The last Cape Air flight landed me back in Boston just after 8:00 p.m. Anderson and I had decided I would shuttle to New York the next morning, provided he could get me clearance that quickly to meet with Billy Bishop at Payne Whitney.
On my way back to Chelsea, I stopped at Mass General. I wanted to make good on my promise to see Lilly Cunningham after the incision and drainage of her leg abscess.
She was sleeping when I got to her room, but her bedside lamp was on. Even from her doorway I could see that the surgery had been more extensive than planned. Her leg was in traction, bent at the knee and suspended six, eight inches off the mattress. Her thigh was covered with a wet gauze dressing. Two thin steel rods had been screwed into each side of her femur.
I knocked on the door frame, but she didn't awaken. I walked into the room. I stood there half a minute, listening to the tired electronic beeping pulse of the ward at night, and watching Lilly breathe. I tried to imagine the emotions she might have experienced each time she buried a hypodermic needle in her flesh, soiling her insides. I didn't settle on rage or panic or even sadness. I thought she probably felt relief. Maybe even euphoria. For the moment, she could shed the pretense of normalcy. Her sham self-esteem and self-confidence could melt away, yielding to her real unconscious vision of herself as dirty and infected. Trash. Like someone finally allowed to drop her arms after holding them aloft for hours, she could give up the struggle to fend off her demons and, instead, let them spirit her away.
"Lilly," I said softly.
She didn't stir.
A little louder: "Lilly."
She slowly opened her eyes, but didn't respond.
"It's Dr. Clevenger," I said. "I told you I'd stop by after the procedure."
She took a dreamy breath, then closed her eyes again. "They gave me something for the pain."
"Would you rather sleep? I could try to stop back tomorrow."
She looked at me, squinting to focus. "No. Stay."
I walked the rest of the way to her bedside, pulled up a chair, and sat down. "How did it go?" I asked.
"Dr. Slattery says the infection had gotten into the bone. They had to take a piece of it."
I nodded, looking at the steel rods holding her leg together. "Opening the wound and letting the bad stuff out should prevent that from happening again," I said, picking up on the metaphor for her psychological trauma that I had started to build during our last meeting.
"Right," she whispered, obviously unconvinced.
I remembered telling her that I wasn't afraid to see the truth-even if it was ugly. I needed to prove that that was true in the physical realm, in order to coax her to reveal her emotional wounds. I leaned forward and touched one corner of the gauze bandage. "Do you mind if I take a look?" I asked.
She shook her head. Her gaze focused intently on my hand.
I gently pulled the gauze back far enough for me-and Lilly-to see the incision. She turned her head immediately and stared at the wall. I kept looking at the dissected layers of skin, fat, and muscle. Sterile gauze, soaked with bloody drainage, filled the base of the wound, which clearly went bone-deep. "Good," I said.
"Good?" she said bitterly.
"All the tissue they left looks healthy," I said.
She rolled her eyes.
"The last thing you'd want," I said, "would be a surgeon who wasn't willing to follow the infection all the way to its source." I noticed a tear start down Lilly's face. I grabbed a tissue from the nightstand and blotted her cheek dry.
She turned her head toward me, but said nothing.
"It's really no different than what I try to do," I said. "I have to help my patients trace the roots of their pain as deep as they go."
A few seconds passed. "What if your patient doesn't know what caused the pain?" she asked.
"Asking the question is half the answer," the voice at the back of my mind said. "She wants to take the journey. At heart, everyone wants the truth."
My breathing slowed. My eyes closed an instant, then reopened. "If you don't know, then we both have to find the courage to figure it out," I said.
Lilly blushed. "I have trouble talking about myself," she said.
"Why is that?" I asked.
"I guess I think it's safer to keep things inside."
"Safer?"
She didn't respond.
"What's the danger in opening up?" I asked.
"People who tell too much about themselves end up…" She stopped short.
"End up… what?" I asked.
