I received a digital ARC from the publisher via NetGalley in exchange for an honest review
It seems an improbable coinsidence, but this is the story of Dr. Benjamin Gilmer, who begins practicing in Cane Creek, North Carolina, essentially taking over for Dr. Vince Gilmer - no relation. The men are not related, but their lives will become entwined in ways that the former never could have imagined. This is due to the fact that the latter shocked his rural community by committing a terrible crime - murdering his father.
Prior to the crime, Dr. Vince was deeply loved by his patients and community. He went out of his way to provide exceptional care, going above and beyond what would be expected. Dr. Benjamin repeatedly hears from these patients, who are now his, how they could not believe Dr. Vince was capable of something so terrible, and this serves as the basis to draw him into the case and as Dr. Benjamin looked into it more and more, that something was not right.
These facts are not in dispute: In 2004 Dr. Vince picked up his father from the assisted living facility where he stayed. He then strangled his father, cut off his fingertips, and dumped the body. On top of all that, Dr. Vince then went about his daily life, showing up to his clinic the next morning for another day with patients.
So ten years later, Dr. Benjamin arrives in Cane Creek and as he learns more, he is determined to find out what really happened. He can't reconcile the portrait painted of Dr. Vince by his former patients with the convicted murderer who was sentences to life in prison for the brutal crime.
When Dr. Benjamin finally works up the courage to visit Dr. Vince in prison, he is shocked as to who he finds sitting across from him. Dr. Vince is suffering from a combination of disabilities that could have contributed to his committing murder. The disabilites are both mental and physical, and to Dr. Benjamin it is clear that Dr. Vince is mentally unwell. Yet others dismiss this as him attempting to wiggle his way out of his lengthy prison sentence.
Yet Dr. Vince is receiving no medical care in any way, shape or form. The book is as much as an indictment of our incredibly shitty treatment of those with mental illnesses who are trapped in the endless cycle of being in and out of the prison system.
Dr. Benjamin uncovers several things that could have contributed to Dr. Vince "snapping". As a child Dr. Vince was sexually abused by his father and as a result had PTSD. On top of that he had recently suffered a traumatic brain injury. We also find out that shortly before Dr. Vince murdered his father, he stopped taking Lexapro cold turkey, which I understand is a terrible thing to do. I take Lexapro to help combat my a-typical anxiety/stress-induced migraines (they're awful, like, SERIOUSLY. They're in the same spot and when one comes on, it feels like the whole right side of my face is melting). My doctor made it very clear that missing a dose would not be good, and starting it I only took half a pill before working up to the full one. And when I went in for a med check the following year, we agreed coming off the Lexapro in the beginning of a global pandemic would not be a good idea.
The whole point of my sharing this is to show how powerful drugs like Lexapro are. Dr. Vince talked repeatedly about feeling like there was something wrong with his brain prior to him stopping the meds, and the murder. In fact, Dr. Vince chose to represent himself at his trial - something that should have also been a major red flag that something was not right in his head. Instead people just assumed that he was using it as a way to get out of a guilty verdict.
Dr. Vince uses the term SSRI brain as his defense. This was something I looked into more in-depth outside the book and it basically means the brain is attempting to withdraw from the med that it no longer has access to.
Dr. Benjamin visits Dr. Vince several times as he comes to believe that Dr. Vince has some pretty severe brain damage. At one point he brings a colleague he agrees that something is not right. He notes several symptoms - tics and tremors, difficulty walking - that could indicate Huntington's. Add to this the statements Dr. Vince made about his brain "not working", and it makes sense.
It will probably not surprise you to find that after finally securing the genetic testing needed to get a diagnosis, that Dr. Vince does in fact have Huntington's. If you are unfamiliar with this degenerative disease, it is devastating. Huntington's causes a breakdown of nerve cells in the brain. This in turn impacts a person's whole ability to live, from physical movement to cognitive functioning. It is a disease for which there is no cure, only treatments that can make the patient as comfortable as possible until dying a horrific, painful death.
Dr. Benjamin spent the next several years working tirelessly to advocate for Dr. Vince to get the treatment he needed, in an appropriate placement; prison was clearly not the right place.
In the end, this is a deeply fascinating and moving story that demands attention. Highly recommended.