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CHAPTER TWO

UNBELIEVABLE, DR. NINA WHITAKER thought as her boss, and she’d like to think her friend, continued to pace in front of her. She just won’t give up. Karen was determined to pull Nina away from her geriatric dementia patients in order to deal with politics and policing issues. Never mind that those things had once been Nina’s passion. They were in her past for a reason.

Almost three years ago, she’d sold her carriage house in Charleston, South Carolina, and moved across the country. Her goal had been to heal and start over, but in running from her past, she’d also been forced to leave behind one of her greatest accomplishments—convincing the Charleston law enforcement community to embrace greater mental health training and oversee the formation of a Mental Health Intervention Team. At one time in her life, Nina would have run with that success and continued to advocate the same kind of change in every city across the nation.

The death of her patient Beth Davenport had changed all that.

After Beth died, Nina had decided to leave crisis work, policy reform and decisions of life and death to others, and instead focus on a quieter though still worthwhile existence. Now, Karen wanted Nina’s help convincing SFPD to adopt the same MHIT training model that Charleston had implemented. Unfortunately, she was no longer content with Nina acting as a source of information on the topic. She wanted Nina to rally for funds. To talk to the police. To act as the program’s spokesperson.

She couldn’t do it, Nina thought.

She wouldn’t.

Stay strong. Don’t give in.

But despite her inner pep talk, Nina could feel herself being swayed by Karen’s words.

“Another homeless man’s been hospitalized after resisting arrest. That’s two this week. Both those men were mentally ill, and both times they didn’t understand they were being arrested. It wasn’t that they were resisting arrest—it’s that they didn’t understand reality. We can put a stop to it, Nina. What’s it going to take before you’re willing to get involved?”

Hell freezing over? The fact that it was a question, even in Nina’s own mind, further signaled her weakening resolve, but she managed to shake her head. Karen was an expert manipulator, but Nina was a psychiatrist. While that didn’t mean she was wholly immune to being manipulated, she had the advantage of knowing it was happening. Not only that, she was a realist. Give Karen an inch and soon Nina would find herself fully immersed in the trap she’d worked so hard to free herself from. “I’m sorry, Karen, but you’ll have to be content with the help I’ve already given.”

There. That was good. She sounded firm. In control.

But Dr. Karen Harper, the chief administrator for San Francisco Memorial Hospital’s Mental Health Division, remained unconvinced. Like a predator scenting weakness in its prey, she moved closer. “Do you want someone to die?” She paused, hands on her hips, looking down at Nina over the tops of her glasses, which were a dark navy blue the exact shade of the top she was wearing. “A transient? Maybe even a cop? Because it’s happened before and it could happen again. It will happen again. It’s just a matter of time. I’m trying to do everything I can to stop it, and with all the bad publicity the police have had with the homeless lately, this is as good a time as any to push. But in order to make the police listen to me, I need your expertise on this, Nina. Please.”

Please.

The word wasn’t normally in the hospital administrator’s vocabulary. It just proved how desperate Karen was for Nina’s help and how passionately she believed in the MHIT program. Obviously, Nina believed in it, too. It could help the city’s police reduce violent confrontations with not just the homeless, but all mentally ill suspects. It could help save lives. But becoming immersed in that kind of advocacy again? It just wasn’t something Nina could afford.

Helping others without actually being responsible for whether they lived or died. That’s all she wanted. That’s why she’d left her home and chosen to work with geriatric dementia patients in the first place. It wasn’t a job without its own pain. She genuinely liked her patients. She tried to help them through their suffering, and eventually she grieved their passing. The fact remained, however, that when the end came, it usually wasn’t a surprise. She was prepared. What Karen was asking of her came without that type of assurance, and she wanted no part of it.

Nina knew herself. Her strengths, but most of all her weaknesses.

What Karen was asking would play into every single one. If she started trying to save lives again, she’d feel duty-bound to save them all, and her failure to do so would eat away at her. Reminding her of the other lives she’d failed to save.

Two lives in particular.

“We’ve talked for hours,” Nina reminded her friend. “I’ve given you the information you need. The statistics. You’re more than capable of educating police officials about Charleston’s Mental Health Intervention Team program and the benefits the city has seen—”

“Not without the support of the program’s creator and chief advocate. With these latest claims of police brutality, higher-ups from the SFPD have finally agreed to meet with me. However, I suspect it’s just a political tactic to appease the press. They want to show the public the police aren’t taking our concerns lightly. But no matter how much you’ve prepared me, I can’t anticipate all the questions that will be asked. And I don’t have first-hand knowledge of how the program was implemented. Having you by my side at these meetings will lend us credibility we just can’t get otherwise.”

