Текст книги "Scared to Live"

Автор книги: Stephen Booth

Соавторы: Stephen Booth
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‘So when was John Lowther discharged from the unit?’

‘In April. He was in good spirits by then. He said he was going to tell everyone that he’d been away on holiday. Somewhere nice, like the Caribbean. Except that it couldn’t be the Caribbean, because he didn’t have a sun tan. I dare say his family didn’t let anyone know the truth either. That’s perfectly usual. There’s still a lot of stigma attached to mental illness, I’m afraid.’

‘He’d have to be on anti-psychotic drugs for some time, I imagine.’

‘Yes. But his records do show that he was worried about the side effects. Mr Lowther complained that he put on weight. And he twitched a lot, which he found distressing. Also, he said the medication made him impotent.’

‘He was very restless when we saw him last week.’

‘But no twitching?’

‘No.’

Sinclair fiddled with his glasses. ‘Mr Lowther was prescribed Orphenadrine for the side effects, but he didn’t like the idea of taking more tablets. So instead …’ He hesitated again.

‘You think he might have stopped taking his anti-psychotic drugs?’

‘Yes, it’s possible. Dealing with side effects is always a bit of a trade-off. It’s a question of striking the right balance for each individual. Mr Lowther said once or twice that the effects of the drugs were worse than a few harmless delusions. He thought he’d return to his old self if he stopped taking the medication – he’d become slimmer, stop twitching, regain sexual function. It’s a common response. Patients feel an overwhelming desire to go back to a time when they felt happy and safe.’

‘Hold on a minute – “a few harmless delusions”?’ said Cooper, picking out the most remarkable phrase in what he’d just heard.

Sinclair fixed him with a sad gaze from his pale eyes. ‘That would be the way it seemed to him, at this particular stage. I think Mr Lowther had probably forgotten the nature of his auditory hallucinations.’

‘How is it possible to forget something like that?’

‘It’s a normal function of the brain to filter out negative experiences and retain the positive ones. This applies to psychotic episodes as much as to anything else.’

‘I can’t see anything positive in what you’ve described, sir.’

‘Then I haven’t described it properly. The fact is, not everyone finds psychosis a negative experience. While some patients suffer persecutory or self-blaming delusions, others develop grandiose fantasies or have an experience of deep religious significance. This can appear very positive and life-affirming.’

‘Are you serious?’

‘Absolutely. I’ve known some individuals describe a psychotic episode as a revelation, a wonderful and exciting new way of seeing the world – in fact, the sort of experience that people seek from hallucinogenic drugs. You know, a surprisingly large percentage of the population have undergone a psychotic episode of some kind, without being disturbed by the experience. At the end of the day, a hallucination is merely the misattribution of internal events to an external source.’

Cooper shook his head, trying to throw off a sudden, unwelcome burst of insight, a glimpse of how it might feel if the reality of his own world became suspect. He was sure he would find it disturbing.

‘Could we get back to the question of John Lowther’s condition, and how he was being treated?’

‘Well, when Mr Lowther was discharged, he returned to the community. He has family members in Derbyshire. It’s normal practice to ensure that the family are fully aware of the importance of maintaining medication. We can’t be there standing over every patient personally, to make sure they take their drugs.’

‘Who was supposed to do that? His parents?’

Dr Sinclair frowned at the file. ‘According to his records, there’s a sister.’

‘She’s dead.’

‘Oh.’

‘And I think she might have been too preoccupied recently to worry about her brother.’

‘Mr Lowther must have been due for a review,’ said Sinclair. ‘Perhaps his GP had examined him recently.’

They looked at each other for a moment, conscious of the futility of trying to work out where and when the system had gone wrong.

‘Basically, a dangerous psychotic was allowed out into society unsupervised,’ said Cooper.

‘No, no, you don’t understand. Once a patient is discharged and living at home, clinicians are helpless. Even if we know they might be a risk to themselves and others, we can’t force an individual to continue medication. Not at present.’

