Chapter One

1999, September 16, Thursday
Our Lady of Lourdes Hospital
Camden, NJ

 Noon. John Samuel Weston lay on his back, motionless, eyes closed as self-awareness slowly replaced the fog of troubled sleep. Images and echoes of a bad dream faded to join the crushed remnants of discarded memories buried deep inside his mind. Nearby, a low, mechanical hum muffled the more reassuring sounds of human activity farther off.

Open your eyes, John! commanded a voice from within.

Reluctantly, John obeyed, forcing his lids apart, slowly, painfully dragging the sandy remnants of sleep across his eyeballs. Mind and eyes now connected, he found himself staring blankly at the bare, white tile ceiling above, and for a fleeting moment he was lying in his own bed, back in his home in Haddonfield, New Jersey. His eyes scanned slowly, left to right and back again, surveying the full extent of this small room: bare white walls melting seamlessly into ceiling, filling the room with the brilliance of the noonday sun. This was not his home, and this was not Haddonfield.

Reacting to a lingering ache in his wrists, John lifted his hands to his face, rotating them for a thorough inspection. He tried massaging away the burning soreness of the red, banded indentations left by the leather restraining straps, which he now recalled as only part of a bad dream. Feeling a similar ache in his ankles, he lifted the sheets and looked down: no problem there. He was now free to move about.

To his left, a soft summer breeze tossed the window curtains lazily aside from the only window in the room: a tall, double-hung sash with a heavy metal grill cage mounted to the outside, similar to what you might find in an inner city high school. He identified the source of the mechanical hum as coming from the AC unit located just below the window.

John flinched as the door to his room suddenly burst open. Entering was a thirty something, medium-sized man sporting a tweed jacket with patched elbows and a mismatched tie, clipboard in hand. Dr. Aldus Caldwell’s stocky build seemed more suited to rugby than psychiatry; thick, straight shocks of blond hair covered his ears, and his mouth was buried under a bushy Roosevelt-style mustache in need of a good trim.

Dragging a metal classroom chair away from the wall in one quick, continuous motion, Dr. Caldwell flipped it around and sat down, straddling it like a barstool, his arms folded across the back of the chair, clipboard dangling from his left hand. Like the screech of a subway train, the mostly empty room reverberated with the sound of metal against hard tile floor.

John was fully awake now.

“Good morning, John. Welcome back to the land of the living,” barked Caldwell, with the bedside manner of a high school football coach. “How are we feeling today?”

Today? What day is today?

Dr. Caldwell gave him a moment to get his thoughts together. “Do you know where you are, John?”

John glanced at the name tag on Dr. Caldwell’s jacket. “Our Lady of Lourdes Hospital?” he offered.

Looking down at his own name tag, a dead giveaway, Dr. Caldwell smiled knowingly. “Very good, John.”

John knew Lourdes, of course, a familiar South Jersey landmark rising ten stories above the streets of east Camden, a multitiered, orange, brick structure, like a large wedding cake, with “Our Lady of Lourdes,” the very bride of God, set high atop its crowning pedestal in gleaming white marble. With head bowed, hands clasped in prayer, she stood as a beacon of hope to all who passed through her doors. And John knew he could use a little prayer right about now.

John massaged his left wrist with his right hand and directed his eyes toward the caged window. “And more specifically,” he continued slowly, testing his hypothesis, “I would say we are in the psych ward of your hospital.”

“Astute observation, John. I’m glad to see that your presence of mind appears to have returned. But,” corrected Caldwell, “we prefer to call this our Crisis Intervention Unit, or CIU for short.” Caldwell sensed John’s concern. “Don’t worry, John, this is a not a locked-down unit. But, we must employ a certain level of security for everyone’s safety and well-being.”

“Guess you still don’t want supermen flying out the windows to test their wings, eh?”

Caldwell smiled and pursued his original line of questioning. “John, do you know how you got here?”

