Breakdown

Chapter 7

Kevin Bracht unlocked the room and handed me the key. I shut the door quietly but failed to squelch the penitentiary clang that said serious hardware was in play.

The form on the bed faced the wall, obscured by the blanket but for errant strands of hair.

I said, “Zelda?”

No response. I tried again, a bit louder. Lifted the hair. Greasy, bristly. Her neck skin was warm and gave off a vinegar smell. I found a pulse. Slow, steady.

Stepping away, I examined the cell.

A chair was positioned at the side of the bed. Soft brown vinyl for the cushions, hard brown plastic for the frame. Low-watt LEDs on the ceiling provided soft light. The sun augmented, filtering through a high window. The view through the glass was sooty sky peppered with listless blue, creating the kind of blurry abstraction you see at amateur art fairs.

I walked around. The floor was plastic pretending to be oak parquet. The walls were covered in sheets of washable, pebbly stuff you find only in institutions. On the positive side, the hue was a cheerful buttercup yellow and the matching blanket appeared fluffy.

The bed was the big surprise: generous pillow-top mattress atop a box spring.

Bolted to the floor.

In the left-hand corner were a lidless toilet and a sink the size of a salad bowl, both stainless steel with rounded edges. Not a sharp surface anywhere but that didn’t matter. Given the right circumstances, the roll of toilet paper near the commode or the toothbrush on the sink could be used to self-destroy.

My eyes rose to a framed print high above the sink, unreachable unless you were a basketball center. Poorly painted landscape.

After meeting Kristin Doyle-Maslow, I was thankful it wasn’t Munch’s The Scream.

By hospital standards, a decent place but anywhere you can’t leave is prison and a day and a half after its debut, this place had acquired the reek of confinement.

I bent to take a closer look at the inaugural patient. The strands of hair were dishwater laced with gray. Thirty-five years old; I could only imagine what life had been like since she lost her job.

Where had she lived? How had she gotten by? Why had she repeated the trespassing that got her busted in Sunland? Had the Bel Air backyard belonged to another ex-lover? Or a man she imagined as such?

Where was her son?

I sat down on the brown chair, tried to shift it closer to the bed. No movement. Another bolt-job.

Zelda continued to sleep and I thought about what it would be like to get stuck in here.

My chest tightened and I felt my pulse begin to race. An issue I’d thought I dealt with years ago.

You could call it claustrophobia. I think of it as a nasty little childhood memento.

All those hours spent hiding in crawl spaces and sheds, crouched behind shrubbery, or squeezing between rocks, trying to escape my father’s unpredictable drunken rages.

I’ll never enjoy small spaces but I really thought I’d gotten past notable anxiety. Even Robin doesn’t know. No reason for her to know.

But here it was again. Nothing serious, I could handle it. Just as I did years ago, practicing my own preaching, drawing upon all those nifty cognitive behavioral techniques.

Mostly, though, I choose to avoid anything close to confinement, maybe because I don’t want to let go of the memories, fearing freedom will soften me when the next big threat rolls around.

I’ve constructed a world for myself that allows lots of elbow room, living in a spacious, sparely furnished house with a view of miles of canyon and an occasional snip of ocean on clear days. My work — short-term custody and injury work for the court, consults on murders with my best friend, a veteran detective — allows me to come and go as I please.

I run for exercise, choosing times when I’m unlikely to encounter company.

I spend a lot of time by myself and when the dreams arrive unbeckoned and I really need to step out of myself, there’s always the grand distraction of helping others.

Now here, in this absurd, surreal place, the person I’d come to help remained drugged up and inert and I craved escape.

Deep breath. Focus.

After a bit of that, I scooted to the edge of the chair and touched Zelda’s cheek. Coarse with some kind of rash.

Not a stir. I patted her again, more firmly.

My third attempt caused her to frown.

I said, “Zelda?”

She murmured but kept her eyes closed. Then she sat up, shook her shoulders, and looked around. The blanket rolled free, revealing what I first thought was an institutional yellow top but turned out to be a cheap Tijuana blouse with ragged black stitching along the seams.

“Zelda?”

She lay back down, rolled away from me, returned to sleep.

I sat there and did more deep-breathing, closed my own eyes and tried to summon up a pleasant scene.

What I ended up thinking about was a small boy building castles with tiles and that brought on the what-ifs.

A woman’s voice shook me alert.

“You.”

Not an accusation, just a pronoun uttered without inflection.

As if the word existed in a vacuum.

Zelda Chase had sat up again, blanket gathered at her waist. This time her eyes were wide open and aimed at me.

“You,” she repeated.

“Do you know who I am, Zelda?”

Confusion.

I said, “Dr. Delaware.”

