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Chapter One

Raging emotions, dead tissue.

Polar opposites was the way Jeremy Carrier had always seen it.

In a hospital setting, no two disciplines were less connected than psychology and pathology. As a practitioner of the former, Jeremy prided himself on an open mind; a good psychotherapist worked hard at avoiding stereotypes.

But during all his years of training and clinical work at City Central Hospital, Jeremy had met few pathologists who didn't fit a mold: withdrawn, mumbly types, more comfortable with gobbets of necrosed flesh, the abstract expressionism of cell smears, and the cold-storage ambience of the basement morgue, than with living, breathing patients.

And his fellow psychologists, psychiatrists, and all the other soldiers of the mental health army, were, more often than not, overly delicate souls repelled by the sight of blood.

Not that Jeremy had actually known any pathologists, even after a decade of passing them in the hallways. The social structure of the hospital had regressed to high school sensibilities: Us-Them as religion, a lusty proliferation of castes, cliques, and cabals, endless jockeying for power and turf. Adding to that was the end-means inversion that captures every bureaucracy: the hospital had devolved from a healing place needing funds to treat patients to a large-scale municipal employer requiring patient fees to meet its staff payroll.

All that created a certain asocial flavor.

A confederacy of isolates.

At City Central, like was attracted to like, and only the last-ditch necessities of patient care led to cross-pollination: internists finally admitting defeat and calling in surgeons, gen- eralists taking deep breaths before plunging into the morass of consultation.

What reason could there be for a pathologist to contact a psychologist?

Because of all that—and because life's hellish wrist-flick had turned Jeremy Carrier into a tormented, distracted young man—he was caught off-balance by Arthur Chess's overture.

Perhaps Jeremy's distractibility formed the basis for all that followed.

 

For nearly a year, Jeremy had seen Arthur once a week, but the two men had never exchanged a word. Yet here was Arthur, settling down opposite Jeremy in the doctors' dining room and asking if Jeremy cared for company.

It was just before 3 p.m., an off-hour for lunch, and the room was nearly empty.

Jeremy said, "Sure," then realized he was anything but.

Arthur nodded and settled his big frame into a small chair. His tray bore two helpings of fried chicken, a hillock of mashed potatoes glazed with gravy, a perfect square of corn bread, a small bowl of succotash, and a sweating can of Coca-Cola.

Staring at the food, Jeremy wondered: Southern roots? He tried to recall if Arthur's voice had ever betrayed Southern inflections, didn't think so. If anything, the old man's baritone was flavored by New England.

Arthur Chess showed no immediate interest in conversation. Spreading a napkin on his lap, he began shearing through the first piece of chicken. He cut quickly and gracefully, using long fingers tipped by broad nails stubbed short. His long white lab coat was snowy-clean but for a disturbing spatter of pinkish stains on the right sleeve. The shirt beneath the coat was a blue pinpoint Oxford spread-collar. Arthur's magenta bow tie hung askew in a way that suggested intention.

Jeremy figured the pathologist for at least sixty-five, maybe older, but Arthur's pink skin glowed with health. A neat, white, mustachless beard, which gave insight into what Lincoln's would've looked like had Honest Abe been allowed to grow old, fringed Arthur's long face. His bald head was lunar and imposing under cruel hospital lighting.

Jeremy knew of Arthur's reputation the way one is aware of a stranger's biography. Once Head of Pathology, Professor Chess had stepped down from administrative duties a few years ago to concentrate on scholarship. Something to do with soft-tissue sarcomas, the minutiae of cell-wall permeability, or whatnot.

Arthur also had a reputation as a world traveler and an amateur lepidopterist. His treatise on the carrion-eating butterflies of Australia had been featured in the hospital gift shop, alongside the usual paperback diversions. Jeremy had noticed the single stack of dry-looking, dirt brown volumes because they drabbed in comparison with the jackets of lurid best-sellers. The brown stack never seemed to reduce; why would a patient want to read about bugs that ate corpses?

Arthur ate three bites of chicken and put down his fork. "I really do hope this isn't an intrusion, Dr. Carrier."

"Not at all, Dr. Chess. Is there something you need?"

"Need?" Arthur was amused. "No, just seeking a bit of social discourse. I've noticed that you tend to dine alone."

"My schedule," lied Jeremy. "Unpredictable." Since his life had gone to hell, he'd been avoiding social discourse with anyone but patients. He'd gotten to the point where he could fake friendly. But sometimes, on the darkest of days, any human contact was painful.