‘But you’d like to be able to compel people to take their drugs?’

‘Detective Constable, fifty thousand patients are detained by psychiatrists every year. If we can’t compel people to continue medication when they’re back in the community, all that happens is that some of them get very ill again and have to be detained a second time, or a third. It just goes on and on.’

‘The revolving door approach. We see it often enough in the courts.’

‘I’m sure you do,’ said Sinclair. ‘Besides, John Lowther isn’t dangerous unless he has stopped taking his medication. And even then, he’s only a risk to himself. You say his sister died? The trauma of her death might have disrupted his normal routine anyway. It would be easy for him to slip. I hope he hasn’t gone beyond caring for himself.’

‘Doctor, if John Lowther’s psychotic episodes returned, would the hallucinations be as powerful as they were previously?’

‘Possibly more so. To be honest, in my next consultation with him, I might have been moving towards a conclusion that he was suffering from a treatment-resistant condition.’

‘What would you have done then?’

‘Tried another drug. Probably Clozapine.’ Sinclair took a tissue from a box on his desk and wiped a drop of sweat from his temple. ‘There’s one other thing that might be relevant …’

‘Go on, sir.’

‘At the time he was admitted to the unit, Mr Lowther was also suffering from night terrors.’

‘You mean nightmares?’

‘No, night terrors. Nightmares occur during REM sleep, terrors are experienced in stage four sleep. In practice, the distinction is that you remember nightmares, but you don’t remember terrors. They’re subconscious phenomena – but no less stressful, psychologically and emotionally.’

‘And those might have returned, too?’

‘It’s possible.’

‘In John Lowther’s case, would his deteriorating condition be noticeable in the way he talks?’

‘Yes, Mr Lowther suffers from thought disorder, another symptom of psychosis. It can lead the patient to speak quickly and incessantly, or to switch topic in mid-sentence. He could eventually become incoherent, using inappropriate words or mispronouncing them, or making up new words altogether.’

Cooper had been trying to make notes as the psychiatrist talked. But his pen paused, and he looked up.

‘Would you be willing to listen to a tape of an interview we conducted with Mr Lowther, and give us your opinion on it?’

‘Certainly, if you think it would help.’

‘How do you think John Lowther is likely to react in the present circumstances?’

‘It’s difficult to say. He’ll be in a rather unpredictable state. But one thing I’m sure of: he must be a very frightened man.’

‘Frightened of what? Of us?’

Sinclair smiled. ‘Hardly. At the moment, you’re the least of his problems.’

‘What, then?’

He put his glasses down and closed the file. Then he toyed with the items on his desk, teasing them into a more satisfactory arrangement.

‘Most of all, John Lowther will be frightened of himself,’ he said. ‘Of his own inner demons, if you like. Whatever form those demons might be taking.’

‘I don’t understand.’

‘I’m doing my best to explain. You see, Mr Lowther knows about the voices from past experience, though he’ll have tried to suppress the knowledge. If he’s off the medication, his auditory hallucinations will return. They might have returned already.’

‘What will that mean to him?’

‘At this stage, he should be lucid enough to understand what’s going on, and to be aware that it will get worse. He’ll be facing up to the horror of what he might do at the urging of those voices, and the options he has left to save himself, to avoid turning back into the evil monster he once considered himself to be.’

‘I can think of one option,’ said Cooper, holding his eye. ‘He might feel the only way he can prevent himself from turning into that monster is to end his own life.’

Sinclair nodded. ‘Yes, you’re right. John Lowther is a much greater risk to himself than to anyone else.’

‘Thank you.’

As Cooper stood up to leave, Sinclair seemed to slip from the script again, just for a moment. ‘A grasp of Mr Lowther’s thought process is essential, you know, Detective Constable.’

‘Why, sir?’

‘Because it’s counter-intuitive.’ The psychiatrist made a weary gesture. ‘I realize it’s difficult to understand. Most of us know what it means to be afraid to die. But it’s rare to meet someone who’s scared to live.’

