Chapter One [[DRAFT]]

Certainty Betrayed

Chapter One

[[DRAFT]]

Intake

James opened his eyes as he felt the ambulance come to a stop. He watched as the paramedic unbuckled his seatbelt and moved toward the back doors of the rig. He lost focus for a few moments, looking around the back of the rig without really seeing the medical equipment stored in the various lockers. The medication he had received in the Emergency Room left him feeling detached and drowsy. His attention was drawn to the back as the medics opened the doors and prepared to remove the stretcher on which James was lying, belted down for his safety, with a blanket over top to keep him warm. He briefly noted the scratchy feeling of the coarse material against his skin.

“OK James,” said the first paramedic and he and his female partner prepared to remove the stretcher from the rig. “Just lie there and let us do all the work.”

The stretcher release clicked and the bed started to move. James felt a thrill of fear as he moved toward the rear doors, expecting a sudden drop that never happened. He heard the legs drop and felt a bump as they connected with the ground. The entire operation was smooth, efficient, and well practiced. The medics might be evil, but they were certainly professional.

“Hi James,” said the new face of a nurse who suddenly appeared at bedside. James flinched and looked around in a brief panic. He noted the fencing around the ambulance bay and the pedestrian gate along the side, with a magnetic card reader for access. He continued to assess his surroundings, looking for escape possibilities and assessing any potential dangers.

“Sorry James. I didn’t mean to startle you. I’m Sarah. I’ll be admitting you to the hospital. We are going to wheel you into the anteroom and get you off this stretcher. Then you and I will go to the intake room and talk for a bit. After that, I can get you something to eat and a bed if you’re tired. I want to make you as comfortable as possible.”

“I want to go home,” James replied.

“I understand. We can talk about that inside. I’ll explain what’s happening and what we need to do to get you home.”

The stretcher started to move again, passing though another door into the anteroom. James noted another magnetic reader, but this one also had a keypad. Across the room was another door leading into the hospital, also with a magnetic reader, but no keypad. Both doors were steel framed with glass panels. He assumed they were laminated tempered glass and would be difficult to break.

The medics removed the scratchy blanket, released the safety straps, and helped him to sit up on the stretcher, his legs dangling off the side. “Let’s just sit here for a moment,” said the female medic, “do you feel dizzy at all?”

James felt another moment of detachment, his mind ceasing to function. It left him disoriented. He struggled to regain control, focusing on the face of the pretty medic. He noted her dark hair, pale skin, red lips, and striking blue eyes. “You look like Snow White.”

“Well thank you!” said the medic with a disarming grin. “Any dizziness?”

“No.”

“OK. Let’s come down off the stretcher. Use my hand to help keep steady.”

James took the proffered hand. It felt small, cold, and boney. He wasn’t surprised. The smile had caused him to drop his guard for a moment, but evil always revealed itself. There was no real warmth behind that smile. But he had to play along. For now.

He felt the cold hard tiles through his hospital socks. In the Emergency Room, they had taken all his clothing and given him the socks along with two hospital gowns, one for the front and the other for the back. He was allowed to keep his underwear, but that was all. He watched as the male medic handed his belongings bag to a large black man on the other side of the stretcher. Where had he come from? James stepped backward before he realized he was moving away from the huge, intimidating man.

“Where did you come from?” he said in a panicked voice?

“It’s OK James. I came through the door as you were getting off the stretcher. I’m Carl. I’m going to help get you admitted so we can get you a bed and something to eat and drink. Don’t worry. I got your back. I’ll keep you safe while you’re here.”

James didn’t believe him, but he nodded and let Nurse Sarah lead him toward the door to the hospital. Immediately to the left of the door was a small room. She led him inside and offered him a chair. Through the still open door, James watched as Carl used his name badge and a code on the number pad to let the medics out of the anteroom and back to their ambulance. Carl then used the badge to open the interior door and join him and Sarah in the intake room.

