“No. It was some free clinic down in Long Beach.”
“And what did they say?”
“They said nothing was wrong, which pissed me off because I never get headaches. Ever. Not even with a hangover. They gave me some Tylenol and told me to come back if it didn’t get any better.”
“Did you go back?”
“Yeah.” False. “I said it hadn’t stopped.” False. Sometimes I’ll wrap an ice cube in foil, crush it with my teeth, spit it out. I can score a prescription for Demerol or Vicodin or something, anything, that I can duplicate for a Chinatown pharmacy that doesn’t bother to verify them. “This time, he gave me a prescription for codeine. But I couldn’t use it because I’d been in there until after the pharmacy closed.” False, false, false. “The next day I felt okay, but a little shaky. I hadn’t eaten much for those three days. I never even used the prescription.” It was in my wallet. I’d made a replica, right down to the doctor’s signature, but had to change the name it was issued to, since I wasn’t Daniel Fletcher a year ago. And suicide/headcase/junkies didn’t keep narcotic prescriptions unredeemed, so that would work in my favor.
Target conclusion: I had seen a doctor and did not have a somatoform pain disorder. I had done everything possible, within reason, given my circumstances.
“Was that last headache a year ago as severe as this one?”
“Not even close.”
“And how long ago was the headache prior to that?”
“About eight months before.” I base my story on the truth, mimicking the current frequency.
“Was it worse? How did it compare with these other two?”
“It was as bad as this one, but it quit a little bit sooner. Really bad.”
“So, you had one less than two years ago, then one a year ago, though not as bad. And a severe one that started Friday, correct?”
“Yeah.” Meaning: They’re not progressive. They’re not getting any worse and there’s nothing to be alarmed at. If I’ve done this right, he’ll want to change subjects at this point. He makes notes, I sigh and rub my eyes.
“Mind if I step out for a smoke?” I ask. I’ve got a one-in-a-thousand chance he’s got enough confidence to let me out alone, in which case I’m not coming back.
“Not at all,” he says, “I’ll have Wallace escort you.”
Outside, Wallace raps with a hospital rent-a-cop, both of them standing between me and the door. We’re on a smoking balcony and there’s a three-story drop between me and the ground. I finish a paper cup of water, light my first smoke in nearly five days, and the flaccid synapses in my head crackle awake, I feel the static between my ears stop, the three-hundred-and-sixty-degree grain-silo information dump that I can’t filter, decipher or contain when I’m like this—it all stops. Sometimes I can be so smart, and sometimes the simplest task is like playing a hundred simultaneous chess games from memory, in the space of minutes.
What I know: If the Evaluator is married, it’s to his work. He looks tired behind his glasses, is on his second or third cup of coffee. Middle-aged, idealistic hippie, hence his job within the System instead of a lucrative private practice at his age.
A workaholic chained to the here-and-now, which makes me his momentary mission in life, which is bad, bad, bad. Perversely, stubbornly idealistic and like every other Evaluator I’ve ever met, evidently incapable of turning his expert scope onto himself.
“You about ready, sir?” Wallace calls from the doorway. Always says sir. I’m starting to like him.
“One more, if it’s all right with you. I think I’ll be in there for a while.”
Wallace laughs, says, “Take your time, sir.”
I chain a fresh smoke, inhale long, close my eyes and piece together his notebook inside my head. I’m fortunate the Evaluator writes in shorthand so he’s not guarded with his notes. That’s a sign of experience, which tends to be good. He’s methodical, writes in chunks across the page, keeps his abbreviations in segregated columns. The electric spark of knowing cracks in my head and I exhale a stream of smoke.
Far left, easy: My verbal responses with his abbreviated notes beside a column of numbers. I know the questions—they’re always the same subject and approximate order, so those are his numbers.
Middle column: Abbreviation codes for patient behavior, my behavior. Eyes, hands, posture, paralinguistics—sighs, volume shifts, etc. HN the moment I said that sleight of hand was a nervous habit. Perhaps Habit, Nervous or Hand, Nervous. Other H notes: HG when I push my hair out of my eyes. Hair/Hand/Habit, Grooming, I think. If H is for hand, then I can nail E for eyes and P for posture or body language.
The right side: Three x’s, one circled. Never seen that before, but if he knows what he’s doing, he’s clocking my responses and placing them within the context of my answers. I’m guessing xxx with one circled is a before/during/after, nonverbal response key. If I’m right, and it’s some mnemonic-chronology tool, then I’m way ahead of him. I’ll test it out.
If the Evaluator lives for his work, and I’m his work right now, I could be in trouble. He could go digging deeper than is good for me. He could be doing that right now.
I grind my cigarette out on the balcony rail, toss it into the roses below, say to Wallace, “He’s probably wondering where I am. Ready when you are.”
August 18, 1987
Richard Carlisle, M.D., Ph. D.
Los Angeles County Department of Mental Health
Referral assessment of patient Daniel John Fletcher at request of Dr. Brian Lomax, Trauma Center Director at Hollywood Presbyterian Hospital. Per Dr. Lomax, patient is to be interviewed to evaluate claims of unintentional painkiller overdose and assess potential suicide risk.
Preliminary Mental Status Evaluation
I interviewed the patient on site at Hollywood Presbyterian. Patient was groomed and presentable under the circumstances, though looked at least two years older than his stated age of twenty-five. While this could be a result of his emergency room ordeal, I will still attempt to ascertain long-term drug and alcohol abuse.
Patient said he was “all right,” and his mood and affect was appropriately euthymic. Patient is right-handed (see attached ER report notes on polydactyly). Patient exhibited no outward signs of stress or discomfort. The only fidgeting exhibited was a series of distracted, sleight of hand routines with his cigarettes while I made notes; patient was observed flipping a quarter end over end across the back of his knuckles, back and forth. Otherwise calm and cooperative with the interview.
Patient is quite lucid and has exhibited initial signs of high intelligence and memory, and performed well on all tests of memory, recognition, direction, orientation, etc. He is fully oriented as to time and place. In all, his Access Level of Consciousness is “Alert,” with an overall Mental Status test score of 30/30.
Will interview for signs of depression or bipolarism, drug use, and evidence of a somatoform pain disorder.
-R.C.
Maybe you stiffed somebody for a lot of cash. Maybe that somebody wears three-hundred-dollar sweatsuits and runs his business in a coded ledger out of a pawnshop back room or pool hall or bar. Maybe you slept with some other guy’s wife while he was doing time. The worst life has to offer doesn’t scare him