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Authors: Randy Chandler

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“Sharyn Rampling, a forty-two-year-old unmarried Caucasian, professor of English literature at the community college. She’s been an outpatient of Dr. Crandle’s for five years.” Carrie paused to consult her admission notes. “Diagnosed as bipolar and hospitalized once in 2004 when she stopped taking her lithium and went into a full-blown manic phase. She responded well to treatment. Dr. Crandle got her stabilized on her medication and she was discharged after two weeks. She says she’s been taking her lithium religiously since then.

“She presented tonight in an agitated state. A state of near-panic, I’d have to say. She said she had to be admitted because this was the only place she had ever felt completely safe and protected. Patient stated, ‘I desperately need to be safe right now.’ When I asked her what she needed to be protected from, she said she would only discuss that with Dr. Crandle. I explained that Dr. Crandle is on vacation and that you’re covering for him. I don’t know if she will share her big dark secret with you or not.”

Knott nodded. “Does she seem manic to you?”

“No. She seems like something scared the bejesus out of her. If she’s delusional, she’s keeping her delusions to herself.”

“Go ahead and do the routine blood work and a lithium level. You have her old chart?”

“Just brought it up from Medical Records.” She handed him a manila folder containing the records of Rampling’s previous hospitalization.

“Thanks. I’ll look this over while you draw her blood.”

Ten minutes later, Knott rapped on the door of room 207 to announce his entrance. “Miss Rampling, I’m Dr. Knott. Dr. Crandle asked me to see his patients while he’s on vacation.”

She rose from a seated position on the edge of the bed. Sharyn Rampling was a tall, attractive woman who looked a little younger than her stated age. The stark whiteness of her oval face was framed by the dark bangs and tresses of her shoulder-length hair. Her dark eyes shone wetly, as if she had been recently crying. She clasped her trembling hands in front of her, interlacing her fingers, and rested them beneath her abundant breasts. Each finger bore a gemstone ring. “I’ve seen you on campus,” she said. “You taught Abnormal Psych.”

“Yes, I did, last year. As a guest lecturer.” He sat in the wing chair in the corner of the private room, crossed his legs and rested the unopened chart on his knee.

She turned her profile to him and appeared to be studying the uninteresting painting on the beige wall. “I don’t know if I should confide in you, Doctor. I’m sure you know your job, but I don’t know that I can just start in cold and trust you with my … my problem.”

“Nurse Sanders told me you said you came here to be protected.”

She turned to face him directly. “Yes, I did say that. But now that I’m here, I don’t feel any safer.”

“What is it that’s threatening your safety?”

“I … I can’t say. I mean, I don’t
know
what it is. I just know it … something … wants something.”

“Wants something from you?” he asked as gently as he could.

She unclasped her hands and slid her bejeweled fingers into the front pockets of her tight jeans, the sparkling rings resting just above the seamed slits and creating the illusion that the pockets were embroidered with gemstones. “I know it sounds at least a little delusional,” she said in a husky voice, “but that’s what I believe. Whatever it is, it
wants
something from me. I can feel it pulling at me.”

“Wants you in what sense?” Knott deliberately shifted the focus onto the patient as the desired object. He hoped he wasn’t being too abruptly obvious with his tactic.

Her eyes narrowed and she puffed herself up in the manner of a cat trying to make itself look more formidable when threatened. “You’re asking me if it wants me
sexually
? Just come right out and say what you mean, Doc. We’re adults, are we not? Does this … this
thing
want to
fuck
me? To defile me in every way imaginable and then in ways you could never
even
imagine? To sully my soul?! Make me do things that would
damn
me
forever?!
” Her shoulders slumped with the release of some of her pent-up emotion. Her voice softened. “I don’t know. I don’t know what it wants. I don’t …”

A volley of thunder shook the building and blowing rain pelted the windowpanes. A tear rolled down Sharyn Rampling’s cheek. She moved to the window and parted the curtains. “All I
do
know is that it’s out there, waiting. Probably watching.”

“And you know this, how?” Knott scribbled a note in the chart:
Pt. histrionic with a flair for melodrama.
But she was a teacher of literature, so it was possible that her melodramatics might be, in part, a function of her educational vocation. He penned a question mark after the notation.

