We Are Monsters (6 page)

Eli stood and gripped the briefcase handle hard to steady his hand. “We all hear voices,” he said, attempting to control his own. “It's all a matter of how we react to them. How they make us feel. What they make us do.” He thought of Crosby and his heartbeat slowed. Crosby's imaginary voices had convinced him to kill. That was clearly a sign of a disorder, not some form of divine persuasion.

Eli concentrated on his breathing.
Insanity is suffering; your job is to relieve suffering.
Rajamadja's manic smile and tittering laugh came to mind.
Not all insanity is suffering, though.

He heard Miranda's melodic voice,
“Who determines who's sick and who's well?”

His heart began thumping again, this time in his throat. He forced a smile and directed it at Randall, his wrinkled skin creating a landscape of canyon valleys. “We'll do this again,” he said and walked away, weaving between pockets of patients on his way to the door. Many of them were mumbling to themselves or to something unseen. He wondered what they heard.

Chapter Ten

“There are forces working to bring about the end of the world,” Crosby said. Cool air rushed through the large vent overhead. He placed his hands under his legs to warm them. “There's a war going on behind the scenes. I'm a soldier of God.”

Alex nodded his head as if Crosby had just told him that he enjoyed playing racquetball. “What forces?” he asked.

“Demonic,” Crosby said, chewing his lower lip. “The legions of hell led by Satan himself. It's an ancient battle that's nearing its end.”

“And…” Alex held a fist to his mouth as he cleared his throat, “…you've seen these demons?”

“I've seen their shadows.”

“Please explain.”

The therapy rooms had all been given names. It was one of Eli's initiatives to create a more calming hospital environment. This one was called Tranquility, which, in Alex's experience, was a misnomer. Nowhere else had Alex heard more irrational ideas or observed more erratic behavior. It did have a tabletop rock garden, though, to reinforce its theme.

“The demons take human form. They look just like you and me.”

You and I look nothing alike,
Alex thought, staring at the scrabbly man before him.

Crosby continued, “But their shadows show their demonic form.”

“You'd think they'd only come out at night, then.”

Crosby furrowed his brow; his chin dimpled. “Well,” he said, thinking, “that's true. I guess it's 'cause most people can't see them, so they feel safe.”

“Ah.” Alex grabbed the tiny rock-garden rake and began combing the sand. “And why do you think that is?”

“Why what is?”

“Why is it that so few people can see them? Why hasn't God called upon more people to join the war?”

“It's not that simple. It goes deep, deep, deep. Society has been blinded through cultural engineering. God has been removed from our everyday lives and replaced with false idols. People worship money, material things, movie stars. It's all part of a plan to distance us from our true nature. From our divine past.”

Crosby's past was far from divine. According to his patient file, he had been raised by a single mother who, by all accounts, was mentally ill herself; a condition she treated with a mixture of meth, men and gallons of cheap vodka. He had been sexually assaulted by more than one of her transient boyfriends and moved to a foster home after he found his mother murdered at the age of fourteen. Strangled, presumably, by a boyfriend, a pimp or a drug pusher. The case had never been solved. The fact that Crosby had been able to eventually secure a job and stay off the streets was indeed a miracle, but Alex doubted that it had anything to do with God.

“And, so, God's soldiers. How do they avoid being blinded by these cultural distractions?”

“Um, well, I know from my standpoint, first of all, I don't own a TV. Well, I do, but I don't have all the channels. Only a few. Just the basic ones.”

“So, cable is Satan's most effective weapon?”

Crosby puffed his cheeks and blew out a gust of air. “It's complicated,” he said.

“I imagine so.” The miniature rock garden was becoming a series of rigid lines pockmarked with pebbles. “Have you seen any demon shadows here?”

“Not yet.”

“And why do you think that is?”

“The pills, most likely. They put your head in a fog so that you can't see clearly. But I don't mind. I'm not sure I want to see the demons no more. I'd rather just live my life. You know what they say, ignorance is bliss.”

Sounds like something social engineers would say.

