The Midlake Center was a short drive from where I used to live, just off the Gorham Road. It stood in a tree-shrouded lot, and looked like any other anonymous office building. It could have housed a lawyer’s office or a Realtor’s. Instead, it was a place for children who had suffered abuse or neglect, or who had made such allegations, or who were having those claims made on their behalf by others. Inside the main door was a waiting area painted in bright yellow and orange, with books for children of various ages lying on tables, and a play area in one corner, trucks and dolls and packets of Crayolas lying on its foam matting. There was also a rack of information leaflets on the wall, slightly higher than a child could reach, containing contact details for the local Sexual Assault Response Team and various social services. The secretary behind the desk took my name and made a call. A minute or two later, a small, spry man with white hair and a neatly trimmed beard appeared at the door connecting the reception area to the clinic. He was probably in his early fifties, and dressed in chinos and an open-collared shirt. His handshake was firm, but he seemed a little cautious. He led me to his office, which was furnished in yellow pine and dominated by shelves of books and reports. I thanked him for seeing me at such short notice, and he shrugged.
“Curiosity,” he said. “It’s a long time since anyone has mentioned Daniel Clay to me, at least outside this branch of the medical community.” He leaned forward in his chair. “Just so we’re clear, I’ll be straight with you if you’re straight with me. Clay and I disagreed on certain matters. I don’t think he cared much for me. I didn’t care much for him. Professionally, most people believed that his heart was in the right place, for what it’s worth, at least until the rumors began circulating, but that element needed to be balanced by objectivity, which I don’t think Daniel Clay had in sufficient quantities for his opinions to be taken seriously.”
“I heard that you’d clashed,” I said. “That’s why I’m here. His daughter hired me. Someone has been asking about her father. She’s worried.”
“So now you’re going back over the trail, trying to find out why someone should be concerned about him so many years after his disappearance?”
“Something like that.”
“Am I under suspicion?” He smiled.
“Should you be?”
“There were certainly times when I would cheerfully have strangled him. He had a way of getting under my skin, both personally and professionally.”
“Would you care to explain?”
“Well, I guess to understand him, and what happened prior to his disappearance, you need to know something about what we do here. We perform medical examinations and psychological evaluations in cases where there are allegations of abuse of children, whether that abuse is physical or sexual, emotional or the result of neglect. A call comes through to Central Intake in Augusta. It’s referred to a supervisor, screened, then a decision is made on whether or not to send out a social worker. Sometimes that call may have originated with local law enforcement, or Child Protection Services. It may have come from a school, a parent, a neighbor, even from the child in question. The child is then referred to us for evaluation. We’re the main provider for this service in the state. When Daniel Clay first started performing evaluations, we were still finding our feet a little. Hell, everyone was. Now, things are a little better organized. We can do everything in this one building: examination, evaluation, initial counseling, interviewing of the child and the alleged perpetrator. It can all be handled here.”
“And before the center opened?”
“The child might have been examined by a doctor, then sent elsewhere for an interview and evaluation.”
“Which is where Clay came in.”
“Yes, but, again, I don’t think Daniel Clay was careful enough. It’s a delicate business, what we do, and there are no easy answers. Everyone wants a definite ‘yes’ or ‘no’—the prosecutors, the judges, obviously the people directly involved, like the parents or guardians—and they’re disappointed when we can’t always give it.”
“I’m not sure that I understand,” I said. “Isn’t that why you’re here?”
Christian sat forward in his chair and opened his hands. They were very clean, the nails cut so short that I could see the soft, pale flesh at the fingertips.
“Look, we deal with eight to nine hundred children every year. In terms of sexual abuse, maybe five percent of those children will have positive physical findings, say small tears in the hymen or rectum. Many of those kids will be teenagers, and even if there are indications of sexual activity, it can be hard to tell if it was consensual or not. A lot of adolescent females can even be penetrated and still have a normal exam that reveals an unbroken hymen. If we do establish nonconsensual sex, then we often can’t tell who did it, or when. All we can say is that sexual contact did occur. Even in a very young child, there may be little or no evidence, especially taking into account the normal anatomical variations that may occur in children’s bodies. Physical findings that used to be considered abnormal have now come to be regarded as nonspecific. The only surefire way to establish sexual abuse is to test for STDs, but that assumes that the perpetrator was infected. If the test is positive, then abuse is a done deal, but even then, you’re no closer to establishing who did it, not unless you have DNA marking. If the perpetrator wasn’t infected with an STD, then you have nothing.”
