Killer by Jonathan Kellerman Page B

partying. You know. What can I say?”
    “Season to be jolly,” I said. “Listen, anytime you want to—”
    “Nah, I’m fine. And so are you. Try to stay that way, Doc.”
    Click
.
    I handed the phone back to Milo.
    He said, “Heartwarming,” and hummed a few bars of “Auld Lang Syne.”
    Millie Rivera said, “Casagrande may be charming but he’s suspected in at least five murders. Doctor, you’ve got to be the luckiest man in L.A County.”
    Milo said, “Let’s keep it that way. Now tell us every goddamn thing about this goddamn crazy lunatic who decided you don’t deserve to breathe anymore.”
    Crazy lunatic
. Redundant. It wasn’t the moment to get finicky about grammar.
    I said, “A thousand down? How much more to complete the job?”
    “Four,” said Millie Rivera.
    “Five measly gees to snuff you out,” said Milo. His green eyes were hot. His pallid, pockmarked face was tight with rage.
    I couldn’t help thinking some of that was directed at me.

CHAPTER
10
    Back when I worked at Western Pediatric Medical Center, my main job was helping children with cancer and their families. But soon I began getting consults from departments other than Oncology, most frequently Endocrinology. And when I switched to private practice, Endo referrals continued.
    It’s a natural pairing. Glandular and metabolic disorders—growth problems, puberty issues, juvenile diabetes—pose obvious emotional challenges. Diabetes adds an additional hardship because it requires a level of patient compliance—monitoring blood sugar, regulating diet, injecting insulin—that anyone would find tough, let alone a kid.
    When diabetic children become teens, it can really get hairy, because adolescence is all about identity, differentiating yourself, breaking away from authority figures. Which isn’t to say that all diabetic teens act out medically. Many ease into mature self-management.
    Others are like Efren Casagrande.

    He came to me as one of those last-resort panic referrals, a fourteen-year-old “exceptionally brittle” diabetic who needed to draw blood multiple times a day and control his food with a level of precision that would faze a competitive bodybuilder. Diagnosed at age eight, he’d been reasonably compliant until the onset of puberty, when his attitude shifted to “Fuck this shit,” and he simply stopped cooperating.
    During the past half year, he’d ended up in the E.R. thirteen times, had nearly died twice.
    His doctor tried to talk sense into him.
    Efren listened attentively, claimed he understood.
    Blithe lie.
    The same applied to pleading by his mother, two older sisters, an aunt who worked as a health care aide and was deemed the family medical guru, a hospital social worker named Sheila Baxter who was damn good and had accomplished wonders with other patients.
    Three days after assuring Sheila he’d changed his ways, Efren ended up in a near coma.
    She called me the day he was discharged. “Got time for an interesting one, Alex?”
    “Anything you can’t handle has to be interesting.”
    She recited the history wearily.
    I said, “Want me to be brutally honest?”
    She sighed. “Hopeless?”
    “I’m always hopeful, Sheila, but I can’t perform magic.”
    “No? Isn’t that what mental health’s all about? Spells and incantations and head-shrinking voodoo hexes? Heck, Alex, maybe I should break out my Tarot deck, couldn’t be any less effective than I already am.”
    I said, “The lightbulb.”
    “I know, I know, it has to want to change. Which is fine when we’re talking naughtiness in school. But this kid—and he’s personable and bright when he’s not screwing up—is going to die soon.”
    “I’ll give it a shot, Sheila.”
    “That’s all I can ask for. And guess what? This family can pay, I’m not asking you for charity.” A beat. “Which leads me to something else about the family. They’re intact in an official sense but the father hasn’t been around for a long time. He