The madness, p.8
The Madness, page 8
Wanker. I don’t deign his comment with a response.
Instead, I say, “I’d like to know precisely what you’ve done with Renée since I’ve been gone. Why she’s been so agitated.”
It hasn’t escaped me that Renée was in no way violent with me during our time together, and only became so after Seward presumably threw things off between us.
“You agitated her, Murray. And I’d sure as hell like to know why you’re here.”
My nostrils flare. “Ron emailed me. He was concerned that Renée was doing badly and asked me to come and check in with her.”
“The registrar?”
“Yes, the registrar.”
“Mmm. Maybe he didn’t realize I’d signed off as primary. I’ll have to send him a strongly worded reminder.”
“I think he emailed me because I made good progress with Renée. She was lucid. We built trust.”
“Yes, but you left,” he quips.
“Clearly you’ve done an excellent job in the meantime,” I snap. “I’m not the one prescribing ketamine, John.”
His eyes flash and I know I’ve gotten to him. “It’s cut-and-dry trauma-induced psychosis. She needs medicating. End of story.”
“She’s my patient.”
“Actually, no, she’s not. The board signed off with me as primary since you were—” an exquisitely timed pause “—unavailable. They clearly feel I’ll do a better job of it. So stay out of my way.”
My blood is boiling. “This is just a game to you, isn’t it? This whole profession and what we do, it’s all just one big sandbox in your playground.”
“Now, now,” he says. “Calm down.”
“These patients are people. Living, breathing human beings with feelings, not toys, and this profession is a sacred charge, not a joke.”
Seward cocks his head, looking down at me with amusement. “Jesus, Murray. You’re so earnest.”
My eyes narrow involuntarily. “Excuse me?”
“You’re wound tighter than a guitar string.”
“I’m a professional.”
He laughs and claps me on the shoulder before walking into the hall, forcing me to trail behind like a puppy. “Lighten up, Murray. Or you’ll have a heart attack before you’re forty.”
“You can’t just lock her in a room and sedate her into oblivion.”
Turning back, he says coldly, “You no longer have unsupervised access to my patient.”
He saunters down the hall and I have to try very, very hard not to throw my shoe at the back of his head.
I hand over my visiting-doctor’s badge at reception and walk as fast as I can without running until I’m back in my car. Once there I drown my hands in sanitizer, then rip the gauze from my neck and check the wound in the rearview mirror. Teeth marks on my skin, bloody but not too deep, overlap the old scars that sit there, a permanent reminder, from collarbone to just below my earlobe. I apply sanitizing alcohol to them as well, wincing at the sting, then rip off my heels and use the last of the sanitizer on my foot and offending shoe.
What a tosser.
The niggle in my mind returns, and with it the smell of a Welsh morning.
Lucy had the same rash. I’m sure of it. And something else...something less definite. Lucy had the same vague, dazed look as Renée did in that hospital room. Both women had a temporary nystagmus, and Lucy too had murmured, “Master.”
What are the chances of two women, hundreds of miles apart, demonstrating very similar, if not the same, symptoms? Perhaps they suffer with a common illness I’ve not yet seen. Perhaps they have the same mental health condition. Could they both have taken the same drug in the last week? Have they crossed paths before?
Renée hasn’t had a seizure, as far as I remember. I make a mental note to double-check. Whatever the connection, it seems tenuous.
I know until I get to the bottom of who Renée is and what happened to her, I can’t know for sure whether there is something connecting her to Lucy.
Still, I have to pull this thread and see where it leads.
Session Recording [Date Redacted]
Dr. John Seward (JS), Nurse Ann Roberts (AR), and Patient Renée Doe (RD)
Reference Number [Redacted]
Dr. Seward: This is Dr. John Seward recording on the twenty-fifth of September, 2015. Session number three. Good morning, Renée. How are you feeling today? How is that rash of yours doing?
[Pause]
[Muffled sound]
Dr. Seward: Please refrain from spitting at me. We talked about this last time.
Renée: [Laughs] Where is the doctor lady?
Dr. Seward: As I’ve told you, she’s no longer treating you. I am.
[Muffled noise]
Dr. Seward: Please stop that. If you need to blow your nose, you can have a tissue.
[Noise repeated over and over]
Dr. Seward: Why are you blowing snot all over your face?
Renée: To smell the lifeblood better!
[Noise repeated]
[Silence]
Renée: Orange juice! I want orange juice!
Dr. Seward: Let’s talk first.
Renée: [Mumbling] She said I could have orange juice.
Dr. Seward: Last time we spoke, you were very insistent that I go and look at the moon.
Renée: The moon...the moon...
Dr. Seward: I went to look at the moon. Can you tell me why the moon is important?
Renée: Moon...moon...moon...moon...
Dr. Seward: Can you tell me more about the moon?
Renée: [Mumbling] Need medicine to make me better.
Dr. Seward: We talked about this before. I can’t give you medication without your medical file. And without your surname, I can’t get your medical file.
Renée: I’m...Renée. I need medicine.
Dr. Seward: We’re going around in circles now.
[Incoherent muttering]
Renée: Fields, fields, fields, fields.
