The next morning, Richard was eager to immerse himself in work. The night had been a restless one. He juggled his coffee and briefcase and made his way through the hospital doors. “Good morning.”
“Morning, Dr. Cassano,” greeted the male orderly. “You’re here early.”
“I’ve got some work to do,” he said. “Anything I should know?”
“Nope, all quiet on the Baycrest front.”
“Good to hear.”
“Oh!” The orderly stopped paging through his magazine. “That one patient of yours…the red-head?”
“Moira?”
“Yeah,” he said. “One of the other patients started a fight with her last night.”
Richard tensed. “Why wasn’t I called?”
“I think they eventually got it under control.” He shrugged. “No big deal. You know how some of these patients are.”
Annoyed with the orderly’s indifference, Richard left without a response. He took the stairs to the third floor and made his way to the nurse’s station.
“Good morning, Dr. Cassano,” Sheila said. “You’re here bright and early.”
“Was there a fight last night?”
“Oh,” she shook her head. “Karen decided to start something with Moira in the hallway. I have no idea what the problem was.”
He set his briefcase and coffee down. “Is Moira all right?”
“It got pretty wild. It took two of us to pull Karen off. This isn’t the first time she’s started a fight with another patient. We’ll have to watch and make sure she doesn’t try anything else.”
“Why did she attack Moira?”
“I’ve got no idea. Moira keeps to herself most of the time. But Karen’s holding a grudge, for sure. We had to confine Karen to her room.” She caught his worried look. “Moira’s fine. Seriously. A couple of scratches here and there, probably some bruises. Good thing she wears her hair in a braid.”
He gave her a doubtful look. “I’m going to check on her.”
“Suit yourself. She’s probably still sleeping.”
Richard opened Moira’s door quietly. The sun had just filtered through the barred windows. As he walked in, he saw that she was asleep. An angry-looking scratch ran along her cheek. Another marked her arm. He ran his hand through his hair and cursed under his breath.
He turned to leave and an icy cold draft raced across his neck. Simultaneously, a brief feeling of rage invaded his senses. Richard took a step and the image of a very tall man hit hard. The man stood right in front of him, his face seething with anger. As quickly as the image was there, it was gone. His heart pounded in his chest. What just happened? He scanned the room, and his gaze fell on Moira again. She continued to sleep soundly, the sun’s rays lighting her hair like fire.
Richard left her room and continued to his office. When he got there, he sank into his chair. It took him several minutes to realize that his hands were shaking; several more to realize he had left his briefcase and coffee at the nurse’s station.
The conversation with Dr. Whyte remained foremost in his mind. On one hand, he knew group therapy was a step in the right direction. A step that would be helpful in Moira’s release. On the other, he was unsure if group therapy was what Moira needed.
* * *
Richard knocked on Dr. Blinderman’s open office door. “Can we talk?”
“Of course, Richard.” He glanced up from his paperwork. “You’re here early. What can I help you with?”
“There was a fight between two of the patients last night. One of them was mine. Moira Flynn.”
“And?”
“Moira didn’t start the fight,” Richard said. “Karen Sawyer did.”
Dr. Blinderman thumbed through a pile of papers. “Who’s her doctor?”
“Dr. Reed and he’s out today.” He ran a hand through his hair. “I need to make sure this won’t happen again. The nurses told me that Miss Sawyer has started fights before. Why hasn’t she been transferred to another facility?” A better one, he thought bitterly.
“I’ll speak to Dr. Reed about upping her medication.”
“I don’t think ‘upping’ Miss Sawyer’s medication is the answer.”
Dr. Blinderman made an impatient sound. “What do you want me to do, Richard? If she’s violent, she gets medication to help manage her behavior. You know how it works here. We discussed this at our last meeting.”
“She needs to be transferred,” he repeated, frustrated. “This facility isn’t set up for violent patients.”
“Hence the medication. We don’t transfer patients to other facilities except under extreme conditions.” A vein in Dr. Blinderman’s temple stood out. “It doesn’t look good for the hospital.”
“It doesn’t look good to have patients hurting each other, either,” Richard replied. “Especially when we know one has a history of behavioral problems.”
“I’ll speak to Dr. Reed.” He eyed him with a frown.
Resigned, Richard nodded briefly.
“I received the group-therapy paperwork for that little red-head of yours, by the way.”
“Moira Flynn.” His jaw tightened.
“I disagree with your choice of treatment, Richard. The no medication thing.” He waved his hand, annoyed. “But once Miss Flynn realizes she isn’t alone in her issues, she can forge a bond with other patients struggling with schizophrenia and the rest of it,” he said. “Anyways, good call. That will look good for the hospital. She’ll be out of here in no time.”
