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  He stared out the kitchen window onto the devastated remains of Mother’s rose garden. Beyond that, completely hidden by trees and brambles, stood the two-story carriage house that Ellen had cleared of its tenants prior to Jimmy’s release from Croton. Growing up, it’s where mother’s chauffeurs had lived. He looked at the gnarled vines, and realized that this was the scene that had started his dream. Great things would soon happen in that building. He hummed the opening bars of Chopin’s Revolutionary Étude—the piece she’d played all those years ago. Closing his eyes he heard the dizzying passages. His breath quickened as he pictured her. She was dressed in a cheap, homemade, blue velvet dress with white lace at the collar and at the hem. He remembered how she’d crossed the stage and sat to play, her thin legs barely reaching the pedals, her eyes intense, and then the music … unlike anything he’d ever heard before … or since. And then he saw the woman who’d come to visit him that one time at Croton, her eyes filled with compassion and love. Her voice, tinged with the soft Southern vowels of his childhood nanny. His chest tightened, and he felt a fierce longing. Lost in the moment, he didn’t hear the phone until the answering machine picked up on the sixth ring.

  He listened as Ellen’s voice spoke over the message. “Jimmy, pick up.”

  He grabbed for the receiver, “Hi, Ellen.”

  “Well,” his sister did not sound happy. “Here’s the deal …”

  TWO

  Dr. Barrett Conyors glanced anxiously over the head of her chain-shackled patient at the wire-fronted prison clock in the cement wall. It was nearly four and it had been one hell of a day. If traffic was good—and that was a big if—she could be parked back in Manhattan by six. It was her mother’s birthday and she would not be late. But there was still the matter at hand to be gotten through, and she’d been dreading this for weeks. Her gray-blue eyes looked Charlie straight on, as she ran a hand through short-cropped hair.

  “What is it, Doc?” he asked. “You got a date?”

  “Nice try.” She leaned forward, the sleeves of her navy suit—bought on final markdown at Loehman’s—touched the scarred wood surface of the bolted-down table.

  “Then what? You’re going to tell me something bad, aren’t you?”

  She met Charlie’s gaze. Over the past eighteen months he’d cleaned up nicely. Not at all the bedraggled and wild-eyed madman who’d been captured—in part thanks to her—in a cave-like stretch of abandoned tunnel near the East 33rd Street station. Now, his beard, shot through with streaks of white, was trimmed and his thick coarse-gray hair had been cut and neatly parted. If it weren’t for the hospital-issue jumpsuit and the chain attached at his waist, his wrists, and his ankles, he might have passed for a professor.

  “You know what this is about, Charlie.”

  “Time’s up, huh?” his arms strained against his shackles.

  “You got it in one.”

  “What’s the verdict?”

  She hated this part; it made her stomach churn. She knew that Charlie Rohr, like others in his family, suffered with serious mental illness. In his case, the voices inside his head and bizarre delusions gave him a diagnosis of schizophrenia. Bad enough, but through some horrible collision of genetics and upbringing, Charlie Rohr was also a murderous sociopath. For nearly five years he’d preyed on transvestite prostitutes on the West Side. His victims were members of a population prone to bad things, but Charlie’s psychotic flourishes had pushed him onto the police radar. And when he mistook a “partying” city official, who was out for the night in drag, for one of his usual victims, Barrett—a forensic psychiatrist—had been called in as a consultant to profile the killer. Some tabloid reporter had dubbed Charlie the Caravaggio killer, after the renaissance painter who had created images that were both glorious and horrifying, most notably Saint Sebastian crucified and shot through with arrows—just like Charlie’s victims. Only instead of arrows, he used knitting needles with which he’d blind and pierce.

  “The judge isn’t buying the insanity plea,” she told him bluntly.

  “Because of you?” Charlie asked.

  “It’s a tough standard, Charlie. And all along you knew your actions were wrong.”

  “That’s not true. It was the voice of God. I was just following the word of God. I was his angel. I am …” he stopped himself.

