The Deception
ALSO BY
BARRY REED
The Verdict
The Choice
The Indictment
Copyright © 1997 by Barry Reed
All rights reserved. No part of this book may be reproduced or transmitted in
any form or by any means, electronic or mechanical, including photocopying, recording,
or by any information storage and retrieval system, without permission in writing
from the publisher.
Published by Crown Publishers, Inc., 201 East 50th Street, New York,
New York 10022. Member of the Crown Publishing Group.
Random House, Inc. New York, Toronto, London, Sydney, Auckland
http://www.randomhouse.com/
CROWN and colophon are trademarks of Crown Publishers, Inc.
Library of Congress Cataloging-in-Publication Data is available upon request.
eISBN: 978-0-307-81633-7
v3.1
TO MY LOVELY WIFE, MARIE,
who waited patiently
while I was off chasing the Muse.
Contents
Cover
Other Books by This Author
Title Page
Copyright
Dedication
Acknowledgments
Epigraph
Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter 5
Chapter 6
Chapter 7
Chapter 8
Chapter 9
Chapter 10
Chapter 11
Chapter 12
Chapter 13
Chapter 14
Chapter 15
Chapter 16
Chapter 17
Chapter 18
Chapter 19
Chapter 20
Chapter 21
Chapter 22
Chapter 23
Chapter 24
Chapter 25
Chapter 26
Chapter 27
Chapter 28
Chapter 29
Chapter 30
Chapter 31
Chapter 32
Chapter 33
Chapter 34
Chapter 35
Chapter 36
Chapter 37
Chapter 38
Chapter 39
Chapter 40
Chapter 41
Acknowledgments
DEEPEST APPRECIATION TO
Carolyn Blakemore of New York City, for her editorial professionalism, her dedication, and her friendship
Frances M. Dyro, M.D., of Portland, Maine, for her neurological expertise
Catherine McDonald, my secretary, for her superb help and suggestions
Peter Matson, my agent, for his professional assistance and encouragement
Betty A. Prashker, my longtime editor and friend, who stuck with me during this literary journey
FROM RIGHTEOUS DECEPTION GOD STANDETH NOT ALOOF.
—AESCHYLUS
1Karen Assad fidgeted in the pocket of her white smock for her pack of Carletons. She was dying for a cigarette and had about three left. Perhaps she could sneak a few puffs in the pantry later. In twenty minutes, she’d give the evening meds to Dr. Sexton’s most promising patient.
Sitting at the desk in the nursing station, she perused the computer EKGs of three patients, watching the luminous squiggles track across the violet screen as a pilot would scan an instrument panel. All systems were go. At ten after midnight, the floor was quiet—at least for now. In the psych ward, this was as good as it could possibly get. The other nurses were off making midnight rounds and the young resident, Dr. Broderick, was engrossed in someone’s chart.
St. Anne’s was a showcase of medical technology, offering the latest in laser surgery, computerized radiographic techniques, and fiber optics, and a surgical staff without equal in the medical fraternity. Cutting into a patient at St. Anne’s, with its cadre of medical specialists, world-renowned experts, and with the cardinal’s peer-review override, was like operating in a fishbowl. No one made a mistake—at least not for the record.
Karen had opted out of Surgery; at age thirty-six, with two young children and no husband, it was too demanding. She had dated a few surgical residents, but they were too intense, boring her with case histories, detailed diagnoses, medical terminology, patient prognoses. And they were too young, if not out of her class: Duke, Harvard, Columbia, Eastern establishment—WASP, mainly. An occasional Oriental with a 240 IQ. Yet it was always the same—differential diagnoses, treatments, prognoses. No one seemed to want to go to bed anymore. But the psychiatric ward at St. Anne’s, apart from its maze of computers, sumptuous game rooms, and homey patients’ quarters, was only a step ahead of the days of Freud and Adler; it lagged behind private sanatoriums in both staff and technology. Cardinal Minehan had tried to spruce up the department: Dr. Pierre Lafollette was enlisted from the Menninger Foundation in Topeka, Dr. Consuela Concepción Puzon came from the Academy Santo Cristobal in the Philippines, and Dr. Robert Sexton had risen through the ranks and was now chief of the department. Of course, it helped that Sexton was the cardinal’s nephew.
