A/N: I have zip all medical knowledge. Seriously. Nada. Anything you will see in the following chapters is gleaned from annoying various medically-minded friends and, uh, Google. In my defence, it's not like Stargates are scientifically possivle so if I'm grossly inaccurate with my medical terms and the uses of them, and if I'm breaking the laws of modern medicine in my descriptions then technically, I'm being canon. Honest.
The Puppet Master
Chapter Twelve - Diagnosis
"You knew he was dangerous?" Bates demanded, furiously, and had the satisfaction of seeing Heightmeyer flinch.
"I never expected him to react like this," the psychologist responded, without looking up. "His condition has deteriorated far quicker than I could have predicted."
They sat in the conference room; Bates, Heightmeyer, Beckett and himself in a circle with Elizabeth at their head. She was still pale, taking frequent sips from a glass of water Beckett had placed at her elbow. A purple handprint was scored against the pale skin of her neck.
"But you thought there was a possibility?" Bates continued, sitting stiff-backed in his chair.
Kate tilted her chin defiantly. "If I were to act on every possibility, Sergeant, I would have half the city in the infirmary. I did not consider Dr McKay to be a risk."
"Nice judgement call," Bates shot back.
"Sergeant," Sheppard warned, but was interrupted.
"I made my decision based on facts and intuition, Sergeant, just as you do."
"He locked the Major out of the city –"
"Who was soon released by Dr Zelenka –"
"- and then tried to kill Dr Weir!"
"Sergeant!" Elizabeth broke the tension, her voice quiet and hoarse. She shot a stern look at Bates, who backed down, settling in his chair with a glower. "Where is Rodney now?"
"In the infirmary, under sedation," Beckett responded.
"He'll need to be guarded."
"Two guards, ma'am," Bates assured her, "and he's restrained."
"Is that necessary?" Sheppard demanded, only to have Elizabeth's icy gaze turned on him with full force.
"Not only has he tried attacking members of this expedition, Major, but Dr Heightmeyer has informed me there's a strong likelihood of him harming himself. It's the best for all concerned, including Rodney."
He flinched, pulling his gaze away from the bruise on her neck. Insisted: "It doesn't feel right. This is McKay, we're talking about. There's got to be some other explanation than he's," and he paused, forcing out the word: "crazy."
"A brain disorder," Kate corrected, gently. "The symptoms point to schizophrenia."
Carson was looking as uncomfortable as Sheppard felt, wringing his hands over the table. "Are you sure? Not that I'm doubting you, Doctor, and given the circumstances…" He lapsed into silence, and gazed at Kate pleadingly.
"He attacked Doctor Weir," Bates pointed out, adroitly.
"Thank you, Sergeant." Weir looked up at him, meaningfully. "I think you can go."
Bates hesitated, glancing at Sheppard who merely nodded in return. He wasn't in the mood to handle military diplomacy with a stubborn security officer. The soldier pushed back his seat and rose, walking towards the door. "I'll check on the infirmary."
"Thank you." Elizabeth's hand reached up to brush her throat as she did what Sheppard hadn't: "Sergeant – your assistance was appreciated."
Bates gave a trim nod of his own, then left, the door closing behind him. Sheppard heard Beckett release a small sigh.
"Though I hate to admit it, he has a point. Rodney would never do something like this if he were in his right mind. Still…" And the Scotsman floundered.
"If this were just one or two instances, then I would doubt it myself." Heightmeyer lifted her gaze to meet Weir's. "But his history shows all the signs. Disorganized speech and thinking, the tendency towards disinhibition, social isolation –"
"That's just McKay being McKay!" Sheppard protested. "I know he shouts it from the rooftops but he's right, he's a genius. There's so many ideas in that head of his I don't blame him for not keeping them straight! But all the geeks are like that, look at Zelenka –"
"John." Elizabeth coughed, pain creasing lines around her eyes. "Please."
"Major, I'm sorry." Kate placed her hand on the papers in front of her. "I wish there was someone to give you a second opinion, but there isn't. I can show you McKay's psychological history. Notes taken by his previous doctors."
