Sister Page 11

  As I did my shift that evening, I thought that because you had died, there was, of course, a part-time position that had needed filling. But recently I discovered that someone else had already taken the job, so she’d hired me out of loyalty to you and sympathy for me.

  I get home from the Coyote at almost midnight and don’t expect many, if any, press. It’s too late and in any case after the frenzy of the last few days they must have got all the pictures and footage they need. But I was wrong. As I get near, I see there’s a gang of them, their huge lights shining, and illuminated in the middle is Kasia. She’s been at a friend’s house for the last two days, until I thought the press attack would have died down enough for her to return. She’s living with me now, which I think you’re pleased about but curious about how we fit. Well, she has your bed and I have a futon in the sitting room, which I unroll each night, and we somehow squash in.

  As I get closer, I see how shy she looks, anxious about the attention, and exhausted. Feeling furiously protective, I shoo photographers and journalists out of the way.

  “How long have you been waiting?” I ask her.

  “Hours.”

  For Kasia that could mean ten minutes upward.

  “What happened to your key?”

  She shrugs, embarrassed. “Sorry.” She’s always losing something and this reminds me of you. Sometimes I find her scattiness endearing. This evening, I have to admit to being a little irritated. (Old habits die hard, and to be fair, I’m exhausted after a long stint at the CPS, a shift as a barmaid, and now I’ve got the press shoving cameras into my face for what I imagine to be a poignant-moment shot.)

  “Come on, you need something to eat.”

  She’s only a week away from her due date now and she shouldn’t go too long without food. She gets faint and I’m sure it can’t be good for the baby.

  I put my arm around her to usher her inside and the cameras click in synch.

  Tomorrow, next to the picture of me with my arm around Kasia, there will be similar articles to the ones there were today about my “saving” Kasia. They actually use words like that: “saving” and “owing her life to,” comic-book words that are in danger of turning me into someone who wears pants on the outside of her tights, switches outfits and personas in telephone booths and has web coming out of her wrists. They will write that I was too late to save you (that telephone booth change just not quite quick enough), but how because of me, Kasia and her baby will live. Like all of us, their readers want a happy ending to the story. It’s just not my story. And my ending was a strand of hair caught in a zipper.

  8

  Thursday

  I am walking across St. James’s Park toward the CPS offices. The sky is blue again today, Pantone PMS 635 to be precise, a hopeful sky. This morning Mr. Wright is going to ask me about the next installment in your story, which is my meeting with your psychiatrist. But still half asleep, my mind lacks the necessary clarity so I will run through it out here first, a mental dress rehearsal before I tell Mr. Wright.

  Dr. Nichols’s NHS waiting list was four months, so I paid to see him. His private patients’ waiting room looked more upmarket hairdressing salon than anything remotely medical: vases of lilies, glossy magazines, a mineral water dispenser. The young receptionist had the same de rigueur disdainful look, lording her keeper-of-the-gate power over the clients waiting. As I waited, I flicked through a magazine in a futile bid to look occupied. It had the next month’s date on the cover and I remembered you laughing at time-traveling fashion mags, saying the date on the cover should alert people to their absurdity inside. Nervous mental chatter because there was so much riding on this meeting. It was because of Dr. Nichols that the police were convinced you had postpartum psychosis, because of him that they were sure you committed suicide. It was because of Dr. Nichols that no one was looking for your murderer.

  The receptionist glanced at me. “What time did you say your appointment was?”

  “Two-thirty.”

  “You were fortunate Dr. Nichols made a space to see you.”

  “I’m sure I’ll be charged accordingly.”

  I was limbering up for a little more confrontation. She sounded irritated. “Have you completed the form?”

  I gave her back the form, which was blank apart from my credit card details. She took it from me, voice snide, eyes scornful. “You haven’t filled in any of your medical history.”

  I thought of people coming here who were depressed, or anxious, or losing their grip on reality and falling into the void of madness; fragile, vulnerable people who were owed at least a little civility by the first person they would have to talk to.

