State of Mind (Brier Hospital Series)
State of Mind
By
Lawrence W. Gold, M.D.
State of Mind 2015 © by Lawrence W. Gold, M.D.
All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without permission in writing from the publisher.
This book is a work of fiction. Characters names, places, and incidents either are the product of the author’s imagination or are used fictitiously, and any resemblance to any actual persons, living or dead, events, or locales is entirely coincidental.
A Grass Valley Publishing Production
Cover Art©2015 by Dawné Dominique
Dedication
To my wife, Dorlis, my biggest fan. She’s been unrelenting in support of my work.
To my readers who encourage me to write.
Acknowledgments
Donna Eastman of Parkeast Literary Agency who first encouraged me to write.
Dawné Dominique, a gifted artist and cover designer.
Donna Meares, a great editor.
Sierra Writers Fiction Critique Group in Grass Valley, CA
The evil that is in the world almost always comes of ignorance, and good intentions may do as much harm as malevolence if they lack understanding.
Albert Camus
Did you hear what one white rat said to another? “I’ve got that psychologist so well trained that every time I ring a bell she brings me something to eat.
David Mercer
The mind, like a sick body, can be healed and changed by medicine.
Lucretius
The care of the human mind is the most noble branch of medicine.
Aloysius Sieffert
If we knew what is was we were doing, it would not be called research, would it?
Albert Einstein
You discover yourself through the research of your work.
Carine Roitfeld
Other Works By
Lawrence W. Gold, M.D.
Fiction:
Brier Hospital Series:
First, Do No Harm
No Cure for Murder
The Sixth Sense
Tortured Memory
The Plague Within
Trapped
Hybrid
Never Too Late
Other Novels:
For the Love of God
Rage
Deadly Passage
A Simple Cure
Non-Fiction:
I Love My Doctor, But…, a lighthearted look at the doctor/patient relationship
All available in print, Kindle, and most as audiobooks.
Author’s Note
While we have made substantial progress against a whole range of medical problems, why do psychiatric and behavioral ones remain so difficult? Depression, schizophrenia, psychopathy, criminality, and the mundane emotional problems of living seem largely beyond our control.
Treating medical problems, except in extraordinary circumstances, avoids moral complexities while attempts at controlling neuropsychiatric disorders are fraught with ethical pitfalls. The newest technology, transcranial stimulation of the brain by electricity, magnets, or ultrasound may prove to be effective tools, but they create the next level of ethical dilemmas in medicine.
Procedures on the brain go back to the late 1800s, but they made their major impact in the 40’s, 50’s and 60’s with a psychosurgical procedure known as frontal lobotomy. While that’s frightening by today’s standards, in 1949 António Egas Monitz shared the Nobel Prize for Physiology and Medicine for the discovery of the therapeutic value of frontal lobotomy in certain psychosis.
Today, we have the ability to perform such surgery without the mess created by the scalpel, the ice pick, or the bone saw.
While I believe that these new procedures offer humanity great hope for dealing with intractable medical problems, such a depression, Parkinson’s disease, PTSD, and others, I’m not as hopeful about our ability to use these powers wisely.
Good intentions, even humanitarian ones, are not enough as J. Robert Oppenheimer, the father of the atomic bomb said, “Now I am become Death, the destroyer or worlds.”
Prologue
2014
The C-130 dipped its wings and descended from a cloudless sky to land on runway 10/28 at the Naval Air Station, Guantanamo Bay, Cuba. It was a crisp Caribbean morning with the aqua-blue bay glistening just off the airstrip. The plane taxied to several white building near the tower where the passengers walked down the boarding steps. A waiting navy bus brought them to the pier and the leeward ferry. Marines guided them aboard.
A sailor smiled and offered Dr. Kimberly Powell his hand to help her board. He stared at her bright blue eyes and chestnut hair, then looked away embarrassed. The boat surged gently against the dock in the light chop.
Dr. David Cohen, Kimberly’s supervisor, followed her. He was six feet three inches with a thin face and curly-brown hair. Although he was in his early thirties, he had a melancholy look. He stepped easily onto the ferry, leading their five technical assistants.
David looked at the ensign, and said, “Please do me a big favor.”
“Anything, sir.”
“This equipment is fragile. Ask your men to be especially careful with it.”
“We will, Doctor. It’ll be on the next boat.”
If we weren’t heading for Guantanamo Bay Prison, Kimberly thought, I’d be enjoying the sun, the sea breezes, and the salty air.
After they were a hundred feet from the dock, the helmsman pushed the throttle forward and they surged east across the bay toward the U.S. Naval Base.
A large uniformed contingent greeted them as they stepped off the ferry. A tall, fit navy Captain in his fifties shook their hands. “I’m Captain Brewster, the base commander. If you’ll follow me, we’ll get you situated at the Navy Lodge.”
“Thank you, Captain,” David responded. “I’d appreciate it if you could arrange for our equipment to be placed in the prisoner center?”
The Captain shook his head. “Detainee center.”
