It was strange, she thought, to hear the birds chirp and sing outside. From her window, all Julia could see across the neverending empty field that stretched past the parking lot was a blanket of white snow. And looming in the not-so-far distance, underneath a veil of gray clouds, the majestic chocolate mountains were still wearing white caps. It looked cold and abandoned and desolate. But right next to the window, in a naked Honeylocust tree sprinkled with snow and crusted with ice, a pair of cardinals was busy building a nest for their babies. Even snow in May couldn’t stop the tiny green buds from pushing through the snow dust, or the birds from building their family a new home. It was a sign of spring, John had told her.
‘The positive thing that we can look to here, if it can be said that there is anything positive about your condition, Julia,’ Dr Ryan was slowly saying, ‘is that you actually recognize the signs of your illness. And, as you know, that is a good sign indeed, in terms of predicting an outcome here.’ A badge clip on her white jacket said Marie G. Ryan, MD Psychiatric Services. ‘And, of course, there is the possibility this is an isolated psychotic episode, although given the family history, I am not holding out much hope that’s going to be the diagnosis.’
She knew she should be listening harder, but she couldn’t focus. The birds were chirping so loudly, it was almost as if they didn’t want her to hear anything but them. Their chirping seemed to fill her brain, so that there was no space left for anything else to be heard. She picked certain words that the doctor was saying to concentrate on, thinking that might make it easier. Positive. Condition. Predicting. She couldn’t let herself lose the words. They were the only rope she could cling to now and she couldn’t let them go, no matter how loud the chirping became. No matter how hard it was to focus. She knew what would happen to her if she got tired and let them go. That was what was so … positive. She knew what would happen to her, and that was a positive predictor. It all suddenly snapped into place and made sense. She breathed a silent sigh of relief.
‘There are other positive factors to consider as well. You’re female. Statistically, females have a more favorable outcome – one, five, ten years down the road – than men. You’re first showing signs of the disease at the age of twenty-eight, which is also good. The older the age at onset is positive. Prior to only a few weeks ago, your behavior, your thinking, as you and John have both related to me, and as your medical history presents, was considered to be relatively normal. You did not suffer from bizarre thinking or associations as a child. No delusions, or hallucinations, no prior psychiatric hospitalizations. That, too, is good for a couple of reasons.’ Dr Ryan looked over at Lat. ‘Individuals who have led a normal childhood,’ she said, holding her fingers up like quotation marks when she said the word normal, ‘and who then have a rapid, sudden onset of the disease, as opposed to one that develops slowly over months or years – well, statistically speaking, those patients have a better long-term prognosis. Of course, everyone is different, and Ido have to stress that that is only statistically speaking.’
‘But what about what happened with her brother? Her parents?’
‘The murders were definitely a traumatic event, no doubt, but by normal childhood, I mean that her development – emotionally, socially, behaviorally – was normal. There were no emotional-development issues reported. And given just how traumatic and stressful that event was, it is remarkable that she did not have a psychiatric history after that. While stress is no longer considered to be the cause of schizophrenia, it may be the proverbial straw that breaks the camel’s back in individuals who may be genetically predis-positioned. In other words, the fact that Julia did not develop schizophrenic or psychotic symptoms long before this suggests she’s very strong.’
It’s as if a cataclysmic earthquake has happened inside her head. The mountains are falling, the seas are opening. The landscape will never be the same.
Julia’s eyes darted to the window again. She watched as the male cardinal, with his brilliant red feathers and black crest, suddenly flew off by himself into all that white. She followed him until he became a small red dot and finally disappeared out of sight. The female stayed back in the branches, next to the window. Julia noticed that she stopped chirping.
‘But we do have your family history to consider, Julia, and that, unfortunately, is not so good.’ The doctor’s soft, tan face changed a bit. It grew more intense and serious, almost as if it were brittle. ‘Again, as you already know, statistically speaking, the more relatives in the family tree with the disease, the poorer the outcome tends to be. You have a father and a brother, both in your direct line of consanguinity, who have developed the disease. And we don’t know about the rest of your lineage, as there’s no one left on either side who can relay that history. But you are responding to the medication nicely, and that is positive, and you are no longer hearing the voices, is that correct?’
The female looked around anxiously for her mate now. She started to chirp again, but it was a different type of chirp, Julia thought. It was a ‘Hey, where’d you go?’ chirp, and it grew a little more insistent. Finally, she left her nest-building behind and began hopping from branch to branch in the sprawling tree.
‘Julia?’
Dr Ryan was looking at her. For how long, she didn’t know. How long had she been gone this time?
‘Julia? Are you still hearing the voices?’ Her voice was slow, but the tone was raised, as if she’d asked the question a few times already.
