Stealing Faces (14 page)

“My second one today. Looks like I hit the jackpot. Lucky me.”

He meant it as a joke, but it hit too close to home, and nobody was laughing as Roy Shepherd walked out the door.

21

The Hawk Ridge Institute for Psychiatric Care was a large, rambling complex of brick buildings, none higher than two stories, set amid rolling greenery in the foothills of the
Pinaleno
Mountains
. Route 366 was nearby, feeding traffic into Safford, but the institute lay on a desolate back road, and its neighbors were farms and ranches and, a few miles distant, a federal prison camp.

From the road, the institute looked something like a prison itself, with its high iron fence and the guardhouse at the gate. But once inside the grounds, visitors were surprised to see flower beds, neatly tended, and sparkling fountains and birdbaths and colonnades of eucalyptus trees. The less severely afflicted patients were free to roam the property, and they could be seen here and there, some clustered in companionable groups, others solitary.

The administration building and one ward of the institute had been built in 1942. By the mid-1960s two more wards had been added, both of them L-shaped one-story structures well removed from the heart of the complex.

Then the trend of deinstitutionalizing mental patients had begun, and over the next thirty years Hawk Ridge’s population dropped by more than half. Today the institute housed one hundred and thirty-three patients, most of them considered chronic and untreatable—the hard cases who did not respond to medication. Only two of the three wards were in use; the third. Ward C, had been shut down as an economy measure. It stood in decrepit isolation, a windowless shell, one of its doors padlocked, the other bolted shut. Occasionally a staff member with a passkey slipped inside to smoke a joint or indulge some other secret vice.

Hawk Ridge was a peaceful place, and remarkably picturesque. The staid facade of the administrative center was softened by closely trimmed fir trees. Behind and above the building were the tall mountains, brownish at the lower elevations, rising to green, the details of even the highest ridgeline visible in the pellucid air.

Sometimes a hawk or, more seldom, a turkey vulture could be seen riding the high thermals, circling above a hidden gorge, and at night the cries of coyotes were heard, shrill and ghostly and unmelodic, though all too often they were drowned out by the screams.

There were screams, of course. In Ward B, known as the violent ward, where the hardest of the hard cases were kept, the screams seemed never to end. There were patients who could be prevented from screaming only by the massive application of tranquilizing drugs, and even then they would eventually learn to tolerate the medication, which would lose its effect.

Some patients would scream all the time if there were no sedatives to quiet them. Others, who cycled through stages of illness, had their lucid periods, when
 
they could be transferred to Ward A, the admitting ward. Here they were installed as temporary guests, until their precarious mental balance was upset, and they had to be drugged and restrained in a private cell.

So, nearly always, there was somebody screaming, but the staff—three psychiatrists, seven supervising nurses, two dozen therapy aides, eight security officers, three cooks, and assorted groundskeepers and maintenance personnel—had learned to pay no attention to the noise.

Only the hospital director, John Bainbridge Cray, M.D., did not ignore the screams.

He rather liked them.

This had been a hectic morning for Cray. He had arrived at his home on the hospital grounds at
 
8:45
,
 
exhausted after his long night and only moderately revived by the coffee he’d consumed during the drive from
 
Tucson
.

Quickly he showered and changed, then spent some time in his garage, taking care of a few unpleasant but necessary details.

By
 
9:20
 
he was in his office. To his secretary, Margaret, he excused his tardiness by saying he’d forgotten to set his alarm dock.

His first order of business was a conference call involving an allegation of misconduct by a therapy aide, David Wilson.
 
Wilson
 
was accused of having beaten an unruly patient, Jocelyn Beatty, who had checked into the hospital voluntarily after experiencing symptoms of manic-depressive illness.

He spent half an hour on the phone with the patient’s mother, the attorney she had retained to represent her daughter, and a case officer employed by the
 
Arizona Health Services Department. Cray informed them that David Wilson already had been placed on paid leave pending the outcome of an internal investigation. He offered to turn over
 
Wilson
’s
 
duty logs to the attorney. He promised his full cooperation. And he meant it.

Cray took any allegation of misconduct with the utmost seriousness. The patients in his care were never to be mistreated. In the performance of his duties, he adhered to the most conscientious standards of professionalism. It was a point of pride with him.

Was this an inconsistency in a man of his predilections? He supposed so. But in truth he did feel something special for his patients. The women he had killed—they were nothing, merely lab rats, experimental animals set loose to run a deadly maze. The patients at the hospital, on the other hand, were his charges, almost his children, and he would not let them be hurt.

Well, there had been one exception. One patient he had meant to harm. But he’d never had the chance.

At least, not yet.

When the phone call was done, he hosted a meeting in his office. A patient, Dennis Callaghan, was set to be discharged. Cray served coffee and pastries to Dennis and his grateful parents. The atmosphere was cheery, and the strong morning sun poured through the spotless windows like a benediction.

“We just don’t know how to thank you, Doctor,” Mrs. Callaghan said, holding tight to her son’s hand. “Dennis has been in and out of places like this for ... well, all his life. You’ve managed some sort of miracle cure.”

Her husband said the same, and Dennis mumbled an echo.

Cray accepted the compliments graciously. To be honest, he did not think that either he or his staff had contributed greatly to Dennis Callaghan’s recovery. The treatment prescribed for him had been entirely routine, not much different from the strategies employed by other hospitals throughout the patient’s history. A loading dose of
 
Haldol
 
had been administered, then tapered to a lower dose, at which point Dennis’s condition had stabilized.

