The clerk paused, then reached down and plucked another, smaller envelope from the desk drawer. “Here,” he said. “This goes with it. But it was attached to the outside of the file, you know, clipped on. I didn’t give it to the guy. I don’t know why. Figured he had it, because he seemed to know all about the case.”
“What is it?”
“A police report and a death certificate.”
Ricky breathed in sharply, filling his lungs with the stale hospital basement air.
“What’s so important about some poor woman who showed up at the hospital twenty years ago?” the clerk abruptly asked.
“Someone made a mistake,” Ricky answered.
The clerk seemed to accept this explanation. “So now someone’s got to pay?” he asked.
“It would seem so,” Ricky replied, as he gathered himself to leave.
Chapter Eighteen
Ricky walked out of the hospital building, still feeling a tingling in his hands, especially in the fingertips that he’d dug deeply into the clerk’s collarbone. He was unable to recall a moment in his life when he’d used force to accomplish something. He thought he lived in a world of persuasion and discussion; the idea that he’d used physical strength to threaten the clerk, even if so modestly, told him that he was crossing some sort of odd barrier, or stepping past some unspoken point of demarcation. Ricky was a man of words, or, at least, had thought so until he’d received the letter from Rumple-stiltskin. In his pocket was the name of the woman he’d treated at a moment of transition in his own life. He wondered if he had reached another such point. And, in the same moment, he wondered whether he was standing at the edge of the road to becoming something new.
He walked toward the Hudson River, heading through the huge hospital complex. There was a small courtyard not far from the front of the Harkness Pavilion, a branch of the facility, one that catered to the particularly wealthy and particularly sick. The buildings were huge, multistory brick and stone edifices, that spoke of solidity and sturdiness, standing defiant against the many faces of infinitesimal and puny disease organisms. He remembered the courtyard from years before as a quiet place, where one could sit on a bench and allow the city noises to fade away, alone with whatever beast of a problem yapped and gnawed at one’s insides.
For the first time in nearly two weeks he found that the sensation of being followed and watched had slipped away. He was sure that he was alone. He did not expect this state to last.
It did not take him long to spot the bench, and within moments he was seated, the file and envelope provided by the clerk in the records office on his lap. To a passerby, he would have appeared to be simply another physician or relative taking a moment outside the hospital to consider some issue, or steal a bite of lunch. Ricky paused, a little uncertain what he might be opening by removing the documents, then reached into the folder.
The name of the woman patient he’d seen twenty years ago was Claire Tyson.
He stared at the letters of her name. It meant nothing to him.
No face sprang into his recollection. No voice echoed in his ear, recalled from twenty years before. No gestures, no expressions, no tones crossed the barrier of years. The chord of memory went silent, unplayed. It was simply one name out of dozens from that time period.
His inability to recall a single detail filled him with ice.
Ricky read quickly through the intake form. The woman had come to the clinic in a state of near acute depression coupled with paniclike anxiety. She had been referred to the clinic by the emergency room, where she’d gone for treatment of contusions and lacerations. There was evidence of an abusive relationship with a man, who was not the father of her three young children. Their ages were given as ten, eight, and five, but no names were included. She was only twenty-nine years old, and had given an apartment address not far from the hospital, which Ricky knew instantly was in a very nasty part of the city. She’d had no health insurance and had been working as a part-time clerk in a grocery store. She was not a native New Yorker, but had family listed in the next of kin space from a small town in northern Florida. Her Social Security number and telephone listing were the only other completed items on the intake form.
He turned to the second sheet, a diagnosis form, and saw his own handwriting. The words filled him with dread. They were clipped, curt, to the point. They lacked any passion and sympathy.
Miss Tyson presents as a twenty-nine-year-old mother of three young children in a possibly physically difficult relationship with a man not their father. She states that the children’s father abandoned her several years ago to take a job working on oil rigs in the Southwest. She has no current health insurance and is able to work only part-time, as she has no funds to hire adequate child care. She receives state assistance from welfare, and federal AFDC, food stamps, and housing subsidy. She further states that she is unable to return to her native Florida, having been estranged from her mother and father by her relationship with the children’s father. She additionally claims no funds available for such a move.
Clinically, Miss Tyson appears to be a woman of above average intelligence, who cares deeply about her children and their welfare. She has a high school diploma and two years of college, having dropped out when she became pregnant. She appears significantly undernourished and has developed a persistent tic in her right eyelid. She avoids eye contact when discussing her situation, only lifting her head when asked about her children, whom she states are very close. She denies hearing voices, but admits to spontaneous eruptions of tears of despair that she is unable to control. She says she remains alive only for the children, but denies any other suicidal ideation. She denies drug dependency or addiction, and no visible signs of narcotics use were seen, but a toxicology screen is warranted.
Initial diagnosis: Acute persistent depression caused by poverty. Personality disorder. Possible drug use.
Staff recommendation: Outpatient treatment to state mandated limit of five sessions.
Then he’d signed the bottom of the page. He wondered, staring at his signature, whether he had signed his own death warrant.
There was another entry, on a second sheet, showing that Claire Tyson had come back to see him in the clinic four times, and had failed to appear for her fifth and last authorized session. So, Ricky thought, at least his old mentor, Dr. Lewis, had been wrong about that. But then another thought occurred to him and he flipped open the copy of the death certificate complete with the city coroner’s seal and compared that date to the initial treatment date on his own clinic form.
Fifteen days.
He sat back hard on the bench. The woman had come into the hospital, been directed to him, and half a month later she was dead.