He nearly choked. “Goody Two-shoes Garnet? You’ve got to be joking.”
“They spent a lot of time together, and were always talking-”
“I know, but he was so straitlaced.” You ought to know, he nearly added, remembering that Melanie had made several obvious plays for Earl and gotten nowhere.
“I thought so, too, but maybe we were wrong. I mean, what do you think? Could it be that he didn’t ask about Kelly’s lover because…” She looked questionably at Tommy.
“It was him all along?” He digested the notion a few seconds, rubbing the palm of his hand through the bristly top of his hair, then chuckled, finding the idea not so crazy once he thought about it a bit. Chaz could be such a mean son of a bitch, why wouldn’t Kelly have tried to sneak around on him? Tommy rather liked the possibility that she and Garnet had been fucking each other with no one the wiser. People who misbehaved, broke the rules, and didn’t get found out always pleased him, especially ones who were so outwardly on the up-and-up. It gave sneakiness a touch of class. Maybe he, too, could slip through the cracks and beat the odds – a loser’s lullaby, he knew, yet seductive enough to make him believe even a guy like him might take a chance and come up a winner.
“Tommy?”
She snapped him out of his reverie. “Sorry. The thought of them doing it, under our noses so to speak, took me a bit by surprise.”
“Do you think I’m right?”
“Maybe.”
“I was hoping you’d tell me that I was crazy.”
He flashed a grin and toasted her with his cup. “Then my verdict, dear Melanie, is you’re crazy.”
“What do you think I should do?”
He ignored the question, too busy wondering if there might be a way to use this information to benefit himself.
11:20 A.M.
Central Park, New York City
Earl hurried along the Central Park side of Fifth Avenue. A north wind sent fallen leaves flying in front of him and whipped up the flaps of his coat in bullying gusts. Cellular in his hand, he punched the redial button for Mark’s number. Still busy.
He walked a few blocks more, punched redial again, and got Mark’s answering machine. “Mark, it’s Earl. I just got out of the McShanes’ apartment. Nothing like a home visit to get at the truth in a family. Call me back as soon as you can. I think I figured out what your father really meant in his notes about Kelly. I need you to tell me if you think I’m crazy.”
He shoved the phone back in his pocket and increased his pace, as much to work off his excitement as to combat the damp and cold insinuating itself through his clothing.
Minutes later he felt the receiver vibrate. He had it to his ear halfway through the second ring. “Mark?’
“Yeah. What’s up?”
“Get out your father’s files and take another look at that medical report of Kelly’s first visit. You know how certain symptoms and signs sometimes fit together to remind us, as doctors, of certain syndromes.”
“Of course.”
“I want you to read it over with a question in mind. If you saw that little girl in an ER today, what might you at least think of?”
“Why? I thought we already agreed that the problem was functional.”
“Just humor me.”
“Okay. Hang on a sec.”
It seemed forever before he picked up again.
“I’ve got it in front of me.”
“Give me the differential you went through to rule out organic causes for her complaints.”
“That’s easy. I first thought of chronic disorders such as inflammatory bowel disease or malabsorption syndromes. But my father said that she’d no history of fever, and her blood tests were repeatedly normal. Presumably that meant they showed no history of anemia, elevated sed rates, or protein deficiencies. Without those changes, I wouldn’t even consider the diagnoses.”
“What else?”
“You mean really bizarre stuff?”
“Yes.”
“I don’t know. If she continued to have complaints, and actually lost more weight or started to have night sweats, I might get more aggressive and want to rule out childhood malignancies, leukemia, lymphoma, that sort of thing. But it obviously wasn’t any of those. Kelly lived to be a healthy adult.”
“All the GI complaints. A history of multiple doctor visits, a surgeon persuaded to operate on a normal appendix and do a laparotomy. Batteries of normal blood tests and negative X rays. And the only concrete sign is her being slightly underweight? Add in the mother being a drama queen who even now uses Kelly’s death to make herself the center of attention, and what does all that suggest? Would you still think the visit to your father involved nothing more than a neurotic, overprotective mother seeking excessive reassurances that her daughter was okay? Or would you think of a disorder that wasn’t even officially recognized until about thirty years after your father saw them?”
“Oh, my God! You mean Munchausen by proxy?”
“I’m not willing to go that far. But there are disturbing similarities.”
Munchausen by proxy syndrome was among the darkest of mental illnesses. Named after a German baron in the eighteenth century who’d been notorious for constructing elaborate lies to scam money from unsuspecting victims, it designated a disorder far more fiendish than any con for money. Parents, usually mothers, would deliberately inflict illnesses on their children. The techniques varied, from rubbing the skin raw to simulate mysterious rashes, through feeding them purgatives and laxatives to create bizarre GI symptoms, to smothering. An offender would then present her child to unsuspecting doctors as a medical mystery, and play the role of an untiring, long-suffering parent who sacrificed all to care for her child, reaping the subsequent attention bound to be lavished on her.
The literature related how a few carried off the ruse so well they’d been awarded Mother of the Year citations before being found out. The worst of them ended up killing their offspring outright, casting themselves in the part of the ultimate victim – a grieving mother – guaranteeing showers of sympathy. Earl’s worst nightmare throughout a lifetime of practice, as it was for all physicians, had been that he would miss diagnosing one of these helpless children because a cunning parent outsmarted his clinical skills. Current estimates suggested 30 percent of the victims eventually perished, but the number could be much higher. Mortality statistics were hard to come by because some of the cases that ended in murder were misdiagnosed as crib deaths, and the children who managed to outgrow the clutches of their secret abusers as they became too old to fool might never be diagnosed.
Mark took a few seconds to reply. “You figure Samantha was… Jesus Christ, her own mother was deliberately making Kelly ill-”
“Whoa, Mark! Quit jumping to conclusions. No, I don’t think it was as full-blown as that. At least there’s no evidence of Samantha having gone as far as actually physically injuring Kelly. But there’s one feature of that syndrome that does remind me of Samantha – the concerned mother carting her daughter from doctor to doctor, all the time insisting the child is ill, and, if her manner then was what it is now, playing the part of a self-sacrificing woman to the hilt.”
“I never would have imagined anything like this.”
“Neither did I, the first time you showed the file to me. But seeing Samantha today on her own turf…” He quickly related the highlights of his visit. “… the narcissism, the sense that only her grief counts, her forever playing to an audience, the fact she’s even made a shrine to Kelly – it all fit together with a big clunk.”
Mark let out his breath in a long, mournful whistle.
“Even if Samantha wasn’t physically harming Kelly, and her particular game doesn’t have its own fancy diagnosis,” Earl continued, “years of telling her that she was sick, suffering from a mysterious, terrible ailment that the doctors could neither diagnose nor make better, would be devastating psychologically. She’d be left with problems of anxiety, self-esteem, image, trust – a host of difficulties…” That he could coolly paint such a troubled clinical picture of a woman he once loved brought him up short. “Well, you get the idea.”