EVEN AN HOUR AFTER SHE’D LEFT the hospital and was on 1-93 north to one of her rest homes in Concord, N.H., René could still hear Jack’s voice—and the image of his eyes cue-balled in his face as he stared at her transfixed with terror.
Terror.
That was the only word for it. She didn’t have a clue what he was seeing as he gaped at her. But what kept playing in her head was that voice—that weird baby-talk voice.
“Mama.”
“Except Jack didn’t have a mother.”
The jangle of her cell phone snapped her back to the moment. It was the secretary at Broadview saying that it was urgent: Carter Lutz wanted to meet with her as soon as possible. René had no idea what the problem was, but she had a prowling sense it wasn’t good.
Half an hour later she reached the home, and as soon as she entered she felt the tension. “He’s waiting for you in his office,” the receptionist said.
René walked down the hall and tapped his door.
Carter Lutz opened it. He did not smile. “I appreciate your coming by.” He closed the door and indicated a seat opposite his desk. He settled in his chair. “I’ll get right to the point. The family of Edward Zuchowsky is taking legal action against this home, and you’ve been named in the lawsuit along with CommCare.”
“What? On what grounds?”
“Gross negligence in his death at the hands of Clara Devine.”
She could barely catch her breath. “That’s ridiculous. I never laid eyes on Edward Zuchowsky or Clara Devine.”
“That’s irrelevant. Within the next few days, Zuchowsky family lawyers will call on you for a deposition. How you respond is critical to the outcome and determination of damages.”
René looked at him in blank disbelief.
“But there’s something that can be done to avoid a horror show for all of us.” Lutz’s face appeared to sharpen. “First, let me ask you a question. Your
work in this home is dedicated to raising the quality of life for elderly people, am I correct?”
She nodded numbly. “Yes, of course.”
“Then you wouldn’t do anything to jeopardize the well-being of our patients, correct?”
Another obvious question. René nodded.
“Or of the home?”
Nod.
“Good, because the welfare of Broadview is commensurate with that of our residents. Our moral mission is to our residents. Is that not so?”
Nod. And a worm slithered across René’s chest.
“What happened with Clara Devine was a terrible thing, and nobody knows what caused her to do what she did. But everybody associated with this home is responsible for keeping track of our patients and not letting them wander away.
“You’re new, but you can imagine that liability is something we worry about here. I don’t need to paint a picture, but lawsuits are horrible and the results can be destructive. But if you’re a team player, we can all help each other. If not, you’ll be alone in the dark.”
Team player.
“For your deposition, it is of the utmost importance that you keep in mind our highest priorities and exercise prudence and consistency.”
Silence filled the room as if the place were holding its breath. Finally René spoke. “What exactly are you asking me to do, Dr. Lutz?”
“I’m asking that you restrict all you know about the incident to the fact that there was an unfortunate failure in the security system, namely, that the locking mechanism had somehow failed and the security camera malfunctioned.”
“You mean you’re telling me to pretend that I never saw the video of Clara Devine letting herself out.”
“In so many words.” Lutz’s eyes were intense with conviction.
“And that I make no mention of Clara’s being enrolled in the Memorine trials?”
“Only because that’s totally irrelevant.”
“Dr. Lutz, you’re asking me to lie and, frankly, I’m not comfortable with that.”
Lutz’s eyes shrank to ball bearings. “You’d be a lot less comfortable with a ten-million-dollar lawsuit with your name on it.”
“But I never even laid eyes on Clara Devine or Edward Zuchowsky.”
“That may be so, but you’re employed to oversee residents’ medications. And lawyers can make ugly mountains out of molehills. It’s for your protection that we’re having this conversation.” He narrowed his eyes to say that she should be grateful.
“Forgive me, but violating the law and ethical standards is hardly protection.”
“Ms. Ballard, we are not talking about ethical standards, but a higher morality—which you agreed was for the welfare of our patients.”
“Clara Devine let herself out by tapping the security code. We all saw the video and I’m told she did that because of Memorine. So, why are we denying that?”
“Because if it becomes known that she was a subject in the clinical trials of a drug which may have made possible her escape, massive lawsuits would fly, and everybody associated with this home and GEM Tech would find themselves tied up in a legal free-for-all for years to come—the results of which could be suspension, heavy fines, exorbitant legal fees, and acrimony. It would almost certainly mean the termination of the development of a cure for Alzheimer’s disease. And that simply cannot happen.”
