Authors: Sandra Block
I
t could be complete bullshit, you know,” Jason says.
The next morning we are in the hallway, waiting for Dr. Grant to come out of a patient room.
“Pshaw!” Dr. A breaks in, looking up from his reading. I have never actually heard someone say the actual word
pshaw
before. “Who would lie about such a thing? No one in their right head.”
“Yeah,” says Jason. “That's the thing. I'm not sure we're looking at the poster child of mental health here.”
“It would explain a lot,” I say. “A possible fugue state. How she could have been pushed into killing her mother.”
“But why didn't she kill her father then?” Jason asks.
“He was already gone. He wasn't an easy target. And she felt like her mother abandoned her to him, so she had a lot of anger.”
He rolls his eyes. “I know this is heresy in our line of work. But what if she's just making shit up? I mean, really, she never told
anyone
all this before? Even when it could have helped her case? I don't buy it.”
I tap my fingers on the table, thinking. “She said she hadn't thought about it for years until she saw her brother. His presence appears to have unleashed a torrent of memories.”
“What about the sister, what does she say?”
“MIA.”
“Still?”
“Yeah. We found Jack in, like, two seconds, but the sister appears to be lost in social-services-land somewhere.”
Jason shrugs. “What did you say to the patient?”
“Not much. I gave her an out. Told her everyone would understand her killing her mother under such circumstances. I mean, some asshole rapes his fourteen-year-old daughter, there's bound to be consequences of some sort.”
“Yeah,” Jason agrees. “I just don't buy that it ends up in you killing your mother.” He straightens out his bow tie, a purple that perfectly complements his lavender shirt. His bangs stand up stiff and glossy, as if on guard for his forehead.
“Nice tie,” I say.
“Thanks. But do you think it makes me look gay?”
I titter, and Dr. A shoots us a look, then dives into his book again. He is memorizing the DSM V. I don't mean he is just reading it closely. He is actually committing it to memory. “It is quite annoying to keep having to look things up in the book” was his comment when I expressed some astonishment at the prospect.
While we're waiting, one of the patients pokes his head out of his room into the hallway. He is about sixteen, skinny and white, dressed in urban clothes with baggy jeans and his baseball cap sideways. “Hey, you got a clicky pen? Anyone got a clicky pen? Clicky pen?” He's jonesing for a clicky pen like he's dope-sick.
“Um, sure,” says Jeff, the new medical student. He looks a lot like Kevin, the other medical student, and I keep mixing them up. He hands him a pen before the nurse can jump in.
“Oh, thanks, man!” the patient yells, escaping back into his room.
“Sure, no problem, man,” Jeff/Kevin answers.
The nurse glares at him. “You didn't just do what I think you did, did you?”
“Um,” he says, wondering where exactly he made his error. A medical student's life is full of these moments. And to be fair, her questions did have a lot of “dids.”
“A clicky pen?” she asks.
“Uh, yeah. Well, I mean, he asked, so I didn't think it was a big deal or anything. I mean, was Iâ¦Was I not supposed to give him one?”
She points to the large handwritten sign drawn in blue Magic Marker on the door: No Clicky Pens, with pink highlighting around it and additional yellow highlighter arrows pointing to i
t
like a huge traffic signal.
“Oh,” he says, crestfallen. “Sorry. Do you, I mean, do you want me to go get it back from him?” Jeff/Kevin's face has turned so red that he looks like a tomato. Cartoon character embarrassed.
“Don't worry about it,” I say, feeling sorry for the kid. “We'll get it later, when we visit him.”
“Good luck with that one,” the nurse snorts. And I can only guess what that means.
Dr. Grant emerges from the room next door. “Change the Valium to q six please,” he says to the nurse over the divider. “The tremors are going down.” He looks down the row of rooms. “So who's our next victim?”
“I'm, uh,” struggles Jeff/Kevin. “We have Mr. Curtis Smith, sir.”
