Chapter 16

My session with Jervis Tetch went fairly smoothly. He was a very strange little man. He was extraordinarily short with a scraggly mop of hair that was either dirty blonde or light brown, it was hard to tell. He had a severe overbite and large square teeth that reminded me of Chiclets gum and there was a sizable gap between the front two teeth. He had a penchant for hallucinogenic drugs, pedophilia, tea, hats, mind control and Lewis Carroll. Not necessarily in that order. It was a surreal combination. Speaking with him was difficult as you had to interpret what he meant by each Alice in Wonderland reference since they were obviously being used out of context. I felt Tetch may suffer from a rare delusional disorder, which fell under the broader category of psychotic disorders. He seemed reluctant to accept treatment which was going to make it all the harder to treat him. Like many with a delusional disorder he still retained many areas of fairly normal functioning and I was optimistic that once a firm, supportive therapeutic relationship had been established between us that I'd be able to make some progress with him. I prescribed a medium dose of Asenapine to help with the delusions.

Tuesday I had my first session with Pamela Isley. I have to admit I found her absolutely fascinating. The first thing anyone would notice about her is her inherent beauty. She had a thick mane of flaming red hair and upturned eyes of emerald green. Her skin was an unusual celadon green color and she actually had winding vines and tiny leaves imbedded into her skin. She was dressed in the standard orange Arkham inmate uniform but her pants were rolled down low which showed off her tiny waist and curvy hips and her shirt was only buttoned enough to keep her ample bosom covered. She was the only inmate in intensive treatment that had a special containment unit. The other SCU's were on the sub-basement level. She needed sunlight in order to survive so it was imperative that her cell had a window. Her cell had specialized filters that both prevented her from releasing her unique mind-controlling pheromones into the ward and also pumped in a very mild defoliant that prevented her from growing anything. Due to this we were forced to have sessions from opposite sides of her cell wall right in the I.T. ward. I didn't like it, it felt like her privacy was being invaded. I made do as best as I could by having a portable partition brought in so we at least had some semblance of privacy.

She wasn't very friendly. She made it pretty clear she thought I was just another "meatbag" who contributed to the destruction of the "green" and didn't want to speak with me. I knew from reading her file that her professor, Dr. Jason Woodrue, had seduced her and then injected her with a deadly plant-based toxin that nearly killed her. The toxin changed Pamela's body chemistry transforming her into the human-plant hybrid she was today. The toxin also resulted in her current state of madness. Due to this she hated humans, particularly men. She apparently saw herself as a plant equivalent of "Mother Nature" and felt that all plants were her children. She was now an eco-terrorist who was out to save the plant world in any way possible. I tried appealing to that side of her nature, asking questions about her "babies" and was surprised when she finally started answering some of my questions. It was short lived however, and she clammed up just as I thought I was establishing some kind or rapport. Jeesh, I thought the Joker was going to be my toughest case, but Pam made me think I might be wrong.

Wednesday was a miserable day. It was dark, dreary and pouring buckets of rain outside. Joker was brought into my office at ten and I could tell almost immediately that something was off. The orderlies quickly restrained him and left. He was squinting and there were dark circles under his eyes. Although it was barely noticeable I saw that his hands were shaking slightly. Joker was like a cat in a way, he knew showing any weakness, illness or injury was dangerous so he had learned to hide it very well. He was noticeably irritable and I was immediately concerned. I left my notebook on my desk, pulled a penlight out of my pocket and approached my patient.

"You're not looking well Mr. Joker, I'm going to need to examine you." I walked over to the couch and broke the cardinal rule; do not cross the yellow line. I didn't care, I thought it was a stupid rule anyway. I softened my voice and said quietly, "Lean your head back, please." He said nothing but complied. I shined the light into Joker's left eye and then the right and he recoiled and squeezed his eyes shut. His eyes were very bloodshot and one pupil was dilated more than the other.

"Jesus Doc! Enough with the light already!" he barked.

"I'm sorry Mr. Joker. Do you have a headache?" I placed my cool hand on his brow to check his body temperature. He was very warm, maybe not quite feverish, but his temperature was definitely elevated. He relaxed slightly at my touch.

