From the desk’s central drawer, he carefully lifted out a fancy wooden box and opened the lid. Nestled in cloth-lined depressions were two custom-made orbitoclasts, which he was going to use for the upcoming lobotomy, one for each eye. The instruments had been designed for Clarence according to the specifications dictated by Dr. Walter Freeman, who had devised the transorbital lobotomy bedside technique that Clarence now exclusively used. The stainless-steel instruments looked surprisingly like traditional ice picks, each with a ten-inch-long pointed stiletto blade. The difference was that they had rounded stainless-steel expanses on the bases of their handles, which enabled them to be struck with a mallet to drive them through the thin, bony roof of a human eye socket. Also nestled in the box in its own cloth-lined depression was a machine-tooled, stainless-steel mallet.
Satisfied that all was in order, Clarence stood up and slipped the box into one of his white coat’s deep side pockets. After a quick check in the mirror behind his coat closet door to make sure his hair was in place, he headed out of his office. Again using the stairs, he ascended to the fifth floor, where he’d had Charlene Wagner moved from the locked ward for disturbed children into a private and particularly photogenic room. As he walked along the two-toned yellow-tan central corridor, passing beneath the squares of purely decorative faux ribbed vaulting that lined most of the building’s hallways, he felt his excitement ratchet upward.
Entering the room, Clarence could not have been more pleased. It was crowded with nursing students in their starched, white-smocked outfits, a handful of interns and residents, and, more important, a number of reporters, some even holding large press cameras. A few flashbulbs went off, causing him to blush and wave.
Just as he expected, Charlene Wagner looked angelic in an off-white dress. Following his orders, she’d been tranquilized with Luminal that morning and was currently asleep in her bed with her blond hair splayed out to frame her cherubic features. She was tall for her age, appearing nearly prepubescent. Three impressively sized psychiatric attendants were grouped around the head of the bed, which had been pulled away from the wall. Behind them were two windows that offered a narrow view of the East River.
After handing off his box of instruments to a nurse who would see to their sterilization, Clarence cleared his throat and gave a short and concise history of the patient and an explanation for why the procedure would be beneficial to everyone, including the troubled girl. He wanted to make the affair as short as possible to emphasize the utility of lobotomy to help empty the disturbed wards of the country’s mental institutions. He asked if there were any questions, but no one raised their hand.
Without more ado, Clarence took the hypodermic syringe filled with lidocaine from one of the attending nurses. While some devotees of the transorbital lobotomy used electric convulsion to render the patient unconscious, Clarence’s opinion was that it wasn’t necessary. He was convinced that local anesthesia was more than adequate since the interior of the human brain was devoid of sensory fibers. After a nod to the male attendants, one grasping Charlene’s head to steady it and the other two holding her arms and torso, Clarence leaned forward and retracted the girl’s right upper eyelid. A hefty psychiatric nurse grasped the girl’s ankles.
Charlene let out a howl and a string of expletives and struggled against the restraining hands, but to no avail. With considerable adeptness, Clarence rapidly infiltrated both medial upper eyelids and then walked the needle point along the roof of both eye sockets to anesthetize those areas. The process took literally seconds. Satisfied, he handed off the syringe, waited a few beats for the lidocaine to take effect, then took up one of the orbitoclasts.
While the psychiatric attendant struggled to keep the screaming child’s head motionless, Clarence raised the lid of her right eye and then pushed the point of the orbitoclast at a forty-five-degree angle into the conjunctival recess until it hit up against the boney vault of the eye socket. He then took the mallet from the assisting nurse and, with a few decisive taps, penetrated the bone, pushing the orbitoclast into the girl’s brain.
Now out of breath, Charlene fell silent as Clarence advanced the orbitoclast to the five-centimeter mark. Once it was at that position, he merely pushed the handle of the instrument several inches medially and then several inches laterally, causing the instrument’s flattened tip to sweep through brain tissue and effectively sever the nerve pathways between the forebrain and the midbrain.
Several flashbulbs went off, but no one said a word. Ignoring the observers, Clarence advanced the orbitoclast to the seven-centimeter mark and repeated the lateral sweeping motion before pulling the instrument out.
“The right eye is already completed,” Clarence said as he handed off the first orbitoclast to the assisting nurse and took the second. “All we need to do is repeat the procedure on the left, and we are done. What should be plainly obvious is that this is a simple, straightforward, and remarkably effective procedure. Are there any questions before we continue?”
Clarence glanced around the room. No one spoke. He could see that the nursing students in particular were agog. Returning his attention to Charlene, Clarence once more began the procedure, again using the mallet and several taps to penetrate the boney roof of the left orbit. After sweeping the orbitoclast medially and laterally at five centimeters, he then advanced the instrument to the seven-centimeter mark, sweeping it medially. But when he swept it laterally, disaster struck. To his horror, a sudden pulsating jet of blood arced up alongside the orbitoclast, forming a miniature geyser and spattering a line of bright crimson dots down the front of his otherwise spotless white coat.
Shocked at this unforeseen event, Clarence reeled back as the throbbing geyser continued spraying blood, causing other people in its path to leap away from the bed. Instantly, he knew what had happened. Given the strength of the pulsating jet of blood, the orbitoclast had undoubtedly severed the anterior cerebral artery, the main blood supply to the forebrain.
Clarence was paralyzed by sheer panic and had no idea what to do as he stood there frozen in place, staring at the offending instrument still sticking out of Charlene’s left eye. As the pulsating jet of blood began to lessen, he briefly considered trying to get the girl over to surgery in the main hospital. Yet his intuition nixed the idea, telling him it would be futile, since she had essentially had a massive hemorrhagic stroke. But in the middle of his confused panic, one thing that seemed clear was that this obstreperous, behaviorally outrageous, and contrary girl had managed to remain in character. Instead of helping his career, she’d probably managed to sabotage it and thereby ruin his chances of using lobotomy to become Bellevue’s psychiatric chief.
Chapter 1
Monday, July 1, 6:15 a.m.
When Michael Fuller’s phone alarm woke him with its insistent jangle, he literally leaped out of bed in a near panic while fumbling to turn the damn thing off. He’d been in the middle of a disturbing nightmare of being chased down endless yellow-tan corridors without the slightest idea of what or who was chasing him or why. All he knew was that he had been panicked out of his mind and as a result his heart was still racing.
With the back of his hand, he wiped his damp brow and took a deep breath to calm down. He’d never before experienced such a uniquely frightening dream. Certainly, he’d had his share of nightmares while growing up, but nothing like what he’d just endured. Although he’d had some minor difficulty getting to sleep the night before, due to his mixed emotions about the upcoming day, he certainly didn’t expect first-day jitters to have caused such a dream.