“Did the girl get better?” Alex asked.

“By the end of her stay, she and Greg were best buds. You’d never know.”

“And Ozzie Harrington?” D.D. said. “Was he another success story-one day roaring like a lion, next day gentle as a lamb?”

Danielle shuttered up. She sat back, stroking the top of the manila file with her thumb. When she met D.D.’s gaze again, her blue eyes were wary, but also hard. A woman who’d been there, and done that. Curious and more curious, D.D. thought.

“Tell me what happened,” the nurse said, avoiding D.D.’s question.

“Been watching the news?” D.D. asked.

“No. Been working the unit.”

“Why do you assume an unhappy ending?” D.D. pressed.

“Ozzie’s dead,” Danielle stated.

“Again, why assume the negative?”

“Because Karen told me to talk to you, and if Ozzie were still alive, answering your questions would violate his rights.”

D.D. considered the matter. “Yeah, he’s dead.”

“Just him, or did he hurt others?”

“Why don’t you tell us what you think?”

“Fuck it.” Danielle broke open the case file and began.

“Oswald was admitted in the spring of last year. He’d spent six months with his foster family before suffering a ‘psychotic break.’ The parents had gone out for the evening, leaving him and their two other children alone with a babysitter. Halfway through dinner, both their cell phones started ringing. The babysitter and two kids were now locked in the bathroom. Ozzie was on the other side of the door, armed with a hammer and screaming he was going to kill them.

“The parents ordered the babysitter to call nine-one-one, then headed home. They arrived around the same time two officers were wrestling Ozzie to the ground. The EMTs sedated the boy and brought him to the ER, which referred him to us.

“Upon admittance, he was nearly catatonic. We see this often in a child who’s just experienced a significant traumatic event. We kept him on Ativan for the first forty-eight hours, while we caught up on his patient history. Ozzie’s file revealed multiple diagnoses, including severe ADHD, attachment disorder, Nonverbal Learning Disorder, Mood Disorder NOS, and other nonspecific development delays. The psychiatrist expressed concern that, due to the death of Ozzie’s birth mother, not enough was known about the first three years of his life.”

“Meaning?” D.D. prodded.

“Ozzie’s speech and social skills were delayed. At eight, he showed some traits that were autistic in nature-he wouldn’t make eye contact, he sat and rocked for hours, while mumbling sounds only he understood.”

“You’re talking Rain Man?” D.D. clarified, making a note.

“That would be one example of an individual on the Autism Spectrum Disorder,” the nurse answered dryly. “Bear in mind, it is a spectrum, and you shouldn’t count on Hollywood for information. In Ozzie’s case, we determined the traits weren’t due to ASD, but were more consistent with the kind of self-soothing techniques learned by severely neglected children. Ozzie was a feral child.”

“So not Rain Man, but Tarzan?” Alex spoke up.

Danielle shot him a look.

“With a feral child,” she continued pointedly, “there’s no caretaker present to meet the child’s needs, disrupting the normal development cycle. The child cries. Nothing happens. The child stops crying. And talking, and bonding, and having any sense of belonging to a larger world. Mentally, the child atrophies, leading to delayed speech and socialization in Ozzie’s case.”

D.D. frowned. “I thought Ozzie’s mom died when he was three. He was home alone with the body, but surely a couple of weeks of abandonment doesn’t cause everything you just described.”

“According to the ME, Ozzie’s mother had died eight to ten weeks prior to discovery. During that time, it appears Ozzie survived by eating dry cereal, uncooked pasta, and anything else he could forage from the cupboards. He was also a good climber, which helped him get water from the sink, etc. In fact, social services thought his survival skills were particularly well developed for a three-year-old-meaning maybe Ozzie’s mother was sick for a bit before she died. Maybe, in fact, Ozzie had been taking care of himself for a long while, which would explain his feral traits.”

“So Ozzie got off to a rough start,” D.D. summarized. “But eventually, the proper authorities got involved and…”

“And he ping-ponged through seven or eight foster families before landing with the Harringtons.”

“Why the Harringtons?”

“Have to ask the state. Though,” Danielle corrected herself, “the parents, Denise and Patrick, both seemed very committed to him. Some foster families request special-needs kids. They have a background with special needs-either grew up with a special-needs sibling, or have occupational training. Some believe they can make a difference and want to try.”

“And Denise and Patrick?” D.D. prodded.

“I don’t think they had any idea what they were getting into,” the nurse answered bluntly. “But they appeared committed to helping Ozzie. They struck me as the religious type-doing God’s will here on earth.”

D.D. made a note. That sounded consistent with other things they’d learned about the happy couple.

“So Ozzie had this psychotic break. What does that mean?”

“He stripped off his clothes, then went around the house with a hammer, trashing the furniture while screaming death threats.”

“So he had a particularly violent temper tantrum?”

“Oh, if he’d caught someone, he would’ve hurt them,” Danielle said seriously. “A kid in such an elevated rage-state is having an out-of-body experience. You can’t reach them with words, with love, with logic. They’re gone, in orbit. Afterward, they’ll remember almost nothing of what they said or did, including that they bashed the brains out of the family dog, or tore apart their own favorite teddy bear. Hiding is the best policy. And in the aftermath, the entire family needs post-traumatic stress counseling, especially the siblings.”

D.D. made a note of that, too. Therapist for the Harrington family? Things can come out in therapy…

“After Ozzie’s admitted here, then what happens?”

Danielle shrugged. “We started him on aripiprazole, often used for the treatment of schizophrenia and bipolar disorder. That seemed to pull him together for about eight weeks, then he began to suffer from akathisia and we had to take him off.”

“Akathisia?”

“Ozzie complained that it felt like little people were inside his skin, crunching his bones. That’s akathisia. He also started suffering from perseverative thoughts.”

“Perseverative thoughts?” D.D.

“It’s like OCD, except with thinking. He’d get a notion in his head, I want a red car, and then he couldn’t get it back out. He’d spend six, seven hours saying over and over again, I want a red car, I want a red car, I want a red car. Now substitute red rum for red car, and you can see the danger of perseverative thoughts.”

D.D.’s eyes widened. “He’s going through all this, and he’s what, seven, eight years old?”

“He’s going through all this, and yes, he’s eight. And we’re seeing more kids like him all the time. Parents think the worst thing that can happen to their five-year-old is cancer. They’re wrong; the worst thing that can happen to their five-year-old is mental illness. Cancer, the docs have tools available. Mental illness in prepubescents… There are so few drugs we can use, then the kids develop a tolerance, and by age eight we’re out of options. They require a lifetime regimen of anti-psychotic medication, except we don’t have anything left. One week we get them stabilized. The next they plunge back into the abyss.”

“Is that what happened to Ozzie?” D.D. asked.

Danielle picked up the case file, read briskly. “We took Ozzie off the aripiprazole. At which time he claimed ghosts were appearing in the windows of his room and ordering him to kill people. So we put him back on a very low dosage of aripiprazole, trying to minimize the side effects while still making some attempt at regulating his brain chemistry. In the short term, we noticed a positive change in behavior.”