The Blind
The Blind
A.F. Brady
‘Taut and intelligent’ Prima‘Utterly addictive’ Lisa HallEvery morning, psychiatrist Sam James gets up at six forty-five. She has a shower, drinks a cup of coffee, then puts on her make-up.She ignores the empty bottles piling up by her door.On this particular morning, Sam is informed of a new patient’s arrival at Manhattan’s most notorious institution. Reputed to be deranged and dangerous, Richard is just the kind of impossible case Sam has built her reputation on. She is certain that she is the right doctor to treat such a difficult patient.But then Sam meets Richard. And Richard seems totally sane.Let the mind games begin.
A. F. BRADY is a New York State Licensed Mental Health Counselor and Psychotherapist. She holds a Bachelor’s degree in Psychology from Brown University and two Masters degrees in Psychological Counseling from Columbia University. She is a life-long New Yorker, and resides in Manhattan with her husband and their family. The Blind is her first novel.
Copyright (#ulink_fb854f22-7a7c-530c-9f1c-6714a7a6ed89)
An imprint of HarperCollins Publishers Ltd
1 London Bridge Street
London SE1 9GF
First published in Great Britain by HQ in 2017
Copyright © A.F. Brady 2017
A.F. Brady asserts the moral right to be identified as the author of this work.
A catalogue record for this book is available from the British Library.
This novel is entirely a work of fiction. The names, characters and incidents portrayed in it are the work of the author’s imagination. Any resemblance to actual persons, living or dead, events or localities is entirely coincidental.
All rights reserved under International and Pan-American Copyright Conventions. By payment of the required fees, you have been granted the non-exclusive, non-transferable right to access and read the text of this e-book on-screen. No part of this text may be reproduced, transmitted, down-loaded, decompiled, reverse engineered, or stored in or introduced into any information storage and retrieval system, in any form or by any means, whether electronic or mechanical, now known or hereinafter invented, without the express written permission of HarperCollins.
Ebook Edition © September 2017 ISBN: 9781474057646
Version: 2018-02-13
For the misunderstood
“Oh, you can’t help that,” said the Cat: “We’re all mad here.
I’m mad. You’re mad.”
“How do you know I’m mad?” said Alice.
“You must be,” said the Cat, “or you wouldn’t have come here.”
—LEWIS CARROLL,
ALICE’S ADVENTURES IN WONDERLAND
CONTENTS
Cover (#u297b17d4-f6d2-5c0e-8df0-163cad5faa41)
About the Author (#u61d411ef-9a0b-5630-814d-2b53802b98a1)
Title Page (#u08684924-ceaf-5189-9355-ea4ee86307c8)
Copyright (#ulink_3b0fcac7-3f7b-5d55-8dac-da2caaf6941a)
Dedication (#uf79ef9bb-d4d3-52a6-95fa-e4174fcf8001)
PART ONE
OCTOBER 18TH, 9:40 A.M. (#ulink_5fd1dc46-051f-54d0-b618-b5828b85b202)
OCTOBER 19TH, 11:12 A.M. (#ulink_76693456-9a62-552e-abc2-b0d4f638f1ee)
OCTOBER 19TH, 1:15 P.M. (#ulink_a2729392-e3dc-5936-872a-1e9da9273e8c)
OCTOBER 20TH, 7:44 P.M. (#ulink_0d83b74e-61b0-511a-8a92-91e4138d5980)
OCTOBER 21ST, 8:55 A.M. (#ulink_b6d12f5c-0daf-5a6a-8a40-0d295a6be057)
OCTOBER 23RD, 11:37 P.M. (#ulink_de209fb5-87a3-5e9b-9761-d884863a8183)
OCTOBER 26TH, 3:35 P.M. (#ulink_3ede9874-b88d-51c0-92e4-061b1f8e2276)
OCTOBER 28TH, 9:12 A.M. (#ulink_42c759d3-6f75-5838-8135-6d136d14c5cd)
OCTOBER 28TH, 11:00 A.M. (#ulink_7ce6e84b-0af0-57fb-b89d-f38d9e85bd62)
OCTOBER 28TH, 10:01 P.M. (#ulink_037a3302-1cbc-5cb2-babb-3186efb79e55)
OCTOBER 31ST, 10:25 A.M. (#ulink_2e230381-e718-5c69-a6f1-561045da5c61)
NOVEMBER 1ST, 11:11 A.M. (#ulink_3a12eaa0-06a1-580e-9eee-21dc6fe627e7)
NOVEMBER 2ND, 10:53 P.M. (#ulink_7669230e-5196-5217-94b6-8637aa448ab2)
NOVEMBER 3RD, 8:31 A.M. (#ulink_422a660c-bcec-59ca-b814-0cd8841b4508)
NOVEMBER 6TH, 6:14 P.M. (#ulink_ca656c1f-d88f-5042-ba71-3eb1f30b6c2c)
NOVEMBER 8TH, 11:03 A.M. (#ulink_938feb30-51c3-556d-8382-c24ed519b500)
NOVEMBER 9TH, 10:00 A.M. (#ulink_0d2f1cc2-b11a-5437-b9e5-cf68ee9b0244)
NOVEMBER 9TH, 4:46 P.M. (#ulink_139e0bb0-cd86-5e48-8e79-efe7618cd5bf)
NOVEMBER 11TH, 8:36 A.M. (#ulink_594ec4a8-73ab-5557-8bb7-c09815a9d86f)
NOVEMBER 14TH, 12:34 P.M. (#ulink_0cec5a63-a111-56d2-baee-324417deaef5)
NOVEMBER 14TH, 9:21 P.M. (#ulink_97bf42d0-fa7f-57b3-8b71-37cd52a15e02)
NOVEMBER 16TH, 9:14 P.M. (#ulink_ccc6299c-3be6-57d6-a2ae-917e28c3826c)
NOVEMBER 18TH, 12:03 P.M. (#ulink_b2dc0d6b-dd40-5ca4-8ca3-083e64b20191)
NOVEMBER 22ND, 11:06 A.M. (#ulink_9df44b6a-e6c5-5e14-bb9c-154c884bca50)
NOVEMBER 23RD, 2:14 P.M. (#ulink_7a72c5ac-3cf7-5a6e-a9d9-41990a4ca84f)
NOVEMBER 26TH, 12:45 A.M. (#ulink_28ce7f43-2b54-53dd-8aaa-070f94620780)
NOVEMBER 29TH, 9:11 A.M. (#litres_trial_promo)
DECEMBER 1ST, 5:30 P.M. (#litres_trial_promo)
DECEMBER 1ST, 7:06 P.M. (#litres_trial_promo)
DECEMBER 1ST, 8:23 P.M. (#litres_trial_promo)
DECEMBER 5TH, 9:21 A.M. (#litres_trial_promo)
DECEMBER 5TH, 2:49 P.M. (#litres_trial_promo)
DECEMBER 6TH, 11:13 A.M. (#litres_trial_promo)
DECEMBER 7TH, 7:22 A.M. (#litres_trial_promo)
DECEMBER 7TH, 12:27 P.M. (#litres_trial_promo)
DECEMBER 8TH, 4:17 P.M. (#litres_trial_promo)
DECEMBER 8TH, 11:28 P.M. (#litres_trial_promo)
DECEMBER 9TH, 12:14 P.M. (#litres_trial_promo)
DECEMBER 10TH, 10:24 P.M. (#litres_trial_promo)
DECEMBER 12TH, 3:23 P.M. (#litres_trial_promo)
DECEMBER 14TH, 7:11 P.M. (#litres_trial_promo)
DECEMBER 15TH, 4:33 A.M. (#litres_trial_promo)
DECEMBER 15TH, 6:16 A.M. (#litres_trial_promo)
DECEMBER 16TH, 2:12 P.M. (#litres_trial_promo)
DECEMBER 19TH, 1:19 P.M. (#litres_trial_promo)
DECEMBER 20TH, 3:46 P.M. (#litres_trial_promo)
DECEMBER 21ST, 9:46 P.M. (#litres_trial_promo)
DECEMBER 22ND, 11:34 A.M. (#litres_trial_promo)
PART TWO
DECEMBER 27TH, 8:37 A.M. (#litres_trial_promo)
DECEMBER 27TH, 11:22 A.M. (#litres_trial_promo)
DECEMBER 28TH, 3:20 P.M. (#litres_trial_promo)
DECEMBER 29TH, 12:47 P.M. (#litres_trial_promo)
DECEMBER 29TH, 5:11 P.M. (#litres_trial_promo)
DECEMBER 31ST, 11:47 P.M. (#litres_trial_promo)
JANUARY 3RD, 11:40 A.M. (#litres_trial_promo)
JANUARY 3RD, 2:00 P.M. (#litres_trial_promo)
JANUARY 4TH, 10:56 P.M. (#litres_trial_promo)
JANUARY 5TH, 1:17 P.M. (#litres_trial_promo)
JANUARY 5TH, 5:34 P.M. (#litres_trial_promo)
JANUARY 10TH, 11:00 A.M. (#litres_trial_promo)
JANUARY 12TH, 3:09 P.M. (#litres_trial_promo)
JANUARY 13TH, 9:50 A.M. (#litres_trial_promo)
JANUARY 17TH, 11:08 A.M. (#litres_trial_promo)
JANUARY 18TH, 10:47 P.M. (#litres_trial_promo)
JANUARY 19TH, 10:19 A.M. (#litres_trial_promo)
JANUARY 20TH, 11:14 A.M. (#litres_trial_promo)
JANUARY 20TH, 2:23 P.M. (#litres_trial_promo)
JANUARY 20TH, 3:15 P.M. (#litres_trial_promo)
JANUARY 24TH, 10:44 A.M. (#litres_trial_promo)
JANUARY 31ST, 11:02 A.M. (#litres_trial_promo)
JANUARY 31ST, 12:01 P.M. (#litres_trial_promo)
FEBRUARY 2ND, 9:37 P.M. (#litres_trial_promo)
FEBRUARY 7TH, 11:22 A.M. (#litres_trial_promo)
FEBRUARY 9TH, 7:21 P.M. (#litres_trial_promo)
FEBRUARY 10TH, 9:13 A.M. (#litres_trial_promo)
FEBRUARY 14TH, 11:01 A.M. (#litres_trial_promo)
FEBRUARY 14TH, 12:11 P.M. (#litres_trial_promo)
PART THREE
FEBRUARY 21ST, 10:57 A.M. (#litres_trial_promo)
FEBRUARY 21ST, 2:37 P.M. (#litres_trial_promo)
FEBRUARY 24TH, 5:41 P.M. (#litres_trial_promo)
FEBRUARY 28TH, 10:32 A.M. (#litres_trial_promo)
MARCH 1ST, 4:46 P.M. (#litres_trial_promo)
MARCH 2ND, 3:20 P.M. (#litres_trial_promo)
MARCH 3RD, 1:14 P.M. (#litres_trial_promo)
MARCH 7TH, 1:57 P.M. (#litres_trial_promo)
MARCH 11TH, 1:41 P.M. (#litres_trial_promo)
MARCH 11TH, 7:11 P.M. (#litres_trial_promo)
MARCH 12TH, 2:39 P.M. (#litres_trial_promo)
MARCH 13TH, 9:22 A.M. (#litres_trial_promo)
MARCH 13TH, 10:04 A.M. (#litres_trial_promo)
MARCH 21ST, 7:44 A.M. (#litres_trial_promo)
Acknowledgements (#litres_trial_promo)
PART ONE (#ulink_cb934b41-7c6a-51b1-b64f-1eb3d487b533)
OCTOBER 18TH, 9:40 A.M. (#ulink_a1e5ea5d-6bd1-5db2-9eae-8011ec85acf2)
I’m kneeling on the floor in my office, tying the top of the garbage bag into a knot and squeezing out the excess air as I do it. The maintenance guys always leave extra bags at the bottom of the garbage can, so I can replace this one with a fresh one and just dump the tied-off bag into the bin. I find this is the most discreet way of hiding the rank stench of alcohol when I throw up into my garbage can. I want to believe that my tolerance is high enough that I never throw up, but the truth is, more often than not, I find myself on my knees in my office the morning after.
My name is Sam. I’m a psychologist, and I work in a mental institution. It’s not like the ones you see in Rain Man or Girl, Interrupted. It’s in Manhattan. It doesn’t have sprawling grassy lawns and manicured hedges. It doesn’t have wide hallways and eleven-foot doors like in One Flew Over the Cuckoo’s Nest. It smells like a combination of antiseptic and bubble gum because they added bubblegum scent to the antiseptic. The lights are fluorescent and the toilets are always broken. The elevator is the size of an airplane hangar and it’s always full. I’ve been working here for six years and I’ve never been in the elevator alone. Someone pushes the alarm button every day.
The ceiling tiles in the unit have leak stains in the corners. All the doors are painted gray and have oval windows with chicken wire in the glass. Except the office doors. There are no windows on the office doors, and they’re painted pale yellow. They all have paper signs on them saying things like Lunch and In Session and Do Not Disturb. We have to make new ones pretty regularly because patients write stuff on the signs.
It always feels like once you walk through the front doors, the world gets smaller. It’s impossible to hear outside sounds and, even though I’m in the loudest city on Earth, I can’t hear it in here. There’s only one group room that faces the sun and that’s where the plants are, but it’s always dusty and no one likes to go in there.
We have a lot of different kinds of patients here, 106 of them. The youngest is sixteen and the oldest is ninety-three. The oldest used to be ninety-five, but he died a few months ago. There’s one wing where the men live and another wing where the women live, and pretty much everybody has a roommate. If a patient is violent or something, they can get a single room. Once patients find this out, they almost always become violent. What they don’t realize is that a single room is just a double room with an accordion divider running through the middle, and when the room splits, someone loses a window. The institution is called the Typhlos Psychiatric Center and I’ve never asked why.
It feels fraudulent and silly and sometimes even comical, but I’m not any different from anyone else here. The clinicians are supposed to instill hope. We’re supposed to take our talents and patience and hard-earned degrees and apply our education to the betterment of others. We pride ourselves on having it all together. We fancy ourselves the shepherds. We are told that this is noble and upstanding work, and a benefit to society. But it’s all a pile of shit. We’re no different from them. There’s no line in the sand. In the end, we don’t have canyons that divide us. We barely have a fissure. I have a key and an office and they don’t. I came here to save them; they can’t save me. But sometimes, the lines get blurred. People say “If you can’t do, teach.” Well, if you can’t save yourself, save someone else.
OCTOBER 19TH, 11:12 A.M. (#ulink_be5a41ef-a2c6-5d60-b340-5a959ffee58a)
There is a new patient starting this week. No one wants to work with him. His file is nearly empty, and the rumors churning among the staff have been filling in the blanks with horror stories and nonsense. (He murdered his last counselor; he refuses to do paperwork; he’ll be a nightmare patient.) Even I don’t want to work with him, and I’m the one who takes all the patients no one wants. No one really knows what he’s all about; what’s true, what’s a rumor. He has one of those charts where nothing is clear. He obviously hadn’t answered the questions during the psychosocial evaluations. Most of what was written was garnered from his physical appearance and intake materials. He was definitely in prison; those records are clear. For twenty-some years, although somehow the charges aren’t written in his file. Then halfway houses for years after prison. And now he’s mandated to treatment as a condition of his probation.
We take so much of our power for granted; it only really exists because our patients aren’t aware of their ability to fight against it. And then this guy comes in and starts unsettling everything. I guess I respect him, in a way. I had been napping in my office hoping that something would change, and I guess this guy may be the one to change it.
OCTOBER 19TH, 1:15 P.M. (#ulink_24e7c637-3905-5c7f-981f-300a6960fab8)
“Okay, guys, what does hereditary mean?” I’m running a group counseling session. This is a psychoeducational group, so I’m supposed to be helping my patients understand their diagnoses. So often psychiatrists will tell a patient that he or she has something and then never explain in plain English what it means.
“It means it runs in your family, right?” This is Tashawndra. She had eleven children. Every single one of them has been removed from her custody by social services. She isn’t sure of the whereabouts of most of them, and she believes that two of them are dead, but isn’t positive. This is her reality.
“That’s exactly right—it means there is a genetic component. So which mental illnesses have a genetic component?” I’m up on top of the desk, where I usually sit.
“Cancer. My mom had breast cancer and I had to go get checked for it because she had it, but I didn’t have it.” Lucy.
“That’s right. Cancer has a big genetic component to it, so it’s important to get checked out if someone in your family has it. But what about mental illnesses? What about the kinds of things we treat here?”
“All of ’em, right? I know that if your parents or your brother is addicted to drugs that you will probably get addicted to drugs, too. And people here are getting treated for that. You treat drug addicts here. And sometimes, if your family is depressed, you could get depressed, too.” Tashawndra.