She turned away from the window, letting the curtain fall over the dark glass. “I know it because it
touched
me.”

A hollow laugh escaped her lips. “That’s funny, isn’t it, Doc? I say it touched me, and you’re thinking, ‘Yeah, she’s
touched
all right. Touched in the head.”

“That’s not at all what I’m thinking,” he said.

“Shrinks are all alike. You never really
say
anything. You just run through your list of premeditated responses and use the ones most likely to hit the patient’s hot buttons. I know how the game is played. I’m not a novice.”

“This isn’t a game. Games are played for amusement, for fun, or for profit. You’re clearly not having fun. Something has pushed you right up to the edge of panic and I’m trying to find out what that something is. Now, tell me how it touched you.”

Her face seemed to relax a little. The patient had challenged the therapist and the therapist had risen to the challenge without getting angry or sidetracked. “There was this
sound
. A terrible shrieking sound, sort of like the cry of a wildcat, but I’ve heard wildcats and that’s not what it was. More like a fox, maybe. No, it was like nothing I’d ever heard before—a wildcat’s cry notwithstanding. I was sitting at home in my study, reading Yeats, and this screeching comes out of nowhere. It was outside the house, but it got louder and louder, almost as if it were somehow inside and outside at the same time. One long, continuous cry that seemed to …
penetrate
me. It was as if I were being
violated
by the sound. I was terrified, so frightened I couldn’t move. Then everything fell out of focus and …” She shook her head. “My memory is fuzzy on this part, but when the shrieking finally stopped, I was shaking all over in terror and I discovered I had actually
wet my pants.

She gave him a pointed look, waiting for a reaction. When she didn’t get one, she added, “I mean, my God, I’m only forty-two. I’m hardly old enough to start wearing Depends.”

“Have you been taking your lithium as prescribed?”

“Oh yes. My lab results will prove it. I’m not going manic, Dr. Knott. I’m not delusional, I’m
scared
.”

He nodded. “We may need to adjust your dosage. Although they are rare, incontinence, ringing in the ears and blackouts are possible side effects of lithium. Since you’ve been taking it for several years, I don’t think that is what’s going on here. It’s more likely that you are in the early stages of lithium toxicity.” He opened her chart to the Physician’s Orders section and began writing as he continued to talk. “You’ve been taking three-hundred milligrams three times a day. I’m going to withhold your lithium until I see the lab results tomorrow, then we’ll know how to proceed. How have you been sleeping?”

She shrugged. “Okay, I guess. I’ve always been a light sleeper. I doubt I’ll sleep tonight, though. Not with that—whatever the hell it is—out there.”

“You’re perfectly safe here, Miss Rampling. If there
is
something ‘out there,’ I’m sure it’s no threat to you. What you probably heard was a couple of cats going at it. Or something just as innocent. I’m prescribing a mild sleep medication. In the morning the internist will give you a physical exam, and I’ll see you again tomorrow afternoon.”

Knott closed the chart and stood to leave.

“I want you to be right about all this,” she said, crossing her arms beneath her breasts. “I hope it’s just a simple matter of adjusting my medication. But you want to know what I
really
believe? I believe something’s happening here that’s beyond the realm of medical science. If that sounds delusional, I’m sorry. That’s what I believe. You’re familiar with the concept of synchronicity? That seemingly random events occurring within a given timeframe form a pattern that isn’t at all random?”

“Yes, I am. I considered myself a Jungian when I first started my practice.”

“Well, I always thought the point of synchronicity is that there’s some underlying Godlike intelligence that pulls cosmic strings to create those patterns. Like Fate.”

“Or the collective unconscious.”

“And that those patterns might provide hints of things to come. Well, when I heard that God-awful shrieking, I was reading Yeats’ famous lines: ‘And what rough beast, its hour come round at last, slouches toward Bethlehem to be born?’ How’s that for synchronicity?”

Knott smiled. “One of the curses of a strong intellect is an overabundance of imagination.”

“Did Jung say that?” She cocked the brow over her left eye.

“No, I did.” He allowed a small smile.

“Oh.” She rubbed her arm as though she were cold. “Those lines of verse keep running through my head like a song you can’t stop humming. But in my twisted version, the beast is slouching toward
Dogwood
to be born.”