Dr. Seward: [Muttering] A new word. How delightful for me. [Sigh] [Rustling of paper]
Renée: Fly...fly...fly...
Dr. Seward: You can’t fly. We also spoke about this. Which is why you can’t have a window.
Renée: WINDOW!
Dr. Seward: [Muttering] Fly, window, roof, blood, moon, and now fields. We’re making progress, aren’t we?
Renée: [Panting]
Dr. Seward: Now, we went over each word already. [Rustling] Fly, window, roof, moon, blood. We went over each. Fly—you can’t fly. You’re a human.
Window—you can’t have a window because you’re light sensitive and started screaming when the sun came up. Moon—yes, the moon is lovely. But what does it mean to you? Blood—you can’t hurt people and it’s not good to hurt yourself either. [Pause] Do you remember, Renée?
Renée: He’s going to rip you to pieces and I’ll laugh.
[Spitting sound]
Dr. Seward: [Sigh] Spitting at me isn’t going to help you.
[Moaning and rustling in the background]
Dr. Seward: Please remain calm. Everything’s okay.
[Moaning grows louder]
Dr. Seward: Look, if you want to be taken seriously, you’re going to have to get ahold of yourself.
[Noises of distress]
Renée: [Screams]
Dr. Seward: If you don’t stop screaming and scratching yourself, I’m going to call the nurse.
Renée: [Screaming. Movement]
Dr. Seward: [Grunt] Renée, let go—[Bustling]
Renée: No...no! No, please—no! [Muffled screaming]
Dr. Seward: Renée—[Grunt]
[Steps, door opening, distant voices, screaming]
Dr. Seward: [Aside] Two mils lorazepam in water for IM. Get the AED and suction equipment in case.
[Grunting]
Dr. Seward: Renée, unless you calm down, I will have to inject you, do you understand? Renée. Do you want to take the sedative orally?
[Screaming. Bustling]
Dr. Seward: Keep her still.
Nurse AR: I’ve got her.
[Screaming]
Dr. Seward: There. Yes, okay. Good.
[Screaming continues for two minutes before receding into incoherent mumbling]
* * *
Post-Incident Report: Dr. John Seward
For the attention of the Health & Social Care Governance Support Team
Patient Renée Doe was compliant and calm when recording began. [what triggered her violence?]. I deemed that nonconsensual Rapid Tranquilization was necessary under Section 62 of the Mental Health Act following a violent outburst where Renée began clawing at her face and eyes, then attacked me, injuring my left cheek with her nails. No information was available to guide the choice of medication, including the age of the patient, therefore 2 mg of intramuscular lorazepam was administered on the assumption that Renée Doe is of greater than eighteen years of age. No contraindications as far as we can tell as the patient has been in sectioned care for a week, and has no evidence of cardiac issues following an earlier echocardiogram. However, the patient arrived severely anemic and is being treated with ferrous fumarate. The patient is not pregnant. Rapid Tranquilization administered to the vastus lateralis muscle was only partially effective and was readministered after thirty minutes for full sedation totaling 4 mg. Intramuscular olanzapine and haloperidol combined with intramuscular promethazine has been added to her authorized medication in case of noneffective administration of further IM lorazepam. Order of medication administration has been filed in her chart. Filing for MHA has been completed online and assessment will begin within the week. Patient is currently in isolation, monitored by Nurse Stevens, with obs taken at fifteen-minute intervals. Upon waking, she will be given the opportunity to offer her own written account of the incident. See attached Incident Form.
Signed
Dr. John Seward, MBBS, MRCPsych, MRCEM
10
By the time I’m done reading the transcripts of Seward’s sessions with Renée, kindly provided to me by Ron, the registrar, her list of words have become a sort of anthem in my mind. Fly, window, roof, moon, blood, fields. I would have done things very differently; RT would have been a last resort. She and I built trust in our two sessions. Trust that Seward completely destroyed.
You left her, a voice reminds me.
And it’s right. I did leave her. One session over which I gained her trust, made her an unspoken promise, and then left her in the cold. I was so focused on Lucy, I essentially handed her over to someone else.
A niggling in my throat warns me of an attack of anxiety on the way, like the first lapping of water on a beach before it withdraws into a tidal wave I can’t stop. Unlike my normal method of stilling my mind, scribbling in my journal isn’t helping.
I push away from my computer and pace back and forth, noting the sound of water from outside.
It’s raining.
Without thinking, I do what I haven’t done in years: I pull open the window leading to the rooftop terrace and climb out, fully dressed, gasping as the rain hits my face, icy pinpricks of wakefulness.
There’s something cleansing about a cold rain. Like a bleached shower. Like thousands of tiny kisses. Almost as good as a hug from a friend. I lie down and let the rain soak me, distantly feeling my body’s transition from rigid resistance to a loose and calm acceptance. Release. Surrender.
I close my eyes and let my mind wander.
Fly.
Window.
Roof.
Blood.
Moon.
Fields.
Fly, window, roof, blood, moon, fields.
Her words become a mantra as my mind searches for the connections, moving them around on the whiteboard of my brain, trying different orders and combinations. I picture myself in Renée’s shoes, alone, confused, trapped. How would she feel? What would her sensations be?