Karen thought about it. For a while, she had been on days. But on that shift, she was going as batty as the patients. They wandered the halls, screeched, and threw rolls during lunch. When a plastic spoon came spiraling her way and hit her just above the left eye, she had had enough. She called in a few chits and landed her present assignment, supervisor of nurses from eleven to seven. Karen thanked God for this shift.
“Dr. Broderick”—she looked over at the resident—“I have to administer five milligrams of that new drug Capricet to Donna DiTullio, Dr. Sexton’s patient. Would you take over the watch for a few minutes? Nurses Collins and Rinaldi are due back momentarily.”
“Sure.” Broderick looked up from his notes and pushed his owlish glasses up into his curly red hair. “The DiTullio girl’s coming along quite well. Sexton’s done a helluva job. Remember when she came here three weeks ago?—a real basket case.”
“And she’s such a nice person,” Karen Assad added. “The doctor wants her to attend a group therapy session tomorrow morning at the Atrium. He’ll have her back on the tennis courts come October.”
“The Atrium?” Broderick pursed his lips.
“That’s where the therapy sessions are held. It’s like a leafy arboretum down there—ficus, bamboo, waterfalls. Even I could forget my troubles in that fantasyland.”
Broderick shook his head. “I don’t know. I walked over there last week. The sessions are held on the fifth floor. The whole thing’s too open. Only has a four-foot railing. It’s like treating psychiatric patients on the edge of a cliff.”
“Sexton knows what he’s doing.” Karen checked Donna DiTullio’s chart. “I’ll never forget when they wheeled her in—completely wasted, her wrists slashed. Severe manic depression with suicidal ideation, under constant surveillance. I didn’t think she’d last the week.”
“That’s just my point,” Broderick said. “On the improvement scale, she went from one to eight-plus in three weeks. No one recovers that fast.”
“Hey”—Karen Assad put a little edge in her voice—“we’ve got to take this psycho business out of the Dark Ages. Only a few years back, we’d have locked these people up in padded cells and thrown away the key. I’ve watched DiTullio’s progress, administered her evening meds. Trouble with most tricyclic drugs is that they take too long to kick in. Prozac might take six to eight weeks, sometimes three months. Same with Halcion and Zoloft. But with Capricet, the effects take hold almost immediately. It’s the best drug we’ve got.”
Broderick wiggled his hand. “Oh, it’s still a little early to tell. Sure, some patients respond
pretty well, but others don’t. And in DiTullio, it could have created a sense of euphoria, masking the deep underlying problem.”
“Well, before she arrived here, Sexton treated her periodically for several months, and believe me, she seems like the old Donna DiTullio who won the New England tennis championship at Longwood last year.
“You know, I was there the other day when Dr. Puzon was giving her the Rorschach test. She asked her what one illustration depicted, and Donna looked at it, squinted, turned it upside down, then said it looked like an inkblot. Not a gargoyle or a man running down a staircase while playing a violin, mind you, but an inkblot.”
Broderick grinned and nodded. “That’s a new one. I gave that test to Mrs. Wheeler down in three-oh-six and she described it as two stingrays having intercourse, and uh … her phraseology was a bit more graphic.”
Karen again fingered the pack of Carletons. If she didn’t leave now, it would be another hour before she could light up.
“Sexton only allows outpatients and those who are ready for discharge to attend group therapy,” she said. “The Atrium gives them a sense of the outdoors, well-being. It’s the threshold to reality.
“Hey”—she glanced at her watch—“I’ve got to shoot the Capricet.”
Broderick nodded again, readjusted his horn-rims, and returned to the patient’s chart.
“Hello.” Karen Assad rapped lightly on the open door. “Time for the little stab in the backside.” She poked her head in.
Donna DiTullio was still awake. A small overhead light illuminated Tennis magazine, which she was reading.
