Robin Cook - Fatal Cure

David knew his only hope was to get Van Slyke talking. "How much should I dig?" he asked as he traded the shovel for the pick.

"I want a big hole," Van Slyke said. "Like the hole of a doughnut. I want the whole thing. I want my mother to give me the whole doughnut."

David swallowed. Psychiatry hadn't been his forte in medical school, yet even he recognized that what he was hearing was called clanging or "loosening of associations," a symptom of acute schizophrenia.

"Did your mother give you a lot of doughnuts?" David asked. He was at a loss for words, but he desperately wanted to keep Van Slyke talking.

Van Slyke looked at David as if he were surprised he was there. "My mother committed suicide," he said. "She killed herself." Van Slyke then shocked David by laughing wildly.

David mentally ticked off another schizophrenic symptom. He could remember that this symptom was euphemistically called "inappropriate affect." David recalled another major component of Van Slyke's illness: paranoia.

"Dig faster!" Van Slyke suddenly yelled as if he'd awakened from a mini-trance.

David dug more quickly, but he did not give up on his attempt to get Van Slyke talking. He asked Van Slyke how he was feeling. He asked what was on his mind. But he got no response to either question. It was as if Van Slyke had become totally preoccupied. Even his face had gone blank.

"Are you hearing voices?" David asked, trying another approach. He swung the pick several more times. When Van Slyke still didn't answer, David looked over at him. His expression had changed from a blank look to one of surprise. His eyes narrowed, then his trembling became more apparent.

David stopped digging and studied Van Slyke. The change in his expression was striking. "What are the voices saying?" David asked.

"Nothing!" Van Slyke shouted.

"Are these voices like the ones you heard in the navy?" David asked.

Van Slyke's shoulders sagged. He looked at David with more than surprise. He was shocked.

"How did you know about the navy?" he asked. "And how did you know about the voices?"

David could detect paranoia in Van Slyke's voice and was encouraged. He was cracking the man's shell.

"I know a lot about you," David said. "I know what you have been doing. But I want to help you. I'm not like the others. That's why I'm here. I'm a doctor. I'm concerned about you."

Van Slyke didn't speak. He simply glared at David, and David continued.

"You look very upset," David said. "Are you upset about the patients?"

Van Slyke's breath went out of him as if he'd been punched. "What patients?" he demanded.

David swallowed again. His mouth was dry. He knew he was taking risks. He could hear Angela's warnings in the back of his mind. But he had no choice. He had to gamble.

"I'm talking about the patients that you've been helping to die," David said.

"They were going to die anyway," Van Slyke shouted.

David felt a shiver rush down his spine. So it had been Van Slyke.

"I didn't kill them," Van Slyke blurted out. "They killed them. They pushed the button, not me."

"What do you mean?" David asked.

"It was the radio waves," Van Slyke said.

David nodded and tried to smile compassionately despite his anxiety. It was clear to him he was now dealing with the hallucinations of a paranoid schizophrenic. "Are the radio waves telling you what to do?" David asked.

Van Slyke's expression changed again. Now he looked at David as if David were deranged. "Of course not," he said with scorn. But then the anger came back: "How did you know about the navy?"

"I told you, I know a lot about you," David said. "And I want to help you. That's why I'm here. But I can't help you until I know everything. I want to know who 'they' are. Do you mean the voices that you hear?"

"I thought you said you knew a lot about me," Van Slyke said.

"I do," David said. "But I don't know who is telling you to kill people or even how you are doing it. I think it's the voices that are telling you. Is that true?"

"Shut up and dig," Van Slyke said. With that, he aimed the gun just to David's left and pulled the trigger. The slug thumped into the root cellar door, which then creaked on its hinges.

David quickly resumed his digging. Van Slyke's mania terrified him. But after a few more shovelfuls, David took the risk of resuming talking. He wanted to regain his credibility by impressing Van Slyke with the amount of information he had.

"I know you are being paid for what you've been doing," David said. "I even know you've been putting money in banks in Albany and Boston. I just don't know who's been paying you. Who is it, Werner?"

Van Slyke responded by moaning. David looked up from his digging in time to see Van Slyke grimacing and holding his head with both hands. He was covering his ears as if shielding them from painful sounds.

"Are the voices getting louder?" David asked. Fearing that Van Slyke wouldn't hear him with his hands over his ears, David practically shouted his question.

Van Slyke nodded. His eyes began to dart wildly around the room as if he were looking for a way to escape. While Van Slyke was distracted David gripped the shovel, gauging the distance between himself and Van Slyke, wondering if he could hit him, and if he could, whether he could hit him hard enough to eliminate the threat of the gun.

But whatever chance there had been while Van Slyke had been momentarily preoccupied was soon gone. Van Slyke's panic lessened and his wandering eyes refocused on David.

"Who is it, who is speaking to you?" David asked, trying to keep up the pressure.

"It's the computers and the radiation, just like in the navy," Van Slyke yelled.

"But you're not in the navy," David said. "You are not on a submarine in the Pacific. You are in Bartlet, Vermont, in your own basement. There are no computers or radiation."

"How do you know so much?" Van Slyke demanded again. His fear was again changing to anger.

"I want to help you," David said. "I can tell you're upset and that you're suffering. You must feel guilt. I know you killed Dr. Hodges."

Van Slyke's mouth dropped open. David wondered if he had gone too far. He sensed that he had evoked a strong paranoia in Van Slyke. He only hoped Van Slyke's rage wouldn't be directed toward him as Angela feared. David knew he had to get the conversation back to whoever was paying Van Slyke. The question was how.

"Did they pay you to kill Dr. Hodges?" David asked.

Van Slyke laughed scornfully. "That shows how much you know," he said. "They didn't have anything to do with Hodges. I did it because Hodges had turned against me, saying I was attacking women in the hospital parking lot. But I wasn't. He said he would tell everybody I was doing it unless I left the hospital. But I showed him."

Van Slyke's face went blank again. Before David could ask him if he were hearing voices, Van Slyke shook his head. Then he behaved as if he were waking from a deep sleep. He rubbed his eyes, then stared at David as if surprised to find him standing before him with a shovel. But his confusion quickly changed to anger. Van Slyke raised his gun, aiming it directly at David's eyes.

"I told you to dig," he snarled.

David rushed to comply. Even then, he fully expected to be shot. When no shots followed, David agonized over what to do next. His current approach was not working. He was stressing Van Slyke, but not enough or perhaps not in the right ways.

"I've already talked to the person who is paying you," David said after a few minutes of frantic digging. "That's one of the reasons I know so much. He's told me everything, so it doesn't matter if you tell me anything or not."

"No!" Van Slyke shouted.

"Oh, yes," David said. "He also told me something you should know. He told me that if Phil Calhoun got suspicious, you'd have to take the blame for everything."