  “I’m not here for a medical consultation.”

  She didn’t want to show me she was interested. Or maybe she thought I was just another barmy patient, not worth the bother.

  “I’m here because my sister was murdered and Dr. Nichols was her psychiatrist.”

  For a moment I had her attention. She took in my greasy hair (hair washing is one of the first corner cuttings of grief), my lack of makeup and the bags under my eyes. She saw the markers of grief but interpreted them as signs of madness. I wondered if, in a larger way, this was what happened to you: your signals of fear being interpreted as insanity. She took the form from me without another word.

  As I waited, I remembered our e-mails when I told you once that I was thinking of seeing a therapist.

  From: tesshemming@hotmail.co.uk

  To: Beatrice Hemming’s iPhone

  A shrink?! Why on earth do you want one of them, Bee? If you want to talk about something, why not talk to me or to one of your friends?

  T xox

  From: Beatrice Hemming’s iPhone

  To: tesshemming@hotmail.co.uk

  I just thought it would be interesting, valuable even, to see a psychiatrist. It’s completely different to talking to a friend.

  lol

  Bee XX

  PS They’re not called shrinks anymore.

  From: tesshemming@hotmail.co.uk

  To: Beatrice Hemming’s iPhone

  But talking to me comes free and I’d have your best interests at heart, and I wouldn’t limit you to an hour time slot.

  T x o x o

  PS They’re a hot cycle for the personality, shrinking you down to something that fits a category in a textbook.

  From: Beatrice Hemming’s iPhone

  To: tesshemming@hotmail.co.uk

  They’re highly trained. A psychiatrist (rather than a psychologist) is a fully qualified medical doctor who then specializes. You wouldn’t say they were washing machines if you were bipolar or demented or schizophrenic would you?

  Lol

  Bee

  From: tesshemming@hotmail.co.uk

  To: Beatrice Hemming’s iPhone

  Fair point. But you’re not.

  T X

  Ps I’ll shout that a bit louder in case it didn’t reach you up on that podium.

  From: Beatrice Hemming’s iPhone

  To: tesshemming@hotmail.co.uk

  I wasn’t just talking about the severely mentally ill needing a psychiatrist; the walking wounded sometimes need professional help too.

  Lol

  Bee x

  From: tesshemming@hotmail.co.uk

  To: Beatrice Hemming’s iPhone

  Bee, I’m sorry. Can you tell me about it?

  T X XXXX

  From: Beatrice Hemming’s iPhone

  To: tesshemming@hotmail.co.uk

  I have to go to a v. important meeting, talk later.

  Bee x

  From: tesshemming@hotmail.co.uk

  To: Beatrice Hemming’s iPhone

  And I’m meant to be waitressing not e-mailing you from Bettina’s computer, and table four’s still waiting for their cheese but I’m not budging till you reply.

  T Xxxx

  From: tesshemming@hotmail.co.uk

  To: Beatrice Hemming’s iPhone

  Table four’s gone home cheese-less. Giv
e me a break here will you? I’m even using Americanisms, so you can see how desperate I am for you to forgive me.

  T XOX

  From: tesshemming@hotmail.co.uk

  To: Beatrice Hemming’s iPhone

  My shift’s over now Bee-bean, and I’m still at Bettina’s computer, so e-mail back as soon as you get this will you? Please?

  T XXXOOOO

  From: Beatrice Hemming’s iPhone

  To: tesshemming@hotmail.co.uk

  I wasn’t avoiding you, I was just in a meeting that ran on. Don’t read anything into this shrink business. It’s just a case of when in New York, do as New Yorkers… It must be past midnight in London so go home and get some sleep.

  lol

  Bee X

  From: tesshemming@hotmail.co.uk

  To: Beatrice Hemming’s iPhone

  If you don’t want to tell me, that’s OK. I’m guessing that your wound is to do with Leo? Or Dad?

  lol

  T X

  The receptionist looked up at me from her desk. “Dr. Nichols can see you now.”