She was right, but Nina told herself to stand firm. Nina was a treasure trove of information when it came to police interaction with the mentally ill, but she could help Karen without becoming personally involved. “I’m sorry, Karen. You knew when you hired me where I wanted to focus my efforts. If my services haven’t been valuable to the hospital then—”

“I didn’t say your work here isn’t valuable, Nina. And yes, you were very clear that you were no longer interested in public policy work. That you wanted to focus your practice in the geriatric department. But I thought...” She shook her head and blew out a breath. “I guess I thought you wouldn’t be able to help yourself. The work you did in Charleston was so important.”

“And it’s work you’ll implement here, too,” Nina said softly. “It didn’t happen overnight in Charleston, either. I’ll continue to be a resource to you. But I don’t want to be directly involved. It took over my life, Karen, and I’m just starting to get it back. This isn’t the kind of thing you can just dip your toes into. It’ll consume my time.”

It’ll consume me, she thought.

“All right. Thank you for hearing me out,” Karen said. “Please...let me know if you change your mind.”

It was only when Karen left Nina’s office that Nina spotted the folders her boss had forgotten.

Or more likely, the ones Karen had deliberately left behind.

She could guess what was in them. Articles about recent confrontations between police and the homeless, most of who were mentally ill or challenged and therefore more prone to intense reactions if the particular responders didn’t know how to deal with that person’s condition. Too often police didn’t understand what was happening in a schizophrenic’s brain, or how mania could induce psychosis in someone with bipolar disorder. Threats only revved up those people’s minds—made things worse, not better.

She told herself she wasn’t going to fall for Karen’s obvious ruse.

Less than thirty minutes later, she opened the folder and scanned the papers inside. Each article had a common theme: that someone—suspect, civilian or police officer—had suffered personal injury or death because a confrontation with a mentally ill suspect had escalated when it probably hadn’t needed to. Several articles also included statistics.

That people with severe mental illnesses were killed by police in justifiable homicides at a rate nearly four times greater than the general public.

That ten to fifteen percent of cases where law enforcement officers acted with deadly force could be considered premeditated suicides.

That people with mental illnesses killed law enforcement officers at a rate five point five times greater than the rest of the population.

The facts went on and on.

She’d seen thousands of articles just like these. It’s what had spurred her to seek change in South Carolina—a task made far easier given she’d had her father’s political influence behind her— and the positive effects of that change continued to bear fruit even today. San Francisco, while more liberal than most cities, still had to function with limited funds, which meant reluctance to provide training that appeared extra rather than essential. Police routinely received training on how to handle mentally ill suspects, but it was usually subpar, barely covering the basics. What if Karen was right and Nina could convince San Francisco officials to take them seriously and make positive changes as a result?

She closed her eyes as guilt prodded at her.

It was one thing to make a lifestyle and career choice, but something else entirely to stand by and do nothing when she had the ability to help society as a whole, and one particular community specifically. What harm could it really do to act as Karen’s consultant, and talk to police about starting a Mental Health Intervention Team in San Francisco? If she could help even a handful of police officers truly understand that those experiencing a state of psychosis could be subdued without resorting to violence, didn’t she have an ethical duty to do it? No, she wouldn’t be able to help everyone, but helping even one person...

Someone like her former patient, Beth Davenport...

Or someone like her sister, Rachel...

Pain rippled through her. Oh, God, Rachel. She still missed her every hour of every day.

What would Rachel want her to do?

She withdrew her purse from the drawer of her desk and took out the small cloth rag doll that had been Rachel’s. She knew what carrying it said about her. That it was an unhealthy attachment brought on by lingering guilt.

A crutch.

A way to punish herself.

It didn’t matter. The doll was the last tangible connection she had to her sister. She wasn’t giving it up.

With a sigh, she put the doll back in her purse, stowed the purse in the drawer, picked up her phone and called Karen. “A phone call,” she said when the other woman answered. “Maybe a meeting or two. But that’s all I’m committing to. And you owe me drinks when this is over.”

“I’ll take it. Thank you, Nina. You won’t regret this. Drinks are on me—I promise.”

Nina hung up. But even as she did, she had the unsettling feeling she’d soon be regretting a lot of things.

Shades of Passion

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