Unease set in as Carl closed the door to the intake room. He watched carefully as the intimidatingly large man carried the belongings bag over to a table and began removing the contents.

“Carl is just going to inventory your belongings. They will be kept in a safe place for you and returned when you are discharged. While you are here, we will provide you with a pair of sweats and a tee shirt. The clothing is brand new, and you can keep them when you leave. We will need to do a quick skin inspection as you change your clothing. We will be looking for scars, tattoos, and any cuts, scrapes, or bruises. You will be allowed to keep your underwear, but we will need to do a quick visual inspection in that area as well. Could you please stand up for a moment?”

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James found himself caught in a memory. He was 18 years old and a freshman at a local university. He had attended a frat party where he had over-indulged in whiskey and marijuana. He couldn’t recall much of the party or the ride to the hospital. He recalled brief flashes of his parents in the Emergency Room, the drone of voices and hospital sounds as he lay on the hard stretcher. He remembered being afraid. And he remembered the Voices.

The Voices were new. They warned him about the doctors and nurses. They were not his friends. He had to be careful. They had tricked his parents. Mom and dad believed he needed their care and wouldn’t take him home.

At the psychiatric hospital, the intake had proceeded in the same way. They took his clothing and inspected his naked body. They locked him up for three weeks, telling him he was paranoid and delusional. They made him take pills that made him feel slow and detached from everything.

“We think the marijuana triggered a schizophrenic episode.” The psychiatrist had said to his father.

He remembered the devastating heartbreak when his father told him he wouldn’t be able to return to college. “Maybe in a year or so, once you’re stabilized,” he had said. But it never happened. A social worker had helped get him on Social Security and Medicaid. The checks came every month. But no one expected him to return to college. No one expected him to have a career. They had listened to the doctors and nurses. They had given up on him.

The medication made the Voices go away, but he remembered their warnings. He didn’t trust the medical staff. The people who had turned his family against him.

Everyone except his brother. Robert still believed in him. He could trust Robert.

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“James? Can you hear me?”

James returned to the present.

“Could you please stand for the skin inspection?”

James stood up and allowed Carl to help him remove his clothing as Sarah inspected every area of his skin, noting any identifying marks and the absence of any injury. He then dressed in the provided sweat pants and tee shirt and sat back down.

For the next twenty minutes, James struggled to maintain focus as Sarah reviewed his medical records and verified his information. She took his blood pressure and asked him the usual questions about voices and delusions. James cooperated as usual. But he could tell something was different this time. The Voices had warned him before the medications had driven them away. He was in danger here. If he stayed, they would kill him.

He looked at Carl standing in the corner, then looked away. He could feel the menace emanating from the big black man. Nurse Sarah was pretty and little, but he could almost smell the evil oozing from her pores. Their friendly tone and polite manners were a thin disguise for the animosity he felt coming from them.

“OK James,” said Carl. “Let’s get you a bed assignment, then I can find you some food.” He crossed the room and opened the door to the hall. He had the belongings bag in his hand. James followed, noting three men at the nursing desk, all dressed in the same sweats and tee shirts. He felt their stares as he passed, looking down to avoid eye contact. He didn’t know if they were real patients or if they were there to spy on him. He would have to remain vigilant.

Carl stopped at a door with a number plaque on the wall reading “109.” “This will be you room, James. You can have the bed by the window. Your roommate is Jeff. He’s a good guy. I think you’ll like him.”

James stepped into the room. It had two beds with wooden frames and rubber mattresses. There was a pile of folded sheets, blankets, and a pillow at the end of “his” bed near the Window. He could hear a soft buzz coming from the fluorescent overhead light. Along the left wall was a small bathroom near the entry and a two-door closet dividing two desks with bookshelves above them. Each desk had a light plastic chair. He noticed each desk had a small fluorescent light encased in a plastic protective shield. There were no sharp edges in the room. He knew from experience that the beds would be secured to the floor. There were no potentials weapons here.