“But what you’re asking me to do is wrong.”
“Some abstract notion of right or wrong is not the point. It’s to do what’s right by our residents.”
“What about the others—nurses, doctors, administrators?”
“They’re in concurrence with our higher mission here.”
So, this was getting the new girl in line. “What about Clara Devine’s medical records? Surely the Zuchowsky lawyers will want to see if anything there can explain her attack.”
“Her records won’t be a problem.”
She looked at him in disbelief. “Altering medical records could cost us our licenses to practice.”
Lutz took a deep breath. “Ms. Ballard, what is proper and improper are relative matters since the circumstances are unique. Greater issues are at stake, namely, the beneficial outcome of this drug research. Secondly, there is absolutely no evidence connecting the compound with Mr. Zuchowsky’s death. Something in her just snapped.”
“But once the drug’s approved, won’t the Zuchowsky family wonder if Clara had been enrolled and attempt to raise a connection?”
“Not unless you say something about it, because I can assure you that the rest of the staff here will not.”
Jesus!
He was putting the whole thing on her. “Do your lawyers know about the clinical trials?”
His face filled with blood. “No. And let me remind you that Clara Devine was suffering dementia and was known to have delusions even before the trials. Any speculation to the contrary could compromise the trials and the marketing of the compound.”
He was telling her to lie and everybody else would swear to it. Because we’re team players.
“You are, of course, free to hire your own attorney,” Lutz continued. “But I’m sure CommCare will provide you with one.”
She nodded, feeling confused and resenting how she was being manipulated. She wished she had never seen the videos, had never noticed the irregularities.
“As you may know, the locking system has been replaced, as has the camera.”
“What about the security video of Clara Devine?”
“I really don’t think that’s something that concerns you.”
“But I thought we were all team players.”
Carter Lutz’s eye twitched reflexively. “Let’s just say it’s no longer a liability.”
Translated: Destroyed.
Lutz closed his hands over the papers and stared at her. “So, are you with us?”
“I need some time to think this over. You’re asking me to compromise some basic professional ethics. You’re also asking me to withhold information from my employer—that because of Memorine, Clare Devine was able to elope from this home and kill someone.”
“There is absolutely no evidence that she did what she did because of the drug. And if you even breathe a hint that there’s a connection, the promise of a cure may be destroyed.”
Then his manner softened. “Look, Ms. Ballard, I’m asking you to put aside your self-concern and think of the residents in this home and the Alzheimer’s patients throughout this country—and throughout the world. Think of your residents. Think of anyone you’ve been close to who may have suffered or died from Alzheimer’s disease.”
She nodded.
“And while you’re thinking about it, I suggest you visit some of the residents who have experienced a miraculous turnaround. And I suggest you do so soon because lawyers will be calling on you any day.” He got up and walked to the door.
René followed him. But before he opened the door for her, he said, “And, it goes without saying, what we discussed in here is to be held in the utmost confidence.”
“Of course.” She left, feeling as if there were a nugget of ice at the core of her body.
THEY MOVED JACK TO A STEP-DOWN unit in another wing of the hospital.
He was still being monitored by machines but not at the same intensity level as in the ICU. It was still impossible to predict the speed of recovery. Or that it would ever happen.
“Mrs. Koryan, I know how difficult it is,” Dr. Heller said, “but I think we have to prepare for all eventualities and discuss long-term care for Jack. He may wake up in the next hour or day, but given the lack of progress in his condition it’s also possible he may go on indefinitely. I’ve arranged a meeting with his other physicians, hospital caseworkers, and an administrator from the insurance company.”
Beth knew what was coming.
“There are some very fine institutions in the area.”
“You mean nursing homes?”
“Well, that’s an option, but it doesn’t make sense for a man thirty-two years old to be put in a facility for elderly patients. There are fine rehabilitation centers in the area. I’m sure we’ll find the appropriate place. Do you have any in mind?”
“Greendale Rehab Center in Cabot,” she said. It was what that pharmacist René Ballard had recommended the other day.
“Yes, Greendale has an excellent reputation. In the meantime, we’re going to move him to Spaulding Rehab right next door.”