Fry burst into the office anxious to know whether Cooper had returned from his visit to Dr Sinclair. But Murfin was taking a call as she walked through the door. His eyes were wide, and she watched him expectantly when he put the phone down.

‘According to the authorities in Pleven, the Mullens’ adoption application was never fully processed,’ he said.

‘What does that mean?’

‘It means they didn’t complete the adoption procedures. There were some legal problems with the papers, apparently, and their application was rejected by the court.’

‘And what happened to Zlatka Shishkov?’

‘They say they can’t tell us that, for reasons of confidentiality. But one thing’s for certain – she wasn’t adopted by the Mullens.’

Fry stared at him in amazement, wondering whether she’d heard him right.

‘So where did their baby come from?’ she said. ‘And who the hell is Luanne?’

31

The bar of the Mulberry Tree in West Street was deserted in the afternoon, once the lunchtime rush was over. It was hardly worth staying open, except as a matter of principle. This afternoon, there were only two customers – and one of them was there reluctantly.

For a moment, Georgi Kotsev smiled at Diane Fry and placed a strong, brown hand on the table between them, like an offering.

‘Baby smuggling,’ he said. ‘It’s very regrettable.’

‘Is that the word you’d use?’

‘Forgive me. My English is not adequate, perhaps.’

‘It’s just fine, Georgi.’

Fry couldn’t remember when she’d last sat in a bar with so little atmosphere. The walls were subdued pastel colours, designed in a mock Georgian style, but with ornate chandeliers. The armchairs were imitation leather and so deep that she had to sit forward on the edge of her chair to remain upright. Kotsev had left his glass of vodka untouched in front of him out of politeness, though she’d refused his offer of a drink.

‘Until the year 2004, baby selling wasn’t a crime in Bulgaria,’ he said. ‘Even now, a woman who sells her baby has committed no offence. By law, she is regarded as a victim.’

‘But what about the dealers? The middle men?’

‘Yes, their activities are now a criminal offence. If they’re caught, they might face a year in prison.’

‘A year? Are you kidding?’

He shook his head slowly. ‘Things are changing. But perhaps not quickly enough for some.’

‘Why would a mother sell her baby, Georgi?’

‘Ah, babies are a valuable commodity. A mother might sell one to buy a house, or to feed the rest of her family for a little while.’

‘It can’t be so easy to smuggle babies out of the country, can it?’

‘What? Bulgaria has five borders – Romania, Serbia, Macedonia, Greece, Turkey – and all of them leaky, like a sieve. And we have the Black Sea coast, with little ports where you can sail a boat across. Yes, our country has become a corridor for smuggling of all kinds. Drugs, cigarettes, vegetables, people …’ Kotsev fingered his drink. ‘A while ago, our authorities broke a kidney-trafficking ring. Six people had been taken to a clinic in Istanbul, where their kidneys were sold to transplant patients. This is a rich business for someone – kidneys are worth between two and five thousand dollars each. It depends on the blood type, you see.’

‘Did you say vegetables just now, Georgi?’

‘Ah, yes. Potatoes, for example. Also apples. Any kind of food that is scarce. In Sofia, the police arrested a smuggler known as Nick the Chicken, on account of his speciality.’

Fry sat back, fighting the feeling that she’d stepped into some kind of Russian farce. The armchair squeaked at her movement. Taped music played somewhere, and a barman appeared to wipe glasses that hadn’t been used.

Kotsev couldn’t resist a sip of vodka. ‘The main interest to us might be in the connection with the victims of the double shooting in Pleven. It seems they not only had a personal relationship, but they were also colleagues.’

‘That’s not unusual.’

‘No. But guess where Dimitar Iliev and Piya Yotova worked.’

Fry didn’t like being asked to guess. Someone who asked you to guess expected you to be wrong, and she usually was. But as she remembered the photo of Iliev’s red Ford Escort with its shattered back window and BG plates, Fry thought she heard distant screams, and the voices of children. And she realized she didn’t have to guess. ‘An orphanage,’ she said.

