After Hours (InterMix)

chapter Eleven


Saturday dawned way too soon.

I woke at the brush of Kelly’s fingertips through my hair, my eyes opening to find him standing beside the bed with a towel around his waist.

“Nooo,” I moaned, turning over.

“Time for school, kid. Get your butt in the shower.”

I heard him moving and sat up so I wouldn’t miss the free show. He draped his towel over the doorknob, and I watched his back and arms flex as he dressed in his Larkhaven gray. I bit my lip, wondering if it would turn him into work Kelly, all cool and civil and alert, or if that metamorphosis didn’t happen until he passed through the institution’s gates.

Once dressed, he gathered jeans and a spare shirt to change into after our shift, then turned to me. His look said, Time’s a-wastin’. He nodded toward the door.

I complied with a sigh and swung my legs to floor. I’d been so annoyed by that leave-a-woman-half-crippled comment he’d made, yet as I hobbled to the bathroom on sore hips, if anything I felt proud of my sexual war wounds. I’d never before gotten so laid I couldn’t walk properly, and it felt smugly pleasing, like a post-workout soreness. Only times a thousand.

I was dressed by a quarter past six, and we only had time for coffee and cereal.

“I can’t believe you eat Cheerios,” I told Kelly as we sat at the counter. “It seems way too wholesome.”

“What’d you picture?”

“I dunno. Raw steaks?”

“You got a lotta weird preconceptions about me.”

As I ate, I wondered whose court the ball would be left in, once we climbed into our separate vehicles and headed to work.

I wanted to do this again. Intensely.

But if he’d targeted me because I seemed hard to get, maybe his fun was over. I hoped not. Though after that little talk we’d had in his bed, about how he had a hard-on for scrappy women, I hadn’t caught any more glimpses of forthcoming Kelly, not the man who’d told me about his fathers over breakfast the previous morning, or begged me to make him come.

We’d had sex, made lunch, had more sex, ordered Chinese food for dinner and watched The Deer Hunter, had more sex and passed out. He’d fluctuated between mean and generous and rough and desperate, but I hadn’t been privy to another glimpse of that inner Kelly. I must have short-circuited his brain with that one orgasm, f*cked the armor right off him and sent it clattering to the floor, if only for a few minutes.

In any case, it seemed eagerness was the wrong card to play, if I wanted another two-day debauchery seminar in my future. I’d go back to how we’d been, me playing the nonplussed skeptic to balance Kelly’s bullish machismo. That game was fun, after all. And I didn’t feel bad playing games with him; it wasn’t as if I were trying to land him as a boyfriend. A bit of manipulation seemed fair when the prize was as simple and equitable as nasty-good sex.

It was raining when we left his place, and Kelly followed me to my car, tenting his hoodie over me in lieu of an umbrella.

“Thanks,” I said, dropping into my driver’s seat.

Folding his jacket under his arm, he crouched at my open door. “Have a good time?”

I nodded. “Thanks for that, too.”

He smiled dryly. “I’d kiss you, but you got that raccoon look back on your face.”

Huh? What look? If I knew how, I’d have erased it. If I’d known I was going to get kissed good-bye, I wouldn’t have strapped on my Kelly-proof vest so soon. Damn it. But I’d committed to our going back to how we’d been, so I ran with it. “I’ll see you at hand-off.”

He stood. “Drive safe,” he said, and shut my door.

My car had become moody of late, especially when it rained, but I got it running after a couple of attempts. I flipped my lights and wipers on, watching Kelly in my rearview as I pulled away from the curb. His light gray shirt was dark at the shoulders from the rain, and as he climbed into his truck I thought he was just about the most handsome man I’d ever seen. It was a sad thought. There was a chance I might never get to be with him again, but at least I’d enjoyed those couple of days.

As I drove, the melancholy I’d known I’d feel kicked in. The weather didn’t help. But this was the price I’d willingly shelled out to play tourist in Kelly’s sexuality, and having been there and done that and bought the tee shirt, I could assure myself it was worth it.

But it always sucked a little when vacation came to an end.

