Critical Conditions

Seventeen

I rearranged my afternoon appointments so I could get to Denver before rush hour clogged the Boulder Turnpike and I-25. Getting Merritt’s admission routine accomplished was going to require some significant time. First I had to meet with her, and then I hoped to find time to interview at least one of her parents. In addition, I had to compose an initial treatment plan and confer with the unit staff. Of course, I also had to complete the rest of the admission paperwork and deal with MedExcel’s institutional reluctance to spend money on psychiatric admissions.

I figured three hours, easy.

The staff at Children’s had settled Merritt into the unit without any fuss. In my initial telephone orders the night before, I had asked them not to pressure her about speaking, and they hadn’t. She had been admitted on the lowest level of privileges-Level One-which permitted her only limited activities, like, say, breathing, without asking the staff for permission. She was, of course, confined to the unit, and was on suicide precautions-all routine for a new transfer after a serious suicide attempt.

On the way to Merritt’s room, the nurse assigned to her prepared me for what I’d find. “Her roommate’s name is Christina. She’s being stabilized on lithium right now and that hole you’re about to see in her cheek isn’t the only one she has. She’s been pierced in a few other places, too, if you know what I mean.”

I didn’t, but I could guess. The details weren’t important. Merritt’s assigned roommate turned out to be a skinny Chicana with big brown eyes full of heat and the promised large piece of metal coming out of her cheek. She was standing just outside the door listening to a CD player on headphones, but I could hear the Latin rhythm seeping out all the way from the door. I waved hello. She waved back.

The nurse paused before she left and pointed across the unit toward an empty consultation room that I could use for psychotherapy sessions. I asked Merritt to join me. She smiled a good-bye to Christina, who smiled back, exposing a metal-embedded tongue and a mouthful of braces. The kid would be hell going through security at the airport.

Merritt sat. I talked. I asked her if she was doing all right. She shrugged. I asked her if she understood the rules of the unit. She nodded yes. I asked her if she needed anything. She shook her head. I asked her if she wanted to be able to see her sister.

She did. Finally I saw some animation.

“I figured that. It’s a privilege, like any other privilege that’s earned by patients on the unit. The way it works is that you won’t be allowed off the unit for anything, even to visit your sister, until you earn the trust of the staff. They will teach you how to accomplish that, how to earn privileges. The intent isn’t to keep you from your sister; it’s to keep you safe. I’m sorry. That’s just the way it works.”

She looked away from me then, and didn’t look at me again. Permission to see Chaney was apparently all she wanted from me. I’d already decided not to do anything more than invite her to talk. That having failed, I had nothing left to say; it was apparent she hadn’t changed her mind about staying mute. I led her back to her room and watched her lower herself to her bed. She curled up facing the wall.

One of the nurses on the cardiology unit helped me track down Brenda Strait and John Trent in the almost deserted hospital cafeteria. They were sitting alone in the far corner of the room, sharing a piece of apple pie, holding hands across the table.

I thought they looked old.

Before I disturbed them, I poked my head into one of the private dining rooms adjacent to the cafeteria, hoping to find a place we could meet privately. The Doctors Dining Room was empty.

Brenda saw me approaching the table and released her husband’s hand. She whispered something and John, too, looked my way.

He wasn’t what I’d expected. Until that moment, I hadn’t realized that I had expectations about his appearance, but I did. In my mind’s eye, John Trent was robust and hefty with a generous smile and abundant hair the color of autumn grasses. In the hospital cafeteria that day, though, he was thin and gaunt and somber and what hair was left on his head was crew-cut and almost black.

He stood.

I said, “No, no, please, sit down. I’m Alan Gregory; it’s nice to finally meet you.”

“John Trent.”

I looked toward Brenda and said, “Hello, Brenda. Well, we pulled it off, the transfer. Thanks for all your help last night.”

She offered a weak smile in return.

“I just checked the Doctors Dining Room over there, and it’s empty. Why don’t we move in there and get some privacy and I’ll catch you both up with what’s going on.”

Trent said, “Fine. Brenda, you want any more of this pie?”

