Therapy (7 page)

She nodded.

“When?”

“Gavin’s been in treatment for about three months.”

“Seven months after the accident.”

“It took a while for things to settle.”

I pretended to read the pad. “He was referred to your group, not to you directly.”

“Pardon?”

“I’ve been told that Gavin began with one of your partners but switched to you.”

She crossed her legs. The black marble pedestal blocked most of the movement, but I could see the tip of one red shoe. “Now that you jog my memory, that’s exactly what happened. Singh referred Gavin to the group and Franco—Dr. Gull—was on call. Franco saw Gavin a couple of times, then I took over.”

“Problems between Gavin and Dr. Gull?”

“I wouldn’t term them problems,” she said. “Back then—immediately after the accident—Gavin was extremely irritable. Once again, par for the course. You know how it can be with therapists and patients. Sometimes you mesh, sometimes you don’t. And Franco’s patient load was already heavy.”

The black eyes found mine. “Like with you and Teresa Wetmore. I’m sure most of your patients adore you and trust you. But others . . . are you with the police full-time or do you still see patients?”

“I do short-term private consults.”

“No therapy?”

“Not usually.”

“Private practice
can
be tough,” she said. “The HMOs with their nonsense, the thin referral stream when money gets tight. I suppose working for the police can be helpful providing a nice steady income.”

“I’m not employed by the police. I do short-term consults for them, too.”

“Ah . . .” She smiled. “Anyway, Gavin did become my patient, and I felt we were making progress.” Her legs uncrossed, and she shifted forward in her chair. “Alex, I can’t think of anything I could tell you that would help a police investigation.”

“What about Gavin’s obsessiveness?” I said.

“I wouldn’t call it that. Nothing on the level of a full-blown OCD. Gavin could be a bit persistent, that’s all.”

“Getting an idea in his head and not letting go?”

She smiled. “You’re making it sound more pathological than it was. He could be a bit . . . enthusiastic.”

“His parents said he’d switched career goals. From business to journalism.”

That seemed to surprise her, and I wondered how well she’d known her patient.

“People change their minds,” she said. “Young people especially. Sometimes tragedies get people to focus on what they really want to do.”

“Is that what happened to Gavin?”

Noncommittal nod.

“Did he have any plans to return to college?”

“It was hard for him to stay motivated, Alex. One of my goals was helping restore a sense of meaning to his life. But it had to be gradual. Gavin was still wrestling with the changes.”

“So he’d slowed down cognitively.”

“Yes, but it was subtle. And, I believe, exacerbated by emotional stress. I’m curious, Alex. Why are you so interested in his personality?”

“I’m interested in his obsessiveness because the police are wondering if it could’ve gotten him into trouble.”

“How so?”

“Angering the wrong person.”

“The wrong person.”

“Anyone who’d react violently.”

She touched a finger to her lip. “I’d be surprised at that—Gavin consorting with violent people. He was a nice boy, a
conventional
boy. He certainly never mentioned anything like that to me.”

“Was he pretty communicative?”

The black eyes rose to the ceiling. “How shall I put this . . . like many young men, Gavin wasn’t much for introspection.”

“What did he talk about?”

“I was working on getting him to open up about his feelings. Anger at feeling different. Guilt, about surviving the accident. Two of his friends were killed, you know.”

I nodded.

She said, “My sense was that Gavin knew he’d lost something—an edge, a sharpness—but he had trouble expressing himself about it. I suppose that could’ve been aphasic. Or just a postadolescent male’s lack of verbal skills. Either way, I knew he was wrestling with his feelings. I couldn’t push him too hard, Alex. One time, though, he did express himself in a way that I thought was extremely eloquent. This was just a few weeks ago. He came to session looking downcast. I waited him out, and finally he punched the arm of the sofa—that sofa—and shouted, ‘This is fucked, Dr. K! To everyone else I look okay, everyone keeps telling me I’m okay, but I know I’m not okay.’ Then he stopped, his chest was heaving and he was flushed, and the next time he spoke it was so soft I could barely hear him. What he said was, ‘It’s like one of those android movies. I’m not me, anymore, I’m still the box I came in, but someone’s fucking with the wiring.’ Then he said, ‘I really miss being
me
.’ And, finally, he cried. I thought it was a breakthrough, but the following week, he canceled his appointment, and the one after that. I’ve only seen him once, since then, and during that session it was as if nothing had happened. All he wanted to talk about was cars and sports. It was as if we were starting from square one. But that’s how it goes with young men.”

I said, “Did he talk about his social life?”

“Social as in dating?”

“Yes.”

“There’d been a girlfriend, some girl he knew in high school. But that was over.”

“Because of the accident?”

“That would be my assumption. Once again, I needed to step around personal topics.”

“Gavin was guarded about his outside life.”

“Very.”

“Did he mention any other girls?”

She shook her head.

“Would you mind looking at a picture of the girl who was killed with him? It is a morgue shot.”

She shuddered. “I don’t see the point.”

“No problem.”

“No, you might as well show it to me,” she said. “I need to integrate all this misfortune.”