* * *
“Mrs. Cook?” Richard switched his phone to the other ear. “This is Dr. Richard Cassano…Moira’s psychiatrist. Did I wake you?”
“Hello, Dr. Cassano,” she answered. “Not at all, I’m usually up at the crack of dawn here. Is everything all right?”
“Everything is fine, I’m sorry to alarm you.” He picked up his gold pen and clicked it a couple of times before setting it down again. “I have a couple of questions. I was wondering if we might meet sometime this week.”
“About what? And please, call me Mom Adel.”
“Of course. I wanted to talk to you a little about Moira.” He cleared his throat. “It would be helpful in approaching her treatment.”
“It’s difficult for me to get away but—”
“I understand completely,” he said. “Would you mind if I dropped by?”
“My door is always open.” Her voice registered surprise. “Anything to help. We want Moira out as soon as possible.”
“Me too,” he said. “Does tomorrow at six-thirty work for you?”
“Sounds good,” she said. “We’re on Telegraph Lane. The only farmhouse out there.”
“I’ll see you at six-thirty, then.” Richard hung up the phone, his heart pounding. He was taking a risk in working outside the parameters of what was acceptable for a psychiatrist. But his gut instinct was telling him to take that risk.
And if Dr. Blinderman got wind of it, he would have some explaining to do indeed.
* * *
The neat-looking, white farmhouse was surrounded by several acres of green hills. A sturdy oak tree grew in the yard, its branches protectively encompassing the area. Several bicycles leaned against its trunk. A black and white cow stood by the fence that separated the pasture from the front yard. The cow chewed its cud and watched him complaisantly.
Walking up the driveway to the door, Richard could hear the din of children’s voices coming from inside the house. He knocked and waited.
The door was finally opened by a tall boy in his late teens. “Yes?”
“I’m Dr. Richard Cassano.” He held out his hand. “Mrs. Cook is expecting me?”
“Travis.” The teen shook his hand with a polite smile and called over his shoulder. “Dr. Cassano is here, Mom Adel!”
“Let him in!”
“Come in.” Travis opened the door wider and stepped aside. “She’s in the kitchen.”
“Thank you.” He followed the boy down the hallway. A peg rack was affixed to the wall, haphazardly draped with coats and scarves. A row of muddy shoes lay on the floor, all different sizes.
A large woman bustled about the kitchen, giving orders to the four children around her. An elderly man in overalls busied himself at the sink. In spite of his stooped and frail appearance, the elderly man seemed to be taking the activity around him in stride. A yellow Labrador sat on the peripheral and waited patiently for something to drop.
“You set the table, Suzie-Q dear.” The woman handed a little girl a large, white plate from the cupboard. “Can you pull the pot roast from the oven, Grandpa Avis?” she continued, speaking a little louder.
“Yes, indeed.” Grandpa Avis opened the oven and the scent of home cooking hit the kitchen with a sigh.
Richard felt his stomach rumble.
“Dr. Cassano!” Mom Adel greeted him. “Just in time for dinner.” She dusted off her jeans. “Suzie, set an extra plate for our guest.”
“Don’t let me intrude—”
“If she can’t feed you, she won’t know what to do with herself,” said Travis as he grabbed a stack of cloth napkins. “Best just to say yes.”
“Travis, no sass from you.” Mom Adel waved a wooden spoon at him good naturedly. “I won’t be able to chat until after dinner, Dr. Cassano, so you might as well have a seat.” She returned her attention to the stove again.
The smells permeating the kitchen overrode his formalities. Richard found himself sitting between two of the children, eagerly looking forward to something that wasn’t microwaved.
Dinner was accompanied by joking and banter. At one point, a bread roll was tossed across the table and landed on the floor.
“Please hand Janine a roll, Peter. This isn’t baseball.” Mom Adel scolded. “So, bright and early, Suzie-Q,” she continued. “You help Travis milk Moo-Moo before school.”
“Bright and early!” Suzie repeated.
“And Janine, you have egg duty tomorrow.”
“I know, I know.” The girl surreptitiously dropped one of her carrots onto the floor. It was immediately gobbled by the dog.
“I saw that,” Mom Adel dished another carrot onto Janine’s plate with one hand, while pouring a glass of milk with the other.
“I don’t like carrots,” Janine whined.
“But they like you. They’re good for your eyes,” Mom Adel replied. “Tomorrow, we’ll cook up some broccoli.”