John was stumped now. Then all at once his mind was filled with an unwelcome stream of disturbing images…Swampy water. A great bonfire. Screams. Shouts of celebration. Large green flies. Then swarms of flies in ever-increasing numbers…Fragments of a dream trying to emerge and reassemble into a more coherent memory of events, people, and places. Then suddenly, as quickly as they came, they were gone!

Was it real? Or just more pieces of a bad dream?

“John, are you OK?”

John snapped out of his stupor. “Sorry, doc. Guess I’m just…tired.”

Sitting up on the side of the bed, John planted his bare feet on the cold tile floor, took a deep breath, and wiped back a wisp of mainly brown hair from his eyes. At forty-one he was beginning to show streaks of gray. “You tell me, doc. What the hell’s going on?”

John’s attention was drawn to the clipboard. Cocking his head, he began reading aloud from the doctors’ notes:

“…patient admitted Monday, 12 September, ′99, in an extremely agitated state exhibiting signs of psychosis and delusional behavior. Suffering from physical exhaustion and dehydration. External examination revealed a 2 cm abscess on left side of neck just below ear, with localized inflammation. Flush around eyes and face. Moderate edematous swelling in neck, face, and throat consistent with allergic reaction…”

Dr. Caldwell flipped the clipboard over as if to say, “okay, I’ll take it from here.” Shifting position to get a little more comfortable, he took a softer tone as he sought to explain events as he understood them. “John, you appear to have suffered from an acute psychotic episode of some kind—what may be known on the street as a nervous breakdown. When you were brought in three days ago you were, well, in pretty bad shape. Physically and mentally exhausted, dehydrated, and delusional to the point of hallucinating, with periods of uncontrolled outbursts, ranting, and raving”—Caldwell looked down and read directly from his clipboard—“insisting you needed to ‘go back and save her.’ I believe they were your words.” Caldwell looked up. “We initially thought drug overdose or adverse reaction of some kind. But your blood tested clean for the usual recreational drugs.”

Caldwell folded his arms and made direct eye contact with John. “So tell me, John. Are you presently taking any prescription drugs, medicinal herbs, anything like that?”

John was quick to respond. “No, doc. I do my best to avoid drugs. Just the usual stuff. You know, vitamins, dietary supplements, Tylenol for a headache.” He smiled. “A good run around the track usually gives me all the lift I need.”

“Hmm. Okay,” Caldwell pondered, consulting his notes again. “I’m not surprised, John. Your cardio checkout showed you to be one healthy specimen.”

“So, what then?” John replied.

“Well John, sometimes a traumatic event following a prolonged period of stress can trigger an episode like this in susceptible individuals. Have you been under any stress lately? Maybe at your job, or with a relationship? Any headaches or backaches?”

John hesitated, with a faraway look in his eyes. “No, not really,” he said finally. “Not in recent years, anyway. Just the usual day-to-day stuff we all deal with while trying to make an honest living.”

“So, you’ve never been treated for emotional problems of any kind. Depression? Anxiety? Or perhaps someone in your family—”

“No, doc. Nothing like that,” John interrupted, shaking his head. “Doc, I really think you’re barking up the wrong tree with this line of questioning.”

Caldwell scribbled some notes on his clipboard before continuing. “John, do you have any known allergies? Foods, drugs, plants? Childhood asthma?”

John considered this. “Well, now that you mention it, me and poison ivy never got along. Very sensitive, well into my teen years. Even the smoke of burning leaves would cause me to break out. Also had to use an inhaler on a number of occasions for what the doctors called ‘reactive airways.’ But I outgrew those allergies as I got older.”

“Hmm. Well now, that may be part of the problem,” Caldwell observed, guardedly encouraged. “A severe allergic reaction perhaps.”

“Allergic reaction? From what?”

“Well, we think it may have had something to do with that abscess on your neck.”

John reached up and touched the bandage on his neck. He honestly hadn’t noticed it before.

