When he returned to school the next Monday, Timothy received a small amount of sympathy from a few people because of the brace on his arm, and he even got some admiring comments from a few of the less savory school types for the damage he had done to the window that he had struck.  He had no use for such recognition, though.  The first order of business for him had been to find Earl and apologize.  He plainly, and in the presence of others, stated that he had been completely in the wrong, that Earl had done nothing to deserve what had happened, and that he, Timothy, had deserved far worse injury and far worse punishment than he had received.  Earl had eyed him suspiciously at first, but he seemed convinced of the honesty of Timothy’s apology, and he accepted it.  That was good, as far as that went.  Earl even listened with interest as Timothy told him about the possibility of a brain tumor, and he seemed to be honestly worried on his behalf.

But their friendship never really recovered.  Earl stopped seeking out Timothy’s company, and though he didn’t rebuff Timothy when Timothy sought him out, he was plainly far from enthusiastic about his former good friend’s company.  Timothy, of course, could not blame him, and though sad, he accepted this as just desserts, and eventually left Earl alone.

He decided, in fact, to expand that policy to everyone else as well.  Since his temper had exploded even against—especially against—his own best friend, that meant it was not good for him to be close to other people.  He knew, from observation, from reading, from thought, that people were most likely to lose their tempers with the people with whom they were closest.  And he certainly couldn’t accept that outcome in his own case.

That began a period of self-imposed semi-ostracism for Timothy’s, one that went on through the rest of his high school career and on into post-high school education and employment.  He was never rude to people—at least he tried never to initiate rudeness—but he also never encouraged people who seemed interested in getting close to him.  He never invited anyone to go to his house after school, or to go to a movie with him, or to hang out on the weekends.  He never sought out nor responded to the advances of any other girls after Allison.  Even worse, in his mind, than getting involved with someone whose tastes ran to a kinky arousal in the face of Timothy’s anger would be the possibility of meeting some wonderful girl and falling in love…and then having his temper explode and be taken out on her, as his father’s temper had on his mother.  As with the case of the possibility of mass murder—something he had never actually contemplated—Timothy would rather die than accept the possibility.

All this was necessary because, unfortunately, the MRI of his brain found nothing at all abnormal.

Timothy really was disappointed by this result, though nearly anyone else would have been relieved.  As he was given the scrubs to change into, as he walked into the big, cool room with the MRI tube, as the little cage was put in place around his head to improve the imaging, Timothy felt no anxiety, no fear, no discomfort.  If anything, he was excited.  He was eager.  As his slender, teenage body slid easily into the narrow tube—after the tech or nurse or whatever had injected something into an IV placed in his arm—Timothy greeted the loud thumping and pounding of the machine as drums of celebration, the sounds of some primeval tribe doing a magic ritual first to locate and then remove the demonic thing that had begun to grow within his head.  He fantasized about meeting with Dr. Putnam, about being shown pictures of where the tumor was, his mother in the doctor’s office with him this time.  He fantasized about being referred to some famous neurosurgeon who worked on kids—he knew enough about medicine to know that Dr. Putnam would not perform such a surgery—fantasized about meeting the surgeon, who was socially awkward but had the manual skills of a brilliant pianist.  He fantasized about going to the hospital, where pretty nurses and candy-stripers sympathized with his plight, commenting on how brave he was, because he was able to tell them with complete honesty that he was not afraid at all.  He imagined returning to school, his head in bandages, greeted with close to awe by his classmates.  He imagined being reconciled completely with Earl, who could surely not help but admit that the assault that had happened before had been a medical problem, one that was now solved.

Alas, when he went to Dr. Putnam’s office the following week, missing school again, this time with his mother beside him, the doctor had told them with what he obviously hoped was unadulterated pleasure that Timothy’s brain looked perfectly normal.  Timothy’s mother had breathed a rather clear sigh of relief; whatever Timothy’s own fantasies, she had obviously been terrified of the possibility of her son needing brain surgery.

Dr. Putnam, looking across the desk in his office at them, had clearly been able to read Timothy’s expression, and he said, “I know you’re disappointed in a way, Timothy.  And I understand.  Like the pheo idea, a brain tumor is something that could be removed and with it the problem of your anger would have been solved.  But it actually is better this way.  I know you don’t know about it, but even the most successful brain surgery can have complications.  There can be permanent neurologic deficits, there can be seizure disorders.  Tumors can recur.  It’s not a good thing.”

Timothy heard him, and he understood his points, but he was not emotionally persuaded.  He felt dejected and dispirited, his hopeful fantasies dashed to pieces.  Still, trying to be manly about it, he grimaced and said, “So, what do we do now?”

Dr. Putnam’s smile of approval gave Timothy some consolation.  “Now,” the doctor said, “we go looking for other things—horses and zebras alike—and see if we can find a culprit that causes your attacks.  Because I honestly…”

He was interrupted by Timothy’s mother, clearly befuddled, saying, “Horses and zebras?  What are you talking about?”

