Breaking the Silence (17 page)

“Ward three,” Mrs. Love said.

“Aha!” He sounded overjoyed, a man who clearly loved his work. “You must be a highly skilled nurse, Mrs. Tolley. Joyce wouldn’t put just anyone on ward three.”

Sarah smiled at the supervisor. “Thank you for the vote of confidence,” she said.

“I put her there because she’s excited about research and she has some surgical experience.”

“Not really,” Sarah said quickly. “Not since nursing school, anyhow.” She didn’t want to find herself assisting at lobotomies.

They ignored her weak protest. “I do most of my work in ward three,” Dr. Palmiento said. “That’s where our more seriously disturbed patients are housed.”

“I’ve heard wonderful things about you and the work you’re doing.” Sarah hoped she didn’t sound quite as reverential as Joyce Love.

Palmiento nodded with a smile and rested his hand on Sarah’s shoulder. “You’re going to be a fine addition to our team,” he said.

Once back in the corridor, Mrs. Love turned to Sarah.

“Isn’t he something?” she asked.

“He seems very excited by his work,” Sarah said, still unnerved by her mixed reaction to the director. He was a doctor, not a patient, she reminded herself. A nationally recognized psychiatrist. And she should know better than to think she could diagnose anyone from the quality of their eye contact.

Her first week at Saint Margaret’s went smoothly enough. She was assigned to just two patients, women, both of whom
suffered from depression, and she found them likable. She was drawn to her patients, and she firmly believed that a positive relationship between patient and caregiver was the catalyst for healing whatever was wrong with the mind. She often talked lovingly with her patients or even held them when they needed comforting.

Toward the end of Sarah’s first week, a new patient, Karen, arrived on ward three and was assigned to her. Forty years old, mother of three children and the wife of a politician, Karen had been completely mute for the past six years. It was the first time Sarah had encountered such severe, pervasive mutism. Karen’s husband denied remembering any triggering event. One spring day, Karen had simply stopped talking, he said. To him, to their children, to the neighbors. She even stopped singing, and she had sung in the church choir for ten years.

Sarah was determined to get to the root of Karen’s problem. She spent hours with the woman, day after day, talking to her, trying gently to unearth the trauma that had led her to lose her voice. She was patient and very, very kind, hoping that Karen would one day realize she could trust her and open up to her.

Dr. P. had an entirely different approach. On the third day of Karen’s hospitalization, Sarah was talking to the mute woman when Dr. P. suddenly burst into the room.

“You hideous wench!” he shouted.

Sarah’s jaw dropped. Which of them was he talking to? Karen looked at him with her big, sad eyes.

“Your husband told me you neglected your children,” Dr. P. said, his green eyes flashing wildly. “You’re the sort of woman who should be fixed. Shouldn’t ever have been allowed to have children at all!” With that he was gone, leaving Sarah trembling and Karen’s face as blank as before.

Sarah touched Karen’s arm and stood up. “I’ll be right back,” she said, walking toward the door.

She found Dr. Palmiento outside the slumber room. It was the first time she’d spoken to him since their initial meeting in his office, and she rued that their first real contact was to be a conflict. But she was angry.

“Excuse me, Dr. Palmiento,” she said. “I don’t understand why you broke into Karen’s room that way. She’s very fragile.”

A warm smile came to his lips, and he touched her shoulder. “Are you questioning my methods?” The words were combative, but it almost sounded as if he were teasing her.

“No…I mean, yes. I think she needs support, not—”

“You handle her your way, and I’ll handle her mine,” he said, as though engaging her in friendly competition. “We’ll see which of us wins.”

For several weeks, Sarah continued to sit for an hour each day with Karen, talking to her, sometimes holding her hand. And during those same weeks, Dr. P. yelled at and berated the patient. If he spotted Karen walking down the hall, he would flood her with insults.

On one occasion, Sarah was walking toward the lounge with Karen when Dr. P. passed them in the hall. Once he was a few steps behind them, he called to them, loud enough for those in the foyer to hear. “I hope you’re taking her down to the beauty parlor, Mrs. Tolley,” he shouted. “Though I’m not sure what they’ll be able to do for her there. Better try a plastic surgeon first.”

Karen swung around, and for the first time Sarah saw life in the woman’s eyes. “Leave me alone, you goddamned son of a bitch!” she said.

Sarah stood frozen, stunned at hearing Karen’s voice. Down the hall, Dr. Palmiento laughed as he walked away.

“I believe I win that round, Mrs. Tolley,” he called over his shoulder.

Everyone loved him, and Sarah grew increasingly confused by her feelings about him. He was mercurial—warm, fatherly and immensely human one minute, clinically detached, even cruel, the next. Everyone thought he’d been very clever in getting Karen to talk. Once her silence had been broken, Karen continued to make progress, although much of her language was peppered with blasphemy and evidence of delusions. Yes, Sarah had to admit, Palmiento’s approach had worked. But at what cost? What did it do to someone’s spirit to be insulted and treated like a project instead of a human being?