“Yeah, that’s a big one,” I say, wagging my finger in her direction. “Depression has a genetic component. So does schizophrenia, bipolar disorder and many of the other problems we treat here.”
“So you’re fucked, huh? If your mom is schizophrenic, then you can’t stop it from happening to you, huh? It’s like you’re born fucked over. You’re born to be crazy, right? Ha, like ‘Born to Be Bad,’ that song? Born to be crazy.” Tyler. Tyler has schizophrenia. At twenty-two years old, he’s very advanced for his age. He seems to have a greater understanding of the world that the rest of us missed somehow. He’s at peace with things that the rest of us struggle with. Tyler has forgiven.
“Well, no, not always. And watch your language. When you have a genetic predisposition, which means when someone in your family has a disorder, then sometimes you will get it and sometimes you won’t. It depends on what else happens in your life. It depends on whether or not you are exposed to things that will help you stay well, or things that will make you get sick.” I’m bouncing my heels off the front of the desk.
“What kind of stuff makes you sick? Like drugs and stuff?” Tyler. “Because I know my brother did drugs in school with his friend, and then he was crazy after that. He got locked up but he was crazy, man. He never acted like that before he did those drugs.”
“Drugs, sure. That’s a significant one, actually.” I’m nodding and explaining, bright-eyed. “Also, poverty, abuse, growing up without both parents, not being able to get enough food or go to school. They are kind of like strikes against you. So, if you have the gene in you to get depression or schizophrenia, and then you have these strikes in your life, too, you could end up with the diagnosis.”
“Like three strikes, you’re out, right?” Tyler. He and I talk baseball in the hallways. I’m afraid of running into him one day at Yankee Stadium.
OCTOBER 20TH, 7:44 P.M. (#ulink_20d593b2-1a4a-5041-8e8c-7020b776de9b)
When it’s almost time to go home, I start to look at all the things I’ve been avoiding all day. I don’t have a drink or a cigarette with me to help me look at these things, but I start to peer into the abyss anyway.
I know when I get home and I am alone, and my phone isn’t ringing, I’ll be looking at this, so I may as well get it started now. Maybe it will ease the burden. Maybe I won’t cry so hard when I’m at home. Inevitably, the only thing that happens is I am going to be forced to wear sunglasses on the train home because my face will be swollen with misery and my eyes will be brimming with tears that somehow, every single day, manage to cling to my eyelids until the very second my apartment door swings open.
It didn’t always feel like this. Sometimes things made sense. Back when I felt like I understood what was going on, and I wasn’t just going through the motions.
The subway is down. There is a fire on the tracks on the A/C Line, and I have to get off the train a hundred blocks from my apartment. For whatever reason, I am walking now. I tend to think when I walk, which is probably not a good thing, because I don’t have any cash and I can’t stop somewhere for a drink to help me stop thinking.
It’s cold out. The kind of cold that makes your knees hurt and your lips get solid, so it’s hard to talk. My eyes are watering, but I’m not crying. I’m smoking back-to-back cigarettes, and I don’t have gloves, so I have to keep switching hands.
Even though it’s freezing, there are families out in the street. I’ve seen them since I got off the train. There is a mother pushing a stroller on the other side of the street, and we have been pacing each other for blocks. She looks like me. Well, she looks like my mom, and I guess I look like my mom, too. We’re blonde, and I’m guessing the woman has blue eyes like we do, even though I can’t see that far. She’s small, like my mother is. I’m much taller than they both are; I always thought my dad must have been a pretty big guy. Now I’m stuck thinking about my own family as I walk south in this bitter city.
It was just me and my mom growing up. My dad is somewhere, but I don’t know where. I’ve never met him, but it doesn’t really make a difference because Mom was almost too much to manage on her own. Sometimes she sang his praises—Your father is a wonderful man. And sometimes she shit all over him—He’s just some mick fuck who doesn’t deserve me. I wonder if that baby in the stroller knows her dad.
My name is Samantha because my mom’s name was Samantha. I think that’s why I go by Sam. Our last name is James. So I have two first names. I always told people never to trust someone with two first names.
I can see my apartment now. It’s the only one on the floor with no lights on. It’s in an old limestone walk-up building in the middle of the block. I’ve been living in New York City for a few years. I bounced around different studios and tiny one-bedrooms in Brooklyn and Manhattan after I came here for graduate school. My current apartment has three closets, which is practically unheard-of, and a bathtub. I have a desk and a coffee table and it could pass for a grown-up apartment if I could just buy food to put in the fridge. My couch is brown and I have different pillow covers for different seasons. Now it’s the dark blue ones. I have a carpet that’s mostly sun bleached because my windows face south, so the summer sun is in here for the whole day, and I used to like the colors but now I think it looks like a little girl’s carpet. My kitchen is very clean and has a window above the sink, so I can look out while I’m washing wineglasses and see what everyone else is doing. The radiator makes noise, which is comforting because if it didn’t, there would be no sound in here. I never turn on the TV because it makes me feel small.
The front door to my building has a tricky lock, and it always seems to get stuck right when the wind picks up and starts to make my ears hurt. The dark green tile floors in the lobby always look dusty and I’m afraid I’ll slip on them and crack my skull. The stairs are wide and rounded, from a New York era long forgotten, and as I wind up them to my apartment, I peel off my outside layers.
I’m opening a bottle of wine that I bought at the liquor store across the street last night. I always make sure to be delicate and grown-up about my drinking. I drink every night, but that’s okay because it’s expensive wine that I drink out of expensive wineglasses that I always remember to wash before I go to bed. I also always clean my ashtrays, because even I think it’s gross to have stale butts around the house. I quit smoking a few times, but then I gave up quitting because something else is going to get me first anyway. Desperation makes you hold on to funny things.
OCTOBER 21ST, 8:55 A.M. (#ulink_a4dcfb57-8942-5506-ae28-fdd06d0fedc9)
I’m sipping the acrid, burned coffee from the lounge, waiting for my boss, Rachel, to start the clinical-staff meeting. My nails are grimy and dirty, and the nail polish is mostly peeled off. I look up to catch my colleague Gary staring at me. He immediately looks away when our eyes meet, but then he quickly turns his head back to me.
“Yes?” I ask him, eyes wide.
He brushes the side of his temple with the back of his left hand and juts his chin in my direction.
“What?”
He does it again.
I put down my red pen and coffee cup and wipe the sides of my face. I pull back my left hand to see a streak of unblended cakey makeup across my pinkie. Crispy little bits of scab are dotting the makeup.
Rachel begins the meeting.
“Good morning, team. Nice to see everyone bright-eyed and bushy-tailed this morning.”
Muffled laugher and sarcastic snorts.
“I know it’s been getting a little overwhelming with all the new patients starting, but as you know, there are seasons and cycles that are at play with mental health, and with winter almost here, even though it’s only October—” she shakes her fists at the windows “—with the shorter and colder days come more depression, seasonal affective disorder, hopelessness and the like. I’m not telling you anything you don’t already know. That being said, as you’re already aware, we have another new patient, and he is starting today.”
The staff begins to look around nervously; people start adjusting their shirts, looking down at notepads, trying to disappear into the noise.
“I’ve heard a lot of chatter in the hallways. I understand that it’s natural to speculate, but it’s very difficult to maintain unconditional positive regard, an unbiased attitude and an open mind when rumors are being spread in this manner. You all know what I’m talking about.” She glares at us like we should know better.
“Well, can you give us a little more insight into the story with this guy?” Gary.
“I’m not really privy to any more information than you are, so we’re in the same boat. But I am urging you to put your preconceived notions away, set down these ideas you have about him and focus on the little information that we do have. He is coming here for treatment, for help, and your job is to provide that treatment without making the man into a monster.”
“Look, I’m all for positive regard and unbiased treatment, but isn’t it important to ensure the safety of the staff?” Gary again. “I mean, I heard his file is incomplete because he attacked his last counselor. I heard he refuses to answer intake questions, and won’t discuss his history, and if you pry, he goes ballistic. I mean, he’s forensic, and I’m not sure I’m comfortable treating a patient who is known for attacking his counselor.”
“Well, we are not in the business of turning away problematic patients.” Rachel lowers her head and shuffles out the file. “And there’s nothing in here that indicates he has been violent with staff in the past.”
“That’s because there’s nothing in there at all! The file is nearly empty. It says he is a big dude and wears a hat and doesn’t talk. It says he’s been in jail half his life. But, somehow, it doesn’t say on what charge? Hmm? That’s insane! You can’t have a forensic patient with no history, and no psychosocial, and no diagnosis, and nothing in his file, just waltz in here, and we’re supposed to figure this all out from nothing!” Gary is exasperated. Gary used to be a social worker in the finance world. He worked for a firm that did corporate layoffs, and Gary’s services were offered to those individuals who lost their jobs. He always ended up feeling like the messenger and he couldn’t hack it anymore, so he ventured into something he thought would be cushier, less dramatic, more sustainable on a daily basis. He went from the frying pan into the fire, and he is still looking around, bewildered, wondering how he got here.
“Then what exactly do you think we should do, Gary?” This is David, who usually stays above the fray in these meetings.
“Send him somewhere else!”
“That’s ridiculous. We are the ‘somewhere else.’ This is the last stop. Would you rather he was out on the street? With no treatment? No chance?” Me, wiping coffee stains from the conference table.
“Look, I mean, I just don’t want him on my caseload. I don’t have a lot of extra time on my hands, and being tasked with completing an entire file of pre-intake data in addition to everything else needed for him, for a guy who will probably stab me and doesn’t even talk? No. I’m sorry, but no, thank you.” Gary folds his arms across his chest and leans back in a huff.
“Then why are you working here?” Shirley immediately regrets these words, and she cowers back into her seat, hoping this comment didn’t open her up to the possibility of being the new guy’s counselor.
Rachel jumps in, taking control of the discussion. “It’s important for all of us to have a forum in which we can discuss the concerns we have with the patients, and to bring everything out in the open. These meetings are exactly that forum. We are not here to attack each other. I want you all to talk to me and each other about what you’ve heard and what makes you so nervous about our new patient Richard. But I will continue to caution you—rumors are usually unfounded, and we need to be careful how we color this man.”
Gary slumps farther down in his chair and disengages from the discussion. Julie, the bubbly princess, pipes up that she is fearful for her safety, and she worries that she’s too physically weak and defenseless to effectively treat someone who intimidates her. Other female staff members coo in agreement. Julie has wormed her way out of taking anyone else onto her caseload for weeks.
“Why was he in jail?” Shirley.
“I honestly don’t know.” Rachel. “As I said, I have access to the same records as you, and I don’t have that information.”
“But isn’t that weird? Shouldn’t we know?” Julie.
“What difference does it make?” Me. “If he were in jail for racketeering or armed robbery or whatever. It doesn’t make a difference. It could be drugs. It could be the third offense for something small, and with the ‘three strikes, you’re out’ law, he could have been in jail forever. It’s not a sex offense, because he isn’t registered—I looked it up. It really shouldn’t matter what he was in jail for. But it’s important to know that he was in jail. His perspective is obviously altered, and he has probably been subjected to some pretty horrific stuff in there.” As I say all of this, it occurs to me that I am completely uncomfortable with not knowing why he was in prison for so long.
“I heard he doesn’t talk, at all, and that he is very aggressive. He refuses to follow protocol, he doesn’t get along with other patients, he doesn’t do paperwork.” Shirley.
“Well, I think it’s clear that he’s not cooperative with doing paperwork, but beyond that, I am going to ask everyone to chalk this all up to speculation and the tendency to fill in blanks with drama when we don’t have sufficient information. The fact of the matter is he is here, and he is going to be working with us.” Rachel is no longer looking at anyone and getting ready to drop the bomb. She’s stalling. Everyone starts to shift uncomfortably.
“Sam—” she looks up and tightly smiles in my direction “—and Gary.” He slumps back into his chair, defeated. “I’m going to put Richard with you, Gary, and Sam will be your backup. You can learn a lot from this patient, and I think you’re up for the challenge. And, Sam, you have the best success rate with difficult patients, and you’re a ranking member of the clinical staff. I prefer to start Richard with a male counselor and see how that goes. We will all be here for extra support should you need it, but I’m sure you’ll be able to handle this.”
Shirley and Julie give each other exaggerated looks of relief, and everyone breathes a sigh. David gives me a conciliatory squeeze on my shoulder. Gary huffs up to Rachel and lolls his head to the side as she hands him a copy of Richard’s intake materials. He says nothing, and instead looks to me with wide eyes and an impatient bend in his leg.
“No problem, Rachel. I’m on it.” I gather my papers and coffee, and as we all bleed into the hallway, Rachel hands me my own copy of Richard’s file.
Gary assures me that he has no problem taking Richard’s case, and I will not need to participate in his supervision. Gary is an idiot.
“Well, that’s all well and good, Gary, but I’d like you to come to my office so we can discuss a plan of action. Not because I don’t believe you can manage this, just because I want to stay in the loop if I’m going to be your backup.”
“I really don’t have time right now, and I’d like to get an initial meeting with this guy done today.” He stands at the door to the conference room with his whole body and one outstretched finger pointed toward his office.
“Come on. It’ll only take ten minutes.” He expels a giant, frustrated moan and follows me down the hallway to my door. “Sit down,” I say, waving my hand at my patient chair. He flops down dramatically and lets his Gatorade slosh onto the carpet in front of him.
“I’m going to find him on the unit and bring him to my office for a meeting this morning. I’m going to talk to him like a man, and I’m going to treat him like he’s not scary and no big deal. I’m sure all this crap about him being scary is just because he was incarcerated and prisoners scare people. Well, not me; I’m not scared.” He rubs his Gatorade spill further into my carpet with his shoe.
“This is the extent of your plan? You’re going to talk to him like a man?” I’m not even bothering to write this down.
“Yeah. It’s not rocket science, Sam. He’s a patient and I’m a counselor. So, he has to answer me. I don’t see why everyone had so much trouble before.”
I shake my fragile, hungover head to try to clear the stupidity of Gary’s response. “Can you please give me something a little bit more specific? How do you plan on getting through to him when clearly no one has been able to until now?”
“Like I said, by talking to him like a man.” He slowly enunciates the last three words.
“What does ‘like a man’ mean?” I hover my pen over my notebook and avert my eyes. I can’t look at him for fear of his response.
“You wouldn’t understand because you’re not a man.” He stands up to leave my office and pats me condescendingly on the shoulder as he leans down to add, “I’ll make another meeting with you after I’ve gotten some answers out of him, okay?” And he’s out the door.
OCTOBER 23RD, 11:37 P.M. (#ulink_fdb099dc-b79f-56e6-b91e-53559b5b25cb)
I have been avoiding garbage day for about a week now, and the recycling bin is overflowing. There isn’t much space under the sink in my kitchen, and since I drink more than I cook, I have the big recycling bin between the front door and the fridge. It looks more like a hamper.
The blue see-through bag has been pulled under with the weight of the bottles, and I need to yank it up by the red strings to get it out of the can. The clattering sound it makes is absolutely insufferable. There is a leak at the bottom, and the putrid stench of week-old wine and booze, mixed with the acidic smell of the Tropicana bottle from this morning’s screwdrivers, is making me gag. There’s a reason I always put this chore off until the last possible minute.
The noise the bottles make as I pull it along the carpeted hallway is not as bad as it would be if I were to pick it up and haul it over my shoulder, Santa Claus–style. I will have to carry it that way when I walk down the old marble steps to the basement.
I push open the refuse-room door, and I see skittering bugs as I turn on the lights. They’ve come inside to hunker down for the winter, and this room is a veritable buffet of gnarly shit for them to feast on. I flip over my huge sack of booze bottles into an awaiting plastic can, and it sounds like several of them smash. I feel the ooze that has spilled down the back of my pajama pants, and I try to dry it off with a rag that was hanging on a hook by the door.
I get back up to my apartment and clean up the smears on the floor. I put the two forgotten bottles of beer into a fresh blue recycling bag and line the can with it. I have two bottles of scotch on my bookcase shelf that I never finish. There’s always at least four fingers left in each bottle so if I have company, it looks classy and sophisticated. I usually have a bottle or two of wine in the fridge, too. Not because I’m saving it, but because I buy in bulk.
OCTOBER 26TH, 3:35 P.M. (#ulink_104b5418-eb84-5473-8073-adb1b9d6b295)
Gary is loitering in front of my office door as I return from running a women’s group.
“Hey, Gary. Did you need something?” I can see the desperation in his eyes, and I know what he came here to discuss with me.
