred of that, up it to two hundred, no, better mix it. Eighteen hundred of Thorazine, no, go higher, switch to Haldol, ninety milligrams of it, well, that's the same as forty-five hundred of Thorazine, too high, how's his dyskinesia? Okay, back to Stelazine . . .

  Muller finally settled on what Kohler himself found worked best with Michael: high levels of Thorazine. Michael's treatment consisted of this workhorse drug and his therapy with Dr. Anne. She met with him every Tuesday and Friday. And what was distinctive about his sessions with this psychiatrist was that unlike so many of his doctors in the past she listened to what he had to say.

  "You've said a couple of times now, Michael, that you're worried about what's 'ahead.' Do you mean your immediate future?"

  "I never said that," he snapped.

  "Did you mean something ahead of you in the hallway? Was someone upsetting you?"

  "I never said a word like that. Someone's making up things about me. The government's usually to blame, the fuckers. I don't want to talk about it."

  "Do you mean 'a head,' like someone's head, a skull?"

  He blinked and muttered, "I can't go into it."

  "If it's not the head maybe you mean someone's face? Whose?"

  "I can't fucking go into it! You're going to have to use truth serum on me if you want that information. I'll bet you have already. You may know that as scopolamine." He fell silent, a smirk upon his face.

  The therapy was no more sophisticated than this. Like Kohler, Anne Muller never tried to dissuade Michael of his delusions. She dug into them, trying to learn what was inside her patient. He resisted with the resilience of a captured spy.

  But after four months Michael's paranoid and contrary nature suddenly vanished. Muller herself grew suspicious--she'd come to recognize that Michael had a calculating streak in him. He grew increasingly cheerful and giddy. Then she learned from the orderlies that he'd taken to stealing clothes from the laundry room. She assumed that his apparently improved temperament was a ruse to shift suspicion about the theft.

  Yet before Muller could confront him, Michael began to deliver the loot to her. First, two mismatched socks. He handed them to her with the bashful smile of a boy with a crush. She returned the articles to their owners and told Michael not to steal anymore. He grew very grave and told her he was "unable
at this time to make a commitment of that magnitude."

  Important principles were involved, he continued. "Very important."

  Apparently so, for the next week, she received five T-shirts and more socks. "I'm giving these clothes to you," he announced in a whisper, then walked away abruptly as if late for a train. The gift-giving went on for several weeks. Muller was far less concerned about the thefts themselves than understanding what Michael's behavior meant.

  Then, when she was lying in bed at three in the morning, the epiphany occurred. She sat up, stunned.

  In the course of a long, disjointed therapy session that day, Michael had lowered his voice and, eyes averted, whispered, "The reason is, I want to get my clothes to you. Don't tell anyone. It's very risky. You have no idea how risky."

  Clothes to you. Close to you. I want to get close to you. Muller bolted from her bed and drove immediately to her office, where she dictated a lengthy report that began with a subdued introduction tantamount to a psychiatrist's shout of joy: Major breakthrough yesterday. Pt. expressed desire for emotional connection with Dr., accompanied by animated affect.

  As the treatment continued, Michael's paranoia diminished further. The thefts stopped. He grew more sociable and cheerful and he required less medication than before. He enjoyed his group-therapy sessions and looked forward to outings that had previously terrified him. He started doing chores around the hospital, helping out the library and gardening staffs. Michael, Muller reported, had even driven her car several times.

  Kohler now looked up from the report and gazed across the gritty parking lot. Lightning flashed in the west. Then he read the final entry in the file, written in a hand other than Anne Muller's. He found he could picture the scene upon which these notes were based only too well: Michael lies on his bed, looking through a history book, when a doctor comes into his room. He sits on the bed and smiles at the patient, inquiring about the book. Michael immediately stiffens. Little sparks of his paranoia begin to burn.

  "Who're you, what do you want?"

  "I'm Dr. Klein. . . . Michael, I'm afraid I have to tell you that Dr. Muller is sick."

  "Sick? Dr. Anne is sick?"

  "I'm afraid she's not going to be meeting with you."

  Michael doesn't know what to say. "Tomorrow?" he manages to blurt, wondering what this man has done with his doctor and friend. "Will I see her tomorrow?"

  "No, she's not coming back to the hospital."

  "She left me?"

  "Actually, Michael, she didn't leave you. She left all of us. She passed away last night. Do you know what it means, 'passed away'?"

  "It means some fucker shot her in the head," he answers in an ominous whisper. "Was it you?"

  "She had a heart attack."

  Michael blinks a number of times, trying to comprehend this. Finally a bitter smile snaps onto the patient's face. "She left me." He begins nodding, as if relieved to hear long-anticipated bad news.

  "Your new doctor is Stanley Williams," the man continues soothingly. "He's an excellent psychiatrist. He trained at Harvard and he worked at NIMH. That's the National Institutes for Mental Health. How's that for credentials, Michael? Very sharp fellow, you'll be pleased to know. He's going to--"

  The doctor manages to dodge the chair, which splinters against the wall with the sound of a gunshot. He leaps into the corridor. The heavy oak door restrains Michael for about ten seconds then he finishes kicking his way into the hall and storms through the hospital to find his Dr. Anne. He breaks the arm of an orderly who tries to subdue him and they finally net him like an animal, a nineteenth-century technique that had been used at Trevor Hill only once since it opened.

  One week later, his advocate and therapist dead, Michael Hrubek and his sole material possessions--toothbrush, clothes and several books of American history--were shipped to a state mental hospital.