  Barrett was startled by an intensity in his dark eyes that she’d not seen in months. She recognized that no matter how good he looked, or how rational he sounded in brief moments, beneath his veneer of sanity lurked a psychosis never fully dampened by the medication.

  “You hid your crimes, Charlie,” she said softly, wondering if there was any way to do this with kindness. “You covered your tracks. If you want a not guilty by reason of insanity ruling you can’t do those things.”

  “But you said I’m sick. Aren’t you the one who keeps telling me that I have schizophrenia,” his voice swelled and his words spilled fast. “Aren’t you the one who tells me that it’s a biologic condition? That I was born with it. This isn’t my fault. I’m sick. I need to be in a hospital.” He glared at her accusingly, “I took your pills!”

  “I know,” despite his shackles, she edged back. “It’s the law, Charlie. You know what’s going on now; you didn’t before. You’re going to have to stand trial.”

  And there it was, the essential kernel of their relationship hung in the air.

  “You must feel real good about this,” he said. “You’ve done your job. That’s what this is about. You were here to get my craziness under control so that they can send me to the chair. I’m competent to stand trial; isn’t that what you call it?”

  “Yes.”

  “So let me get this straight. You’re a doctor, right?”

  “Yes.”

  “I thought doctors weren’t supposed to kill their patients. You made me better so that I can fry.”

  “This is my job, Charlie,” she replied, hating the canned sound of her answer.

  “Did you know that the Nazis put doctors in charge of the concentration camps? Just following orders? Well, fuck you, Dr. Conyors!”

  Barrett pushed away—under normal circumstances she would already have been out of there. She didn’t put up with this kind of language from anyone. But Charlie had reason. While she’d repeatedly told him the rules, that there was no confidentiality and that her alliance was to the State of New York and the preservation of public safety, she was also his psychiatrist. And for the last eighteen months she’d worked hard to get his voices under control … so that he could stand trial. He was correct; he could get the death penalty—in addition to the prostitutes and the councilman, he’d killed a cop with a crowbar—at the very least he’d get life without the possibility of parole.

  “So now what?” His words spat between clenched teeth.

  “You’ll leave here, she said, her body tense. “You’ll go to a behavioral health unit in a maximum security facility while you await trial.”

  “When?”

  “Today,” she said, knowing that there were two marshals just outside, ready to transport.

  “And my lawyer?”

  “She knows.” What she omitted was the request from Charlie’s chicken-shit public defender that Barrett be the one to break the news.

  “Then we’re done,” he said.

  She wanted to tell him that she was sorry. But what good would that do? Sure she was sorry, sorry that he had to have schizophrenia and sorry that he was tormented by voices that told him to do horrible things. “Goodbye, Charlie.” Barrett stood and walked back to the door of the interview room—she wanted out. She looked through the wire-mesh window and saw the two marshals—a twenty-something man and a stocky Latina woman—whose job it was to transport Charlie from Croton State, where he’d lived since his arrest, to a maximum security prison.

  She tapped on the door and tried not to think about what she’d just done. Charlie was crazy, but stupid he wasn’t and he’d honed in on her dilemma. Doctors weren’t supposed
to hurt their patients, and that’s exactly what she’d made possible. Because of her, Charlie could get death. “What have you done, Barrett?” she muttered. And not for the first time she wondered if this was any kind of work for a psychiatrist, any kind of work for her.

  She stepped through the door and stood back as the marshals and the guard entered the interview room.

  As the Croton guard unlocked Charlie’s shackles her gaze landed on something that shouldn’t have been. She wasn’t the only one to see it, and what happened next took on a horrifying slow-motion quality. The younger of the two marshals had somehow made it through security with his sidearm—a severe breach of policy.

  In the split second that she realized the potential for disaster, Charlie’s shackles clicked open, and the previously docile patient leapt at the inexperienced officer. Barrett stood transfixed as Charlie’s sinuous fingers liberated the weapon from its holster. The marshal, realizing too late, grabbed for his gun. A shot exploded in the cement-and-metal room. The marshal, who looked like he could have just graduated from high school, clutched at his throat. There was a wet sucking noise as bright red blood gurgled between his fingers and he sank to the floor.

