Rafael Yglesias - Dr. Neruda's Cure for Evil

“Hey!” His companion complained.

The bald man glared at me, but didn’t make a move.

I told them to call an ambulance to take him to Columbia Presbyterian. I checked Al and was sure that he had a concussion. He slipped in and out of consciousness, losing it at one point for over a minute, his respiration so feeble that I began mouth-to-mouth and was prepared to do a tracheotomy. He roused enough from the CPR. I made sure his air passages were unblocked, that he was warm, and I quizzed the attendants about his medications. They claimed to know nothing. I didn’t believe them. I suspected they had raised his dose of Ritalin. I went along in the ambulance to the hospital. I called ahead to a friend in residence there who met us at the emergency room.

What followed was hours of bureaucratic hassles. X-rays confirmed Al had a concussion. The shelter insisted Al should be transferred to Metropolitan State. I wanted him kept overnight at Columbia until I could get the results of blood tests.

Until then, I had had good relations with the head of the Yonkers shelter, Becky Thornton. Not this time. She was outraged by my interference and stonewalled my questions about Albert’s assault on the boy as well as what drugs he had been given. She threatened to get a warrant and have Albert transferred by the police.

“You don’t want to do that,” I told her. “You don’t want me to go to court to vacate the warrant and demand an investigation. You don’t want people to ask how Albert got ahold of a weapon—”

“It was a spoon!”

“—or how well the children were being supervised or to have me testify to the brutal treatment I witnessed by your employee.”

“Tom and Bill were trying to protect you. That’s all.”

“Tom and Bill could have accidentally killed Albert.”

“That’s an outrageous charge.”

“No it isn’t. Something was affecting Al’s respiratory system and once he concussed he was in real danger of total failure. That would have been a disaster for your shelter and for my clinic. I don’t plan to expose their negligence. But if you interfere with Albert’s care, I will. At this point, I have no confidence in your people.”

“Look, I admit we can’t handle him. That’s why we want to transfer him to the Met State. We took him to your clinic as scheduled only because I knew you’d throw a fit—”

“Throw a fit? When have I ever thrown a fit?”

“Excuse me. I knew you would complain if we transferred him without your seeing him. It was out of respect.”

“It wasn’t out of respect. The court ordered those visits. You had to bring him. Do yourself and me and Al a favor. Leave him at Columbia overnight.”

“And what if he attacks somebody there?”

“He has a concussion.”

“That’s not a guarantee.”

“I’ll take full responsibility for him. If something happens, it’s on my head.”

“I need that in writing.”

Her two attendants, Tom and Bill, were still at Columbia. I wrote a note to satisfy her and gave it to them.

To be safe I would spend the night at his bedside. Albert was certainly capable, psychologically, of attacking someone, or escaping, or committing suicide. I could order them to put him in restraints or heavily sedate him, but that was exactly how people like Al, who have no one to sacrifice themselves for their benefit, are treated by our system. Drugs are used in place of contact; indifferent or hostile attendants instead of care. He had been bounced from psychiatric jail to shelters to foster care since he was rescued from his mother — Al’s rape of his niece was what called the police’s attention to his own abuse. I believed this new attack was another call for rescue. Something had happened; maybe it was the medication. Didn’t matter. I had to show him that someone was willing to deal with him as a person. Otherwise, certainly he would be lost. Lost as a human being; not as a menace. Eventually, the system would let him out and he could well become the world’s notion of an unfathomable monster — a vicious serial killer.

I called Diane and explained. She listened to the full account, not commenting until I was finished. “I fucked up, honey,” she said. “I was a wimp and I dumped it on you. I’m sorry. I’ll come right over.”

I insisted she rest and perhaps join me in the morning. I told her not to blame herself for her antipathy to Albert. And we discussed the beginnings of a plan.

When our talk was over, I walked down the hall to Al’s room. He was tied to the bed. I wouldn’t have the test results until morning. He was awake. His right foot was shaking, the leg’s quadricep bulging and releasing rapidly. He stared at me. I untied the straps and massaged his leg. The spasms were ferocious and completely local. The rest of his body was enervated and motionless.

“Is it hurting you? The spasms?”

He shook his head. “I don’t feel pain, you know,” he said.

I couldn’t help the muscle — its demonic animation seemed to mock me. I covered him with another blanket and asked if he wanted to eat.

He shook his head.

I rang for the nurse and told her to bring soup.

When it arrived, he said, “Don’t want it.”

I spooned up some and held it near, but not at, his lips. He stared at me. “What?” he asked.

“I think you should reconsider.”

He turned his head away, then quickly back to swallow the soup, as if tricking me. I measured another spoonful and waited. He looked at me this time without any hostility. “I ain’t gonna change,” he said.

“That’s what everybody else thinks,” I said.

“Except you?”

“Me? I don’t know. I don’t have an opinion. Whether you change or not I’m still here to help.”

He took the spoonful, swallowed and then said mildly, “I tried to fuck him.”

“The boy whose arm you broke?”

“Yeah.”

“You tried to rape him?”

“No. He wanted me to fuck him. He’s gay.”

“He’s gay? They told me he was ten years old.”

“So what?”

“At ten I don’t believe people are gay or straight.”

“That’s bullshit. Everybody knows people are born gay.”

I offered another spoonful of soup. Al said, “I can feed myself.”

I gave him the bowl. He ignored the spoon and took a long drink.

“Are you gay?” I asked.

“I’m nothing. I can’t fuck.”

“That’s why you broke his arm?”

“That gets me hard.”

“And then you can fuck?”

“Yeah.” He smiled at me. “Fuck them over. Then I can fuck.”

“I see.”

“Now your Johnson is happy.”

“I don’t know what you mean.”

“That makes you hard. You got a jones for knowing shitty stuff.”

“I’ll listen if that’s what you mean.”

“I can tell you lots of nightmares. None of that Freddy the Thirteenth shit. Real nightmares. That what you want?”

“Yes,” I agreed. “You tell me all the shitty stuff.”

TWO DAYS LATER, WITH LESS THAN TWO HOURS OF SLEEP UNDER MY BELT, I was startled by Gene’s appearance at lunchtime for his session. I had forgotten our appointment. Diane, Ben, and our recently added therapist, Rand Carlton, were on their way out of my office after a staff meeting. Diane and I had told the others of our idea that we add a ten-room dormitory to the clinic, hire a few non-professionals we knew who had experience with abused children, and house those, like Albert, who were truly at risk in the welfare system. They were enthusiastic. Diane, still feeling guilty, told Rand and Ben that she had lost her nerve on Saturday and deserted me. I said her reaction was understandable, that Albert’s mental condition was frightening and now we knew why. The tests showed he had toxic levels of Ritalin in his system, prescribed by the Metropolitan State’s casual psychopharmacologist, who had spent less than ten minutes talking to Albert. I consulted Joseph as soon as I had the results. To his credit, he admitted that probably a rebound effect was in play; the medicine, instead of curing Albert’s alleged hyperactivity, was now its cause.