“Yeah, I need to talk to you. Do you have a minute?”
“I sure do, come on in.”
Gary slumps low in my patient chair and rakes his sweaty fingers through his hair. “This is making me crazy. I can’t get a word out of this guy, and I’ve had meetings with him every day since Friday.”
“You mean Richard McHugh?” I know exactly who he means.
“Yeah. I brought him in on Friday, like I said, and I tried to start the evaluations and assessments for his patient file, right?” He’s leaning on my desk and waving a meaty paw in my face. “And he doesn’t say a word. Not a word. He just sits there, and I thought he must be deaf or something, because he just didn’t say anything. He didn’t get mad or anything; he just sat there. I kept asking him the same questions, and he just looked at me or looked out my window. So, then I figured maybe he wasn’t ready. I told him about me, tried to relate to the guy, said I would treat him like a man if he treated me like a man, and still nothing.” Gary is genuinely surprised that his presumptuous macho plan didn’t work. Half of me wants to laugh in his face, and the other half wants to be professional and help him develop as a counselor.
“Okay. So, the original plan didn’t work. You said you met with him every day since then. Did you change your approach?”
“Yeah. I mean, I did everything I know how to do. First, I was just trying the ‘talk to him like a man’ thing, and that didn’t work. Monday, I asked him to come back to my office, and he didn’t put up a fight or anything. So, I figured this time I would just be all business and make him answer the evaluation and assessment questions. But he didn’t answer a single question! He started reading the newspaper. He brought this huge stack of newspapers with him to read and wouldn’t even look at me when I asked him questions.”
“Okay, and I imagine the sessions yesterday and today were more of the same?” I’m already tired of hearing this.
“Yeah, total silence. He doesn’t even say hello.” Gary leans back, satisfied that this is my problem now.
“Gary, you’ve made four attempts to talk to a man who apparently doesn’t like to talk much. So, you shouldn’t be surprised or disappointed that conventional methods aren’t working.”
“I don’t think it’s my methods, I think it’s me. I think he just doesn’t like me.” Gary is saying this to appeal to my ego, so that I offer to take over for him and he doesn’t have to ask me.
“How would you like to proceed?” I’m not letting him off that easy.
“I think you should take him. I don’t have this kind of time to waste on someone who doesn’t talk, doesn’t want to be helped.” He is crossing his arms and shaking his head in fast, erratic twitches that make him look like a frightened woodland creature.
“I can’t make that call. You’re going to have to speak with Rachel.”
“Oh, come on, Sam, can’t you just take this one for me?”
“I’ve already taken Shawn for you.” I sigh. “But if Rachel signs off on it, I will take him. Until then, he’s yours.” I close my notebook for effect and open my door, allowing Gary to go find Rachel and deal with this.
OCTOBER 28TH, 9:12 A.M. (#ulink_b536a1f1-ad5b-5c03-9dcd-ff243e5512f6)
We have a 9:00 a.m. staff meeting most mornings to discuss our patients and any administrative nonsense that needs to be addressed. Everyone usually drags ass in the meeting except for me and my boss, Rachel.
Rachel is a linebacker. She is a formidable presence, and her booming voice and sharp intellect scare the shit out of everyone. She was born to run an institution, and her lack of a private life really helps her excel at her job. Her stringy, mousy brown hair is pulled back with a velvet scrunchie and she is always wearing a sweater set and chinos that are too tight in the hips and it makes the slash pockets stick out like little ears.
Rachel likes me because she needs to believe that I really am always energetic and positive and a barrel of sunshine. Whenever I am out on the unit, I am a superhero. I am a troubleshooter, and a problem solver, and the go-to gal to get stuff done. My coworkers hate this about me. Until I cover their groups, or take their patients to the ER, or finish their case reviews/progress reports/treatment plans; then they love this about me. I make self-deprecating jokes as a defense mechanism. I always ask people about their weekend and how they’re doing because people are narcissistic and won’t ask me how I’m doing in response. This way I don’t have to lie to anyone.
“Frankie’s back in the hospital.” Shirley begins her report. “Apparently he was standing in the middle of the street trying to direct traffic. This was an intersection on Broadway, and it’s amazing that he isn’t dead. Supposedly, when the police tried to stop him and arrest him or whatever, he started running away from them, bouncing off of cars, running in between them… It was a mess. Eventually they tackled him, I’m not sure, and they brought him to the psych unit at Columbia University Medical Center. He is on suicide watch right now, and I keep getting calls from the docs telling me that he’s not cooperating. I’m not sure what I’m supposed to do about this.” Shirley is both disengaged and disenchanted and ran out of empathy years ago.
“You go to CUMC, Shirley,” Rachel responds, irritable, frustrated, possibly menopausal. “You talk to the doctors. You make sure they know you’re the point person in his continuing care. Eventually, Frankie is going to be coming back here for inpatient services once he is cleared to go, and he needs to be aware that he wasn’t abandoned in the psych unit at CUMC.
“Remember, all of you.” She is looking at us like bad kids who ate all the cookies. “We are the only resource for many of our patients here. We are their mothers and fathers, their caretakers and confidants…”
I didn’t sign up to work on this unit to be anyone’s mother or father and I resent her for saying this as she drones on with the lecture she has delivered so many times. I sip my coffee and stare out the only window in the conference room. There is construction going on across the street; I can hear it a little bit, but mostly I just watch the men in jeans and reflective vests glide up and down this building as they work the planks and rods of the scaffold, and I wonder what would happen if someone jumped off.
“In other news,” Rachel continues, “I’m announcing a caseload change this morning, as well. Gary has been working hard to reach our newest patient, Richard McHugh, but unfortunately, he hasn’t gotten anywhere. I met with Richard yesterday to discuss a change in his counselor, and he asked for you, Sam, by name. So, tag—you’re it. Good luck.” Rachel told me about this before the end of my shift yesterday, so this is nothing more than a performance for the rest of the staff.
Rachel pulls me aside and thanks me for playing along. I rejoice in being her golden girl, and whenever she has faith in me, it helps me to have faith in myself. She reminds me again that Richard specifically said he wanted to work with me, Samantha James.
Julie is waiting for me outside the conference-room doors. “No wonder Gary couldn’t handle that guy, I’m sure you’re going to do a much better job. I can’t believe Rachel even wasted our time assigning him to someone so incompetent.” Julie, always looking for someone to tell her she isn’t incompetent. She is huddling next to me like we’re girlfriends of twenty years, holding my arm and whispering her hot-coffee whisper into my hair.
“I just think it’s stupid to have these meetings at the ass crack of dawn when everyone is still hungover and can’t even read yet,” I say, trying to lose her.
“You’re hungover?”
“It’s a figure of speech, Julie. I am not literally hungover.” Lies. Lies. Lies. I would be much better off wrapped around a toilet right now, but Julie will offer me no solace.
“Oh—I know—I guess I just thought maybe you went out last night again. When are we going to go out together? Are you doing anything tonight?”
Julie likes me and wants to be my friend, but I find it impossible to like her. As much as I appreciate her for being an idiot who can’t get over high school, I still can’t tolerate listening to her inane musings and cotton-candy problems with her debutante friends and country-club life. David walks past us and gives me a knowing smile and chuckle.
“I never make plans this early in the day. I will let you know, though; we should definitely grab a drink sometime.” I smile broadly and disengage from her grasp as we are getting close to my office. I juggle my coffee and my case files to try to get the keys out of my pocket when I see that my door was left open anyway.
Nothing is amiss. I must have just left it unlocked. Maybe I’m still drunk. My iPod is still sitting tangled in the headphones on top of a stack of books on my desk. That wouldn’t be there if anyone had come into my office. My sneakers are in the corner where I leave them every morning. A couple of months ago, Shirley left her door open during one of her group sessions and the batteries got stolen out of all her electronics.
OCTOBER 28TH, 11:00 A.M. (#ulink_c101af97-0533-5e43-be55-708d7e9f43ac)
My initial meeting with Richard is already happening today, and I have been fixing my desk and my hair and my face and my office for the past hour to prepare for it. I am afraid of him, and I haven’t had this feeling since I started on my first psych unit nearly fifteen years ago. I was barely twenty-two. I never feel like this anymore. I’ve sat across from lunatics and psychopaths, diplomats and dignitaries; it’s all the same to me now. I haven’t been scared like this in ages.
My office is configured the way it’s supposed to be, with the desk chair closer to the front door than the patient’s chair. This is done just in case the patient gets violent and the therapist needs to escape, but we say it’s done so the clinician can obtain emergency services more quickly should the patient need it. I’ve never had a patient get violent in my office; it usually happens out in common areas. I realize I have the scissors closer to the patient’s chair and I move them to the drawer. Sometimes I sit on my desk so I can gaze out the window and pretend I have a different life.
The door knock is so loud and jarring that my already frazzled nerves just explode and lodge themselves in my throat, making it hard to speak. I have to appear calm no matter how scared I am.
“Hi, Richard. Come on in, have a seat.” I remain standing, holding the door open for him. I’m waiting for him to sit, then I close the door and begin to get dizzy. He sits in my patient chair and places a large stack of newspapers at the corner of my desk. “I am going to be your counselor. I wanted to set up this initial meeting so we could get to know each other a little bit, and maybe get started on some of the clinical documentation we need to do.” I sit down as I say this.
Richard doesn’t say anything in response. Instead, he lifts the top paper from the pile and makes a show of opening it up and finding his intended section. He slips off his hat. It’s a brown herringbone newsboy cap. He places it gently on top of the newspapers. As he turns his neck, I notice two small, round scars under his collar.
I rustle the papers of his blank file and begin again. “Why don’t we start with the family history section? This way you can tell me about your family, and we don’t have to dive right into talking about you personally.”
He turns away from me, folds his paper in his lap and focuses his attention on the men climbing the scaffold across the street.
“Okay, no family history. What about goals for treatment? Would you be willing to talk about what you’d like to achieve while you’re here at Typhlos?”
He raises his eyebrows, releases a breath and adjusts his seat to get a better view of the construction workers.
“Okay, that’s a pretty obvious no. How about telling me a little bit about yourself, informally, and I will gather whatever information I need. How’s that?”
Richard glares disapprovingly. “You want me to sit here and tell you all about me? Like a job interview?”
“If that’s how you want to look at it, yes. A job interview would be great.”
“No.” Blunt. Decisive.
I’m barely making more progress than Gary did. It looks like I’m going to have to work on this guy a bit more than I’d anticipated. I feel exhausted just thinking about it.
I sigh an enormous, frustrated sigh, and I intentionally blow it in Richard’s direction. I hope it stinks of booze and vomit and coffee so he knows how much his resistance is pissing me off.
OCTOBER 28TH, 10:01 P.M. (#ulink_5dca1343-60ff-5915-a4f1-812108881026)
I’m on the train, watching the people in front of me arguing. It’s packed, and it’s cold outside, but the body heat from the rest of the riders is making me sweat into my scarf. The sways and jolts of the train are lulling me into a trance, and all I can hear is the woman in front of me telling her boyfriend that she has had enough.
I am currently seeing someone. I don’t know why that is the terminology we use—“seeing” someone; usually, I say “seeing someone” in reference to a therapist, but this is how I describe my relationship because I don’t want to say “relationship.” We have been involved for a while.
His name is Lucas. On paper, he is the type of guy you’re supposed to marry. He does something in finance, and he calls it “finance,” which makes me want to punch him. He knows the difference between Cabernet and merlot and wants me to taste the tannins. He has a King Charles spaniel named Maverick, which of course just makes him wildly out of my league. He went to Cornell, and he actively parts his hair. In the morning, he uses a fine-tooth comb and creates a straight line down the left side of his head, and he tucks stray hairs behind the line. I am anal, but he is crazy. He wears shoes that he keeps shoe trees in. He finds it very important that when he gets home from work and he takes off his shoes he immediately puts the shoe trees into the shoes because they are warm from wear and more susceptible to morphing into an undesirable shape. I care less about shoes than he does. He has dirty-blond hair, is tall and wears suits with pocket squares that he has to have folded just so. He’s prettier than I am.
He talks to me about getting married. I find this completely ridiculous. I am not the girl you marry. The only reason I have stayed with him for such a long time is because I am trying to rescue him. This is a well-known pattern in my life, and I have only recently become aware of it and okay with the fact that this is what I do.
He has all the things that girls are looking for: the stability, the money, the good looks, the education. But underneath it all lies a very damaged, very insecure little man, and that is who I am dating.
I do not want this picture of perfection; I do not want this combed, shoe-treed, elitist, country-club gentleman. I want the broken-down little puppy inside of him who is desperately trying to play pretend. I want to find that puppy, I want to rub his belly and give him a good home, and then, when he’s better, I will leave. This is a project. This is a way of making sure that I don’t get hurt, and making sure that someone values me.
I have no way of getting value from within, so I get value from without. As soon as I see the reserves beginning to dry up, I will walk out of his life and move on to the next well of validity. The truth is, this plan isn’t working, and hasn’t been working, but I’m not ready to give up just yet.
OCTOBER 31ST, 10:25 A.M. (#ulink_28e9f8b0-2f31-5839-8f27-d71e2ccf073c)
Richard is in my group this morning, and I suddenly feel like I am performing more than facilitating a therapy session. He’s sitting next to a relatively new kid named Devon. Devon is my age and surprisingly stylish. Today he’s wearing designer jeans, distressed black leather shoes that extend too far out and look like cartoon cowboy boots, a gray athletic T-shirt and a pretty badass leather motorcycle jacket. Not the kind you pick up at a department store for nine hundred dollars; the kind guys who actually ride motorcycles wear. His long dreads are twisted into a thick ponytail. If I had seen him under different circumstances, I might have said he was hot. Except for the shoes.
Devon is diagnosed with schizophrenia, disorganized type. This isn’t particularly common here; most of the patients with schizophrenia are diagnosed with paranoid type. People outside these walls call it paranoid schizophrenia, but when I’m here I have to say it the right way.
He sits with his legs twisted around each other, at the edge of his seat, constantly wringing his hands together and twisting his arms around one another. At several points during today’s group, he looked like he was about to tip over. After a few groups, Devon began standing up in this position. He would perch on one bent leg with the other leg twisted around it, holding his arms out in front of him and eventually doing something that looked like martial arts. He would shadow box standing like that; he would move his arms in slow, concentrated motions like tai chi. This was both fascinating and distracting.
I’m seeing Devon twitch and perch now, and I’m inwardly terrified of how this is going to affect the other patients—particularly Richard. I’m watching him with one eye while keeping the other eye on the group. Richard is keeping to himself; he’s arranged it so there’s more than one chair between him and any other patient, but he is looking up from his papers over his glasses, and he is noticing Devon. The other patients start to become wary of Devon’s behavior, and some become obnoxious and say they don’t want to be around this weirdo and I should kick him out of the group.
“No one is getting kicked out, Barry. Take it easy.” I lean back on the desk.
“Nah, man, this dude is weird, I don’t want none of his weird getting on me, man. He distractin’ the group! He shouldn’t be in here!” Barry likes to be the peacekeeper while not keeping the peace at all. He frequently causes uproars in the name of justice and the betterment of the group process. I think Barry makes big scenes to distract himself from the voices in his head.
“Barry, since you’ve elected yourself to be the spokesman for this group, why don’t we follow your lead and talk about stigma.” Everyone hates when I do this.
“Aww, Miss Sam, can we not? I’m tired of talkin’ ’bout stigmata.”
“Stigma.”
“Whatever you call it. I’m tired of it.”
“Okay. First of all, what is stigma? What does it mean?”
“Stigma is like prejudice, right? Like when you an asshole to someone because of how they look, or being black or something, right?” This is Lucy. Lucy is seventeen. She wears sexy outfits and too much makeup. She has bipolar disorder. Some days she is so with it, I want to send her to Harvard, and some days she can’t tell you her name.
“That’s right, Lucy. Good job. Stigma is a lot like prejudice. It’s a negative belief that exists about a member of a group that is based solely on group membership. Anyone ever have experience with that?” Sometimes, I’m more of a teacher than anything else. When I get into a good discussion, I start kicking my heels against the front of the desk. We are not supposed to be sitting on the desks; it’s another one of the rules about making sure we keep a proper level of separation between “us” and “them.” The longer I’m here, the less I care about this separation.
Everyone raises their hands to indicate they have been stigmatized in the past. Even Richard has his hand up. Devon is the only one who doesn’t respond. I call him out.
“Devon, you see everyone else has their hands up? This has never happened to you?” I’m trying to involve him, not alienate him, but I fear I’ve made the wrong impression. He looks at me and seems to say something.
“I’m sorry, Devon, I can’t hear you from all the way up here. Can you say that one more time?” He responds again, this time unlocking his chin from his neck and seemingly trying to project.