  Charlie’s gaze darted around the room; he pointed the gun first at the guard—an old-timer—then at the female marshal. Like an uprooted carnival wheel his gun hand spun around, as he tried to think.

  He saw Barrett through the open door. “You see what you did, doctor! All your fault. I don’t want to fry!”

  “Don’t do this, Charlie.” Barrett tried to hold his attention, but almost telepathically she knew what he intended. “Don’t do it.”

  “And why not, doctor?” His voice softened and his eyes fixed on hers. Never breaking their gaze, his gun hand came up to the side of his head and he lodged the barrel against his ear. Words spilled fast from his mouth, at first she couldn’t hear, but then, “ … I shall not want. He maketh me to lie down in still waters, he leadeth me by the way. Yea, though I walk through valley of the shadow of death I shall fear no evil.” His eyes burned into hers, his lips kept moving. He squeezed the trigger, and mainlined a ball of burning lead into his brain; there was little blood as his head jerked, his knees buckled and he fell to the floor.

  “No!” Barrett screamed as her nostrils filled with the bitter smell of singed flesh and hair. Her ears rang with the gun’s reverberation and the hoarse screams of the elderly guard. She moved slowly toward Charlie and felt something stick to the bottom of her low-heeled pump. She looked at a puddle of something oily and dark. She turned. The marshal Charlie had shot stared back at her. Tears tracked down his clean-shaven face; he tried to speak, no words, just a froth of pink blood that dribbled from his lips.

  “Call a code!” Barrett shouted to the guard. Even as the words left her mouth she realized where she was. Croton Forensic was a hospital all right, but the only kind of doctors wandering the halls were shrinks like her. Not exactly what you needed for a direct hit to the carotid artery.

  The white-haired guard, who was counting the months until his retirement, was having trouble standing. His arthritic knees shook beneath his gray polyester uniform. “You mean a code yellow?” he gasped, clutching at his chest.

  “Whatever. Just get an ambulance and paramedics as fast as you can. You …” she turned to the female marshal, “go with him.” The dark-haired woman nodded mutely, shell-shocked and eager to flee. Barrett turned her attention back to the injured officer. “It’s going to be okay, just hang on, we’re going to get you help.”

  The young man tried to speak.

  “Don’t,” she knelt down and put her hand over his. She pressed in against the side of his neck to stem the massive seepage.

  His brown eyes blinked as he struggled against the blood loss and encroaching shock.

  “Hang on,” she whispered as his hand lost strength. “Just hang on.” His body went limp. She checked his damaged neck, and then jammed her hand back down. His liquid pulse throbbed against her palm; with each beat she felt it weaken. She watched his chest waiting to see the rise and fall; it didn’t come. He’d stopped breathing and it would be a matter of seconds before he’d go into full cardiac arrest. Keeping her hand clamped to his neck she eased him down flat onto the cement floor. She pinched his nose shut, sealed her lips over his and attempted to breathe into his lungs. She felt resistance as her air didn’t make it past his throat. She repositioned his head, feeling his ever-weakening pulse against the flat of her hand. She broadened her stance and heard the unmistakable rip of her skirt. She pressed her full lips against his open mouth, tasting blood and the salt of his saliva; no air went in. As seconds passed, she felt him slipping away. She tried a third time and a fourth. She pushed his head back, hoping to open the airway, but still nothing. Her fingers felt tiny crackles beneath the clammy surface of his upper chest. She looked down at his neck and saw that his Adam’s apple and windpipe had twisted toward the left. It took her brain a panicked moment to register the reality; he’d dropped a lung. She’d seen this before as an intern, even performed the procedure once. Only then, she’d been surrounded and supervised by emergency room doctors and trauma nurses, with all of the latest equipment, and years of experience.