* * * *

Knott envied his colleague, Steve Crandle. Sharyn Rampling was the type of patient a good psychiatrist hopes for but seldom encounters. Witty, well-educated and, above all, challenging. And it didn’t hurt that she was alluringly attractive. The bulk of Knott’s patients were middle-aged deadly-dull depressives and poorly educated schizophrenics whose treatment consisted primarily of medication maintenance, and only a very few of them were amenable to true psychotherapy. Sharyn Rampling was the exceptional patient, and Knott wished, for selfish reasons, that he could engage her in ongoing psychoanalysis. A patient of her caliber was wasted on a doctor like Crandle, whose psychoanalytic technique consisted of engaging the patient in aimless chit-chat or babbling on about his collection of antique cars, while scribbling scripts for medication. Knott consoled himself with the fact that he would have nearly two weeks to work with Miss Rampling before Dr. Crandle returned from his European vacation.

On his way back to the nursing station, he saw Tom Riley, the night-shift PA (Psychiatric Assistant), conducting his hourly bed checks, going room-to-room with a flashlight to make sure each patient was safe (and breathing) in his or her own bed. As they passed in the corridor, he and Tom quietly acknowledged each other with a nod. Before Knott reached the nursing station, Tom called out to him in a loud whisper: “Doc! Doc, you gotta see this!”

He did a quick about-face and joined Tom Riley in the doorway of room 202. Tom turned on the overhead light and the room seemed to leap forward out of darkness. An emaciated elderly woman in a wispy white gown was marking on the wall with a red crayon. When Knott recognized the patient, he understood Tom’s sudden animation. She was Elsa Loveless, the ninety-two-year-old resident of a nearby nursing home who had been transferred to Ridgewood after she lapsed into a near-catatonic state. In the week since her admission, she had remained completely uncommunicative and incapable of feeding herself. And now here she was, standing on frail legs and drawing on the wall, apparently oblivious to the presence of two men in her room.

“Miss Loveless?” said Knott. “Elsa?”

She gave no sign that she had heard him, and continued her work with the crayon.

“What the heck is that?” Tom pointed at the red confusion of squiggles, swirling lines, and blotchy shadings of the old woman’s childlike drawing.

“I think she’s writing a caption,” Knott said. “Let her finish.”

They watched in silence as she printed a single word beneath her artwork, the crayon clamped awkwardly in her gnarled claw-like fingers. When she was done, she turned away from the wall and began to slash at her wrist with the waxy tip of the crayon.

“That’s really weird,” Tom said, shaking his balding head.

“Let’s get her back to bed,” Knott said, gently taking hold of both her wrists. “Come on, Elsa. It’s bedtime. We don’t want you to fall.”

She offered no resistance. After she was safely tucked in, the two men raised the metal bed rails, and then simultaneously returned their attention to the markings on the wall. Like patrons of an art museum trying to make sense of a mystifyingly abstract painting, they stared at the bizarre artwork of Elsa Loveless. The word printed beneath the helter-skelter sketch only added to the enigma of the drawing itself:

HELLING

“What does that mean, Elsa?” asked Knott. “‘
Helling
.’”

A faint smile (or perhaps a grimace) appeared on her thin lips, then she closed her pale blue eyes and immediately began to snore.

“Considering that she was working in the dark and she’s legally blind, I guess we can’t expect it to look like much of anything,” Tom observed.

“You’re right. Still, I’d like to know what she
thought
she was drawing.
And what prompted her to come out of la-la-land long enough to draw it.”

“Well, clearly she’s not going to tell us.”

Knott took another long look at the mystery sketch, then said, “Tom, make sure that no one cleans that off the wall. Not without my say-so.”

“You got it, Doc. Mind if I ask why?”

“Yes, I do.” Tom Riley shrugged.

“Ooh-kay.”

Knott hated to be rude, but in this case a rude response was better than a truthful one, and the truth was, he wasn’t sure why he wanted the strange drawing left intact. He knew only that he did.

Chapter Two

From the front porch of her house overlooking the hamlet of Widow’s Ridge, Liza Leatherwood watched the sun climb higher above the mist-shrouded hills and wondered if she could survive another sleepless night. “Lord,” she said, sighing. “I feel nea’ly ’bout as old as them hills.”

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