Life's little wrist-flick . . .

"Of course," said Chess. "Given the nature of your work, that would have to be the case."

"Sir?" said Jeremy.

"The unpredictability of human emotions."

"That's true."

Arthur nodded gravely, as if the two of them had reached a momentous agreement. A moment later, he said, "Jeremy—may I call you Jeremy?—Jeremy, I noticed you weren't at our little Tuesday get-together this week."

"A situation came up," said Jeremy, feeling like a child caught playing hookey. He forced a smile. "Unpredictable emotions."

"Something that resolved well, I hope?"

Jeremy nodded. "Anything new come up at T.B.?"

"Two new diagnoses, an adenosarcoma, and a CML. Typical presentations, the usual spirited discussion. To be honest, you didn't miss a thing."

Our little Tuesday get-together was Tumor Board. A weekly ritual, 8 to 9 a.m., in the larger conference room, Arthur Chess presiding over a confab of oncologists, radiotherapists, surgeons, nurse specialists. Commanding the slide projector, wielding a light wand, and his voluminous memory.

For nearly a year, Jeremy had been the mental health army's representative. In all that time, he'd spoken up once.

He'd attended his first Tumor Board years before, as an intern, finding the experience an ironic grotesquerie: slides of tumor-ravaged cells click-clicked on a giant screen, the images obscured by nicotine haze.

At least a third of the cancer doctors and nurses were puffing away.

Jeremy's supervisor at the time, an astonishingly pompous psychoanalyst, had wielded a Meerschaum pipe of Freudian proportions and blown Latakia fumes in Jeremy's face.

Arthur had been running things back then, too, and he'd looked much the same, Jeremy realized. The chief pathologist hadn't smoked, but neither had he objected. A few months later, a wealthy benefactor touring the hospital poked her head in and gasped. Soon after, the hospital passed a no-smoking rule, and the mood at subsequent Tumor Boards grew testy.

Arthur sectioned a tiny square of corn bread from the host slab and chewed thoughtfully. "No loss for you, Jeremy, but I do believe that your presence contributes."

"Really."

"Even if you don't say much, the fact that you're there keeps the rest of us on our toes. Sensitivity-wise."

"Well," said Jeremy, wondering why the old man was bullshitting him so shamelessly, "anything that helps sensitivity."

"The time you did speak up," said Arthur, "taught us all a lesson."

Jeremy felt his face go hot. "I felt it was relevant."

"Oh, it was, Jeremy. Not everyone saw it that way, but it was."

 

The time he spoke up had been six weeks ago. Arthur flashing slides of a metastasized stomach carcinoma on the big screen, defining the tumors in the precise Latin poetry of histology. The patient, a fifty-eight-year-old woman named Anna Duran, had been referred to Jeremy because of "unresponsive demeanor."

Jeremy found her initially sullen. Rather than try to draw her out, he refilled her empty cup with tea, got himself coffee, plumped her pillows, then sat down by her bedside and waited.

Not caring much if she responded, or not. It had been that way since Jocelyn. He didn't even try anymore.

And the funny thing was, patients reacted to his apathy by opening up more quickly.

Grief had made him a more effective therapist.

Jeremy, flabbergasted, gave the matter some thought and decided patients probably perceived his blank face and statue posture as some sort of immutable, Zen-like calm.

If only they knew . . .

By the time she finished her tea, Anna Duran was ready to talk.

Which is why Jeremy was forced to speak up, twenty minutes into a contentious exchange between Mrs. Duran's attending oncologist and the treating radiotherapist. Both specialists were voluble men, well-intentioned, dedicated to their craft, but overly focused, baby-bathwater-tossers. Complicating matters further, neither cared for the other. That morning they'd slipped into an increasingly heated debate on treatment sequence that left the rest of the attendees peeking at their watches.

Jeremy had resolved to stay out of it. Tuesday mornings were an annoyance, his turn the result of a mandatory rotation that placed him in too-close proximity to death.

But that morning, something propelled him to his feet.

The sudden motion fixed fifty pairs of eyes upon him.

The oncologist had just completed a pronouncement.

The radiotherapist, about to embark on a response, was deterred by the look on Jeremy's face.

Arthur Chess rolled the light wand between his hands. "Yes, Dr. Carrier?"

Jeremy faced the sparring physicians. "Gentlemen, your debate may be justified on medical grounds, but you're wasting your time. Mrs. Duran won't agree to any form of treatment."

