Victims by Jonathan Kellerman Read Free Book Online

Drive. Not a trace of street noise; double- or triple-glazed glass. The requisite professional paper adorned the wall behind a modest walnut desk: doctorate, internship, postdoc, license. The only thing mildly interesting was a Ph.D. from the University of Louvain in Belgium.
    Shacker said, “My Catholic days,” and smiled.
    The wall to the left of the desk bore the auxiliary door that had allowed Shacker’s patient to exit into the hallway without encountering me. Next to that hung a chrome-framed cubist print of fruit and bread. Two Scandinavian leather chairs sat in front of the desk, facing each other. Shacker motioned me to one, took the other.
    He crossed a leg, tugged his trousers up, flashed argyle sock. “Over the phone I mentioned insurance lawyers. They’re the ones who sent Vita to me.”
    “Therapy was part of a settlement?”
    “Three years ago she sued her employer. The case dragged on. Finally the employer’s coverer was ready to settle but insisted upon a psych evaluation. Insurance work isn’t my usual thing but I’d treated an individual with a connection to the insurer—obviously I can’t say more—and was asked to see Vita.”
    I said, “What was the purpose of the evaluation?”
    “To see if she was malingering.”
    “She was claiming some sort of emotional damage?”
    “Supposedly she’d been bullied at work and the company hadn’t done enough to ensure a hostility-free work environment.”
    “What company are we talking about?”
    Shacker recrossed his legs. “I’m sorry, I can’t give you that, one condition of the settlement was a ban on discussion by both sides. What I can tell you is that it was an insurance company. Health insurance, to be exact. Vita worked for them as a screener.”
    “She decided who got care and who didn’t?”
    “The company would call it managing the flow of treatment requests.”
    “Was she a nurse?”
    “She’d had two years of secretarial school and her employment history consisted of nonmedical clerical positions.”
    “That qualified her to decide who got to talk to a doctor?”
    “Who got to talk to a nurse ,” he said. “She was a pre-screening screener. It’s called diagnosis-specific utilization management and yes, it’s atrocious. Vita described working at a huge phone-bank, claimed she’d been provided scripts to read from. Certain conditions were to be ignored, for others she’d suggest an over-the-counter remedy. She was given a list of various call-back protocols—a week for this, a month for that. Acute conditions were to be referred to local emergency rooms, serious diagnoses were put on hold as she pretended to search for the next available nurse.”
    I said, “Telemarketing in reverse: Don’t use our product.”
    Shacker said, “This is what it’s come to. What was different about Vita was that she loved her job. Getting back at ‘weaklings’ and ‘fakers.’ ”
    I said, “That didn’t apply to her post-traumatic symptoms.”
    He smiled. “What can I tell you?”
    “What kind of bullying are we talking about?”
    “No physical intimidation, just pranks and ridicule from some ofher co-workers. Vita said she complained repeatedly to her supervisors but was ignored. Her suit was for five million dollars.”
    “High-priced ridicule. What were her symptoms?”
    “Difficulty concentrating, insomnia, appetite loss, stomach problems, aches and pains. Ambiguous things unlikely to show up on a medical exam but impossible to disprove. Since the alleged root cause was emotional trauma, the health insurer’s casualty insurer wanted an official opinion as to her psychological status.”
    “What did you tell them?”
    “That her claims couldn’t be validated or invalidated and that she came across as a hostile individual. I didn’t offer a diagnosis as it wasn’t requested. Had I been asked, I suppose I could’ve dug around the DSM for something that fit, but I’m not one of those therapists who feel bad