“Sorry, sorry,” Dr. Putnam said with a placating raise of his hand.  “It’s a…private joke between me and Timothy.  It’s a way of saying ‘common and uncommon,’ basically.”

“Oh,” Timothy’s mother said.  Based on her look of combined puzzlement and disgruntlement, Timothy guessed that some part of her was wondering if Dr. Putnam himself was completely right in the head.

If Dr. Putnam recognized this, it didn’t seem to bother him.  He went on, “Anyway, I think it’s pretty clear that there is some…biological cause of your bursts of anger.  Because the way they’ve been described to me, they don’t completely match your personality in other ways.”

Timothy thought he knew what Dr. Putnam was getting at; it was similar to what the counselor, Ms. Gibson had said.  His mother, however, asked, “What do you mean by that?”

“Well, what I mean is, people who are violent, or who act out violently,” Dr. Putnam replied, “are often people with a…recognizable constellation of personality traits.  People—children and teenagers—who have problems with violence often have a general pattern of anti-social behavior of one kind or another.  This doesn’t mean they’re all budding sociopaths or anything along those lines.  Quite the contrary.  Many of them simply have problems adjusting, have social difficulties of various kinds, or home situations that are particularly problematic…that sort of thing.  Timothy is not at all that sort.  Though I know his father is no longer alive, you clearly provide a stable, nurturing home environment, and he gets good grades and has a good attitude about school, according to the report of his guidance counselor.”

Timothy felt himself blush a bit, though he’d known that Ms. Gibson had said many complimentary things about him in her initial referral.  His mother, he noticed, also seemed to find Dr. Putnam’s remarks nice to hear.  Timothy was glad.  He knew that life was hard for his mother a lot of the time, and she certainly didn’t get the thanks and recognition she deserved.  He, as a teenage boy, probably didn’t let her know often enough that he really appreciated her.  He made a mental note to try to do so more regularly, but such mental notes are easily mislaid.

Dr. Putnam went on, “What’s more, though he’s clearly gotten into some pretty serious fights, he doesn’t seem to have been involved in bullying anyone.  Nor, from what I can tell, has he ever been the victim of significant bullying.”

“Ha!” Timothy’s mother said, almost sardonically.  “No, you can definitely say that again.  Timothy’s particularly unwelcoming to bullies.”

Dr. Putnam looked surprised by this interruption, and he cocked his head and asked, “What do you mean?”

Timothy’s mother waved a hand, still smiling from the doctor’s earlier compliments, and she said, “Oh, nothing.  Just that…well, a lot of his fights, or whatever, seem to happen when he, or someone else, is getting picked on by someone.  Not all of them, obviously…not this last one…but a lot of them, going right the way back.”

“Interesting,” Dr. Putnam said.  If he had other, more particular thoughts about that observation, he didn’t express them, instead saying, “But you see my point.  Timothy’s acts of…of temper are not typical expressions of those who tend toward violence as young people, and his other personality traits are generally positive.  This makes me think there is some more…medical cause for the problem.”

Timothy’s mother, far from being a dummy, even in the face of some welcome flattery, said, “I hear what you’re saying, doctor, but…well, isn’t it just possible that they could be…true, true, and unrelated.  I mean, people are complicated, and can have lots of different parts to their personality, right?”

“Absolutely true,” Dr. Putnam said with a bright smile, obviously pleased by the question’s intelligence, even though it went against his main point.  “It’s entirely possible for a person to have a personality with seemingly contradictory parts.  Like Whitman said, ‘I am large, I contain multitudes.’”

“Song of Myself,” Timothy’s mother said, confusing Timothy mightily, but conjuring an even broader grin on the doctor’s face.  “I read that in college.”

“You have good memory and good taste, in addition to being a good mother,” Dr. Putnam said.  Timothy felt like saying, “Get a room, you two,” but he would have said it in an encouraging rather than a disparaging way.  It would have made him quite happy to think that his mother and Dr. Putnam might flirt and become romantically entangled.

Of course, then he looked at the doctor’s left hand a saw a wedding ring—he assumed it was a wedding ring, he didn’t see why a man would otherwise wear a plain gold band on his left ring finger—and his sense of justice rose up to block off even speculation about possible liaisons between the doctor and his mother.  Propriety would not allow him to encourage, even in his imagination, the doctor to be unfaithful to his wife, whoever she was.  If he thought Dr. Putnam was that kind of person, he would not want him as his doctor.

While Timothy’s mind bounced between the aspects of his own personality, Dr. Putnam went on, “But though you make a good point, and it may be true, I think we need to consider it a diagnosis of exclusion.  Meaning, we want to rule out all the other reasonably possible explanations before we let ourselves accept that one.  And not just because it’s one that’s harder to…well, to treat, I guess you could say, but also because it really does seem to me as though this…this anger of Timothy’s is something separate from the rest of his personality.”

Timothy’s mother smirked, and she said, “In the old days, you might sound like you were saying that you thought he was possessed by an evil spirit or something.  But I know what you mean.  Timothy’s father was…similar to Timothy that way.  He was a good man.  I married him, after all, and I’m not the sort of person who’s attracted to dangerous boys because they’re dangerous.”

