“Why? Because you were once a drug addict yourself? That gives you all the authority here? It’s been my opinion, Lou, that your past experiences don’t help your judgment. They cloud it.”

“John didn’t need psychotherapy, if that’s what you’re getting at,” Lou said. “He needed to get sober and to keep going to meetings, and that’s what he was doing.”

“Until he killed seven people. I can’t think of one of your cases that shouldn’t have involved some degree of psychotherapy,” Filstrup said. “I conducted a thorough review of your clients, including ones from before I joined the PWO. You recommend a comprehensive mental health course of treatment less than ten percent of the time in your substance abuse cases.”

“Because that’s not the way we’re going to get their licenses reinstated,” Lou said, feeling heat beginning to scorch the back of his neck. “Psychotherapy can drag on and on, when recovery is no farther away than attendance at meetings and adherence to the principles of AA, the first of which is that you can’t drink. There may be other approaches and programs that will get drunks sober, but this is one that I know works. That’s why I haven’t gone out of my way to recommend any others.”

“So John Meacham is a success by your standards?”

Lou took in a sharp breath.

Here we go.

“No,” he managed, no longer able to cull the strain from his voice. “Obviously, something went terribly, terribly wrong with John. But I was monitoring him, Walter. He was doing everything required of him. He was happy and productive. We never got a positive on his urine tests. This wasn’t about alcohol.”

“My point exactly, Welcome. This is a straightforward mental health issue. It always was.”

Redonkulous.

Cap’s portmanteau popped into his head. The boxer was right, and so was Filstrup. And so, for that matter, was he. Meacham was crazy at the moment he fired those shots—absolutely insane. But something had created the insanity, and it was nothing that Freud or Jung or any therapist could have couched out of him.

“We have an obligation to protect the public from doctors who pose a danger to their patients,” Filstrup was saying.

Lou shook his head in dismay. “No, Walter,” he said, “that’s what the board of medicine is for. Of course we need to pay attention to that, too, but we also have an obligation to our docs. Sometimes we’re all they have—the only ones who are going to give them the benefit of any doubt. The only ones who know and can vouch for the extent to which they are recovering from their illness.”

Filstrup had had enough. “John Meacham did not receive proper treatment,” he said, “and that’s exactly what I told the PWO board.”

Ka-boom! Ka-pow! Dr. Louis Francis Welcome, exit stage left.

“I don’t believe I’ve ever seen you move this definitively on a case, Walter,” he said.

“Now that’s the wise-ass Welcome I know. It’s elementary, my dear Watson. You didn’t follow my recommendation. You went out on your own, like you always do with anybody who has a drug and alcohol problem. And now you are up to your glutes in casualties and disgruntled board members.”