  As I walked to his room, I remembered our phone call that evening (my time; two in the morning your time). I still didn’t tell you why I wanted to see a psychiatrist, but you explained why you didn’t think it was useful.

  “Our mind is who we are; it’s where we feel and think and believe. It’s where we have love and hate and faith and passion.”

  I was getting a little embarrassed by your earnestness, but you continued, “How can someone hope to treat another person’s mind unless they are also a theologian and a philosopher and a poet?”

  I opened the door to Dr. Nichols’s consulting room and went in.

  When you saw Dr. Nichols in his NHS clinic, he would have worn a white coat, but in his private consulting room he was in faded corduroys and an old lambswool sweater, looking scruffy against the regency striped wallpaper. I put him in his late thirties; do you think that’s about right?

  He got up from his chair and I thought I saw compassion in his rumpled face.

  “Miss Hemming? I am so very sorry about your sister.”

  I heard the sound of thumping from beneath his desk and saw an ancient Labrador dozily chasing rabbits in her sleep, tail wagging onto the floor. I realized that his office smelled slightly of dog, which I liked more than the lilies of the waiting room. I imagined the receptionist dashing in between patients with air freshener.

  He gestured to a chair near his own. “Please take a seat.”

  As I sat down, I saw a photo of a little girl in a wheelchair prominently displayed and I liked Dr. Nichols for being unconditionally proud.

  “How can I help you?” he asked.

  “Did Tess tell you who was frightening her?”

  Clearly taken aback by my question, he shook his head.

  “But she did tell you that she was getting threatening phone calls?” I asked.

  “Distressing phone calls, yes.”

  “Did she tell you who made them? Or what the person said to her?”

  “No. She was reluctant to tell me about them and I didn’t think it helpful to pursue it. At the time, I assumed they were most likely a cold caller or someone phoning a wrong number, and it was because of her depressed state of mind that she felt victimized by them.”

  “Did you tell Tess that?”

  “I suggested to her that might be the case, yes.”

  “And she cried?”

  He looked surprised that I knew. But I’ve known you all your life. At four years old you could have grazes on your knees and a bloody nose, but you never cried—unless someone didn’t believe you when you were telling the truth and then your streaming tears would express your outraged indignation.

  “You said that at the time you assumed them to be a cold caller or wrong number?” I asked.

  “Yes. Later I realized that Tess wasn’t depressed, as I’d first thought, but was suffering from puerperal psychosis, more commonly called postpartum psychosis.”

  I nodded. I’d done my homework. I knew that puerperal psychosis simply means it occurs during the six weeks after the birth.

  “Anyhow,” continued Dr. Nichols, “once I realized that she was suffering from puerperal psychosis, I realized that the phone calls were, most likely, auditory hallucinations. In lay terms, ‘hearing voices,’ or in Tess’s case, the sound of the phone too.”

  “You changed your diagnosis after she was found dead, didn’t you?” I asked and saw a flash of emotion over his crumpled face, momentarily hardening it. There was a moment before he spoke.

  “Yes. I think it might be helpful if I tell you a little more about puerperal psychosis. The symptoms can include paranoia, delusions and hallucinations. And the consequences, tragically, are a highly increased risk of suicide.”

  From my own research, I already knew that.

  “I’d like to get this clear,” I said. “It was after she died that you changed your diagnosis from depression to psychosis. And it was only then that the phone calls became ‘auditory hallucinations’?”

  “Yes, because auditory hallucinations are a symptom of psychosis.”

  “She didn’t have psychosis. Puerperal or postpartum, or any other kind.” He ineffectually tried to interrupt me but I continued, “How many times did you meet my sister?”

  “Psychiatry isn’t about intimate knowledge of a specific person, which you get in close friendships or with family members, nor in acute cases is it anything like the long-term relationship a psychiatrist has with a patient as a therapist. When a patient has mental illness the psychiatrist is trained to recognize certain symptoms the patient demonstrates.”

  For some reason, I imagined him practicing all this in the mirror beforehand. I repeated my question, “How many times?”

