Jonathan Kellerman: The Conspiracy Club

“Well,” said Jeremy, wondering why the old man was bullshitting him so shamelessly, “anything that helps sensitivity.”

“The time you did speak up,” said Arthur, “taught us all a lesson.”

Jeremy felt his face go hot. “I felt it was relevant.”

“Oh, it was, Jeremy. Not everyone saw it that way, but it was.”

The time he spoke up had been six weeks ago. Arthur flashing slides of a metastasized stomach carcinoma on the big screen, defining the tumors in the precise Latin poetry of histology. The patient, a fifty-eight-year-old woman named Anna Duran, had been referred to Jeremy because of “unresponsive demeanor.”

Jeremy found her initially sullen. Rather than try to draw her out, he refilled her empty cup with tea, got himself coffee, plumped her pillows, then sat down by her bedside and waited.

Not caring much if she responded, or not. It had been that way since Jocelyn. He didn’t even try anymore.

And the funny thing was, patients reacted to his apathy by opening up more quickly.

Grief had made him a more effective therapist.

Jeremy, flabbergasted, gave the matter some thought and decided patients probably perceived his blank face and statue posture as some sort of immutable, Zen-like calm.

If only they knew…

By the time she finished her tea, Anna Duran was ready to talk.

Which is why Jeremy was forced to speak up, twenty minutes into a contentious exchange between Mrs. Duran’s attending oncologist and the treating radiotherapist. Both specialists were voluble men, well-intentioned, dedicated to their craft, but overly focused, baby-bathwater-tossers. Complicating matters further, neither cared for the other. That morning they’d slipped into an increasingly heated debate on treatment sequence that left the rest of the attendees peeking at their watches.

Jeremy had resolved to stay out of it. Tuesday mornings were an annoyance, his turn the result of a mandatory rotation that placed him in too-close proximity to death.

But that morning, something propelled him to his feet.

The sudden motion fixed fifty pairs of eyes upon him.

The oncologist had just completed a pronouncement.

The radiotherapist, about to embark on a response, was deterred by the look on Jeremy’s face.

Arthur Chess rolled the light wand between his hands. “Yes, Dr. Carrier?”

Jeremy faced the sparring physicians. “Gentlemen, your debate may be justified on medical grounds, but you’re wasting your time. Mrs. Duran won’t agree to any form of treatment.”

Silence metastasized.

The oncologist said, “And why is that, Doctor?”

“She doesn’t trust anyone here,” said Jeremy. “She was operated on six years ago- emergency appendectomy with postop sepsis. She’s convinced that’s what gave her stomach cancer. Her plan is to discharge herself and to seek out a local faith healer- a curandero .”

The oncologist’s eyes hardened. “Is that so, Doctor?”

“I’m afraid so, Doctor.”

“Quaint and charmingly idiotic. Why wasn’t I informed of this?”

“You just were,” said Jeremy. “She told me yesterday. I left a message at your office.”

The oncologist’s shoulders dropped. “Well, then… I suggest you return to her bedside and convince her of the error of her ways.”

“Not my job,” said Jeremy. “She needs guidance from you. But frankly, I don’t think there’s anything anyone can say.”

“Oh, really?” The oncologist’s smile was acrid. “She’s ready to see her witch doctor, then curl up and die?”

“She believes treatment made her sick and that more will kill her. It’s a stomach carcinoma. What are we really offering her?”

No answer. Everyone in the room knew the stats. Stomach cancer so advanced was no grounds for optimism.

“Calming her down’s not your job, Dr. Carrier?” said the oncologist. “What exactly is your job, vis à vis Tumor Board?”

“Good question,” said Jeremy. And he left the room.

He’d expected a summons to the Chief Psychiatrist’s office for a reprimand and a transfer off the board. None came, and when he showed up next Tuesday, he was met with what seemed to be respectful looks and nods.

Drop your interest in patients and patients talk to you more readily.

Mouth off at the honchos and gain collegial esteem.

Irony stank. From that point on, Jeremy found excuses for missing the meeting.

“The thing is,” said Arthur, “we cellular types get so immersed in details that we forget there’s a person involved.”

In your case, there’s no longer a person involved.

Jeremy said, “Dr. Chess, I just did my job. I’m really not comfortable being thought of as an arbiter of anything. Now, if you’ll excuse me.”

“Of course,” said Arthur, unperturbed, as Jeremy bussed his tray and left the dining room. Mumbling something Jeremy couldn’t make out.

Later, much later, Jeremy was fairly certain he’d decoded Arthur’s parting words:

“Until the next time.”

The way Jocelyn had died- the image of her suffering- was plaque on Jeremy’s brain.

He was never allowed to read the police report. But he’d seen the look in the detectives’ eyes, overheard their hallway conferences.

Sexual psychopath. Sadistic. One for the record book, Bob.

Their eyes. To do that to a detective’s eyes…

Jocelyn Banks had been twenty-seven, tiny, curvy, bubbly, talkative, blond, a blue-eyed pixie, a source of great comfort for the senescent patients she chose to care for.

Ward 3E. All ye who enter here, abandon all reason.

Advanced Alzheimer’s, arthrosclerotic senility, a host of dementias, undiagnosed rot of the soul.

The vegetable garden, the neurologists called it. Sensitive bunch, the neurologists.

Jocelyn worked the 3 to 11 P.M. shift, tending to vacant eyes, slack mouths, and drool-coated chins. Cheerful, always cheerful. Calling her patients “Honey” and “Sweetie,” and “Handsome.” Talking to those who never answered.

Jeremy met her when he was called up to 3E for a consult on a new Alzheimer’s patient and couldn’t find the chart. The ward clerk was surly and intent on not helping. Jocelyn stepped in, and he realized this was the cute little blonde he’d noticed in the cafeteria. Thatfacethoselegsthatrear.

When he completed the consult, he went looking for her, found her in the nurses’ lounge, and asked her out. That night her mouth was open for his kisses, breath sweet, though they’d eaten garlicky Italian food. Later, Jeremy was to know that sweetness as an internal perfume.

They dated for nine weeks before Jocelyn moved into Jeremy’s lonely little house. Three months after that, on a moonless Monday just after Jocelyn ended her shift, someone carjacked her Toyota in or near the too-dark auxiliary nurses’ parking lot half a block from the hospital. Taking Jocelyn with him.

Her body was found four days later, under a bridge in The Shallows, a borderline district within walking distance of the city’s cruelest streets. A place of thriving businesses during the day, but deserted at night. On the periphery were derelict buildings and ragged fencing, stray cats and long shadows, and that was where the killer had dumped Jocelyn’s body. She’d been strangled and slashed and wedged behind an empty oil drum. That much the detectives revealed to Jeremy. By that time, the papers had reported those bare facts.

A pair of detectives had worked the case. Doresh and Hoker, both beefy men in their forties, with drab wardrobes and drinkers’ complexions. Bob and Steve. Doresh had dark, wavy hair and a chin cleft deep enough to harbor a cigarette butt. Hoker was fairer, with a pig snout for a nose and a mouth so stingy Jeremy wondered how he ate.