  His life was once again about to become an endless stream of Pill Time and Meal Time and Shock Time. And it would have too, except that after sitting in the hospital's intake waiting room for two hours, temporarily forgotten about, he grew agitated and strolled out the front door. He waved goodbye to a number of patients and orderlies he'd never met and continued through the gate, never to return.

  Dr. Richard Kohler noted that the date of that disappearance had been exactly fourteen months ago; the next official record about Michael Hrubek was an arrest report written by the unsteady hand of a trooper at Indian Leap State Park on the afternoon of May 1.

  The psychiatrist set aside Anne Muller's file and picked up the small notebook filled with the jottings he had made at Lis Atcheson's house. But before he read he stared for a moment outside at the drops of thick rain that rattled on the windshield, and he wondered just how much longer he'd have to wait.

  21

  "Where'd you find this?"

  Under the bed, up a tree, in between Mona the Moaner's legs . . .

  Peter Grimes didn't respond and to his great relief the hospital director seemed to forget the question.

  "My God. He's been talking to DMH for three months ? Three fucking months! And look at all of this. Look!" Adler seemed almost more astonished at the volume of paperwork that Richard Kohler had generated than by the contents of those papers.

  Grimes noticed that his boss was touching the sheets rather gingerly, as if afraid of getting his fingerprints on them. This was perhaps Grimes's imagination but it made the young doctor extremely uncomfortable--largely because it seemed like an excellent idea, one he wished had occurred to him earlier, before he'd left the evidence of his identity imprinted all over the documents.

  Adler looked up, his thoughts hovering, and to keep him from asking again where the papers had come from, Grimes read from the sheet that happened to be faceup in front of the two men. " 'Dear Dr. Kohler: Further to your proposal dated September 30 of this year, we are pleased to inform you that the Finance Division of the State Department of Mental Health has provisionally agreed to fund a program for inpatient treatment of severely psychotic individuals according to the guidelines you have set forth in the aforementioned proposal. . . .' "

  "Goddamn him," Adler interjected with such vehemence that Grimes was afraid to stop reading.

  " 'A preliminary budget of 1.7 million dollars covering the first year's financial needs for your program has been provisionally approved. As agreed, funding will come from existing allocations to the state mental-health hospital system, in order to bypass the necessity of a public referendum.' "

  But stop he did when Adler muttered "bypass" as if it were an obscenity and snatched away the sheet to read the final paragraph himself. " 'This is to confirm that your proposal is conditioned upon approval by the Board of Physicians of the State Department of Mental Health, following your final presentation of the six case studies and verbatims upon which your proposal was based (Allenton, Grosz, Hrubek, McMillan, Green, Yvenesky). A representative of the Board will contact you directly regarding times for oral presentations of those case studies. . . . ' "

  Adler slammed the paper to the desk and Grimes decided that, while his fingerprint paranoia was perhaps misplaced, the hospital director should be somewhat more careful. If Kohler noticed damaged pages he might complain of a suspected theft--to which, Grimes was painfully aware, there'd been a witness. A half hour before, the assistant had summoned an irritable Slavic janitor to open the door of Kohler's office. Not a seasoned burglar, Grimes had neglected to send him away and had failed to notice that the squat man planted himself on the threshold to watch with amusement the young doctor's heist from start to finish.

  "Our money. He's getting our money, on top of everything else! And, look at this. Look at it, Grimes. He's using our patients to fuck us! He's selling us out--our patients, our money--for his program."

  Adler grabbed the phone and made a call.

  As he gazed out the window, Grimes considered Kohler's scheme and he was both shocked and impressed. Kohler had used Michael Hrubek as a shining example of how his combi
nation of drugs, delusion therapy and milieu resocialization treatment could produce dramatic improvements in chronic, dangerous schizophrenic patients. The Department of Mental Health had agreed to give Kohler a great deal of money and let him create a little fiefdom--carved out of Marsden hospital itself, at Adler's expense no less. But of course if Hrubek wasn't captured quietly, if he injured or killed someone, the DMH Board of Physicians would abort Kohler's plan as unworkable and dangerous.

  Still, it was an admirable scheme, Grimes thought, and he regretted playing a part in the downfall of a talented man, one who probably would've been a better choice to hitch his star to--if of course Kohler's career had survived this evening. Which it surely would not.

  The rain spattered the greasy windows. A huge wail of wind ended in a crash of plate glass from somewhere in the courtyard below. Several other patients had joined Patient 223-81 and a chorus of frightened wailing filled the halls. Grimes looked absently out the window and tried to avoid thinking about the effect on patients if a tornado touched down nearby.

  Adler slammed down the phone and looked at him. "He's not at the halfway house. Some son of a bitch tipped him off."

  "Who, Kohler?"

  "He got a call a couple hours ago. He's out there. He's after Hrubek right now."

  "By himself?"

  "He has to go by himself. He has to get Hrubek to come back like a quiet little lamb. Then he'll claim he simply walked up to him and asked him to come home. And the son of a bitch will. After Kohler hits him with a taser or a tranquilizer gun . . . Shit! The break-in."

  "I'm sorry?" the assistant asked cautiously.

  "Security said somebody broke into the pharmacy tonight."

  "Right. Well, they said it was a car accident, looked like. We won't know till morning if anything's missing."

  "Oh, something's missing, you can bet on it. That son of a bitch lifted a tranquilizer gun. He's going to . . ." Adler spat out, "Jesus, he's going to make Hrubek look like the fucking little puppy I've said he is all along. Jesus Lord."