The Patient Read online

  “How does that make you feel, Ella? Having to always be ready to leave town because you are afraid the truth will come out?”

  Tears trickled down her face, and pieces of my heart tumbled into her stream of tears.

  “I can never let my guard down. Never get comfortable. Never have a place I can truly call home.” She looked so broken, as if sharing her truth fractured the cracked walls she’d pieced together around her heart and soul.

  I wanted to fix her, to fumble forward with her until our footing was solid and we found peace, together.

  In that moment, we were a unit of like-minded hearts, with shared fears and dreams, and it blew me away.

  “You’re crying,” she said. “You’ve never cried for me before.” There was wonder in her voice, as if she couldn’t believe the empathy, which broke my heart even more.

  “I’m crying with you.” I reached for a tissue and wiped away my tears. “The loneliness you live with . . .” The words I wanted to express were like a hot rock lodged in my esophagus.

  “But why? You feel it too, don’t you? You know what it’s like to be alone, to feel this way. Why cry for me? You should be crying for yourself.”

  The hatred and self-loathing I’d caught on her face earlier were back.

  “There’s nothing wrong with allowing yourself to feel, Ella,” I said.

  It made sense she had walls around her heart, that she blocked off emotion when it came to anything personal and instead projected all her hopes and dreams and the love she’d held in her heart onto the children she worked with.

  It all made sense. It wasn’t particularly healthy, but it was her reality. I got it.

  “It makes me uncomfortable, that’s all.” She crossed her legs and rubbed her calves absentmindedly.

  I fingered the chain at my throat.

  “Does it make you uncomfortable to feel emotion or when others feel it for you?” I asked to clarify.

  She shrugged.

  “What about the children you work with? They must like you, right?” I waited for her to think about that. “I’ve seen you hug them and hold hands with them. I’ve seen how you interact with them on multiple occasions, Ella. You’re very much full of emotion then.” I smiled at the memory.

  She smiled as well.

  “That’s different,” she said. “They’re innocent and kindhearted and deserve to feel love.”

  “They are no different from you.”

  Her eyes rose to mine, and any softness on her face disappeared.

  “There’s a crater full of difference between us,” she scoffed.

  “But if you’re so bad, don’t you think they would know it? Within that innocence and need to feel love, they’re sensitive to others around them. If you were so evil . . . those children would sense it, don’t you think?” I didn’t mean to sound harsh, but I wanted—no, I needed—to help her understand and to work with her on changing her sense of self-worth.

  “They know I love them,” Ella agreed. “And yes, they are pure. But that love would disappear the moment they found out the truth. I’m not blind to that. It hurts, knowing even they would turn their backs, but . . . it’s what I deserve.” Her shoulders hunched, turtlelike, over her chest. “Ava says that it won’t always be this way. She says one day we’ll find a child in need of love that we can raise, together. She’s waiting to find the perfect one, she says.” There was an innocence to Ella’s voice, a naivete that wasn’t like her.

  What story was she living now to think that could happen?

  “How is Ava going to find you a child?”

  I fully expected Ella to dive into a book she’d been reading about an orphan child or something remotely similar.

  “By finding one that needs to be loved. One who has no one else left.” Her guileless eyes blinked with innocence.

  Fear grabbed a choke hold on my heart and squeezed.

  “How . . .” I swallowed hard, desperate for water to coat the sandy texture of my throat. “How is Ava going to do that?”

  I was afraid to hear her next words, and yet I already knew what she was going to say.

  But I didn’t want to hear it, regardless.

  Was that wrong? Cowardly?

  “Ella.” I changed the subject, based mainly on fear. “Tell me more about Ava. You started to, the other day in the park, but I don’t think I have a full picture yet of who she is to you.”

  If she was about to say what I thought she was going to say, I needed more information.

  I needed to understand how Ella could find herself mixed up with someone like Ava.

  I needed clarity on Ella’s involvement.

  I needed . . .