“I love broccoli!” Suzie exclaimed.
Janine made a face at her. “You love everything.”
“None of that.” Mom Adel handed Richard a bowl of mashed potatoes. “Another day in the Cook family, Dr. Cassano, what can I say?”
“This is…wonderful.” He felt the pang of loss from his own childhood. “We should all be so lucky to have a family like yours.”
“I’m lucky to have them,” Mom Adel said a smile.
“How long did it take you to become a psychiatrist?” Travis asked.
“Eight years,” Richard answered. “Plus another four for my residency.”
“I’m starting university in the fall,” Travis said as he piled mashed potatoes onto his plate. “I’m going into computer programming.”
“Good for you,” Richard said. “That’s quite a booming field right now.”
“We’re all very proud of Travis. He was just awarded a full scholarship,” Mom Adel said. “We’re going to miss him, though.”
“I promise to bring my laundry home every weekend,” he teased.
“You’ll do nothing of the sort, young man,” Mom Adel scoffed. “I’ve got enough laundry from Peter’s collection of socks he leaves lying around.”
“I like clean socks,” Peter said with a shrug.
“Then why do your feet still smell?” said one of the older girls.
“Ha-ha,” Peter said. “They don’t smell nearly as bad as yours, Riz. Yours smell like stinky cheese.”
“Blue cheese or cheddar?” Riz shot back, batting her eyes.
“Okay, kids.” Mom Adel gathered her utensils and stood. “You know the drill. Peter, when everyone is finished, you’re responsible for clearing the table. Travis, you wash. Janine, you dry. Riz, you put the dishes away.”
“What about me?” Suzie asked.
“Suzie-Q, you get the most important job of all. You get to feed Squid.” The dog wagged its tail, as if he knew his fate was being decided.
“Goodie!”
“And dog food only, please. No more bread rolls, though you can give him a little pot roast, if you’d like,” Mom Adel added with a smile. “I’m going to be chatting with Dr. Cassano on the back porch. If you need me, that’s where I’ll be. Travis, you’re in charge. I can hear everything, even if Grandpa can’t, so no fighting over jobs. At Mom Adel’s we all get along—”
“Through thick and through thin,” Suzie finished for her.
“You are a smart girl, Suzie-Q.”
The girl beamed at Mom Adel’s praise.
The backyard overlooked a grassy-green field dotted by white oak trees. Several baseballs littered the porch, along with a soccer ball and a mud-splattered Barbie. In the distance, a large pond was surrounded by a fence.
Mom Adel settled in a chair and gestured to another across from it. “We probably have all of ten minutes before my services will be needed back inside.”
“I understand,” Richard said. “Thank you for dinner. Moira was right; you are a fabulous cook.”
“That’s my girl,” Mom Adel grinned.
“I really hadn’t intended on imposing,” Richard began.
“Oh, shush.” She dismissed him with a wave. “Nobody imposes here. An extra plate is never a bother.”
“I wish every foster home was run like yours.”
“So,” Mom Adel settled her hands in her lap, “what can I tell you about Moira?”
Richard moved a bucket filled with colored chalk and sat. “Moira and I are making progress in her treatment,” he began. “I can’t really discuss details…” he hesitated. “I was hoping you could help me with some information.”
“Anything you need.”
“I had a question about the foster home she was at before yours. Do you know why they intended on splitting up the children?”
“My understanding of the situation was that there was an incident with one of the boys.”
“Did Moira tell you about it?”
“Yes, she told me.” Mom Adel shook her head. “I can’t even imagine, poor thing. She still has a burn scar on her thigh.”
“I see.” Richard’s hand moved to his collarbone and he rubbed at it, distracted. “Did she seem traumatized by the event at all? Do you think anything else happened?”
“Honestly, no. I think what would have been more traumatic was if the courts would have split her and Liam up.”
“It was good of you to step in when you did.”
“Never regretted it, either. They were a blessing. That particular foster home wasn’t the best place for them. But the system is what it is—overloaded.”
“And you’re sure nothing else happened?”
“As far as I know. They found out later that the boy had a drug problem too. I discussed it with Moira. Between that and what happened to Liam,” she shook her head, “she wouldn’t touch anything out of a bottle after that. Aspirin, cough syrup, I could never get her to take any of it, no matter how sick she was.”
“What happened to Liam?”
“He had a reaction to penicillin. Put him in the hospital. It scared the daylights out of Moira. She was only eleven when it happened. I think she thought he was going to die, poor thing.” She saw his look and stopped. “She wants to get better, Dr. Cassano. Moira is very practical. I know you’ll prescribe what’s best for her.”
