Dante's Poison (30 page)

I tossed and turned most of that night, haunted by fantastic dreams. I was in a cavernous place lit by green light, surrounded by mountains of trash. Mike was there, cooking a rat on an open grate. He offered me a chunk on the tip of his knife, the gold in his chipped tooth gleaming. But I couldn't stay for dinner. I was already late for my appointment with Melissa. Then I was walking through endless tunnels limned with mold and dripping wet. I needed my cane, but it was back in my room. In the distance a single light burned, and I hurried toward it, finally becoming aware of the footsteps at my back. I quickened my pace, but the footsteps kept gaining. I reeled and turned to find the Red Queen leering at me with wide, toothless lips. Remember, she said, what the dormouse mouse said. Then her guards were upon me, and I was falling, falling . . .

I woke to find myself half out of bed in a tangle of sheets and breathing like an ultra-marathoner. I untwisted myself and got up, feeling forward with my toes. I went to the kitchen and poured myself another shot of bourbon, downing it in a single gulp and waiting for my pulse to subside before returning to bed.

When I woke again it was late morning and pale sunlight was streaming through the window, the storm having finally taken itself off. In the bathroom I splashed water on my face and peered at my ghostlike reflection in the mirror. I went to the kitchen and put on a pot of tea and drank a big glass of water to ease the hangover. I took another pill and switched on the television, idly registering the white noise while I went back over the events since the previous Sunday. The attack on Hallie and me. The bizarre note left for me in reception. Jane's challenge—or was it?—to find out something she knew and wouldn't tell me. My trip with Bjorn to confront Gallagher's nephew and the discovery of the other note. My certainty, although I had nothing to prove it, that the thread running through it all was Atria and whatever had both terrified its employees into silence and come close to getting me arrested.

The exercise left me thoroughly depressed. I'd spent almost a week tracking down clues and was still no closer to understanding how or why Gallagher had died than when I'd started, all the while neglecting what should have been my first and only responsibility.

I'd long been aware of my tendency to wall myself off from others. Maybe it was a consequence of growing up the only child of a widowed, overbearing father. Maybe it was knowing that I never had—or ever would—live up to his impossible expectations. I'd stayed away from Louis for three long years, telling myself he was better off without me. Was I about to make the same mistake with Hallie? All my activity of the past week, senseless as it now appeared, was just a way of avoiding the dismal truth of my failure to protect her. I could pretend all I liked that it was about bringing her assailant to justice, but in reality I was simply running—from fear, from shame, from my own damnable helplessness. It was time to stop. Let Bjorn—or Jane, if she ever decided to lift a finger in her own defense—figure it all out.

I spent the rest of the morning getting myself cleaned up and making plans: to make my long-overdue appearance at the hospital, to get a head start on the week's work, to see if Richard had made any headway about Mike. I had just picked up my phone to confirm the ICU's visiting hours when it began ringing of its own accord. It was Annie, calling to tell me that Louis was ill.

My blood pressure shot up like a Saturn V. “Does he have a fever? Have you taken him to the doctor?” I demanded in a cold sweat.

Annie let the irony of my asking sink in for a moment before replying. “My father came over early this morning. He'll be staying until Louis is better.”

Which meant I wouldn't be Skyping with my son that day. My ex-father-in-law, Roger, despised me with a vitriol that exceeded even Annie's. So far, she and I had concealed from him the deviation from our custody agreement that enabled periodic contact with my son. It carried the bonus of not filling Roger in on what had happened to me since I'd left his employ. As far as Roger knew, I was still the same careless playboy who'd put his grandson in a grave, not the shambling mess I'd become. All things considered, I preferred to keep it that way.

“That's good, Annie,” I said hoarsely. “What does your father think it is?”

“Just a bad cold. But we won't be taking any chances,” she said, making no effort to keep the bile out of her tone. It sent a hot poker into my gut.

“Uh-huh.” I fished about lamely for something to keep the conversation going. “What's Louis doing now?”

“Sleeping. He was up most of the night, but he's resting quietly at the moment. He was asking about you.”

“While your father was there?” I said, panicking again.

“No, but that's another reason for my call.” She lowered her voice. “I think we should tell him about our arrangement. I'm not comfortable with all the secrecy, and it's only a matter of time before Louis lets on he knows you.”

“Won't your father try to shut it down?” It was what I feared more than anything else.

“Probably,” Annie said, with a hard practicality that was new to her. “But I'm Louis's mother. And not such a daddy's girl anymore. That's one small thing you did for me. God knows I don't want you around us any more than he does, but we have to do what's best for Louis. I'd like you to come out to Greenwich as soon as you can. Then the three of us will sit down, reach some kind of understanding.”

I was already imagining the scene: me entering with my cane, Roger wordlessly gloating, Annie off to the side with a brittle twist to her mouth. It sounded like being the butt of every joke in a full season of the
Three Stooges
. I swallowed hard and said, “I'll do whatever it takes to be a father to my son.”

“Well, we'll see about that.”