And then I am Renée. My mind is broken; I’m desperately trying to convey information to someone unable or unwilling to see.
“Okay, Renée,” I whisper, raindrops hitting my tongue, cold and sweet.
I consider each word in turn, mulling them over. By the time I’m pondering the word moon, I’m beginning to lose hope of seeing anything relevant. It all feels like such a stretch, as if I’m forcing a round peg into a square hole and calling it a good fit.
But fields... My mind has been catching on that word over and over. In all of the recordings, until the last, she had never said this word. It’s new.
The spark of an idea flashes across my closed eyelids. I get up and climb back through my window, dripping all over the floor. I strip off my clinging clothes in the bathroom, put on my bathrobe, and head for my computer, pulling up Google Maps.
I find the location they picked her up from and scan the area, looking for football stadiums, fields, parks, or greens—anything to give me an idea of where she might come from. After twenty minutes of careful searching, I admit defeat.
I go back to the email Ron sent me and pull open the transcript for session three again, reading, reading, trying to find any pattern, any clue at all. It could be the tiniest thing; it could be—
And then I see it. Every word spoken had been a response to a question. She responded “moon” when asked about when she was found. After checking the date, I realize it was a full moon. She responded “fly” when asked why she wasn’t eating. She didn’t want to fly, she wanted to eat flies. “Roof” when she was asked about her new room, and “window” when asked about her room on a different occasion. Renée is in a kind of fugue state, not wholly present, but she is answering questions.
I can see the connection with most of the words. Including the most vital:
Seward needed her name...and Renée had told him.
Fields.
Renée Fields.
I snatch up my phone and dial the number for my favorite contact at the Met.
“George Baxter.” As brisk as ever.
“George, it’s Mina Murray.”
“Hi, Mina. What can I do you for?”
“I have a Jane Doe over at Brookfields. I think her name is Renée Fields. Late teens or early twenties, blond hair. Do you have any missing persons reports matching that description?”
“Give me a sec. Renée... Fields... Docklands area?”
My shoulders sag with relief. “Yes.”
* * *
I forgot what night tastes like, that salty, moon-licked rot of London after dark. As I lace on my running shoes, banishing the impulses shrieking that I’m breaking the pattern, that the back hand of fate is chomping at my heels, I chew on a diazepam. Maybe the lazy benzo tide will smother the compulsions, sweep me away from the broken glass of my thoughts and grind them into soft, fine sand.
Before we hung up, George gave me Renée’s address when I told him I needed to follow up on some questions for her medical treatment. A stretch, technically and ethically, but one I was willing to make.
It’s an easy ten-minute jog from Kensington to Notting Hill Gate, where I hop on the Central line to Bank. I watch the moonrise as my trainers pound the pavement, feeling my skin prickle as a low fog rolls in from the distant river.
Another short jog to the Princes Street stop, where I take the 141 Palmers Green bus five stops to Bevenden Street, Hoxton. I discreetly allow my maps app to lead me verbally, via my headphones, through a half-mile walk to Caliban Tower, where Renée’s family lives. In the pocket of my hoodie, I grip my keys between firm fingers just in case.
The fog has risen higher, turning the shuttered, graffiti-riddled shops into mini Cewri. I can’t read many of the neon spray tags, but one looks like Demon Lord, and another like Farce Princess.
The tang of kebab grease from the takeaway fifty paces away and the sour stench rising from endless clumps of rubbish bags awaiting the morning collection commingle into a unique aroma of carrion sweetness. I breathe through my mouth, avoiding the man sitting on the pavement devouring a doner, oily onions dripping into his beard. By his foot, a used condom sits in the gutter.
“All right, love?” calls a skinny man as he passes. He makes my skin crawl and I hurry past, but he turns and follows, a swagger in his step. I grip my keys harder.
“Great tits,” he says so low I almost don’t hear it.
I wish I had a Taser or pepper spray, but my keys will have to do.
“Oi, you, chat to me,” he demands, walking too close now. “And give us a smile.”
Something venomous rises in my chest and I stop and face him, meeting his gaze. “Fuck off.”
“Oooh, very rude!” he says, mock offended. He reeks of nicotine and beer. “What? You think you’re too good for me?”
I stare at him, not moving, not speaking. It takes everything I have not to scream and I clutch my keys so hard they dig into my skin. Eventually, after far, far too long, he glances from side to side, uncomfortable.
“You’re not that good-looking anyway.” He spits on the road and saunters away.
By the time I’m knocking on number forty-two, I’m still shaken. Somewhere in one of the flats, an infant screams a hungry protest and in the small concrete square below a bunch of lads kick a football about, yelling profanities at one another.
The door creaks open a few inches. A little boy, maybe two or three years old, stares up at me. He’s in a nappy and nothing else, and a dribble of slime that reminds me very much of Renée glistens on his chin and chest.
“Hello. Is your mummy home?”
He shakes his head and closes the door.
I frown and knock again. There’s a long wait, a yell from inside, and then the door is yanked open and a teenager with brown hair glares at me from the entrance.