“Of course,” David said. “We’ll need a day, at least, to get organized and to set up our equipment.”
“That long?” the Captain asked.
David nodded. “At least the first time.”
“I assume that you’re a physician?” the Captain asked.
“Yes, I’m a neuropsychiatrist,” David answered, “but that’s about all I can say.”
Brewster nodded.
When they reached the Navy Lodge, the Captain said, “I’ll have one of my men direct you to your rooms.”
Captain Brewster turned to leave, and said, “Lieutenant-Commander Arthur, the facility director, will pick you up at 1300. If you need anything, my superiors have instructed me to assist you in any way I can.”
David offered his hand. “Thank you, Captain.”
A sailor directed them to their rooms.
Outside her door, Kim turned to David. “Come in while I change.”
She appeared moments later wearing jeans and a white cotton short-sleeve blouse.
As Kim stood before the mirror checking herself out, David placed the red-suede box before her.
“What’s that?” she asked.
David smiled. “Open it, and you’ll find out.”
“Nothing’s going to jump out at me, will it?”
David reached for the box and pulled it back. “It’s not easy to give you a gift, Kim.”
Kim extended her hand. “Give.”
When she carefully opened the box, her eyes widened. “I don’t know what is, but it’s beaut
iful and unusual, too. What is it?”
“I knew you were uneasy coming here. It’s the Alchemical Wedding Talisman, gold with a silver chain. They make it only once a month, depending on the phase of the sun and the moon. It provides good luck and protection.”
“I see the caduceus, the sun and the moon. What does it mean?”
“It shows the balance between the sun and the moon on an astrological scale.” He paused. “Like it?”
“Like it—I love it,” she said placing it around her neck.” She walked back to the mirror and posed. “This isn’t exactly a gift I would have expected of a hard core scientist.”
“I’m full of surprises.”
Kim leaned over and placed a soft kiss on his lips. “Thank you, David. I may be full of surprises, too.”
After the crew dropped their gear in their rooms they went to the cafeteria for lunch.
“The place is spotless,” Kim said.
“It’s the navy, after all,” David replied.
Kim scanned the room. “It’s so calm and controlled, almost pristine, that it’s difficult to believe what people say about what goes on at Guantanamo Bay.”
At exactly 1300 hours, Lieutenant-Commander Arthur entered the cafeteria and walked up to David and Kim. “Lieutenant-Commander Chester A. Arthur at your service.”
Arthur was a small man in his late thirties with a ready smile.
David stood. “I’m Dr. David Cohen and this is my associate Dr. Kimberly Powell.” He paused. “Chester A. Arthur?”
Chester laughed. “Yes, my great-great-great grandfather. I’m carrying on a family tradition and hope, someday, to enlighten the world on his presidency.” He paused. “If you’re ready, I’ll take you to your clinic area.”
They drove by a sign reading Camp Delta-Maximum Security with the motto: Honor Bound to Defend Freedom. Contractors had surrounded the camp with double chain-linked fences topped with coiled razor wire. Detainees wearing orange jumpsuits and orange prayer caps squatted in cages. Several scowled as the medical team passed by.
“My God,” Kim said. “This reminds me of Nazi concentration camps.”
“That’s a ridiculous comparison,” Chester growled. “These men are well-fed, clothed, and receive first-rate medical care. You’ll notice that every area for detainees has a painted arrow pointing to Mecca.”
“I’m sorry,” Kim said, “but to an outsider, this place is pretty grim.”
“It’s a detention facility, after all, Doctor, and things are even more stark in the facilities for our non-compliant detainees. That’s where you’ll be working.” He paused. “I don’t envy you.”
As they entered each corridor and the door slammed behind her, Kim startled and trembled. In the most secure areas, Navy Military Police wore white coveralls and patrolled with splash masks and blue gloves to protect themselves from feces and urine hurled by detainees. Through small barred windows were flashing images of heavily bearded men in orange jumpsuits screaming, shaking fists, and shouting obscenities. Several cried out, “They chain us like animals.” Another cried, “Please, treat us like human beings.”
Kim turned to David. “What in hell are we doing here?”
David took Kim’s hand and gave it a squeeze, and whispered, “We’re trying to make a bad situation better. That’s right up your alley.”
As they turned the corner into a long corridor, Chester said, “You ain’t seen nothin’ yet!”
The Lieutenant Commander passed his security card through the reader, and they entered the control room. High-resolution monitors showing each cell covered three walls. Other monitors had images of the entire compound.
“You monitor every cell?” Kim asked.
“24/7,” Chester nodded. “Take a seat. I need you to know what you’re up against.” He paused. “What I’m about to show you—what the powers that be want you to see, is the worst of the worst. Here, these violent detainees are the rule, not the exception.”
David and Kim watched as several detainees were forcefully removed from their cells.
Chester pointed to a monitor. A heavily bearded man paced in his cell. “Here’s your first subject, Muhammad Abdul Raqi, a vicious murderer. He’s a remorseless psychopathic killer. The litany of his atrocities would turn your stomach. He’s a Saudi and spent several years in the United States at UC San Diego.”