Why had the pharmaceuticals worked here and now, but not before? There was no reason. More precisely, the reason was unknown, owing to the mysterious complexity of the human organism. A certain chemical would work in one instance, have no results in another, produce crippling side effects in the third, and there was no logic to it, no pattern, only the randomness of accident.

Dennis Callaghan had been cured—at least for the moment. This was enough for his parents and for Dennis himself, and it was enough for Cray. He had learned humility in this field. He had learned not to expect to understand too much.

Once the
 
Callaghans
 
were gone, Cray asked Margaret to send for Walter
 
Luntz
. “There’s an errand I need him to run,” he added quite unnecessarily

Walter
 
Luntz
 
resided in a guest room adjacent to the kitchen area, quarters intended originally for a live-in cook. But Walter was not a cook. He was a permanent resident of the Hawk Ridge Institute, a man of forty-nine who had spent the last twenty-five years of his life under psychiatric care.

His was an unusual case. He had responded quite well to pharmacological treatment in certain respects. His thought processes were fairly lucid, and he suffered from no evident delusions. Within the structured environment of the hospital, or outside it for brief forays into the larger world, he was fine.

But send him to a halfway house or ask him to fend for himself in a rented apartment—two strategies that had been tried in the early years—and he quickly
 
decompensated
, reverting to an acute psychotic state.

Cray was just as glad that Walter could not leave the institute. The man was useful here. He did clerical chores, even ran errands, driving a used Toyota
 
Tercel
 
that Cray had paid for out of hospital funds. His driving was quite good, and his license had never been revoked throughout all his years of hospitalization.

The institute was understaffed, and Cray could use all the help possible.

Today Walter would perform his greatest service.

Cray heard him coming—fast, clumsy steps—and then Walter
 
Luntz
 
appeared in the office doorway, a tall, stoop-shouldered wreck of a man, with long, ropy, simian arms and a potbelly and a conical, hairless head.

Unlike the other patients, Walter was permitted to wear street clothes. His taste in fashion was idiosyncratic at best. Today he wore khaki trousers, a turquoise-encrusted belt, and a lime-green open-collar shirt.

“Dr. Cray?” he asked hesitantly, afraid to cross the threshold without permission.

His voice was reedy and weak, a wind instrument breathlessly played.

“Yes, Walter. Come in.”

Cray shut the door after him, then ushered Walter to the couch. The door was oak, solid-core, and it ensured privacy.

Then he explained to Walter what he wanted. He explained more than once, keeping his words simple. Walter was not unintelligent, but he was naive and prone to childish misunderstandings.

The assignment Cray offered was a challenge, perhaps too great a challenge for a man whose tasks rarely required driving more than a few miles into nearby Safford for some office supplies. But curiously Cray felt sure Walter was up to it, so long as he had clear instructions and a couple of visual aids.

One of these was a photo Cray had downloaded from the Internet during a brief on-line session this morning, and the other was a slip of paper filled out with a few letters and numbers in a large, careful hand.

“Do you understand?” he asked the man who sat with him on the sofa.

Walter nodded. His head gleamed in the sun. “I can do it, Dr. Cray”

Even so, Cray reviewed the matter one last time before sending Walter
 
Luntz
 
on his way.

At
10:30
he toured the facility, opening a succession of locked doors with his passkey, checking in with the psychiatrists and supervising nurses on duty in the two active wards. He had heard of hospital directors who stayed in their offices all day, inaccessible and aloof. This was not Cray’s approach.

Anyway, he needed to keep moving. There was a restlessness in him today, a droning background hum of frustration, of fury.

He had come so close with Kaylie. Had his reflexes been a few degrees sharper, or had he simply put the canister of liquid nitrogen in the backseat, safely out of her reach ...

A hundred times he had replayed the scenario in the desert, always with himself as the victor.

God damn that woman. Still alive.

But perhaps not for long.

In Ward A, Nurse Killian reported a problem with a recently admitted patient who was not responding to a rather high dosage of
 
Haldol
.

“Let me talk to him,” Cray said. “What’s his name?”

“Roger.”

“Bring him out.”

Cray met Roger at the nurses’ station. The man was young and tall, and he had the moist, limpid eyes of a suffering artist.

“Have you been hospitalized before, Roger?” Cray asked kindly.

“Yes, sir.”

“And they gave you pills?”

“Yes.”

“Which ones?” Cray swept his hand over the metal tabletop, where he had laid out a variety of standard
 
neuroleptics
. “The red? The yellow? The green?”

“All of them.”

“Which ones worked?”

A ghostly smile lit up Roger’s pale face. “The red ones were pretty good. I got better on the red.”

“Then that’s what you need. Thank you, Roger.”

When the man was gone. Nurse Killian objected to the procedure. A patient could not be allowed to prescribe his own medication.

Dorothy Killian was a good RN, and Cray was lucky to have her, but she was new at Hawk Ridge, and she didn’t know how he did things.

“It’s been my observation,” Cray said, “that the patient, especially an experienced patient like Roger, often knows which pharmaceuticals have been most beneficial to him. Let’s take him at his word.”

He prescribed a loading dose of
 
risperidone
—the red pills—and left Nurse Killian shaking her head.