I didn’t see Kelly on the drive, nor in the lot when I arrived at work. I even dawdled a bit, hoping we might walk into the building together, but maybe he’d given me a few minutes’ head start on purpose, for discretion. The rain was heavier now, and I ran for the employee entrance, soaked by the time I reached the awning. At least the weather made for a good excuse, should anyone spot my car and raise an eyebrow over the fact that I’d driven to work this morning, when I normally walked the five minutes from the apartments.

The locker room felt weird. The clean scrubs I changed into felt weird, too. The last two days had transformed me, and why shouldn’t they have? It’d been over a year since my last boyfriend. In that time I’d forgotten how opened up it can make you feel, relating to somebody flesh to flesh that way. Kelly and I had basically spent all of Thursday and Friday in one long, carnal conversation. No wonder my body felt hoarse.

When I got into the sign-in room, I was surprised to find my name already written in the nurses’ area. In the duties slot someone had noted, Admission—see DF. That’d be Dennis.

Admission. I shivered, dropping instantly into work mode.

Admission meant a new resident, maybe an entrance interview. Given that three-quarters of Starling’s patients were what administration called 401s—401 being the state’s code for involuntary hospitalization—any newcomer to the ward was nearly guaranteed to be two things: dangerous enough to be forced to come here against his will, and not at all happy about that fact.

I had ten minutes before hand-off was due to start, so I went straight to Dennis’s office on the second floor, knocking on the window. He waved me in.

“Erin, good morning.”

“Morning.”

“Have a seat.”

I wheeled a chair up to his desk.

“You saw my note, I take it. Ready for an adventure?”

“Sure,” I lied. I didn’t feel ready at all. I felt wrung out for completely unprofessional reasons, but at least I hadn’t been warned. If I had, I’d have spent the hours leading up to this playing a theoretical movie in my mind, trying to game the scenario.

“Jenny says you’re starting to really find your way on the ward. With the residents.”

“Oh.” Really finding my way? I hadn’t been sexually threatened by any new foodstuffs, but I didn’t think that counted as exemplary progress. “Well, that was nice of her. Um, thank you.”

“And I remember Jenny mentioned you were considering pursuing a BSN . . . ?”

I blushed, nodding. Back in school, I’d made noncommittal noises about going for my RN someday, if I enjoyed the actual day to day reality of nursing. But my advisor had insisted I ought to aim even higher, and Jenny had echoed the sentiment. “I’m giving it some thought.”

“So you’re interested in the higher-level responsibilities of psychiatric nursing.”

“I am.” I was warming to this invitation, nerves banished by the praise and a chance to prove myself. Deep down I was a terminal teacher’s pet.

“We’ve got a new resident joining us this morning, a referral from the ER, previously en route to Cousins.” Cousins Correctional Facility, Dennis meant, a medium-security prison a couple of towns over. “Short-term, we hope, but that’ll be for Dr. Morris to decide.”

“Do you know what he did to get arrested?”

“Dr. Morris will debrief you, before the interview.”

“Oh, sure. Okay.”

“You’ll only be in there to observe, get a sense of how the admission process works here. Just be quiet and take notes if you want, and you’ll probably be ignored. If your presence is upsetting to the patient, you’ll simply be asked to leave.”

“Right.”

“If I were you, I’d pay close attention and be prepared to give your diagnosis and treatment plan to Dr. Morris once the patient has left.”

My eyes went wide. “Uh . . .”

Dennis smiled. “Don’t worry—you’ll probably get it wrong. Way wrong. But then Dr. Morris can walk you through his own interpretations of the patient’s symptoms. Give you some insight into how we come up with the pharma regimens we do, how we choose roommates, how we predict length of stay and so forth.”

“Okay. That sounds very interesting.” And intimidating. What if I told Dr. Morris I thought the guy was suicidal and should be prescribed antidepressants, but it turned out he was just lethargic from a Haldol dosage or something?

“Don’t worry. It’s not a test, just an opportunity to learn. Just don’t let any of those psychiatrists talk you into abandoning nursing in favor of some fancy white coat.”

Yeah, right. Me and what med school tuition? “Only if it’s a straightjacket,” I countered with that patented Starling sarcasm, and I took Dennis’s cue, getting to my feet. His outstretched hand invited me to precede him through the door.

