She was surprised when the doctor answered his own phone. She stammered briefly as she went through the now-memorized bit about Uncle Ed and a memorial fund.
“A memorial fund?” the doctor asked.
“Yes,” she said.
He hesitated. “Well, I suppose I could kick in a small amount.”
“That would be great,” she replied.
Again he hesitated. His voice seemed to take on a different pitch. “That can’t really be why you’re calling,” he said decisively.
She tried to rapidly form some sort of excuse or explanation, but could not. “No. Not exactly,” she said.
“Then, please, what is it?”
“We… I… uh, don’t think Ed committed suicide. We think there’s some incident way in his past that…” She paused, unsure how to continue.
“An incident? What sort of incident?”
“Something that connects his past with his present,” Andy replied.
“That is about as simple and accurate a description of psychiatry as you could possibly come up with,” the doctor said with a small, disarming laugh. He continued, “And my part in this?”
Again she paused. “Third year, medical school.”
Now it was his turn to be silent for a few seconds.
“The best worst year,” he said. “What’s the cliché? That which doesn’t kill you makes you stronger. Whoever thought that foolishness up never spent three hundred and sixty-five days as a third-year medical student and certainly knew nothing about mental illnesses.”
“Do you remember Ed?”
“Yeah. Maybe. A little bit. He was a good guy. Smart and incisive, I remember. We shared a class or two, I think-no, we had to have. We were in the same field, heading in basically the same direction. But that’s not the point, is it?”
“No.”
“I’m not accustomed to speaking with people about sensitive matters over the telephone,” he said.
“We need help,” Andy burst out.
“Who is the we you refer to?” The doctor was being cautious.
“Ed’s nephew. He’s my friend.”
“Well, I don’t know how much I can help.”
Andy Candy remained quiet, figuring he would continue. She was correct.
“What do you know about the third year of medical school with a concentration in psychiatry?” the doctor asked abruptly.
“Not much. I mean, it’s when you make a decision-”
“Let me interrupt you,” he said sharply. “It is…” He paused, considering what he was going to say. “There was a movie. The Year of Living Dangerously. A nice descriptive phrase. That’s what it was for all of us.”
“Can you help me understand?” Andy Candy asked, thinking that was a good way to keep a psychiatrist talking.
The doctor paused.
“Two things. First the context: third year. Then what happened, although I’m not sure I know too much about anything. There were some rumors, I recall. But none of us had the time to pay any attention to rumors. We were all too concerned with what was right in front of us.”
“Okay.” She was trying to lead him.
“Third year is filled with stress for any medical student. But psychiatry provides a different stress, because of all the disciplines in medicine, ours is the most elusive. There’s no rash on the skin, trouble urinating, difficulty breathing, or unexplained cough to help us out. It’s all about interpreting unusual behaviors. Third year, we were all physically exhausted, half-psychotic ourselves. We were vulnerable to many of the diseases we were studying. Crippling depressions. Doubts. Sleep deprivation and hallucinations. It’s a very difficult time. The demands were relentless and fears of failure very real.”
“So…”
“I hated that year and loved it, too. In retrospect, it’s a year that brings out the best and worst inside you. A defining year.”
“Did you take a course with Professor Jeremy Hogan?”
The psychiatrist hesitated again.
“Yes. His lecture course on forensic psychiatry. It had a great nickname: Reading Killers. It was fascinating, even if outside my interests.”
“Ed Warner was in the course too, and something connected Doctor Hogan to Ed and some other students…” She quickly read off the names of the other dead psychiatrists.
The doctor paused again. “To the best of my memory-remember, we’re going back decades here-those were probably the members of Study Group Alpha. I can’t be sure, understand? I mean, it was many years ago. In third-year psychiatry, there were three study groups: Alpha, Beta, and Zeta. That was a joke in Latin-first, second, and last. There were five of us randomly assigned to each group. Some natural rivalries arose-every group wanted the best GPA, wanted the best Match Day results. But there was a problem in Alpha.”
“A problem?”
“One student seemed to be trapped in psychosis. At least, that was the story that went around. Of course, with the stress, the decisions, the never-ending course work, plus the fear that we’d make a diagnostic mistake, every group had members on edge. Breakdowns weren’t uncommon…”
The psychiatrist paused again.
“His was.”
A Short, but Dangerous Conversation That Actually Happened
“Doctor Hogan, I’m sorry to disturb you…”
“What is it, Mister, uh… Warner, correct?”
“Yes, sir. I’m here on behalf of my fellow study group students…”
“Yes? I have a class scheduled and not much time. Can you get directly to the point?”
Ed Warner: Deep breath. Organizing thoughts quickly. Shuffling feet. Sensation of doubt.
“Four members of Study Group Alpha are concerned with the behavioral patterns of the fifth member. We sincerely believe that he presents a genuine threat, either to himself, or perhaps to us.”
Jeremy Hogan: A pause. Rocking in a chair. Tapping a pencil against teeth. Scheduled class mentally postponed.
“What sort of threat?”
“Physical violence.”
“That’s quite an accusation, Mister Warner. I hope you can back this up.”
“I can, sir. And coming to speak to you was, all of us felt, the last resort.”
“You understand an accusation like this can impact all of your careers?”
“We do. We’ve taken that into consideration.”
“And why have you brought this to me?”
“Because of your expertise in explosive personalities.”
“You believe your fellow student is on an edge that might result in… precisely what, Mister Warner?”
“Over the last weeks, this student’s behavior has grown increasingly erratic, and-”
“Exams are approaching. Many students are on edge.”
Ed Warner: Another deep breath. A quick glance at sheaves of paper from each member of the group, outlining impressions.
“Last week he strangled a lab rat in front of all of us. No reason. He just seized the rat and killed it. Flat affect as he did it. It was like he was demonstrating his ability to kill without remorse. He constantly talks to himself, in a rambling, disjointed, usually incomprehensible, but frequently angry manner-especially as it relates to his family pressures and then, about us. He is isolated, but threatening. He claims to own weapons. Guns. Every effort we have made to engage him, maybe defuse the situation, get him to seek help, has been rebuffed. Sometimes his facial expressions are labile and disconnected to recognizable context-one second he will laugh inappropriately, then a second later he will burst into tears. Last week he took a scalpel from a surgical theater and sliced the word kill into his forearm in front of all of us, while we were holding a pre-exam cram session. I’m unsure that he either felt any pain in that second, or realized what he was doing. Whenever anyone in the study group seeks to correct him, point out a difference of opinion, even suggest a different type of answer to an academic question, he is likely to suddenly scream in their face, or else stare hatefully at them. Sometimes he writes down our names, the date, and a description of the dispute in a notebook. It’s like he’s not taking notes for class, but taking notes on us. Preparing a case, I think, to internally justify an act of violence…”