“When you were brought into the ER,” Caldwell continued, “that carbuncle was quite inflamed and your swollen neck was threatening to close your air passages. The ER took the usual precautions and treated you with steroids for the swelling, then ran the usual blood work and lab cultures. You were cleared for killer staph, but put on broad-spectrum antibiotics just in case. Dr. Ritchie thought it may have been an insect bite somehow gone bad.”

“Dr. Ritchie?”

“Yes, Dr. Alex Ritchie. He was the on-call physician in the ER the night you came in. A damn good internist, with a special interest in infectious and parasitic diseases.”

“I see,” John nodded.

“But quite frankly, John, I’ve never seen an allergic reaction manifesting the kind of psychosis you exhibited. We’re not really sure if there is a connection with the bite, if that’s what it is. It may just be a coincidence.”

Dr. Caldwell stood up and slowly pushed the chair away. “John, if you don’t mind, we’d like to keep you here for a few more days for observation and testing. We want to be sure there’s no”—pausing for a moment—“relapse of any kind. We’ll need to determine, if possible, what actually precipitated this episode. Then we can determine the proper course for follow-up treatment. Capiche?”

John sighed. “Well, you’re the doc, doc.”

Caldwell smiled. “Anyway, I think you’ll find the accommodations around here quite, well…quite accommodating!” Caldwell pronounced with a wave of his arms, in the manner of a Maître d’.

Dr. Caldwell sat back down in the chair, folded his legs, and began tapping his pencil slowly against his clipboard. Taking a more subdued tone he proceeded slowly, choosing his words carefully.

“John, have you ever been placed under—hypnosis?”

John’s eyes widened. “You mean, as in mind control? Magicians’ parlor tricks?”

“No, John,” Caldwell objected condescendingly. “I mean as in a safe and proven method of psychoanalytical inquiry. When administered by a trained professional, that is. I’ve found it to be a very useful tool in cases like yours, and often quite effective in helping to identify the deeper, rooted causes of a person’s neurosis. If, in fact, that is what we are dealing with in your case.”

John chuckled. “Like—you think maybe I want to knock off my father to marry my mother?”

“Well, I don’t think it will come down to that,” Caldwell replied stifling a laugh, “but you’d be surprised what secrets we find lurking in the subconscious.”

Shifting to find a more comfortable position, Caldwell placed the clipboard under his left arm and reached into the left inside pocket of his jacket. Removing a small black notebook he thumbed through its pages until settling on a page with a turned down corner. Without looking up he asked, “John, what can you tell me about—a witch burning?”

John reached up and touched the bandage on his neck. Witch burning? What kind of question is—?

Suddenly, another torrent of disturbing images, just like before! Only this time they were accompanied by strange buzzing sounds…Swampy water. A great bonfire. Screams. Shouts of celebration. Large green flies. Then swarms of flies in ever-increasing numbers. An old woman, laughing…

And then in a flash—it was gone!

John took a deep breath, wiping away the beads of sweat from his brow. “I’m…not…sure I know what you’re talking about, doc.”

Dr. Caldwell just stared at him, drumming his fingers across the open pages of his notebook in slow rhythm.

John focused on the motion and sound of the fingers, moving ever more slowly in hypnotic rhythm:

…thud-thud-thumb…thud-thud-thumb…

“Doc, may I”—thud-thud-thumb— “please have a”—thud- thud-thumb— “drink of water?”

The drumming stopped. Then, like a host who suddenly remembered his manners: “Yes, of course, John. I can arrange that.”

Caldwell stood up, regaining his professional composure as he returned the notebook to his inside jacket pocket.

“John, if it’s okay with you, I’d like to schedule a therapy session in the morning. For the time being, I’m going to maintain your Seroquel at 200 mg, two times a day. It appears to have gotten your psychosis under control, and your body seems to tolerate it well enough.” Caldwell cocked his head to get a closer look at John’s neck. “How’s the neck feeling?”