“I’m sorry, still can’t hear you.”
“He says he stays away from people.” Stephan.
“Thank you, Stephan. Sometimes it’s hard to hear. So, Devon, you stay away from people? Is that to avoid being stigmatized?”
He nods.
“It hurts to be the victim of stigma, doesn’t it?”
He nods.
Everyone else nods.
“What kinds of things do you think other people believe about people with mental illnesses? What kind of stigma have you experienced?”
“People say we’re crazy.” As Stephan says this, I start writing the words on the blackboard behind me.
“Lazy. Uneducated. Stupid.” Barry.
“People say we a burden. Like we don’t do nothin’ to help America.” This is Lucy again.
“Dangerous.” I’m surprised at who this is coming from. Adelle is about a hundred years old. She is as frail as they come, and I wouldn’t imagine she experiences the stigma of being dangerously mentally ill. Then I remember that while off her meds, Adelle once stabbed a man in the chest with a pair of scissors.
“Dirty. Disgusting. People don’t want to stand near us. Even we don’t want to stand near each other.” Darryl says this. Darryl is suffering from a traumatic brain injury that resulted from a self-inflicted gunshot wound to the head. He still struggles with major depression, but he swears he will never attempt suicide again. His wife left him after the incident because she couldn’t bear to look at him with the resulting disfigurement.
“Alright, I’ll say it: they say we’re weirdos.” This is Barry making amends. He looks at Devon. “Sorry, man, you don’t need me calling you a weirdo when everyone else already does.”
Devon nods.
“Thank you for that, Barry; that was very nice of you. What else, guys? What are some other stigmas you’ve experienced due to mental illness?” I see Richard looking at Barry, seemingly approving of his apology.
“People think they could catch it from you. Like if they have sex with you, they could get bipolar.” Lucy.
“Does anyone know if that’s true or not?” Me, I’m trying to teach without making the patients feel like they’re in school. I’m looking at Richard, but his head isn’t in the room.
“Nah, you could get AIDS and shit, but you don’t catch crazy.” Barry.
As I’m writing all the words on the board, I’m beginning to feel guilty because I’ve held every single one of these beliefs. I feel simultaneously sad and defensive.
As the group finishes, I wait for everyone to file into the hallway. I am walking around the room putting the chairs back into a semicircle, picking up the garbage left by the patients. As I walk past the chair that Devon squeezed into the corner, I notice little flakes, like paint chips or confetti, scattered at the base of his seat. I brush them onto the floor and keep walking.
I erase the board, making a mental note of all the words written, wondering how often I’ve felt stigmatized. Wondering how many of these things people think about me. Wondering, not for the first time, if I fit a profile.
NOVEMBER 1ST, 11:11 A.M. (#ulink_2d9ddee4-2deb-5629-b05b-863adc7f221a)
I’ve given Richard a schedule with weekly one-on-one sessions with me, as well as several group therapy sessions most days of the week. Patients often respond well to structure, and I want to keep him busy while I figure him out. We have our regularly scheduled Tuesday 11:00 a.m. session this morning, and he is shuffling and wiggling and trying to get comfortable in my patient chair. He is too large for my office. He looks like a doll two sizes too big for the dollhouse. He is holding that stack of newspapers under one arm while shifting his weight back and forth in the seat. When he finally finds a comfortable position, he drops his papers onto the corner of my desk and awkwardly bends his elbow on top of them. His left arm bows at a strange angle, and he holds his wrist rigid, so it looks like he has a prosthetic arm.
“So, now that we’re settled, I’m going to try to get going with your file again. Can you give me a few minutes of attention to get this ball rolling?” Hopeful, positive, maybe even energetic.
“What’s this? Another test?” he asks. He doesn’t take off his hat, which pisses me off because I think it would be polite if he did. I realize that the best way to suppress my fear might be to replace it with anger, so I momentarily dwell on being pissed that he is impolite. It’s still the tweed newsboy cap, like the ones R & B groups made popular in the ’90s.
“I’m not doin’ no more paperwork.” His voice is calm, masculine. He isn’t arguing with me, simply stating a fact.
“Any more…” I absentmindedly correct him while sifting through my files and avoiding eye contact.
“Look, I’m here because I chose to be here, and I know that I don’t have to fill out the forms, and I have confidentiality and privacy, and I don’t have to answer any of your questions, and if you want to kick me out then that’s fine. I know my rights. I heard you were the best counselor here and I didn’t think you’d give me trouble like that last dud they put me with.” He shifts farther away from me as he says this. He wrings each hand individually, as if he were wiping something off his thumbs. He is fidgety. He is nervous.
“You don’t have to do anything you don’t want to do. But you’re going to make it harder on yourself if you avoid me. I am the person you’re going to be working with for the duration of your time here. I am here to help you and to make your stay as painless as possible. If you need anything, I am the person you come to. If you have problems with anyone else on the unit, and you need an intervention, I am the person you come to. But I can’t help you until you help me.” Rehearsed.
I think the masking-scared-with-pissed ploy is working. He says nothing. I am looking at his eyes for the first time and I realize they are blue. For whatever reason I hadn’t expected this. He keeps them squinted. I can’t decide if this is because he is using his scary face or if he has sensitive eyes. They are light blue, much lighter than mine.
He is unfurling his hands now, and I see his fingernails are well maintained. This is notable only in the fact that it is completely opposite from every other patient. Even the women who spend their last dime on a fancy manicure will allow it to get gnarly and grow out so far that they have a quarter inch of real nail visible beneath the green, sparkly talons of a month ago.
But he remains silent. I can’t tell if this is because I have stumped him or he is about to rip my face off for talking to him like that. I know no one else has said as much as this to him, and right now I can’t imagine what gave me the balls to do it.
“Let’s start with something light.” I put on my glasses and I reach for a pen. “Name?”
I want to hear him pronounce his last name, because I am afraid he will be offended if I say it incorrectly. McHugh. I don’t know if you’re supposed to say the h or if it’s silent or what. I’ve got him talking, and I don’t want to compromise my progress.
“Richard McHugh.” Sounds like mah-Q. Okay, now we have that settled. “Am I supposed to call you Doctor, or what?
“You can call me Dr. James, but I prefer Sam.”
“Why do you prefer Sam?”
“Well, Richard, to be honest with you, I prefer Sam because it’s easier to yell down the hallway. Why do you use your full name? Richard has so many appealing nicknames.” Am I being obnoxious? Flippant? Nonchalant? I feel exhausted, like I can’t conjure the energy I need to be a professional here, or to fake it anymore. I feel like there is a miscommunication happening in my brain and I am accidentally betraying my real feelings in a session and not putting on the appropriate mask.
“I like Richard. No one’s calling me Dick.”
“Okay, sir.”
“No, I didn’t ask you to call me sir; I said Richard.”
“Okay, Richard.” I’ve never seen a reaction like that. Who doesn’t like to be called sir? “Moving on— Date of birth?”
“July fourteenth, 1960. It was a Thursday.”
“Really?” Now I’m interested. “How do you know that?”
“My mother told me. She said it was the worst day of her life and that’s why she always hated Thursdays.” I can’t believe we’re getting somewhere. I am afraid of reacting incorrectly and shoving the turtle back into its shell.
“Well, I love Thursdays.” Benign response, please don’t shut down. Please open up to me. “Whole weekend in front of me. And where were you born, Richard?”
“Queens.”
“Ah, right here in New York, huh? Siblings?”
“No.” Back to one-word answers.
“Family history…”
“No.”
“It’s not a question; we are moving to a section regarding your family history, your backgr—”
“No. I’m not answering any questions about family.” He cuts me off again.
“Okay, well, I understand completely if you’re not comfortable, but it’s vital for your treatment, and—”
“No. I said no. I’m not saying anything else.” It’s over; the turtle is back in his shell.
“Okay, you don’t have to do this now; we can come back to it another ti—” He stops me before I can appease him.
“Are we done? I want to leave.” Before he even finishes his request to leave, he is out the door and halfway down the hall. I am facing the bookcase instead of the desk because he brushed my chair and spun it off balance. What just happened? What did I say? How did I lose him?
NOVEMBER 2ND, 10:53 P.M. (#ulink_989e06be-b617-50a2-a18e-16bdcecf2e0c)
I’m going to meet Lucas for drinks. We don’t live together, but we spend enough time at each other’s places that sometimes I wear his clothes instead of doing my laundry. Dating Lucas is like dating two people, and I can’t take one of them out in public. The scabs on my scalp are itchy and raised, but I still go to him, and I still tolerate this treatment.
Ninety percent of the time we go to the same bar and meet up with the same people. Some are friends; some are just other bar regulars who have become friends; sometimes David from work comes to the bar. But tonight Lucas and I are going somewhere different because he said he doesn’t have the energy to party tonight.
Somewhere different turns out to be Flatiron Lounge on Nineteenth Street. The drinks are really interesting and expensive, and it’s dark and none of the seats are actually comfortable, and the waitresses are hot enough to make me feel insecure, but Lucas looks really nice in candlelight, so I try not to worry that he might have brought me here to break up with me.
“You look great tonight, honey.” Lucas. His voice sounds a little bit like what I would imagine a diesel engine covered in melted butter would sound like.
“Well, thank you, my dear. I have been sober for a shocking number of hours, and I’m sure that’s a good look.” I have trouble being serious when I’m nervous. Even though Lucas is a project, it’s not part of my plan for him to break up with me, and it’s not part of the plan for the relationship to end now, so I hope this is about something else. Inevitably, this forces me to remind myself of why I’m with Lucas to begin with and why I continue to put up with this.
“I just didn’t have the energy for all the guys tonight, you know? It can be so exhausting going to Nick’s Bar every night.” He really does look like he has it all together.
“Yeah, I hear you.” I lie. On the inside I really want to be at Nick’s because everyone there knows me only just enough to think that I am fabulous and attractive, and they have no idea that I am actually a mess. That’s the kind of crowd I need to be around. When someone else believes this show, when a whole group thinks this act is real, when scores of intelligent human beings look at Lucas and me together and they see us as stable, rational, healthy adults in a stable, rational, healthy adult relationship, then I can believe it. I need to believe it. This fancy show we put on, this ruse, this bullshit we sling, I need it. I need to make people believe that I am alright, because if they think I am, then maybe I can think I am, too. And that’s why I tolerate it.
Right now, as I’m looking at all these leggy Europeans, I am starting to feel smaller and uglier and more and more in need of alcoholic sustenance, but I am drinking something made with frothy egg white and it isn’t going to cut it.
“Also, I have to admit, that’s not the only reason I wanted to go somewhere quiet tonight.” He is looking at me with what I would describe on someone else as sexy eyes, but on him I just find it comical. He is very handsome, but I’m nervous and I think he looks like a cartoon.
“Oh, yeah? Whassat?” I can feel the sweat starting to bead between my boobs.
“I wanted to talk to you again about the idea of you and I moving in together.” He leans even closer to me, and his elbow takes up the entire cocktail table between us, and I am suddenly aware of how small this bar is, and the lights start to look like they’re pulsing, and I am getting that dizzy feeling where I want to put one foot on the floor, but both my feet are already on the floor, and the music is too loud, and someone is asking me if I want another drink and I think I’m going to pass out. Lucas reaches his hand over to stabilize me, knowing the look I have on my face.
“I’m not pressuring you,” he lies. “I just want to open up these lines of communication again. I know you’re not a fan of cohabitation, and I know you want your independence. But my place is too big for just me, and you would have plenty of space there.” He has leaned back and let go of me.
I’m gesturing to the bartender, so he looks at our waitress and sends her my way. All seven feet of her approach the table and bend down to hear me croak out an order for four shots of Patrón Silver. Lucas gives me a condescending eye that he likes to use on me in places like this because he wants the other guests to believe that he doesn’t binge on booze every single day, and at this club he can keep up that appearance. And Lucas thrives on appearances.
“I like the way things are going with us, Sam. I think we could really make something here.”
“I like us just fine the way we are, Lucas. I don’t think we need to change anything.”
“Why do you have such a fear of commitment?” Crossing his arms, getting defensive. People don’t usually say no to him. I usually say no to him.
“I don’t have a fear of commitment; I’m as committed to everyone in my life as I possibly can be. I’m committed to you, aren’t I? So why can’t I keep my independence?” I may be talking louder than I should.
“You can have your independence and live at my apartment, you know. It doesn’t have to be mutually exclusive.” He can tell that he is getting nowhere. He usually gets nowhere.
The shots arrive, and I throw back two of them before we even have a chance to cheers. Lucas gently picks up the third shot glass, and as I’m reaching for the fourth, he says the same stupid toast he always says: “To being the best at everything, all the time.”
I don’t bother clinking glasses when he leans in, because I think his toast is ridiculous and pompous, and I throw back my third shot. The waitress promptly appears with more napkins and some pretentious artisanal beer, and I wonder if Lucas is living in an alternate universe.
NOVEMBER 3RD, 8:31 A.M. (#ulink_b8f683a6-7b16-5aa1-bdd5-0ba7d7d616e4)
Richard is in my office. He was standing outside my office door when I came in this morning. Something is bothering him. I am just putting my game face on, still stinking of my morning cigarettes, and I’m not sure I am ready to manage this particular crisis.
“Well, I’m not going to be in groups with her anymore,” he says.
“Richard—” exasperated, tired, extremely hungover “—why can’t you be in groups with Julie?”
“She doesn’t know what she’s talking about. She’s telling me that if I eat beets my shit will turn red. What do I care about beets? I’m not eating beets. You don’t give us beets here, so where am I gonna eat them? I don’t need to learn about the color of shit from this woman. I’m not going to her groups. I’m not. Give me something else.”
“It’s a nutrition group. These are topics that come up.”
Eyebrows.
“Okay, fine. What other groups do you want? Who can you tolerate?”
“What do you teach? I mean during that time, what group do you teach?”
“The group I run at that time is not appropriate for you. We have a lot of different kinds of patients here, and many of them require more specialized groups. I run a group like that.”
“Can I have free time? Or computer-room time?”
“Well, I think we should look into what your goals for treatment are and how your time would best be spent.”
“My goals? I certainly don’t need to learn about beets and shit.”
“Excrement, Richard. Feces. Don’t say shit.” Which defeats the purpose, but who’s keeping score anyway? He’s seated in my patient chair now, and he leans back and glares out the window with his arms crookedly crossed over his chest.
“You don’t want me causing a scene and yelling at Julie in group.”
“This is true, but it seems to me that you’re a rational adult, capable of controlling yourself and being respectful. If that group is unhelpful, I will take it off your schedule.” I sit down at my desk and reach into my drawer for his file. “What we need to do is work together to figure out what you need from treatment. That includes you completing the clinical evaluations—” I shake the unfinished sheets at him “—and then I will be better able to recommend a group schedule for you that could help you to reach your goals.”
“Again with the goals.”
“Yes, most people are here to strive toward therapeutic goals.”
“Fine.”
“Fine?” I ask. The hangover headache is gripping my eyeballs, and I want nothing more than to close my eyes and lie down. “Shall we take this time to discuss your goals?”
“I’ll think about what I want to get out of my time here.” He walks out as he says this. I realize that I have achieved nothing but giving Richard the upper hand. Now he doesn’t have to go to one of his assigned groups, and I am not closer to completing his file, or having any clue what he’s doing here. I swallow two Advil with a long pull of coffee and prepare to face the day.
My phone rings before the Advil has the chance to take effect. It’s David.
“Good morning, sunshine,” he says in his happy, sober voice.
“Good morning. Please don’t need anything from me. I’m dying from a hangover.”
“Well, that’s a nice change from every other morning. Did you steal my Advil?”
“Yes. Is that why you’re calling me?” I’m rubbing the bridge of my nose with one hand and turning the volume down on the receiver with the other.
“No, I’m calling because I didn’t bring anything for lunch today, and I want you to come with me to that new place on Riverside.”
“You want me to walk to Riverside Drive?”
“Stupid question, huh?”
“Yes. Very, very stupid. But you should feel free to bring me a sandwich when you come back.” I smile to myself. I don’t know what I’d do if I didn’t have David here to bullshit with.
NOVEMBER 6TH, 6:14 P.M. (#ulink_d67ab1d1-2374-54f3-8703-20f15ce43dd0)
I’m sitting on the roof of Lucas’s apartment building with his dog, Maverick. Maverick is wearing a cashmere sweater, and we are waiting for Lucas to come back up here with a bottle of wine he’s been talking about. Lucas wanted to come up to see the sunset before daylight saving time turns the city dark at 4:30 p.m. It’s Sunday, and other people seem to have had the same idea. Manicured boxwood hedges are separating the section we are sitting in from other seating areas on the roof, and every now and again, I see the plume of someone else’s cigarette smoke.