They wanted him out of the hospital as soon as possible, Beth thought. They had stabilized him, and their job was done. The rest was rehabbing his muscles, monitoring his vital functions, and just waiting for him to surface. She glanced at Jack, stuck wherever he was, his breathing the only sign beyond the electronics that he was alive.
“I’ll look into Greendale,” Beth said, and Dr. Heller left the room.
A few minutes later one of the machines made a double chirp. And on the screen the green sawteeth made a series of ugly spikes.
Jack began to wince and thrash. This lasted for almost a minute, then subsided.
Ordinarily Beth would have called the nurse, but the spells usually passed.
As she looked down at Jack, so wan and withered, it crossed her mind that this was no life for either of them. And even if he were to wake up, it could be months or years from now. And what would they have? What would they do while she hung around nursing him back to health? And even if he got better, regained his memory and physical health, they’d be back to where they had left off—estranged at best. Wishing they were living somebody else’s lives.
She hated herself, but she had to admit to a thought which had several times wormed its way up from the recesses of her mind: That it would have been better if Jack had drowned.
“THEY’RE COMING BACK. I MEAN, if you saw them a year ago you wouldn’t believe it.”
René followed Alice Gordon down the corridor toward the dayroom, knowing that she was hoping to sway René into agreeing to the cover-up.
“At first, I thought it was my imagination—subtle little changes we chalked up to ward acclimation and fine-tuning their meds. But then we ran some cognitive tests. Something’s happening, and it’s for real.”
It was Monday morning, and René had returned to Broadview for the records that Dr. Carr had promised her. Also, to follow up on Carter Lutz’s suggestion that she meet the trial patients.
Because CommCare was named in the Zuchowsky suit, her boss, Mike Carvalho, had given her the name of the pharmacy’s lawyer who would contact her soon. He said he was also confident that the Zuchowskys had no case against her or CommCare—that neither she nor the pharmacy was negligent in their duties to Broadview, the residents, or the Zuchowskys. Of course, he had no idea about Memorine or what she had seen in that video. Meanwhile, because the records contained six months’ worth of data on Clara Devine, plus the four other phantom test subjects, it would take René days to transfer everything to her laptop. But a cursory check showed that for these patients on the trial drug a simple “T-drug 10 mgs” was recorded each morning, the nurses not even knowing GEM’s big little secret. When asked for an explanation, Alice replied, “What can I say? They told us that it was Dr. Carr’s project and he was taking full responsibility. They gave us two cards of pills, one labeled Trial, the other Placebo. It’s irregular, but I think they just wanted to keep everything mum until the data started accumulating.”
“Were residents’ families informed they were in the trial?”
“At first the patients were wards of the state, so there was no need for family consent. The lawyers took care of that, and nobody came by to visit. But you can get just so many wards.”
“So nobody outside the home knew about the trials.”
“Uh-uh. Now we’re enrolling patients with family consent, of course.”
“And how did the families react to the changes?”
“You can ask for yourself. But first I’d like you to meet Ernestine. She’s eighty-two years old, and two years ago she was admitted here with moderate Alzheimer’s.” They entered the activities room. At a table sat a little white-haired woman pasting cutout pictures of flowers onto colored paper. As they approached, René could hear her singing to herself.
“Mammy’s little baby loves short’nin, short’nin’, Mammy’s little baby loves short’nin’ bread.”
“Hi, Ernestine,” Alice said. “How you doing today?”
“Put on the skillet, put on the lead, Mammy’s gonna to make a little short ‘nin’ bread.” The woman slowly glanced up at the nurse and René, then looked back down to the puzzle. “Fine, thank you.”
“That’s good.”
“Mammy’s little baby loves short’nin’, short’nin’, Mammy’s little baby loves …”
“Ernestine, this is René. She’s come to say hello.”
“Hi, Ernestine. Nice to meet you. Those are pretty flowers.”
“It’s for my book.”
“Isn’t that nice. It looks like it’s coming along very well.” A small pile of pasted pages sat neatly beside her.
“I’m going to call it
My Flower Book.”
“What a great title,” René said, a little distracted by the woman’s manner. She had pronounced the book’s title with the deliberate carefulness of a child.
“Mammy’s little baby loves short’nin’ bread.”
