Monitor 6 Video: ECT 21794, 6:00 a.m., 4 minutes
Patient stable after administration. Patient in position. Guardrails highest level. Patient unoriented to time and space. Citalopram 20 mg once daily and sodium valproate 200 mg two times a day.
Monitor 7 Video: ECT 21794, 7:06 a.m., 2 minutes
Patient anxious. Alprazolam given. Muscle suppression still present. Possible atypical absence seizures noted. Postictal response.
These read like clinical notes for electroconvulsive therapy, but why on earth would they be doing that to him? It’s not a treatment for autism and definitely not any form of treatment that psychiatrists go around giving kids. A child has to be severely depressed to be given shock therapy, and even then, you have to get permission through a special committee. A thorough psychiatric evaluation has to be completed beforehand, but there’s not a psychiatric report anywhere to be found or a mention of depression in any of his intakes.
None of this makes sense, and it doesn’t line up with Genevieve’s descriptions of Mason. He clearly has more issues than she lets on. These are important pieces of Mason’s life. Is she hiding them on purpose? But then why give all this stuff to Detective Layne if she’s trying to keep it a secret? The questions compete for space in my head. There are lots of missing pieces, but one thing is certain—Genevieve never would’ve let a boy with the kinds of impairments and limitations described in these reports walk around next to a creek by himself.
SEVEN
CASEY WALKER
Annabelle’s smiling face on her reward poster greets me as I push open the coffee shop door. The entire town is plastered with her picture. Some people have it on their house windows or on signs in their front yards. Her reward poster is taped on every business door in town. People are petitioning for anyone with information to come forward with the type of fervor that is usually reserved for political elections. There are even buttons marked with JUSTICE FOR ANNABELLE and the anonymous tip-line number underneath that have started circulating. It won’t be long until everyone has one.
The shop is quiet. Barely anyone inside. This isn’t the place to go if you want to talk. That’s the Starbucks two miles down the road across from the mall. But it’s the perfect spot if you want total privacy for a conversation like we do.
Detective Layne is meeting me here instead of the police station to go over what I’ve found in Mason’s reports so far. He wanted to meet at the station again, but I got him to agree to meet here. Hopefully, this will be more comfortable. I’m not too keen on the idea of people seeing me come in and out of there during all this. Gossip is people’s favorite thing to do around here—the juicier the better—and I shouldn’t do anything that brings attention to me right now.
Detective Layne sticks out like a sore thumb in his uniform among the few people studying or reading books scattered around the café. He’s tucked behind a small round table in the back corner. He spots me immediately and points to the two steaming drinks on the table in front of him. I texted him my order on the way here. I hurry over.
“Thanks,” I say, settling into the space across from him and setting my purse down next to me. He’s wearing one of the JUSTICE FOR ANNABELLE buttons on his breast pocket underneath his badge. His navy-blue shirt stretches tight across his chest like he stuffed himself inside it.
“No problem.” He points to the cream and sugar in the center of the table. “Didn’t know how you liked yours, so I left it black.”
“That’s perfect because that’s exactly how I like it,” I say, blowing on the top of the mug before taking a sip.
“Girl after my own heart.” He gives me a smile. I quickly check his hand to see if he’s married. There’s a ring. Good. At least it makes him hitting on me less likely.
“That file is huge,” I say, wasting no time getting down to business.
He nods in agreement. “I’ve only gotten halfway through it myself, so I don’t expect you to have reviewed it all, but what are your initial impressions?”
There are so many things I could touch on that I don’t even know where to begin, but I don’t want to waste his time on stuff that’s not important to the investigation. “Maybe you can start by letting me know the critical things I should be looking for?” I know the issues I’m dying to talk about, but that doesn’t mean they’re the same ones for him.
“I’m not too worried about all the medical mumbo jumbo about all the disorders the doctors say he has. Autism spectrum disorder. ASD. Learning problems. Heck, whatever it is. That’s just fine with me if that’s what he’s got. Doesn’t make a lick of difference.” He stretches out his arms and cracks his knuckles. “Here’s what I want to know about the boy—is he violent?”
Of course he starts with the question that’s the most difficult to answer or predict. “His test scores would say no. They describe a pretty stable picture of a young boy with autism who has significant intellectual impairments but doesn’t have any issues with violence and aggression unless he’s frustrated or trying to avoid something that makes him uncomfortable. He’s more likely to inflict violence on himself than he is somebody else. But those are just his tests scores. If you look at the narrative parts of the reports, you’ll see that they change over time and start suggesting an undertone of aggression even though his scores on the standardized tests stay the same.”
He puts his hand on his chin. “I’m not sure I’m following you.”
“In every report, there’s always a long written part where the evaluator describes Mason. You can usually find it in the introduction or in the background section. That’s where they talk about the behaviors they witnessed during the testing session. Those descriptions of Mason change over time,” I explain.
“Got it.”
“Everything shifts right when he hits ten. In early reports, everyone says things like He engaged in self-stimulating behavior for twenty minutes to decrease anxiety, or Client twists hair when agitated to self-soothe. All those behaviors are just ways he’s managing his anxiety and trying to juggle his internal state. They’re all super common, too, especially in kids that age. Nobody’s threatened by those behaviors, but all that changes as he gets older. An agitated teenager, especially one who looks like a grown man, doesn’t look as harmless and innocent as an agitated little boy. You see the change happen in how they describe his similar behavior.” I pull up another part of the report and scroll to the highlighted section. “Like right here when he’s thirteen: Patient became agitated and aggressive when unable to complete tasks. My guess is he probably engaged in the same self-stimulating behavior that he did when he was ten, but they interpret it differently.” I keep going through the section. “And here’s another one—Mason pulled his hair out when frustrated. In both cases, he was twisting his hair, but you form a very different opinion of him based on the words the examiner uses to describe him.” I pause for a second. “Is this too much?”
“No, no, this is great. It’s exactly why we brought you on. These are the things we need to help us. Fascinating stuff.” His face is so hard to read sometimes. This is one of them.