Projection: A Novel Hardback - 1999

Excerpt

I watched Josiah King pace in front of the witness stand. His stout, six-foot-two frame, outfitted in a plum-colored, double-breasted suit, dominated the scene. "Dr. Elmonte," he started, "can you give an opinion, with a reasonable degree of medical certainty, whether Dr. Lucas knew right from wrong at the time he took the lives of Sarah Johnston and Monique Peletier?"

Elmonte, a slender and pretty blonde who was a full professor of psychiatry at Yale Medical School, stared at Lucas and nodded once. "I can."

Lucas pulled at his salt-and-pepper hair and whistled from the defense table as though he was heckling a schoolgirl. Three television cameras -- two from local networks and one from COURT TV -- swung in his direction.

"Dr. Lucas," Judge Barton scolded.

Lucas shoved his heavily casted right arm off the table and slumped forward to lay his head down. He was wearing the scrubs he'd been given at Lynn State Hospital, where, for the past five months, he had been locked up on a unit for dangerous patients.

Defendants accused of capital crimes are usually held at the Massachusetts Correctional Institute in Concord, but Lucas had unraveled there, ranting around the clock about the devil. Early one morning he had braced his right arm between the bars of his cell and snapped his radius, ulna and humerus. That was enough to make the transfer to a psychiatric ward happen.

King had been watching Lucas, but now looked back at Elmonte. "I'm sorry. Your opinion, doctor?"

Elmonte turned to the jury. Her blue blazer and gold monogram lapel pin complemented her authoritative tone. I could see why King had chosen her as an expert witness for the defense. "Dr. Lucas lacked the capacity to distinguish right from wrong at the time of Ms. Johnston's and Ms. Peletier's deaths," she said.

King nodded and glanced at Lucas. "Did Dr. Lucas, therefore, lack the ability to conform his behavior to the requirements of the law?"

"He lacked that ability. He could not control himself."

"You would conclude, then, doctor, that Trevor Lucas should not be held legally responsible for the violent acts he committed on the days in question."

Red Donovan, the new district attorney, shot to his feet. "Objection." Mid-forties, with an athlete's build and waves of rust-colored hair, he reminded me of a human torch. The Lucas case was his most publicized trial since taking office just eight months before. "Dr. Elmonte was qualified before the court as a psychiatric expert, not a legal scholar."

"Sustained," Barton said. He looked down at Elmonte. "The jury will decide questions of legal responsibility. Please confine your comments to the patient's state of mind."

"Of course," she said, a touch of arrogance in her tone.

King was still pacing. "You would conclude, Dr. Elmonte, that the accused was insane at the time he killed Ms. Johnston and Ms. Peletier."

"I believe he was insane."

Lucas stood up for the fifth time. "Objection," he barked, staring down at his casted arm. "I didn't kill anyone."

"Dr. Lucas," Barton fumed, "sit down and be quiet." His bald head, large even for his massive shoulders, reddened. He waited a few moments after Lucas took his seat, then turned to Josiah King. "Defense counsel has submitted a motion indicating that the defendant's impaired state of mind at the time of the crimes in question shall serve as the mainstay of his defense. Is that still your contention?"

"It is, Your Honor," King said.

"Then I would advise you -- and your client -- that further outbursts will not be tolerated."

"Understood, Your Honor," King said. He walked to the defense table and stood by Lucas. "May I continue?"

"Of course."

King took a few moments to refocus. "Dr. Elmonte, would you tell the jury what you have learned about Dr. Lucas that supports your conclusion that he was insane at the time of the two homicides?"

Elmonte turned to the jury again. "Dr. Lucas suffers from bipolar disorder," she said. "Even while functioning brilliantly as a plastic surgeon, he has, at least for the past decade, been subject to severe mood swings. At one moment he is somber, at another elated, without any stimulus intervening. His appetites -- for sex, sleep, food -- wax and wane unpredictably. He may be voracious today and completely disinterested tomorrow. Most importantly, his thinking often includes paranoid delusions."

I looked over at Emma Hancock, Lynn's Police Commissioner. Monique Peletier, the second victim, had been her niece. She looked back at me and shook her head in disgust. Her lips silently mouthed, "Bullshit."

"Might the symptoms you speak of explain Dr. Lucas' violent acts?" King asked.

"They would. In the weeks prior to the murders, Dr. Lucas developed the fixed and false paranoid belief -- the delusion -- that he was an agent of Satan, a pawn in a final struggle between forces of good and evil. As he put it, he was the devil's 'right-hand man.' "

I heard sobbing from the front of the room and noticed Karl Johnston, Sarah's father, bent over in his seat at the end of the second bench, his head in his hands.