  Shit, what I really needed was to wake up from all of this and start the day over.

  Rather than respond, Ella asked for a break. While she composed herself, I swallowed Tylenol and realized the bottle was almost empty. Damn. I’d gone through that bottle too fast.

  When Ella rejoined me in my office, I was ready to find out more about Ava and her influence on Ella’s life.

  I was ready for whatever truth Ella wanted to share.

  I had to remind myself that Ella was mentally unwell, and it was possible that whatever truth she shared was a fabrication, part of a story, a dream world she lived in.

  I needed to remember that.

  It was my job to help her navigate from that dream world, from the story of her own telling, to reality.

  I’d forgotten for a moment, but Tyler’s session yesterday had sparked the idea.

  It was entirely possible Ava wasn’t even real, when I thought about it.

  Until the other day, Ella had never mentioned a roommate or friend from prison. I would have thought that in all our sessions together, especially in the beginning, when I’d asked a plethora of questions to get to know her, a roommate would have been mentioned.

  She wasn’t real. She was Ella’s comfort blanket, her imaginary friend. I was able to breathe better now that I’d wrapped my head around Ava.

  Ella sat cross-legged on my couch, her knee-length skirt tucked around her legs, her hands folded in her lap.

  “Ava is like me. Sometimes I think we’re sisters or even the same person, though she’s so much older than I am.” She sighed and breathed in deeply.

  Her words confirmed my suspicions.

  “Ava was my cellmate in prison. She was the first person I met, and she was a bitch. I hated her at first. I wanted to stab her in the heart so many times that first year. I used to dream about strangling her in the middle of the night, shivving her in the shower, doing something, anything, to get her in trouble with the prison guards.”

  Ella sounded . . . foreign. Unrecognizable. A stranger on my couch.

  “Why did you hate her so much?” I picked up my notepad. Much of what Ella was about to share would mirror her own life and would hopefully reveal more than she had in the past.

  “She reminded me of myself. Her anger was so powerful, a pungent aroma that poured out of her until it became addictive. She did the one thing I had been too afraid to do.”

  “What was that?”

  “She accepted who she was. Embraced her destiny and never faltered. Fear was a word she never knew. Fear, for me, was all I ever knew.”

  The words rested there between us, and their power and strength in that moment said more than any other confession she’d made during our previous sessions.

  Her pupil size decreased in both eyes, and her nose flared until her facial features were unrecognizable. The glow of hatred that surrounded her physically pushed me back in my seat and attempted to flatten me.

  “Ava castrated her uncle.” Ella’s lips slithered into a smile. “She castrated him while he was drunk and high and then fed it to him before slashing his throat.”

  I tried hard to hide my recoil.

  “All I did was stab my parents. What she did was . . . beautiful. Poetic. I was jealous, and that jealousy ate at me for that first year. But then something cha
nged. She caught me crying one day in the shower, and rather than feel naked and vulnerable, I felt understood.”

  For a young woman sentenced to prison, the need to be wanted and loved would be overpowering. For a young woman who had been sexually abused for years, to find a way to survive in prison, where she would either continue to be abused or become the abuser . . . it could be destructive.

  The woman in front of me wasn’t someone I would classify as an abuser, and yet that’s exactly who she’d become, according to the notes I’d received from her therapist during that time.

  “Ava taught you how to survive.” I filled my voice with understanding, with sympathy, with forgiveness.

  Ella nodded.

  “She did more than that, though. She gave me strength to not only become a survivor but to also discover a better person in myself. It’s why I got early parole. I was able to let go of that anger, that hatred, and find a way to survive and thrive.” Ella leaned forward and reached for her now cold tea. In three gulps she emptied the cup.

  “Ava needs me as much as I need her,” she continued. “I’m her yin. I soften her rough edges and calm her when life gets too crazy for her. I help her focus and find purpose in life.”

  Ascribes unwanted attributes to Ava, I wrote.