Her lips screwed up like a pig’s tail. She scratched her chin, then her cheek, then her forehead. Burped loudly and did it again and rotated her head and flittered her fingers.

Five years had wreaked decades of damage, the once-oval face a lopsided hatchet collapsed at cheek and jaw. A caved-in mouth said most of her teeth were gone. Her complexion was livid — street sunburn — her lips shrunken and blistered and parched. Deep furrows ran vertically from her nostrils to her chin. Her eyes were pink where they should’ve been white. Thirty-five years old, but I’d have guessed fifty-five, minimum.

“Zelda—”

She drew her hands up defensively but without confidence, like an outclassed boxer.

I sat back as far as I could in the immovable chair. “Alex Delaware. We met a few years ago.”

Nothing.

“I was told you asked for me.”

The hands dropped a bit. The near-stuporous confusion behind them might’ve been mental illness but I bet the real cause was Kristin Doyle-Maslow’s manipulation. Zelda had no conscious need to see me; The Hyphen’s project required an inaugural documented patient and I was the sucker who’d responded to a guilt trip.

I tried anyway. “We met five years ago, Zelda. When you were seeing Dr. Sherman.”

Blank stare.

“He was your psychiatrist, Zelda.”

A single blink.

“I’m a child psychologist, Zelda. I spent some time with Ovid.”

Blink blink blink.

“I got to know Ovid while you saw Dr. Sherman. While you lived in the Beverly Hills Hotel.”

Blank as the wall behind her.

I continued, prattling like a serious obsessive. “Dr. Sherman and I arranged babysitting for Ovid so you could return to work. Actually, I did. From the HGK agency?”

Now a hapless smile, the kind you see with aphasia patients who know something’s wrong but aren’t sure what it is.

“Do you know where you are, Zelda?”

Brow-knitting consternation. I repeated the question, expecting very little.

She said, “Here.”

“Where’s here, Zelda?”

“This...”

“Do you know what this is?”

She squinted. Laced her hands together and dropped them into her lap.

Maybe the lack of acuity was a good thing, what the hell would I tell her? You’re a federally funded lab rat?

Where was the boy?

I said, “Yesterday, you were in a hospital, Zelda. You were moved here but just for a couple of days.”

No reaction.

“Do you know what day it is, Zelda?”

“Now.”

My next question was routine and idiotic. “How about a day of the week?”

I might’ve been speaking Albanian.

“Do you remember what got you to the hospital, Zelda?”

Her hands pulled apart and shot up, blocking her face. Twin fists made small tight arcs.

“Zelda, I’m sorry if these questions—”

“Disappeared,” she said, suddenly loud and harsh.

“Who disappeared, Zelda?”

“Mommy.”

“Your mother—”

“No no,” she said, punching air. “Nononononononono.”

All those syllables but any budding anger was gone — more like a weary mantra. She slumped, pressed her hands to her temples.

I said, “Mommy—”

“Gone.”

“When?”

Nothing.

“You were looking for your mommy.”

She snuffled.

“You didn’t find her.”

She regarded me as if I were the crazy one. “I find her, they don’t put me here.”

“Of course — so you were looking for Mommy when—”

Growling in frustration, she slammed back down, drew the blanket over her head.

“Zelda—”

The blanket heaved. I waited.

This time her sleep was punctuated by aggressive, raspy snoring.

For the next half hour I waited, passing time and suppressing my tension by conjuring pleasant imagery. Intruded upon far too often by bad thoughts.

Eleven years old.

When Zelda’s breathing slowed further and she showed no sign of waking, I used the key and let myself out.

Kevin Bracht looked up from his book. “Anything?”

I shook my head.

“So what now, Doc?”

I gave him my card. “I’ll be by tomorrow before she’s discharged. Let me know if there’s any sort of problem.”

He walked me to the door. “What’ll happen to her?”

“I’ll try to get her somewhere safe.”

“But only if she agrees. What a system.”

I knew what he meant. The rule for involuntary commitment was clear: If a patient displayed imminent danger to others or self, I’d be obligated to file. If not, total freedom, no exceptions. That started me wondering what Zelda had done to qualify in the first place. I asked Bracht if he had any idea.

“Nope, they just brought her in and said she’d been arrested.”

“I didn’t see any abrasions or signs of a struggle.”

“Me, neither. Except for that initial period when they restrained her, she’s been exactly what you just saw. Should I try to push more meds? Off the record.”

“No, just keep an eye on her.”

“You bet, Doc. I could also look out for a reason to recommit her.”

I shook my head. “If it’s real, you’ll know.”

“True.”

When I reached the door, he said, “I hope I wasn’t out of line. About another hold. I was just thinking of her safety. I mean, what’s someone like her going to do out there?”

“That’s how I took it, Kevin. I’m glad you’re here.”