He checked his watch. “Coffee time, methinks. The admission interview’s scheduled for nine thirty, so go ahead with your usual rounds until nine, then head to Dr. Morris’s office on S1 and he’ll prep you.”

We got to hand-off a minute late, but I figured I wasn’t busted, since I was walking in with the ward supervisor.

I spotted Kelly across the circle of staff, his cold eyes fixed on one of the overnight doctors, who was rattling through recent developments. Kelly’s arms were crossed over his chest as always, and I stole glances at the shapes of his shoulders and biceps, trying to square this man with the one I’d spent the past couple of days with. All this gray calm versus the frantic, flushed body that had owned mine on the floor, the couch, in his bed. That cool, unwavering expression versus the way he’d averted his eyes when he’d told me about his biological father.

He didn’t look at me once during the meeting. I hoped he wasn’t going to overcompensate for our unprofessional extracurricular activities by ignoring me from now on. Frankly, I’d been hoping we might share a subtle, knowing glance or two. Nothing seedy enough to distract me from my job, but something.

What I got was a pleasant, neutral, “Good morning,” as the meeting disbanded.

“Morning, Kelly.”

“Enjoy your days off?”

I bit back my smile. “Yes, thanks. You?”

“Yup.”

“Do anything special?”

“Oh, you know. Some work around the house.”

Yes, indeed. Nailing, drilling, screwing.

“Sounds productive,” I said, and we broke away. Kelly headed to the residents’ quarters, I for the nurses’ booth.

That little exchange kept me feeling all mischievous and cheerful through morning meds, and even Lonnie couldn’t put a crimp in my mood.

“Your hair looks different, kid.”

“It shouldn’t. I didn’t do anything special, except get rained on.” That and having it fisted and pulled and mashed into Kelly’s pillow.

“It’s different. I liked it better before,” Lonnie announced, then downed his cup of pills like a shot of bourbon and headed for the dining room.

The morning was quiet—so quiet I could hear the caffeine ticking through my veins to the exact rhythm of my anxiety. At two minutes of nine I headed down to S1 for my special assignment.

Dr. Morris was the most senior psychiatrist in our building; late forties, an intimidating, decisive type, with a crisp and competent air. He would’ve been handsome, with his dignified, prematurely silver hair and pale blue eyes, except I found him impossible to relax around. I’d only interacted with him during hand-off meetings, where he spoke quickly and clearly, and nodded with his gaze on the ground as he listened to everyone else’s reports. But Jenny respected him, and she was a tough crowd when it came to the doctors, so I suspected he knew his stuff.

I knocked on the heavy oak door of his office, and it opened shortly.

“Good morning, Miss Coffey.”

“Good morning, Doctor.” We’d never been formally introduced, so we shook. He cut an impressive figure, tall and rigid, with authoritative, extra-white streaks at his temples. His shake was firm.

“Come on in and I’ll give you the rundown.”

His office was far tidier than Dennis’s, lined with books and books and more books.

He said that a psychiatric intern and I would be in on the interview. I flushed with pride to hear I was being offered the same experience as a medical student. We weren’t to say anything, except to explain who we were, if the patient demanded to know. Other than that, we’d just observe, and take our best stabs at diagnosis and suggesting treatment once the interview was over.

“I know you’re only an LPN.” The way he said it, I knew Dr. Morris wasn’t trying to be a dick about it. Not like, I know you’re only a lowly LPN with some piddly certificate from a no-name technical college. More like, I know this is the deep end and you didn’t sign up for it. Don’t panic. “But Jenny said you’re looking to continue your education, so this might be a useful peek at what goes on, behind the scenes.”

“I’m sure it will be. Thanks for even inviting me, Dr. Morris.”

Jenny had told me once, toss the docs’ titles at them in conversation, any chance you find. It’s courtesy, of course, but it’s also currency. They can’t get enough of that, she’d said, like we were talking about dogs and belly scratching. Think of it as an investment in your career. Kiss a little doctoral ass, and it’ll pay off when you need an emergency consult someday. Let them think you worship that white coat. It must have been working for Jenny. She was a regular puppeteer when she wanted something for the ward and its residents. Or for her colleagues, it would seem, if my invitation to sit in today was her doing.

