Эд Макбейн - Snow White and Rose Red

“What are the other symptoms?” I asked.

Helsinger looked at his watch.

“If you have the time,” I said.

“you’re asking me, in effect, aren’t you, to defend my diagnosis,” Helsinger said. “ And the confirming diagnosis of Dr. Bonamico at Good Samaritan. And the corroboration of the entire medical staff at Knott’s, who unanimously agree that Sarah Whittaker is a paranoid schizophrenic.”

“If you have the time,” I said again, “I really would like to know the basis of your diagnosis.”

Helsinger sighed again. He did not look at his watch this time, but like a professor patiently lecturing to a dullard class in Psych 101, he began ticking off the symptoms of schizophrenia on the fingers of first one hand and then the other.

“One,” he said, “hearing your own thoughts aloud as you think them. Two, hearing hallucinatory voices discussing you or arguing about you. Three, hearing those same voices commenting on your actions. Four, believing that your body is being influenced or controlled by uncanny powers. Five, believing that your thoughts are similarly controlled. Six, believing that your thoughts are not your own — we psychiatrists call it ‘thought insertion.’ Seven, believing your thoughts are being broadcast to the outside world. Eight, believing that everything you do, feel, think, experience is being controlled by someone or something quite other than yourself. And lastly, the delusional perception I spoke of earlier.”

“Which manifests itself in what way?” I asked. I kept thinking that Sarah Whittaker had not behaved or sounded like anyone but the person I assumed she actually was.

“Let me quote C. S. Mellor. In commenting on Schneider’s work — That’s Kurt Schneider, who formulated the diagnostic criteria I just outlined for you — he said, ‘Schneider described the delusional perception as a two-stage phenomenon. The delusion arises from a perception which to the patient possesses all the properties of a normal perception, and which he acknowledges would be regarded as such by anyone else. This perception, however, has a private meaning for him, and the second state — which is the development of the delusion — follows almost immediately. The crystallization of an elaborate delusional system following upon the percept is often very sudden. The delusional perception is frequently preceded by a delusional atmosphere.’ Does that explain it, Mr. Hope?”

I did not feel particularly enlightened.

“And Sarah Whittaker was exhibiting all of these symptoms when you examined her?”

“Many of them,” Helsinger said. “It’s not necessary for all of the first-rank symptoms to be present in order to diagnose schizophrenia.” He looked at his watch again. “Enough of the symptoms were present, however.”

“And these symptoms included — what did you call it? — delusional perception?”

“Indeed.”

“Whom does Sarah believe herself to be?”

“I beg your pardon?”

“doesn’t a delusional system—”

“Oh, Napoleon, you mean,” Helsinger said, and smiled. “Yes, of course, That’s often the case. Sarah’s delusion, however, is more elaborate. You must understand, Mr. Hope, that a delusion is a belief — not a view, not an emotion, not a feeling, but a firm belief — that has absolutely no basis in reality but is nonetheless unshakably held despite factual evidence to the contrary.”

“And Sarah’s belief is what?”

“She believes — she knows with certainty — that she is being persecuted, deceived, spied upon, cheated, and even hypnotized by her mother and/or people in her mother’s employ.”

“You said a little while ago that the delusional system may have been triggered by the comparatively small inheritance—”

“Perhaps. But the delusional atmosphere must have been present long before her father died.”

I took a deep breath.

“Dr. Helsinger,” I said, “I saw no evidence that Sarah Whittaker is functioning under any sort of delusional system.”

“She told you she was sane, didn’t she?” Helsinger said. “She wants you to get her out of the hospital, doesn’t she? She’s being kept there against her will, isn’t she? Her mother had her committed wrongly, isn’t that her story?”

“Yes, but—”

“That’s all part of her delusional system. Persecution, deception—”

“Unless she really is being persecuted and deceived.”

“Yes, but where’s the basis in reality for such a belief?”

“You find no such basis, is that correct?”

“None whatsoever.”

“When were you first called into this, Doctor?”

“On September twenty-seventh last year. After Sarah tried to kill herself ”

“By allegedly slashing her wrists with a razor blade.”

“Allegedly? She did , in fact, slash her left wrist.”

“You saw the results of this suicide attempt?”

“I did.”

“Her left wrist was cut?”

“It was.”

“She was bleeding when you examined her?”

“No, her mother had put an adhesive bandage on the wound. It was only a superficial cut.”

“Did you remove the bandage to look at the cut?”

“I did.”

“And saw the cut?”

“Saw it, yes.”

“Did you see the razor blade as well?”

“No, I did not.”

“Do you know what happened to that razor blade?”

“I have no idea.”

“Was it given to the police?”

“Why would it have been?”

“Dr. Helsinger, when I was visiting Sarah, I saw no scars on either of her wrists. I looked for them, and there were no—”

“As I told you, she managed to cut herself only superficially.”

“Mrs. Whittaker called you first, is that correct? Her daughter was bleeding, but she didn’t call a general practitioner, she called a psychiatrist instead.”

“A Band-Aid took care of the cut. I’ve told you several times now that it was merely superficial. Her daughter had just attempted suicide, Mr. Hope, and suicide is not the act of a so-called normal human being. It seemed obvious to Mrs. Whittaker that a psychiatrist was needed. In the same situation, wouldn’t you have called a psychiatrist?”

“You said a delusional atmosphere had undoubtedly existed before her father—”

“I said it must have existed.”

“That’s the same thing, isn’t it?”

“It’s a reasonable assumption based on the usual development of delusional patterns. The physicians treating her at Knott’s would be able to tell you more about the origins of her disease.”

“But when you examined her—”

“Yes?”

“Did you then conclude that this delusional atmosphere had existed?”

“I considered it a definite possibility. In terms of my personal experience with such cases.”

“Had you ever examined Sarah before then?”

“No.”

“No one had called you to say that Sarah was hallucinating or hearing voices or in any way exhibiting symptoms of delusional perception?”

“No.”

“Had you ever treated or consulted with any other member of the family?”

“No.”

“Then Mrs. Whittaker just picked you out of the phone book, did she?”

“I’ve been a friend of the family for a good many years now,” Helsinger said. “Mr. Hope, you will forgive me, but I’m expecting my next patient in ten minutes, and there are still some calls I have to return.”

“Just a few more questions, Dr. Helsinger, if you can spare me the time.”

He looked at his watch again.

“Well,” he said, and sighed.

“When you examined Sarah for the first time — was she hearing voices?”