“Ernestine, do you remember me?” Alice asked.
Ernestine stopped singing and looked up at her again. “Oh, sure.” For a moment there was no light of recognition in the woman’s face. Then she looked at the woman’s nametag and said. “Can’t you read? You’re Alice.” And very slowly and deliberately she recited, “A-L-I-C-E. Alice!” And she went back to her puzzle. “Mammy’s little baby loves short’nin’ bread.”
“That’s great, Ernestine. I’m so proud of you.”
The woman smiled. And they moved away. “Two months ago I could walk in the room, tell her my name,” Alice said, “and twenty seconds later she’d ask me who I was. I’d tell her again, and another twenty seconds later she’d ask me who I was again. She could recognize the face, but forget about putting a name on it.” She shook her head in dismay. “If I hadn’t seen it with my own eyes, I wouldn’t believe it.”
“That’s incredible.”
“Yes, and
that’s
what it’s all about.” And she gave René a knowing look—a wordless plea not to raise a flag—not to report the irregularities to the authorities.
“I hear you,” René said, still a little dazed by how complicated life had become. One word from her and all this could explode. “You think it’s the drug that brought back her reading?” She hadn’t seen Ernestine’s cognitive evaluations, but some early dementia residents still retained rudimentary reading powers.
“When she was admitted to Broadview two years ago she couldn’t read her own name. But I suppose the proof of the pudding is how she’s doing six months or a year from now.”
“You mean if she’s sitting there reading
War and Peace.”
Alice laughed in relief. “Given the way things are heading, that may not be a joke.”
As they walked down the corridor, René remembered how common nouns for her father had faded into “whatchamacallits” and that to avoid the humiliating frustration, she had put big labels on objects around the house—“telephone,” “dish,” “lamp,” “fridge.” As his ability to read faded, he began making excuses about needing a new prescription for his glasses. Eventually the synaptic wiring got so clotted that written words were meaningless blotches and books were things that filled shelves.
Alice led René into a room where a woman bedridden with a fractured hip was sitting with her visiting son and daughter-in-law. Alice explained that Lorraine Budd, age eighty-one, had been diagnosed with moderate dementia when she was admitted over a year ago.
Alice made the introductions. “Hi, Lorraine, this is René.”
The woman had a pink face flecked with brown spots, but despite the discoloration and the soft folds of loose skin, René could see that she had been a beauty in her youth: the bright sapphire eyes and fleshy mouth and high intelligent forehead. Thick white hair was brushed back neatly and held by combs.
“I knew a René from school.”
“You did?”
“René St. Onge.”
“And you still remember her?”
“Oh, yes, we were best friends.”
“I’m impressed,” René said. “And where did you go to school?”
Without a moment’s hesitation she said, “North Central High in Kalamazoo, Michigan.”
“That’s amazing.”
Lorraine smiled proudly.
“And do you remember what year you graduated?” her son asked.
Lorraine frowned a bit as she thought about the question. “It was 1946. And I had poison ivy all over me. My face was all blown up and pink with the medicine. And it was very hot and I had to wear gloves to shake hands so people wouldn’t catch it.” She chuckled to herself.
“And do you remember your guest’s name here?” Alice nodded toward René.
“Yes, René like my friend René St. Onge.”
Long-term memory
and
short, René thought with amazement.
Before she and Alice left, Lorraine’s son said, “I’m not particularly religious, but this is like a miracle.”
“It is a miracle, and you better believe God was listening,” his wife declared.
“Whatever, the people who developed this should get the Nobel Prize,” the son added. “I can’t tell you how much better she is. Right, Mom? You’re getting your memory back.”
The woman smiled. “That’s what they say.”
“Here you go, Mom. Remember what day it is today?”
The woman stared at the wall as if trying to read a teleprompter. “Sunday.”
“Close enough. It’s Monday.”
“But you usually come on Sundays.”
“Jeez. That’s right, and today’s a holiday. It’s Labor Day. I forgot.” Then he looked at René. “See what I mean? It’s unbelievable.” Then he squeezed his mother’s hand. “Mom, you’re a miracle.” And he kissed her hand.
Alice led René back out and into the dayroom, René’s head spinning. All her previous suspicions of exaggerated claims were diminishing. And according to Alice the cognitive test scores would bear out the evidence.
