Through a fourth-floor wall of smoked glass I looked down at the flank of the mountain and the winding road that I'd driven in on, and the heavy blanket of oaks and manzanita and conifers. Boulders the size of cars, tan and rounded, some stacked, some strewn. Directly below us I saw a kidney-shaped swimming pool, blue and shimmering, with a few swimmers and waders overseen by white-clad attendants.
The patient in question had "left the premises" two days ago, as Dr. Hulet had told me the previous evening by phone. When someone escapes from a place like Arcadia, the hospital will rarely call law enforcement. Too many potential embarrassments and liabilities. Mental illness still brings fear and shame, especially to the rich and powerful. Police draw media, which draw the public. So a missing patient is the responsibility of either hospital security—which had failed to find the man—or a private locator, such as myself. Looking down on the dense forest surrounding Arcadia I saw that our AWOL patient could easily be hunkered within a mile of the building and it might take a bloodhound to find him.
Dr. Hulet's office was a corner with floor-to-ceiling windows. Waiting for us was Alec DeMaris, a wedge of muscle in an expensive suit, who introduced himself as Arcadia's director of security. Hair short and curly, face set. His handshake was intended to punish so I punished back. Men. We sat across from Dr. Hulet, who rested her elbows on the green-marble desktop, working a never-sharpened yellow pencil with both hands. She pointed the eraser end at Alec.
"His name is Clay Hickman and he's twenty-eight years old," said Alec. He was a notch older than me and his voice was sharp, martial. "Missing at the lunchtime head count two days ago, Monday. We searched the compound and grounds and found where he'd dug out under the security fence. Rough country out there. I hired a bloodhound handler from Ramona. We got some clothes from Hickman's hamper and the dog took off down a dirt road on the other side of the fence. Then the dog turned around and brought us back to the escape hole and went yapping up the road the other way. So we figured our boy had gotten into a vehicle. The road is public but unmaintained and not used much. Tried the dog at the three nearest gas stations down- mountain, the Amtrak stations from San Diego to Oceanside, the Greyhound station in San Diego. No scent. Nada. That went into Tuesday afternoon. The handler wanted to try a different dog but I fired him and we called you. Why you, Mr. Ford? You've only got five years of experience as a PI and a rocky history with the San Diego Sheriff's. But I can tell you why you—because of your good reputation as a locator, and your service in Iraq as a United States Marine. Fallujah, I gather. I was a lieutenant during Operation Iron Harvest in Iraq, a little after your time. The taking-out-the-trash phase. So here we sit, brother."
They say once a Marine, always a Marine, brothers for life, always faithful. I say fine, but don't let it cloud your judgment.
I looked at Dr. Hulet, then out the southern window for miles and miles, to where the pale desert waited. "Why is Clay Hickman in this place?"
Dr. Hulet's gaze was calm and direct. "Schizoaffective disorder, the bipolar subset. He has been delusional, paranoid, and at times violent. He was admitted to Arcadia three years ago as a danger to himself and others. Clay Hickman is the son of Rex and Patricia Hickman—yes, of Hickman Homes. Like you two, Clay served our country in the second Iraq war—Air Force. He returned home in late 2009, rented an apartment in San Diego. He found some security work but was soon exhibiting symptoms of what was assumed to be PTSD— hypervigilance, sleeplessness, anxiety, and depression. It escalated. He experienced his first psychotic break six months after coming home. He was stable for a year and a half, then broke again. The next two episodes came just six months apart. Erratic behavior. Fighting. One charge of assault with a deadly weapon—he struck someone with a gun. Shoplifting, drunk in public, resisting arrest. Alcohol and drugs. Unaccounted for, weeks at a time. His sixth fifty-one fifty landed him in Patton State for observation. That's what it takes for a disturbed person to get help these days in our system. Even a veteran of war. That would have been 2014. Luckily for Clay, his family brought him to us. Mr. Ford, I want you to know that Clay Hickman—when he's taking his medications and keeping himself active here in a structured setting—is a peaceful, deep-feeling, generous young man."
Dr. Hulet took a deep breath and let it out slowly. "Two years ago, when I took over his therapy here, I began to suspect that he was suffering what is now called moral injury. From the war. Some therapists call such psychological trauma a soul wound. It is caused by something you do. Not by something done to you. I've published on the subject. It is very different from PTSD. They are not the same."
DeMaris deadpanned her.
I watched a vulture fly by the window, up close to the smoked glass. He seemed to eye his reflection, then continued his reconnaissance. As nature made him. Clay Hickman sounded a lot like some veterans I knew from my Marine days. As a veteran I wondered for the millionth time why some of us had such profoundly bad reactions to war but others did not. Why some had lost their bearings while others had managed to move on to the next thing. As nature made us? As war changes us? Either way, stress was a constant torment to all of us, and maybe an excuse to some.
"Is he suicidal?"