John reached up and gently massaged the surrounding area. “It’s feeling pretty good. Like I said, I hadn’t even noticed it until you mentioned it.”

“Good. But I’ll let Dr. Ritchie make that call. He’ll probably want to continue the antibiotics. Capiche?”

“Capiche,” John echoed.

“Good. And I’ll also let Dr. Ritchie know you’re feeling well enough to see him. Probably drop by during his afternoon rounds. I’m sure he’ll want to run more tests to rule out anything organic. Okay by you?”

“I’ll have to check my appointment calendar to see if I can fit him in,” John deadpanned.

Dr. Caldwell smiled. “Glad to see you’re feeling better, John. So, I will see you in the morning then?”

John nodded.

Caldwell smiled, turned, and left the room.

After just sitting there for a moment, John took a deep breath, stood up by the side of the bed, and looked around. A small plastic bin on the night stand contained the usual complementary toiletries: toothbrush, toothpaste, comb, a pair of floppy slippers, and a terry cloth robe folded and over-wrapped in a poly bag. John tried on the slippers, then ripped open the bag, and removed and donned the robe.

“One size fits all,” he mumbled.

The robe barely reached his calves. But that was okay. He was feeling a bit chilly, so anything helped. They keep the rooms so damn cold in these places. He walked over to the window and peered out.

John’s room was located in the west wing of an upper floor of the hospital. From his window, he had a good view of downtown Camden, with Philadelphia’s modern center city skyline visible in the distance, just across the river (the Delaware River) separating the two cities. Spanning the river were two great suspension bridges bearing the names of two famous native sons hailing from opposite sides: the Ben Franklin and the Walt Whitman.

Focusing just outside his window, John followed the antics of a gray squirrel as it leaped from its treetop nest onto and across the rooftop shingles of the neighboring church, exchanged some nervous chatter with another squirrel it met along the way, then darted off in a new direction with the other in close pursuit. Leaping into space from roof to limb and back to roof again, from one gray stone building to another, they danced their way across the church and convent grounds and onto the six-foot gray stone wall that surrounded the compound, scampering along the top of the wall until they disappeared in a dense patch of vegetation that bordered the gardens. Seems like a nice, safe place to hide away, John thought.

John remembered now having been treated at Our Lady of Lourdes Hospital on one previous occasion, about fifteen years ago. He was suffering a chronic infection of the prostate. His urologist said it had to be “massaged,” a polite way of saying “lanced from inside.” “A good job for Roto-Rooter!” John had remarked. Ouch! He recalled being sedated with a twilight anesthesia that worked really great. Even asked the nurse for a “six-pack to go” as he was coming out of it. But once it wore off, well, it was like pissing nails! Just the thought of—

“Hello, John.”

A soft, familiar, female voice broke his meandering thoughts. John turned to see a woman standing just inside the doorway—medium build; sturdy, but not too stout; a pretty, round face framed in a blonde, page boy cut—appearing smartly attractive in business casual attire: pants and a jacket. “I—brought you a pitcher of water,” she said hesitantly. “Dr. Caldwell said you might be needing it.”

“Katie? Katie Fenwick.” John looked puzzled. “What are you doing here, Katie?”

“Well, for one, I do work here, John.”

Yes, of course! Katie, the wife of his good friend and partner, Bob Fenwick, was a certified occupational therapist and activity director of Lourdes’ Crisis Intervention Unit. He knew that, right? He just forgot what he knew, for the moment. He would instantly recognize Katie in her role of soccer mom or gracious host, but seeing her out of familiar context caught him off guard.

“Sorry, Kate. I’m still having trouble piecing things together.”

Katie poured a glass of water and handed it to John. He took a long drink and returned the empty glass to the bedside table.

“John, you really gave us a scare. Are you—feeling alright?” she inquired. She spoke in the caring tone of a good friend, or surrogate mom.

“I think so, Kate. But I’m still trying to figure out how I got here.”

