back of the head and pain behind the eye sockets. He’d also have had palpitations, flushing, nausea, and sweating. Then, if he didn’t get immediate treatment, intracerebral bleeding, a stroke, a burst aneurysm, or whatever, to finish him off.”
“It doesn’t sound like a pleasant way to go,” said Sandra.
“No,” said Miller, shaking her head sadly. “If he’d gotten to a hospital, five milligrams of phentolamine would have saved him. But if he’d been alone, he could easily have blacked out.”
“Had Churchill been your patient long?”
Miller frowned. “About a year. See, Rod was in his sixties. As often happens, his original doctor had been older than him, and he died last year. Rod finally got around to finding a new doctor because he needed his Cardizone prescription renewed.”
“But you said you were treating him for depression. He hadn’t come to see you specifically for that?”
“No—but I recognized the signs. He said he’d had insomnia for years and when we got to talking about things, it seemed clear that he was depressed.”
“What was he sad about?”
“Clinical depression is a lot more than just being sad, Detective. It’s an illness. The patient is physically and psychologically unable to concentrate and he or she feels dejection and hopelessness.”
“And you treated his depression with drugs?”
Miller sighed, picking up the implied criticism in Sandra’s tone. “We’re not stringing these people out, Detective; we’re trying to get their body chemistry back to what it should be. When it works, the patient describes the treatment as being like a curtain drawing away from a window and letting the sun in for the first time in years.” Miller paused, as if considering whether to go on. “In fact, I give Rod a lot of credit. He’d probably been suffering from depression for decades— possibly since he was a teenager. His old doctor had simply failed to recognize the signs. Lots of older people are afraid of having their depression treated, but not Rod. He wanted to be helped.”
“Why are they afraid?” asked Sandra, genuinely curious.
Miller spread her arms. “Think about it, Detective. Suppose I told you that for most of your life your ability to function had been severely impaired. Now, for a young person like yourself, you’d probably want that fixed—after all, you’ve got decades ahead of you. But older people very often refuse to believe they’ve been suffering from clinical depression. The regret would be too much to bear—the realization that their lives, which are now almost over, could have been so much better and happier. They prefer to shut out that possibility.”
“But not Churchill?”
“No, not him. He was a Phys. Ed. teacher after all— he taught high-school health classes. He accepted the idea and was willing to try the treatments. We were both upset when the reversible inhibitors didn’t work for him, but he was game for trying phenelzine—and he knew how important it was to avoid the wrong foods.”
“Which are?”
“Well, ripe cheese for one. It’s full of tyramine as a breakdown product of the amino acid tyrosine. He also couldn’t eat smoked, pickled, or cured meats, fishes, or caviar.”
“Surely he’d notice if he was eating any of those things.”
“Well, yes. But you also get tyramine in yeast extract, brewer’s yeast, and meat extracts such as Marmite or Oxo. It’s also in hydrolyzed protein extracts such as those commonly used as a base for soups, gravies, and sauces.”
“Did you say gravies?”
“Yes—he should have avoided them.”
Sandra fished in her pocket for the small, stained slip of newsprint—the receipt from Food Food for Rod Churchill’s last supper. She handed it across the glass desktop to Dr. Miller. “This is what he ate the night he died.”
Miller read it, then shook her head. “No,” she said. “We talked about Food Food the last time he was in. He’d told me he always ordered their low-calorie gravy—said he’d checked and that it was free of anything he was supposed to avoid.”
“Maybe he forgot to specify low-cal,” said Sandra.
Miller handed back the printout. “I doubt that, Detective. Rod Churchill was a very meticulous man.”
TEN MINUTES EARLY, Becky Cunningham arrived at Carlo’s. Peter got up. He didn’t know what kind of greeting to expect: a smile, a hug, a kiss? Turned out he got all three, with the kiss being a lingering nuzzle of his cheek. Peter was surprised to find his heart racing slightly. She smelled terrific.
“Petey, you look wonderful,” she said, sitting down in the chair opposite him.
“So do you,” said Peter.
Actually, Becky Cunningham had never been what one would