She shook her head.

We all settled at one end of a table in the private room. The room smelled of burnt toast. In the distance, some food-service workers were complaining about not getting their breaks.

I waited to see if either John or Brenda was eager to start. They weren’t. I said, “How’s your little one doing?”

Trent answered. “Chaney’s…all right. She’s resting now. She had a decent enough day today, wouldn’t you say, Bren?”

“Decent. Yes. A decent day. The pulmonary treatments went well. That’s something.”

“I’m glad to hear that. I’m looking forward to meeting her. Maybe tomorrow? I just came from the psychiatric unit where I saw Merritt. You saw her earlier, too?” The nurses on the unit had informed me that Merritt’s parents had stopped by.

Brenda said, “Yes. She looks fine to me. Totally recovered, I would say. Trent?”

“From the overdose, sure. She looks like herself. Still silent, though. She won’t talk to us at all, not a word. You either?”

“Nothing to me or the staff. She may be talking to the other kids, but if she is, we haven’t heard about it yet,” I said.

John’s eyes were warm as they held mine. “I think she realizes what’s at stake now, though. Brenda and I told her what we could, what we’ve learned from the lawyers and the police. She realizes how serious things are, how bad it looks with the clothes and the blood and everything.”

I assumed “everything” was a palatable euphemism for the gun.

Brenda stared at me, away, then she leaned forward, halfway across the table before words spilled from her mouth like ice from a bucket. “How could she do it? Kill that man? How could they accuse her of that? With a gun? How? She’s a child, she doesn’t know about guns, and, and…”

John took her hand across the table. “The situation is bad, Dr. Gregory. We talked to that lawyer, Mr. Maitlin, an hour ago. The evidence doesn’t look good for Merritt. When you found us, we were talking, trying to come up with some way to cope with the possibility that Merritt may have actually gone and…killed that man.”

“And what were you coming up with? Anything?”

John seemed prepared for the question. He didn’t hesitate. “If she did it-and I’m not convinced she did, despite how it looks-it was stupid, stupid, stupid. An awful tragedy for his family. And now another tragedy for ours. But for Merritt, right now, I-we, Brenda and I-we have to view whatever happened, if Merritt was involved, as an act of…for lack of a better word…honor. If she did it, it was like sticking up for her sister in a schoolyard fight-don’t get me wrong, this was much more serious. Twisted somehow, but honorable.”

I thought I could guess where John Trent was going, but I wanted him to finish, I wanted to hear the rationalization in his own words. “Go on.”

“For the sake of argument, let’s assume she was involved somehow. All I can think is that, that Merritt must have viewed him, Dr. Robilio, as a bully, a bully who was hurting Chaney, picking on Chaney. Merritt went over there, to his house, to stick up for her sister, to stand up to the bully, and something went terribly wrong. The shooting…was an aberration, an…accident, I’m absolutely sure of that. Merritt’s not an aggressive kid. It’s her biggest liability on the basketball court. She just isn’t aggressive enough, won’t play to her own advantage. So I don’t know what happened at his house with the gun, maybe no one does. I don’t think she could have shot him; I just can’t picture her…you know. But what drove her there in the first place was honorable, I’m sure of that. Merritt was trying to help her sister stay alive and she saw Dr. Robilio as the enemy.”

Brenda had started to cry and to make those little popping noises with her lips that I’d heard for the first time in Boulder.

Therapeutically, I had a half-dozen choices about which trail to follow. I didn’t take any of them.

Instead, I asked, “How did she know about Dr. Robilio’s relationship to Chaney’s medical care? It’s not the sort of information a typical teenager would understand or have access to.”

They looked at each other.

Brenda said, “We’ve wondered about that, too. And we’re not sure. We knew, of course, about Dr. Robilio, that he founded MedExcel. We’ve researched everything we could about MedExcel to try and get some leverage to get them to grant an exception for Chaney’s protocol and the transplant. We talked about it at home, Trent and I, openly. Our frustration, whatever. Merritt must have overheard us and remembered his name. That’s the best explanation we’ve been able to come up with.”