Sheppard forced himself to take a deep breath before responding. "If they'd diagnosed him as schizophrenic he'd never have been allowed to work for the military."
"True." She hesitated, clearly taking care over her words. "It is not uncommon for schizophrenia to be diagnosed later in a person's life. Patients may have experienced mild symptoms for many years, only for a traumatic event to lead to a psychotic break such as this one. And given the amount of time he has spent on international assignments it's unsurprising that there's no consistent journal of his behaviour. And…" she looked at Sheppard, "much of it has been explained in just the way you've used. It's McKay being McKay."
"And now?" Carson asked.
"I'll need to speak with him, run a number of tests. EEGs, MRIs, a PET scan…"
Beckett nodded. "I'll see to it."
"I want to make sure I've eliminated any other possibility before making an official diagnosis."
"But your current judgment," Elizabeth prompted.
"Is paranoid schizophrenia. I've read the material you passed to me, Elizabeth, and I've heard the Major's account of his conversation with Doctor McKay."
"He was upset," Sheppard protested weakly, feeling swamped.
"I'm sorry, Major." Again her gaze turned to his, and he saw her professional demeanour falter, her face shadowed with regret. "It's not a diagnosis I want to make, but it's the only one I can when considering all the facts."
"We'll do the tests," Beckett added, gently. "Believe me, Major, if there's any other explanation, we'll find it."
"It still doesn't make sense," he insisted. "For him to change so suddenly –"
"I know," the Scotsman agreed, dropping his hands to the table. "I don't want to accept it either, but with the lack of any other evidence…" He trailed off.
Kate glanced at him with an expression of regret. "It's my belief that Rodney has been coping with a number of mild symptoms for many years, but recent events…" And she stopped, delicately. "The disorder means he is less able to cope. Hence the sudden deterioration, the delusions, paranoia, the violent attack against Dr Weir..."
Sheppard swallowed, his mouth dry. "So what do we do?"
Kate exchanged a look with Carson, who shifted in his seat. "We can't begin to decide upon a medication until we've examined Rodney's results," he admitted.
"And then?"
"John, there's no cure for schizophrenia, and any progress we make will be mostly trial and error."
He knew that already, not entirely ignorant as to medical procedures used on Earth, though his experience was limited. And even without his shaky grasp on the science behind the condition, Carson was less adept than Kate at concealing his emotion. The man was an open book, increasingly uncomfortable, guilt and sorrow etched on his face. Elizabeth was doing a better job at remaining in control, but her right hand was gripping the glass of water so tightly Sheppard could see the whites of her knuckles.
"So he's off the team," he said, bleakly. "Permanently."
Elizabeth looked at him sadly. "You know there's no choice."
"And lab work?"
"Let's concentrate on treating him," Kate said, gently. "That's all that matters right now."
He took a breath and nodded, grimly. Glanced at Elizabeth. "I want to see him."
The shadow of a smile tugged at the edges of Elizabeth's mouth as she nodded. "I imagined you would. Doctors?"
"Shouldn't be a problem," Carson agreed.
"It might be helpful for McKay to see a familiar face when he wakes up."
"And my team?" Sheppard questioned. "Teyla and Ford?"
"That's your call, Major." Elizabeth leant forward in her chair. "If you believe they need to know –"
"They're his team," he said, simply.
She nodded. "I will need to brief Dr Zelenka as well. I want him to take over as head of the department whilst…" and Weir hesitated briefly, and corrected: "in Rodney's absence. Otherwise I'd rather the details of this be kept within this room."
"You know that won't last," Carson warned. "Not with Kavanagh's mouth. This station's worse than my ma's book club for local gossip."
"Nevertheless, I would rather we kept this as quiet for as long as possible." Elizabeth took a deep breath, sitting more formally in her chair. "My priority is ensuring this city is protected. At present, doctors, yours is to help Dr McKay in any way you can." Her expression faltered. Read clearly what Sheppard himself was thinking, and couldn't bear to voice.
You help him, because I no longer can.