"I don't know." Her brow furrowed. "Alone, I think."
That statement spoke volumes about Lilly. Fabricating an illness-lying-had brought her close attention from a team of doctors. Coming to terms with the real source of her suffering, especially if that source was abuse at her grandfather's hand, would end her relationship with him, and possibly with other family members as well. The risk of abandonment was real and had been with her since her childhood. There was no sense candy-coating the stakes. "I know how frightening it is for you," I said, "but you have to be willing to be alone, for a while. At the very least, you have to be willing to be alone with your own thoughts."
She nibbled at her lower lip, like a timid little girl. "I can't stand being by myself."
That was a pretty clear message. She needed something-someone-to count on, no matter what she divulged. I touched her thigh, just above the incision. "I promise to stay with you every step of the way," I said.
"But how can you say that?" she asked. "You don't even know me. How am I supposed to trust you?"
I could have come up with a platitude to sidestep that question, but only an honest response would count with a person whose life had become a lie. "You can't be sure that I'm trustworthy," I said. "You can never be certain-not with anyone. Eventually, you'll have to take a leap of faith. You'll have to go with your gut."
"I don't know," she sighed. "I'm so confused."
Another small victory; confusion is often the first sign of weakening in the mind's defense mechanisms. I didn't want to seem too eager to breach them. "Shall I stop back in a few days, then?" I asked.
She stared at me several seconds. "Okay," she said. "Yes."
I made it home just before 11:00 p.m. A message from North Anderson on my voice mail told me I was scheduled to interview Billy Bishop at 10:30 a.m. the next day. Judging from my experience flying to Manhattan on other cases, that would mean taking the 7:30 A.M. shuttle, planning for it to be late by a couple hours, which it pretty much always is.
I decided to hop on the Internet and learn what I could about Darwin Bishop. Yahoo! came up with 2,948 references, from sources like the Wall Street Journal, BusinessWeek, and CNN Financial News. The pieces told me Bishop had founded CMM with over $40 million of venture capital, that he had recruited engineers and metallurgists out of MIT, CalTech, and the University at St. Petersburg, and that his company had grown to one thousand employees within eighteen months. A mention in the New York Times noted Bishop's winning bid of $4.2 million for a Mark Rothko oil painting that had been predicted to bring $800,000 at auction at Sotheby's. His lavish lifestyle caught the eye of Vanity Fair, which published photographs of his vintage car collection and his nineteen-thousand-square-foot River House penthouse, as large as a quaint hotel. The property, located on 52nd Street, on a cul de sac between First Avenue and the East River, was also home to Henry Kissinger and Sir Rothschild. The penthouse had itself been owned by the Astor family before Bishop picked it up for a mere $13 million. And that was before Manhattan real estate really went through the roof.
I lingered over an archived, older piece from New York magazine entitled "Bishop Takes Bride on Ride of Her Life" that focused on Bishop's marriage to "socialite and Elite model Julia Oakley." A photo captured the Bishops in tux and wedding gown, driving a red Ferrari Testarossa down Fifth Avenue. Julia looked ravishing.
Midway through the article, Bishop commented on his first marriage. "Lauren and I had two great years," Bishop had told the reporter. "I wouldn't trade our time together for anything. We just sort of woke up one day and said, 'We're better as friends than we are as husband and wife.' And let me tell you something: I couldn't have a better friend."
I chuckled. You had to figure there was a lot more to that story.
I scanned dozens of entries, flew past a couple hundred others, then stopped short when my eye caught one that seemed out of sync with the rest. It was a 1995 article in the New York Daily News, headlined "Trouble at the Top," that described Bishop's arrest for drunk driving.
STUART TABOR
SPECIAL TO THE DAILY NEWS
MANHATTAN
A Manhattan man was arrested shortly after 2:00 a.m. yesterday when his Porsche Carrera slammed into two other cars on the Triboro Bridge, and he then fled the scene.