“So.” Dr. Morris opened a folder on his desk, tapping the stack of forms with a pen. “Patient is thirty-two, long history of violence, multiple convictions. Drunk and disorderly, assault and battery, breaking and entering . . . Every unsavory ampersand combo you could want. Latest and most credible diagnosis lands him on the psychotic end of the schizoaffective rainbow, with some major and long-lasting mixed and manic episodes. Multiple voluntary drug treatment programs—for cocaine mainly, plus alcohol, and a botanical garden’s worth of cannabis, which never plays nice on that spectrum. Oh and meth, one conviction.”

I shivered at meth. The closest thing the human race currently had to a zombie plague.

His gaze zigzagged down the page. “Five voluntary programs, to be precise, and exactly zero completed. Not a finisher, shall we say. History of violence with treatment facility staff.” Dr. Morris smiled wanly at me like, Oh goody! Lucky us. “Bit of a pharma cocktail, both prescribed and recreational. Though his outbursts seem to have lessened greatly since he’s been treated as a schizoaffective case.”

“That’s good.”

“He was interviewed during an emergency hold following an assault, and the doc there wants him with us, instead of prison. Patient doesn’t relish either option, but who would?”

A knock came at the door behind me and Dr. Morris boomed, “Come in.” I swiveled as a gangly young African American guy in a white coat entered the room. He smiled at me and adjusted his glasses, and pulled over a second chair.

“Erin Coffey, this is Darius Flowers, my talented new victim from CMED. Coffey and Flowers,” he mused. “Charming. Darius, Erin’s one of our newer LPNs, with an eye on earning her BSN. She’ll be sitting in as well.”

We shook.

He rewound the spiel and briefed Darius about the incoming patient. We both nodded like babies watching a yo-yo, and I caught myself thinking, I could’ve been a med student. I was studious, and had managed strong grades even with all the drama I’d had going on through my certification, plus I had a pretty high tolerance for blood. All I was lacking was the huge wad of cash, and the nuts to cut the cord with my sister. I wouldn’t hold my breath.

“I think that’s enough of my yammering,” Dr. Morris announced, getting to his feet. “The admission interview will teach you more than this stack of papers ever could.” He shut the folder and we followed him out of his office, waiting as he locked it.

He led the way. I hardly spent any time on S1. It was mainly the psychiatrists’ domain, and while the nurses from the locked ward were often in and out, conferring about residents, orderlies and techs and junior staff like me received most of our information secondhand.

The first floor was nicer than S3. It seemed sunnier, with oak wainscoting and hardwood floors, not the speckled linoleum we had upstairs. Our footsteps were noisy, echoing with history.

Dr. Morris led us down a long hall, punctuated by doors with frosted windows, each boasting the name and credentials of one of the staff doctors. At the very end of the corridor was a windowless door with two plaques. The first read Admissions and the one below it, Vacant. Dr. Morris slid the bottom plaque from its brass runners, flipped it over, and put it back in place reading In Session. He keyed in a code and led us inside, leaving the door swung wide.

“Only S1 office without windows,” he told us, wheeling chairs over. “Normally we’re happy to give patients a view, minimize the confinement vibe, but in here we can’t afford too many distractions. Too much stimulation. No telling what shape folks are in when they get delivered.”

He arranged two chairs facing another two chairs, plus one more, off toward the corner. That was my seat. Part of me was a bit hurt, shunted to the sidelines, but another part didn’t envy Darius’s proximity to a new and unpredictable patient. Who the fifth body would be, I didn’t know. A police escort or security guard, likely.

Darius and I were both nervously eyeing the room, scanning the austere wood paneling, and like me, maybe he was getting an escape route plotted, in case things got intense.

Dr. Morris flipped the folder open on his crossed legs. “Don’t you two just tremble like fawns?” he teased, scanning a page. “No need to panic. The patient’s been detoxed to his previous doc’s satisfaction, and his paliperidone regimen seems to be working.”

I scanned my mental flashcards for the side effects—restlessness, tremors, tics—so I wouldn’t make the mistake of blaming them on his disorder, when and if Dr. Morris asked my opinion. Darius was surely doing the same, nodding with a blank expression as Dr. Morris outlined the patient’s meds situation.