“Play the video from yesterday,” Chester said.
Kim felt a chill through her spine.
Chester nodded to a sailor, and the LCD screen opened to a corridor where eight guards stood before a steel door with a small barred window. They adjusted their shields, gloves, and chest and shoulder pads. Several men carried short wooden bats and others, Tasers.
On signal, one soldier pulled open the door while the other seven rushed in.
As the door swung open, Raqi’s eyes widened and he became enraged, and screamed, “Allah will strike you down. He gives me his strength.”
Raqi attacked the first guard, kicking, screaming, spitting, and trying to bite. They managed to get a bite block into his mouth, tying its leather bands to the back of his neck and head. He fought, kicked, and shouted in Arabic and in English until finally they had him under control with hand and ankle cuffs. While they held him, still thrashing on the ground, a medical officer entered and injected him in the arm. In moments, the man was still.
David turned to an ashen Kim, and said, “A good specimen, don’t you think?”
“Specimen—what are you talking about,” Kim said. “I can’t stand that word in association with a human being, any human being—even a terrorist.”
“Okay, I apologize, but you choose the word for these men,” David said, “how would you like to meet up with that gentleman in a dark alley?”
“I’m not so sure that I’d be happy meeting you in a dark alley if these guards had subjected you to the same treatment as Raqi.”
“It’s all academic,” David said. “We have a job to do, and if we do it well, perhaps even Mr. Raqi might thank us.”
“I hate to interrupt such an enlightening conversation,” Chester said, “but right now we need to make preparations to move him for you.”
The next day, while Kim, David, and their team waited, the guards dragged Raqi into a treatment room that contained the usual array of medical equipment, including a surgical table, overhead lights, oxygen, suction and several stainless steel cabinets containing dressing, instruments, and medications. They restrained him in a chair that sat in the corner with an IV stand and feeding tubes.
Kim pointed to the chair and said, “That’s not for…”
“Yes, Chester said, “We use that chair to force feed them. It’s that or let them die.” He looked around the room. “I’ll leave Mr. Raqi in your hands. My guards will remain right outside should you need any assistance.”
“We won’t be feeding anyone today,” David said, “but this chair will suit our purposes.” He paused. “You have cameras in the treatment room?”
“Yes, of course.”
“Turn them off.”
“They’re for your own safety, Doctor,” Chester said.
“Turn them off.”
Two hours later, the Lieutenant Commander’s phone rang. The guard said, “The doctors have completed their procedure. They’re just about to bring Raqi out, sir. My men are ready.”
“I’ll be there in a moment, Chester said.
He had just made it as the door opened, and Raqi stepped out. The guards tensed and circled Raqi with their face shields down and their cuffs ready.
When they began to close on Raqi, David said, “It’s okay. Give him a moment.”
Raqi stood upright, scanned the guards, the Lieutenant Commander, David, Kim, and the medical staff. He smiled and turned to Chester, “I don’t think we’ve had a formal introduction.” He offered his hand to Chester. “So you’re in charge here. I do wish we had met under more pleasant circumstances.”
The commander and the guards stared at R
aqi with their mouth’s agape.
Raqi stretched, yawned, and said, “I have a bit of a headache and I’m tired. Is it okay if your guards take me back to my cell? I could use a nap.”
When Raqi walked slowly down the corridor, the guards continued to surround him until he stepped into his cell.
Chester stared in awe at David and Kim. “My God! What have you done?”
“Amazing, isn’t it?” David smiled, “but I’m afraid that our procedures are classified as top secret.”
“But I have that clearance,” Chester said.
“Not for this material, Commander. If you need to know more, the Secretary of Defense will grant you the appropriate clearance.”
Chapter One
Kimberly Powell grew up in the San Francisco Bay Area in Moraga, an upscale community in Contra Costa County. Her parents were busy high achievers, but remained lovingly devoted to their daughter. Peter, her father, was a financial analyst, and her mother, Anne, a sixth grade teacher. They led a comfortable, but not an exorbitant lifestyle. Materially, Kim had much, but they made sure she took nothing for granted and worked for and appreciated most of what she had.
She begged for a sister, but her mother said, “I’m sorry, but you’ll have to settle for the burdens of being an only child.”
“Why, Mommy?” the seven year old asked.
“Another pregnancy would be too dangerous for my health.”
Kim’s years at school were nearly perfect. She was an excellent student with many friends and activities. She played the piano and thought she had some talent until she realized that the price for a professional career as a pianist, iffy at best, had to be counterbalanced by practice drudgery, tens of thousands of hours at the keyboard.
She’d met Holly Cantor in summer camp at the end of 9th grade and planned to spend her spring break in March with her at Santana High School in Santee, California, near San Diego. During her stay, a fifteen-year-old student, Charles Andrew Williams, went on a rampage, killing two children and wounding fifteen.