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that first-hand. She didn’t want to lose her son.”

“Is that why you prescribed the medication to her and not him?” Josie asked.

“She didn’t want him to have the stain of taking those kinds of drugs so early in life. It was easier, fewer questions asked, if I prescribed them to her rather than to a young boy. There are also drugs and certain combinations of drugs I could not prescribe to a child, but could to an adult. We had to take some extraordinary measures to bring Rory to a place where he was functioning without violent outbursts. She was always afraid that if even one person saw him when he was at his worst, they would call the authorities, and he would be placed into the state system, and out of her reach, especially given her history of having her license revoked.”

“That’s why she was so secretive about him?” Noah asked.

“If you were in public somewhere, and your son began punching and slapping your younger daughter, shaking her, pushing her down, pulling at her limbs and saying things like, ‘I’ll find the knives and stab both of you to death. I’ll cut you into pieces. I’ll kill you,’ do you think people around you would walk on without doing anything?”

“Probably not,” Josie said.

“As I said, Rory could not control these rages or impulses. Just because they were out in public didn’t mean he would behave. If violent ideations overcame him, he would try to act on them. He once beat Holly bloody in the car on the way home from the playground. I believe that was the last time Lorelei ever took him out in public.”

Noah said, “It didn’t bother her that he was hurting her other child?”

“Of course it did,” Buckley said. “But what was she to do? They’re both her children. Both her responsibility. She wanted to protect both of them.”

“She thought she could save Rory,” Noah said, a slight edge to his voice.

“Noah,” said Josie.

“I’m sorry,” he said to Buckley. “I’m trying to understand. How do you protect both children when one of them is trying to kill the other?”

“Well, that’s just it, isn’t it? It’s an impossible situation. Both are your children. Must you choose? If you choose the one who doesn’t have psychological issues, then what do you do with the afflicted one?”

“Lorelei didn’t feel she had a choice,” Josie said softly.

“She loved her children,” Buckley said. “Intensely and passionately. More than anything or anyone else in the world. Holly could be insulated from harm to a large degree with an effective safety plan. But Rory was more difficult to protect. Lorelei felt she had to keep him away from a world that would not understand or accept him. She did not want a repeat of what had happened with her last patient.”

Josie and Noah were silent for a long moment, taking in this information. Then Josie said, “Holly’s autopsy showed chronic signs of physical abuse. It was from Rory. Not from Lorelei or the children’s father.”

“Correct.”

“You and Lorelei weren’t able to manage his violent behavior,” Noah said. “Not if there were still safety plans in place in the home. What was Lorelei’s long-term plan for Rory? He couldn’t stay there in the woods with her forever.”

“I often asked her that myself, but she was so exhausted and frazzled from being in a constant state of crisis with him, I don’t think she had thought that far ahead. I think she truly believed she could get him to a place where he would become high-functioning and non-violent. It’s certainly possible. One should never count these children out. But treatment is difficult. It’s very complicated. With these kids, it’s often like throwing spaghetti at the wall and seeing what sticks.”

“That’s reassuring coming from a psychiatrist,” Josie said.

Buckley laughed. “I only mean to say that every person is different. What might work for one, might not work for another, even if they’ve got the same diagnoses. As I said, I suspect Rory had several comorbidities, and some we hadn’t yet fully addressed. With someone who is in almost a constant state of crisis, you’re always trying to put the fire out, and it becomes more and more difficult to find the time to look beneath and address all the things that continue to cause those fires in the first place. We did not learn to manage his violent behavior in the sense that we made it go away forever. It may never go away. But we managed to get him to a point where his outbursts were less frequent and less intense, where he had more control over them. Lorelei and her girls had a safety plan for when Rory would act out. Also, to my knowledge, he rarely hurt the younger one. What was her name?”

“Emily,” Josie supplied. “Have you met her?”

“Only twice, very briefly. Years ago. She was probably too young to remember me.”

“The safety plan,” Josie said. “Would that involve hiding? Keeping all dangerous or sharp objects away from Rory?”

“Yes, indeed. I had brought Rory here again when he was a bit older after some particularly violent episodes with Holly. His meds needed to be adjusted. Lorelei said she was going to convert her bedroom closet into some sort of hiding place for the girls to go while I had him here with me. After I sent him home that time, I didn’t hear from her again, other than to check in and refill Rory’s meds.”

“Does Rory have OCD?” Josie asked.

“Rory has many diagnoses, but no, that’s not one of them.”

Noah said, “You said you haven’t had contact with Rory for several years now, but you think that he killed Lorelei?”

“It would be the most obvious explanation. The last time I saw him, I believe he was starting to experience hallucinations as well as paranoid delusions. I spoke with Lorelei about it, but she believed she could still manage him with medication and her own efforts. However, I do not believe that Rory

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