Voices came from down the hall, but I was too far from the door to see who was approaching. A woman’s voice grew louder, then a face I recognized appeared—a senior nurse who spent most of her time on S1 but made the occasional appearance during hand-off.

“Ready for Mr. Paleckas?”

Dr. Morris smiled graciously, all his wryness dutifully packed away. Darius’s hand was frozen above a legal pad, pen hovering at the ready.

Two men entered. I barely noticed the first one, as the second was Kelly.

My nerves short-circuited, morphing from trepidation to that funny, pleasurable knot of misgiving I always got around him. I kicked it aside. Now was not the time for distraction.

Kelly waited for the patient to sit, then did the same, linking his fingers atop his belt buckle and looking blasé. I just bet he’d prefer to be standing, arms folded, but I supposed it wasn’t helpful to give the patient the impression he was being held and interrogated. Kelly and I shared the briefest eye contact, and if he was as surprised to see me as I was to see him, he didn’t let me know it.

The nurse briefed Dr. Morris on the patient’s latest vitals before taking her leave. She shut the door with a heavy, telling click, and Dr. Morris leaned forward to offer his hand. “I’m Dr. Robert Morris. You must be Lee Paleckas.”

Lee accepted the shake. He was medium height, wiry, and surprisingly attractive—charismatic, if not actually handsome. He looked a bit like Edward Norton, only . . . twitchier, and with an unhealthy milkiness to his complexion. A vampire Edward Norton, who could stand a few square meals. He was already dressed in Starling’s gray uniform, and it made him look undeniably like a convict. He even seemed to be wearing invisible cuffs, his hands now dangling limply from his wrists between his spread legs.

“Who’re these people?” Lee asked Dr. Morris, sounding more tired than suspicious.

“This is my intern, Darius, and one of our nursing staff, Erin. I’ve asked them to sit in on this chat, but all the same confidentiality applies.”

Lee sniffed and rolled his eyes, clearly annoyed to have an audience but seeming resigned to us. Resigned to this entire situation, maybe resigned to his whole damn life. I decided to channel my inner Kelly Robak and sit nice and still, blend into the furnishings until or unless my services were needed. I’d observe with my ears and eyes and intuition, and leave the obsessive scribbling to Darius.

Dr. Morris opened the interview with the basics, determining that Lee had grown up outside Louisville, Kentucky, in a broken home, had been getting into trouble since he could crawl, and had been paranoid and punchy for as long as he could remember.

“I just don’t trust people.”

My gaze shot reflexively to Kelly. His cold gray eyes settled on mine before I could look away. Which of us was accusing the other of distrust?

“And if I asked what your diagnosis is,” Dr. Morris said to Lee, “what would you say?”

“I’m bipolar. That’s what every shrink’s said about me since I was nineteen.”

“It was the hospital’s opinion that you may be what we call schizoaffective. And that’s a possibility I’d like to explore during your time here at Larkhaven.”

“Ain’t those the same thing?”

“Similar, but not the same.” Namely, not the same to the tune of psychosis. “You may also have a combination of the two.”

“F*ckin’ great. Lucky me.”

“In the last interview, you told your doctor you’ve heard voices. Is this a new phenomenon?”

He shook his head. “Nah. It’s just not something you want to advertise, you know? ’Less you’re looking to wind up in the nuthouse.” He cast his gaze around the room. “But it’s a little late for that, now ain’t it?”

“What do your voices say to you, Lee?”

He tensed for a moment, then slumped with a sigh, too worn down to bother resisting the conversation. “They don’t say things to me, exactly. But sometimes, if I’m talking to somebody and I don’t trust them . . . I’ll hear what they’re saying, with their mouth. Then I’ll hear like this echo of what they’re really thinking.”

“Okay.”

“I mean, I’m not stupid. I know it ain’t actual mind reading. But maybe some guy at a bar’ll say, ‘Did you catch the Lions game?’ But then I’ll get this echo, with his voice saying all f*cked-up shit, sex shit sometimes, stuff this stranger wants to do to me.”

“That must be upsetting.”