Donna smiled. She liked Nurse Assad. During the initial confinement, she had resented the nursing staff, doctors, and assistants, but at night, when the hectic bustle seemed to calm down, Assad would spend some time with her, and just before her injection, they’d chat about little things—like growing up in Donna’s world, high school, hiking up Mount Monadnock, summer camp on Martha’s Vineyard, and tennis. Karen Assad had never gone to summer camp, never played tennis or climbed Mount Monadnock. Her world was tough inner city, the local school of nursing, a dead-end marriage, and constant work. But Karen was a good listener and a good cheerleader, and she had the ability to withstand the anxiety generated by working with psychiatric patients, many of them suicidal. Most of all, she felt a certain inner satisfaction in being on the team that brought patients back from the brink of hopelessness. Donna DiTullio, a few weeks shy of her twenty-second birthday, was one of those patients.
“Have you got a cigarette, Karen? Or maybe a joint?” A puckish smile tugged at the corners of Donna’s eyes.
“I could use a cigarette myself,” Karen Assad replied, “but I promised my aging grandmother I’d quit smoking if she’d quit drinking.”
“What was the result?” Donna propped herself up on her elbows, her dark brown eyes now alert.
“A Mexican standoff,” Karen said as she flipped off the overhead light. “We still drink and smoke, but we renew our promises every Ash Wednesday.”
Karen was now all business. Capricet had to be injected just right—in the upper-right quadrant of the buttocks—to avoid hitting the sciatic nerve. She held the needle up to the light, squeezing the syringe slightly.
Almost reflexively, Donna DiTullio rolled over and pulled down her pajama bottom. A rub with an alcohol swab, a slight stinging sensation, and it was over. Donna welcomed the evening shot. It started to kick in within minutes, relieving any lingering anxiety, replacing it with a sense of well-being and slight euphoria.
“You’re going to be discharged day after tomorrow,” Karen said as she straightened the bedsheets.
“Do you think I’m ready?”
“That’s what Dr. Sexton thinks. Everything points in that direction—your attitude, your outlook on the future.…” Karen noticed her patient glowed at the mention of Dr. Sexton, even before the Capricet had had a chance to take effect. She knew that Donna had been his patient even before slashing her wrists. He had been treating her for depression ever since she lost in the second round of the U.S. Open. And that was almost a year ago.
“I get along with my mom.” Donna’s lips tightened as she shook her head. “But Papa Gino …”
“We had a team meeting last week. I think you’ll find a more understanding father from now on in. And maybe you should give up tennis as a competitive sport. Do a little volleying on the weekends. Live a little. Find the right guy.”
“I’ve found the right guy.” Donna smiled impishly. Karen didn’t press it.
“I wish I could say the same,” Karen said as she started to wrap a blood pressure cuff around Donna’s arm.
“How about some nice doctor?” Donna mused, her voice upbeat, the smile now full and dimpled.
The banter continued as Karen assessed her patient. The recovery was remarkable. Karen had never seen such a quick rehabilitation in her five years of working on the psych ward. She had studied the new mind-altering drug Capricet. It was still experimental—not FDA-approved. Somehow, it effectively blocked out stressors that bombarded the frontal lobes of the brain—similar to electroshock therapy, but without leaving the patient in a zombielike state. And, unlike other, overused antidepressants, it started to act within an hour. Donna DiTullio’s return to normalcy was startling.
Yet Karen wondered about it. Right now, Donna DiTullio was in a safe hospital environment, where the staff monitored her carefully, talked with her, listened, cajoled, made sure she took her medications. Each increase in Donna’s level was interpreted as a sign of improvement. Maybe Dr. Broderick was correct; the new drug could be masking an underlying disorder. But she wasn’t a psychiatrist. Dr. Sexton and the psych team had been meticulous in assessing Donna’s progress. Donna’s suicidal crisis seemed to be over. And if Dr. Sexton said Donna was ready for hospital discharge, who was she to second-guess the chief of Psychiatry? Yet, she had a nagging feeling of unease.
