Shared Madness

  Shared Madness

  Rick Moskovitz

  FLUKE TALE PRODUCTIONS

  Copyright © 2020 Rick Moskovitz

  All rights reserved

  ISBN-13: 978-1-7341789-7-5

  The story and characters in this book are fictitious. Any resemblance to actual persons, living or dead, is entirely coincidental. While there are references to real places, institutions and landmarks within this book, they are used fictitiously and any connections with the characters or story are entirely fictitious.

  Book Cover Design by The Book Cover Whisperer:

  ProfessionalBookCoverDesign.com

  table of contents

  Preface

  1

  2

  3

  4

  5

  6

  7

  8

  9

  10

  11

  12

  13

  14

  15

  16

  17

  18

  19

  20

  21

  22

  23

  24

  25

  26

  27

  28

  About the Author

  Most men are within a finger’s breadth of being mad

  Diogenes

  Today I felt pass over me a breath of wind from the wings of madness

  Charles Baudelaire

  Preface

  As a psychiatrist, I often struggled with competing ethical and legal responsibilities. In the course of providing treatment to relieve distress, I was expected to keep whatever my patients told me strictly confidential. At the same time, I was entrusted with preventing harm. Some patients posed the risk of harm to themselves, some of harm to others, and still others offered information about people around them who posed danger to them or to others. The responsibility to prevent harm was further complicated by my limited influence upon my patients’ fates.

  For the benefit of my trainees while I was teaching psychotherapy, I coined the “168 hour rule.” Therapists typically spend an hour a week with their patients, helping them to understand how their thoughts and behavior influence their emotions and the course of their lives. During the remaining 167 hours, they are subject to the influence of others around them, of the media they consume, of the slings and arrows or ordinary life, and of their own impulses, any of which can screw up their lives in a heartbeat. And still, the doctor may be held responsible for bad outcomes, particularly if they occur by their patient’s hand.

  Balancing the duty to maintain confidentiality with the duty to prevent harm and walking the often fine line between them caused me many a sleepless night. And the severity of the dilemma was directly related to the magnitude of potential harm that I envisioned.

  The seeds of Shared Madness, originally titled Folie à Deux, arose out of this ever-present burden and the aftermath of the attack on the World Trade Center on 9/11/2001. What if, I imagined, a patient were to share with me information about a possible future terrorist attack? And what if this information was shrouded in sufficient doubt that the consequences of withholding it weren’t clear or compelling? Would the potential magnitude of an unlikely event be enough to breach the confidence of a patient and perhaps even put that patient in legal or physical jeopardy?

  I framed my story against a backdrop of a psychotic patient who heard voices and experienced delusions of persecution that altered his perception of reality. What might a psychiatrist believe about a tale of treachery told by someone with such an unreliable and distorted view of his world? And it occurred to me that if the doctor was also hallucinating and delusional, assessing the validity of the threat would become even more daunting.

  I wrote a half dozen chapters starting in 2005 along with some character backstories, got stuck, and filed it away while I continued to practice psychiatry. After retirement from practice, I turned again to writing, veering into science fiction, and completed the Brink of Life Trilogy in fits and starts over much of the past decade. The blank canvas of the future fed my imagination and the stories began to flow with increasing ease.

  Last year, I stumbled upon the nearly forgotten file of Folie à Deux. Having drawn my trilogy to a close and honed my storytelling craft, I embraced the project with new confidence. And I brought to the task a new perspective, venturing into the first person, writing entirely through the eyes of my protagonist, and balancing the constraint of that limited perspective with the freedom of living in my character’s head and experiencing his world fully. The story grew organically, expanding beyond its original framework into a full blown thriller.

  I invite you now into Zack Tripler’s world, filled with doubt and more than a touch of madness as he grapples with a life and death struggle and seeks to recover his sanity.

  Rick Moskovitz

  June 2020

  1

  HOW DEAR the price of an unasked for kiss?

  “You can’t do this to me. Let me go. It’s much too dangerous for me to be here.”

  Youssef glared at me with bloodshot eyes, deep set beneath thick black eyebrows that nearly met in the middle. His olive skin was darkened by several days of stubble. He wore black dress pants and a white button down shirt that was wrinkled and grimy. My eyes moved from the cuts and abrasions that covered his hands to the dirt packed under his fingernails.

  “Please, Youssef,” sobbed the dark skinned woman from across the room, “You’re sick. You need help. Please talk to the doctor.”

  “This is your fault,” he snapped back, pointing a grimy finger at the now cowering woman. “You had me brought here. Now you’ve put us both in danger.”