“No need to call me sir.”
“Yes, sir. Dr. Grant, sir. Dr. Grant, I mean. Just Dr. Grant.”
Inwardly I sigh. I can tell Jason is inwardly sighing, too.
“Okay, fine. Tell us about Mr. Smith.”
“Yes.” He pulls out an index card. “Mr. Smith is a seventy-five-year-old white male with a history of hypertension, sleep apnea, and diabetes, who presents with an exacerbation of schizophrenia.”
“Okay.”
The clicky-pen man steps out of his room for a second, spies the nurse, and motors back into his room.
“Yeah, okay,” says Jeff/Kevin, trying to stay on track, red splotches creeping up his neck like a vine. “He has been stable for some time in an assisted living facility, but recently he thought the TV was giving him a secret message that he was Jesus.”
“Jesus?” Dr. Grant asks.
“Yes, Jesus,” he confirms. Mr. Smith is a bit late on that one. In December, you tend to get a lot of folks coming in here on the off chance that they might be Jesus. In January, not so much.
“Yes, all right. Any violence or aggression?”
“No,” the medical student adds. “Just became very insistent with the staff and started writing messages all over his room about the Ten Commandments.”
Wrong testament, I think but don't say.
“So.” Dr. Grant looks over to Dr. A, who is overseeing the medical student on the case. “Dr. A, is this a typical presentation for schizophrenia?”
Dr. A nods vigorously. “Indeed, Dr. Grant. Delusions of grandeur such as believing you are God and ideas of reference such as the television having a conversation with you are quite typical and, in fact, in some ways characteristic of this disorder.”
“Code Blue Emergency Team A. Code Blue Emergency Team A” pipes into the hallway. The operator's voice has a forced calm. Jeff/Kevin looks out toward the hall wistfully. I remember those days, running down the hallway, heart squishing in my chest, pulling out my Advanced Life Support card so I got nothing wrong. I have never been a cowboy. I did not enjoy barking orders, pushing IVs, leaning over my patient and rhythmically pushing my hands over a brittle sternum, face going blue before my eyes, and knowing, despite what they show in Hollywood, that the person was not going to live. I could never live Mike's life. Just as, I suppose, he could never live mine. Mike, who hasn't texted since I turned him down for dinner and gave me the curtest of nods when we passed each other in the ER last week. So someone else is in the picture, or he got tired of chasing the six-footer.
“All right,” says Dr. Grant. “In full agreement. Shall we?” He points to the room, and we file in like geese following our mommy. Mr. Smith is pacing the room, muttering. He walks about two feet, his hospital slippers nearly coming off his cracked heels with every step, then raps with some violence two times on the window, then turns and repeats, like some endless hellish loop. His beard is scraggly, gray-black, and matted.
The medical student looks on with some degree of horror. Ophthalmology, I'm guessing. Jason is sprucing up his bangs.
“Hello, Mr. Smith?” Dr. A says. The patient keeps pacing in his worn track, not even looking up. He does wave him off with some annoyance, so at least we know he can hear us. “How are you doing today, Mr. Smith?” Dr. A asks, increasing his volume as if hearing loss were the issue here. “How are all of the things going for you?”
“What are his meds?” Dr. Grant asks.
“Abilify, ten. Humalog, Cardizem, and Inderal.”
“Has he ever been on Haldol?”
Dr. A scans the chart. “Briefly, about five years ago. There was some concern regarding tardive dyskinesia.”
“All right.” Dr. Grant spins to me. “Would you put him back on it?”
I shrug. “I'd go up on his Abilify first.”
“Jason, how about you?”
“I agree with Zoe.”
“Dr. A?”
“Yes, I would also tend to agree on this treatment plan.”
Dr. Grant looks at the medical student, who swallows, Adam's apple rising. “Me, too.”
