The Rome Prophecy

39

Louisa Verdetti arrives at work exhausted.

She hasn’t slept.

The first thing she does is head to Valducci’s office and tell him everything about her overnight adventure with the Carabinieri.

The administrator says little as she explains about the body and possible links to the patient on their ward. ‘I’m sorry. I should have called you and informed you of the police request for me to accompany them.’

‘You should. You exposed both yourself and the hospital.’ He swivels in his black office chair and looks out of the window as he talks. ‘Are they likely to interview you formally?’

She shrugs. ‘I don’t know. I suppose so.’

He turns to face her. ‘It’s not an offence to help the police, but I do want to be kept in the picture. Is that too much to ask?’

‘Of course not.’

‘Okay.’

She starts to raise herself from her seat.

‘Before you go, I want to compare notes on our increasingly famous patient.’

‘ Scusi? ’

‘Diagnostics. You keep telling me she’s DID and I keep thinking schizophrenia, so let’s try to settle the matter so that when your police friends start asking, we’re on the same page.’

What he’s saying makes sense, although she’d really rather not do it right now.

Valducci senses her discomfort. ‘Louisa, if your diagnosis won’t hold water when analysed by a friend and colleague, then what hope have you in the stormy sea of external critique?’

‘I’m sorry. It’s just that I had such a bad night and I have a migraine.’

‘Then a contextual review of the symptoms of both schizophrenia and dissociative identity disorder will clear the fog for you. What diagnostic tools have you used so far?’

She’s annoyed that she’s being asked. ‘DES, DDIS, SDQ-20. We’ve been through the whole tick list on amnesia, depersonalisation and derealisation before making a final diagnosis.’

‘Good, then you’re well prepared. I want you to list unique symptoms that are not indicative of schizophrenia. Let’s start. Symptom one…’

She grinds her brain into first gear. ‘Identity confusion. Suzanna consistently has identity problems. These are obviously manifested in the form of her alters.’

‘Obviously,’ he answers sarcastically. ‘Schizophrenics also have a lack of a sense of identity and can’t see their role in society. So no uniqueness there. Point unproven. Next.’

‘Schneiderian symptoms and delusions. Again these are evidenced in the presentation of multiple personalities and even include bodily changes from alter to alter.’

‘Hmm, I’m not so sure they do. Any physical changes could be psychosomatically caused. Besides, schizophrenics are notoriously delusional – our wards are full of people who think they are being chased by aliens or are on the run from the government or the mafia.’

‘I suspect some of them might well be.’

Valducci almost laughs. ‘Point unproven. Next.’

‘Comorbid diagnoses.’

He stares at her. ‘You know your patient to be clinically depressed?’

‘No. I’m clutching at straws, but I strongly suspect it. It’s likely she-’

‘Not good enough. Besides, even if full depressive or manic syndrome coexisted with your dissociative syndrome, it still wouldn’t be unique. Schizophrenics have more than their share of mood episodes. Point unproven. Next.’

Louisa feels totally stressed. ‘Okay. We can do this all day. I throw up a DID symptom and you knock it down by matching it to schizophrenia, but that doesn’t resolve anything. Suzanna doesn’t have many of the things schizophrenics have.’

‘Such as?’

‘Catatonic behaviour.’

‘Good.’

‘Other psychotic symptoms.’

‘Such as?’

‘Well – her thinking isn’t characterised by incoherence.’

‘Good.’

Louisa dries up.

She’s out of ideas and her head is pounding. She rubs the back of her neck and hopes to massage a brilliant thought or remark out of her dulled brain.

‘More, come on!’

The best she can manage is a confession she really hoped not to make. ‘I recorded my last session with her.’

‘What?’

‘It was mainly for diagnostic purposes, though I hoped it would present a platform to therapy. Let me send it round to you. Please watch it and tell me what you think.’

He looks like a hog that’s found a truffle. ‘I’d be delighted to!’

She stands and makes for the door. ‘I’ll be surprised if – once you’ve watched it – you don’t believe she’s a genuine DID case.’

He smiles wryly. ‘I won’t be.’

Louisa reaches the door and turns. ‘Thanks for your understanding about last night. I’m grateful. And I really will make sure you’re kept in the picture from now on.’

Valducci doesn’t reply.

He knows that if he gives her enough rope, she’ll hang herself.

And with a little luck, the Carabinieri might just help her do it.