Chapter Two

The way jocelyn had died—the image of her suffering—was plaque on Jeremy's brain.

He was never allowed to read the police report. But he'd seen the look in the detectives' eyes, overheard their hallway conferences.

Sexual psychopath. Sadistic. One for the record book, Bob.

Their eyes. To do that to a detective's eyes . . .

Jocelyn Banks had been twenty-seven, tiny, curvy, bubbly, talkative, blond, a blue-eyed pixie, a source of great comfort for the senescent patients she chose to care for.

Ward 3E. All ye who enter here, abandon all reason.

Advanced Alzheimer's, arthrosclerotic senility, a host of dementias, undiagnosed rot of the soul.

The vegetable garden, the neurologists called it. Sensitive bunch, the neurologists.

Jocelyn worked the 3 to 11 p.m. shift, tending to vacant eyes, slack mouths, and drool-coated chins. Cheerful, always cheerful. Calling her patients "Honey" and "Sweetie," and "Handsome." Talking to those who never answered.

Jeremy met her when he was called up to 3E for a consult on a new Alzheimer's patient and couldn't find the chart. The ward clerk was surly and intent on not helping. Jocelyn stepped in, and he realized this was the cute little blonde he'd noticed in the cafeteria. Thatfacethoselegsthatrear.

When he completed the consult, he went looking for her, found her in the nurses' lounge, and asked her out. That night her mouth was open for his kisses, breath sweet, though they'd eaten garlicky Italian food. Later, Jeremy was to know that sweetness as an internal perfume.

They dated for nine weeks before Jocelyn moved into Jeremy's lonely little house. Three months after that, on a moonless Monday just after Jocelyn ended her shift, someone carjacked her Toyota in or near the too-dark auxiliary nurses' parking lot half a block from the hospital. Taking Jocelyn with him.

Her body was found four days later, under a bridge in The Shallows, a borderline district within walking distance of the city's cruelest streets. A place of thriving businesses during the day, but deserted at night. On the periphery were derelict buildings and ragged fencing, stray cats and long shadows, and that was where the killer had dumped Jocelyn's body. She'd been strangled and slashed and wedged behind an empty oil drum. That much the detectives revealed to Jeremy. By that time, the papers had reported those bare facts.

A pair of detectives had worked the case. Doresh and Hoker, both beefy men in their forties, with drab wardrobes and drinkers' complexions. Bob and Steve. Doresh had dark, wavy hair and a chin cleft deep enough to harbor a cigarette butt. Hoker was fairer, with a pig snout for a nose and a mouth so stingy Jeremy wondered how he ate.

Big and lumbering, both of them. But sharp-eyed.

From the outset, they treated Jeremy like a suspect. The night Jocelyn disappeared, he'd left the hospital at six-thirty, gone home, read and listened to music, and fixed dinner and waited for her. The hedges that sided his tiny front lawn prevented his neighbors from knowing what time he'd arrived or left. The block was mostly renters, anyway, people who came and went, barely furnishing the uninviting bungalows, never taking the time to be neighborly.

The late supper he'd prepared for two proved scant reassurance to Detectives Bob Doresh and Steve Hoker, and, in fact, fed their suspicions. For at 3 a.m., well after verifying that Jocelyn hadn't taken on an emergency double shift, and shortly after phoning a missing persons report to the police, Jeremy had placed the uneaten pasta and salad in the refrigerator, cleared the place settings, washed the dishes.

Keeping busy to quell his anxiety, but to the detectives, such fastidiousness was out of character for a worried lover whose girl hadn't come home. Unless, of course, said lover knew all along . . .

It went on that way for a while, the two buffaloes alternating between patronizing and browbeating Jeremy. Whatever background check they did on him revealed nothing nasty and a DNA swab of his cheek failed to match whatever they were trying to match.

His questions were answered by knowing looks. They spoke to him several times. In his office at the hospital, at his house, in an interrogation room that reeked of gym locker.

"Was there tissue under her nails?" he said, more to himself than to the detectives.

Bob Doresh said, "Why would you ask that, Doctor?"

"Jocelyn would resist. If she had a chance."

"Would she?" said Hoker, leaning across the green metal table.

She was extremely gentle—as I've told you. But she'd fight to defend herself."

"A fighter, huh . . . would she go easily with a stranger? Just go off with someone?"

Anger seared Jeremy's chest muscles. His eyes clenched and he gripped the table.