Alex had been a staff psychiatrist at Sugar Hill for over eight years. During that time, he had learned that there was no way to reason with schizophrenics during one of their episodes. To argue against their paranoid delusions would only work to implicate you in the plot. To encourage acceptance, as was Eli's primary philosophy, only encouraged the patient to further indulge in their delusion.

In Alex's experience, words could not fix the break in a psychotic's ability to perceive the world rationally. Although words could facilitate the break. Traumatic words, rather. When the closest people in your life—the ones who are supposed to protect you—cause you harm, a fracture in your psyche can occur. This fracture creates uncommon levels of stress, which can lead to the release of chemicals that alter your conscious mind. Suddenly your subconscious begins to manifest into your reality. Your demonic mom becomes a shadow figure following some stranger on the street. To the psychiatrist, this is called projection. To the psychotic, it's considered reality. And the only cure is to stop the frazzled neurons in the brain from misfiring, to stem the flow of chemicals that alter perception.

Current medications only masked the symptoms caused by this imbalance. Alex's drug would cure it, resetting the patient's mind to function properly. Then, and only then, could any form of talk therapy provide a therapeutic purpose for someone with a severe psychotic disorder. Only then would such a patient be in a position to comprehend the connection between prior events and their present condition.

But this is Eli's hospital,
Alex reminded himself,
so, until my drug is approved I must continue to offer lip service to this schizophrenic, as if it will make a difference.
He checked his watch and refrained from rolling his eyes.
Besides, I can't afford to be fired.

Crosby placed his elbows on the desk and leaned over for a better view into the rock garden.

Alex felt conspicuous under his stare. He opened his mouth to address Crosby's latest comment, but couldn't remember what he said. He pushed the box of sand and small rocks across the table to Crosby, who accepted it with the wide eyes of a toddler receiving a puppy on Christmas morning.

He grabbed the rake and immediately scrambled the meticulous lines.

Fuck this,
Alex thought,
let's get to the point.
“Let's talk about the attacks,” he said.

The central air cut off and the only sound in the small room was the scrape of the tiny rake through sand.

Crosby frowned. “What about them?”

“Well, let's talk about them. What was going on that day? Who were they? What were you thinking at the time?”

Crosby began to draw a stick figure in the sand, a circular head with a narrow neck and long, angled arms. He exhaled heavily. “I had gotten the message earlier in the day. I knew to be on the lookout. I had to be ready.” He added hands to the end of the arms, with sharp, pointy fingers. Claws.

“How did you receive the message? What did it say?”

Crosby flipped the rake over, holding it like a pen. He tilted his head to the side, examining his work, and his tongue pushed against his lower lip.

“I was walking up to the gas station to get a pack of smokes and a Mountain Dew. It was nice outside, sunny, not too hot. A few clouds in the sky, just floating up there, not moving at all, although there was a bit of a breeze. Then I knew something was coming because they started to glow. Not from the sun or nothing. It was like a light was shining from inside the clouds, almost too bright to look at.”

He drew a pair of legs with clawed feet.

“I put my hand up to shade my eyes…” he pantomimed the movement, squinting up at the acoustic-tile ceiling, “…and the clouds began to change shape. I could see these faces. They looked all nice and smiley. And then their faces changed and they became mean and evil looking. I looked around, but no one else seemed to notice anything. I knew it was meant just for me.”

He drew two intersecting circles over the chest and placed a pebble in the middle of each one. Breasts.

“Then there were some words that formed underneath the clouds. They came from the Bible, I think. Some Scripture. Said that in the final days, demons will walk the earth. And the righteous will be called upon to smite them down.”

Alex nodded. “And what book in the Bible is that passage from?”

Crosby shrugged his shoulders. “I don't know for sure. I haven't looked it up. It just sounds like something from the Bible. Maybe it was a direct message from God.”

“But that's what it said?” Alex read from the line he had written down, “In the final days, demons will walk the earth. And the righteous will be called upon to smite them down.”

Crosby shrugged again. “Something like that. I don't recall word-for-word.”

