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Chapter Two

I’d been working on the unit almost two years. Feeling frustration with the attitude of the administration in Washington toward special education and foreseeing the inevitable cutbacks and job losses that would result from administration policy changes, I had decided to take a break from teaching. Some years earlier, I’d completed my psychology credentials, so this seemed the right time to move in that direction. My intention had been to join a small clinic where a friend of mine worked. It was located in a city I had lived in previously, a city I knew and loved well and where I already had a good social network. What had attracted me most, however, was a chance to work with the clinic’s director. He not only had a formidable reputation in child psychiatry, which was reason enough to want to learn from him, but he was also a skilled administrator, known for his creative thinking. Breaking free from the often restrictive attitudes of psychiatry, he had sought to set up the clinic with a more holistic approach, drawing together professionals from several allied fields – child psychology, psychiatry, pediatrics, social work – to work together in a broad, cross-disciplinary manner. This ability to “think outside the box” appealed to me greatly.

How I’d left the small town where I had been teaching with the intention of taking up a position in that wealthy, well-funded, broad-minded private clinic and ended up instead working in the claustrophobic world of a closed psychiatric crisis and assessment unit for children in a metropolitan general hospital was somewhat of a mystery even to me. It had involved one of those encounters one can only write off later as “fate,” when a colleague of a colleague contacted me late one Sunday afternoon, saying something about being familiar with my former project in elective mutism and would I be willing to give an in-service to staff at the hospital. While on the unit to do the in-service, I found out they were desperately looking for a specialist in psychologically based language problems. I was not such a specialist, but I was free for a few months, since times had not quite coordinated between the end of the school year and the opening of the position at the clinic. I said if they were interested, I’d be willing to give it my best shot. They were and I did. And months zoomed by. The position at the clinic came and went and I remained at the hospital.

It was a good choice. No doubt the clinic would also have suited me well, and I still had occasional idle dreams of switching over at some later date, but I loved the gritty, front-line feel of working in a hospital. We were a shortterm facility, designed primarily for diagnosis and assessment, as well as acute crisis intervention, and as a county-funded institution, many of the cases referred to us came from the poor under-belly of society. The continual struggles for enough time, enough money, enough choices never went away, lending a certain frisson to the work and provoking among the staff an attitude akin to that of comrades-in-arms in a MASH unit. Like a good political debate, this kind of edgy atmosphere stimulated me. I enjoyed, too, the flexibility of my position, which allowed me to continue liaising with many of my patients long after they had left the hospital unit and returned to their homes and schools, and I enjoyed being a “language specialist,” of seeing the many variations of one presenting problem.

Which is how Cassandra came my way.

In the beginning Cassandra Ventura’s life had looked promising. Her father was a security guard. Her mother had been a secretary but gave up work when Cassandra’s elder sister, Magdalena, came along. During those years, the family exuded the American dream. They worked hard, were committed members of their church, helped out in community activities. Dad was a regular on the company bowling team. Mom baked cakes that won prizes and sewed enviably well, providing the two girls with elaborate costumes at Halloween, new dresses at Easter, matching outfits for the school pictures.

Behind closed doors, however, it was a very different scene, one of drug problems and domestic violence. Mr. Ventura claimed never to have abused the children until that final incident. Before that point, it had been only his wife who had suffered the cruel put-downs, the beatings, the dishes smashed over her head. But then on that night, six-year-old Magdalena had tried to intervene, getting physically between her arguing parents. Mr. Ventura swung out at her, meaning only to push her aside. She fell and was knocked unconscious. That proved the breaking point for Mrs. Ventura. She could no longer keep up the pretense of being a happy family. Taking the girls, she fled to a women’s refuge. The next day she went to the police.

It unraveled swiftly from there. As well as the domestic abuse, Mrs. Ventura also revealed her husband had long-term drug problems and had been using his position as a security guard to procure a regular supply of cocaine. The criminal trial that followed was ugly and rancorous and made worse because it required testimony not only from his wife but also Magdalena. Mr. Ventura was jailed for eighteen months.

Mrs. Ventura rebuilt her life with rather disconcerting speed. All within the space of time her husband was in jail, she managed to file for divorce; meet and move in with another man, whose name was David Navarro; relocate to a new community about an hour’s drive from the city; and give birth to a third daughter, Mona.

Cassandra had been three at the time of her father’s imprisonment. Two years later, when she was in kindergarten, she came out of school to find a car waiting for her. When the man in the driver’s seat said he was Daddy, she hesitated. She didn’t actually remember her natural father well, so she didn’t know if this was him or not. When he tried to call her over, she replied that she needed to wait until Magdalena came out. He said, “I have some of your old toys here. I thought you might want them.” So she went to see.