"Yeah Doc I do, and it's a killer." He attempted to laugh at his pun, then winced and remained silent. I walked over to my desk and flipped on the switch to my tiny lamp, then crossed the room and turned off the overhead fluorescents.

"Does that help?" I walked back over to him and kneeled down next to the couch. His eyes opened cautiously.

"I suppose that's better." He grumbled.

I took his wrist in my hand, turned it over and checked his pulse. It was also slightly elevated. I then placed his fingers in my open palm to judge the extent of the tremors in his hands. They were moderate, but still caused me some concern. I had changed his medications this week and he was obviously suffering side effects from the Paliperidone. I dropped his hand and looked back up at his face to meet his half closed eyes.

"You are either very brave or very stupid to step into the lion's den like this. Aren't you afraid of getting eaten?" I giggled and covered my mouth with my hand.

"Mr. Joker, I'm not sure if you're threatening me or flirting with me." He considered it before responding.

"Ya know, neither do I?" He started to laugh and abruptly stopped. "Don't make me laugh Doc, it hurts."

"I know, I'm sorry. I know from your file you have a high tolerance for pain, but you're having a migraine. I'll lower your dosage of the new anti-psychotic until you get used to it. Have you eaten or slept?"

"No. Couldn't." he said simply then leaned his head back and closed his eyes again.

"I need to use my penlight again so keep your eyes closed and open your mouth for me please?" He must have been feeling terrible because he complied without any argument. I looked into his mouth and saw his tongue was slightly swollen and had a thin white film, also a side effect of his medication. He wasn't producing as much saliva as he should have been and I thought he was slightly dehydrated. I clicked off the penlight. "Mr. Joker are you nauseous?" He gave me an aggravated look.

"Can you drop the Mr. Joker crap already? It's annoying!"

"I apologize. What would you prefer I call you?"

"My friends call me J."

"Well I am your doctor not your friend, so how about I call you Mr. J instead? Does that work for you?" He cracked a smile for the first time all session.

"Mr. J, I like it. Okay Doc, Mr. J it is!" I kept my voice as soft and quiet as possible to prevent exacerbating his migraine.

"You didn't answer my question Mr. J, are you nauseous?"

"A little." He grunted.

"Do you think you can try drinking a little water for me?" I stood and walked over to my desk. I bent down, unzipped my attaché case and pulled out a bottle of water, removed the lid and walked back over to my patient. He was watching me very closely.

"You're not afraid of me are you?" I handed him the water bottle.

"Actually I am, maybe not as terrified as everyone else but I accepted this case. No one forced me into it. You're my patient and my responsibility. I do what I need to do to get the job done. Now can you try drinking please? You need hydration." He took a small sip of the cold water. He looked exhausted. "Mr. J you look very tired, would you like me to call the session early today?"

"No. It's just low blood sugar, my true arch-enemy." I giggled and once more covered it with my hand.

"Why do you do that?" I gave him a puzzled look.

"Why do I do what?"

"You cover up your laugh and your smile. It's kinda infuriating to a guy like me. Why do you do it?"

I pulled my desk chair next to the couch, the other chair in the room, much like the couch, was bolted to the floor.

"My mother always told me that no one takes a girl who giggles seriously, so I guess it started there but when I went away to college I kinda loosened up a bit and stopped doing for a while." He raised an eyebrow waiting for me to continue. "Then one day in class I was quietly talking to a friend and I accidentally laughed out loud just as my professor had stopped talking. He kinda freaked out on me, accused me of not paying attention and embarrassed me in front of the entire class. Then he made me stay after and told me the same thing my mother always had, no one takes a giggler seriously. So the habit kind of stuck."

"Well that's one of the most terrible pieces of advice I've ever heard! You have a beautiful smile and a tinkling laugh. It makes a guy like me happy to see it. It's a crime to cover it up." I felt my cheeks flush and was glad for the darkness of the room.

"Well thank you for saying so Mr. J." I stood back up and went over to my desk. I kept some snacks and Excedrin in my drawer. I pulled out the bottle and shook two pills into my hand and grabbed a packet of peanut butter filled crackers then sat back down. I held out the tablets. "Here, for your headache." He accepted the proffered medication and swallowed it with a sip of water. I handed him the crackers. "When your nausea subsides you need to eat something."