There are lots of those big space heaters that look like giant silver dildos wearing beanies, and Maverick and I are sitting close to one. He’s on my lap, on top of a huge orange horse blanket with a big H in the corner that Lucas insisted I bring upstairs. If I owned an Hermès blanket, I probably wouldn’t actually use it, let alone bring it to the dirty outdoors.
Lucas rounds the bend from the elevator, carrying a crystal decanter filled with burgundy liquid and two spotless glasses. Maverick doesn’t pay him any attention and instead burrows farther into my lap. Lucas makes a big show of waving away the smoke as he walks by another couple holding cigarettes, as if he were the only one allowed to poison his pristine lungs. He gently lays the two glasses down on the teak coffee table and swirls the wine around in the decanter.
“This is the one I was telling you about when we were at dinner the other night. I’ve been thinking about it, and tonight seems like a good time to bring it out.”
“Sounds good to me.” I wipe some stray hairs out of my eyes and watch as he pours about three sips’ worth of wine into each glass. He hands me one and leans back into his chair with his nose buried in the other as he puts his feet up on the table. He closes his eyes and inhales deeply. He tells me to do the same.
“What can you smell?” he asks, his eyes still closed.
I stick my nose into the glass of wine and swirl it around like he showed me. I smell wine. “Leather,” I say, because I’ve heard him say that before about red wines. I pull out a cigarette and place it between my teeth. “And tobacco,” I add.
“Good. What else?” He is in a different universe, his pretentious wine world, where there’s no such thing as just having a glass of wine. There’s no such thing as drinking. There is only a full-body, total-immersion experience. I light my cigarette. His eyes snap open at the scratch of the flint. He pulls his feet off the coffee table and swiftly grabs the cigarette out of my mouth. The filter sticks to my dry lips, and, as he snatches it from me, he pulls away a piece of skin. “You can’t smoke while you’re having an ’86 Margaux! You’re going to ruin the experience. For yourself and for me. Jesus, Sam. Pay attention!”
His scolding cuts me, like I’m some petulant child who can’t follow directions. His look of disappointment and contemptuous attitude cram me further down into a feeling of emptiness. When I lose his approval, he seems to get so big, and I feel so small. He was being nice today, and I had to go and fuck it up.
“I’m sorry; you’re right. I didn’t mean to ruin it. What should I be smelling?” I suck my bleeding lip and try to listen to him. I lean forward and hold the glass to my nose, but now all I can taste is the metallic blood in my mouth, and when I sip the wine, it stings. Maverick notices the tension and begins to get restless. He sniffs around my mouth and awkwardly readjusts himself on my lap. As I try to hold him and stabilize his little paws, I tip the glass and spill the tiniest drop onto the orange blanket. The dribble of wine seems to escape my glass in slow motion as I hold Maverick, whose furry paws are slipping off the cashmere blanket, and try to catch the drop back into my wineglass. My ears are hot and full, and I watch helplessly as the drop of ’86 Margaux splashes onto the big H. I look up to catch Lucas witnessing this, and already angry, he drops his head. Before I can apologize and blot the stain with the sleeve of my sweater, he picks up his decanter and walks away. Maverick laps at the wine. I wipe at it furiously with my fingers, but it’s not helping. It’s hardly even visible, but I know that to Lucas, I’ve wrecked the blanket.
I gather my cigarettes and wineglass into one hand and put on Maverick’s leash with the other. My heart is beating in my throat as I fold the blanket the way Lucas likes it folded and tuck it under my arm. I push the chairs back into their original position, and steel myself to go downstairs and face him. He had a perfect plan designed in his head, where we would drink his perfect wine, and watch his perfect sunset, and his perfect dog would sit calmly on his perfect blanket, and I spoiled it all. I shouldn’t have lit that cigarette. I shouldn’t have spilled the wine.
I push the button for the elevator, and my stomach squeezes and flips. I step inside the mirrored elevator and see the fear on my face. Maverick sits on my foot and looks up at me as we descend. The adrenaline is pumping fast now as we walk toward Lucas’s apartment. And then it subsides when I see his front door. My handbag, the contents of which are now strewn around the carpeted hallway, is upended in front of his door. This is my invitation to leave. I bend down and gather my things, shoving everything back into my bag. I hook Maverick’s leash to the doorknob and gently place the wineglass on the carpet. I fear for a moment that Maverick will try to lap at the wine and knock the glass over, so I gulp down the Margaux. Doesn’t taste like such a big deal.
I see a pad of yellow Post-it notes in my handbag, with bits of fuzz and tobacco stuck to the gluey line at the back. I fish a Typhlos pen out of a zipper pocket and write “I’m sorry I ruined your evening” on a bent note with frayed and blackened edges. I peel it off and stick it to the door. I snuggle Maverick’s face as the first tear falls, and I think to myself that this humiliation is better than the alternative. If he had left the door open or invited me in, I would be recovering for days.
NOVEMBER 8TH, 11:03 A.M. (#ulink_4e94be60-4085-584e-8830-58c10d5ef1e7)
It’s Tuesday at 11:00 a.m., and Richard is about to come sit in my office for an hour. To date he has said nearly nothing to me until I ask him to focus on paperwork, and then he squeezes out one-word answers or angry refusals to respond. I am still scared of him, but it’s getting better. I’m trying to show Rachel that I am capable of managing this, that I will be the singular psychologist able to get through to him and eventually give him the help he needs. I need to maintain her approval, keep her A-plus rating. It keeps me functioning.
Despite wanting to save the day, my mind is elsewhere this morning; I’m harping on what could have been on Sunday night, so I am thinking of bailing on the attempt to work on the files with Richard. I haven’t yet made more progress than any of my predecessors, but I can’t handle another issue right now.
I hardly notice as Richard walks through my door and sits down with his stack of papers. He takes his hat off in my office and gently sets it atop his pile of newspapers. Sometimes he wears the tweed newsboy cap; sometimes it’s a gray one. He seems to have gotten more comfortable around me, now that we’ve had a few sessions and groups together. He sometimes says good-morning, sometimes nothing, but today I wouldn’t have heard him if he had greeted me.
After a short while, he speaks. “You’re different today.”
“Nope, I’m the same today. Same old Sam, right as rain.” I’m not even looking up.
“How come you’re reading that same page over and over, then? You haven’t turned that page in twenty minutes.”
“I’m concentrating.”
“On what?” He is incredulous; he is noticing. He is supposed to be crazy and I am supposed to be able to get away with my mind wandering sometimes.
“If you’re not going to work on your file or talk about treatment goals, then please, read your papers and let me do my work in peace.” Calmly, softly, defeated.
“I’ve never seen you in peace.”
What are you, my therapist? You’ll never see me in peace, Richard; stop looking.
We resume ignoring each other, and I sit quietly wondering what I’m doing with my life. Richard is shifting and wiggling uncomfortably in his chair. He reaches his crooked left arm out in front of him, as if trying to straighten it out properly. He huffs, and he’s distracting me.
“Something bothering you, Richard?”
“Yeah, what’s going on with that kid from the group you were running the other day?”
“I’m not sure what’s going on with Devon. Why do you ask?”
“He always does this contortionist act when he’s in group. I find it very distracting. And he always wears a jacket even though it’s practically boiling in here. He leaves confetti wherever he goes. He’s making me uncomfortable. How am I supposed to get better in an environment like this?” It seems it’s his size that’s making him uncomfortable, but I’d rather hear him complain than continue to avoid speaking altogether.
“Okay, what exactly is it that you would like me to do here?”
“I don’t know—you’re the shrink, not me.” Richard waves his hands at me dismissively.
“This seems like more of an administrative problem. Or even a janitorial issue. I can ask that he refrain from contorting in groups. But, you have to remember, this is an institution, and we need to live with the foibles and behaviors of others.”
“Within reason.”
“Yes, Richard, within reason, but a little shadow boxing never hurt anyone. Maybe what we need to talk about is your ability to tolerate frustration.”
“I tolerate it fine. I’m just not interested in being in groups with a man in a leather jacket who leaves confetti and makes himself into a pretzel.”
“Noted. I will follow up, and should I discover anything, I will let you know. Fair?”
He raises his eyebrows at me, unconvinced, and returns his gaze to his newspaper.
“And he stinks, too. Just sayin’.” One last jab and now he’s finished.
NOVEMBER 9TH, 10:00 A.M. (#ulink_6fc5aabb-e910-542a-96f1-41dad67c6146)
Jenni is nervously twisting the hem of her shirt in my patient chair. She has a long history of being abused, and associates anyone in a position of authority with fear and danger. She hasn’t been at Typhlos for very long, and she is still healing physically from the abuse she experienced before she got here.
“How are you getting along with your roommate?” I usually try to start sessions with something light and administrative so patients can get comfortable before we address anything serious.
“Tashawndra? She’s good. We make good roommates, I think. She’s clean and she keeps her stuff on her side, and I try to keep my stuff on my side, too. She’s been here for so long now, she knows all about everything, so she’s helping me get used to stuff. She lets me use her lotion.”
“I’m glad to hear that. Tashawndra is very nice. I’m glad you are comfortable in your living space. How have you been feeling since detox?” Jenni had to go to detox before being admitted to Typhlos because she was addicted to heroin and going through withdrawal.
“Better, but it still hurts. I’d never been so sick before. The smack just takes the life out of you, and when you can’t get any, it takes the life out even more. I thought I would never get better. It’s scary, when you get heroin sick. It’s very scary.” She holds her stomach and rocks back and forth as she says this.
“It is, and you’re very brave for committing to treatment so you’ll never have to have those withdrawal symptoms again. Now that your physical addiction is under control, we are going to be spending more time focusing on the psychological and the emotional components of the addiction. I’ve changed around your group schedule a little bit to include some recovery groups, and some dual-diagnosis groups, as well. You and I are going to spend time in our sessions talking about your addiction, too. You think you’re ready for that?”
“What’s duo diagnosis?” she asks, scraping at the edges of a scab on her head.
“Dual diagnosis. That’s when you have both an addiction to drugs or alcohol and a diagnosed disorder or mental illness. When you’re struggling with both those things at the same time, you’ve got a unique set of circumstances, and we want to make sure that you can get all the support you need.”
“Okay, that sounds good. What are we going to talk about in our sessions with you and me?” Jenni rolls up the sleeves she’d been tugging on and I can see the track marks still dotting her arms, from the crook of her elbow all the way down to between her fingers.
“Well, I wanted to start today by asking you to tell me a little bit about your history of drug use. When did you start, how did you use, those kinds of things. You ready for that?”
“Yeah, I’m ready.” She takes a deep breath and pulls what’s left of her hair into a stringy knot on top of her head. “I started doing drugs when I was really young. I was still in school, and I dropped out in tenth grade, so I must have been twelve or eleven or something like that.
“My mom was always out of the house; she worked two jobs and when she was finished working, she would go to the bars, so my sister and I were alone at home a lot. My sister, Jackie, is four years older than me. She had her friends and boyfriends over to the house all the time, and they would sit in her room and smoke weed and cigarettes and drink alcohol and listen to music. Her room was the garage.
“Sometimes I would come to the garage when she was with her friends, and I would just sit there and watch them, but I wouldn’t smoke or anything. She didn’t mind. Some of her friends were nice to me. There was one boy who came over who liked me, I think. His name was Ronnie.
“One time, he came over and sat next to me while they were all hanging out. I was in the corner next to the garbage cans, and he came over and asked how old I was, and if I had ever smoked weed before. I said yes, even though I hadn’t because I didn’t want to look like some lame kid.”
I silently smile at this notion, remembering being a kid among the older crowd, claiming to have personally experienced adventures I had seen on after-school specials.
“So, he handed me the joint and he told me to prove it. I took a hit that was way too big because I thought it was like smoking cigarettes, and I had smoked a cigarette before. I started coughing really hard, and I knew I was going to get sick, so I ran out into the driveway and I barfed all over the place. Ronnie came out after me and was rubbing my back. He told me I did good, and I could come and sit with them.” She looks at me and smiles a sad, nostalgic smile. “I don’t know why but I remember that night really well. After that, it all sort of gets hazy and blends together. I started sitting with them whenever they came over, and I started smoking weed every day. I was scared at first because I know you’re not supposed to do drugs, but they all told me that weed was a plant from the earth and that made it natural and only the chemical drugs were bad for me. They made it all sound like everything we were doing was okay. It was normal. Ronnie was always sitting next to me and rubbing my legs and my back.
“Sometimes he made me uncomfortable because he was so much older than me, but I liked the attention, too. I knew Jackie would never let anything bad happen to me. Then he started bringing in junk. They said that heroin came from a plant, too, the plant where the poppy seeds for the bagels came from, and they told me that if I was okay having a bagel with poppy seeds, then it’s the same thing.” She snorts and shakes her head. “I can’t believe I thought that bagels and junk were going to be the same.”
Jenni continues her story, telling me about Ronnie tying her arm off with a rubber band because the belts they were using on their own arms were too big for her skinny adolescent body. As with so many other patients here, she tells me of becoming dependent on both heroin and Ronnie, and the tables turning after a while—Ronnie starting to demand something in return. Jenni has been desensitized to all this and retells the story as if she were reciting a grocery list. The word rape has lost its meaning, and she reports that sometimes her sister, Jackie, would step in and offer herself in place of Ronnie raping her twelve-year-old sister.
“Jenni, we are getting to the end of our time today, so I wanted to stop and thank you for being so brave and honest about all of this. I think I’m going to add you to a women’s group that we offer here, where survivors of sexual abuse can work together to manage what happened to them.” Jenni cheerfully nods along as I talk.
As she walks out the door, I look at the scabs on her scalp, I see the missing chunks of hair. I see the track marks on her arms and thank God alcohol leaves less of a trace. I think of Ronnie taking advantage of her, pushing her into a corner with heroin and then not letting her leave. I think of Lucas. I wonder if I can walk away with all of my hair.
NOVEMBER 9TH, 4:46 P.M. (#ulink_9e79f945-e579-581a-a848-56e1f595aea3)
Richard is still complaining about Devon and his jacket; he’s become obsessed, and he isn’t letting it go. He spent half the day today indicating that something must be done about this man and his jacket and his confetti. We didn’t have a session together, but he showed up at my door over and over again, demanding action. I’m going to Shirley’s office. Shirley is Devon’s counselor, so she must know something.
“Shirley, what’s the deal with Devon? The jacket? I have a patient who is completely disturbed by his jacket. Don’t ask me why.”
“What jacket?” Shirley is eating a fruit cup with a plastic spoon.
“Really? Shirley? The leather jacket he wears all day every day. The old, scrappy motorcycle jacket? You can’t tell me you haven’t noticed this. He wears it every day. And what’s up with the confetti he puts everywhere? Every time I have him in a group, he leaves these little brown scraps of paper or paint or something behind. Do you not notice this?” I’m looking at her chair, and it’s covered in the confetti. It’s covered in everything.
“Oh, the shit jacket.”
“What? The what?” I’ve never heard Shirley curse. It’s like Grandma taking a whiskey shot or smoking a blunt—what the hell is this? “Shirley!”
“He wears that jacket as a repellent.”
“A repellent from what? From who?”
“Whom. It’s a people repellent. It’s his shit jacket. He learned this while he was homeless. He was constantly getting harassed while sleeping on the streets. He needed to find a way of surviving out there, so he smeared shit all over the back of his jacket so he would stink and people would stay away from him.” She says this like she is telling me the turkey is done. She is nonchalant and unfazed by this information. I’m fascinated and repulsed.
“Oh, my God, Shirley! They’re shit flakes? You mean to tell me the confetti all over the unit is really a pile of dried shit flakes! Jesus Christ!”
I’m slamming her door; I’m barreling into the bathroom. I’m scrubbing my hands, I’m fuming. I’m shocked. How is it possible that we have all been handling shit flakes, and Shirley never bothered to tell us any of this? Jesus, no wonder Richard was disturbed by the jacket.
I sit down at my desk and compose three emails. One to Rachel to ask her to confiscate the shit jacket now that I know it’s a fucking biohazard. One to the head of the maintenance staff asking for a deep clean of the group rooms. And finally, one to the staff to let everyone know that the confetti they have been surrounded with is actually dried shit flakes, and in case we had forgotten, we are surrounded by insanity. With the pressure to keep myself sane—the need to ensure that something exists to keep a line between me and my patients—days like these help me believe that there really is a reason that I have keys and they don’t.