“Then we are agreed. Go up by five milligrams today, then go to a full twenty tomorrow.” We leave the room, the patient ignoring us. Dr. Grant turns to me. “Any more news on Sofia?”
“Nothing more,” I say. “She's still very definite on the sexual abuse from her father.”
He gives a terse nod and marches down the hall. “Quite classic. Memory suppression due to trauma.”
“Yes, butâ”
“But what?” He turns back to me.
I hesitate. “I don't know. On the one hand, it makes sense forâ¦everything really. But on the other hand⦔
Dr. Grant stops short. “On the other hand?” he asks, staring at me. “There is no other hand, Dr. Goldman. If she says her father raped her, we have to assume that's what happened. Are you telling me you don't believe her?”
I swallow. “Not exactly.”
Jason, who argued with me a minute ago that she might be “making shit up,” is now steadfastly avoiding my gaze.
“Dr. Goldman, I know your patient has done someâ¦unsavory things in her past. But she
is
your patient. For better or worse. And that means treating her as such.”
I nod, chastened.
“And unless you can prove to me that she poses a direct threat to herself or anyone else, you need to start thinking about a discharge plan. And you need to start thinking about it now.”
Dr. Grant starts down the hall again and I walk fast to keep up with his angry stride, my face burning hot. So that answers that. According to Dr. Grant, Sofia Vallano is cured, right as rain, ready to go out and become a productive member of society. She'll never hurt anyone else, ever again.
And maybe he's right. But what if he's wrong?
T
hat evening, Mom is waiting for us in her wheelchair by the large, rectangular French window in the lobby. The window frames a patch of dark sky, a few planets tentatively peeking out before the stars steal the show.
We're shaking clomps of snow off our boots on the black rubber entryway rug when she spots us and points, a smile filling up her face. “My kiddos!” she sings out.
Scotty smiles back, and we exchange our weekly hugs. We wheel Mom back to her room through reams of red hearts and lacy doilies running up and down the hall. With the rose-pink walls, it looks like Valentine's Day on steroids. Fat, half-naked angels are aiming their bows at us, though it's not even February yet.
“How's the Frenchman?” she asks as we cross the threshold to her room. Speaking of stupid and Cupid. Scotty smirks because he just can't help it.
“That's over, Mom,” I say. I have told her at least ten times already.
“Oh,” she says. “Okay, what about that other nice boy? The hockey fan.”
“No, Mom. Nothing happening there.”
Scotty double smirks. My mom takes her usual seat in her rocker, old lilac afghan hugging her shoulders. Scotty turns on the TV and puts his enormous, shiny, lime-green-sneakered feet up on the mahogany coffee table. Those sneakers probably cost him a week's pay. We are watching the news on CNN, though none of us are really watching, just some noise to drown out the beeping and moaning in the other rooms.
“So how's the Frenchman?” my mom asks again.
“What did you do this week?” I ask her, remembering the social worker's advice: “Try not to challenge, just redirect.”
“I met a very nice man, actually,” she says, her face lighting up.
“Really?” I say. Even Scotty turns to look at her.
“Tom Burns is his name. Tom Burns.” She says the words like they are a delightful mantra. “âIf I weren't a married woman, Tom Burns,' I told him. âYou'd be in some serious trouble.'”
“Yeah, but Mom, Dad'sâ”
She shoots me a frightened look, all glow fading away. “Dad's what?”
“Nothing,” I say. It's just not worth it. “Just that Dad would like you to have friends.”
“Yes.” She nods thoughtfully. “I think so, too.”
Graphs zip up onto the TV screen with a loud, overdramatic announcer explaining them. Basically, red line for Republican, blue line for Democratic, and ne'er the twain shall me
et
.
“Oh, I made something,” Mom says, grabbing on the top of her dresser. She hands me a hot pink felt pillow. The white cotton stuffing is pouching out, with black Frankenstein stitching holding it together. It reads “I Love You” in glittery silver glue. “It's for you,” she says.