“You’ll love the Atrium,” Karen said gently as she rearranged Donna’s blanket. “It’s over in the Kennedy Wing, where you’ll be tomorrow morning for a group therapy session. There’ll be two others, whom you’ll meet for the first time. They were hospitalized and placed under Dr. Sexton’s care—a man and a woman, both about your age, both of whom had hit rock bottom but who are now productive—weller than well, as we like to say—the gold star of therapeutic end results.
“Dr. Sexton and Dr. Puzon will be there, as well as a psych nurse and your social worker, Joe Sousa. He’ll be your contact following discharge.”
They kept up the good-natured give-and-take for several minutes. Donna DiTullio leaned back into the pillows, her shiny black hair framing her youthful face. She half-closed her eyes and issued a contented sigh. The Capricet was taking effect.
“Okay, Donna.” Karen reached over and snapped off the light. “You’re looking good. You won’t have me to ace anymore.… I’ll check in on you just before I sign out in the morning. Good luck.”
They exchanged soft smiles.
There were some who thought Dr. Robert Sexton should have been a talk-show host rather than a psychiatrist. His aristocratic good looks, russet blond hair, and trim six-foot frame belied his forty-five years. Unmarried—there were rumors of a youthful divorce—he was seen with some of Boston’s most attractive women. Congeniality was his hallmark. He carried it with him like the ubiquitous stethoscope that dangled from his white coat pocket. He had a good word for everyone, from the nurses, orderlies, and candy stripers to the cleanup crew. Even at staff meetings and monthly peer reviews, where Phi Beta Kappa egos and professional jealousies could prove disruptive, Sexton knew how to pay deference, soothe, ameliorate—keep issues from deteriorating into collision courses. He often joked that anyone, including himself, had to be a little crazy to become a psychiatrist—and there were those on the faculty of St. Anne’s who were not in disagreement with his assessment.
So there was some grumbling. Some felt he was too silky smooth, a fence-straddler, an
d this, coupled with the fact that he made twice the salary of the chief of Orthopedics, one of his main detractors, didn’t ride too well with others on the hospital staff.
But while other department heads—in particular Dr. Max Gelberg, chief of Oncology, and Matthew Fucci, chief of the Cardiovascular Service—were aloof, imperious, and at times arrogant with the nursing personnel, Dr. Sexton realized early on, from his med school days at Columbia, that in a hospital setting the patient’s survival depended on the nurse; the nurse, not the doctor, practiced the nitty-gritty of medicine; and the nurse was never to be alienated.
Dr. Consuela Puzon knocked lightly on Dr. Sexton’s door.
“Come in, Doctor.” Sexton flashed a smile full of Anglo-Saxon charm as his assistant department head entered. He motioned with his gold-plated fountain pen for her to take a seat on the brown leather sofa next to the inlaid teak coffee table.
The early-morning sun filtering through the bronzed skylights added a silky black sheen to Consuela’s Joan of Arc hairdo. Her skin, the color of antique gold, contrasted with her white tunic. She unconsciously checked her black-banded wristwatch—7:30 A.M.
Sexton liked Consuela Puzon. She was not overly attractive—a little short, even squattish—but her large blackberry eyes at times seemed to dance beneath the curtain of her forehead bangs. A graduate of Santo Cristobal Academy in Manila, she had been on the staff for over a year, having been recruited by the cardinal, who had been impressed with her work and credentials during a visit to the Philippines. Originally a resident in Neurology, she seemed to have a psychological bond with patients. For Connie, as she liked to be called, treating and sometimes curing the elusive disorders of the mind were just as important as curing cancer.
Sexton quickly recognized Dr. Puzon’s superior intellect, and her practical bedside demeanor, sparked by her good humor, made his decision easy. He promoted her over Dr. Lafollette as his first assistant. And even Lafollette was impressed by her clinical ability. Puzon had instant recall, could cite the Diagnostic and Statistical Manual of Mental Disorders and its international classifications with computerlike accuracy, and had a diagnostic acumen that Lafollette hadn’t seen since his days at the Menninger Foundation.