Hoker sat back. "Doctor?"

"You're saying that's what happened?"

Hoker smiled.

Jeremy said, "You're blaming her?"

Hoker looked over at his partner. His snout twitched, and he looked satisfied. "You can go now, Doctor."

Eventually, they left him alone. But the damage was done; Jocelyn's family had flown in—both her parents and a sister. They shunned him. He was never informed of the funeral.

He tried to keep up with the investigation, but his calls to the detective squad were intercepted by a desk officer: Not in. I'll give 'em yer message.

A month passed. Three, six. Jocelyn's killer was never found.

Jeremy walked and talked, wounded. His life shriveled to something sere and brittle. He ate without tasting, voided without relief, breathed city air and coughed, drove out to the flatlands or the water's edge, and was still unable to nourish his lungs.

People—the sudden appearance of strangers—alarmed him. Human contact repulsed him. The division between sleep and awareness became arbitrary, deceitful. When he talked, he heard his own voice bounce back to him, hollow, echoing, tremulous. Acne, the pustulant plague forgotten since adolescence, broke out on his back and shoulders. His eyelids ticced, and sometimes he was convinced that a bitter reek was oozing from his pores. No one seemed repulsed, though. Too bad; he could've used the solitude.

Throughout it all, he kept seeing patients, smiling, comforting, holding hands, conferring with physicians, charting, as he always did, in a hurried scrawl that made the nurses giggle.

One time, he overheard a patient, a woman he'd helped get through a bilateral mastectomy, talking to her daughter in the hallway:

"That's Dr. Carrier. He's the sweetest man, the most wonderfulman."

He made it to the nearest men's room, threw up, cleaned himself off, and went to see his next appointment.

Six months later, he felt above it all, below it all. Inhabiting a stranger's skin.

Wondering what it would be like to degenerate.

Chapter Three

After the chat in the dining room, Jeremy braced himself for some sign of familiarity from Arthur Chess at the next Tumor Board. But the pathologist favored him with a passing glance, nothing more.

When the meeting ended, Arthur made no further attempt to socialize, and Jeremy wrote off the encounter as a bit of impulse on the older man's part.

On a frigid autumn day, he left the hospital at lunchtime and walked to a used bookstore two blocks away. The shop was a dim, narrow place on a grimy block filled with liquor stores, thrift outlets, and vacancies. A strange block; sometimes Jeremy's nose picked up the sweetness of fresh bread, but no bakeries were in sight. Other times, he'd smell sulfurous ash and industrial waste and find no source of those odors, either. He was beginning to doubt his own senses.

The bookstore was filled with raw pine cases and smelled of old newsprint. Jeremy had frequented its corners and shadows in the past, searching out the vintage psychology books he collected. Bargains abounded; few people seemed interested in first edition Skinners, Maslows, Jungs.

Since Jocelyn's death he hadn't been back to the store. Perhaps now was the time to return to routine, such as it was.

The shop's windows were black, and no signage identified the business inside. Once you entered, the world was gone, and you were free to concentrate. An effective ruse, but it also had the effect of discouraging venture; rarely had Jeremy seen other customers. Maybe that was the way the proprietor wanted it.

He was a fat man who rang up purchases with a scowl, never spoke, seemed pointedly misanthropic. Jeremy wasn't certain if his mutism was elective or the result of some defect, but he was certain the man wasn't deaf. On the contrary, the slightest noise perked the fat man's ears. Customer inquiries, however, elicited an impatient finger point at the printed guide posted near the shop's entrance: a barely decipherable improvisation upon the Dewey Decimal System. Those who couldn't figure it out were out of luck.

This afternoon, the bearish mute sat behind his cash register reading a tattered copy of Sir Edward Lytton's Eugene Aram. Jeremy's entrance merited a shift of haunches and the merest quiver of eyebrow.

Jeremy proceeded to the Psychology section and searched book spines for treasures. Nothing. The sagging shelves bore the same volumes he'd seen months ago. Every book, it appeared, remained in place. As if the section had been reserved for Jeremy.

As usual, the shop was empty but for Jeremy. How did the mute make a living? Perhaps he didn't. As Jeremy continued browsing, he found himself fantasizing about sources of independent income for the fat man. A range of possibilities, from the loftiest inheritance to the monthly disability check.

Or, perhaps the store was a front for drug-dealing, money-laundering, white slavery, international intrigue.

Perhaps piracy on the high seas was hatched here, among the dusty bindings.