“Wow,” I say. “It's beautiful, Mom.”
“Not for Tom Burns?” Scotty asks, teasing.
“No, I made him a purple one.”
“Oh.” I laugh. “So I know where I stand.”
A commercial breaks into the show. A woman is looking forlornly at the residue on her just-washed dishes. I wish I had the time for such nonsense. The woman finally gets the right product and does a huge leap into the logo. Bored, I grab my mom's yearbook off her shelf again and start thumbing through the pages. I zero in on the picture of her and Beth, with the pink highlighter encircling it, then flip forward to the class pictures to find out this Beth's name, at least, and land on the group photo: a big mass of smiling faces with halos of windblown hair. It looks as if they took the picture in the fall sometime, outside on the football bleachers. Some of the boys look short and ten years old, others appear eighteen and muscular, ready for battle. Girls sit bracing against the wind, in various stages of maturity and social disarray. Some will go on to be doctors, lawyers, social workers. Others, too depressed to get out of bed in the morning, will be drunk by noon. Some could even end up on the couch in my office someday.
I scan the blurb of faces for names and I find my mom, curly side of her hair blowing into her face, and Beth right next to her. Scanning down to the names, I see Sarah Meyers, my mom, and next to her Beth Summers.
My breath catches. Beth Summers.
Beth Winters is my birth mother, Mom's other best friend. And her high school best friend is Beth Summers?
This seems perilously coincidental.
The rocker creaks away as the newest headline crawls along the bottom of the screen. My knees feel rubbery, and I slump back down on the corner of the bed, wrinkling her quilt. Maybe it is just a coincidence. They are different names after all, different people.
“Hey,” Scotty calls to me, mouth full of pear from my mom's fruit bowl. “What's up with you?”
“Nothing,” I say, my mind racing a million miles.
“You look kind of pale or something.”
“Just tired.”
“She works too hard, Scotty, don't you think so?” says my mom in a worried voice.
“She can't help it,” answers Scotty, taking another chew. “It's like a disease.”
Out of nowhere I think back to my college roommate, Natasha, who was majoring in psychology. She was the artsy type, with purple hair and black dresses, when everyone else was wearing jeans. We got in a debate over dinner one night over Jung (this passes for fun among us Ivy Leaguers), and I was arguing that what she called “Jungian synchronicity” was actually just a matter of coincidence.
“Ah,” she said. “But that's where you are wrong. There is no such thing as coincidence.”
Beth Winters. Beth Summers. What if Natasha was right?
I swallow. “Mom, do you know a Beth Summers?”
She stops rocking and stares straight at me, twirling the balled-up tassels of her blanket in her fingers. “Who told you about Beth Summers?” she demands in a whisper, almost a hiss.
Scott looks away from the TV and up at me. “What's going on, Zoe?”
“Nothing,” I say, to tone down the tension in the room. “Beth Summers. She's in your yearbook. See?” I point to the open copy on my lap, and she lunges for it, falling onto her knees. The yearbook slaps onto the ground, my mom grabbing after it, her afghan tumbling off her.
“That's mine! Not yours!” she yells, gasping.
“Mom, it's okay,” I say, fighting the quiver in my voice. “I'll put it back.”
“No!” she screams, kneeling in front of the bed now, arms crossed over the book as if she is protecting her newborn from certain death. “Mine!”
“Mom, come on.” Scotty jumps off the love seat and helps her up by the elbow. “It's okay. No one's trying to get your stuff. It's your yearbook. We get it.” He guides her shakily back into her rocker, and she holds the yearbook on her lap with her hands guarding it, her knuckles a row of white knobs over the spine of the book. Her eyes are avoiding mine now.
Scotty gives me his best “What the fuck?” look and I answer with my best innocent eyebrow raise. But I know some way, somehow, I have to get my hands on that yearbook again.