Sure sounds like God. Vague, indirect and easily misinterpreted.
“And you took that to mean you were being called upon to kill?”

“Sort of, but I was mostly just…I don't know, amazed. My whole body was buzzing. It was like I had been shot up with some high-grade speed. Everything was super bright and crystal-clear. I could see every little detail and hear every sound. It was like I'd been dialed into a higher frequency.”

That's not God,
Alex wanted to say.
That would be textbook schizophrenia, my friend.
“What happened next?”

Crosby turned his attention back to the busty stick figure in the sand. He added two oblong eyes and slashed vertical slits in their center.

“I went inside the gas station, feeling like I'm floating on air. I walk up to the counter to ask for a pack of smokes and then I see this bright light out the corner of my eye. I look over and it's a hunting knife in a glass case beside the counter. It was all natural looking with a rustic wooden handle with an ivory stripe in it. All the other ones were made of steel, with knuckle guards and metal spikes, like something a serial killer would carry. But this one was different. It was like the kind of knife an Indian chief would've used in a ceremony. Or to scalp somebody.”

It was most likely made in China.
“Go on,” Alex said.

“So, I knew that I was meant to have it. That it was part of the message. But I didn't have enough money.”

“How much did it cost?”

“I don't know, I didn't even look.”

Alex's amusement was only betrayed by the rapid blinking of his eyes.

“But then the cashier's phone starts ringing, back on the far side of the booth. He turns to answer it and starts yapping in some foreign language. Then it's like he's in an argument. He starts getting angry and raising his voice. He holds up a finger, like he wants me to hold on, and walks through the door to a back office or something and I'm left all alone in the store with that old knife that's glowing bright as the sun.”

“Convenient timing,” Alex said.

Crosby chuckled. “A little too convenient is what I'm thinking. So I check the case and there's this notch where a padlock is supposed to go but there isn't one attached. The case is just sitting there unlocked, and the knife is shining so bright it's about to blind me. So I open the lid and lift it out, but I don't have anywhere to put it or nothing, so I just kind of tucked it up against my arm and walked out the door. First thing I ever stole in my life.”

Crosby's criminal record proved otherwise, but Alex didn't contradict him. Instead, he let silence settle into the room. He shifted in his seat and it squeaked.

“When I walked out, the clouds had come together in a kind of line, like a conveyor belt flowing in a single direction. I looked up ahead and it made a ninety-degree turn at an intersection a couple of blocks down the road. It was like it was telling me where to go.”

Crosby leaned back over his drawing. He drew horns on the head and a crooked mouth with two triangular teeth.

“I followed it for a few turns and then it ended in a wide, flat storm cloud over this small group of people. Thunder rumbled, and it cast a dark shadow over the spot where they were standing. I looked over and there was nothing unusual about any of them. They were just standing together, talking. But then the cloud cover cleared and the sun shone through and I could see their shadows.”

His hand hesitated over the drawing in the sand. He lowered the rake and drew a large erection rising up from between its legs ending in a diamond tip. He leaned back and admired his work.

“And then?”

Crosby's face turned into a scowl. He raised the rake and then slammed it down into the center of the rock garden, scattering the sand. He looked across the table at Alex; his face became calm.

“And then I did what God wanted me to.”

Tranquility my ass, Eli,
Alex thought as he brushed sand off the front of his shirt.

Chapter Eleven

Alex didn't realize how much he had been dreading encountering Eli until he saw him round the corner of the hallway up ahead. A jolt of adrenaline raced through his system and his initial instinct was to turn and walk away.

Antiquated operating system,
Alex thought, striding forward. Fight or flight made sense when facing a hungry predator, not a familiar colleague whom one is slightly anxious to see.
Perhaps I'll make a drug one day to cure that as well.

He quickened his pace and fixed a large smile to his face as he closed the distance, extending his hand.

“Welcome back,” Eli said. “I've been looking for you.”

“I know, sorry. It's been one of those days. You know, with the Jerry situation and everything.” Eli was two inches taller than Alex, but appeared to be shrinking with age. They stood nearly eye to eye without Alex having to elevate onto his toes, which he was prone to do. Angela often joked behind his back that he should just wear platform shoes.

