The Rome Prophecy

PART TWO
26

Monday morning isn’t Louisa Verdetti’s favourite time of the week. Especially, if she’s already worked Saturday and Sunday.

To make matters worse, the first part of her least favourite day is being spent with the man who tops her list of least favourite people.

Hospital administrator Sylvio Valducci is mid-fifties. He has white hair and is one of those bosses who one minute manages from a distance of six miles and the next from six inches. He’s the kind that conveniently ignores you when you’re in the middle of a crisis but is all over you about the cost of paper clips when it’s annual budget time. He and Louisa only have one thing in common – a mutual loathing of each other.

Valducci doesn’t knock on her office door or even manage a good morning as he bursts in. ‘I’m told you have something of a cause celebre.’ He tosses a manila file on her desk and enjoys watching it slide. ‘I’d very much like to hear about it. In person. From you. I prefer it that way – it’s much better than getting it second-hand from the animals who gather around the water cooler.’

Louisa takes off her glasses. She slowly spins her desk chair and vows not to lose her temper. ‘I’m not sure I would call it a cause celebre, but the patient is certainly interesting.’ She opens the file he dropped and sees inside a copy of medical notes she’s made. ‘As it says in here: our admission is an Italian woman, identity so far unknown, mid to late twenties, well nourished.’

‘This I know.’ He pats his mouth to stifle a fake yawn and settles into a seat opposite her.

‘And as you are also apparently aware, she’s exhibiting as DID. Dissociative identity-’

‘I know what DID is,’ he snaps. ‘Or to be more specific, what it isn’t.’ He shows his teeth, in what he mistakenly believes is an enigmatic smile. ‘Better doctors than you have made fools of themselves with this little acronym.’ He melodramatically puts his hand to his forehead. ‘And my, isn’t it strange that patients with DID are so often involved in criminal activity? Crimes they conveniently blame on one of their many other personalities. Stranger still if you ask me that none of those other personalities turn up at the police station and confess, or rat on the offending alter, as you so ridiculously call them.’

Louisa tries to ignore his goading. ‘Our patient is presenting classic symptoms. She’s writing and drawing in different personalities. Speaking in multiple voices and tones, as though she were different people of different ages. Her mood swings are extreme – from timid to violent.’

He waves a hand dismissively. ‘Fakery! This is all rubbish and you know it. Have you run diagnostic tests for borderline personality disorder?’

‘Of course we’ve run tests – and we’re running more. You don’t need to tell me how to do my job. We’ve taken more blood and urine samples than an Olympic doping committee, and before you ask, no, there is no chance of amphetamine-induced psychoses, if that’s what you’re fishing for.’

He’s amused by her anger.

Pleased that he has roused it so fully.

‘There’s nothing wrong with fishing, Louisa. When you have but a small crack in the ice of the mind, fishing is the best thing you can do.’

She is bursting to tell him not to be so stupid and so pompous.

He stands and folds his arms autocratically. ‘And while we’re angling away, we should make sure we also run endocrine function tests to rule out hyperadrenalism, pernicious anaemia and thyroid disorders.’ He takes her silence as a sign of his intellectual victory. ‘Given the delusionary symptoms, don’t dismiss the possibility of schizophrenia. It’s tricky to diagnose-’

Louisa’s out of her chair before he can finish. ‘ Schizophrenia? She’s no more schizophrenic than you or I. With all respect, can I remind you that I am a qualified neuropsychiatrist? At least credit me with some expert judgement.’

Snapping point. He just loves it when he gets people here. ‘Not in this country.’ He wags a finger at her, ‘Your qualification is an American one, and as you know, we don’t follow the outdated bible of the Diagnostic and Statistical Manual of Mental Disorders quite as slavishly as your American mentors do.’

Louisa shakes her head at him. Boss or no boss, he’s a sentence away from getting a slapped face. She worked damned hard to get qualified, and even in Rome, ten years at Johns Hopkins should stand for something.

The administrator picks his file up off her desk. ‘Blood tests, urine tests, tox tests: I want more doing – and all of them completed – before you even mention DID again. Do I make myself clear?’

If looks could kill, he’d be no more than a plasma stain up Louisa’s office wall. ‘Perfectly.’

‘These beds are expensive. If she’s fit, I want her out on the street and off my budget as quick as possible. Let the police work out what to do with her.’

Before Louisa can explode, her door bangs shut and he’s gone.