  He glanced away from me. “Just once. She was automatically referred to me because of her baby’s death, but she discharged herself from the hospital almost immediately after the birth, so I couldn’t visit her on the ward. She was given an emergency outpatient appointment two days later.”

  “Was she a National Health Service patient?”

  “Yes.”

  “On the NHS, your waiting list is four months. That’s why I am paying to see you.”

  “Tess was an emergency. All potential puerperal depression and psychosis cases are dealt with immediately.”

  “Dealt with?”

  “I’m sorry. What I meant was in terms of jumping any waiting list.”

  “How long is an NHS appointment?”

  “I’d rather have more time with each patient but—”

  “With a waiting list of four months, you must be under a great deal of pressure to get through them.”

  “I spend as much time as I possibly can with each patient.”

  “But it’s not enough, is it?”

  He paused a moment. “No. It’s not.”

  “Puerperal psychosis is an acute psychiatric emergency, isn’t it?”

  I thought I saw him flinch because I knew this, but I’d done my research beforehand.

  “Yes, it is,” he replied.

  “Requiring hospitalization?”

  His body language was rigidly controlled, arms held determinedly at his sides, his corduroyed legs a little splayed, but I knew that he wanted to cross his arms over his chest and put one leg over the other to give physical expression to his mental defensiveness.

  “Many psychiatrists would have interpreted Tess’s symptoms as I did, as indicators of depression rather than psychosis.” He absentmindedly reached down to stroke his dog’s silky ears as if he needed comfort, and continued, “Diagnosis in psychiatry is far harder than in other branches of medicine. There aren’t any X-rays or blood tests to help us. And I didn’t have access to her notes, so I didn’t know whether there was a history of mental illness.”

  “There isn’t any history. When was her appointment with you?”

  “The twenty-third of January. At nine a.m.”

  He hadn’t
consulted his diary or looked at his computer.

  He had come prepared for this meeting, of course he had. He’d probably been on the phone all morning with his medical defense union. I saw in his face a beat of some genuine emotion. I wondered if it was fearfulness for himself, or genuine upset about you.

  “So you saw her the day she died?” I asked.

  “Yes.”

  “And you thought the morning she died that she was suffering from depression not psychosis?”

  He could no longer hide his defensiveness, crossing one leg over the other, huddling into himself. “At the time, I didn’t see any indicators of psychosis. And she didn’t show any signs that she was considering hurting herself. There was nothing to suggest that she was going to take her life.”

  I wanted to scream at him that of course there were no signs, because you didn’t take your life; you had it violently cut from you. I heard my voice sounding distantly quiet against the shouting in my head. “So it was her death that rewrote your diagnosis?”

  He didn’t reply. I no longer found his rumpled face and corduroys endearingly scruffy, but hopelessly negligent.

  “Your mistake wasn’t that you diagnosed her with depression when she was actually psychotic.” He tried to interrupt me but I continued, “Your mistake is that you didn’t once think that she might be telling the truth.” Again he tried to interrupt me. Did he interrupt you too as you tried to tell him what was happening to you? I thought psychiatrists were meant to listen. I suppose in an emergency NHS appointment, probably shoehorned into a full clinic, there’s not much time for listening.

  “Did you even consider that the phone calls threatening her were real, just as the man who followed her to the park that day and murdered her was real?” I asked.

  “Tess wasn’t murdered.”

  I thought it strange he was so adamant. After all, murder would have let him off the misdiagnosis hook. He paused, then forced the words out as if they physically pained him.

  “Tess was having auditory hallucinations, which I’ve told you about, and we can disagree about the interpretation if you wish. But she was also having visual hallucinations. At the time, I interpreted them as vivid nightmares, not uncommon for a patient who’s depressed and bereaved,” continued Dr. Nichols. “But I’ve reread her notes and it’s clear they were hallucinations, which I missed.” The beat of upset in his face I’d seen earlier seemed to spread across his features. “Visual hallucinations are a clear signifier of acute psychosis.”