This comment disturbed Timothy, reminding him of his brief relationship with Allison, but he was too intrigued by his mother’s words to dwell on it too much.  She didn’t often talk about his father, and Timothy’s memories of the elder Mr. Outlaw were mainly incoherent.

“He definitely wasn’t as smart as Timothy is,” his mother said, “but I don’t think his temper was quite as bad, either.  Which isn’t saying much, mind you.  It was plenty bad when it went off.  But it always seemed to go off in response to something, if you know what I mean.  Even those times when it…when he got violent with me, it was always after I said or did something that was at least a little bit…mean-spirited, I guess you’d say.  Not to say that I thought I deserved it, mind you.  I want to make sure that’s absolutely clear.  I’ve never done anything in my life to deserve being punched in the face by a man twice my size.”

This seemingly casual remark drew a raising of the eyebrows and a look of sympathy and almost shock from Dr. Putnam.  Timothy, too, felt a bit of a wallop.  He’d never heard his mother speak so openly about those occasions when his father had abused her.  He didn’t think he’d ever witnessed anything like what she had just mentioned, but he knew that she’d been hit by his father and had borne bruises and worse from such assaults.  He’d also known—even his younger self had recognized this—that his father had been horrified and guilty about such violence, that he’d been filled with self-loathing because of it.  Timothy had wondered, on more than one occasion, whether his father’s death had not been a completely random shooting in a bar fight, but had actually been, perhaps unconsciously, sought out, rather as Timothy had decided to kill himself if he ever felt that he was in danger of killing innocent people.

Dr. Putnam grimaced as though sharing the pain Timothy’s mother had felt when Timothy’s father’s fist had connected with her face in a rage so similar to Timothy’s own.  He said, “Tell me…did Timothy’s father ever…well, did he ever strike Timothy?”

“No,” both Timothy and his mother said at the same time.  They looked at each other and shared a tiny smile, then his mother repeated, “No.  No, he…I think he would rather have cut his own hands off rather than hit his own son…or any child, really.”

“Or put it through a window, maybe?” Dr. Putnam asked.

Timothy thought he might be trying to be funny, but his face was as deadly serious as it was surely possibly to be, and Timothy’s mother clearly took him seriously, and seemed to recognize his point.  “Well…maybe,” she said.  “I think that’s true.  I think if he’d been in a situation where he thought he was going to hurt Timothy, he would very much have put his hand through a window, or a wall rather than actually hit Timothy.  I don’t know why he didn’t feel so strongly about me, but…well, I’ve always been able to take care of myself pretty well, in general, so maybe he didn’t feel like he needed to hold back, or wasn’t able to hold back in my case.  And I did divorce him, after all.  To his credit, he never tried to fight me about it, or to threaten me or frighten me.  He wasn’t that kind of abuser, if you take my meaning.”

“I think I do,” Dr. Putnam said.  “And I think it all goes toward what I was saying earlier.  This anger, this rage, seems to be at least partly genetic, or at least congenital, and it’s clearly in conflict with the larger aspects of both Timothy’s and his father’s personalities.  The very similarities between them make me think that it’s not just a personality trait—or at least, I think that’s a less likely explanation.  I think it’s some more basic, some more physical process.  And if that’s true, then there may be ways to treat it.”

“Okay,” Timothy’s mother said with a shrug, “I guess I’ll go along with that.  But…it’s not a tumor, obviously, and I thank God for that, but if it’s not, then what is it?”

“It’s a fair question,” Dr. Putnam responded.  “We’ve looked for the most obvious, most easily-corrected things—at least from a certain point of view—to start with, which makes sense.  It’s like looking for your keys under a streetlamp because that’s the place you can see.  But if the keys aren’t there, you just have to bite the bullet and try to find where they really are, even if it means you’re going to have to grope in the dark a little bit.”

Timothy found the doctor’s tendency toward figurative speech a trifle irritating, but his mother seemed to follow without effort.  “That groping around can be expensive,” she said.  “I know it might be an interesting problem for you, and I believe you want to do what’s best for Timothy, but…well, insurance companies aren’t known for being so generous, even though they ought to be, considering their business.”

“Of course,” Dr. Putnam said.  “I understand your concern.  But I think that’s going to be the least of our worries.  I’m very good at arguing with insurance companies, usually because I know very well why I’m doing what I’m doing, and what the medical basis for what I’m doing is.  I’ve never yet lost an appeal with an insurance company on behalf of a patient.”

Timothy’s mother raised her eyebrows.  “That’s impressive,” she said.

Dr. Putnam shrugged, and he said, “I don’t tend to give up easily when I’m fighting on behalf of my patients.  The insurance people don’t have quite that strong a motivation.  And they don’t tend to have as thorough a knowledge of medical science, though there’s no good excuse for that last bit.”

“Okay, well, then, I’ll rely on your skill,” Timothy’s mother said.  “So, where do we go from here?”