Darwin Bishop, age 45, of 32 East 49th Street, was charged with driving under the influence, driving to endanger, leaving the scene of an accident and resisting arrest. Police apprehended him after a high-speed chase that ended in Astoria, Queens.
Despite a prior 1981 conviction for assault and battery, Bishop was released today on personal recognizance after posting $250,000 cash bail.
Estelle Marshfeld, 39, was transported from the scene of the crash to the Columbia Presbyterian Hospital, where she is listed in guarded condition, with injuries to her chest and abdomen. There were no other reported injuries.
A photograph showed a very different Darwin Bishop from the unflappable man I had seen earlier in the day on Nantucket. His head was down and his hands were cuffed behind him as two police officers escorted him into the Twenty-third Precinct station. Bloodstains covered the front of his blue and white pinstriped shirt.
I kept looking at the image of a drunken Darwin Bishop with bowed head. He had seemed so starched and buttoned-down in his Nantucket digs. Invulnerable. The picture made him real to me because it confirmed what I had long believed: Everyone-rich or poor, black or white, educated or not-is in emotional turmoil, in some sort of pain. For years I had doused mine with booze and cocaine. Bishop obviously had had his own trouble with alcohol. Now he was high on money, a drug at least as intoxicating.
But maybe that meditation on humanity was only part of what kept me looking at the photograph. Maybe I liked seeing a humbled version of Bishop because the thought of him with his new bride, Julia, irked me.
I wondered why Julia Bishop had made such an immediate and powerful impression on me. She was stunningly beautiful, but that didn't feel like the whole reason. It didn't even feel like half the reason. I thought back to our conversation in front of the Bishop estate and realized that, within those few minutes, I had come to feel that she was suffering and that she might need my help. And, for me, a woman in distress is the ultimate motivator.
My mind wandered to my mother, a weak person who had the unattractive habit of locking herself in the bathroom when my father was three sheets to the wind and looking for somebody to hurt, no doubt to avoid the hurt festering inside himself. I was the only other one in the apartment, the top floor of a run-down tenement house in decaying Lynn, Massachusetts, and my father invariably spent his rage on me, until he was spent and fell down, or fell off into a drunken slumber. And even though my mother was not a loving person, nor brave, nor responsible enough to get us out of that house and out of harm's way, she was my mother and I loved her. And that made me feel a little bit like a hero as the blows landed. And with all the time I spent on Dr. James's couch, untying the knots in my psyche, I was never able to free myself from that double bind of pride and pain. I am still happier to suffer than to watch a woman suffer.
I shook my head and refocused on the computer screen image of Darwin Bishop being led away in cuffs. I wanted to find an article that would fill me in on what sort of sentence he had received for his crime. I spotted one entry slugged Bishop's Day in Court, clicked onto it, and got a nice glimpse of how money speaks in the courts-or whispers behind the scenes. The entry was for coverage in the New York Post six months after Bishop's arrest, buried as the second-to-last item in the "Local Notes" section of the paper. It told of the case against Bishop being dismissed. He didn't get a day of probation, let alone jail time.
A Manhattan court dropped charges of driving under the influence, driving to endanger and resisting arrest lodged against Darwin Bishop, 45, of 32 East 49th Street, citing questions about the validity of the field sobriety tests administered to him at the scene, a lack of credible eyewitnesses and the unavailability of key police testimony. Defense attorney F. Lee Bailey stated, "No one came forward in this case because everyone knows Mr. Bishop had an accident, plain and simple. Then things got out of control, as much due to overreaction on the part of law enforcement as anything else." Bailey said he has not decided whether he will file litigation against the city or against any of the officers involved.
I tried to find information about Bishop's prior conviction for assault and battery in 1981, but couldn't come up with any other reference to it.