“Right, well, we have several issues to address. Is now a good time?”

Alex examined his watch as if it held his schedule. “Yeah, sure. Your office?”

“Why don't we get some air?” Eli said.

They started out walking side by side silently. Then the quiet became tense. Alex could sense scrutiny in the silence.
Has he found out about the test trials, somehow? What “issues” was he referring to?
Every step felt like a lost opportunity to say something, every stark footfall a gavel strike sentencing his guilt.

He pulled out his iPhone and opened the email app in order to feign a distraction. He dropped a step behind Eli and let him lead the way, tension pulling his chest tight.

Eli walked out onto the courtyard, an extended stretch of dark-green grass walled in by hedgerows. Flowerbeds lined the perimeter and the concrete walkways that led up to a large water fountain featuring a young maiden pouring water from a stone vase. Eli always thought of the woman in the fountain as Miranda, finally at peace in her pool.

He walked to a bench on the far side of the fountain and gestured for Alex to sit, then joined him.

“What a mess,” Eli said, shaking his head.

Alex's heart began to hammer. He nodded gravely. “I know,” he said, hedging his bets.

“Under normal conditions this is something I'd prefer to let slide, but given the circumstances, particularly with the review meeting pending, I just don't know that I can.”

Alex continued to nod his head, watching the fountain recycle its water while his mind raced through his most rehearsed justifications.

“But this impacts you more than me,” Eli continued. “I want to hear what you have to say.”

When Alex first decided to solicit a buyer for his experimental medication, he knew he'd have to perform test trials to prove that it worked. The best course of action at that point would have been to pursue a grant to help fund his laboratory work. That would have eliminated the need for secrecy. But he knew it would also have driven a wedge between Eli and him. And Alex was not willing to relinquish his position as a potential successor to Eli at Sugar Hill. It was better, he had decided, to keep his good standing at the hospital and pursue placement with a pharmaceutical company on the side. But he always feared having to face Eli before his plans came to fruition. And he hadn't yet considered how he would handle it. “Well, obviously I think it may be time we reconsider our approach,” he said, speaking hesitantly.

Eli crossed his legs and laced his fingers around his knee. “How so?”

“I mean in terms of treatment. I'm not sure the current plan is working.”

“Given recent events, I would tend to agree. So, what would you recommend?”

Alex sat up straighter. He turned towards Eli.
Maybe this won't be so bad after all.
“Well, for starters, a different approach to therapeutics. We need medicine that does more than dull the symptoms. We need something that addresses the root of the problem. A medicine that—”

“Doesn't exist,” Eli interrupted. He shook his head and sighed. “Medicine won't fix Jerry's condition. You know that. I'm surprised to hear you say so, given his history.”

Alex was nearly trembling with adrenaline. When Eli mentioned Jerry, however, it all drained away, leaving an acrid taste in his mouth and a ringing in his ears. “Well,” he said, mentally switching gears, “I'm just basing this off of a brief meeting with him this morning. His dosage is clearly off. He's still displaying severe paranoid delusions. He…I understand that he assaulted an orderly? He's never been violent before.”

“I suspect that he stopped taking his meds,” Eli said. “According to Manny he had been acting peculiar for a few days before the incident. We haven't been able to get a straight answer from Jerry. I was hoping you could help get to the bottom of it. I've prescribed 20 mgs of Clozapine to be taken under supervision while we determine what caused the episode.”

“That's what I thought. Eli, that dosage is too low.”

Eli sat still, staring at the lady watering the fountain. “You know how I feel about antipsychotics. But I won't interfere with your recommended treatment plan. Unfortunately, we can't continue to offer vocational training while he's unstable.”

It was Eli who had set up the vocational program at Sugar Hill. It helped provide purpose and offered structure to outpatients still struggling with mental illness, two essential components for recovery and quality living. And it was Eli who'd suggested that Alex enroll Jerry in the program, had, in fact, held the landscaping position open with him in mind, knowing how much he liked to be outside.