When Magdalena came out from her third-grade class, there was no sign of her younger sister. Her mother was called. The police were called. Nothing. No trace. Cassandra had disappeared.

The Navarros’ efforts to find Cassandra were unrelenting. Police bulletins, news reports, searches over several states, posters in the local grocery store, on the side of milk cartons, efforts through Mr. Ventura’s parole officer – everything anyone could think of was tried in an effort to find out what happened that afternoon – but nothing turned up. It was as if Cassandra and her father had, as the old cliché goes, simply vanished into thin air.

Twenty-six months passed without any word of Cassandra’s whereabouts. Then three states away, a young man working in a 7-Eleven convenience store discovered a small girl in the alley behind the store going through their garbage. Suspicious that she was there to steal something, he gave chase when she tried to run away, and caught her. When she wouldn’t speak to him, wouldn’t answer his questions about her name or where she lived, he called the manager. The manager realized immediately that the girl was too young to be alone in such a place at that time of day, and he was concerned about her unkempt appearance; so he called the police. It was Cassandra.

No one ever knew precisely what had happened to her during those twenty-six months. Cassandra was totally mute for the first weeks after her return. Her father, when found, was in a drug-addled stupor, and he seemed incapable of giving much information beyond indicating the motive behind the abduction had been revenge against his ex-wife. “I wanted to make her suffer for what she’d done” was his only real explanation.

Cassandra had been not quite six when she was abducted and was now approaching eight. She was very dirty and suffering from malnutrition, giving the impression she had spent at least part of the time living rough or in very poor conditions. No one knew whether this was in the company of her father or others, because her father gave a muddled, inconsistent picture and Cassandra said nothing. Even when she did begin to speak again, she usually refused to talk about the abduction. The few things she did say turned out to be mostly lies.

The longed-for homecoming proved to be nothing like Cassandra’s mother had dreamt about for so long. In place of the cheerful, loving daughter who had been abducted that autumn afternoon, she welcomed home a wary, mute stranger.

Cassandra found it impossible to settle back into her former life, which, in fact, was not her “old life” at all, but rather a completely different one from what she’d been living before the abduction. She hated her stepfather and wouldn’t tolerate him in the room. She refused to talk to him or even look at him. She fought constantly with Magdalena and did many small, nasty vengeful things to her. With her new sister, Mona, she was so spiteful and short-tempered that her mother didn’t dare leave the two of them alone together.

Cassandra startled easily, was prone to unexpected tantrums, suffered horrific nightmares, and alternated between shouting at everyone and not speaking at all. She lied constantly, stole from everyone in the family, and had chaotic eating problems, tending to hoard and hide food, or else taking too much, consuming it too fast, and vomiting it back up, occasionally while still at the table. She also had digestive problems and was plagued by many other minor illnesses associated with a compromised immune system.

In addition, it appeared Cassandra had not attended school at all during the time she was gone. Indications when she was in kindergarten were that Cassandra, like her elder sister, would be an able student. Old enough to be in second grade when she returned, she was now behind in everything and could neither read nor do basic adding and subtracting.

Cassandra’s mother and stepfather attempted to deal with the situation as appropriately as they could. Her parents decided to restart Cassandra’s education from the beginning, so she was placed in first grade, a year below where she should have been for her age. This still left plenty of catching up, as the academic year was well under way when she returned, so she was also given extensive resource help. To deal with the psychological trauma of the abduction, Cassandra had individual therapy with a child psychologist for twelve weeks, which was the length of time covered by the Navarros’ insurance.

And Cassandra did start to recover. She began to speak reliably again. First it was at home and then, more slowly, at school, although she could still be oddly unpredictable and sometimes went silent for hours and occasionally even days. She was making reasonable academic progress and generally keeping up with her class. At home she was still difficult and prone to tantrums, but the family felt this was improving, too.

Yet …

It was Cassandra’s third-grade teacher, Earlene Baker, who kept pressure on the Navarro family to seek further help for their daughter. Mrs. Baker found Cassandra’s behavior disconcerting and difficult to cope with in the classroom. She was most concerned about the amount of very manipulative behavior Cassandra engaged in, which mostly took the form of lying and “storytelling.” A number of the lies, she said, seemed completely pointless, such as coming to school in a pair of running shoes she wore almost every day and insisting they were new. Many others were malicious, such as on one occasion when Cassandra had purposely hidden her schoolwork and then told the school staff that another child had stolen it from her. The only thing that had saved the other child from serious trouble was a playground aide who had happened to notice Cassandra placing something carefully into a trash bin outside the school and had later gone to investigate. Most of the lies, however, were about hideous but outlandish things, like her little sister falling in the canal and being swept under the culvert but then being rescued by an unidentified boy who just happened to be passing.

