Brian Hodge - Prototype

“I’m trying to be as ethical as I know how,” Adrienne said, “and not bypass hospital hierarchy.”

From across his desk, for the most part clean as a windswept plateau, Ferris Mendenhall eyed her. He was a lean man in his mid-forties whose white coat tended to flap upon his frame like a clipper’s sail, and had no upper lip that she had ever seen. It remained hidden behind a drooping moustache that curled down with lazy bravado, a relic of a bygone age. If the sunburned pate visible through his thinning hair had been covered by a cavalry officer’s hat, he might well have been dashing.

“ This should be interesting,” he said.

“How long would you estimate that Clay Palmer might be here before you start getting some real pressure to discharge him?”

“Clay Palmer…” Mendenhall leaned back in his chair and steepled his fingers. “This would be the patient with the broken hands?”

“Yes.”

“Given that he came in under dual admission, so to speak, I’d say at least a few weeks.” He frowned with his deep-set eyes; it looked perilously close to bureaucratic scrutiny. “Why?”

Adrienne took a deep breath. “I’d like your support with something as regards his case. Let me preface this by stating that he needs more help than he’s likely to get here, unless somebody takes extra initiative. He’s from Denver, and twice he was committed there for observation and, I assume, some rudimentary treatment" — this she realized she had said with disdain — “and it certainly didn’t come close to meeting his needs. He needs more intensive therapy than he’s had an opportunity to get.”

Mendenhall rolled his chair back up to the desk. “This is not a county hospital for charity cases, and his insurance matter hasn’t been resolved yet, although it doesn’t look like the policy carrier has much ground to stand on. Still, if he needs months or years of therapy, refer him to County Services, where someone can deal with him on an outpatient basis.”

“That’s not good enough,” she said, and shook her head. “For a couple of reasons. First, he isn’t from here. If he were discharged, he’d have no place to stay. And even if he did, his dexterity’s so limited by those casts that, he is, for most practical purposes, helpless. Which means he’d have no choice but to return to Denver, and honestly, I don’t think he can even afford a bus ticket.”

Mendenhall fiddled with his moustache, a sad Monday-morning look about him. “And reason number two?”

“ I’m making progress with him. In our midweek session last Wednesday, he made a specific request that I help him. Send him elsewhere, and not only is he forced to start over with someone new, but the trust that I’ve established with him is completely shattered. Which can’t help but impact the way he views the next therapist who tries to work with him.” Adrienne scooted to the edge of her chair. “Ferris, it’s my most sincere recommendation that discharging him anytime soon would be disastrous. Take one look through his file, and factor in what brought him here the night he was admitted, and you’ll see that his violent outbursts have been getting worse over time. He’s stabilized now, but he’s still in a very precarious state of mind.”

Mendenhall swiveled in his chair and stared for a moment at a file cabinet across the room. Upon it sat an iron casting of a Remington sculpture, horse and rider frozen in a moment of pure, perfect panic as, below, a rattlesnake hung poised in defiance. A curved symmetry rippled through the horse; it could either soar or collapse.

He swiveled back to her. “Unless his insurance carrier gets more cooperative, the administration will never allow him to stay here for any protracted length of time, and they are not swayed by arguments such as this, Adrienne.”

She knew this, of course. Administrative logic was cold and precise and devoid of heart. There was compliance with the Hippocratic oath, yes, and they could not have turned Clay away at the door. Moreover, though, there was a bottom line. Too often the two pursuits were incompatible.

Nor was she entirely above it. Why else was she here, rather than at County? Every fourteen days she cashed her check from here and not once thought it too high a reward.

“I’m not asking for an indefinite stay,” she said. “Before long, I may be able to work out a solution where Clay Palmer can be discharged and I can continue to treat him.”

One of Mendenhall’s eyebrows creaked upward. “And this would come about…?”

“You might as well know it now" — she paused, with a curt nod — “I recently applied for an independent grant to study male aggression.” Talking herself in deeper by the minute. Certainly she was committed now to taking action over the next day or two.

Mendenhall’s face seemed to glaze with incredulity, each pore constricted, each hair a stiffened bristle. “You will not bring your personal agendas to this ward, and expect to be automatically accommodated.”

“I don’t see anything here as being mutually exclusive. While my first priority is the welfare of my patient, I’m not going to sit here and tell you that, in a case like this, I have no auxiliary interest in it at all.” Adrienne leaned forward and relinquished Clay’s file onto Mendenhall’s desk, pecked it with a fingernail. “Just go through his file and see if you can find fault with a single thing I’ve said.”

“I’ll do that.”

The skirmish was hers. Now, to press the advantage. And hope it was not too much, too soon.

“I’d like your permission for a simple test on Clay that may seem a bit out of the ordinary. I’d like to have his genetic karyotype run.”

Mendenhall looked as if he had bitten into something sour. “What possible use could you have for that?”

“Specifically, to check him for a double-Y genotype.”

Mendenhall began to laugh, short hitches of breath that rippled his moustache. “There’s never been any conclusive correlation between a double-Y and aggressive behavior.”

“I’m aware of that. But it’s not been disproved, either.”

Double-Y’s possessed an extra male chromosome, an anomaly whose 1961 discovery had led to its carriers being regarded as “supermales.” Subsequent studies caused a sensationalized fear of genetically predisposed criminals, but this was largely the result of sloppy research methodology: Subjects in influential studies in Great Britain and Sweden had been culled from mental institutions and prisons, rather than from the general population.

Mendenhall grabbed the file and shuffled to general patient data, scanned it quickly. “No indication of subnormal intelligence — hmm, to the contrary. Height only average.” He closed the file and met her with quizzical eyes. “How could you possibly suspect he’s a double-Y?”

“I don’t,” Adrienne said. “He does.”

Mendenhall groaned and rubbed his crinkling forehead. “And he got this idea from where? Movies, or TV?”

Adrienne shook her head. “Neither. Clay has a collection of books about serial murders and criminal abnormality. He first read about the double-Y in connection with Richard Speck — ”

“Amateur speculation. Speck didn’t even have a double-Y.”

“Well, I gather most of the books Clay has, if not all, are more sensationalistic than scholarly in nature. But to be fair, I even looked it up in one of my old academic texts, and it was in error, too.”

“Is he fixated on this?”

Adrienne nodded. “To an extent. He mentioned it in our third session and didn’t much dwell on it, and once I’d explained that he shouldn’t consider himself a candidate for it — because of his intelligence and height — I didn’t think it was significant. But he brought it up again yesterday.”