*Â Â *Â Â *
Dr. Grant has asked me to arrange another conference with Sofia's brother, by phone if necessary, to discuss the incest allegations. He wants to wrap up all the loose ends before discharge. And despite being an overall believer in women not lying about being raped, I'm still not sure about Sofia. My intuition tells me that Jason could be right; she could be making it up. It would fit the narcissist-sociopath profile of her like a glove, a woman well schooled in the arts of manipulation and lying. But I have little to go on, except my intuition. And as Dr. Grant once sniped at me, “Just because you don't want to have tea with her, Dr. Goldman, i
t
doesn't necessarily mean she's a psychopath.”
Jack Vallano answers on the third ring, and I explain the situation to him.
He doesn't pause for a second. “She's lying!” he bellows. I have to hold the phone a couple inches from my ear.
“Okay,” I say. “That's why I wanted to talk to you about it.”
“I'm coming down there,” he says.
“You can do that. But it's not a hurry or anything. Nothing's being decided today.”
I can hear his fast breathing into the phone. Obviously he is disturbed by this news. Jason sits to my right, scrolling through an
Up-to-Date
article on electroconvulsive therapy. Green stripes from the screen reflect on his forehead. Dr. A has his face buried in the DSM V, his left hand tying one-handed knots with prolene string. I didn't know it was even possible to tie one-handed surgical knots, let alone with the nondominant hand, let alone while memorizing a five-hundred-page text.
“I knew she would try something like this,” Jack says.
“So, in your opinion, it didn't happen?”
“Didn't happen, couldn't happen. No way.”
I can't help but think back to what Sofia said: “Of course he won't believe me. I'm the big, bad boogeyman.”
“Listen,” I say. The medical student across from me flips through index cards of his patients, perfecting his presentations. It looks as if he's dealing from a deck for a poker game. “I'm not trying to convince you of anything. I just wonder⦔ I take a deep breath.
There is a long pause on the phone. “Go on.”
“Here's the thing: It would kind of make sense, if it were true. This is the kind of deep emotional trauma that can lead to a fugue state, even multiple personalities, in a child. Severe emotional stress leads the brain to break off from everyday life and go into another, safer world. It could even lead to murder.”
“Right.” Jack pauses to let this sink in. “I got to be honest with you, Doc. It sounds like a bunch of hooey to me.”
“Maybe. You might be right. But it does sort of make the unfathomable more, well, I don't know, fathomable.”
Jack sighs into the phone. “You know, Dr. Goldman, we all want to understand things. I get that. It's human nature. Even cavemen wanted to understand the world. But as much as we want to attach meaning to things, and nothing against your profession but that seems to be the main purpose of it, some things are
not
fathomable. Some things are just plain, unfathomable
mysteries.”
“Maybe so,” I answer. I haven't had enough coffee for a philosophical discussion this early in the morning. “I think she might be telling the truth. But to be honest, I'm just not sure.”
“And why do you think she is suddenly remembering this? Isn't that just a bit odd?”
“Actually, she says it was always there, in the back of her mind. She just didn't want to think about it. I don't think she fully believed it herself.”
“So what's changed her tune now?”
I pause. “She says it was seeing you.”
“Oh, right. And how did that work exactly?”
“I only know what she says. But she says you bear a striking resemblance to your father, and seeing your face brought it all back.”
“How convenient.”
“Maybe,” I hedge again. “But again, not unheard of.”
Dr. A has switched hands. His fingers arch in a blur. Jason is showing the medical student his patient's CAT scan. I can't help but glance over. Lots of atrophy, no big lesions. “Does he have boxcar ventricles?” the medical student asks. “Nope,” answers Jason, tracing the caudate nucleus. “Just plain schizophrenia.” The medical student looks disappointed.
“Do I get any kind of say in this whole matter?” Jack asks.
“Of course. That's why I'm calling you. Dr. Grant wanted me to set up a conference. Either via phone or you can come down again.”
“Name the date,” he says. “I'm coming.”