  He clutched a laptop computer tightly to his body with his ragged hands. The aides had tried to take it when they admitted him, but he wouldn’t surrender it. They decided that it wasn’t worth the battle and let him keep it.

  “What danger?” I asked, looking for some way to engage him.

  “What danger?” he echoed, rising suddenly to his feet. “How do I know that you’re not one of them?”

  I resisted the temptation to stand in response to his threatening posture. It was best not to challenge a frightened patient.

  “Them?”

  He opened his mouth as if to speak, but fell silent and sank back into his chair, the laptop still clutched to his chest.

  “He hasn’t slept in days,” said the woman, who identified herself as his wife. “He’s been hiding out in the woods, with a gun, from God knows who. He’s been having terrible headaches and I think he’s been hearing voices. He thinks someone’s trying to kill him.”

  “Shut up! You’ve told him too much already. You’ll get us both killed.”

  “Please help him doctor. He’s not himself. He’s always been so gentle. I don’t know what’s gotten into him.”

  When the aides came to take Youssef to his room, he went without a struggle. I wrote orders for close observation and olanzapine, an antipsychotic medication that I hoped would curb the terror and quell the voices that tormented him. Getting him to let down his guard enough to sleep would be the first hurdle in his treatment.

  Youssef Al Saud had been brought to the hospital by Sheriff’s deputies for emergency psychiatric evaluation. Despite being armed, he’d surrendered without a fight and had given up his weapon upon command. He hadn’t volunteered anything about why he was hiding in the woods and responded to the officers’ questions with stony silence.

  According to his driver’s license, he was 34 years old, but little other information about him had been available when he arrived at the hospital. The deputies had tracked down his wife from the address on his license and she’d arrived while he was being admit
ted. When Youssef did begin to speak, his English was fluent, but accented in a rhythm I took to be Middle Eastern in keeping with his name.

  The next time I saw Youssef, he was dressed in clean hospital scrubs. He was freshly showered, but still unshaven, and his long, black hair was slicked straight back, still wet. The larger cuts on his hands had been dressed with Band-Aids. Traces of dirt were still visible under his fingernails. He sat across from me in the small consultation room, sipping coffee from a Styrofoam cup.

  “How are you feeling this morning?” I asked.

  “Groggy. Drugged. What the hell did you give me?” His speech was now slurred, but without any trace of the accent from our first encounter.

  “A tranquilizer. To calm you down and help you sleep. You were very agitated last night.”

  “Agitated,” he repeated, shaking his head, then scowling from beneath the dark eyebrows. “Why the hell wouldn’t I be? Wouldn’t you be agitated if the police tackled you, handcuffed you and brought you to some God forsaken lockup without any defenses against your enemies?”

  “What enemies?”

  “No. I’ve said too much already.” The coffee cup in his hand was shaking. He set it down on the table beside him. “What have you done with my laptop?”

  “We sent it home with your wife. It’ll be safer with her than here.”

  His olive skin turned ashen as he shot to his feet. “You idiot. You have no idea what you’ve done,” he screamed, taking a step toward me. “You’ve endangered my whole family. I must get it back. I must get out of here right now.” He moved toward the door and began to open it.

  “You can’t leave yet. You need treatment.”

  “Treatment for what? You think I’m crazy?”

  “You’ve been running around in the woods with a gun. You’ve been hearing voices. You’re not thinking clearly.”

  “And drugging me is going to make me think clearly? You’re playing right into their hands. They want me weak and defenseless. You’re helping them kill me.” His words were now slow and deliberate. He looked outside the door of the room and saw the burly orderly standing just outside. After sizing up the situation, he let go of the door and sat back down.

  “Look,” he said, making direct eye contact, “I know what this must look like. You’re just doing your job. I’ll make you a deal. I’ll stay a few days so you can see I’m not a maniac, but no more drugs. And I need to get my computer back before they find it. I need it here with me.”

  “I think you’re going to need medication, but we can talk more about that later. If you cooperate, I won’t force you to take anything without your consent. I’ll see what we can do about getting you your computer tomorrow.”

  “No, not tomorrow.” He wagged a single finger in front of his face. “Tomorrow will be too late. You must let me call my wife this morning. That is not negotiable.”

  I began to tell him that he was in no position to make demands, but thought better of it. There was an earnestness about his manner that was compelling. He was not the raving madman of the night before.

  “All right,” I said. “You can call her.”

  A broad grin lit up his dark face with rows of ivory and a single gold tooth on the lower right. It was a victory smile mixed with an undertone of gratitude, connecting us for the first time since his arrival.

  I asked the orderly to bring his cell phone.