Mrs. Baker said she was aware that in all likelihood Cassandra had suffered terribly during her abduction and she tried to take this into account, but even so, why would a nine-year-old spend recess cheerfully helping the school janitor sweep leaves and then come in and say he had tried to push her down the stairs?

Mrs. Baker also wondered if Cassandra could be suffering petit mal seizures. It was a bit of joke with everyone at school, even Cassandra, that she “should have been born blond” because she could be very “ditzy” – not paying attention to what was going on around her, not remembering obvious details about ordinary things. Mrs. Baker didn’t always find the behavior funny. She felt the forgetfulness, which could be very abrupt and out of the blue, was often manipulative in nature and just a further extension of the lying. Occasionally, however, she said Cassandra did genuinely seem not to remember things that had just happened, and this occurred often enough for it to interfere with learning and social interactions. This led Mrs. Baker to wonder if there could be a neurological underpinning for such behavior.

Cassandra’s erratic speech also bothered her. Most of the time, Mrs. Baker said, Cassandra was chatty to a point of being verbose; however, every once in a while she’d suddenly refuse to speak to anyone, and this could last anywhere up to a few days. Mrs. Baker saw no particular pattern to these silences, but they did occur at home as well. Cassandra’s mother was resigned to them, feeling they were another outshoot of the traumatic abduction and the best response was to give Cassandra peace and support and not call attention to them. Mrs. Baker couldn’t be this lackadaisical because not talking interfered with the learning process. Given the randomness of the behavior, Mrs. Baker’s mind again went back to the question of a neurological basis. When she spoke to me, she mentioned Cassandra’s father’s drug problems and wondered if Cassandra had been the victim of any drug-taking while she was with her father, or if there had been some kind of horrible abuse that might have caused brain damage, which was now throwing up these odd neurological signs.

The final concern was what Mrs. Baker called Cassandra’s “creepy” behaviors – actions that, while there was nothing inherently wrong with Cassandra’s doing them, made Mrs. Baker uneasy. Among these was a tendency for Cassandra to turn otherwise ordinary conversations into nonsense. She would be chatting normally and then unexpectedly get what Mrs. Baker described as her “Bad Seed” look. Suddenly her replies would become off-topic, occasionally provocative, and often make little sense. This was a very disconcerting behavior, Mrs. Baker said, because it “felt crazy.” And very off-putting. Other children quickly became disconcerted or irritated and avoided her.

Another creepy behavior was Cassandra’s tendency to pretend she was some kind of animal, like a vulture or a bear, and then only relate to people using shrieks or growls. Often she picked a violent animal and then used the animal’s normal aggression as an excuse for hitting, biting, spitting, or doing other hurtful things. Mrs. Baker said Cassandra often did this playfully, as if she were in control of the behavior and it was only a game; however, she could persist with the animal-like behavior for several hours, despite repeated requests to stop or even punishment.

Neurological investigations turned up no evidence of seizures. The doctors concluded Cassandra’s problems were psychological, most likely part of post-traumatic stress disorder resulting from the abduction, a diagnosis she already carried. She was given a prescription for antidepressant medication and sent home.

Mrs. Baker didn’t see a significant change in Cassandra on the antidepressant, so she persisted in her efforts to pressure the parents into getting more treatment for Cassandra. She claimed the various difficult behaviors were soon going to make it impossible to keep Cassandra in regular education. She kept insisting the parents continue searching for help. Consequently, Cassandra was eventually referred to one of the senior child psychiatrists affiliated with our unit at the hospital. He spent time in Cassandra’s school, observing her, then met with both Cassandra and her parents. In the end he decided it would be beneficial to bring Cassandra to the unit as an inpatient for observation and assessment.

The child psychiatrist, Dave Menotti, was to oversee the case, but I was given the individual daily therapy sessions with Cassandra. Dave’s thinking was that my experience with psychogenic language problems might prove useful here, even though her occasional mutism was not the presenting problem. He described her to me as a child “where something doesn’t add up,” which I knew meant we were still very much in the diagnostic stage. While we assumed we had the source of her problems – the twenty-six-month abduction – we had no understanding of how that pieced together with her difficulties now.