"The devil's right-hand man." King looked over at Johnston, pursed his lips and closed his eyes in the necessary display of empathy. His fingers massaged his overgrown eyebrows. "This is very difficult for everyone involved, Dr. Elmonte," he went on, "but I need to ask whether Dr. Lucas' psychiatric symptoms might explain why the victims were disfigured in the way they were."

She nodded. "In the days prior to Ms. Johnston's and Ms. Peletier's deaths, Dr. Lucas had come to believe that his right arm was no longer his own. It was Satan's. The doctor was horrified as he removed the breasts of each woman, even more so as he lacerated the genital area of Ms. Peletier, but he had no control over what his arm did."

"Is there a scientific name for this phenomenon?" King asked.

"Alien hand. The condition is well known in the literature. Oliver Sacks even writes of it."

I smiled, in spite of my raw nerves. Before closing my psychotherapy practice and becoming a forensic psychiatrist myself, I had treated more than a thousand patients and had never seen a single case of alien hand syndrome. Neither had any psychiatrist I knew.

"We notice that the arm is casted today," King continued. "Could you tell us why?"

"Dr. Lucas fractured the arm in three places using the bars of his cell for leverage. He wanted to be rid of it. Its actions -- the arm's -- were abhorrent to him."

Donovan popped up, again. "Objection. The doctor qualified before the court as a psychiatrist, not a mind-reader. She can't speak for the -- "

"Dr. Lucas hates what the arm did," Elmonte interrupted. "That's why he tried to break it off."
***
I left for the lobby before King had finished his questioning. The judge had announced there would be a short recess before Red Donovan's cross-examination of Elmonte, but I couldn't sit in the courtroom any longer.

My head was tight with anxiety. A cigarette would have calmed me down, but I didn't feel like freezing in the winter air. I thought of sneaking one in the men's room, but that reminded me too much of the days when I would have rushed into the stalls for a blast of cocaine. And I didn't have enough sober time behind me to risk rekindling old habits. So I just stood there, watching the sculpted metal doors of the courtroom.

Nicotine wouldn't erase the truth anyhow. And the truth was the thing eating at me: Lucas had pled NGI -- not guilty by reason of insanity -- but he hadn't actually murdered anyone. Four mutilated bodies had been found in and around the urban squalor of Lynn, not two, and the last victims had been killed after Lucas had turned himself over to the police.

The prevailing theory was that Lucas' crimes had spawned a "copycat" killer. I knew better. One person had claimed all four victims.

Josiah King had to have considered making that argument the focus of Lucas' defense, but it would have been tough to sell to a jury. There were disparities between the first two killings and the last two. Sarah Johnston and Monique Peletier had been Lucas' patients and his lovers. The breast implants he had placed in each woman had been cut out of them. Their genitals had been shaved clean or mangled.

The victims found after Lucas had surrendered were also cut up, but their bodies were discovered in neighboring cities, not Lynn itself. The third victim, Michael Wembley, had been male. The fourth, Rachel Lloyd, had been set afire after her death. And neither Wembley nor Lloyd had been linked romantically to Lucas.

Those differences would go most of the way to supporting the "copycat" theory and pinning the first two killings on Lucas, especially since a jury might relish sending a rich doctor away for life. No wonder a not guilty by reason of insanity verdict seemed like a deal to him. Five, ten years on a locked psychiatric unit beats life in prison hands down.
The only way Lucas would go free would be if I told what I knew about the four murders.
And I couldn't.

Thinking about that started my heart pounding. I stepped into an alcove off the lobby, took a cigarette from my shirt pocket, lighted it and inhaled a third of its length.
I turned and blew the smoke in back of me, took another long drag, then ground the butt out with the heel of my boot.

I wondered whether Lucas was fabricating all of his symptoms or whether the stress of his impending trial had actually touched off a break with reality. I had known for a long time that his character was warped, but what he had done to his arm seemed the act of a truly insane man, not simply a sociopath.

The doors to the courtroom opened. King, Donovan and a flood of reporters and spectators poured out. I spotted Emma Hancock right away. She was fifty-five years old, with graying hair, but her powerful build still demanded space in a crowd. I walked over to her. Without a word, we picked up our pace and started toward the concession stand one floor down.

Calvin Sanger, a reporter from the Lynn Item, appeared by Hancock's side and started matching our stride. He was a black man in his early thirties who was persistent and
insightful -- a good combination for a reporter and a nightmare for the police. He himself had made news every year for the past five, finishing the Boston Marathon near the front of the pack. He raised his pad and pen and started to ask a question.