I looked at the clock-12:54 a.m. That didn't leave much time for sleep. I turned off the computer and headed to bed. But as tired as I was, my mind kept racing as I lay there. Because I had the growing suspicion that Darwin Bishop was playing me. I just didn't know exactly how- or precisely why. And while shielding a woman from harm can fill me with mixed-up pride, it is nothing compared to the energy that fills me when a man tries to use me, or bully me, or make me the fool. Maybe that surge of determination is all tied up with the rash of adrenaline that used to course through my bloodstream every time my father came up with some cockamamie reason to take his belt to me. Maybe my inability to step away from trouble, to retreat one inch from aggression, is irrational-rooted in a boy's shame for yielding so much to a brutal father. But Dr. James never managed to untie that knot in my psyche, either.
Monday, June 24, 2002
The shuttle into LaGuardia was only eighty minutes late, so I arrived shortly before ten at Payne Whitney, a nondescript building at 68th and York, on the New York Presbyterian Hospital-Cornell Medical Center campus. Billy Bishop was a patient on the third-floor locked unit for children and adolescents. I took the elevator up, followed signs down a long white hallway, and pressed the buzzer at the side of a gray steel door labeled "3 East." Through a security glass window in the middle of the door I could see girls and boys of various ages milling about the unit, while staff members circulated among them. -
"Yes?" a female voice emanating from a speaker next to the door asked.
"I'm Dr. Clevenger," I said. "I'm here to interview Billy Bishop."
"We were expecting you at ten-thirty," she said.
"I'm early."
"Did you want to get a bite in the cafeteria?"
Psychiatry units are all about establishing boundaries and maintaining control. Patients whose minds are unraveling are comforted by the rigid structure. The trouble is that the staff can get addicted to it, unable to budge an inch, on anything, for anyone. "No," I answered. "I already ate."
"There's a very nice coffee shop across the street."
"I'd rather get started with the interview."
"I'll find out whether that's possible," the voice said coldly. "Please wait."
Five minutes passed before a portly woman about my age, wearing half-glasses and a blowzy Indian print dress, walked to the door, unlocked it, and let me in. Her graying hair was long and unruly. She wore half a dozen strands of pearls. "I'm Laura Mossberg," she said, in an unmistakable New York accent, "Billy's attending psychiatrist."
I shook her hand. "Frank Clevenger."
"I'm sorry if the ward clerk put you off," Mossberg said.
"No problem," I said. "I'm forty minutes early. I know something like that can turn a locked unit inside out."
She laughed. "Why don't we take a few minutes together in my office, then I'll get Billy for you?"
As we walked through the unit, we passed patients as young as four or five years old and others who looked closer to seventeen or eighteen. They seemed perfectly normal as they spent the weekend chatting in the hallway or playing board games in their rooms or watching television in the lounge. But I knew from my own rotation in child and adolescent psychiatry, back when I was a resident at New England Medical Center in Boston, that only the sickest young people got access to inpatient units, the ones at risk of committing suicide or homicide. Managed care insurance companies indiscriminately shunted the rest to outpatient treatment. The patients here were on multiple psychoactive medications. Any one of them could fly into a rage or be overwhelmed by hallucinations, without warning. Their minds had already veered into chaos-whether due to trauma, abuse, or addiction to drugs or alcohol. They might never live normal lives, no matter how much help they got. Kids are less resilient than people think.
I thought of the murderous violence Billy had witnessed in Russia and the trauma he had, no doubt, suffered in the orphanage. Was it at all surprising that a boy whose world had been destroyed would come to be destructive? Wasn't it obvious that the ruinous potential of fire would feel as warm to him as returning home after a long journey?
Would he not be drawn to revisit his private terrors by looking into the eyes of a neighbor's terrified pet? And then this more disturbing thought came to mind: Would watching his baby sister struggle for her last breaths speak to him of his own emotional suffocation?
We walked into Mossberg's office, an eight-by-ten-foot space piled high with books and medical journals. "Please," she said, pointing to a chair next to her desk.