After she hung up, I abandoned the idea of accomplishing anything productive that day. My thoughts would all be with Louis in his sickbed. And with his brother, in whatever place babies went when their tiny, vulnerable hearts stopped beating. I said a fervent prayer for them both and wondered how anyone could put their trust in a deity that treated its creations so carelessly. If I were running the cosmos, there would be no sick children and especially no dead ones. Even mental illness wasn't reserved for the old. Hell, I knew of kids as young as ten being treated for serious depression . . .

And that's when the first piece clicked into place.

“Explain this to me again,” Bjorn was saying. “Shrinks can prescribe any drug they want, but the drug companies have to pretend they're not selling it to them? Sounds a little schizophrenic, if you'll excuse the pun.”

We were again in my office, where I was taking the first steps toward a radical housecleaning, aided by Yelena, whose sunny mood was still holding, though she steadfastly refused to say why. I began to suspect that she had her sights on a more hospitable job placement—though it was hard to conceive of another institution that would pay her an hourly wage just for keeping up with the latest issue of
Glamour
—and was softening me up for a letter of recommendation. She tramped out of the office with another box of paper I'd decided I could live without while I continued with my explanation.

“It goes back to what I was telling you earlier. Compared to most other medical specialties, psychiatry is still almost as primitive as when doctors were leeching their patients. We know when people are suffering, and we can divide them into diagnostic categories based on their symptoms, but the brain is so complicated and difficult to study, we rarely know what's causing the underlying problem. Genes appear to play a part, but that doesn't explain why two people with the same genealogy can have radically different outcomes—for example, when one identical twin develops schizophrenia and the other doesn't.”

“So you're basically in the dark when deciding what to do.”

“That's right. Take antidepressants, for example. We know that they've been remarkably successful in reducing rates of depression and anxiety, and that they work by altering levels of neurotransmitters, the chemicals that cause brain cells to fire. The most common antidepressants are called SSRIs—or ‘selective serotonin reuptake inhibitors'—because they disable the function in the brain that reabsorbs the neurotransmitter serotonin, thereby maintaining a bigger supply. What we don't have is any explanation for why SSRIs work. Study after study has attempted to link depression to a serotonin deficiency without turning up a shred of proof that it or some other chemical imbalance is at the root of the problem. Same with other illnesses like schizophrenia. It's clear that we're looking at a biological cause for most of these problems, but we're still light-years away from understanding what it might be.”

“So how
do
you choose one drug over another?” Bjorn asked.

“Don't quote me on this, but it's mostly trial and error,” I said. “Oh, sure, there are studies showing that some drugs work better than others—most of which, by the way, are paid for by the drug companies themselves—but they're just as often contradicted by different studies. Some drugs do seem to have fewer side effects, either alone or taken in combination with other medicines, which can be an important reason to choose them. But getting back to my depression example, when it comes to picking which drug to prescribe to the average patient, it's about as scientific as throwing darts. You try something and see if the patient improves. If they don't, you try something else. Which is where the antipsychotics, particularly the second-generation ones like Lucitrol, come into play.”

“How? Aren't they only supposed to be for the real nutters?”

“In theory, yes, at least insofar as they were originally approved by the FDA. But the number of people with schizophrenia or bipolar disease is miniscule compared to the adult population with everyday problems like anxiety, insomnia, and eating disorders—not to mention adolescents presenting with those issues. The drug companies quickly figured out that their profits from a drug like Lucitrol would increase dramatically if doctors could be persuaded they were effective for a much larger group. Since the FDA prohibits marketing for non-approved or ‘off-label' uses—including, most notably, children—their dilemma was getting the word out to psychiatrists without getting noticed.”

“And you think that's what Atria's been doing?”

“Yes, if the documents you're holding in your hand are any indication. It's not immediately obvious and it took me a while to see it myself. But the list of ‘top' Lucitrol prescribers in the Chicago area contains at least two child psychiatrists I know of and a few others with adult practices who wouldn't be caught dead in a psychiatric ward. Couple that with the astronomic growth in the company's sales revenue, and it's obvious what Atria's been up to. In fact, I blame myself now for not having put two and two together much earlier. The figures I gave Hallie to cross-examine that detective with also show revenue from Lucitrol sales well in excess of what you'd expect if it were just being used to treat serious mental illness.”

“OK,” Bjorn said. “But if I understand what you've already told me, the medicos are free to prescribe whatever they want to whomever they want. Where does it show that Atria is egging them on?”

“That's harder to spot, but I think it's reflected in some of the charts in the back, divvying up return on investment and comparing marketing expenses to sales of specific drugs. They're spending a huge chunk of change on Lucitrol, which wouldn't be reflected in the more generalized information they're putting in their public financial statements. I'm betting they've instructed their sales staff to cover their tracks by keeping mum about the promotional efforts with doctors and that Gallagher somehow caught wind of it. If you could prove it, it would mean billions in fines and legal fees. And it might tell us why someone was hell-bent on putting Gallagher out of commission.”

Bjorn agreed. “It would also explain the cold shoulder I got from the Atria employees you put me onto. They were practically shitting their knickers when I tracked them down. I'm afraid we'll never get anything out of them.”

I'd figured as much and was pondering various ways to break the logjam. But first I wanted to confirm a suspicion.