“We know a few things,” said Manlow. “But you’re right, there’s much to be done in the way of establishing criteria for success. And let me assure you that anything approaching the seventy percent figure is likely to be either an outright lie or based exclusively on self-report, which is a fancy term for bragging. That’s not to say most facilities are moneymaking rackets, though some are. It’s really the nature of the beast that we stalk: Addiction isn’t a sin nor is it simply a set of bad habits, though bad habits inevitably follow addiction. The crux of the problem is that when people get hooked on a narcotic substance, their brain chemistry changes. We can detoxify addicts during acute phases and we can teach them to reverse destructive patterns of behavior if they’re sufficiently motivated. But I’ve yet to see anyone claiming to undo the basic addictive biology.”

Milo blinked. Clicked his tongue. A signal I’d never seen before but decoding was easy. Take it, pal.

I said, “Sounds like a chronic disease.”

“Precisely, chronic care is the best-fit model,” said Beth Manlow.

“And this relates to Steve Muhrmann because—”

“I gave you that little speech because I need you to be realistic about what I can tell you. We are one of the best facilities in the country but we do not turn a profit, nor do we aim to. Awakenings was started by a man who lost two children to addiction and sought to prevent the same tragedy in other people’s families. Solon Wechsman passed away five years ago and left an endowment that funds this place, but only partially. I was hired after he died and a bit of financial freedom allows me the luxury of brutal self-appraisal. Our success rate—accurately determined—is thirty-six percent. It may not sound like much but I think it’s pretty good. It’s like being an oncologist—a cancer specialist. If you’ve allowed someone several constructive years, you’ve accomplished something important.”

“You’re saying Steve Muhrmann was one of the sixty-four percent.”

“I can’t talk about him or any other patient specifically. But I won’t tell you you’re wrong.”

“Did he create special problems when he was here?”

She shook her head. “I can’t get into details.”

“Can you say what he came to you for?”

“All I’m going to tell you is that for the most part patients come to us volitionally. But a few are sent to us.”

I said, “Muhrmann had a couple of DUIs and the court imposed treatment.”

“In a perfect world,” said Beth Manlow, “everyone would have sufficient insight to know when their engines needed a tune-up. In our world, some cars need to be towed in.”

“Have you found any difference between mandated patients and those who come on their own?”

“My preliminary data say there is a difference.”

“Court-appointed patients are more problematic.”