I placed the death shot on the glass tabletop. She didn’t attempt to touch it, just stared at it. Her mouth lost determination. A vein pulsed at her temple. Rapid pulse.

“You know her?” I said.

“I’ve never seen her in my life. I’m just imagining. The way it was for the two of them.”

CHAPTER

7

M
ary Lou Koppel walked me out of her waiting room and watched me descend the stairs. When I paused to look back, she smiled and waved her fingers.

Back home, I checked my messages. Three nuisance calls and Allison letting me know she’d had a cancellation, it had been a long time since we’d seen a movie, did I have time tonight? I phoned her exchange, said how about dinner first, I could be there by seven.

Next, I booted up the computer, logged on to my faculty MEDLINE account, and reviewed articles on closed-head prefrontal injuries. With serious brain trauma, bleeding and lesions showed up on X-rays or CAT scans. But in less dramatic instances, the damage was subtle and invisible, the result of something called
axonal shearing
—a microscopic shredding of nerve fibers. Those cases resisted neurological tests and could be best diagnosed by neuropsychological evaluation. Instruments like the Wisconsin Card Sort or the Rey-Osterreith Complex Figure test pulling up problems in attention and thought and information processing.

Patients with prefrontal injuries sometimes had temper-control problems. And they could grow impulsive and obsessive.

I printed a few articles, changed into shorts and a T-shirt and sneakers, and took a long, hard run, not wanting to think about the short sad life of Gavin Quick. I thought about it, anyway, and focused on appreciating my own life. After showering and getting back into street clothes, I tried Milo at the station. By the time I’d reached his car phone, I’d put the interview with Mary Lou Koppel in context.

She’d cooperated but really hadn’t told me much. Maybe she didn’t know much. Gavin had been in therapy for three months, and my guess was there’d been plenty of missed appointments. Combine that with his resistance and Koppel’s avoidance of his cognitive problems, and treatment didn’t amount to much.

Mary Lou Koppel’s approach boiled down to what’s known in the trade as “supportive therapy.” Not necessarily a bad thing; sometimes all a patient needs is a yeah-saying or a shoulder to cry on. But sometimes being “supportive” is an excuse for not doing more.

“You’re saying she was phoning it in?” said Milo.

“Maybe she did her best. She sat in that office with Gavin, I didn’t.”

“Chivalrous. But you still don’t like her.”

“I have nothing against her,” I said.

“I must’ve heard wrong. You get into why she stonewalled you the first time?”

“She brought it up right away. Said the patient hated and distrusted me and forbade her to tell me anything.”

“Taking a dig at you, pal?”

“The patient did file an ethical complaint against me.”

“Ouch,” he said.

“The charge was dismissed.”

“Course it was,” he said. “What, a disgruntled weirdo?”

“Something like that.”

“Assholes.”

Supportive therapy.

I said, “Anyway, that’s about it on Gavin’s emotional state.”

“Not as smart as he used to be and obsessive.”

“We knew that before.”

“It’s still interesting.”

I said, “Anything new on the girl’s ID?”

“Nope. Not much in terms of physical evidence, either. Gavin’s prints popped up on the steering wheel but nothing on any of the door handles, not his, not the girl’s. Someone did a careful wipedown. Meaning an organized mind, right? Which would fit with the stalker scenario. Plenty of tire tracks on the driveway. Unfortunately, a whole mesh of them, too much overlay, so the techies couldn’t pick out a good impression. With Realtors going in and out, it’s what you’d expect. None of the neighbors saw or heard anything, no reports of suspicious characters or unfamiliar cars. I’m having the Sex Crimes people look at their files, see if any scary Peeping Toms are newly out on parole.”

“Any more about the sequence of death?”

“The coroner agrees with your logic about Gavin getting shot first, but he can’t make a definitive statement, has no physical evidence to back it up. The blood spatter says both Gavin and the girl were sitting down when they got popped, and the blood all over the girl’s chest plus almost nothing around the head wound says she was alive when that iron stick got jammed through her. I drove around looking for construction sites, see if I could find any missing wrought iron, but
nada
. I’m getting the feel of a surprise blitz. That make sense?”

“It makes perfect sense,” I said. “The bad guy follows them, watches, probably parks out on Mulholland and continues onto the property on foot. He waits, sees some necking, gets aroused. If the condom was Gavin’s, he and the girl would’ve been about to consummate. At that point, the bad guy steps out of the dark and boom.”

“The element of surprise. There was no semen in or on her, even though she was topless, her leggings were still on, so that sounds right.”

“Anything else on the autopsy?”

“Her last meal was half a Big Mac, a few fries, and ketchup. The estimate is six hours before she died. Gavin’s stomach gave up pasta with basil and garlic bread. Mrs. Quick confirms that’s what she’d cooked for dinner. She and Gavin ate together five hours before the murder. Then he spent some time in his room, and she went to hers and watched TV.”

“No dinner date,” I said. “Gavin and the girl ate separately, then hooked up. What time did Gavin leave his house?”

“Sheila didn’t hear him leave—got defensive about that and went on about Gavin being an adult, she didn’t want to hover.”

