Jodie Picoult - Plain Truth

The psychiatrist marked something down on her notepad. “Then what happened?”

She had been waiting for this, for the moment when the small flashes of light that had been bursting in her mind these past few days would fly from her mouth like a flock of scattering starlings. Katie could almost feel the cut of the pain again, slicing like a scythe from her back to her belly with such a sharp, reaching pull from inside that she found herself knotted in a ball by the time she could breathe again. “I hurt,” she whispered. “I woke up and the cramps were bad.”

Dr. Polacci frowned. “Dr. Cooper told me that you haven’t been able to remember labor pains, or the birth of the baby.”

“I haven’t,” Katie admitted. “The first thing that came to me was that I was pregnant-I told Dr. Cooper how I remembered trying to bend down and feeling something stuck in the middle there that I had to work my way around. And since then, I keep remembering things.”

“Like what?”

“Like that the light in the barn was already on, when it was way too early for the milking.” She shuddered. “And how I was trying and trying to hold it in, but I couldn’t.”

“Did you realize that you were giving birth?”

“I don’t know. I was awfully scared, because it hurt so much. I just knew that I had to be quiet, that if I yelled out or cried someone might hear.”

“Did your water break?”

“Not all at once, like my cousin Frieda’s did when she had little Joshua, right in the middle of the barn-raising lunch. The ladies sitting on both sides of her on the bench got soaked. This was more like a trickle, every time I sat up.”

“Was there blood?”

“A little, on the insides of my legs. That’s why I went outside-I didn’t want it to get on the sheets.”

“Why not?”

“Because I wash ’em, but my Mam takes them off the beds. And I didn’t want her to know what was happening.”

“Did you know you were going to go to the barn?”

“I didn’t plan it, exactly. I never really got to thinking about what would happen . . . when it was time. I just knew that I had to get out of the house.”

“Did anyone in the household wake up as you left?”

“No. And there was no one outside, or in the barn. I went into the calving pen, because I knew it had the cleanest hay put out for the expecting cows. And then . . . well, it was like I wasn’t there for a little while. Like I was somewhere else, just watching what was happening. And then I looked down, and it was out.”

“By ‘it’ you mean the baby.”

Katie looked up, a little dazed to think of the result of that night in those terms. “Yes,” she whispered.

“Approximately two hundred to two hundred and fifty neonaticides occur each year, Ms. Hathaway. And those are only the ones that are reported.” Teresa Polacci walked beside Ellie along the stream that bordered the farm. “In our culture, that’s reprehensible. But in certain cultures, such as the Far East, neonaticide is still acceptable.”

Ellie sighed. “What kind of woman would kill her own newborn?” she asked rhetorically.

“One who’s single, unmarried, pregnant for the first time with an unwanted baby conceived out of wedlock. They’re usually young, between the ages of sixteen and nineteen. They don’t abuse drugs or alcohol, or have run-ins with the law. No, they’re the girls who walk the neighbor’s dog as a favor when they’re on vacation; the ones who study hard to get good grades. Often they’re overachievers, oriented toward pleasing their parents. They are passive and naïve, afraid of shame and rejection, and occasionally come from religious backgrounds where sex is not discussed.”

“I take it from your comments that you think Katie fits the mold.”

“In terms of the profile, and her religious upbringing, I’ve rarely seen a closer case,” Dr. Polacci said. “She certainly had more reason than most girls in this day and age to face shame and persecution both within her family and without if she admitted to premarital sex and pregnancy. Hiding it became the path of least resistance.”

Ellie glanced at her. “Hiding it suggests a conscious decision to cover up.”

“Yes. At some point she knew she was pregnant-and she intentionally denied it. Curiously enough, she wasn’t the only one. There’s a conspiracy of silence-the people around the girl usually don’t want her to be pregnant, either, so they ignore the physical changes, or pretend to ignore them, which just plays into the system of denial.”

“So you don’t believe that Katie went into a dissociative state.”

“I never said that. I do believe it’s psychologically impossible to be in a dissociative state for the entire term of a pregnancy. Katie-like many other women I’ve interviewed who have committed neonaticide-consciously denied her pregnancy, yet then unconsciously dissociated at the time of the birth.”

“What do you mean?” Ellie asked.

“That’s when the moment of truth occurs. These women are extremely stressed. The defense mechanism they’ve had in place-denial-is shattered by the arrival of the infant. They have to distance themselves from what’s occurring, and most of these women-Katie included-will tell you it didn’t feel like it was happening to them, or that they saw themselves but couldn’t stop it-a true out-of-body experience. Sometimes the appearance of the baby even triggers a temporary psychosis. And the more out of touch with reality the women are at that moment, the more likely they are to harm their newborns.

“Let’s look at Katie, specifically. Thanks to her brother’s experience, she’s been living with a very primitive survival script in her head, believing that if Mom and Dad find out her secret, she’ll be excommunicated and forced out of the household. So there’s this covert idea in her mind that it’s somehow okay to get rid of your children. Then she goes into labor. She can’t deny the baby’s existence anymore-so she does to the baby what she’s afraid will happen to her-she throws it out. The dissociative state lasts long enough for the birth and the murder, and then she reverts to using denial as a defense mechanism, so that when she’s confronted by the police, she immediately says she didn’t have a baby.”

“How can you tell that she dissociated at all?”

“When she speaks about giving birth, she shuts down a little. She doesn’t rely on other defense mechanisms-for example, denial, or something more primitive.”

“Wait a second,” Ellie said, stopping. “Katie admitted to giving birth?”

“Yes, I have it on tape.”

Ellie shook her head, feeling oddly betrayed. “She didn’t fold when Coop pressed her.”

“It’s not unusual for a client to admit something crucial to a forensic psychiatrist that she hasn’t admitted to a clinical psychiatrist. After all, I’m not talking to her to make her feel comfortable, but to keep her from going to jail. If she lies to me, she’s hurting herself. It’s my job to uncover the can of worms; it’s the clinical psychiatrist’s job to help stuff them back in.”

Ellie glanced up. “She told you about killing the infant too?”

The psychiatrist hesitated. “Actually, no. She says she still can’t remember two specific points: the conception of the baby, and the murder.”

“Could she have been in a dissociative state both times?”

“It’s entirely possible that she dissociated during the birth of the baby and during the killing. In fact, since her recollections don’t match entirely with the forensic records you’ve given me, the discrepancy flags just that. But as for the sex . . . well, that’s not something these women usually forget.”

“What if it was traumatic for her?” Ellie asked.