NOVEMBER 11TH, 8:36 A.M. (#ulink_ffc611e5-daff-5b63-863e-17b4e28ccab9)
“Good morning, Rachel,” I say with a sunshiny voice as I saunter through Rachel’s door and sit in her patient chair.
“Morning, Sam. You’re very chipper today.” She clears away a corner of her desk for me to put my files down so we can begin our supervision session. Rachel does very minimal supervision of the staff because she doesn’t have the time, and she is forced to believe that everyone is able to take care of themselves. There’s been a recent influx of new patients, and Rachel is preoccupied with placement and intakes, so she’s been putting off traditional supervision and replacing it with encouragement to call her if we have questions or problems.
“Chipper every morning,” I lie, swallowing my hangover heartburn. I put on my reading glasses and pull out Richard’s incomplete file. “So, I figured since we only have a short time together this morning, I should jump right into business.” Rachel nods, sips her coffee and swivels her chair to face me. She crosses her giant calves and waves me along. “Richard McHugh and I have been meeting weekly on Tuesdays at 11:00 a.m. There was a lot of speculation that he was uncooperative, but he always shows up to our sessions, and he’s always punctual. He seems to like the structure. Now, that being said, he is extremely uncooperative during the sessions. He is absolutely unwilling to complete the psychological assessments and gets very defensive and cagey when I try to pull any information out of him.”
“Do you feel safe in sessions with him?” Rachel asks.
“Sure. He isn’t threatening or violent, he’s just very quiet and guarded. I don’t imagine that he would hurt me. He seems to be protecting himself by staying quiet. He doesn’t like to share his story.”
“Have you been able to determine why he was in prison?”
“No. This is actually one of the other issues with his chart; there isn’t a lot of stuff in his continuation-of-care section. I have the names of the halfway houses he attended, but no contact number or contact person there, no sponsor or mentor. I have the names of the prisons he was in, and the dates he was there, but no further information. It’s all very unclear. There are some xeroxed pages with huge swaths of the page blacked out. There is no information about the charges, so there’s no way to know what he did to end up in prison. And he certainly hasn’t made any effort to tell me.”
Rachel nods. “I was the one who did his intake, actually, and I found the same thing. There was very little information available to us, but he was strangely insistent on coming here. He didn’t tell me much of anything at all, but he was polite, if standoffish. It’s a complete question mark. I got in touch with the teams at Revelations and Horizon House, the halfway houses, but they didn’t have anything on him. The staff turnover at those places is ridiculous, and they don’t seem to keep proper records.” She’s reaching around her desk and pulling at scraps of paper poking out of various in-boxes and out-boxes. She’s looking for something.
“Have you had patients like this before? I’m not entirely sure how best to proceed. He’s a giant question mark, like you said, so I don’t know how to properly place him in groups, and I’m not sure how to draw out the information we need to help him.” Rachel loves it when I ask her for advice.
“I’m looking for his original intake stuff. I gave him a blank sheet to write on when he refused to fill out the intake materials. I asked him about his goals for treatment and that kind of thing. I know he scribbled something down, but I can’t remember what it said.” She pushes her chair around the office, opening file drawers and checking inside a massive disorganized cabinet.
“For now, I’m just going to keep up our weekly sessions,” I reassure her, “keep him in some of the high-functioning, intellectual groups, and see if we can get him comfortable with me, and maybe then he’ll come out of his shell.” Rachel doesn’t seem to be listening to me anymore as she’s seeking this document.
“Here! Here it is,” she says, pulling a page with rolled corners from the back of a notebook. “See if this can be useful to you.”
I take the page from her hands and look over Richard’s handwriting. He was using a dull pencil and the lines of his cursive are blurry and uneven. He made a heading that says “Goals at Typhlos” and he filled in the section with bullet points: “To get better. To forgive. To reenter life.” He specifically writes Typhlos in various places on the sheet. He obviously wanted to come here in particular. There are several other sections, but the pencil lines have been smeared and I can’t read much. Under another heading called “Therapy,” he wrote something that looks like open up and something else that looks like Samantha.
NOVEMBER 14TH, 12:34 P.M. (#ulink_c3fa2681-84f6-5362-ba1a-97bab2eb1563)
It’s snowing outside. I’m up on the corner of my desk, staring out the window. The guys on the scaffold are still working, despite the change in weather. It’s been brutally cold, but for some reason, when the snow starts, it feels warmer. Like the snow is creating a blanket that covers the world and keeps it safe. The flakes are fat and wet and sticking to the cars parked on the street below. In the city, the snow only stays beautiful for a couple of hours. Once the plows come through, the perfect white shroud becomes a thick, gray sludge, sometimes piled to waist height. The only thing I miss about my house growing up is the way the snow stayed untouched.
My door is slightly ajar, and I hear the chatter of patients in the hallway. My office is across from the computer room, a popular spot for patients to try to break into porn sites or gather to chat with each other. There are two dilapidated couches and someone is always asleep in there.
I hear an unfamiliar voice outside my door, probably someone leaning against the wall outside the computer room. It’s a man’s voice, Brooklyn accent, and the hiss of missing teeth. His voice is loud and abrasive, but he hushes it down to a whisper scream to add a conspiratorial air to his story. I move to the crack in the door and listen to him without showing myself.
“It’s women—women get you into these places, man. No matter what you do, you can’t please ’em.”
“A woman got you in this place?” Another male voice I can’t quite recognize.
“Yeah, she did. My ex.”
“What did she do?” Whoever is telling this story is certainly commanding the attention of his listener.
“Well, she broke up with me, first of all. Then she went and started fuckin’ my best friend. Mmm-hmm. And you know that ain’t right. So, I had no choice; I had to get her back. Ain’t nobody gonna disrespect me like that.”
“How’d you do it? How’d you get her back?”
He hushes his voice back down to the whisper scream: “I killed the bitch.”
“You killed her?” The listener gasps.
“Man, shhhhhh! Shut the fuck up, yo. I ain’t gonna tell you nothing you keep hollerin’ like that.”
“How’d you do it?” the listener whispers back. I’m still eavesdropping from my office. I’m not concerned yet—these kinds of grandiose stories are not uncommon here. Some patients treat the unit as if it were prison, and the scarier they make themselves appear, the safer they feel, so bullshit stories about murders are rampant.
“Ha. I’ll tell you how I did it. She had a house in the Bronx, right? And she would let her dog out the back to run around and piss and whatever. So one night, I went to her house, and I waited for her to let that dog out. Once I seen the dog, I jumped the fence and I grabbed him.”
I hear chairs from the computer room scooting across the floor, followed by a few short footsteps. The story is getting more listeners.
“He was some old shaggy piece of shit dog. I had a can of lighter fluid with me, and I dumped it all over that dog. He was so stupid, he started to lick it off. He liked it, too. Just kept lickin’ at that lighter fluid. But he stopped when I lit him up.”
“No shit? You lit the fuckin’ dog on fire?”
“Damn right, I did! And he starts barkin’ and yellin’ and shit, so I pick him up, and I throw his ass through the back window of the bitch’s house. It smashes the window, and the curtains got lit up, too. I could hear the dog, and it was screamin’ and then I heard Alisha, and she start screamin’, too. And she trying to put the dog out, and he dyin’ and the fire just getting bigger and bigger.” His voice is getting loud now, and I can feel my fists clenching.
“So, she says ‘fuck the dog, I gotta get out,’ and she runs out the back door, and where am I? Right there waitin’ for her. And it’s dark out, and she don’t even see me, so she runs right into me. I grab her and turn her around so she has to watch the house burn. I put my hand over her mouth so she can’t scream. You see that?” I can almost hear the craning necks looking to see what the storyteller is showing them. “Bitch started biting my hand. But she stopped biting when I popped her in the mouth.
“The house was going up fast, I mean fast, and it started to get hot and the smoke made it hard to see, so I pulled her back into the alleyway behind the house. She was kickin’ and pullin’ and she knew she couldn’t save nothin’, and so she stopped strugglin’ and just watched it burn. The fire was mad loud, and then when the trucks came, you couldn’t hear nothin’, not even screamin’. So I took my hand off her mouth, and I told her: this is what she gets for fuckin’ with me.”
“And no one saw you? You didn’t get caught?”
“Nah, man. Nobody even knew we was there. And she starts beggin’ and sobbin’ and slobberin’ all over, and that’s when I finished it. I just put my hand around her neck, and I squeezed. Didn’t even take that long.”
I feel my face contort into an angry grimace as I hear this macho bullshit. I find myself overwhelmed with disappointment at the pathetically appreciative response from the listeners. This sociopathic story, this admiration from peers—I’ll never understand this shit. The more I keep hearing it over the years, the more I feel like it’s seeping into me, disturbing my sanity. I keep listening and I hear some of the guys relaying bits of the story to latecomers. I even hear what sound like high fives. And then I hear raspy, almost panicked breaths. I hear a familiar voice now, shaking, furious. Tyler.
“You set a woman’s dog on fire? You threw her dog into her house and her house caught fire?” Tyler has obviously been listening, and he is appalled.
“Yeah, bro, and what?”
“And what? You murdered her? For cheating on you?” His voice is getting higher.
“You got problems, bro?”
“Yeah. Yeah, I got fuckin’ problems.”
“Hi, guys!” I shout as I open my door and pretend I haven’t been listening. “What’s happening? How’s everyone?” It’s clear there’s tension in the hallway, and various patients have fled to the safety of the couches in the computer room. Everyone’s eyes are glued to Tyler and the storyteller.
“Hi, I’m Dr. James. I don’t think we’ve met.” I extend my hand to the storyteller, who has his eyes trained on Tyler. He ignores me. “What’s your name?”
“Floyd.” He still won’t take his eyes off Tyler. Floyd is about a foot shorter than Tyler is, but has probably sixty pounds on him. Tyler is vibrating with anger.
“Miss Sam, I don’t think you should be here right now.”
“Really, Tyler?” Chipper, unaware. “How come?”
“This man got no respect for women.” Tyler is shifting his weight from one foot to the other, clenching and unclenching his fists. Floyd doesn’t move. He stares, unblinking, at Tyler, waiting for him to act.
“Pitchers and catchers report in a couple months, you know.” Talking Yankee baseball with Tyler is my ace in the hole to defuse this without security or backup. “Floyd, are you a baseball fan?” I ask as I move to the space between them, and the air is thick with perspiration and rage. “Tyler and I are huge Yankee fans.” I’m a little taller than Floyd, so when I’m up close to his face, he has to shift his gaze to make eye contact with me. I’m obscuring his view of Tyler, so he’s forced to address me.
“Yeah. I could watch some baseball, miss.”
“America’s pastime. It’s a beautiful thing. Now—” I clap my hands together “—where are you gentlemen supposed to be? I’m sure there’s something productive we could all be doing instead of loitering here in the hallway, huh?”
No one responds to me, but several patients observing from the computer room peel themselves off the couches and move on. Tyler is backing up slightly, but I can still feel his breath at the back of my neck.
“No? Okay. But I’ve got things to do. Tyler? Want to walk me to my next group?” I know Tyler is a gentleman and he wouldn’t let a lady walk by herself if she asked for an escort.
“Alright, Miss Sam.” I hear his teeth grind as he steps in front of me and starts slowly moving down the hallway. I pull my glasses down my nose and glower at Floyd.
Tyler and I walk down the hall, and I again ask him about baseball. Completely distracted, trying to shake the story from a moment ago, he falters and mumbles. When we reach an empty group room, I step inside and ask him to follow me.
“Tyler, when you hear something like that and you react, it just feeds the beast. He was telling that story to get a reaction out of people. Let’s not give him the satisfaction, okay? When you’re disturbed by somebody, you walk away. You don’t engage. Come find me or another staff member if you feel you’re not able to take it, okay?”
“He killed that dog. I just got so mad when he said he killed that innocent dog and that innocent lady.”
“Yeah, me too, Tyler. Me too. But we can’t let it get to us, okay? We have to rise above it.”
“You think it’s bullshit? He’s making it up to scare the other patients?”
“Maybe. Maybe he’s making it up. But even if he didn’t kill an innocent dog or an innocent lady, you and I both know that there are innocent ladies and dogs getting killed every day. But we can’t go to pieces and get in fights because of it. You’re here to take care of you, not to worry about anybody else. Right?”
“Yeah. I know you’re right, Miss Sam. I’m here to worry about me. And the Yankees, because, last season, our pitching wasn’t looking so good.”
“You’re damn right about that.”
NOVEMBER 14TH, 9:21 P.M. (#ulink_0b3515b1-3249-5d6a-8fae-76baa62dc26a)
I’m sitting on my couch waiting for Lucas to show up with takeout. He said he was going to be here an hour ago, but he’s not here yet. I’m trying to read a book, and I have to close one eye to see the words. I’m distracted and hungry, and I keep checking my phone to see if Lucas is going to text me. Nothing. I texted him thirty minutes ago, asking when he’s planning on arriving, but I didn’t get a response. I reread the same page over and over again.
My glass is empty now, and so is the bottle next to it. When I’m anxious, I drink faster than I should. Even though it’s cold outside, colder than the last few Novembers, I’m still drinking white wine. I carefully wipe up the condensation on the coffee table with the sleeve of my sweatshirt and tiptoe to the recycling bin. I plop the still-sweaty bottle into the bin and crack open the twist-off lid of another one. It’s better if Lucas doesn’t know that I already drank a whole bottle. As I’m tiptoeing back to the couch, my phone buzzes and my foot catches the leg of the coffee table.
It’s Lucas. Buzz me in, forgot my key.
I write back, You have to push the button first; it won’t work if you don’t buzz.
The buzzer blares a long and angry scream into my apartment, and I depress the button to release the door. I can see Lucas’s bad mood on the grainy security camera. He slaps the up button for the elevator. He usually takes the stairs, because I’m only on the third floor, but when he’s pissed, or drunk, or carrying something, he takes the elevator. Tonight, it seems he’s all three. I leave the front door ajar and return to the couch. I pour a small glass of wine and clutch it as I wait. I pull my knees up to my chest and hunker down into my pillows.
Lucas marches in the front door and promptly dumps the take-out bag on the floor. He shoves it into the kitchen with his foot and angrily peels off his coat.
“Well, you could offer to give me a hand.” He huffs at me. I pop up off the couch and greet him with a kiss on the cheek. I pick up the take-out bag, which is filled with something that has gone cold, and I lift it onto the kitchen counter. Lucas is very obviously on drugs. His hair is matted down to the back of his neck and his collar is soaked with sweat. He is clenching and unclenching his jaw, and he has thick white spit gathered in the corners of his mouth. Cocaine. He doesn’t say anything else to me and instead walks to the bathroom to tidy himself up. As I hang his coat on the back of a barstool, I reach into his pockets to see what I can find.
A half-smoked pack of cigarettes next to an unopened pack. A black Bic lighter with gouges at the bottom from using it to open bottles. A crumpled credit-card receipt from First Wok with today’s date on it. The time stamp was from two hours ago. I stuff the contents back into his pockets and reach into the breast pocket. A rolled-up fifty-dollar bill with one end wet and the other end powdery, and a tiny empty bag that used to house a gram of cocaine. Adrenaline burns in my stomach as I drop the contraband back into his coat.
I sit down on the couch and take a big gulp of wine. I light a cigarette and wait to hear the toilet flush. He usually muffles the sounds of his snorts by flushing the toilet. He probably has another bag in there with him. My building is old, and so is the plumbing. He overflowed the toilet once from flushing too many times because he was snorting so many lines. Somehow, he still thinks I haven’t figured out what he’s doing in there. I hear the telltale flush, and then he appears outside the bathroom door.
“Whew, sorry about that,” he says as he plops down on the couch next to me. “Been a long day, and I’m lugging this Chinese food here, and I can’t find my keys, and I just got frustrated. Hi,” he says, turning to me and kissing me on the mouth. “How was your day?”
I can taste the coke and it immediately makes my lower lip numb, so I pull away from him and wipe my mouth. “My day was fine. How was your coke?”
“Oh, Sam. I don’t want to get into this.” He rolls his eyes and flaps his hands at me. “I had a long day and I needed a pick-me-up. Brian from the office was holding and he gave me a bag as we were leaving. We were working on a very important merger, and it was sort of a celebration. I’m sorry I didn’t tell you, but I knew you would make a big deal out of it.” He reaches down and takes a sip of my wine. He is leaning forward on the couch, hovering over the coffee table, picking at the label on the wine bottle. He’s not looking at me. I’m not responding. Instead, I stand up and walk to the kitchen to get him his own wineglass. The adrenaline kick sobered me, and I feel like I haven’t had anything to drink at all.
He keeps picking at the label until I sit back down and pour him a glass of wine. I refill my own glass and lean back, silent. I know the coke isn’t going to let him stay quiet for long, so I wait and give him the rope to hang himself.
