Rachel Alexander 09 - Without a Word

had been hired, perhaps part of her overhaul of office procedures, her redecorating intruding into the patient files. The notes were easier to read this way. If the change had been the result of Ms. Peach’s suggestion, you had to give her that.
    I read all the notes, the recommendation of an ear, nose and throat specialist, a child psychiatrist, relaxation exercises, biofeedback, increasing the amount of exercise Madison did, including the recommendation that she be taken swimming. But no drugs had been prescribed. Until the first and only Botox shot, there was no mention at all of medication.
    Leon had to be with her for the first few years. She wouldn’t have been old enough to walk to the doctor’s office on her own, but the records didn’t say whether he was there or not, what he’d been told and what he hadn’t been told. Either way, there were no medications used at all until the Botox, and there was a note prior to the use of Botox that Leon had been “informed” and had signed the appropriate forms giving permission for the procedure.
    When I got to the last page, I was surprised to find a note written the day Bechman had been killed. Often doctors take notes while they talk to you, ask you questions about your health, your habits, your complaints if any. But Madison didn’t talk. So he must have stopped after examining her to make his notes before attempting to give her the shot.
    Is that when she drew the picture, when he told her he wanted to give her Botox on the other side, that he was willing to take the chance that both her eyelids would droop and make her feel like a total freak?
    Notes the last day.And then nothing, of course.
    I put the pages back inside the envelope and closed my eyes, thinking of the drawing. Would that seal Madison’s mens real. A threat would surely show intent, would surely demonstrate malice, premeditation and deliberation, wouldn’t it?
    And no meds. I’d been hoping for something that would lead to a lesser charge, but it wasn’t there. I’d looked up the side effects of Botox, hoping that might explain Madison’s actions, and to my surprise, dysphasia, the inability to speak or understand words, was at the top of the list. But Madison could understand words without any difficulty, and no one, not her father, her former doctor, the throat specialist, the child psychiatrist, none of them thought that Madison couldn’t speak, only that she wouldn’t speak.
    None of the other side effects could mitigate mens rea; nausea, neck pain, an asymmetry if the Botox were injected into the wrong muscle, ptosis or drooping of the upper eyelid, the side effect we know Madison had, bruising at the injection site, headache, upper respiratory infection and, of course, the intended effect of Botox, paralysis of the muscles in the area of the injection.
    How could anyone think an extremely bright twelve-year-old couldn’t figure out what Botox could do to the human heart, her own paralyzed for so long?
    Homicide was at an all-time low in the city, but still, no one liked the idea of a murderer on the loose, even one who was only twelve. The cops weren’t going to let this go. They were going to keep at it, no matter what it took. Well, so would I.
    I closed my eyes and must have fallen asleep because the next thing I remember was the sound of the landing gear descending, then clicking into position, and the announcement alerting passengers to fasten their seat belts and return their trays to the upright position. The envelope with Madison’s medical records was still on my tray. I tucked it into my tote bag, zipping it closed, then waited for the plane to land, taxi up to the terminal and let us go on our way.
    I was walking toward the exit where the taxis lined up when my phone rang, the number familiar but only vaguely so.
    “Alexander.”
    “Rachel? It’s Charles Abele. I’ve been trying you at home and when you didn’t return my call...”
    I wasn’t sure if I’d lost the signal or if Charles had temporarily lost his voice. I reached the door and stepped outside, but still I heard nothing.
    “Charles?”
    “I’m sorry,” he said. “I can’t. . .“
    “What happened?”
    A cabdriver opened the rear door for me but I stood on the sidewalk, not wanting to lose the signal.
    “It’s Celia,” he said. “She’s dead.”
    “Oh my god.How?”
    “They’re saying it was suicide, but it can’t be. It just can’t. She never would have left JoAnn.”
    “Where