"No comment," Hancock said.

Sanger slowed his pace, drifted in back of us and reappeared next to me. "He has no comment, either," Hancock bristled.

"Do you agree with Dr. Elmonte's diagnosis?" Sanger persisted.

Hancock stepped in front of us and blocked the way. She glared at Sanger. "Don't make me say it again, Calvin. I've always kept you in the loop, when I could. Right?"

"Right, but . . ."

"But nothing. Don't blow it."

"Give me a break. You haven't said a word about Lucas since he was arrested."

Hancock started to walk away. I jogged a few steps to catch up with her.

"Any progress toward finding the second killer, Commissioner?" Sanger called after us.

My pulse quickened. I glanced at Hancock. "He can go straight to hell," she said.

I bought our coffee at the concession stand. We sat down on a wooden bench carved with obscenities. The jingle I had learned growing up on Lynn's decrepit streets, empty veins of a city that died with America's industry after World War II, was etched in ball pen next to my thigh.

Lynn, Lynn, City of Sin,
Never Come Out the Way You Went In.

"Elmonte's a piece of work," she said. "You can pay a psychiatrist to say anything. Present company, of course, excepted."

"Thanks."

"I didn't mean it as a compliment," she smirked. "I thought you might learn something from her."

Hancock had hired me as a forensic psychiatrist for the Lynn Police Department dozens of times, including the case that ended with Trevor Lucas' arrest. When she had run for mayor of Lynn, I figured I was about to lose my meal ticket, but she'd lost that election, then been promoted from captain to Commissioner. "I thought you valued my independent thinking," I said.

"I'm already paying you two hundred fifty an hour. If  I value your independence any more, the department's gonna go broke."

I ran my fingertip back and forth over the word sin. "What do you think the jury will do?" I asked.

"Convict. Two counts, murder one."

"If he's found NGI he still goes away a long time."

"Time isn't the point."

"What's the point, then?" I took a gulp of coffee.

"Like the Bible says, 'An eye for an eye.' " Hancock often quoted Scripture. Unmarried and childless, she had focused her love on work and church. She crossed and uncrossed her legs, obviously uncomfortable in the gray flannel skirt she was wearing. Street clothes went with the Commissioner's job, but they didn't go with Hancock's demeanor.
"Glad to see you dressed for court. With that ponytail of yours you could do some fine undercover work -- as a dealer."

I was wearing jeans, a black turtleneck and black cowboy boots, pretty much what I always wore. "The jeans are only a couple of years old," I joked.

Hancock was looking away and shaking her head.

"It's not like I'm on the stand today." I saw the muscles in her jaw working against each other and realized she was listening to her own thoughts, not me. She started clicking the long, red nails of her thumb and forefinger together. That was a bad sign. "Emma," I said. "You there?"

"I want Lucas in prison, not some cushy hospital."

"What difference does it make, so long as he's off the street?"

She turned and squinted at me. " 'What difference does it make?' Obviously, you haven't spent much time in places like Concord."

"I've evaluated prisoners there."

"Sure, in some interview room, with waxed floors and a Mr. Coffee outside the door. I mean the bowels of the place -- the filthy, rodent-infested, eight-by-eight cages where they warehouse monsters like Lucas."

"No. I haven't seen those."

"It's hell on earth," she said, toying with the gold cross around her neck. "Terrible things are allowed to go on. Beatings. Rapes. Stabbings."

"Torture."

"Punishment. I want him to suffer for what he did to Monique."

I didn't want to argue social policy with Hancock where her niece's accused killer was involved, but I'd never had much use for the penal system. "I thought we were supposed to be rehabilitating people." I half-smiled.

"Now there's the bleeding heart shrink I know and love. All excited about reclaiming a soul. You think you could heal Lucas, make him all better?"

I shook my head. I had shut down my psychotherapy practice when an adolescent boy I had been treating committed suicide. I wasn't sure any more how much help I could be to anyone. And Lucas, while no killer, was a very sick character. One of his passions had been hunting for vulnerable women, usually naked dancers, and bartering cosmetic surgery for sex. They had to pay him back with the sadomasochistic games he liked, whenever he liked. The games could get pretty ugly. "I couldn't heal him," I said, "but maybe somebody. I don't know."

"Well, I do. Evil only comprehends raw force." She finished her coffee and tossed the cup in the garbage. "Anyhow, it's too late for Lucas. If he needed help, he should have gone and gotten it before he butchered two good people."

I knew Monique's death had left Hancock in that cold space between grief and rage. "I can't begin to think what it's like for you sitting in that courtroom," I said, hoping she would open up.