I navigated my way to the chair, careful not to knock over any of the stacks of reading material. I moved a bunch of New York Times newspapers, two volumes of Tennyson's poetry, and a copy of Harry Crews's A Childhood off the seat, and sat down. Once I did, I was nearly face-to-face with the only thing hanging on Mossberg's walls: a three-by-four-foot painting of a dog with electric blue fur, a white snout, and big, pointy ears. Sitting amidst rolling green hills and blue-black oak trees, the dog had a questioning expression on its face and big, golden eyes that stared into the room, seemingly waiting for something.
"Interesting painting," I said.
"Blue Dog? She helps the kids talk. Sometimes they tell her things they can't tell me, and I just listen in."
"She looks like she's heard a lot of stories," I said.
"Those big ears," Mossberg said. She smiled.
I felt comfortable in Mossberg's space, and with her. The ability to inspire that kind of feeling in people is essential-and rare-in psychiatrists. One in fifty might have it. "You like pearls," I said, nodding at her.
"I like the lesson they teach," she said. She reached to her neck and rolled one of the pearls between her thumb and forefinger. "The grain of sand is an irritant, but the oyster turns it into something beautiful. An oyster without a grain or two of sand doesn't have much potential. Same with people, if you ask me."
"Agreed," I said. "I feel like I'm sitting with a friend."
She smiled. "Maybe you are," she said. "I know of your work. You've had fascinating cases."
Every so often I bump into someone who's read one of the profiles of me that ran in publications ranging from the Annals of Psychiatry to People magazine when I was taking one forensic case after another, each more chilling than the last. But that was a different time, and I was a different person, and I didn't want to get into any of it with Mossberg. "I gave up my forensic practice a couple years back," I said. "I wouldn't normally be involved in Billy's case. I'm interviewing him as a favor to a friend in law enforcement."
She didn't take the hint. "I've never heard anything like the case of that psychotic plastic surgeon," she led. "Where was it? Lynn, Massachusetts? The state hospital?"
"Right," I yielded.
"Dr. Trevor Levitt."
I really wished she would stop.
"No. Lucas," she said. "Trevor Lucas. He had taken hostages. Nurses, patients, and so forth."
"Yes."
"And you negotiated their release," she said.
I could feel my pulse in my temples. "Not all of them," I said. "Lucas butchered a few of them before I declared victory and had my picture taken for the papers. It's a minor detail people tend to forget."
"I'm sorry," she said. "I do recall reading about an elderly woman. Her body had been disfigured-with a knife."
I didn't respond.
"And if I remember correctly, Lucas performed some sort of crude neurosurgery on another hostage?" She shook her head. "It was very brave of you to go onto that unit in the first…"
My brow was damp. I wiped it with my shirtsleeve. "These memories are very painful to me. I don't talk about them."
Mossberg leaned back in her chair, then sat there, watching me intently. "I see," she said, a therapeutic strain of kindness in her voice.
I knew what she was thinking. I would have been thinking the same thing: That not being able to talk about a memory means your mind is still enslaved by it. But I wasn't ready to do the work of freeing myself, and I hadn't come to Mossberg for that kind of help, anyway. I had come for clues to help solve the murder of an infant girl- and to make sure that her twin sister stayed alive. I sat straighter in my chair. "What can you tell me about Billy Bishop?" I asked her pointedly.
Her eyes narrowed, and she pressed her lips together, as if finalizing her diagnostic impression of me. If she was as sharp as I thought she was, she'd get it right: something just shy of full-blown post-traumatic stress disorder. A few moments passed. "Very well," she said. "I'm sorry to intrude. I tend to wander places I haven't been invited."
"No offense taken," I said. "I understand."
She nodded. "About Billy…" she said, reorienting herself. "I can tell you he's a very dangerous person. He seems to be a young man without conscience. I'm not surprised that he lashed out at his sister."
"Why do you say that?"