Hold on to the words. Medication. Positive. Voices. She shook her head. ‘No. They’ve stopped, I think. Sometimes …’ Her voice drifted off. The room was very hot.
‘They stop sometimes?’ Dr Ryan tried not to frown. ‘I thought you weren’t hearing them anymore.’
Julia shook her head again. ‘No. I don’t. I don’t, I don’t hear them anymore. Sometimes I get, ah, I get nervous again, like they …’ She took a deep breath. The room was so hot now. And the words felt thick as they came out of her mouth. She could feel both of them watching her, studying her, analyzing what she was doing and saying and comparing it to normal reactions, sentences, emotions. To be sure, Dr Ryan was more clinical in her observations, comparing her to her other psych patients, or maybe to a textbook. But John was more personal. She assumed he was comparing her to the ‘old’ Julia that he used to know. The Julia that didn’t babble sentences which made no sense or hold her head like it hurt. Or drift off somewhere where no one could find her. She looked at the floor, embarrassed that he had to hear her say these things. ‘Like they might come back. Like I won’t know it if they do.’
Like a cancer patient in remission or an MS patient in between episodes, everything now related back to her disease, as, she suspected, it always would. Was she exhausted because she hadn’t slept well or was her brain throwing another white spot? Did her back hurt because she’d pulled a muscle, or was it the cancer cells back, building another complex tumor somewhere in her body? She had to analyze every thought now to see if it was indeed normal, or if she was being tricked by her own mind. Would she know if the voices came back? Would she be aware next time that something was horribly wrong in her head? Or would madness consume her completely on her next go-round and she would be too sick to help fend it off again?
She knew all about the disease, all about the prognosis. She’d studied it for months. From how she remembered it, the odds weren’t looking so good. And unfortunately, her awareness of being sick was the one reality she hadn’t lost yet. It was the one thing she clung to. Like a drowning pathologist lost in the middle of the Atlantic without a lifeboat, she would know the clinical experience of her own tragic demise before it took her under.
Almost as if he had read her mind, Lat leaned over and grasped her hand, rubbing it gently. ‘People beat this, you know.’
‘John is right, Julia,’ Dr Ryan said slowly. ‘With the help of medication, some people do go into full remission. I know you’ve had a horrible experience with your own family, and I know that you’re familiar with the disease in a negative, forensic setting. But more than two million people live with schizophrenia in the United States, Julia. With treatment, some of them fare quite well. They have jobs and families. They don’t all live on the streets or commit homicide. Forget what you’ve seen in a courtroom, or watched on TV. They’re not all violent and they’re not all homeless. There is hope.’ She finally smiled and then looked over at Lat. ‘You have many positive predictors for a good outcome. And, perhaps more importantly, I can see you have a wonderful support system. I think you’re more than ready to continue treatment on an out-patient basis.’
She smiled and stood up from the seat that she’d pulled up next to Julia’s. ‘The most important thing will be for you to continue to make sure you take the medication. Even when you’re feeling completely normal again, for lack of a better description.’
‘I get very tired,’ Julia said.
‘Yes, well, the Mellaril seems to be working for you right now, and I’m hesitant to change that. The other antipsychotic drugs can have some very serious side effects, including the second-generation antipsychotics. I don’t think we should change what’s working. And the Elavil will help with anxiety and depression. That takes a bit longer to see results.’ She headed to the door, opened it and turned back to Julia with a final, soft smile. ‘I’ll see you in three days in my office and we’ll look at how things are going for you. Good luck to you.’ Then she disappeared out the door and they were alone.
The chirping and singing started again. Julia looked back out the window. The male was back, his beak filled with twigs and brush.
‘When can we go home?’ she asked softly. ‘I …’ she tried to finish the thought, but it got stuck somewhere, so she just stopped.
‘I’ve rented a house in Anaconda,’ he said, his eyes following hers out the window. ‘It’s only a few miles away. It’s laid-back and ultra-quiet, so don’t expect South Beach and the hootchie mommas.’ He smiled. ‘’Cause I didn’t pack your leopard pants. Or mine.’
She finally smiled and laughed a little.
‘I think we’re going to stay out here for a while, though,’ he said quietly.
‘Lay low,’ she whispered, growing serious again.
‘That’s what the cowboys and criminals do. Welcome to the Wild West. Everyone lays low out here, separated by a few hundred acres of land.’ He followed her gaze out the window. ‘It’s beautiful, isn’t it, though?’
She nodded, but his words slipped off and she blanked out yet again. Her mind kept doing that. Taking short catnaps without telling her. When it woke up, everyone and everything seemed to have moved on without her.
‘What do you think?’ he asked softly, trying to find her again. He waited a few moments before trying once more. ‘What do you think? I sn’t it pretty country?’