“You talked about it?”

Brenda answered, “You know that Dr. Robilio was a local doctor, that MedExcel was his company, that he could order them to approve the protocol Chaney needs if he wanted to. We were angry, bitter-especially after we appealed to their medical board. Half a million dollars is nothing to MedExcel. The head of the medical board,” she closed her eyes and shook her head, “his response to our appeal was so cold. He ignored Chaney, he focused on the danger of the precedent. They can’t go start approving risky experimental procedures, that’s what he said. We’re even more angry and bitter than we were at the beginning. What’s risky is doing nothing. If we do nothing, barring a miracle, Chaney is going to die, Dr. Gregory. The fund-raising that’s been going on is stalled. Merritt knew all that. Trent and I have been over this stuff a hundred times together. Merritt must have heard us once or twice.”

My eyes were on John as Brenda spoke about knowing about Dr. Robilio. His face betrayed nothing but compassion for his wife. I wanted to ask him about the custody situation he was evaluating that just happened to involve Mrs. Robilio’s sister and brother-in-law. I wanted to ask if he had received any feelers from the family about cutting a deal that would result in MedExcel granting approval for Chaney’s medical needs. I wanted to know if maybe Merritt had overheard any of that. But I couldn’t press him. I had no reason to know about any of those connections myself.

I asked about money instead. “Merritt knows how far short the family is of being able to pay for the protocol and transplant through fundraising?”

Brenda scoffed. “We don’t have a prayer of self-funding this, barring some benefactor stepping forward. My divorce and the move to Colorado killed us financially. Our total net worth isn’t even a hundred grand and most of that’s in the house. The Chaney Fund that Channel 7 organized has raised, what, honey, a little over thirty thousand? Which is great, we’re grateful, but most of that will go to cover expenses here in Denver. We won’t come up with the money we need to pay for Seattle in time.”

“There’s no family money?”

“No. They’ve offered everything they have. But we both come from blue-collar families. There’s no family wealth to tap, no rich aunts, if that’s what you’re wondering.”

“And Merritt knows all this?”

John replied, “She asks us things. We tell her. She’s mature, responsible. We try to treat her that way; she’s earned it. Yes, although she may not know the details, she knows how gray things look for her sister.”

“Black,” corrected Brenda.

“Black,” said John.

“Does this make sense, though? Think about what you’re saying. Merritt heard the two of you talking about how desperate things are. And she hears you mention this local man, Dr. Robilio, who has the power to help her sister. And she felt she could influence his decision by going to his house, and what, threatening him with his own gun? Does that sound like something Merritt would do?”

Immediately, John said, “No.”

Brenda opened her mouth and then closed it.

John continued. “No, it doesn’t sound like Merritt at all. That part I don’t get. I told her today when we visited that I didn’t get it, why she went to his house on her own, what she was thinking. I said, ‘Merritt, how did you think this was going to help?’”

I waited for John to tell me Merritt hadn’t answered.

He didn’t.

“How does it not sound like her, John?”

“She’s…not a leader. She’s not…she’s not a kid who will even confront a teacher who she thinks has graded a paper wrong. Don’t misunderstand me, she’s an independent thinker, she does her own thing, but she’s not a kid who fights the system.”

Brenda said, “But this time it was about her sister, Trent. Not about some English paper.”

He smiled ruefully. “I know, Bren. That must be it. I mean, if she was there, that must be it. If she did something, she did it for Chaney. Whatever it was that happened is horrible. But if Merritt went to Dr. Robilio’s house, she did it thinking she could help Chaney.”

“How did she respond when you told her you didn’t understand her going to his house? What did she do?”

Trent answered. “She looked down. Shook her head a little bit. She didn’t say a word.”

I asked, “What about the silence? Has she done this before? Just totally stopped talking?”

Brenda said, “Like this, no.”

“But something similar?”

“When she’s in trouble, she clams up. I think it’s my fault. I’m the cross-examining type. She always tells me that I use what she says against her. So sometimes, when I’m really going at it with her, she just won’t talk to me. Says it’s the only smart thing to do.”