Seeing the pained look on Katie’s face he drew closer and added, “Kate, I haven’t forgotten everything. Tell me, how is Bob doing?”

Katie’s head drooped, the corners of her mouth quivered slightly as she wiped the moisture from the corners of her eyes; then, looking up, she took John’s hands in hers and squeezed them tight.

“The kids are doing better, John. They spoke with their father the other day. He was actually able to carry on a conversation with them, and”—Katie stopped mid-sentence and broke down. John braced her to keep her from falling and continued to hold her in a gentle hug. Sobbing, Katie tried to speak.

“Bob is going to Lakeland, John. They’re afraid he might try to harm himself. And he should get better treatment there.”

“Lakeland? You mean the psychiatric hospital?” John asked.

Katie simply nodded yes.

John knew the name. The county operated a number of public health and human service facilities at its Lakeland complex, located in Blackwood, NJ, about eight miles south of Camden. But when one heard the name Lakeland, it was the psychiatric hospital that most often came to mind.

Regaining her composure, Katie released herself from John’s hold.

“There’s a Dr. Alexander there who wants to try a new kind of treatment for this form of”—she found it hard to say the word—“schizophrenia.”

John’s memory was returning now. He recalled the last time he’d seen Bob. It was less than two weeks ago, Labor Day weekend. John had been invited over for a cookout at their Moorestown home. He remembered bringing some legal papers over for Bob and Katie to sign. On the surface, Bob appeared normal and was able to engage in intelligent one-on-one conversation. But in his delusional state of mind, he had become increasingly obsessed with a messianic mission of some kind, and when the subject turned to events of that day, something was triggered in Bob’s head; his countenance had turned sullen and strained, the color fading from his face, as he’d stared distantly into space.

John tried to reassure her. “I’m sure he’ll be getting the best of care possible, Katie.” But he found it difficult to hide his own concern.

Changing the subject, John asked her about Dr. Caldwell. “The doctor seems a little rough around the edges,” he said. “Like a bull in a china shop. Is he for real?”

Katie laughed. “He’s got a unique style, I’ll give you that. But, he’s really quite good at connecting with the patients in here, John. You must know how difficult that can be”

“Takes one to know one. Capiche?” John rebounded.

Katie laughed knowingly, recognizing Caldwell’s trademark expression.

“Funny, he doesn’t look Italian,” John said.

“No, but his wife is. Grew up in South Philly.”

“Oh, I see. Well, that explains it.” John paused. “And who is this Dr. Ritchie?”

“I don’t know too much about him,” Katie replied. “Just that he’s an Internist and a pretty good infectious disease doc. I think he specializes in parasitic diseases, or something. Why do you ask?”

“Dr. Caldwell said he wanted to drop by and talk to me.”

“Well, come to think of it. I believe he was on duty Monday night, the night you were brought in. Probably just wants to evaluate your progress.” She glanced at her wristwatch. “Oh m’gosh! John, I’m gonna hafta go. Gotta set things up in the activity room for this afternoon’s events.”

Katie, in her role as CIU Activity Director, was responsible for keeping the patients occupied and entertained as part of their treatment program. The activity room was her domain. Located in the east wing on the same floor, it was equipped with a TV, a computer station, ping-pong table, and an assortment of tables and chairs for arts and crafts.

“Why don’t you drop by after lunch, John. I’ve got a live classical guitarist coming in at two o’clock. Should be nice. Good therapy, too.”

“Well, that sure as hell beats a dead classical guitarist,” he chortled.

“Great! See you there.” Katie turned and left the room.

John took a seat in the same clanking metal chair used by Dr. Caldwell. He closed his eyes and allowed his thoughts to drift back to his Haddonfield home. That’s where he longed to be, back in his restored Victorian home in the middle of a town rich in family and local colonial history. A little nap, a little day dreaming, just before lunch couldn’t hurt.

Copyright 2016 by Stephen Goldhahn