"There's a very nice coffee shop across the street."

"I'd rather get started with the interview."

"I'll find out whether that's possible," the voice said coldly. "Please wait."

Five minutes passed before a portly woman about my age, wearing half-glasses and a blowzy Indian print dress, walked to the door, unlocked it, and let me in. Her graying hair was long and unruly. She wore half a dozen strands of pearls. "I'm Laura Mossberg," she said, in an unmistakable New York accent, "Billy's attending psychiatrist."

I shook her hand. "Frank Clevenger."

"I'm sorry if the ward clerk put you off," Mossberg said.

"No problem," I said. "I'm forty minutes early. I know something like that can turn a locked unit inside out."

She laughed. "Why don't we take a few minutes together in my office, then I'll get Billy for you?"

As we walked through the unit, we passed patients as young as four or five years old and others who looked closer to seventeen or eighteen. They seemed perfectly normal as they spent the weekend chatting in the hallway or playing board games in their rooms or watching television in the lounge. But I knew from my own rotation in child and adolescent psychiatry, back when I was a resident at New England Medical Center in Boston, that only the sickest young people got access to inpatient units, the ones at risk of committing suicide or homicide. Managed care insurance companies indiscriminately shunted the rest to outpatient treatment. The patients here were on multiple psychoactive medications. Any one of them could fly into a rage or be overwhelmed by hallucinations, without warning. Their minds had already veered into chaos-whether due to trauma, abuse, or addiction to drugs or alcohol. They might never live normal lives, no matter how much help they got. Kids are less resilient than people think.

I thought of the murderous violence Billy had witnessed in Russia and the trauma he had, no doubt, suffered in the orphanage. Was it at all surprising that a boy whose world had been destroyed would come to be destructive? Wasn't it obvious that the ruinous potential of fire would feel as warm to him as returning home after a long journey?

Would he not be drawn to revisit his private terrors by looking into the eyes of a neighbor's terrified pet? And then this more disturbing thought came to mind: Would watching his baby sister struggle for her last breaths speak to him of his own emotional suffocation?

We walked into Mossberg's office, an eight-by-ten-foot space piled high with books and medical journals. "Please," she said, pointing to a chair next to her desk.

I navigated my way to the chair, careful not to knock over any of the stacks of reading material. I moved a bunch of New York Times newspapers, two volumes of Tennyson's poetry, and a copy of Harry Crews's A Childhood off the seat, and sat down. Once I did, I was nearly face-to-face with the only thing hanging on Mossberg's walls: a three-by-four-foot painting of a dog with electric blue fur, a white snout, and big, pointy ears. Sitting amidst rolling green hills and blue-black oak trees, the dog had a questioning expression on its face and big, golden eyes that stared into the room, seemingly waiting for something.

"Interesting painting," I said.

"Blue Dog? She helps the kids talk. Sometimes they tell her things they can't tell me, and I just listen in."

"She looks like she's heard a lot of stories," I said.

"Those big ears," Mossberg said. She smiled.

I felt comfortable in Mossberg's space, and with her. The ability to inspire that kind of feeling in people is essential-and rare-in psychiatrists. One in fifty might have it. "You like pearls," I said, nodding at her.

"I like the lesson they teach," she said. She reached to her neck and rolled one of the pearls between her thumb and forefinger. "The grain of sand is an irritant, but the oyster turns it into something beautiful. An oyster without a grain or two of sand doesn't have much potential. Same with people, if you ask me."

"Agreed," I said. "I feel like I'm sitting with a friend."

She smiled. "Maybe you are," she said. "I know of your work. You've had fascinating cases."

Every so often I bump into someone who's read one of the profiles of me that ran in publications ranging from the Annals of Psychiatry to People magazine when I was taking one forensic case after another, each more chilling than the last. But that was a different time, and I was a different person, and I didn't want to get into any of it with Mossberg. "I gave up my forensic practice a couple years back," I said. "I wouldn't normally be involved in Billy's case. I'm interviewing him as a favor to a friend in law enforcement."

She didn't take the hint. "I've never heard anything like the case of that psychotic plastic surgeon," she led. "Where was it? Lynn, Massachusetts? The state hospital?"

"Right," I yielded.

"Dr. Trevor Levitt."

I really wished she would stop.

"No. Lucas," she said. "Trevor Lucas. He had taken hostages. Nurses, patients, and so forth."

"Yes."

"And you negotiated their release," she said.

I could feel my pulse in my temples. "Not all of them," I said. "Lucas butchered a few of them before I declared victory and had my picture taken for the papers. It's a minor detail people tend to forget."

"I'm sorry," she said. "I do recall reading about an elderly woman. Her body had been disfigured-with a knife."

I didn't respond.

"And if I remember correctly, Lucas performed some sort of crude neurosurgery on another hostage?" She shook her head. "It was very brave of you to go onto that unit in the first…"

My brow was damp. I wiped it with my shirtsleeve. "These memories are very painful to me. I don't talk about them."

Mossberg leaned back in her chair, then sat there, watching me intently. "I see," she said, a therapeutic strain of kindness in her voice.

I knew what she was thinking. I would have been thinking the same thing: That not being able to talk about a memory means your mind is still enslaved by it. But I wasn't ready to do the work of freeing myself, and I hadn't come to Mossberg for that kind of help, anyway. I had come for clues to help solve the murder of an infant girl- and to make sure that her twin sister stayed alive. I sat straighter in my chair. "What can you tell me about Billy Bishop?" I asked her pointedly.

Her eyes narrowed, and she pressed her lips together, as if finalizing her diagnostic impression of me. If she was as sharp as I thought she was, she'd get it right: something just shy of full-blown post-traumatic stress disorder. A few moments passed. "Very well," she said. "I'm sorry to intrude. I tend to wander places I haven't been invited."

"No offense taken," I said. "I understand."

She nodded. "About Billy…" she said, reorienting herself. "I can tell you he's a very dangerous person. He seems to be a young man without conscience. I'm not surprised that he lashed out at his sister."

"Why do you say that?"

"Certainly not because of anything he's told me," she said. "He's happy enough to talk about Nantucket, Manhattan, sports, television, and anything else unrelated to the Bishop baby's death-or to his life in Russia. He avoids those topics like the plague."

"I can understand that," I said.

"Of course you can," she said. She paused to underscore her point.

"Let's stick to Billy," I gently reminded her. "I promise to work on my own avoidance another time."

"You're right. I lost my head." She winked. "My main concerns about Billy," she continued, "come from the psychological testing we conducted yesterday, shortly after he arrived on the unit."

Psychological testing involves a variety of evaluations, including the Minnesota Multiphasic Personality Inventory, the Bender Gestalt Intelligence Test, and the Rorschach series of inkblots. The goal of the testing is to determine whether the examinee suffers from any major mental illness, as well as to assess his core character traits, how he thinks about himself, and how he responds to the world around him.