Some of the patients turned to stare.
“Come over here,” he whispered, escorting her into the farthest corner of the room. “Sorry, but you need to calm down. You’re under a lot of pressure right now, and this isn’t helping.”
“I’m having a perfectly normal reaction to a very creepy encounter.”
He studied her with sympathy. “The world is full of whackos, Kate. We both know that. Maybe it wasn’t intentionally creepy? Maybe it’s more innocent than creepy? I mean, your reputation precedes you. It’s not every day one of us gets an APA award. Penny… Nelly… whatever her name is… she probably read the Globe article about you and remembered who you were from school. And now she’s got a very sick kid of her own who needs a good female psychiatrist and she’s desperate… and she thinks, okay, I’m going to take my child to see this person. Is that so far-fetched? So she drops off her mentally ill daughter at the hospital where you work because she read an article that said you get great results.”
“If that’s true, then why all the secrecy? Why not tell me?”
“Maybe she was afraid you wouldn’t treat her daughter if you knew the truth?”
Kate frowned. “I probably wouldn’t.”
“There. See? That’s why she didn’t say anything.”
Kate fell silent.
He took her hand. “You’re still wearing my ring, I see.”
“I haven’t had time to think about whether it itches or not.”
He smirked. “Maybe if we called it an engagement ring.”
“Are you trying to piss me off?”
“No, I’ve fulfilled my quota today.” There it was again— that crooked-ass grin of his, the one thing that never failed to lift her spirits. “Life has a funny way of fucking with us, Kate.”
“So I’m fucked? Is that what you’re saying?”
“No, silly. We’re both fucked.”
She cracked a smile. “Shut up.”
“Inject some irony into your veins, quick.”
“Shut up, you dork.”
“You can abuse me all you want. Go ahead. I can take it.”
“Asshole.”
“There. Better now?”
“Yes. Actually.”
“You’re welcome. Just take it in stride, okay?” He caressed her cheek. “Be my hero, Kate. I need you to be strong for me.”
“Yeah, I’m fucking Lara Croft.”
“You are Lara Croft. Which means that I’m fucking Lara Croft.”
“Ha. My boyfriend is hilarious.”
“See you tonight, babe.” He gave her a fist bump.
She paused. “I’ve got to get Maddie admitted, so I may be a little late.”
He smiled cynically at her. “A little, huh? I’ve heard that song before.”
“Okay. Maybe a lot late.” When he didn’t respond, she said, “Hey, this is what we both signed up for, isn’t it?”
He nodded. “Not to worry. Just take care of yourself, Kate.”
“I’ll call you later, babe.”
11
KATE SPENT THE REST of that afternoon and evening with Maddie Ward, who turned out to be fourteen, and not twelve, as Kate had assumed. Maddie came across as very childlike for a fourteen-year-old, which alarmed Kate and sent up a red flag. Delayed puberty was fairly common, with plenty of causes: genetic, hormonal, environmental. Sometimes a child’s growth spurts occurred on the outer edges of her teenage years, but Maddie was small for her age, without any of the precociousness of a typical teenager; she hadn’t even begun menstruating, and her immaturity could be a symptom of serious abuse.
They’d taken away Maddie’s pink blouse and jeans, her backpack and goose down jacket, and now she wore the pajamas her mother had dropped off in the rumpled grocery bag, along with a pair of grippy hospital socks from her “welcome” bag. The nurses let her choose the color, and Maddie had picked bubblegum pink.
She sat in an adult-sized wheelchair, looking orphaned, while various hospital personnel came and went, wheeling her from one department to another, monitoring her vitals, scanning her insides and running a bunch of tests to see if there was anything physically wrong with her.
Once in a while, Kate would step out into the hallway and try reaching the Wards on their landline, but they weren’t picking up. They must’ve unplugged their answering machine, too, because she couldn’t even leave a message.
The hospital’s forensic psychiatrist photographed all the scars and scabs on Maddie’s body and went away to make a professional assessment, while Kate called up the electronic medical records on her laptop and read through the doctors’ notes and diagnoses in order to piece together a medical history—childhood illnesses, physical injuries, drug interactions. She was looking for a pattern of abuse and neglect.
She didn’t find much. There was a broken finger at age five, when Maddie “accidentally” caught her hand in a car door. There were two fractured ribs and a concussion at age eight, when she “fell out of a tree” in her backyard. There were minor sprains and injuries at school, but no history of cigarette burns or choke marks, no signs of malnutrition. The most troubling aspect for Kate was the lack of regular doctor’s visits, just a handful of emergency room visits and a string of psychiatric consultations. This wouldn’t have been unusual if the parents didn’t have health insurance, but the Wards were adequately covered. Most parents rushed their kids to the doctor at the first signs of a sniffle. Not the Wards. That alone was highly suspicious. Maddie was generally healthy, but she was definitely not okay.
After a hearty meal in the cafeteria, Kate’s patient was looking better. Her eyes were clear. Her cheeks were rosy. She’d perked up a little. Kate wheeled her over to Radiology to have X-rays taken of her bones, since any fractures, fresh or healed over, could provide evidence of abuse in the home. Abused children had a tendency to protect their parents—sometimes out of love, sometimes out of fear.
In between each intrusive medical procedure, Kate plied her patient with questions in order to get past her built-in apprehension. While they waited for the X-ray tech to arrive, Kate said, “I had a favorite tree I used to climb in our backyard. This huge old oak. I’d always climb as high as I could, because… from way up there, life didn’t seem as daunting.”
Maddie smiled. “I fell out of a tree once. It really hurt.”
Kate nodded. Such a childlike way of speaking.
“I had to go to the emergency room.”
“When was this?”
“I was eight. I hit a branch on the way down and broke my ribs.”
Kate winced. “Ouch.”
“I had to stay in the hospital overnight.”
“Do you know why you’re in the hospital now?”
Maddie shrugged. “Because I’m sick in the head?”
“We’re trying to figure out what’s going on.” Kate reached for the girl’s forehead to brush away a few stray hairs, and Maddie flinched. That flinch told her a lot. “Sorry. I didn’t mean to startle you.”
“You didn’t,” she said defensively, playing with her ponytail.
“What does your father do, Maddie?”
“He drives a truck. He’s gone a lot.”
Maddie’s demeanor was that of a ten-year-old, both emotionally and mentally, and Kate was deeply concerned. “But he’s home now, right?” she asked.
“Not for a few more days.”
“Oh. Really?” Nelly had told her that Mr. Ward was resting at home. “Are you sure about that?”
Maddie nodded.
Kate decided to drop it for now. “So it’s just you and your mom and dad at home? Any brothers or sisters?”
“Nope. Just me.”
“Do you have any pets? A dog maybe?”
She shook her head. “We had a hamster at school once.”
“Yeah?” Kate smiled. “I had a hamster. I called him Felipe.”
Maddie giggled. “Ours was called Snark.”
“Snark the Snarky School Hamster?”
Maddie had a ticklish laugh.
“Did you ever wish you had any brothers or sisters?”
“Uh huh. But Mommy says I’m a handful.”
“I see.”
Mommy? Most fourteen-year-olds called their parents Mom and Dad.
“My best friend has two brothers and three sisters.”
“Wow, that’s a full house. Who’s your best friend?”
“Melissa.”
“What’s the one thing you like most about Melissa?”
Maddie thought for a moment. “Her family.”