‘You are almost correct. Iliev and Yotova were employed by an official organization which places children in state orphanages.’

‘So they had a lot of power in deciding the fate of those children?’

‘Da, razbira se.’

‘And perhaps they were in a position to falsify paperwork, remove records, take illegal payments –’

Kotsev threw out an arm dramatically. ‘Where money is involved, someone will become corrupt. But perhaps they thought they were doing good work too.’

‘Doing good? How?’

‘At one time, our Bulgarian orphanages were not very pleasant places to be. Some children stayed in them for many years, without ever finding homes. Who can say whether it might not have been better to find a child a home, even if illegally?’

‘Somehow, Georgi, I suspect these people aren’t too scrupulous about checking where children are going to end up.’

He bowed his head slightly. ‘Perhaps you’re right. It’s possible some of those orphans went to a bad fate.’

‘Why hasn’t this trade been exposed?’

‘Well, there are political ramifications …’

‘Oh, the European Union,’ said Fry. The phrase had begun to sound like the kiss of death to rationality.

‘Yes, indeed.’

‘I suppose what it boils down to is that the Bulgarian authorities wouldn’t want evidence of large-scale baby smuggling to come to light right now.’

‘Especially if other EU member states are involved. It would cause quite a scandal. Worse, it would give ammunition to those who do not want Bulgaria to join the EU.’

Fry felt suddenly exhausted. No matter how hard you tried to achieve some kind of justice, there were occasions when it was obvious you were wasting your time. The realities lined up against you were insurmountable. And this was the way it always would be. Human nature would never change.

‘So we’re looking at a baby selling ring, with at least four people involved. Is that right? The two people killed in the shooting in Pleven, plus Rose Shepherd and Simon Nichols. Or, rather, Rosica Savova and Simcho Nikolov. And what about the Zhivko brothers?’

‘There are connections between them, certainly.’

‘Were Dimitar Iliev and Piya Yotova wealthy?’

‘No, not all. They had an ordinary home in an apartment block in Pleven. They drove an aged Ford Escort, as you saw. They had no money hidden away, that we could find.’

‘And Nikolov was pretty much destitute.’ Fry thought of the electronic gates guarding Bain House in Foxlow. ‘So it appears that Savova made all the money from the enterprise.’

‘Da. It would seem so.’

‘Do you think there was a falling-out between the principal players? Was it Nikolov that Rose Shepherd was afraid of? Did he come to Derbyshire looking for her?’

‘I do not know, Diane.’

‘Well, someone did. And the Mullens got innocently mixed up in this?’

‘It depends what you mean by “innocently”. They must have removed the baby from Bulgaria illegally.’

‘True. We know that much, at least. But why would the Mullens’ adoption have failed?’

‘Who can tell? Adoption has become very difficult for foreigners.’

‘But Bulgaria was supposed to be the place to go to adopt a baby. According to Henry Lowther, anyway.’

‘No longer,’ said Kotsev. ‘Since Bulgaria wishes to join the EU, it has signed the Hague Treaty. As a consequence, our new laws say that orphans or abandoned children become available after having no contact with their family for six months. I understand there are now fifteen thousand children in our orphanages, but only a very few legally adoptable.’

‘So the Lowthers fell foul of that change?’

‘I would say so. It is a legacy of the Soviet mentality – let the state do everything for you, from cradle to grave. And this is the result. The state can look after your unwanted child, why not? So yes, it is difficult. It costs many thousands of dollars.’

‘So they went for the illegal option. They must have been desperate by then.’

Kotsev nodded. ‘Is there a photograph of this child?’ he asked.

‘Yes, here –’

He looked at the photo of Luanne for several minutes. Then he muttered under his breath something Fry didn’t catch. For the first time, she thought she saw his confident exterior dented.

‘She looks to me as though she might be a Roma,’ said Fry.