‘Yes,’ she said, biting her lip and looking at the cardinals building their nest together in all that snow. ‘Is it really cold?’
‘Everyone says this was just a late-season storm. Spring’s here, that’s for sure,’ he said, tapping on the window. The birds ignored him. ‘It’s so peaceful out here. I think that’s what you need right now, Julia. That’s what I know I need. Get away from all that craziness and get you better.’
All that craziness. The last few weeks were a blur. Maybe that was a good thing. She couldn’t remember exactly when she’d figured out her head was not working right anymore. Even with all the medicine, and the whispers in her head now gone, she couldn’t figure out what had been real. The phone calls, the protesters, the reporters following her … It wasn’t like she now saw the past clearly and lucidly. It was still deceptively foggy. David Marquette’s smiling face flashed in her mind too many times. Over and over. Had she been wrong all along about him? Had that really happened? Had the devil really smiled at her? It was the one thing she was afraid to ask John about. So she lived with it.
He insisted no one else knew what had happened with her. He’d told her there was no public breakdown. Nothing made the papers. In the days after the trial had ended, she’d gotten progressively worse – strange and reclusive – and he’d known something was going really wrong. When he’d finally sat her down and asked her, she could remember telling him that something was not right in her head. That her thoughts were not sounding like they used to. That they sounded like they belonged to someone else. That they sounded like they were coming from the TV sometimes. It was probably the hardest thing she’d ever had to say to someone, much less someone she knew she was falling in love with – but she’d wanted it to stop so bad. She’d wanted to be normal again. And she was so scared. She didn’t know where to start or what to do. And she didn’t want anyone to know.
That very night, he’d gotten on a plane with her and taken her here – far, far away from the spotlight of Miami. She hadn’t known where they were going. She hadn’t known where they were for a few days. She’d signed whatever papers he put in front of her; she’d taken whatever medicines he fed her. She remembered crying when they pulled past the sign for Montana State Hospital. Here, in the middle of the Rocky Mountains and the snow and the quietness, finally no one knew her name. That’s what he’d told her.
‘… before I plunk down any money, I want to make sure I actually like it out here. Real estate’s always a good investment, I think, even if retirement is a long while off. I’ve been thinking of looking at Bozeman. That’s where Montana State University is. One of the Robbery guys went there. Talks it up all the time. Nice college town. Not too far from Helena. Or maybe Jackson Hole, Wyoming. You’d be a cute ski-bunny, I bet.’ He turned away from the window and took her hand. ‘So what do you think, pretty lady? Would you like to raise some horses out here with me someday?’
‘What about work?’ she asked. ‘Don’t you have cases?’
‘Miami’s not going nowhere. They’ll live without me for a little while. A long while, if that’s what it takes.’ He laughed. ‘I just got a cell message from Brill. Apparently some of the boys are hoping I don’t ever come home.’ He looked at her for a long moment. ‘Look, I got a ton of time saved up. I haven’t taken a vacation in years. Haven’t had a need to. This is good for me.’
She hung her head and closed her eyes, hoping to hold back the tears.
‘Hey, hey, hey,’ he said, reaching over to touch her face. ‘We’re gonna get you better. We’re gonna relax. We’re gonna go fishing and walking and hiking. And then maybe we’ll go back. Maybe. But right now, let’s take this one day at a time.’
She looked at him. He was smiling, but she could see how tired he looked. And incredibly worried. ‘I don’t want you to do this for me,’ she started, the tears falling once again.
‘Listen to me, Julia. I love you. And that’s real. I’ve known it for a long time. I love how strong you are. I love how unpredictable you can be. I love how determined you are. No matter how crazy life may become, I’ve never been so sure of anyone or anything before. And this,’ he said squeezing her hand, ‘this is reality. We are reality. In the Rockies or in Miami, wherever you want, wherever works, I’ll help you get through this. You’ll beat the statistics and you’ll be fine. And if you doubt it, if you slip backwards, if you relapse, just remember that we are reality. And I will still love you. And I’ll be there to help bring you back.’
She nodded and closed her eyes. ‘I love you, too,’ she said. She just wished their relationship didn’t have to start like this. It wasn’t fair. ‘Thank you,’ she said.
‘Your aunt’s been calling, too,’ he said softly. ‘I didn’t tell her anything, but she wants to talk to you. She says she’s been trying you for weeks …’ his voice trailed off. ‘She told me to tell you she misses you.’
The tears started. There was no way to hold them back. Where had everything gone? What was real?
He smiled again, wiped her tears with his thumb and kissed her softly on the lips. ‘Now let’s get you out of here and back into all that beautiful, cold sunshine. I got a log cabin I want to take a look at with you.’