“But what about the child’s behavior. Wouldn’t that change after abuse?”
“The effects vary, and there are no specific behavioral indicators to suggest abuse. We may see anxiety, difficulty sleeping, sometimes night terrors, where the child wakes up screaming, inconsolable, yet will have no memory of the event in the morning. There may be nail biting, the pulling out of hair, refusal to go to school, an insistence on sleeping with a trusted parent. Boys will tend to act out, becoming more aggressive, while girls will tend to act in, becoming withdrawn and depressed. But those types of behavior may also occur if, say, the parents are going through a divorce and the child is becoming stressed. By themselves, they don’t offer proof one way or the other of abuse. At least a third of abused children will have no symptoms whatsoever.”
I took off my jacket, then continued making notes. Christian smiled. “More complicated than you thought, isn’t it?”
“A little.”
“That’s why the evaluation process and the interview technique employed for it are so important. The professional can’t lead the child, which is what I believe Clay did in a number of cases.”
“Like the Muller case?”
Christian nodded. “The Muller case should be offered as a textbook example of all the things that can go wrong during the investigation of alleged child abuse: a child being manipulated by a parent, a professional who sets aside his objectivity as part of some misguided crusading impulse, a judge who prefers black-and-white to shades of gray. There are those who believe that the vast majority of sexual abuse allegations that arise during custody disputes in divorce cases are fabricated. There’s even a term for the child’s behavior in such disputes: Parental Alienation Syndrome, where a child identifies with one parent and in so doing alienates the other. The negative behavior toward the alienated parent is a reflection of the alienating parent’s own feelings and perceptions, not the child’s. It’s a theory, and not everyone accepts it, but looking back at the Muller case, it should have been clear to Clay that the mother was hostile and, had he asked more questions about her own medical background, he would have discovered that there were indications of personality disorder. Instead, he sided with her and appeared to accept the child’s version of events unquestioningly. The whole affair was a disaster for everyone concerned, and damaged the standing of those who work in the field. Worst of all, though, a man lost not only his family, but his life.”
Christian realized how tense he had become. He stretched, and said: “Sorry, I got us kind of sidetracked there.”
“Not at all,” I said. “I asked you about the Mullers. You were talking about interview techniques.”
“Well, it’s pretty simple, in one way. You can’t ask questions like ‘Has something bad happened to you?’ or ‘Did X touch you somewhere special or somewhere private?’ That’s particularly the case when you’re dealing with very young children. They may try to please the evaluator with the right answer just so they can leave. We also have instances of what’s called ‘source misattribution,’ where a kid may have heard something and applied it to himself, perhaps as a way of seeking attention. Sometimes, you may get a good disclosure from a younger child initially but find that the child then recants under pressure from, say, family members. It happens also with teenagers, where Mom has a new boyfriend who starts abusing the daughter but Mom doesn’t want to believe it because she doesn’t want to lose the guy who’s supporting her and would rather blame the child for telling lies. Teenagers in general bring with them their own challenges. They may lie about abuse for gain, but generally they’re pretty resistant to suggestion. The problem with them is that, if they have been abused, it can take a couple of sessions just to get the details from them. They won’t want to talk about it, maybe out of guilt or shame, and the very last thing they’ll want to discuss with a stranger is oral or anal abuse.
“So the evaluation has to be conducted with all of these elements borne in mind. My position is that I don’t believe anybody: I only believe the data. That’s what I present to the police, to the prosecutors, and to the judges if the case gets to court. And you know what? They get frustrated with me. Like I said, they want definite answers, but a lot of the time we can’t give them those answers.