Jeremy indulged himself with thoughts of unimaginable felonies. That led him to a bad place, and he cursed his idiocy.

A throat clear stopped him short. He stepped out of Psychologyand sighted down the next aisle.

Another customer stood there. A man, his back to Jeremy, unmindful of Jeremy.

A tall, bald man in a well-cut, out-of-fashion tweed suit. White fringes of beard floated into view as a pink skull turned to inspect a shelf. The man's profile was revealed as he made a selection and extricated a tome.

Arthur Chess.

Was this the Lepidoptery section? Jeremy had never studied the fat man's guide, had never been interested in expanding.

Funnel vision. Sometimes it helped keep life manageable.

He watched Arthur open the book, lick his thumb, turn a page.

Arthur kept his head down. Began walking up the aisle as he read.

Reversing direction, head still down, coming straight at Jeremy.

To greet the pathologist would open the worm-can of obligatory conversation. If Jeremy left now, quickly, stealthily, perhaps the old man wouldn't notice.

But if he did notice, Jeremy would earn the worst of both worlds: forced to socialize and robbed of browsing time.

He decided to greet Arthur, hoping that the pathologist would be so engrossed in his butterfly book that the ensuing chat would be brief.

Arthur gazed up before Jeremy reached him. The book in his arms was huge, bound in cracked, camel leather. No winged creatures graced the densely printed pages. Jeremy read the title.

Crimean Battle Strategy: A Compendium.

The tag on the nearest shelf said, military history.

Arthur smiled. "Jeremy."

"Afternoon, Arthur. No lunch today?"

"Large breakfast," said the pathologist, patting his vest. "Busy afternoon, a bit of diversion seemed in order."

With what you do all day, it's a wonder you ever have an appetite.

"Lovely place, this," said the old man.

"Do you come here often?"

"From time to time. Mr. Renfrew's quite the crosspatch, but he leaves one alone, and his prices are more than fair."

For all his purchases, Jeremy had never learned the proprietor's name. Had never cared. Arthur had obtained the information because, like most gregarious people, he was excessively curious.

Yet, for all his sociability, the old man had chosen to work among the dead.

Jeremy said, "Very fair prices. Nice seeing you, Arthur. Happy hunting." He turned to leave.

"Would you have time for a drink?" said Arthur. "Alcoholic or otherwise?"

"Sorry," said Jeremy, tapping the coat cuff that concealed his wristwatch. "Busy afternoon, as well." His next patient was in an hour and a half.

"Ah, of course. Sorry, then. Another time."

"Absolutely," said Jeremy.

Later, that evening, walking to his car, he noticed Arthur in the doctors' parking lot.

This is too much. I'm being stalked.

But, as with the bookstore encounter, Arthur had arrived first, so that was ridiculous. Jeremy chided himself for self-importance—paranoia's first cousin. Had he slipped that far?

He ducked behind a pylon and watched Arthur unlock his car, a black Lincoln, at least fifteen years old. Glossy paint, shiny chrome, kept up nicely. Like Arthur's suit: well used, but quality. Jeremy envisioned Arthur's home, guessed the pathologist would inhabit one of the gracious old homes in Queen's Arms, on the North Side, a shabby-elegant stretch with harbor views.

Yes, Q.A. was definitely Arthur. The house would be a Victorian or a neo-Georgian, fusty and comfortable, chocked with overstuffed sofas in faded fabrics, stolid, centenarian mahogany furniture, layers of antimacassars, doilies, gimcracks, a nice wet bar stocked with premium liquors.

Pinned butterflies in ornate frames.

Was the pathologist married? Had to be. All that cheer bespoke a comfortable, comforting routine.

Definitely married, Jeremy decided. Happily, for decades. He conjured a soft-busted, bird-voiced, blue-haired wife to dote on Dear Arthur.

He watched as the old man lowered his long frame into the Lincoln. When the big sedan started up with a sonorous rumble, Jeremy hurried to his own dusty Nova.

He sat behind the wheel, thinking of the comforts that awaited Arthur. Home-cooked food, simple but filling. A stiff drink to dilate the blood vessels and warm the imagination.

Feet up, warm smiles nurtured by routine.

Jeremy's gut knotted as the black car glided away.

Excerpted from THE CONSPIRACY CLUB © Copyright 2003 by Jonathan Kellerman. Reprinted with permission by Ballantine Books, a division of Random House, Inc. All rights reserved.

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