Kotsev sighed deeply. ‘Yes, you’re right. I had a suspicion, but no more.’

‘Suspicion?’

He waved a hand, as if he were swatting away a fly. ‘I understand if you’re angry at this, but there is some information that is difficult to share.’

‘Oh, really? I thought you were sharing everything with me, so we could work together as colleagues.’

‘Very well.’ He shrugged. ‘It’s possible that this child belongs to one of our leading criminals, the Mafia boss I mentioned. A very unpleasant gangster.’

‘What do you mean “belongs to”?’

‘They say he had a child, born to a young Romani woman. The woman ran away from him when the baby was born. It took him a little while to catch up with her.’

‘What happened to the woman? Is she dead?’

‘People who upset mutra chiefs don’t survive very long. But her body has never been found, that’s all I can say.’

‘And she sold the baby?’

‘It is possible,’ said Kotsev. ‘Her concern might have been to save the child, to get her out of the way of danger. That is how it is with mothers, I understand. But fathers want their children, too. Some want them very badly.’

‘How would he have tracked her down here, to Derbyshire? Could his influence reach here so easily?’

‘Yes. In fact, he might have preferred it. It’s not so easy in Bulgaria for the mutras now. As I said, the country is changing. There’s no place for those who grew up in the old ways.’

‘The old ways, Georgi? You mean bribery and corruption?’

Kotsev shrugged. ‘After the Change, that was the way things worked. It was the system.’

‘But the system didn’t work equally for everybody, did it? Isn’t that important?’

He smiled. ‘Ah, now you sound like a Communist.’

But Fry didn’t return his smile. ‘In particular, it didn’t work for Zlatka Shishkov.’

‘This is true.’

‘Georgi, would a father really go so far to get his child back? Would he go to any lengths?’

Kotsev took a drink, started to shake his head, then nodded instead. ‘I can’t answer that question, Diane.’

Fry looked at him, wanting to ask him whether he was a father himself. But she was afraid it would sound too personal.

Kotsev shrugged. ‘We might have expected the child to be taken – to be returned to her father. But that hasn’t happened.’

‘Not yet,’ said Fry. ‘It hasn’t happened yet.’

Fry updated her colleagues at West Street with the news, and they considered the theory suggested by the latest information.

‘You know, I never thought the fire made sense myself,’ she said. ‘And it still doesn’t.’

‘No? What do you mean?’ asked Cooper.

‘Well, starting that fire was a very dangerous thing to do, wasn’t it? It doesn’t fit the same pattern as the killing of Rose Shepherd. Apart from the effectiveness of the technique, there are no signs that it’s a professional job. Where’s the planning, the cool calculation?’

‘Perhaps you’re right, but I’m not sure why.’

‘Ben, look. For a start, they must have known Luanne wasn’t in the house with the rest of the family, or they wouldn’t have risked it. Not if they wanted to get her back so badly.’

‘Yes, I agree.’

‘And I’m not even sure what they hoped to achieve by starting the fire. Did they mean for the Mullens to be killed?’

‘Maybe they just made a mistake. If they acted recklessly and failed to make sure that Luanne Mullen wasn’t in the house –’

‘They’d be in big trouble, wouldn’t they?’

‘But now it’s Luanne who’s at risk again, isn’t it? These people will stop at nothing. So forget the fire – the living are most important. We have to save that child.’

‘If Brian Mullen is thinking straight, he ought to realize the risk,’ said Cooper.

Fry shook her head. ‘This case has been the same all the way round. No one has behaved in a rational way. Everyone involved seems to have gone headlong towards their fate with blinkers on. You’d think they were a lot of lemmings throwing themselves off a cliff.’

‘Emotions,’ said Cooper. ‘Emotions always interfere with rational behaviour.’

Fry began to put together her notes to update the DI and Mr Kessen.

‘Do you want someone to check on the Heights of Abraham later, Diane?’ asked Cooper. ‘The Lowthers said that’s where John is likely to go.’