She steered clear of the invitation. "King has no chance with the NGI plea," she said, shaking her head. "He would have been better off working the 'They've got the wrong man' angle. Sanger can be a pain in the ass, but he's sharp. We don't have a single decent lead on the copycat killer, and he knows it. So does that jury, if they read the Item. All it takes to gum up the works is one good citizen who's watched too many Perry Mason reruns."

My guilty conscience spoke: "You think there's a chance they'll acquit Lucas based on reasonable doubt even without King raising the issue?"

"No way. King would have had to put the single-killer argument front and center, then stand his ground like a great oak. And it still would have been a hundred-to-one shot." She shook her head. "Lucas is going down. Premeditated murder, with extreme atrocity and cruelty. Life in prison, no possibility of parole. I just wish we had the death penalty back on the books. I'd pull the switch myself."

I didn't respond. Half a minute passed in silence.

"You seem a little out of it today," Hancock said. "Any news on Kathy?"

My skin turned to goose flesh. I'd been living with Kathy during the murders. "Still no sign of her. Just the one-way airline reservation to London. She could have gone anywhere from there."

"I don't get that. She just up and left?"

"Once we called it quits, there wasn't a lot to stick around for. She was completely estranged from her family."

"Still, one day she's the star obstetrician at Stonehill Hospital, the next she throws it all away and takes off for another country."

"She was unpredictable."

"So were you, Francis -- with your intentions. Not that it's any of my business."

"My intentions?"

"Did you expect her to live in sin forever? She's a Catholic." She paused. "Not to mention your 'extracurricular' activities. You never made a secret of your wandering eye."

I had even less desire to talk sex and religion with Hancock than I did social policy.
"Maybe she'll be back someday," I said dismissively.

"Anything's possible," Hancock said. "People will surprise you, usually when you least expect it."
***

***
Red Donovan stood at the prosecution table and buried the fingers of one hand in his hair. He blew out a long breath. "Let's see if I followed everything you had to say, doctor," he started. His voice was a street-fighter's rasp. "The defendant believes his right arm has a will of its own. Is that about the long and short of it?"

"Not exactly," Elmonte said flatly.

"No?"

"Dr. Lucas is unshakably convinced the arm is not only beyond his control, but that it does not belong to him. It is Satan's arm."

I heard Hancock clear her throat. She had taken a seat in the middle of the front row, just behind the defense table. I was on the aisle, near the door.

Donovan held up his hands. "My mistake." He walked around to the front of the table.
"The defendant believes his right arm is owned and operated by the devil."

"You could put it that way."

"Kind of like a franchise."

A few jurors chuckled.

"Objection," Josiah King said, rising out of his seat.

"Sustained," Barton said. He looked at Donovan. "You are welcome in my courtroom -
as an attorney. If you've decided to become a comic, you'll need to find another stage."

Donovan nodded. "Pardon me." He paused. "Are you aware, Dr. Elmonte, of Dr. Lucas' activities on the days that Sarah Johnston and Monique Peletier were murdered?"

"I'm aware of some of his activities."

"Are you aware he performed surgery on three patients on each of those days?"

Elmonte straightened up in her seat. As the fabric of her blouse shifted, I noticed it was unbuttoned lower than courtroom etiquette would dictate, showing the top of her white lace bra. "I was not aware of the number of surgeries, but . . ."

Donovan walked back to the table and picked up a folder. He turned to Elmonte. "In fact," he said, reading from the folder, "he removed a basal cell carcinoma from one patient's nose, performed two blepharoplasties -- what are those?"

"Blepharoplasty involves excision of superfluous tissue from the eyelids."

"OK. Two lid jobs." He smiled. "A rhinoplasty. I know that one: it's a nose job. And two liposuctions -- that would be sucking fat from thighs and tummies and what have you." He tossed the folder back on the table. "Is Dr. Lucas right-handed or left-handed?"

"He's right-handed."

"And that's the hand owned and operated by Satan."

Another chuckle from a juror.

"Mr. Donovan," Barton deadpanned. "Careful."

Donovan nodded. He was playing with fire, and he knew it. Robert "Buzz" Barton, also known as the "Rock," was one of the smartest and toughest Superior Court judges in the country.

Barton looked down at Elmonte. "Answer the question, doctor," he said.

"The right hand is the one afflicted," Elmonte said.

"Well then, Dr. Elmonte, how do we understand Dr. Lucas performing complicated surgical procedures with that hand on the days in question?"

"The fact that Dr. Lucas suffers with alien hand does not necessarily prevent him from performing some behaviors he has mastered. Technical work like surgery can become quite automatic."