“I’m not trying to lie to you,” he implores me. “It’s just that we’ve had this coke conversation so many times, and I told you that I was going to cut down, but honestly, it just comes with my business.”
“This isn’t the ’80s, you know.”
“Maybe not wherever you live, but in the finance world, the ’80s are the revered decade. Everyone is hoping to get back to that, and sometimes, we behave as if we are back to that. It’s not a big deal; it’s not about you.”
“Lying to me is about me.” We are both smoking cigarettes now, and the smoke is hanging in the air like a gray aurora borealis.
“I shouldn’t lie to you, you’re right.” He turns to look at me and squeezes my knee with his left hand, his cigarette tucked between his fingers. He holds his wineglass with the other hand and continually slurps tiny, noisy sips. He is looking at me with wild eyes between his little sips, and he begins rubbing my thigh.
“Why were you so late tonight?” I ask.
“Because Brian and I were doing drugs, Sam. How many times do I have to explain this to you? You don’t need to punish me; I’ve already admitted it. Can’t get anything by Detective Sam.” He pulls his hand back, and his cigarette leaves ashes on my pants.
There were about thirty seconds when I had the upper hand as he was apologizing, and now I see it falling out of my grasp and rolling under the couch. Of all the things that Lucas does and then lies to me about, for some reason I have attached myself to the cocaine. The Serenity Prayer has taught me that there are some things I cannot change, but for some reason, I think his coke use is one of the things I can. Baby steps. I’m chipping away at the vices. One day I’ll have the strength to stop him from all the other damage he does, to me and to himself.
Lucas is reeling now, angry that I caught him. I’m contemplating my exit strategy when he suddenly pops up to his feet and offers me a hand to help me off the couch.
“Why don’t we eat something? There’s all this Chinese food in the kitchen; let’s just have a bite to eat and forget this shit ever happened, okay?” He is clenching my wrist and pulling me into the kitchen. He takes two plates out of the cabinet above the sink and slaps them both down on the counter. He reaches into the First Wok bag and pulls out two white cardboard containers. Lucas drops my wrist and it falls to my side with a thud, and he begins unloading lo mein and sesame chicken onto the plates. I can see him getting angrier and angrier with each shake of the to-go containers; I start slowly backing out of the kitchen.
“Where the fuck are you going? You asked me to come over and bring dinner, and here I am, preparing dinner for us. Don’t sneak out of here and pretend you didn’t ruin our evening together with your accusations and your detective work. Here—” he shoves a plate of cold Chinese at me “—eat this. It’s what you wanted, isn’t it?” He leaves his plate on the kitchen counter and stalks toward me with his head bowed and his eyebrows clamped in rage. I’m holding my plate between us with both hands, backing up.
“Thank you for bringing Chinese food, but I didn’t ruin our evening. You’re the one who came over hours late and coked up.” I keep backing up.
“So, I ruined the evening?” he growls.
“Look, the evening doesn’t have to be ruined at all—” I implore him, but as soon as he’s close enough, Lucas slaps the plate out of my hand, and sesame chicken and lo mein and broken shards of plate scatter on the floor around us. He pushes the mess out of his way with his foot and keeps lumbering closer to me. I hold my hands up against his chest and try to push him off me, but he is too big, and too angry, and already nearly on top of me.
“Hit me,” he says calmly, with a twisted grin. “Hit me, since I fucked everything up. I ruined dinner, didn’t I? So hit me.” He starts yelling and chest bumps me, sending me stumbling back into the wall. “Hit me!” He points to his jaw and chest bumps me again, and now I’m pinned between him and the wall, and I can’t find the room to squirm out. I feel the handle to the closet door with my left hand, and I try to pull it open, but Lucas’s big arm is over my head, holding the closet door closed. “Hit me,” he says again as his other hand rises up and grips me by the throat. “Hit me!”
NOVEMBER 16TH, 9:14 P.M. (#ulink_3c828b00-612d-5eae-bd91-17181f590812)
I’m at Nick’s talking to a friend, and although I’ve been told that he’s very sexy and charming, I haven’t noticed it until right this minute. He’s standing in front of me, and we’re flirting. Everyone else we know here is behind me, jammed in near the DJ booth. He’s looking at me with a pair of eyes that I have never seen in his head, and I feel like the universe is shifting and my stomach is flipping. He is devouring me and I don’t want him to stop.
He’s a player—we all know it; I have always known it. I watched him hook up with a prepubescent neophyte yesterday and he has been picking the low-hanging fruit for years. I see every woman fall for him; I laugh at them and silently hope they remember to wrap it up, and I giggle at the girls who are mad at him for the fuck-and-run. I’ve always considered him a decent soul, and at the same time I don’t see any of this right now. All I see is man. Man who can take my whole world and turn it upside down, just by paying me the slightest bit of attention.
Someone has taken out their camera phone, and of course this is a problem because everyone here knows Lucas, and I’m dating Lucas, and I should be thinking about Lucas, but I can’t even remember his name right now. I’m absentmindedly pulling my scarf up around my neck to keep the bruises from the other night obscured. We are all crammed together, taking pictures that someone will inevitably post on Instagram, and then all infidelity will be exposed and I’ll be the bad guy and Lucas will run from me and I will be alone and I can’t have that.
So I pose and I smile and I pretend that all the feelings I have rushing through me—the fire, the heat that’s pulsing in my veins, in my stomach, in my pants—all of this is not happening. And of course, he comes to stand next to me for the pictures, and he is almost in front of me, and he is kissing my cheek for the photo.
The group is closely huddled together, and without anyone else seeing, while we’re no more than a quarter inch from all our friends, he reaches his hand behind him, between us, and holds my breast. He’s killing me and he knows it and I love it and all I want to do is stay and take more pictures and have him keep his hands on me and all over me and take me away from here and make me something better and never, ever, ever leave me.
Somehow it’s all over and in a whirlwind, I’m on the street walking home. When we said goodbye he kissed me on the lips, but we all kiss each other on the lips, so this didn’t mean anything to anyone witnessing it. But we had never kissed on the lips before and mine are burning with man all over them, and I am walking home toward Lucas and I want to turn back and run into the arms of man, but Lucas will leave me and I can’t have that. But I need to see this guy again. When will we be able to do this? This is a mission and I must accomplish it, and I will have him no matter what it takes. His name is AJ. I don’t even know what it stands for.
NOVEMBER 18TH, 12:03 P.M. (#ulink_021b5226-7120-5956-8eea-4f34fad987e6)
David and I are sitting in his office, avoiding the world, eating our lunches. He usually brings something in, and I end up stealing half of it, or we go to one of the sandwich shops down the street. There’s a halal truck on the corner, and today we both got chicken over rice. We usually eat when the patients get their lunch, whether we’re hungry or not—that way we’re less likely to have visitors or intruders.
“Did you see Julie in the meeting this morning?” I ask, plastic fork between my teeth.
“Yeah, I saw her. Why? What’d she do?”
“She was doing her makeup in a Chanel compact at the fucking conference table.”
“Is that a big deal?”
“She works in a mental institution. Why does she care so much about how she looks? It’s pathetic.”
David laughs at me. “You really hate her, huh?”
“I don’t hate anybody. I just think she’s incredibly silly and she doesn’t belong here. She should be working at Bloomingdale’s.”
“You ever sat in on any of her groups?”
“No, have you?” David rarely engages in Julie shit-talking and gossip with me, because he’s mature and above it all, so I love when he descends to my level.
“Yeah, I was at the one that your patient stormed out of. The new guy, big dude.”
“Richard? The thing with the beets?”
“Ha!” David opens his mouth to laugh and a single grain of rice flies past me and sticks to the window. “Yeah,” he says, wiping his lips, “she was trying to delicately explain that some foods can change the color or consistency of pee and poop, and he just bolted. I think she wanted to get the message across that people panic when their shit turns red, thinking it’s blood, so she was trying to preemptively quell the anxiety.”
“Sure, which would make sense if anyone ever had beets here. What an idiot! Such a princess. I told you she shouldn’t be here.”
“Yeah, Rachel asked me to keep an eye on her because she’s been racking up complaints.”
“Really? How wonderful! Maybe Typhlos will give me an early Christmas present and fire her!” I joyfully scoop another forkful of chicken into my mouth.
“Yeah, don’t hold your breath. How is the new guy, by the way? Last we talked you were getting nowhere.”
“I’m still getting fucking nowhere. It’s confusing. He’s so high functioning, seems to be completely normal, so what is he doing here? Why is he in treatment?”
“What’s his diagnosis?”
“Oh, right. Like there’s a diagnosis in his chart. That would be too easy.”
“Do you think he’s diagnosable?”
“If I were to slap something on him, like for insurance purposes, I’d say adjustment disorder. And that’s a stretch. There’s got to be something that I’m completely missing. It’s too weird for this guy to be admitted to a mental institution. Aside from being uncooperative and stubborn, he seems normal.”
“You want me to meet with him? See if I can figure something out?” David is always incredibly helpful, always willing to go the extra mile for me.
“No, thanks. But keep an eye out if you notice anything.” David smiles his sweet, protective smile at me and clumsily pats my knee with his free hand. I try to examine his thoughts as he turns toward the window; I’m looking for a place inside him where I could fit.
NOVEMBER 22ND, 11:06 A.M. (#ulink_26140e17-9c2e-5b87-b833-947407be0e88)
Although we haven’t made progress with his file, it seems that Richard is getting more comfortable with me. He may even be developing a foundation of trust. He’s speaking now, not about anything relevant to his mental health, but he’s saying words out loud. He tells me about books he’s read, or ones he’s heard of that he hasn’t had a chance to pick up yet. I tell him about what’s happened in the music industry, and he’s never happy to hear it. Today is another session with us just warming up to each other.
“You have a cell phone?” he asks me. He hasn’t shaved this morning, and I can see the prickles of a pale beard poking out of his fat pores.
“Yes, I have a personal phone. Why do you ask?” I’ve got my legs crossed and I’ve twisted my chair to face him. We usually sit this way, even if the sessions are uncommunicative. It’s a therapeutic technique. People are uncomfortable with silences, so often if a therapist faces a patient like they’re talking, the patient will feel obligated to fill the silence.
“That was a shock to me. I was away when those things came out. Now even the homeless people have them.”
“You were in prison when cell phones became popular?” This is the first time he has acknowledged his incarceration to me, and I want to draw more information out of him.
“We didn’t even have personal computers. Now everyone has a supercomputer in their pocket.”
“Did you have computers available to you in prison?”
“Well, the phones are even more advanced than the computers now.” He’s not going to engage on this with me.
“It’s true. They really do make communication much easier.” Hint.
“Not just communication—everything. It’s got a camera now, the internet, the emails. You can read books on those things! It used to be you had to have a whole suitcase worth of stuff to have everything that these phones have now. And they’re this big.” He holds out his wide palm to indicate the size of today’s cell phones.
“A miracle of technology.”
Richard shakes his head in wonder and returns his attention to his newspapers. Maybe I can draw him further out of his shell if I tell him that I addressed the issue with Devon and his shit jacket.
“Before you disengage completely, I wanted to let you know that I looked into the issues you were having with Devon.”
“Oh?” He raises his eyebrows in anticipation.
“I put in a request with his counselor to take up the issues that you conveyed to me, including the hygiene problem and the disruptive behavior in groups. It has since been addressed with Devon personally, and I hope you will show some patience and tolerance as he adjusts.”
“Well. Thank you.”
“Is that a commitment to give the guy a break?”
“Not exactly.”
“What is it, then?”
“It’s a thank-you. I haven’t said thank-you to anyone in a long time. I appreciate that you followed through.” Richard bows his head to me.
“Maybe since I’ve shown you the respect of following through, you’ll show me the same, and we can work on completing your file.” Once last try for today.
His eyes return to his papers and he brushes his cheek with the back of his hand, as if he’s brushing away my request.
My chest tightens as I draw in another disappointed breath. It’s been almost a month now and all I have are his basics. I’m running out of ways to get through to him.
NOVEMBER 23RD, 2:14 P.M. (#ulink_23248ab7-3dda-59fa-8264-fab4ca5c84d1)
Julie is buzzing the intercom looking for me. Her shrill, piercing voice is making my eardrums explode, so I pick up the phone as quickly as I can and hold the receiver about a foot from my face.
“Yes, Julie?” I grumble from a safe distance. “What do you need?”
“Hi, Sam!” I can hear the syrupy ooze of her voice falling down the telephone line, threatening to come trickling onto my neck through the receiver. She pauses, waiting for me to return the cheerful greeting. I say nothing. “Um, I wonder if you have a moment to come to my office? I’m meeting with one of your patients right now; we had a little incident in group.” She says little incident like she’s talking about a kindergartner who wet her pants during nap time.
“Which patient?”
“I’m with Tashawndra.” She enunciates each syllable slowly, fearful that her inability to properly articulate Tashawndra’s name will indicate she’s racist, or out of touch, or not relatable.
“Give me a minute.” I hang up the phone before she inundates me with more pleasantries, and begin the slow walk to Julie’s office.
I knock loudly on her door and realize that though we’ve worked together for several years, I’ve never seen the inside of her office before. She pulls it open, and I see Tashawndra with a shamed expression on her face, sitting on a blue plastic group-room chair. Looks like there weren’t enough office chairs for Julie. She invites me in, and I take in my surroundings.
She doesn’t have books or files or anything visible that would indicate this is a clinician’s office; instead she has a large stuffed bear wearing a green Ralph Lauren sweater sitting on her bookshelf. She has pictures of her family with quotes about sisters etched into the white wooden frames. As she closes her door, I hear the plink of bells, and I turn to see she has two coat hooks, one with her pale camel-colored coat with a pink plaid scarf over it, and the other with a stuffed fabric wreath with lacy edges and bells hanging off it. The final straw is a framed plaque of faux reclaimed wood with intentionally worn writing and painted flowers that reads Live, Laugh, Love. I can feel the bile and undigested lunch rising in my throat, and I hesitate to stop myself from projectile vomiting directly into her perfectly combed hair. The look of disgust on my face must be apparent because Julie reaches out to touch my arm and ask me if I’m okay.
“Sam? You alright?” I yank my arm away from her and nudge her out of the way as I take a seat in Julie’s desk chair. There’s a scent diffuser somewhere in here, and it smells like baby powder.
“Tashawndra?” She hangs her head, and I lower mine to catch her eyes. “You wanna tell me what happened?”
“Can’t Miss Julie tell you?” She hides her face in her hands. Her hair is twisted in ropes and dreads of various lengths and rigidity, some poking straight up out of her scalp and others falling forward into her eyes. She twists them when she gets nervous, and when she’s feeling happy, she ties ribbons and strings to the ends. She’s pulling at one of the strings now, a yellow piece of yarn tied to a dread on the left side of her face.
“I’d like to hear it from you, if you’re willing to tell me. I want to know what you think happened.” The yarn pops off between her fingers.
Tashawndra releases a snort like a bull about to charge. “I was in Miss Julie’s group, minding my own business, and out of nowhere, I look over and I see that Barry is staring at Miss Julie, and his mind ain’t right, and I know what he’s thinking.”
“What was he thinking?” I ask. Julie is hovering over us, blushing as her name is mentioned.
“He was thinking he like to sink his teeth into those legs!” She gestures toward Julie’s panty-hosed legs, exposed beneath her admittedly work-appropriate skirt. Julie involuntarily bends and covers her knees with her hands.
I can’t help smiling as I listen to this. “And then what did you do?”
“I threw my coffee cup at him.” Tashawndra leans back and crosses her arms over her chest. She is braless as usual and her pendulous breasts fall into her armpits.
“Was there coffee in your coffee cup?” I’m nearly laughing as I ask.
“No! It was empty. I should have slapped his face.”
“What’s going on between you and Barry?”
“Well, nothing now! But before he decided to get all inappropriate with the counselor, we was seeing each other. Been a couple of weeks. He brung me flowers from the table in the lunchroom last week. And before that, he gave me the rest of his pack of cigarettes. He told me I was the most beautiful girl he ever saw, and we had lunch together and we smoked on the smoking balcony together, too. But all that over now!”
“Anything else going on between the two of you?” Sexual contact between patients is strictly forbidden at Typhlos, although it’s nearly impossible to enforce. With the growing number of patients, it’s hard enough to keep track of where everyone is all the time, let alone try to figure out what everyone is doing. Patients have sex with their roommates at night, whether they’re gay or not, in the bathroom stalls, out on the smoking balcony in broad daylight. Sometimes right in the open in the hallways and group rooms. Tashawndra has lost privileges and been isolated because of sexual misconduct many times before, but Barry has never been her partner.