The rest of the staff thought it was exciting that Dr. P. was experimenting with new drugs on his patients. “If my mother needed to be in a psychiatric hospital,” Sarah heard one of the nurses say, “I’d want her to be here so she could get the latest treatment.” But Palmiento’s experimentation made Sarah nervous. He’d inject depressed patients with something called LSD, day after day, in an attempt to “break down their walls.” The LSD scared Sarah. Patients reacted to it in unpredictable ways. They’d scream, or try to climb the walls of their rooms, literally, or they’d attempt to throw themselves through their windows. Others slept for days at a time, tossing from wild, unimaginable dreams. And Dr. P. observed it all from his clinical perspective, writing copious notes on the patients’ reactions and applying for yet another grant to fund more research into the next drug possibility.

There were other patients, some of them Sarah’s, on whom he performed electroshock treatments. Sarah, herself, had suggested it for one patient who was so depressed she tried to hang herself from a doorknob with her underpants. But at the time, Sarah had not known about Dr. P.’s experimental approach to ECT. He used 150 volts several times a day instead of the usual 110 volts every few days. Instead of one shock, he would fire off eight or more of them, right through the patient’s convul
sions. The patients no longer knew where they were or even who they were. Then Dr. P. would combine that treatment with his unique brand of drug therapy. He was after “extreme confusion,” he explained. His approach would wipe clean the slate of the patients’ old maladaptive ways of thinking and behaving. Then he and the staff could teach them healthier ways to live. The theory was sound enough, yet it seemed to Sarah that few patients were actually getting well.

She finally went to Mrs. Love with her concerns.

Mrs. Love smiled at her, condescension in her expression. “Dr. P. is way ahead of his time,” she said. “You’re a smart woman, Sarah. You know people tend to laugh at geniuses. Or berate them. Look at Einstein. People thought he was retarded. And Copernicus. They thought he was crazy.”

“I’m concerned that his methods might be making some of the patients worse rather than better,” Sarah said.

“You haven’t been here long enough to see the real progress yet,” Mrs. Love said. “You must keep the big picture in mind. The things we’ll learn from Dr. P’s treatments here at Saint Margaret’s will one day be applied to other patients in other hospitals in the future. You’ll see.”

“I’ve just…it’s so different from what I was used to at Mercy,” Sarah said.

The condescending smile again. “I don’t want to say anything negative about Mercy,” Mrs. Love said. “It’s a fine hospital. But the truth is, their approach to mental illness is rather antiquated. Don’t stand in the path of progress, Sarah.”

She wondered if Joyce Love might be right. Everyone seemed so enamored of Dr. P., so respectful of the “important work” he was doing. Was she the type of person who would have laughed at Copernicus? She would have to keep a more open mind.

T
HE DARK, EARLY MORNING AIR HAD A CHILL TO IT, DESPITE
the fact that it was the middle of August, and Laura opened the car windows as she drove toward the wine country.

“Doesn’t it feel wonderful to be up this early?” she asked Emma, who was strapped into the back seat behind her.

Emma had frowned when Laura told her they were going to visit Dylan, and it must have seemed odd to her that they were getting up in the dark to do so. But she nearly leapt out of her bed when Laura told her they would watch him fly his balloon. “He flies it very early in the morning so he and his passengers can watch the sunrise,” she’d added, suddenly realizing that the hot air balloon might be the key to Emma’s heart.

The day before, she and Emma had taken an early morning drive in the opposite direction, into Maryland. Laura needed to see Saint Margaret’s, the spooky, old mental hospital Sarah had described so vividly. Saint Margaret’s, she discovered, no longer existed. At least not as a hospital. It was now a boarding school, but viewing it from the street, she had to admit it still had that house-of-horrors appearance, and she could imagine the jokes the students who lived there made about it.

She’d wanted to see the inside. The high-ceilinged foyer, at
least. Parking the car in the circular driveway, she and Emma walked up to the foreboding double doors. Inside, she found the foyer much as Sarah had described it, except that the light from the skylights was milky and indistinct. And rather than nurses and doctors, girls in navy blue uniforms roamed the diamond-patterned floor.

“Can I help you?” a young woman asked as she approached her and Emma.

Laura smiled at her. “I just wanted to see the foyer,” she said, even though she would have loved to see the rest of the building, as well. Did students now live in the slumber room? But the expression on the young woman’s face told her she didn’t have a snowball’s chance in hell of getting past the foyer unless she could come up with a better reason for being there.

Holding Emma’s hand, Laura walked back outside and into the hazy sunlight. She’d been a little crazy to drive all the way out here just to see this building. Ray had been right. She was becoming obsessed with Sarah Tolley, just as she had with every other project in her life.