"Thanks, Doc. I gotta be honest, I don't really feel up to talking today but I don't want to go back to my cell yet either. It's too bright in there. How about you tell me a story until this headache goes away?" I felt guilty, I was the one who prescribed the medication after all and I was obviously heavy handed with it. He was known to have a high tolerance to medication and I overestimated what he could handle.

"What kind of story do you want to hear, Mr. J?" He leaned back against the couch, closed his eyes and relaxed.

"Hmmmm, tell me about the worst thing you've ever done."

Wow, that was a big one. I had never told anyone this story before. What the hell, who was he going to tell and if he did who would believe him?

"Um, okay. Well this happened back in my university days. The head of the Psychology department at Gotham University, Dr. Markus, had been giving me a hard time about my final thesis. He said I showed a lot of initiative but I needed something "big" to impress him enough to pass me with honors. He hinted around that if I slept with him I was home free, but there was no freaking way I was screwing that fat mook! I had a boyfriend at the time, his name was Guy Kopski and he would have done anything for me. He was absolutely obsessed with Chaos theory. In a way, you kind of remind me of him a little bit." Joker opened his eyes and rolled his head towards me.

"Should I be flattered?"

"I think so. He was a great guy. That's what makes what I did so much worse." He smiled widely.

"Well this doesn't sound boring! Carry on Doc!" He closed his eyes again.

"Dr. Markus, in lieu of me sleeping with him, said if I presented a really good experiment I could still graduate with honors. So that's exactly what I planned to do. My theory was that there were only two circumstances in which a person would disregard the rules of society. Those instances were when someone commits a crime or when they're in love.

"I thought it was going to be a well-controlled experiment, but I should have known better. Guy studied chaos; I shoulda paid more attention. When Guy got back to the apartment that day I told him I had done something terrible. I told him I was having trouble with my grades and met Dr. Markus in the gym to blackmail him. I told Guy I was going to accuse Markus of raping me, but that Markus laughed at me and pulled out a tape recorder in one hand and a gun in the other. I said that Markus threatened to call the cops and that I suddenly saw my whole life falling apart in front of my eyes.

"I told Guy that I tried to get the tape away from Markus, but in the scuffle the gun somehow went off. I said in my panic I had stolen a car and had to run from the cops because they were chasing me but that I thought I had lost them. I had a real gun and at that moment I pulled it out and showed it to him. I asked if he would stand by me as I cried crocodile tears into my hands and when I looked up both he and the gun were gone." Joker looked surprised.

"So your experiment cost you your lover?"

"Yeah but not in the way you think, it gets worse. I knew where Guy had to have gone, so I ran to the gym to tell him it was just an experiment, a prank, a lark. When I found him he looked panic stricken so I immediately leveled with him that I didn't shoot Markus and that this whole thing was a stupid experiment.

"Then Guy told me a story of his own. He had gotten to the gym and thought he saw Markus in the shadows, still alive….so he shot him. Except it wasn't actually Markus, it was some homeless guy. The body was lying there and blood was pooling beneath it. Guy said he wanted to save me from the man who was going to ruin my life because he loved me, but he ended up killing an innocent man instead. He was beside himself. He knew he'd go to jail; knew he couldn't live with himself. He put the gun under his chin but he couldn't pull the trigger. He begged me, begged me to help him pull the trigger. He pleaded with me and said that if I really loved him, I would do it."

Joker was sitting up at full attention now.

"And I did, God help me, I did it. I pulled the trigger and watched Guy's brains paint the walls. I did it because I loved him and I have never told another living soul. The cops ruled it a murder-suicide." I had tears rolling down my cheeks. I sniffled and wiped my nose with the back of my hand. Joker started laughing hysterically.

"Well, I certainly didn't expect a story like that! Oh, you are indeed something special!"

At that moment there was a loud knock on the door.

"Dr. Quinzel, is everything alright in there?" I looked at the clock, we were a half hour over our time limit.

"Yes everything is fine, we're just wrapping up! Just give me a minute please." I moved my chair back behind my desk, wiped my eyes. I looked at the Joker.

"I expect that story to remain between us." He flashed that predatory smile.

"My lips are sealed, Doc."

I walked over to the door, opened it and allowed the orderlies to unshackle the Joker. As they lead him out of my office he turned his head and winked at me. Ben was right, I had to be completely out of my mind.