  The more Ella described Ava, the more certain I was she wasn’t real.

  “What is Ava’s purpose in life, then? What does she do?”

  I could have thought up numerous responses to this question.

  Ella was a complex person with a history so destructive it was a wonder she was able to find healing. The therapist she’d worked with previously had spent a lot of time on self-abusive behaviors, and if ever one had a success story to tout, it would be Ella.

  Attributing her unwanted emotions and expectations to a persona of her own making made sense. We’ve all done it in one form or another. We all wear masks, hide our true selves, present the versions of ourselves that we need to be in order to be accepted.

  That’s exactly what Ella had done in this scenario.

  I wrote this down in my notebook, only half listening to Ella as she continued to talk.

  “Ava’s purpose is to protect those who can’t protect themselves,” she said.

  I leaned forward to grab my cup.

  “She watches out for the children who need to be loved.”

  I brought the cup to my lips and looked toward Ella, ready to listen.

  “I find the children, and she protects them.”

  The grip around my cup loosened, and it fell onto my lap, spilling my tepid tea all over my notes and my lap and staining my soul as I realized what she’d just confessed to.

  I jumped up and grabbed a handful of napkins to clean my mess while Ella sat there, calm, as if she didn’t have a care in the world.

  I didn’t want to believe Ella’s confession. I didn’t want to hear what else she had to say. I wanted to remain in my own little reality, ignorant of the truth that had been staring me straight in the eyes the whole time.

  All this time, I’d been wrong. Wrong about Ella. Wrong about the serial killer. Wrong about everything.

  Ella’s mind was fractured, and in her brokenness, she’d destroyed lives.

  And in my own blindness, I’d allowed it to happen.

  Whoever had left me those notes, they’d known. They’d been right to blame me. But they were just as guilty. They could have gone to the police.

  So why hadn’t they?

  Why come only to me?

  And what did I do now?

  Chapter Thirty-Eight

  WEDNESDAY, AUGUST 28

  PATIENT SESSION: SAVANNAH

  It was too beautiful a day to be cooped up inside, and I was too antsy, so when Savannah arrived, I talked her into joining me on a walk.

  I was a little surprised she didn’t fight me on the idea.

  I needed a distraction. After yesterday’s session with Ella, I’d called Dr. Brown to see if I could get in today to see her, but she was out of the office, and the earliest appointment she had available was for tomorrow. I knew I needed to act fast. Stalling could mean another lost life on my conscience, but I also needed to talk the situation through with Dr. Brown first. It was possible I was misinterpreting things, and I needed a second opinion before I potentially ruined Ella’s life.

  Between Ella’s confession and the fact Tami had gone radio silent on me, it didn’t surprise me when I’d woken up this morning outside in my backyard, listening to soft classical music via headphones, curled up in the lawn chair with my comforter wrapped around me.

  The last thing I remembered was leaving Tami a voice message to let her know I’d left a plate of food in the microwave for her before I went to sleep in my own bed.

  The circles beneath my eyes were more pronounced, and the stabbing pain in my head had grown from the dull throb I’d woken up with.

  I’d been tempted to hunt Tami down, to go to her place or even the police station and find out why she’d ghosted. If it weren’t for the fact I was exhausted, had Savannah’s appointment, and knew that Tami must be in the middle of something huge to not return my calls, I would have.

  “Hellooo. Earth to Dr. Rycroft.” Savannah faced me, walking backward. She’d lifted her large heart-shaped sunglasses up so I could see her eyes.

  “Sorry, I must have been daydreaming,” I said.

  “You haven’t heard a word I’ve said, have you?”

  “I’m sorry, Savannah. Can you tell me again?”

  “I just admitted to being the serial killer, that’s all.” She twirled around so her back was to me. I picked up my pace so I was walking beside her. “It’s not nice to ignore people when they’re talking, you know,” she continued, sounding hurt.