Lee leaned back in his chair and gave Dr. Morris a leveling stare, one that said, loud and clear, Is that shit the best shrink line you got for me, Doc? And in that moment, I decided I liked Lee. I hoped he’d find his time at Larkhaven useful, and that I might be able to make his stay a little more pleasant.

“And your voices never tell you to do things?”

“Not really. Only if the person I’m talking to is thinking that. But nothing like you hear about, about demons and aliens. Just made-up whatcha-call-it. Telepathy.”

“Have you heard people’s thoughts for a long time?”

“Since I was a teenager, maybe?” That was in line with schizophrenia and schizoaffective disorder, for auditory hallucinations to begin manifesting in young adulthood.

“Did you believe you were hearing people’s real thoughts, all this time?”

“At first, yeah. I thought I was special. Like I had a superpower. Except it scared me, since nobody was ever thinking anything nice, nothing that ever made me feel anything but sick.”

As forthcoming as Lee was being, his affect was incredibly flat and dry, making it difficult to know if he was being open or just rattling off the same answers he’d given to a dozen doctors before. He also seemed tense, a bit jittery—but it felt like that was more physical than mental, a side effect of the antipsychotics.

“When did you first begin to suspect the voices might be coming from your own head?”

“I guess I was maybe twenty-one. I was visiting my grandma, and we watched this old movie. Black and white. I can’t remember what it was called, but it was about this chick that like, wakes up in a mental hospital.”

The Snake Pit, I thought. I’d watched it with my grandma, too, years before I wound up nursing her.

“The chick heard voices. Not like the way I did, but that was the first time I kinda got what people meant when they talked about ‘hearing stuff.’ I’d heard about crazy people having that, but for some reason, I never thought I was crazy. I thought I was special. That my brain was better than everybody else’s. Until I saw that movie. Then everything kind of went to shit, because back when I’d thought I was reading everybody’s thoughts . . . It sucked. I didn’t trust nobody, but I trusted myself. And my own brain. After I started thinking maybe I was crazy, then I didn’t trust anything. And I knew all that f*cked-up shit I was hearing, that must be stuff I’d come up with. In my subconscious or whatever.”

“When did you first start experimenting with drugs?”

“Shit, I dunno. Fifteen? That’s when I started smoking pot, anyhow. I didn’t do nothin’ worse until I was in my twenties.”

“And is that around the time the voices started? When you started smoking pot?”

“Maybe, yeah. I never really liked it much—the weed. But after I got told I was bipolar, this one doctor mentioned, just like, in passing, how some people with that got benefits from smoking.”

Dr. Morris’s professional façade fell away for a moment, an exhalation of pure annoyance hissing from his nose. “I see.”

“So I smoked a lot, the last ten years. It was cheaper than seeing a shrink.”

“Pot has been shown to ease some symptoms of bipolar disorder. But it’s also been shown to exacerbate those on the schizoaffective spectrum. Did your trouble with the law begin during this period?”

“I was never a good kid, but it did get way worse after the pot, yeah. And the voices got louder. And nastier.”

The interview went on for another hour, a conversational trip down Lee’s crime-riddled memory lane. He didn’t withhold much of anything as far as I could tell, but his flatness made it difficult to get any handle on his temperament. And temperament was telling, just as much as these illuminating anecdotes.

But one thing was refreshingly clear—he was one of the most self-aware schizo patients I’d yet encountered. And that could be the difference between an institutionalized life and a manageable one.

After Dr. Morris had heard everything he cared to, he shook Lee’s hand, and opened the door, calling for the nurse. She appeared shortly, and she and Kelly escorted Lee down the hall. I’d nearly forgotten Kelly was there. He knew how to make himself inanimate when that was what a patient needed.

“I look forward to talking some more this afternoon,” Dr. Morris called after them, then bade Darius and me to stand. “Let’s take this back to my office.”

We followed him out the door, waiting as he slid the Vacant plaque in place. After a pit stop for coffee, we re-adjourned to his stately quarters.

“Well,” Dr. Morris said, crossing his legs and glancing between us. “What did we think of Mr. Paleckas?”