He assessed the new information and continued, hesitant. “There’s something else I wanted to ask you. Public record, and I hope you’ll forgive me for bringing it up, but…the death of a child in your care?”
Mom Adel’s face lost its smile. “That was a very sad day for all of us.”
“Can you tell me what happened?”
“Well,” she said with a deep sigh, “it was the first month Moira and Liam came to live with me. The children were playing on the swing.” She pointed to a white oak tree in the yard. A rope swing hung from one of the branches. “I was sitting right here, watching them. It was Moira, Liam…and Isabella.”
His heart began to thud. “Tell me about Isabella.”
“Isabella was a handful. A good child, but a handful.”
“You probably get quite a few of those here.”
“I do,” she agreed. “Farm work is good for kids like that, though. It gives them a purpose and teaches them responsibility. Anyways, I told them I was going to grab some sunscreen and would be right back. You know how fair-skinned Moira and Liam are. It took me a couple of minutes to find some. It was still the beginning of summer. When I got back, Moira and Liam were still over by the swing and Isabella was nowhere in sight.” A frown creased her brow. “I found Isabella in the pond. The water’s not very deep, but deep enough, I guess. It looked like she had fallen from the tree branch that grows over the water. She was always climbing trees, that one. I tried to revive her, but…” She paused and blinked the gathering tears from her eyes. “I put a fence around the pond the next day and made it off limits. It was a tragedy, Dr. Cassano. A real tragedy.”
“To be sure.”
“I was investigated.” She looked him straight in the eye. “Nobody grieved more than I did at the death of that child. I loved her like she was my own. I love all my foster kids.”
“I can see that,” he said. “How did Moira react to the accident?”
“She clammed up, got quiet. Sometimes, I’d catch her talking to herself.”
“Did she go into counseling?”
“A school counselor stepped in, Medicaid being what it is. And she went. For six weeks.” Mom Adel gazed across the field toward the pond. “After that, Moira threw herself into her school work. Coming from her situation, I thought she’d have more of a difficult time. I suppose she probably did, in retrospect. But I let it go. Maybe I shouldn’t have.” She dropped her gaze. “I was grieving too.”
“I understand.”
“There’s not a day that goes by that I don’t fault myself for leaving those children alone out here, even for the couple of minutes that I did.”
He looked across the field. “How did her brother react?”
“Liam was a sensitive one. He saw a school counselor too.”
“Six weeks?”
“Eight,” she replied. “He got involved with the band at school and that seemed to be therapeutic. Music was his thing. Moira too.”
“Moira likes music?”
“Oh yes. She never played, but she always went to Liam’s band practices after school. Moira loves music. Liam’s music, the radio, her CD player, all of it. Classical especially. I was always telling her to turn it down.” She laughed at the memory and became serious again. “But in answer to your concerns, Dr. Cassano, yes, both went to counseling after Isabella’s accident. And they seemed to adjust fine after that. I never had a problem with either one of them.”
“I’m not here to judge you, Mrs. Cook,” he began.
“Mom Adel.”
“I’m not here to judge you,” he repeated. “I’m just trying to get a better picture of Moira’s past.”
“Has she mentioned Isabella?” she said with a small frown.
“I’m not at liberty to say,” he said automatically. “Patient confidentiality.”
“You know, I wouldn’t think Isabella’s death would stick with her.” She stopped. “I didn’t mean that the way it sounded. Isabella could be quite the…she knew how to push Moira’s buttons. As kids do. Used to follow her around and make fun of Liam’s crying. I think Isabella actually liked Moira. She just had a difficult time showing it. Given a couple of weeks, they probably would have been inseparable.”
“Right,” he replied, pondering on her words. “I appreciate the time taken, Mrs.—Mom Adel. I’ll let you get back to your kids.”
“Any time.”
“Would you mind if I took a look at the pond?”
“Not at all.” She stood. “Forgive me if I don’t come with you. I don’t go down there anymore.”
“Understandable.”
Richard made his way across the field, stirring up insects in the grass. As he approached the water, he could see the pond was completely surrounded by a sturdy, iron fence. He peered through the bars.
The pond was about a hundred feet across and coated with green algae. Dragonflies, floating up and down with the currents of the breeze, skimmed across its surface. A single, gnarled white oak grew close to the edge. One of its branches reached out across the water. He could see how a kid would want to climb it. He probably would have done the same when he was young. He felt a tug at the back of his shirt. Richard turned with a start, but there was nobody there.