“John?”

“After a while, maybe a few minutes, maybe a couple of hours, she’ll talk to me. It never lasts long. She and her mother do all right, eventually. Brenda cools off. They iron it out.” He paused before asking, “Any chance this is hysterical?” His tone said he didn’t believe it, but felt he had to ask.

I said, “Not in my opinion, no.”

“Organic?”

“The neurologists have ruled out an organic etiology.”

Brenda interjected, “There is something else. Trent, you remember right after we got to town and I was doing the plastic recycling story that was getting so much play? Remember, we had that discussion at dinner where I was incredulous that people kept answering my questions when they didn’t have to, really digging themselves in deeper and deeper?”

“I remember.”

“Was Merritt there?”

“Yes, she was. I’d made those ribs she likes so much. She was there at dinner that night.”

“I wonder, maybe, if she’s just been taking my advice. I remember saying that the best thing to do when someone sticks a microphone in your face is smile politely and walk away. Well, she can’t walk away, and there’s not much to smile about, but she’s certainly not digging herself in any deeper by keeping her mouth shut.”

“Do either of you recall how she reacted to your comment, Brenda?”

“No,” she said.

“It was just another dinner conversation,” John said.

“Well, it’s a provocative explanation. Maybe I’ll explore it with her. Did you two get a chance to meet the unit social worker? She’ll schedule some time to get a detailed history and maybe meet as a family.”

John said, “She introduced herself. We’re going to try and get together tomorrow.” He paused to see if I wanted to go somewhere else. “Can we talk treatment plan for a minute, Dr. Gregory?”

“Sure. That’s easy; I don’t have much of one. Right now I want to keep her safe and reduce pressure on her, let her settle in. We also need to be prepared for more bad news, from a legal point of view. The treatment planning team will meet tomorrow and we’ll put something more long-term together.”

I was aware of the sounds of traffic increasing in the cafeteria as the dinner hour approached.

I continued. “To change the subject for a second-we’re facing two bureaucratic problems right now. If-when-Merritt is arrested, the court is going to have to approve her receiving continued care here, as opposed to at the state hospital at Fort Logan. They don’t have to allow her to stay here, at Children’s. Second, in the meantime, MedExcel is going to need to approve Merritt being in a psychiatric hospital. You understand that?”

John Trent did, of course. “Oh, I think they’ll approve the admission, Dr. Gregory. Her suicide attempt was potentially lethal, so the inpatient stay is indicated. They won’t argue that. And I think MedExcel will eat a thousand dollars a day in inpatient costs just so they don’t have to take the public relations flogging they would get for turning our family down a second time. The policy allows twenty-one days of approved inpatient care. They’ll give us that and they’ll hope the problem goes away before then.”

“I hope you’re right, John.”

“It’s a cynical point of view. That alone makes me think I’m right.”

Brenda was heading to Channel 7’s studios to tape a piece about lax inspections at highway scales. John was going back upstairs to be with Chaney. We said good-bye, and as I waited for the elevator I wondered how I would cope with the latest assault that the Trent/Strait household had suffered and decided that finding honor in my teenage daughter’s arrest for murder would be relatively adaptive.

I had tossed it around a lot already and could fathom no motive for what Merritt was accused of doing other than to protect Chaney’s welfare.

There was honor there. At least in the motive.

So what was troubling me? Something didn’t feel right about the meeting with Brenda and John.

The elevator arrived. I entered with a crush of employees and a couple of distraught-looking parents who were holding hands with a young boy of around seven.

The mother had a twangy voice that caused her words to bounce around the elevator. She was impossible to ignore. She said, “We’re so proud of you, honey. You acted like such a big boy down there.”

Her words clanged through my reverie. And suddenly I knew what had been troubling me. Brenda and John weren’t just rationalizing Merritt’s actions as being honorable.

They were proud of her. If Merritt had done this, her parents were proud of her. Maybe not of what she had done. But at least they were proud of why she had done it.

That’s what was so troubling.