He walked over to the windows and turned a knob, opening the integrated blinds. The windows overlooked an internal courtyard with grass, picnic tables, and a basketball hoop. There were no trees or structures that could be used to access the roof for escape.

James quickly made his bed and laid down. He still didn’t feel safe, but the drugs and the continuous vigilance had made him tired. He needed to close his eyes for a few minutes. His mind immediately began to lose focus and he drifted into a light sleep.

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“I’m joining the Army, Jimmy!” Robert told his brother. “I’m so excited! The recruiter says my rank in the Sea Cadets will give me an E-3 rank right out of Basic! I signed an Option 40 contract so I can go to Ranger School after AIT and jump school. I’m going to be a Ranger just like Rambo!”

James smiled and tried to match his brother’s enthusiasm. Six months earlier, James had a whole future ahead of him. All of that had changed after the party. Now no one talked about college. They only talked about his medications and his next visit with the psychiatrist or social worker.

Except Robert. Robbie still talked about James returning to college and pursuing his dream of working as a foreign translator. He would sit with James in the evenings and they would practice speaking in Arabic and Spanish. James would help Robert with his physics homework for his AP high school exams. The brothers were extremely close.

“Oh! Mom said dinner’s ready. She made Yankee Pot Roast!”

James smiled at Robert’s enthusiasm. He had always been energetic and optimistic. Robbie was the captain of the school wrestling team, an Athletic Scholar, a Valedictorian for his class, and had college credits for four classes through the AP program. He was also a Petty Officer Third Class in the Naval Sea Cadets. Both brothers had been over-achievers in high school. But, while James was reserved and nerdy, Robert was outgoing and popular.

Both young men ran downstairs, racing to be first to mom’s table, laughing and elbowing each other like they were each 10 years younger.

“Easy boys,” said Richard O’Loughlin as they each slid into their usual seats. The stern older man sat at the head of the table, folding his newspaper and setting it aside. He smiled at the boys as Nancy, their mother carried a dish to the table.

“I’ll help!” said Robert, jumping from his chair. He ran to the kitchen and juggled two hot dishes and a basket of biscuits back to the table, much to his mother’s dismay.

“If you drop those, we’re all going hungry, Robbie.”

“I’ve got them Mom. See? Everything’s safe,” he declared, dropping the biscuits to the table and quickly catching the basket as it started to tip over. He flashed his mother a Cheshire grin.

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“Hey Buddy! You must be the new guy!”

James jerked awake and jumped out of bed, throwing his pillow at the intruder.

“HEY! Take it easy! I’m just saying Hi.”

A lanky young man in sweats and tee shirt walked forward and extended his hand, a big grin on his face. “I’m Jeff, your roommate. Been here two weeks. Food’s not bad, but careful. Everybody gets fat in this place. The staff is cool though. They do games and stuff. And music nights. And sometimes they buy us pizza…”

James ignored the hand and looked away as Jeff continued to drone on about the facility, its staff, various patients, and a dozen other unimportant topics. He walked around the bed, keeping a careful distance between himself and the other patient. Jeff kept talking as he followed James into the hall and toward the common room James had noticed next to the nursing desk. He could see 6 patients in the common room, sitting at tables talking and playing games. James scanned each one as he entered the room and headed to the coffee machine. He did not sense any immediate danger. He sat at one of the empty tables, only for Jeff to take the seat across from him shortly after, his own cup of coffee in hand.

“Coffee kinda sucks, but it’s hot and they keep it coming.” Jeff said, taking a big sip, then breathing hard through his mouth to cool the burn. “Damn. I gotta remember it’s hot! You don’t talk much do you? That’s OK. I like to talk. My mama says I talk too much, but she don’t mind. She says she likes to hear me talk. I sing too. Do you want to hear me sing?”

Jeff started singing an old Brittany Spears song, only a bit off key. James noted the obnoxious young man had a nice voice, if untrained. He tuned it out and looked up at the TV. The news was on, showing the usual political drivel that drove commercial sales these days.