  “No,” said Youssef, “no cell phone. Mine, at least, has likely been compromised.” He pondered a moment, rubbing the stubble on his chin. “Yours, perhaps, or better yet a landline.”

  The office next door had a phone. I handed him the handset and dialed an outside line. He clutched the handset to his chest, looked up at me, and waited.

  “You want privacy,” I guessed. “OK. you have five minutes. I’ll wait outside.”

  By the time I reentered the room, the call was over. Youssef looked up at me with a faint smile. His breathing was slow and even. He looked composed for the first time since we’d met.

  “Jamilah will be here in twenty minutes,” he said. “When she gets here, we’ll need some time alone for me to check out the laptop and to bring her up to speed. I need to make sure that she’ll be safe after she leaves.”

  I usually avoided any semblance of joining with a patient’s delusion, but by this time I was in his spell. He was no longer agitated and was taking control. His quiet resolve was persuasive.

  When Jamilah entered the locked unit for the second time, a leather valise slung over her shoulder, she, too, was calm and purposeful. She was tall, around five nine and now stood fully erect, her bearing almost regal. The curls of her flowing black hair kissed her shoulders, framing an oval face that was almost too small for her body. Her eyes were dark and deep set. Her aquiline nose perfectly bisected her face, stopping just above cupid’s bow lips gently kissed with color. I wasn’t prepared for such an elegant presence.

  I escorted her to the consultation room where Youssef was waiting. He rose to greet her. She placed the valise on the table and they briefly embraced. Then they both looked at me and waited.

  “How much time do you need?” I asked.

  “Ten or fifteen minutes ought to do it. We’ll come out when we’re done.” He’d by now asserted full control.

  Twenty minutes later, the door opened. Jamilah emerged first, no longer in possession of the computer. She walked straight to me, wrapped her arms around me, and touched her lips to my cheek just below my right ear while Youssef watched smiling by the open door.

  “Thank you,” she whispered at the end of the kiss. “You have no idea how you’ve helped us.” And then she was gone.

  Hours later when I reached for the coins in the back pocket of my pants, my fingertips touched a tiny wafer-thin object and a crumpled bit of paper. The wafer turned out to be a Micro SD memory card. On the paper was scrawled a terse message:

  “Hide this somewhere very safe and tell nobody. You are part of this now.”

  2

  I MET with Youssef again early that afternoon. I still knew almost nothing of his background and had not yet conducted an intake interview. He sat across from me, slouched a bit, legs slightly apart, and palms up, looking remarkably unguarded for someone so paranoid just hours before.

  “What do you want to know?” he asked, again without a trace of the accent from the day before.

  “Why don’t you start by telling me a little about yourself?”

  “ I was born in Riyadh, Saudi Arabia. My father was a physician. We emigrated to the United States when I was 11 because my father wanted me to have the educational opportunities that this country offered. It was a struggle at first, because he had to start his training over almost from the beginning, which caused more financial hardship than he’d anticipated.

  “I knew some English when I came here. My classmates ridiculed my accent and my broken grammar, but by the end of my first semester, I’d become sufficiently fluent to earn their respect. I graduated from high school in Marblehead third in my class and was admitted to Amherst College, where I graduated magna cum laude in computer science. I got an MBA at Columbia Business School.”

  His English was now flawless. His Middle Eastern roots lurked beneath the surface and seemed only to poke through under stress.

  “While there, I met my wife Jamilah, who was a student at NYU. Jamilah was originally from Lebanon and, like me, came to America as a child, in her case at age twelve. She, too, is fluent in English. We both usually pass for native born Americans, although we still get profiled when traveling by air.

  “Go on, Youssef.”

  “Joe. You can call me Joe. That’s what most people call me.”

  “Joe, then. Thanks for telling me.”

  “After graduating from Columbia, I got involved with an Internet startup company that went bankrupt after two years. I came away from that venture an expert in web design, which landed me a job in advertising for a cellular phone company. I’m very good at what I do and was
earning six figures within a year.

  “Most of my work is on my computer. I carry my laptop wherever I go and once even created a major ad campaign while sitting on a beach in Aruba. I was on deadline, but this still didn’t go over well with Jamilah, who’s usually very tolerant of my working style.”

  His narrative so far was all fact, no emotion.

  “You talked about your father, but you haven't mentioned anything about your mother.”

  “My mother is dead. She took her own life when I was fifteen.” Youssef's dark eyes seemed to scan the horizon and moistened ever so slightly.

  “That must have been terrible for you.”

  “By then, tragedy was already too familiar. But yes, it broke my heart again.”

  “Again?”