  “I wasn’t ignoring you. I was just . . . lost in my own head.” Spaced out, exhausted, should have been in bed . . . I could describe it any way I wanted, but truth be told, she was right.

  “My dad would say that’s the same as ignoring someone.”

  “Again, I’m sorry.” We walked side by side. “My mom would have called it maudlin.”

  She paused in her stride. “Maudlin? That sounds old-fashioned. What does it mean?”

  “Sad. Sentimental. Self-pitying.” Take your pick. It was a word she’d used whenever she’d been drinking and wasn’t paying attention to me when I was trying to talk to her.

  “Why are you sad?”

  “More like emotional. Or just overly tired.”

  She nodded. “That would explain those dark circles. You should try wearing some makeup when you’re in public.” She sipped the smoothie I’d bought her earlier.

  “You didn’t admit to being the serial killer, did you?” I brought the conversation back to what she’d just said.

  “Guess you should have been listening. Now you’ll never know,” she quipped with a saucy grin on her face. I couldn’t see her eyes, covered by the dark lenses, but from the way she jumped ahead and spun around so she faced me once again as she walked backward, I knew she was in a mood.

  A good mood.

  She was dressed in cutoff jeans and a snug black T-shirt that showed more belly skin than was appropriate and had a plaid shirt wrapped around her waist. Her braided hair was decorated with tiny little skull bobby pins, but her face was devoid of makeup.

  “I haven’t seen this side of you in a long time.” I liked it. It was exactly what I needed today.

  Savannah laughed.

  A real air-filled-with-the-trill-of-birds kind of laughter. Laugher that was infectious.

  “I’m good. I’m happy even.” She stuck her tongue out. “There, I said it. Are you satisfied?”

  My brows arched as high as my smile was wide.

  “Satisfied? With one measly little happy? Come on, Savannah. I need a few more emotional adjectives than that,” I teased, enjoying the sparkle in her eyes.

  I was thrilled, more than I would ever let on.

  “So what brought about this . . . happ
iness?” I tempted fate by asking, but I figured it was worth a shot.

  “Why do you have to push? Push push push push.” Savannah twirled one more time. “You know, I think I kind of like you.” She gave me a sidelong glance, and her lips hinted at a smile.

  I shrugged. She laughed again. I liked the sound.

  We crossed the street and headed into Wonderland Park. Savannah led the way, and I had a feeling I knew where she’d take us.

  After a few right turns, we sat down in the Red Queen’s courtyard, surrounded by red rosebushes. Not only were the queen’s guards standing at the entrance of this garden, but there were also smaller statues along the walkway, hidden among the bushes. The queen herself stood in the middle, surrounded by a variety of flowers at her feet.

  “Doesn’t it look like she’s watching us?” Savannah walked around the statue, at times looking over her shoulder as she passed by. “I swear her eyes move.”

  “Neat work of art, for sure.” I settled down on a bench.

  “Don’t you wish that these stories were true? I think it would be cool.” She plopped down beside me, one leg resting on the other, and leaned back in a completely relaxed pose.

  I would have bought it, except she drummed her fingers along the top ledge of the bench, and the muscles in her thighs remained taut.

  “You would want to live in a world where a queen chops people’s heads off for little reason?”

  Her lips quirked. “As long as it wasn’t my head, I’d be fine with it. But come on, a rabbit that hops everywhere wearing a clock, a cat that materializes out of thin air, and a place where everyone wears outrageous hats? I’d be down for that in a heartbeat.”

  “Some days it would be nice to live in a fictional world—I get that.” My world would consist of a beach, a cabana boy, and endless books to read.

  “Did you know there’s a librarian who dresses up as Alice? I saw her the other day.”

  I’m pretty sure she was talking about Ella.

  “It was neat. She was reading the kids a story and had the best voices too.”

  “Did you go and listen?”

  One brow rose. Her nose wrinkled. Her lips turned down in a frown. But her eyes twinkled. She was still a kid at heart.