“Thanks, Doc.” He laughed. “Wish I was.”

I stepped back into the maze of cubicles. Kristin Doyle-Maslow was at a nearby station, working an iPad. She didn’t seem to notice as I approached but when I was a foot away she startled and clicked off.

Not before I had a look at her screen.

Watching a movie. Something with shields and lances and lots of blood.

I kept going.

She said, “What’s the status?”

I said, “Quo.”

“Huh? Oh, ha ha. So when are you coming back?”

“When will she be discharged?”

Back to the iPad; she touched a screen. “Three p.m. tomorrow.”

“I’ll be here before then.”

“What if there’s an event?”

“An event?”

“A problem.”

Why not just say that? “Your nurse has my number. Do you have any post-discharge plans?”

“Isn’t that your job?”

I walked past her.

“That’s it?” she called out.

“What more could there be?” I said.

“If you know of other patients who’d fit well with our program, you should tell them.”

I sat in the Seville, phoned the U.’s medical center, and asked for Dr. Nehru. The operator said, “We have three. Which one?”

“Psychiatry.”

“Hold, please.” Gypsy guitar music came on. “That’s Dr. Mohan Nehru. Would you like the number?”

I got Psychiatry Department voicemail, returned to the main exchange, and asked a new operator to page Nehru.

“If you’re a patient, there’s a message line—”

“I’m a colleague. Dr. Alex Delaware. It’s about a mutual patient.”

“Hold, please... yes, you’re on our list... Alexander... oh, you’re crosstown but... okay, looks like you’ve still got privileges here, one moment.”

Two nuevo flamenco instrumentals later: “He’s listed as here today but he’s not answering his page.”

“What specific service is he on?”

“We don’t have that level of information.”

The drive to Westwood was on my way home. I turned onto campus at the main southern entrance and made a left at the medical office complex. The health center spans both sides of the street. Bustling, today, like the mini-city it was.

Ravenswood Psychiatric Hospital was one of the newest, prettiest buildings in the complex, a six-story art-piece in limestone and copper endowed by and named after an industrialist whose child died from complications of anorexia. I parked using my faculty permit, clipped on my Western Peds badge, took the elevator to the fifth floor, and pushed the red button on the locked door of Adult Inpatient Psychiatric Services.

The med center has nearly a thousand beds, eighty of which are allotted to Ravenswood. Of those, twenty are pediatric, ten are for Alzheimer’s patients who agree to be researched in return for hope, and thirty-five are devoted to the U.’s rehab program for adolescent eating disorders, a service that brings in huge money.

That leaves fifteen beds for general psychiatric care, divided into an eight-bed voluntary ward for patients not much different from the rehabbers next door, and seven beds for 5150 commitments.

No surprise that Zelda had arrived when the place was full. LACBAR didn’t amount to much but if it hadn’t existed, she’d probably have been sent crosstown to a county-run human zoo with its own issues.

So maybe things had worked out for the best.

If I could do my best to find her somewhere to live tomorrow.

Get her settled and more coherent and willing to tell me where her son was.

Five years ago, she’d been a troubled but devoted mother. Shortly after that she’d lost her career and gone who-knew-where. One positive: Lou Sherman had stuck with her, maybe even after she’d lost her insurance. Not transferring her until he knew he was seriously ill.

But he hadn’t called me...

No one had shown up at the locked door so I pressed again. Several moments passed before a young nurse studied me through Lexan panels and buzzed herself out.

“Can I help you?”

“I’m looking for Dr. Nehru.”

She scanned my badge. “Mike’s in the cafeteria, Doctor.”

“Thanks. Were you on last night?”

“I wasn’t. Why?”

“I just saw a patient who arrived here as a 5150 and got sent to a place over in mid-city. Dr. Nehru authorized it and I’m trying to get hold of the chart, see if he can offer any clinical advice.”

“There’s a hospital in mid-city?”

“Not exactly,” I said. “It’s a community mental health center with a limited inpatient facility.”

“Oh. Well, Mike’s eating lunch.”

The cafeteria was crowded with hordes of white-coated and scrub-suited people hoping for nutrition. Plenty of Indian males, at least two dozen.

Step one: Concentrate on doctors.

Step two: Focus on younger men, given Mohan “Mike” Nehru’s status as a resident.

That left five possibilities. I got myself a cup of coffee and began walking by each of them, trying not to be obtrusive as I read their badges.

M. M. Nehru, M.D., was my second target, a smooth-faced, clean-shaven man around thirty, sitting by himself, eating a huge burrito and sipping from a can of Coke as he played with his phone.

I settled across from him. He took a while to realize I was there. Just like Doyle-Maslow with her movie. Cyber-play does that, everyone on digital delay.

Finally, he looked up and I told him why I was there. He scanned my badge. “Sure, I remember her. The one we referred out. How’s she doing?”