  She looked around, her eyes wide. She needed help, and there was none. Everything was bolted to the floor. She needed a chest tube. She patted her inside breast pocket and found a ballpoint pen. Biting down on the tip she pulled out the ink cartridge and then bit off the nub on the other end.

  The man’s pulse was barely palpable. Holding tight to his neck, she ripped his shirt open with her other hand; a button hit her below the eye as another pinged against the floor. She flinched slightly, eyeballed his rib cage, and grasping the plastic pen casing, placed its tapered end against the flesh an inch below and a palm’s-breadth lateral to his right nipple. Using all her strength, and praying that the plastic wouldn’t shatter, she pressed in, tearing through skin and muscle as she jammed a bloody path between his ribs and the membranous casing that surrounded his lungs. Seconds ticked by as she worked at her gory task, it seemed like hours, and she wondered if all she were doing was defacing the body of a dying man. In reality, it was just over a minute before a moist sputtering sound rewarded her efforts, as blood and air escaped from the deputy’s chest.

  Leaning over, she again attempted to breathe into him, and this time the air passed through his mouth and expanded his lungs. Between bloody breaths she clamped down on the pen, knowing that to not do so would cause his lungs to again collapse. At least his pulse was still pumping, weakly, but still there.

  When the paramedics finally arrived, she felt a tremendous wave of relief, as they stomped in with their bright-orange field kits and oxygen tanks strapped to a gurney. They quickly replaced her makeshift chest tube with the real thing, hooking it to a vacuum seal in an attempt to stabilize the critically wounded marshal’s chest.

  “Tension pneumothorax,” one of the medics commented, as he strapped a pressure bandage onto the man’s neck, letting Barrett have her hand back. “That’s quite a pickup. You a doc?”

  “Yes,” Barrett rolled back on her heels, not caring that she was perched in a pool of blood. She started as her gaze met Charlie’s open eyes; even in death they held his accusation.

  “Emergency room?” the medic asked.

  “Huh?”

  “Are you an emergency room doctor?”

  “Psychiatrist,” she pulled her gaze off Charlie.

  “No shit.”

  She stood to help the paramedics slide the marshal onto the wooden backboard.

  “No shit,” she answered dully, as they hoisted him onto the stretcher and beat a hasty retreat.

  ___

  Two hours later, and still badly shaken, Barrett pressed down with a new ballpoint through quadruplicate carbonless forms attempting to put what had just happened into a sequence. They had sent the guard home, leaving her as the only witness to fill out the paperwork. There would be hell to pay on
this one. How did they let the kid into the facility with a firearm? She tried not to think about that, just like she resisted the urge to call the hospital—yet again—to get a status report on the wounded officer, Corey Williams, aged twenty-two. He’d be in surgery for hours; at least he was still alive. But Charlie, her patient, was dead. She kept seeing his eyes, and hearing his accusations. “Doctors aren’t supposed to kill their patients ...”

  Alone in the guard’s grungy office, she tried to focus on the stupid little check boxes. The instructions were clear—“leave no blanks.” Much as she detested filling out forms, she knew that what found its way into the medical record became history. As a forensic psychiatrist, this was especially true. It’s what she was taught and it’s how she instructed her medical students and residents. “If it’s not in the record, it didn’t happen.”

  She signed her note, and entered a second one into Charlie Rohr’s chart. A tear slid off her cheek and splattered on the blue-lined paper.

  Her pager—set on vibrate—buzzed against her hip. She looked at the display—it was her home number.

  She dialed; her fingers felt numb.

  “Barrett?” her sister picked up on the first ring.

  “Justine.”

  “Where are you, girl? … What’s wrong?”

  “Don’t ask.”

  “You’re still at work, aren’t you?”

  “Uh huh,” Barrett signed her note.

  “We have reservations for seven,” her younger sister reminded her.

  “I’m still at Croton.”

  “Barrett … if I didn’t know you better I’d say you were avoiding coming home.”

  “I’m sorry,” she struggled to keep her voice steady. “You would not believe the day I’ve had.”

  “Well, we still love you. So what’s the plan?”