Just three years.
The niggling voice was back as they made their way into the dayroom.
He could have held on.
Christ, you’re going to let this eat you to death,
she told herself.
Promise me … to die with dignity.
He would have continued to waste away, full-coded to be kept alive by machines and tubes and IV drips, antibiotics, CPR, emergency trips to the hospital.
You didn’t know. You didn’t know.
And she latched onto Nick’s words like a life raft.
“And this is Louis Martinetti,” Linda said.
Louis was standing in front of them wearing jeans and a khaki shirt with
pockets and epaulets. Hanging conspicuously around his neck was a chain with some kind of dull gray metal pendant.
“Louis and I met the other day. Good to see you again, Louis. How you doing?”
“How am I doing? I’ve got Alzheimer’s.” And he gave René a glacial stare to gauge her reaction. “I’m the sum of all I’ve forgotten.”
“Well, I hear you’re doing very well,” René said.
He looked at René and squinted. Then something shifted in his face. “Your name Rita Swenson?”
“No, I’m René Ballard. We met the other day.”
Unconsciously Louis’s fingers gripped the pendant around his neck. They were military dog tags.
“Maybe your glasses will help,” Alice said, and she pulled the case out of his shirt pocket, extracted his glasses, and handed them to him.
Cautiously, Louis slipped them on and began to study René’s face. After a moment, his expression shaded to embarrassment. “Sorry, I sometimes get a little confused. You’re the pharmacist.”
René was delighted at his recall. “That’s right. Very good, Louis. René Ballard.” And he squeezed her hand.
Louis shook his head as if dispelling a thought. “But you don’t know who she is, do you? Nah, you wouldn’t know.”
“Well, maybe you can tell me about her and who Fuzzy Swenson was.”
Louis thought that over. Suddenly, something passed through him and he became agitated, his eyes flitting and his expression darkening. He moved toward the nearby window and became fixed on something outside. “From the southeast corridor,” he mumbled. “Maybe hundred fifty, two hundred men tops …” He continued to mutter to himself as if having an interior conversation.
“What’s that, Louis?” Alice asked.
Louis did not turn but continued muttering to the window. “Light armaments the northwest … half dozen … reconnaissance … Seventeenth Infantry Regiment …” Then his face screwed up as if he had just seen something awful. “I’m
telling
the truth. That’s all I know.” Then his head cocked and his face smoothed out again. “Tell them he’s only a kid, only a boy. He knows nothing. I know nothing. Nobody knows nothing.”
“Louis, are you all right?”
Louis rotated his head toward René and Alice, and for a long moment he stared at René. “He was a good guy, a good stand-up guy is all. Told some good jokes.” His eyes appeared to fill with tears. “I loved him like a brother, you
know?” His head cocked and he nodded as if he were taking in responses from some invisible companion. “I know, I know. But I swear we’ll get them back is all.”
Alice leaned toward her. “Sometimes he talks to himself. But it’s never a problem.” And she nodded a reassuring expression at René.
“I promised him that night and I promise you now,” he said to René. “We’ll be there—me, Captain Mike, and Jojo. I swear.”
René had no idea whom he was addressing in his head or what he was swearing, but the look in his eyes sent a small electric shock through her.
Louis then turned and headed back to his room, still muttering. But he wasn’t simply talking to himself. He was engaged in a full-fledged conversation with people in his head. “His charts say you’ve been treating him with antipsychotics.”
“Yes, well, only when … you know, the delusions become a problem.”
“Like what?”
Alice appeared to squirm. “Well, like when he gets paranoid or frightened.”
“He’s on a high dosage of Haldol.”
“Well, sometimes he gets pretty upset and doesn’t snap out of it.” Then her face brightened. “But the thing is, his short-term memory is coming back like gangbusters. I’ll show you his scores.”
They walked down the hallway. But what bothered René was how Alice wanted to put the best face on Louis’s delusions—and the weird sensation that Louis’s mind was toggling between the ward and some dark and faraway time. Yes, that happened with dementia patients. Her own father had had occasional delusions, sometimes thinking René was his wife as a younger woman or someone from television. But what struck her was how Louis had looked at her as he stood there fingering his dog tags. He looked lethal with conviction.