Mercifully, Darius went first. He gave a long account of his observations and detailed an impressive list of treatment suggestions, many points of which I wasn’t familiar with or hadn’t thought of. Suddenly the line between LPN and third-year medical student was crystal clear, and I felt deeply lame, standing on my side of it. I hoped Dr. Morris might not bother asking my opinions. I’d lost all faith in them.

He checked his watch. “I know you’ve got an appointment with Dr. Fenton,” he said to Darius. “I won’t keep you.”

“Thanks so much, Dr. Morris.”

“My pleasure. Excellent work.”

Darius left, and I got to my feet as well, poised to say my own thanks and escape back to S3, where I at least felt halfway qualified to exist.

“Not so fast, Miss Coffey. I’m dying for your analysis as well.” He linked his fingers atop Lee’s folder.

I sat heavily, weighed down by dread. My face felt warm, my hands like ice. “Well . . .”

He smiled. “Just tell me what you think. Unlike poor Darius, my opinions won’t be making it back to your academic advisor.”

“Well, I kind of thought . . . I can’t tell yet. The paliperidone seems like it’s made him all flat. And tense. I’m sure the other doctor knows what they’re doing, but I kind of wish I could meet him on a lower dosage. It didn’t seem possible to get a real read on his personality, with the meds in the way.” A luxury we didn’t have, and I damn well knew it. Dr. Morris probably thought I was making up excuses to avoid offering my own treatment strategy, or that I didn’t have one. Which I didn’t. “Sorry. I’m not comfortable recommending a course of action if I don’t know what his . . . what his baseline personality is. I’m way too new at this to be able to separate the side effects from his normal affectations.”

“Can I share with you my own perceptions, Miss Coffey?”

“Of course.”

“Every patient who arrives here—every person you pass on the street, for that matter—is a complex recipe. Perfectly unique but mixed from a set number of ingredients.”

“Okay.”

“With the mentally ill, the symptoms are flavors, all mixed and mingled, shared between patients who are on a similar spectrum, but in all different measurements. Two patients might share a certain quality, say, paranoia. But one could be schizophrenic and the other merely anxious and under-rested. A third might be intoxicated. By itself, paranoia is a single flavor, found in a dozen distinct dishes. Like pepper if you will.”

“Sure.”

“Lee Paleckas is paranoid. And while a meatloaf might taste of pepper, there’s more going on—salt and basil and garlic powder, any number of things. Follow?”

“I think so.” Though I had no clue what it meant about my lame-ass non-treatment plan.

“Whatever flavors Mr. Paleckas has going on in him aside from paranoia, I can’t tell yet. He’s too smothered in gravy, from the meds the hospital’s got him on, and whatever extracurriculars may have tainted his earlier diagnoses.”

I couldn’t help but crack a grin at this ridiculous metaphor.

“So until we can scrape some of that gravy off and figure out what recipe we’re looking at, I’m in perfect agreement with you, Miss Coffey.”

My brows popped up, and Dr. Morris smiled.

“You looked surprised.”

“I am surprised. I thought it must’ve sounded like a cop-out.”

“In my not-always-popular opinion, there is far too much gravy-ladling going on with patients like Lee Paleckas.” He stood, tidying the files on his desk. “And somewhere, a mob of psychopharmacologists is sharpening its pitchforks.”

I got to my feet.

“But as his new doctor, I plan to lessen Lee’s dosage and get a good look at what’s underneath the side effects, just as you suggested.” He opened the door for me and we exited his office. “Pardon me, but I have a session to head to.”

“Sure. Thanks so much for letting me sit in, Dr. Morris.”

We shook hands.

“You LPNs are refreshing. You haven’t had your intuition crowded out by a skull full of med school texts. So, well done. If a time comes when you find yourself in need of a letter of recommendation, don’t hesitate to knock.”

I blinked, floored, and Dr. Morris started down the hall, the opposite way I’d be heading. He turned after a pace. “And Miss Coffey?”

“Yes?”

“With all due respect to our stellar nursing staff—give some thought to joining the dark side.” Demonstrably, he straightened the collar of his white coat.

Me? A psychiatrist? That was just whacked.

Dr. Morris pumped his fist in the air, cultishly chanting, “One of us. One of us,” as he turned and headed down the hall. And I thought, maybe whacked is exactly what it takes.