‘Yes, thanks.’

As she was on her way out of the room, Cooper remembered one more thing. ‘By the way, I’ve asked Dr Sinclair to listen to the interview we did with John Lowther. He’ll be coming in any time now.’

‘Good idea. It’ll be interesting to hear what he has to say.’

‘Would you be worried if you had hallucinations, Diane?’

Fry frowned. ‘I suppose so.’

‘Apparently a lot of people aren’t troubled by them and don’t seek psychiatric help.’

‘Really?’

‘Yes. It’s strange, isn’t it?’

Cooper felt he was putting it mildly. Of course, he only had his experience with his mother to go by. She’d certainly been troubled by the hallucinations caused by her schizophrenia, and so had everyone else around her. But his experience might be a narrow one.

‘What sort of hallucinations are we talking about, though?’ said Fry.

‘According to Dr Sinclair, the misattribution of internal events to an external source.’

Fry laughed. ‘Oh, those sort.’

After she’d been interrogated for twenty minutes by Hitchens and Kessen, Fry felt exhausted. Her eyes were dry and her skin felt grimy. She nipped down the corridor to the ladies’, where she splashed cold water on her face and practised controlled breathing for a while until she felt calmer.

Then she looked at herself in the mirror over the washbasin. Some days, it wasn’t a good idea to do that too often. If she wasn’t careful, she could suddenly get a glimpse of a person she’d almost forgotten – the girl who’d lived in those foster homes back in the Black Country. Sometimes it seemed like a million years ago. But at other times, she knew it was really just yesterday.

Fry had once seen a newspaper article that began: ‘Kate Adie, Marilyn Monroe, Jim Bowen, Larry Grayson, Edgar Allan Poe, Bill Clinton and Steve Jobs … What do they all have in common?’

The journalist’s answer, of course, was that they were all adopted or fostered. It made Fry want to rip the newspaper into shreds and stuff it up the feature writer’s backside. As if she might aspire to make it on to a list that included Larry Grayson and Bill Clinton. It didn’t fill her with positive emotions to know that she shared something in common with Jim Bowen. And Edgar Allan Poe? Wasn’t he stark, raving bonkers?

Fry dried her face, combed her hair, and brushed her jacket. There was no reason for her to look as untidy as Ben Cooper.

Of course, there were a lot of bad reasons for adopting children. Adoption was often a selfish act, but some of the reasons were selfish in particular ways. Some couples thought it would save their marriage, others wanted to replace an infant who’d died, or provide a companion for an only child. They might do it because all their friends had babies, or because they saw a child as a fashion accessory, or a political statement. They thought adoption would provide company in their old age, or a pension plan, a successor in the family business, or just someone to carry on the name. All of those reasons were essentially exploitative. None of them focused on the child for its own sake. So what had Lindsay Mullen’s reason been? Could she believe what Henry Lowther said?

Adoption was always tough. But it seemed evident that the Mullens loved Luanne. If her natural father succeeded in getting her back, there was no knowing what her fate might be.

Fry stared at her reflection and shook her head. She was starting to feel better. She was thinking again, instead of just reacting. She needed expert advice really, but it was difficult to know where to go for expertise in baby trafficking. Not every agency was forthcoming with information.

She remembered that there was a South Yorkshire Police unit called Operation Reflex, set up to combat human trafficking. An officer from the Immigration Service worked with the team to provide information on individuals who might be involved in immigration crime.

But Reflex were interested in women being trafficked for the sex trade. They’d scored a success in Sheffield a little while ago, with the case of a fifteen-year-old Lithuanian girl sold into prostitution. The girl had arrived at Heathrow Terminal Three to take up a job selling ice cream, and had herself been sold for the price of a second-hand car. Before she arrived in South Yorkshire, the girl had been passed around from hand to hand, gradually losing her value when she was no longer a virgin and had suffered damage from regular beatings. It was probably what the car trade called depreciation.