Two deer stood in the darkness at the edge of Dylan’s driveway.

“Look, Emma!” She stopped the car on the side of the road and pointed toward the deer. “A mother and a baby.”

Emma pressed her face against the car window, but it was too dark for Laura to see her expression. Emma used to know that a baby deer was called a fawn. Was that word going through her mind right now? Laura felt a sudden, near-tears sort of exasperation.
Talk to me, Emma
, she wanted to say.
Tell me what you’re thinking
.

She drove down the long driveway, the woods surrounding them in darkness. There were two vans in front of the garage this morning, and she parked to the side, trying not to block
anyone in. Getting out of the car, she spotted several dark figures standing in the center of the field.

Taking Emma’s hand, they walked toward the activity. Laura felt her daughter’s mounting resistance in her lagging step and the tight grip of her fingers. She was probably a bit spooked by the darkness.

“Those people are working on the balloon.” Laura pointed toward the center of the field. The crew was bustling around the huge balloon, which still lay on the ground as it filled with cold air from the fan. The sky was lightening quickly, and by the time she and Emma reached the balloon, Laura could see that Dylan was working on the burner. She thought of pointing him out to Emma, but decided against it, remembering Emma’s frown from earlier that morning.

Dylan glanced up from his task, and Laura waved. He said something to Alex, who was working next to him, and walked toward her and Emma.

“Hey,” he said as he neared them. “Two of my favorite ladies.” He gave Laura that smile that made her remember exactly why and how her daughter had been conceived, then knelt down in front of Emma. He was wearing his blue jumpsuit again and heavy work gloves. “Did you come to watch the balloon go up?” he asked.

Emma sidled halfway behind Laura.

“Can you explain a little of what you’re doing?” Laura asked him.

“Sure.” He stood up again. “First we’re filling the envelope—the balloon—with cold air, and after it’s partway filled, we’ll heat the air. Remember I told you about hot air making the balloon rise, Emma?”

Laura wasn’t certain if Emma nodded or not.

“The way I do that is with a very big flame. So when you see the flame, you don’t need to be afraid. It’s supposed to be there.”

Dylan’s gaze was drawn to something behind them, and Laura turned to see a man and woman walking across the field from the driveway.

“Excuse me,” Dylan said, and he started toward the couple.

He spoke to them for a few minutes, then returned to the balloon, and the man and woman came to stand near her and Emma. They looked as though they might be close to seventy, and they wore anticipatory smiles.

“You must be the passengers for this morning,” Laura said to them.

“Yes,” said the man.

“I don’t know how I let him talk me into this,” said the woman, laughing.

“It’s our fiftieth anniversary,” the man said. “And this is something I’ve always wanted to do, so she gave it to me as a present.”

“Congratulations,” Laura said, thinking of her sham birthday flight. “What a wonderful way this will be to celebrate.”

“Have you ever been up in one of those things?” the woman asked, clearly hunting for reassurance.

“Yes,” Laura said, and Emma looked up at her in sharp surprise. “I have, honey,” she said to Emma. “I went up with Dylan a few weeks ago.” To the woman she said, “It’s breathtaking. You’re going to love it.”

“You must be friends of the pilot, then,” the man said. “Of Dylan Geer’s.”

“That’s right. I’m Laura, and this is Emma.”

The man turned his attention to Emma. “What a pretty name,” he said to her. “How old are you, Emma?”

Emma pressed her face against Laura’s hip.

“She’s shy,” Laura said. She hated calling Emma “shy” but didn’t know what else to say. Coping with a mute child wasn’t in the parenting books. Still, she was afraid that by labeling her shy, Emma would begin to think of herself that way. Well, it was becoming the truth, wasn’t it? But it was the last word Laura would have used to describe her in the past.

Emma suddenly gasped, and Laura looked at the balloon. Dylan was standing in front of its large, round opening and had lit the flame.

“Watch now,” she said to Emma. “He’s heating the air and the balloon will slowly rise up.”

Dylan was silhouetted in the circle of light from the balloon opening. The muscles in his arms were cut by the light from the fire behind him, and Laura wondered if she could possibly be feeling the heat from the flame from where she stood. She was reminded for a moment of Sarah, staring at the paintings of nudes in the restaurant, growing hotter by the minute, and she stifled a laugh.

He’s Emma’s father
, she told herself, unnerved by the sudden visceral attraction.
That’s all you need him to be
.

As the colorful fabric began to rise above the basket, Emma slowly moved apart from Laura and closer to the balloon. Laura thought of calling her back but didn’t dare squelch this small act of independence as long as Emma was not in the way. Emma stopped a safe distance from the balloon, and there she stood, small hands knotted behind her back, and although Laura could not see her face, she was certain the little girl’s eyes were wide with wonder. She was so tiny. Her hair was in a ponytail, and her neck looked thin and fragile. Laura finally stole her gaze from her daughter to watch the balloon herself, trying to imagine how magical it would look through Emma’s eyes.