“She’s mostly sleeping. Do you have time to chat?”

“Sure.” He pushed his burrito away.

“Don’t let me interrupt your meal.”

“I’m finished and it’s pretty much crap, anyway. So you’re with that administrator — Kirsten, whoever? The one with the big-time NIMH funds?”

“Not exactly.” I explained my original connection to Zelda Chase via Lou Sherman, how I’d ended up at LACBAR.

He said, “So she worked on you, too. I knew Dr. Sherman, had him in med school, good teacher. When I saw his name in the chart I said, ‘Too bad he’s not around anymore.’ He died, right?”

“Two years ago.”

“Yeah. I think I heard that.”

“Any way for me to see his notes?”

“We can go upstairs and get a copy but don’t expect too much. Basically, he transferred her with no treatment notes except for the meds regimen he had her on.”

“What’s that?”

“He started her on Haldol, upped the dosage a couple of times, then switched after a year to Ativan, so that’s what I went with. I gave her a serious dose before sending her off, figuring she’d probably habituated and would need it to stay calm during transport.”

He looked at me. “That work out okay?”

“No problems on the trip and she’s sleeping peacefully.”

“Okay, good, so what’s your plan?”

“Don’t have one,” I said. “She’ll be discharged tomorrow and so far she’s done nothing to justify another 5150.”

“So she gets kicked to the curb. Same old story.”

“Why was she committed in the first place?”

“Good question,” said Mike Nehru. “It’s not like she was waving a gun at anyone. What the cops said is she created a disturbance in someone’s backyard and when they came to get her she freaked out and the cops felt threatened, quote unquote — pretty wimpy, no? Like one of those spoiled-ass college students, everything’s a trigger. They said they wouldn’t press criminal charges if we cooled her off so I figured I was doing her a favor and we did have a bed, which isn’t always the case.”

He drank soda. “What’s the place like where she is now?”

I described LACBAR.

Mike Nehru said, “What a bullshit artist. She made it sound as if they were well established.”

“She’s self-serving but the room isn’t bad for what it is and there’s a full-time nurse assigned to her who knows what he’s doing.”

“So it worked out,” said Nehru. “But if she asks me again I’ll tell her where to shove it.”

“Nothing like an anatomy lesson.”

He grinned. Turned serious. “So after three p.m. tomorrow, she’s gone and unprotected. Wish I could say I’m surprised. I’m in my last year, thinking of getting an MBA or an MPH and working as a consultant, maybe doing some public policy work.”

I said, “Better the hammer than the nail?”

“Better something that actually has efficacy.” He tried another bite of burrito, grimaced and pushed it farther away. A couple of other residents passed by, bleary-eyed; Nehru’s eyes were getting there. “I didn’t become a physician to be a jailer but let’s face it, some people need protection from themselves. The night Ms. Chase came in was hectic, patients I’d already admitted were acting out, and then what’s-her-name comes to me and says she’s got a solution and shows me all these letters from NIMH. The facilities really are okay?”

“For a couple of days under proper supervision.”

“One patient in a skeleton facility. Weird,” said Mike Nehru. “So should we go get that chart?”

As he searched his office computer, I said, “When Dr. Sherman began seeing Zelda, he wasn’t clear about her diagnosis. Did his notes clarify that?”

“Nope, but given the meds I figured he was concentrating on anxiety rather than bipolar... okay, here it is, let me print.”

A single sheet slid out of his printer. Zelda’s name, no phone number, just an address long outdated, plus the fact that she had an eight-year-old child once evaluated by me. The final sentence a legalistic-sounding statement that he could no longer assume medical responsibility for the patient and hoped she’d follow through on his advice to enter treatment with someone at the U. Including resumption of her medication. Haldol replaced by Ativan.

Resumption meant she’d stopped, probably against his advice. His mention of the first drug made me wonder if he thought she might need it again.

Sometimes Haldol’s the drug of choice when extreme confusion looms.

No sign she’d ever followed through on his advice. The only reason she’d ended up at the U. was proximity to Bel Air.

Mike Nehru said, “That address, Sunset Boulevard, Beverly Hills. Those houses are huge and she sure doesn’t look like she’s got dough.”

I said, “The Beverly Hills Hotel. She was living in a bungalow there.”

“You’re kidding. So once upon a time she was rich. Amazing, I thought it was a misprint because she came across homeless.”

“She probably is now. How was she identified?”

“The cops I.D.’d her by her fingerprints and gave us her name. Once we had it, we looked through our records and found the report.”

“Her son’s mentioned. Did she say anything about him?”

“Nope, she just screamed at being restrained. Like they all do. Then I got the Ativan in her and she quieted down. But some of the others didn’t. It was some night.”