Fry watched her face change in the mirror. That was better. Now she looked more like someone who was in control.

‘Fear is a very interesting emotion,’ said Dr Sinclair. ‘You can’t be afraid retrospectively. You can only fear something that hasn’t happened yet.’

Setting up the tape for him, Cooper paused before pressing the ‘play’ button. Damn right, he thought. That was why there were so many things to be afraid of.

‘Scared to live,’ he said. ‘That’s the way you described Mr Lowther’s current state of mind.’

‘That’s correct.’ Sinclair looked up. ‘If you don’t understand that concept, then you haven’t learned to glimpse what goes on in other people’s minds. Some individuals find life unbearable, every day a torment. They become convinced that continuing to live will be such an ordeal that dying is the only possible escape.’

Cooper couldn’t think of an answer to that. He started the tape, and they listened to John Lowther’s interview in silence for a few minutes.

‘Yes, some people go abroad, hunting for whores. No – for babies.’

‘Sorry?’

‘I’m not sure what you’re asking me. Is it time?’

‘He’s conflating two subjects in his mind here, I think,’ said Sinclair. ‘The whores and babies thing, I mean.’

‘I wondered if John Lowther could be a paedophile. What do you think, Doctor?’

Sinclair shook his head vigorously. ‘No, there’s no indication of that.’

‘Are you sure? I’m no psychiatrist, but babies and whores sounds a very dubious association of ideas to me. I understand that Mr Lowther doesn’t quite know what he’s saying, but isn’t that sort of thing called a Freudian slip?’

‘Freud has nothing to do with it. You don’t understand how this works. What we’re dealing with here is not an association of thoughts, but a disassociation. Mr Lowther’s brain is skipping so quickly to an unrelated subject that there appears to be no distinction or separation between them, as far as the listener is concerned. That’s not the way it is in the patient’s mind – his brain just isn’t making normal connections, the way ours would. Mr Lowther is probably saying words that sound like the ones he’s thinking.’

‘OK. Anything else?’

Cooper pressed the ‘play’ button again, and they listened to the rest of the interview. Sinclair jotted a few notes.

‘Yes, in this interview, I think we can hear pressure of speech, where the patient speaks quickly and incessantly. Also derailment, or flight of ideas, when he switches topic, sometimes in mid-sentence. That can be in response to an outside stimulus.’

‘I like your tie.’

‘Yes, that sort of thing. You might also detect a degree of tangentiality, when he replies to questions in an oblique or irrelevant manner. To you, in your profession, that would probably sound very suspicious and evasive, I imagine.’

Cooper nodded. Evasive was the exact word that he’d used about John Lowther after his interview.

‘In this form of speech, he reaches conclusions that don’t follow logically, or his thoughts might have no conclusion at all. Sometimes the individual words are correct, but the manner they’re put together is wrong, resulting in what some clinicians call word salad. Sounds rather than meanings govern the connection between words – a clang association. He might also repeat a word over and over, or echo other people’s speech.’

‘That confusion in his speech was already evident a few days ago.’

‘Really?’ Sinclair frowned. ‘It varies with the individual patient, of course. But perhaps he had stopped taking the medication earlier than we thought.’

‘Will this get worse?’

‘Yes, as his condition deteriorates, he might become incoherent, using inappropriate words or mispronouncing them, or making up new words altogether.’

‘Hunting for whores. No – for babies.’

Sinclair shrugged. ‘It’s impossible to interpret his real meaning without having Mr Lowther here for a proper interview.’

Cooper bristled. ‘A what?’

‘My apologies. I meant a properly structured clinical interview.’

Cooper watched Sinclair gather up his notes, plucking up the courage to say what was on his mind.

‘Doctor, you said that many people who have psychotic episodes find them a positive experience.’

‘Yes. Many of them are non-clinical individuals, of course.’

‘Non-clinical?’

‘Individuals who have hallucinations but aren’t troubled by them, so they don’t seek treatment.’