“Given what he’d been through,” I said.

“Yeah,” he said. “I showed Blondie’s picture to her again, ’cause she didn’t seemed as drugged. Same answer: total stranger.”

“Maybe it was a pickup,” I said.

“I thought about that and assigned a D-I to comb the clubs with both their pictures. The coroner prepared blood and tissue samples for DNA processing, but unless the girl’s physical data got coded in some official data bank, that’s likely to dead-end. So far, she doesn’t seem to be listed in any of our Missing Persons files. That could mean a runaway from another town, or the running away would’ve happened years ago. The coroner’s reluctant to estimate her age, but I had a close look at her and she seems slightly older than Gavin, maybe twenty-three to twenty-five. And she doesn’t look like a runaway. Her clothes were good, and she was put together nicely—makeup, earrings, nail polish. Not great teeth—she’s missing a few in the rear—but what shows is straight. Tint in the hair, but she’s a natural blonde. Coroner said he could smell perfume on her, thought it was Armani. I didn’t pick that up at the scene, and by the time I got to the morgue she was smelling of other things. But I’ll buy it, Dr. Quan has a good nose.”

“Too put-together for a prostitute?” I said.

“For a street girl, yes. Too conservatively dressed for your basic hooker. A higher-priced spread? Maybe. Why?”

“No dinner date,” I said. “Hooking up for one purpose.”

“You see a kid like Gavin knowing how to find himself a nice-looking pro like that? He was dressed like a student, it’s not like he put on a Zegna suit and trolled the B.H. hotels with a wad of cash.”

“But growing up in B.H. he might know about the hotels. With enough cash in his pocket, he’d be in a position to negotiate.”

“We found thirty bucks in his wallet.”

“What if he’d already paid the girl, and she had the money? Her purse is missing. If so, robbery would have been icing on the cake for the bad guy.”

“A call girl doing an outdoor trick with a brain-damaged kid,” he said.

“That’s the thing about some closed-head injuries. The problems can be subtle. Unless you knew what Gavin was like before, he wouldn’t have come across brain-damaged. Just a clean-cut kid driving a cute little red convertible. We know he could be impulsive and compulsive, and maybe that’s what led him to approach a pro. He’d have his needs—especially since the relationship with Kayla Bartell was over.”

“Koppel say why they broke up?”

“She assumed it was due to the accident. I don’t get the feeling she really knew much about Gavin.”

“A pro,” he said. “A young, horny guy, his girl breaks up with him, maybe his confidence slipped . . . could be.”

“Something else,” I said. “His talk about digging up dirt. What if he actually followed up on his tabloid dreams? What better place to nab a celebrity than an expensive hotel?”

“He starts out trawling for movie stars and picks up a pro?”

“Youthful impulsiveness heightened by brain damage.”

“Okay,” he said, “I’ll check out the concierges at all the Beverly Hoo-Has. Not that they’re going to admit letting pros through the door. I’ll also ask BHPD if they know her, as well as show her picture to our Vice guys. Meanwhile, she’s just a well-dressed blonde.”

“Anything traceable in her clothing?”

“The blouse was DKNY, Calvin Klein thong panties and pushup bra, no label in the leggings. Good shoes. Excellent shoes—Jimmy Choo. From what I hear, that’s a serious investment. There’s a Jimmy Choo store right in B.H, on Little Santa Monica, so I went over there. We’re talking five, six hundred bucks for a spike and a strap. No one recognized her as a customer, but when I described the shoe, the saleswoman knew it right away. Two seasons old, coulda been bought at discount at Neiman’s, Barneys, whatever.”

“Expensive shoes,” I said. “Well put-together. You’d think someone like that would be missed.”

“Sure, but a girl living alone, it could take a while for someone to realize she’s missing. It looks like this is gonna be a long, drawn-out deal. Thanks for your help, Alex. If I learn anything, I’ll let you know.”

*

I picked Allison up outside her office. Her hair was loose, and she laced her fingers through mine and kissed me hard. Neither of us was hungry, and we opted for movie first, food later. An old Coen Brothers film,
Blood Simple,
was playing at the Aero, a few blocks up on Montana. Allison had never seen it. I had, but the picture merited a second look.

We left the theater shortly after nine and drove over to Hakata on Wilshire where we sat in a booth, away from the rock-star posters and the good cheer of the sushi bar, and ordered sake and salmon skin salad and steak teriyaki and mixed sashimi.

I asked Allison how she’d have treated Gavin Quick.

“When I get head injuries they’ve usually been through a complete neuropsych eval,” she said. “If they haven’t, I send them for one. If the testing pinpoints deficits, I recommend some targeted special ed. With that out of the way, I concentrate on marshaling the patient’s strengths.”

“Supportive therapy.”

“Sometimes they need more than that. The challenge is learning to deal with a whole new world. But sure, support’s a big part of it. It can be tough, Alex. Two steps backwards for every step forward, lots of mood changes, and you never know what the end result will be. Basically you’ve got a person who knows he’s not what he used to be and feels helpless to change.”