Alex had been hesitant at first, unsure that Jerry was capable of handling any level of responsibility, given his condition at the time. But he'd agreed to give it a shot. More out of an obligation to Eli than any optimism that it would help Jerry's well-being. But it had, almost immediately.

Jerry had come alive while performing remedial tasks in the courtyard. He had made friends with the other workers, even some members of the hospital staff. In just a few weeks his malaise had lifted and he had become nearly self-reliant, getting up by himself each day and preparing for his shift. After a couple of months, Alex had been able to help him find an assisted-living center where he moved in on his own. He had become happy, coherent, and even displayed some of the characteristics of his old personality.

In many ways, Eli had helped bring his brother back. It was a gift Alex was not quick to forget.

“I know,” Alex said. “I was afraid of that.”

“I don't believe that medication is the only answer, though, Alex. I worry about a complete relapse. I would be reluctant to strip him of a constructive outlet. I can help find a temporary position for him with a work-release program for more severe cases. Once we get him stabilized, he's welcome to return to work here.”

“I'll think about it,” Alex said.
I've got some more pressing problems at the moment,
he thought. “First, I'm going to have him released and brought home. Rachel can watch over him and make sure he's taking his meds.”

Eli nodded and said nothing. Alex's wife was not a nurse.

The silence threatened to become uncomfortable again, so Alex broke it. “I met with our new patient, Crosby. We've got our work cut out with that one.”

Eli seemed content to sit forever in silence. Alex couldn't bear it. “I hear that you had a run-in with him yourself,” he said, and immediately wished he hadn't.

Eli arched his eyebrows. “What did you hear?”

“Nothing, just that there was some sort of a confrontation. That he threatened to tackle you.”

Eli appeared fascinated by the fountain. His mouth was clamped shut.

Alex waited, waited—the gurgling water echoing the sound of his rising blood pressure—then continued, “And that you got in the way of an orderly attempting to subdue him. The man's dangerous, Eli. I know your stance on the use of force, but you can't put so much trust in these patients. The man attacked a group of people with a hunting knife, for Christ's sake. And you're…”
old,
he almost said, “…coming up on a critical review meeting. Think how it would look if you facilitated an assault.”

It was true, Eli knew. Had he been involved in a physical conflict with Crosby, it would give the board an excuse to reassess hospital protocol. It would support their argument for tighter restrictions, fewer patient liberties, more medical intervention. It would undermine much of the progress he had made to bring a more humane approach to the hospital. And it would likely hasten his exit. Something he was becoming less convinced was such a bad thing anyway.

So long as Alex can carry the torch,
he thought, which he had begun to question recently as well. He needed to be sure.

“Perhaps you're right,” Eli said and rubbed his eyes. “I don't need to be as involved in patient care. It's past time I turn those responsibilities over to you and concentrate more on hospital operations.”

Alex pressed his lips together to keep from smiling. When they'd walked outside, he thought it was to discuss his dealings with Philax Pharmaceuticals. Now it seemed as though he was cementing his position as the next Chief Medical Director of Sugar Hill. When he inhaled it inflated his chest, and he liked the way it made him feel. “You've set the guidelines, Eli. I'll just be following your lead. I hope that I've proven myself capable of continuing your ideals.”

Eli's nod was slight. He placed a hand on his stomach as though from a pang of indigestion. “I'll tell Angela that I'm placing you in charge of patient care. We'll need to be aligned as we prepare for our review meeting. You know the battle we face with the board.”

It was a board member who had put Alex in contact with the Philax representative in the first place. He was intimately familiar with the battle over the appropriate use of antipsychotic medicine at the facility and the board's desire to take a more active approach. Not to mention their willingness to accept money from pharmaceutical companies. Had he sold his experimental medicine to Philax, he would not have been the only one positioned to benefit financially.

Alex smiled and gave a conspiratorial nod to Eli. “You know I have your back,” he said.

They both turned and faced the fountain, admiring the pretty lady forever filling her pool.