“I don’t want them back. Ever.”
“So your mom dropped you off here this morning and then went home?”
She nodded.
“She can’t do that, Maddie. We have a policy. She can’t just leave you here. I’d like to talk to her. What’s your home number?”
Maddie rattled it off, and Kate recognized the familiar area code. “Do you live in Blunt River, New Hampshire?”
“Wilamette.”
“Wow. Right across the river. You’re a long way from home.”
Maddie shrugged.
Wilamette shared a border with Kate’s hometown, but the two municipalities were miles apart in terms of social and economic disparity. Wilamette was basically Blunt River’s ugly stepsister.
“We’re practically neighbors,” she told the girl. “I grew up in Blunt River.”
Maddie smiled.
“Wait here. I’ll be right back.” Kate left Admissions to go stand in the corridor, where the cell reception was better. She dialed Maddie’s home phone number, and a woman with a soft, crinkly voice answered.
“Hello?”
“Ms. Ward? My name is Dr. Wolfe. I’m calling from Tillmann-Stafford Hospital. You left your daughter in our care this morning, and I wanted to…”
Click.
She stared at her phone. She hit redial.
“Hello?” said the wrinkly voice.
“Sorry, we got cut off. Or did you just hang up on me?”
“What do you want?” the woman snapped.
Kate was taken aback, but it wouldn’t be the first time she’d had to deal with an uncooperative parent. “Your daughter has been sitting in our admitting room all day. Did you drop her off here this morning?”
“She’s sick. She needs help.”
“This is a psychiatric unit. Does she need to be admitted to the ER?”
“No. She’s sick in the head.”
“I’m sorry, Ms. Ward, but—”
“Please. It’s Mrs. Ward. I’m not a Ms. Okay?” She had the dry voice of a longtime smoker.
“Why didn’t you admit your daughter, Mrs. Ward? What’s going on?”
“I don’t know what to say.”
Kate had a mental picture of Mrs. Ward, similar to the women from her hometown who hadn’t been so lucky in life; who’d married badly or dropped out of school after getting pregnant, who would starve themselves just to afford another carton of smokes, but never deprive their kids. They loved their children to pieces but didn’t know how to be good mothers, hitting them in the grocery store when they wouldn’t stop screaming or whining, then daring the other shoppers to judge them. Let he who is without sin cast the first stone. Their lives were mostly out of control, because they were so rooted in their troubled pasts.
“You can’t just drop her off and go home. There are procedures to be followed. Forms to fill out. You and your husband need to come down here so that we can discuss Maddie’s situation, otherwise you’ll have to take her home. I don’t want to have to call social services, but—”
“Okay,” she interrupted. “I’ll come.”
“And your husband as well?” Kate was concerned that this woman might not be stable, and she wanted to meet them both.
“Yeah, okay.”
“Good. When are you available?”
“I can be there at four.”
“Okay. I’ll see you at four o’clock this afternoon. In the meantime, I’ll make sure Maddie has something to eat and…”
Click.
“What the hell…?” Kate stared at her phone. “What is wrong with you, lady?”
It took a moment for her to compose herself and coax the professional Kate back into broad daylight. Sometimes the parents turned out to be more psychologically damaged than Kate’s troubled patients.
Once she got back to Admissions, she found Maddie in the same position on the sofa, except now she was jabbing herself with a pencil. Gently. Absently. Stabbing the sharp end of the pencil into her thigh through her neatly pressed jeans.
Kate tried not to alarm her. “Maddie? I’ll take that now.”
The girl paused. “They aren’t coming, are they?”
Kate nodded. “They’ll be here at four.”
“No, they won’t.” She jabbed the pencil a little harder into her left thigh. There were spots of blood on her jeans.
“Maddie, please.” Kate held out her hand. “Give it to me. Now.”
The girl froze and looked at the pencil as if she didn’t know how it had gotten into her hand.
“I’ll take that.”
After a moment, she handed it over. There was blood on the tip.
Kate called Yvette over. Although the nurses seemed like formidable characters, they were great with the kids. Yvette strolled over. “What’s up, Doc?”
“We need to admit her. She’s cutting herself.” Kate held up the bloody pencil.
Yvette put on a pair of gloves and called out, “Tamara?”
A collective sigh went through the nurses nearby, though no patient would have detected it. Ah, they seemed to acknowledge in unison—we have a cutter.
Yvette leaned down, the loose flesh of her jowls moving. “You hurt yourself, sweetheart. You’re bleeding. This is a hospital. We can help.”
The child played nervously with her bangs and her long blond ponytail. She cast a deeply skeptical glance Kate’s way. She gave off a small heat, like a flushing rose.
“We need to put a Band-Aid on that and make sure it doesn’t get infected,” Yvette explained. “Okay?”
“Are they really coming?” Maddie asked Kate.
“Your mother said she’d be here at four.”
“Don’t hold your breath.”
Kate balked. It was such an adult thing to say.
Yvette held out her hand. “Will you come with me, young lady?”
Maddie scooped up her jacket and climbed down off the sofa like a condemned prisoner.
9
THERE WAS SOMETHING DISTURBINGLY truthful about the mentally ill. They had the kind of clarity that most people lacked, an ability to cut through the bullshit and say exactly what was on their mind, no matter how warped or confused. Even their delusions were layered with meaning and truth.
Exam room 4 was an amalgam of sterile disinfected surfaces and well-stocked medical supplies—tongue depressors, Q-tips, gauze bandages, surgical tape. Maddie sat on the padded table kicking her bare legs back and forth, hands placed primly over her knees to keep the paper johnny from inching up. She seemed more curious than afraid.
The harsh fluorescent lights illuminated a multitude of scars and scabs on the girl’s undernourished body. Kate counted at least fifty old injuries, along with some newer abrasions—mostly scrapes and small puncture wounds. Whether these were self-inflicted or evidence of abuse had yet to be determined.
Yvette rolled her eyes in disgust as she finished bandaging the fresh wounds. “I gave her a Children’s Tylenol for the pain. I’ll put her on one-to-one until she’s admitted.”
“If she’s admitted,” Kate corrected.
“If that child isn’t admitted by the end of the day, I’ll call social services myself.” She left in a huff.
Once they were alone, Maddie asked, “What kind of doctor are you?”
“A psychiatrist.”
“Oh.” The girl scrunched her nose.
“Why? What’s wrong?”
“I don’t like psychiatrists.”
Kate smiled. “Why not?”
Maddie shrugged. “Just don’t.”
“How many psychiatrists have you been to, Maddie?”
“Three.”
“Back in Wilamette?”
“Blunt River. At the hospital there.”
“And you didn’t like any of them?”
“The worst was Dr. Quillin. He smelled funny.”
Kate couldn’t help laughing. “Well, the truth is, us doctors are only human. Despite our white coats and fancy degrees, we all have failings. For instance, my stomach growls when I’m hungry. And I mean… it can get really loud.”
“Mine too.” Maddie giggled.
“It’s embarrassing.”
“Mine sounds like a lion.”
“Mine’s more of a ticked-off badger.”
They had a good laugh over that.
“So tell me about Dr. Quillin. Besides the funny smell.”
Maddie wrinkled her nose. “He used to call himself a ‘professional listener.’ I was supposed to do all the talking, but Mommy said, ‘I’m not paying you to listen! I’m paying you to fix her!’ So she took me to see Dr. Hoang. But he couldn’t fix me either. And neither could Dr. Madison.”