She and Emma watched as the man and woman climbed into the basket. The woman giggled like a schoolgirl, making Laura smile. She reminded Laura of Sarah. Why, though, had fate allowed this woman a husband, a fiftieth anniversary and the means to climb into a balloon and sail into the air, while Sarah was left alone with her fading mind in the retirement home? Laura was surprised by the quick rise of tears, and she blinked them back. Maybe she could visit Sarah more than once a week.

“See you in about an hour,” Dylan called to them from the basket. “I’ll make you and Emma breakfast. Bye, Emma.” He waved.

He was good about this, she thought. For a guy who knew nothing about children, he remembered that Emma was there, and he spoke to her even though she would not speak back.

They watched the balloon rise into the air. Alex got into his truck, which was parked in the field, and Brian walked with Laura and Emma back toward the driveway.

“Dylan said for you two to follow me in your car while we chase the balloon,” Brian said to Laura. “Keep a close eye on me, though. You never know when we’re going to have to turn and go in another direction. You know, like if someone gets sick or something.” He grinned at her, and she guessed that he knew the true nature of her birthday ride deceit.

“Okay,” she said with a smile.

She buckled Emma into the back seat of her car, then followed Brian’s van down the driveway to begin the chase.

Alex and Brian were waiting for him. Dylan saw them as he guided the balloon toward one of his favorite landing sites—an empty pasture belonging to a balloon-friendly farmer—but it wasn’t his crew he was looking for.

“Is it going to bounce when we land?” his female passenger asked him.

“Nope,” Dylan said. “This is going to be one smooth landing.”

The woman had relaxed once they were in the air, enjoying the ride with her husband, but she’d become unnerved again as he began the descent and they swept over the tops of the trees.

Searching the pasture, he finally spotted Laura and Emma walking toward his crew, and he felt relief at seeing them there. Relief and trepidation. He wanted to help that little girl, and he didn’t know how. There’d been wonder in her eyes earlier when he was readying the balloon, and he wished he could tap into that wonder somehow. Free her up enough to talk. Usually, children who were around when he was inflating the balloon were filled with questions and curiosity. They’d try to get too close, the questions spilling from them as they inched nearer. Why doesn’t the balloon catch fire? How do you steer? He’d seen those questions burning inside Emma. It had to be the worst thing in the world to be filled with questions and unable to get them out.

He was in over his head with this child, but he was in for good.

Once Dylan had helped his passengers out of the basket, he worked with the crew to dismantle the balloon. Then he sent the elderly couple back to his house in Brian’s van to pick up their car, while he rode with Laura and Emma.

The moment Emma stepped inside his cabin, she ran over to the aquarium in the wall of the living room, instantly attracted to the colorful, exotic fish. Dylan stood next to her, as close as she would allow, and told her about each type. Emma’s hands were linked behind her back, her head raised to see the fish, and her eyes reflected the colors in the tank.
She had her mother’s long, smoky eyelashes and a small, perfect nose. One strand of dark hair had come loose from her ponytail, and he longed to slip it behind her ear, but of course, he didn’t dare. He settled for standing there, engaged in a monologue, a tightness in his chest that had something to do with his feelings for this little girl.

They ate fruit salad and toasted bagels for breakfast. Laura asked the sort of questions about the balloon that a child might ask, and he knew she was asking them for her daughter. Answering them in basic terms, Dylan shifted his gaze between his two guests, and although Emma appeared intent on her food, he knew she was listening.

Laura helped him with the dishes after breakfast, not uttering a word about the fact that he had no dishwasher, while Emma wandered back into the living room.

“She loves those fish,” Laura said as she dried a plate.

“Has she ever had one?” Dylan asked. “A fish for a pet?”

“No. Just a guinea pig named Michael, who is no longer with us.”

“What do you think about me getting her an aquarium?” He rinsed a soapy glass under the tap, already thinking about the types of fish he could put in it.

“It’s a great idea,” Laura said.

Dylan looked out the window as Alex pulled in the driveway, the balloon neatly folded in the back of his truck. He watched as Alex turned onto the dirt road leading to the barn.

Laura followed his gaze through the window. “He and Brian really seem to know what they’re doing,” she said.

“Oh, yeah.” Dylan handed her another glass. “They’re great. Alex is working on getting his license, though, so I’ll lose him eventually. He’s going on a cruise next week with his girlfriend to get me used to him being gone, or so he says.”

Laura suddenly stopped drying the glass. She looked at him with a surprised expression on her face. “That’s it!” she said.

“What’s it?”

“You know Sarah? The woman I visit in the retirement home?”

“Your father’s friend.” Dylan nodded.