"Certainly not because of anything he's told me," she said. "He's happy enough to talk about Nantucket, Manhattan, sports, television, and anything else unrelated to the Bishop baby's death-or to his life in Russia. He avoids those topics like the plague."
"I can understand that," I said.
"Of course you can," she said. She paused to underscore her point.
"Let's stick to Billy," I gently reminded her. "I promise to work on my own avoidance another time."
"You're right. I lost my head." She winked. "My main concerns about Billy," she continued, "come from the psychological testing we conducted yesterday, shortly after he arrived on the unit."
Psychological testing involves a variety of evaluations, including the Minnesota Multiphasic Personality Inventory, the Bender Gestalt Intelligence Test, and the Rorschach series of inkblots. The goal of the testing is to determine whether the examinee suffers from any major mental illness, as well as to assess his core character traits, how he thinks about himself, and how he responds to the world around him.
"He cooperated with the testing?" I asked.
"Not really. The deception scale shows he gave untruthful answers to many of the questions. He was trying so hard to appear absolutely healthy psychologically that he didn't endorse a single sign or symptom of psychic distress. He rated his mood at ten out of ten. He insisted that he saw only happy scenes in the inkblots. No blood. No monsters. No storms. He said he 'always' gets along with people and that they do nothing to irritate him."
"So did the testing yield any useful data?" I asked.
"It did." She picked up a set of sheets from her desk and turned a page. "First things first: Billy is highly intelligent. His IQ tested full scale at 152. He's in the extremely gifted range. In his case, that's good news and it's bad news."
"What's the bad part?"
"The bad part is that his intelligence seems to exist in a moral vacuum. It may just make him a more cunning predator. On the projective sections of the test, his responses were highly egocentric. He saw people almost exclusively in terms of what they could do to satisfy his needs." She flipped a few more pages. "Billy was asked, for example, to tell a story about a drawing of a police officer chasing a man. The man is holding a fistful of money. Billy's only comments were, 'I wish I had that money. He'd never catch me.' When the examiner coaxed him to say more about the scene, all he added was, 'I want a gun like that someday, too.' "
"He didn't say anything about what the man had done wrong?" I asked. "He didn't offer any thoughts about what would happen to him if he were caught?"
She shook her head. "Nothing related to law, morality, or punishment." She looked at the report again. "A drawing of a baseball player lying on the ground between bases, clutching his knee, yielded, 'I didn't want to play baseball this summer, but my father made me. It's a stupid game.' "
"He showed no interest in how the man had been injured?" I asked.
"None whatsoever," Mossberg said without looking up. "A third example: When he was asked to describe what was happening in a picture of a man leaving a room, obviously angry, with a woman in tears looking after him, he said, 'She should stop crying. She's loud, and it's hurting his ears. He should go back and make her stop.' "
I cringed at that narrative, remembering how Tess, the surviving Bishop twin, had cried out while North Anderson and I were with Darwin Bishop in his study. Could little Brooke Bishop's wailing have annoyed Billy enough to seal off her windpipe? "Did you question Billy directly about the loss of his sister?" I asked.
"In a general way," Mossberg said. "I asked him what had happened to Brooke."
"And?"
"He said she had stopped breathing."
"Did he show any emotion when he answered?" I asked.
"No."
"Did you sense he was suffering any guilt?"
"He insists he had nothing to do with it," she said.
"But you don't believe him," I said.
"Well… no. Of course not."
"Why not?" I asked.
Mossberg looked at me askance. "I hadn't heard anyone express doubt that Billy committed the crime. Mr. Bishop's wishes were for a secure setting where his son could be held-away from the glare of the media-until trial. I assumed you would be helping to craft an insanity plea."
"Did Bishop say that? He expects Billy to stand trial for murdering Brooke?"
"Very clearly," Mossberg said. "Am I missing something? Is there confusion on Nantucket about whether Billy killed his sister?"
I took a deep breath, let it out. "Less than you might expect," I said.