"Is it possible Dr. Lucas believed that Satan conducted those surgeries?"

"I would assume that is exactly what he believed."

"You would assume."

"To a reasonable degree of medical certainty," she deadpanned.

"You didn't ask him directly?"

"No."

"Why not?"

"I didn't need to. Alien hand is a major mental illness. It doesn't come and go like a headache."

"Why didn't he sign Satan's name to the invoices?"

"Objection!" King shouted.

"In fact, he signed bills under his own name totaling thirty-two thousand dollars for those procedures on those very days," Donovan went on. "With his right hand."

"That's irrelevant," King said. "Dr. Lucas' income and billing practices are not -- "

"The objection is . . . ," Barton started.

"Your honor," Donovan argued, "those billings go directly to the defendant's mental state on the days of the murders. He had the self-control to perform delicate surgeries and even the presence of mind to oversee the bookkeeping. But we're being asked to believe his hand was possessed by the devil."

"As I was about to say, Mr. Donovan, the objection is overruled. But I'm warning you: the court does not appreciate your tone."

"Understood. Thank you." Donovan walked toward Elmonte. He stopped about six feet from her. "Isn't it possible, doctor, that the defendant is fabricating his symptoms?"

"There is almost no possibility," Elmonte said.

"Why do you say that?"

"The psychological testing we administered to Dr. Lucas, including both the Minnesota Multiphasic Personality Inventory and the Rorschach, showed him to be minimizing his symptoms. He was trying to appear less sick than he is, not more sick."

"But the defendant is a pretty smart guy, isn't he?"

"Dr. Lucas scores in the extremely gifted range," she said. "Under more ideal testing conditions, he would certainly reach the genius level." She smirked. "He's a 'pretty smart guy.' "

"Truly." Donovan paused. "You admire him."

"Objection," King said.

"Could that affect the test results?" Donovan pressed.

"Sustained," Barton said. He glared at Donovan. "Last chance."

"Wouldn't such a gifted man," Donovan continued, "be able to figure out what answers to give on a standardized test, so as to appear one way versus another? Say, ill versus depraved?"

"The tests are very sensitive. They generally detect when someone is lying."

"Generally."

"Almost always."

"Isn't it the case that the tests are less reliable when administered to individuals who are legally sane, but have severe character pathology -- psychopaths and sociopaths?"

"It is correct that the tests are somewhat -- "

I heard a shriek from the front of the courtroom. I jumped up and saw the stenographer cover her mouth, her eyes wide with terror.

Lucas was clutching Josiah King's gold fountain pen in his fist, high above his head. He drove his fist down to the table.

Several jurors turned away. Others gasped and leaned forward for a better view. An elderly woman in the first row broke down in tears. The television cameras panned the courtroom like hungry aliens, their lenses spinning into focus here, then there, feasting on the turmoil.

King lunged to restrain Lucas, but couldn't stop the pen from rising and falling a second, then a third time. Blood sprayed from the pen as it arced up and down.

"Security!" Barton shouted.

The guard rushed to help. Together they managed to force Lucas into a headlock, with his arms in the air. I saw that the center of his hand was punctured in three places. Blood streamed down his arm.

Barton hammered away with his gavel. "Remove the defendant!" he seethed.

Another guard had rushed in from the lobby. Each of them wrestled control of one of Lucas' arms and one of his legs and started to carry him out.

My eyes met Lucas' as he passed by. "Clevenger!" he screamed. He threw his head back to keep looking at me.

My stomach fell. I felt a wave of nausea coming. I slipped out of the courtroom amid the chaos and climbed into my Ram truck -- a silver '89 I'd taken in trade for a '94 Range Rover I'd fallen behind on. I lighted another cigarette and filled my lungs with smoke, holding my breath as long as I could. I did that again, then started the car and headed past the boarded storefronts of Union Street and onto the Lynnway, toward Boston. As the road curved past the Schooner Pub I pictured the bar, stocked with single malt scotches. A few ounces, and I'd be rid of the churning in my gut. I could almost taste the bronze-colored liquid, the aroma blanketing me, the warmth spreading down my throat. I gritted my teeth and accelerated past the place, frightened by how much I wanted to turn in.

Media reviews

"Projection is a crime novel like no other. It's a week in the loony bin; it's a psycho tour de force. Keith Ablow has the expertise and an overachiever's grasp. He's got the instincts of a Zen Thomas Harris."    
-- James Ellroy, author of L. A. Confidential
"Now the shrinks are doing it, and damned well too. Projection is first-rate fiction: smart, tough and moving."
-- Robert B. Parker, author of Hush Money