James didn’t like being in the public space, but he needed to understand the facility. He had been admitted on six previous occasions, but never to this hospital. This one was state run. He needed to understand how that was different from the private hospitals he had stayed in in the past.

He stood up and walked toward the door.

“You have to drink that here,” said Jeff, nodding toward the drink in James’ left hand. “They don’t let you eat or drink in the hall. At least not usually. Sometimes they let folks eat in their rooms, but only if the doctor says so. And you can’t keep food in your room.”

This was good information to have. He nodded his gratitude to Jeff and stood at the doorway drinking his coffee as he surveyed the unit.

From this vantage he could see the unit was made up of two hallways with one corridor lined with 10 patient rooms, five on each side. At the end were several closet doors with keyed locks. The other hall held the common room across from two offices with large glass windows. At the end of the hall was a door with a magnetic reader. At the corner of the two halls was the nursing station with an office behind the desk. Across from the desk, down another short hall was the intake room across from a wooden door with a keyed lock. Between the two was the exit to the ambulance bay. The egress doors all had magnetic readers. The office doors had keyed locks. The strange wooden door was also keyed. James assumed that door led to an isolation room.

“Medications!”

James splashed a bit of hot coffee on his hand as he startled away from the loud voice. Sarah was standing behind the nurse’s desk with a medication cart and a pitcher of water. He moved back into the room and pressed himself against the wall as the seven other patients moved quickly into the hall to receive their evening meds. James set his cup on an empty table and headed toward his room, passing six patients coming out of patient rooms. Once alone, he opened the closet and grabbed a small hand towel from the upper shelf. He took it to the bathroom and washed the coffee from his hands before using the toilet. He kept the towel and returned it to his closet. He didn’t want Jeff using it.

“Hi James.” Came a voice from the doorway. It was Carl, the tech. “It’s medication time. Can you please go see Sarah to see if the doc want’s you to take anything?”

“I haven’t seen the doc yet. I don’t want any medications. I just need to be left alone.”

“OK. Are you under court order?”

“No. Just pit and cert. I don’t have to take drugs yet.”

“You’ve done this before.”

“Yes. I know my rights. I just need to be left alone.”

“OK. I’ll tell Sarah. Let me know if you need anything. I was going to get you some food, but you were sleeping. Kitchen’s closed now, but I can warm up a tray or get you a sandwich.”

“Sandwich.”

“I can do that. But you have to eat it in the common room. I’ll meet you there in a few minutes.”

“OK.”

Carl headed up the hall and James followed a few moments later, his stomach making grumbling sounds in response to the talk of food. He made his way back to the common room, which was now filled with a dozen others. There were empty seats, but no empty tables. He grabbed a cup of water and sat across from an older obese man who was sitting alone and quietly mumbling to himself. The man looked up, then looked away, continuing to mumble as he ignored his new tablemate.

A table on the other side of the room erupted in laughter. James looked over quickly and saw Jeff with three other young men talking and laughing as they played a game of Yahtzee. James jerked away as an arm reached around him. He looked up to see Carl placing a paper plate in front of him beneath a pathetic turkey sandwich and a small bag of Nacho Cheese Doritos.

“Sorry I can’t get you anything better. Breakfast will be hot though. And the food here is usually pretty good.”

As Carl walked away, James began to eat the sandwich and chips. His tablemate looked up occasionally, only to quickly look away again. Neither man attempted to make conversation. The other man kept to himself, and James finished quickly and headed back to his room.

In the closet, James found a toothbrush and toothpaste. He brushed his teeth in the small bathroom and went over to the bed. He looked out the window before lying down. A rain storm had moved in and rain drops made a gentle tapping on the window pane. James found the sound both annoying and soothing. He hoped the white noise would help him sleep. He would need to be rested if he was to escape. He estimated he had about 2 days to make his plans.