“Nah. I know I’m not allowed to bang nobody while we doing treatment here.” She fiddles with the yellow string, and I believe her that they weren’t having sex. She seems to care about him, and she rarely has sex with people she cares about.
“Good. I’m glad we’re making progress on that front. And you know you can’t throw anything at anyone, whether they’re looking at another girl or not, correct?”
“Yeah, I know.” She shoots her arm out in an aw-shucks gesture and throws the yellow string onto the floor. “He gave me these yarns for my hair, too.”
I pick up the string and hold it in my fist. “Tashawndra, I know it hurts when someone you like looks at someone else, but it’s important to react appropriately. Do you want to say anything to Julie?” Julie’s been leaning over us like an eager water boy during the halftime huddle. Her mouth hung open as she observed our interaction, and now that she’s being addressed, she pops up straight and composes herself.
“I’m sorry I got jealous in your group, Miss Julie. I know people gonna look at you because you beautiful, and I know it don’t mean that I can throw things at anybody.” She tugs at her dreads.
“Thank you, Tashawndra. And I think you’re beautiful, too.” Tashawndra blushes as a shy smile spreads across her face, and she pulls her shoulder up to her chin.
“You gonna talk to Barry about this?” I ask her.
“Yeah, I guess I could forgive him.”
“I’m glad to hear that.” I hand her back the yellow string, and she ties it into one of the dreads flopping down over her eyes. We walk out of Julie’s office together, and I take a deep breath of institutional air to clear my nose of the insufferable scent from her diffuser. It’s days like this that make me feel like a zookeeper, and I’m in awe of the level of shit I can continue to tolerate.
NOVEMBER 26TH, 12:45 A.M. (#ulink_79194289-aad4-537f-80a8-e6600c2a3c20)
I find myself at Nick’s again, waiting for David to show up. Lucas and I came together, but he is too drunk to function, so he parked himself at one end of the bar, staring at his phone, while I schmooze with our buddies. Everyone at Nick’s thinks that Lucas and I are the perfect couple, and it’s a very delicate dance, because we know this perception, and without speaking, we do everything we can to uphold it. Even if I’m afraid he might end up killing me when we are alone, in front of others, we put on the show that we need to put on to pretend to ourselves that each of us is fine, and that together we are the ideal couple: the beacon of domestic bliss that shines amid the crumbling failures of their past. It gives hope, and I am in the business of giving hope.
If I told them that he beats me, or that he had sex with a faceless hooker in the back room of a porn store earlier today, or that he is currently wolfing oxycodone in the bathroom, it would ruin their night, and I certainly don’t want that. This perception that Lucas and I are perfect…it helps me believe it. And it’s one of the last strings I have holding my life together.
David just walked into the bar, and he’s scanning the room trying to find me. I’m waving with one hand while drinking a Jack and Coke with the other. He’s probably the only person who knows the truth about me, the truth about Lucas and some truth about me and Lucas. Our offices share a wall, which means he can hear everything that goes on in mine. When I’m throwing up in the garbage can, or crying into my coffee, he tends to ask questions. Over the years, instead of lying to him, I’ve let him in, and he hasn’t used it against me yet.
David is my best friend. Not just my work best friend, but the closest thing I have to a real-life best friend. I’ve never slept with him, although maybe I should. He has a crush on me, I can tell, and I flirt with him and humor him just enough to make the crush continue, but I’m careful to never allow it to turn into something that would require reciprocity. Just the way I like it. He walks over, we look at each other, and without saying anything, he drinks from the straw in my drink. I signal to Sid, the bartender, for another round.
David and I stand too close together and gossip. We find safety in our bubble and use that safety to dismantle the other people around us. David pretends not to notice Lucas. I can’t tell if he’s being polite or defensive.
Lucas is in a state now. His tie is partially loosened and partially tight, one of the middle buttons of his shirt is undone, his jacket is strewn in a booth somewhere, his glasses are all greased and cockeyed on top of his head, and he needs to lean on the bar for support. Despite this, he’s become even more disarming and lovable to everyone in the room. The cocktail waitresses are huddled in the corner talking about him, and he has his hand on the panty-hosed leg of someone else’s girlfriend. No one seems to mind.
When I approach, his hand slides back into his own lap.
“Act like you love me, you stupid asshole,” I say with a smile.
“I do love you, you dirty whore,” he replies, and he might not be joking. “But I’m tired, and I have a long week coming up, so I’m going home.” He pulls his coat into his hands and makes a show of looking around the bar for his suit jacket. “If you see my jacket, will you bring it home with you? I don’t have time to go searching for it now.”
“No problem,” I say, hiding the cigarette and lighter I have clutched in my fist, as if I wasn’t about to step outside. If I give him a seamless exit, I can save myself from another one of his drunken attacks.
“You don’t have to come with me. I’ll get home fine,” he slurs, and I give the panty-hosed girl a side-eye. We perform our saying-goodbye act, with big hugs and kisses, and after he doesn’t bother to pay his tab, he stumbles out the door. I pretend not to notice the panty hose follow him out.
“You gonna be okay if I go, too?” David asks, joining me in pretending he didn’t see anything.
“Yeah, I’m probably only going to have one or two more.”
After tugging his coat over his shoulders, he leaves a fifty on the bar and wraps me in a bear hug. “I’ll see you on Monday, but call me if anything stupid happens, okay?”
“Thanks, David. I’ll see you Monday. Home safe.”
Now that David and Lucas are both gone, I can turn my attention to AJ. He’s been sitting at a booth with some people I don’t know, but from the looks he’s been giving me, I know that we’re both waiting for the moment—the moment in time when it’s going to be okay and we can run into the other room, the other world, the other universe where we can wrap up in one another and not worry what anyone else thinks, what anyone else knows, what anyone else can see, but at the same time, we know that that’s never going to happen. So we have to live in between the lines. We have to be somewhere only he knows, and only I know, and no one says anything, because there’s nothing to say. Where we can walk in daylight and hear no voices.
Even though it’s the same bar we’re always at, somehow the walls seem new to me. All the things around us seem to be brighter. The cheeky quotes written in chalk on the blackboard behind the bar are funnier. The music sounds like something I haven’t been listening to for the last two months. There’s something about the way he looks at me that takes down every single wall I have ever erected in order to keep people out.
He’s standing at the DJ booth now, putting on a song and pointing at me across the bar. I’m doing everything I can to stay as far away from him as possible. He sees this and he sees me, and he puts on my favorite song and mouths to me, This is for you.
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A.F. Brady
‘Taut and intelligent’ Prima‘Utterly addictive’ Lisa HallEvery morning, psychiatrist Sam James gets up at six forty-five. She has a shower, drinks a cup of coffee, then puts on her make-up.She ignores the empty bottles piling up by her door.On this particular morning, Sam is informed of a new patient’s arrival at Manhattan’s most notorious institution. Reputed to be deranged and dangerous, Richard is just the kind of impossible case Sam has built her reputation on. She is certain that she is the right doctor to treat such a difficult patient.But then Sam meets Richard. And Richard seems totally sane.Let the mind games begin.
A. F. BRADY is a New York State Licensed Mental Health Counselor and Psychotherapist. She holds a Bachelor’s degree in Psychology from Brown University and two Masters degrees in Psychological Counseling from Columbia University. She is a life-long New Yorker, and resides in Manhattan with her husband and their family. The Blind is her first novel.
Copyright (#ulink_fb854f22-7a7c-530c-9f1c-6714a7a6ed89)
An imprint of HarperCollins Publishers Ltd
1 London Bridge Street
London SE1 9GF
First published in Great Britain by HQ in 2017
Copyright © A.F. Brady 2017
A.F. Brady asserts the moral right to be identified as the author of this work.
A catalogue record for this book is available from the British Library.
This novel is entirely a work of fiction. The names, characters and incidents portrayed in it are the work of the author’s imagination. Any resemblance to actual persons, living or dead, events or localities is entirely coincidental.
All rights reserved under International and Pan-American Copyright Conventions. By payment of the required fees, you have been granted the non-exclusive, non-transferable right to access and read the text of this e-book on-screen. No part of this text may be reproduced, transmitted, down-loaded, decompiled, reverse engineered, or stored in or introduced into any information storage and retrieval system, in any form or by any means, whether electronic or mechanical, now known or hereinafter invented, without the express written permission of HarperCollins.
Ebook Edition © September 2017 ISBN: 9781474057646
Version: 2018-02-13
For the misunderstood
“Oh, you can’t help that,” said the Cat: “We’re all mad here.
I’m mad. You’re mad.”
“How do you know I’m mad?” said Alice.
“You must be,” said the Cat, “or you wouldn’t have come here.”
—LEWIS CARROLL,
ALICE’S ADVENTURES IN WONDERLAND
CONTENTS
Cover (#u297b17d4-f6d2-5c0e-8df0-163cad5faa41)
About the Author (#u61d411ef-9a0b-5630-814d-2b53802b98a1)
Title Page (#u08684924-ceaf-5189-9355-ea4ee86307c8)
Copyright (#ulink_3b0fcac7-3f7b-5d55-8dac-da2caaf6941a)
Dedication (#uf79ef9bb-d4d3-52a6-95fa-e4174fcf8001)
PART ONE
OCTOBER 18TH, 9:40 A.M. (#ulink_5fd1dc46-051f-54d0-b618-b5828b85b202)
OCTOBER 19TH, 11:12 A.M. (#ulink_76693456-9a62-552e-abc2-b0d4f638f1ee)
OCTOBER 19TH, 1:15 P.M. (#ulink_a2729392-e3dc-5936-872a-1e9da9273e8c)
OCTOBER 20TH, 7:44 P.M. (#ulink_0d83b74e-61b0-511a-8a92-91e4138d5980)
OCTOBER 21ST, 8:55 A.M. (#ulink_b6d12f5c-0daf-5a6a-8a40-0d295a6be057)
OCTOBER 23RD, 11:37 P.M. (#ulink_de209fb5-87a3-5e9b-9761-d884863a8183)
OCTOBER 26TH, 3:35 P.M. (#ulink_3ede9874-b88d-51c0-92e4-061b1f8e2276)
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DECEMBER 16TH, 2:12 P.M. (#litres_trial_promo)
DECEMBER 19TH, 1:19 P.M. (#litres_trial_promo)
DECEMBER 20TH, 3:46 P.M. (#litres_trial_promo)
DECEMBER 21ST, 9:46 P.M. (#litres_trial_promo)
DECEMBER 22ND, 11:34 A.M. (#litres_trial_promo)
PART TWO
DECEMBER 27TH, 8:37 A.M. (#litres_trial_promo)
DECEMBER 27TH, 11:22 A.M. (#litres_trial_promo)
DECEMBER 28TH, 3:20 P.M. (#litres_trial_promo)
DECEMBER 29TH, 12:47 P.M. (#litres_trial_promo)
DECEMBER 29TH, 5:11 P.M. (#litres_trial_promo)
DECEMBER 31ST, 11:47 P.M. (#litres_trial_promo)
JANUARY 3RD, 11:40 A.M. (#litres_trial_promo)
JANUARY 3RD, 2:00 P.M. (#litres_trial_promo)
JANUARY 4TH, 10:56 P.M. (#litres_trial_promo)
JANUARY 5TH, 1:17 P.M. (#litres_trial_promo)
JANUARY 5TH, 5:34 P.M. (#litres_trial_promo)
JANUARY 10TH, 11:00 A.M. (#litres_trial_promo)
JANUARY 12TH, 3:09 P.M. (#litres_trial_promo)
JANUARY 13TH, 9:50 A.M. (#litres_trial_promo)
JANUARY 17TH, 11:08 A.M. (#litres_trial_promo)
JANUARY 18TH, 10:47 P.M. (#litres_trial_promo)
JANUARY 19TH, 10:19 A.M. (#litres_trial_promo)
JANUARY 20TH, 11:14 A.M. (#litres_trial_promo)
JANUARY 20TH, 2:23 P.M. (#litres_trial_promo)
JANUARY 20TH, 3:15 P.M. (#litres_trial_promo)
JANUARY 24TH, 10:44 A.M. (#litres_trial_promo)
JANUARY 31ST, 11:02 A.M. (#litres_trial_promo)
JANUARY 31ST, 12:01 P.M. (#litres_trial_promo)
FEBRUARY 2ND, 9:37 P.M. (#litres_trial_promo)
FEBRUARY 7TH, 11:22 A.M. (#litres_trial_promo)
FEBRUARY 9TH, 7:21 P.M. (#litres_trial_promo)
FEBRUARY 10TH, 9:13 A.M. (#litres_trial_promo)
FEBRUARY 14TH, 11:01 A.M. (#litres_trial_promo)
FEBRUARY 14TH, 12:11 P.M. (#litres_trial_promo)
PART THREE
FEBRUARY 21ST, 10:57 A.M. (#litres_trial_promo)
FEBRUARY 21ST, 2:37 P.M. (#litres_trial_promo)
FEBRUARY 24TH, 5:41 P.M. (#litres_trial_promo)
FEBRUARY 28TH, 10:32 A.M. (#litres_trial_promo)
MARCH 1ST, 4:46 P.M. (#litres_trial_promo)
MARCH 2ND, 3:20 P.M. (#litres_trial_promo)
MARCH 3RD, 1:14 P.M. (#litres_trial_promo)
MARCH 7TH, 1:57 P.M. (#litres_trial_promo)
MARCH 11TH, 1:41 P.M. (#litres_trial_promo)
MARCH 11TH, 7:11 P.M. (#litres_trial_promo)
MARCH 12TH, 2:39 P.M. (#litres_trial_promo)
MARCH 13TH, 9:22 A.M. (#litres_trial_promo)
MARCH 13TH, 10:04 A.M. (#litres_trial_promo)
MARCH 21ST, 7:44 A.M. (#litres_trial_promo)
Acknowledgements (#litres_trial_promo)
PART ONE (#ulink_cb934b41-7c6a-51b1-b64f-1eb3d487b533)
OCTOBER 18TH, 9:40 A.M. (#ulink_a1e5ea5d-6bd1-5db2-9eae-8011ec85acf2)
I’m kneeling on the floor in my office, tying the top of the garbage bag into a knot and squeezing out the excess air as I do it. The maintenance guys always leave extra bags at the bottom of the garbage can, so I can replace this one with a fresh one and just dump the tied-off bag into the bin. I find this is the most discreet way of hiding the rank stench of alcohol when I throw up into my garbage can. I want to believe that my tolerance is high enough that I never throw up, but the truth is, more often than not, I find myself on my knees in my office the morning after.
My name is Sam. I’m a psychologist, and I work in a mental institution. It’s not like the ones you see in Rain Man or Girl, Interrupted. It’s in Manhattan. It doesn’t have sprawling grassy lawns and manicured hedges. It doesn’t have wide hallways and eleven-foot doors like in One Flew Over the Cuckoo’s Nest. It smells like a combination of antiseptic and bubble gum because they added bubblegum scent to the antiseptic. The lights are fluorescent and the toilets are always broken. The elevator is the size of an airplane hangar and it’s always full. I’ve been working here for six years and I’ve never been in the elevator alone. Someone pushes the alarm button every day.
The ceiling tiles in the unit have leak stains in the corners. All the doors are painted gray and have oval windows with chicken wire in the glass. Except the office doors. There are no windows on the office doors, and they’re painted pale yellow. They all have paper signs on them saying things like Lunch and In Session and Do Not Disturb. We have to make new ones pretty regularly because patients write stuff on the signs.
It always feels like once you walk through the front doors, the world gets smaller. It’s impossible to hear outside sounds and, even though I’m in the loudest city on Earth, I can’t hear it in here. There’s only one group room that faces the sun and that’s where the plants are, but it’s always dusty and no one likes to go in there.
We have a lot of different kinds of patients here, 106 of them. The youngest is sixteen and the oldest is ninety-three. The oldest used to be ninety-five, but he died a few months ago. There’s one wing where the men live and another wing where the women live, and pretty much everybody has a roommate. If a patient is violent or something, they can get a single room. Once patients find this out, they almost always become violent. What they don’t realize is that a single room is just a double room with an accordion divider running through the middle, and when the room splits, someone loses a window. The institution is called the Typhlos Psychiatric Center and I’ve never asked why.
It feels fraudulent and silly and sometimes even comical, but I’m not any different from anyone else here. The clinicians are supposed to instill hope. We’re supposed to take our talents and patience and hard-earned degrees and apply our education to the betterment of others. We pride ourselves on having it all together. We fancy ourselves the shepherds. We are told that this is noble and upstanding work, and a benefit to society. But it’s all a pile of shit. We’re no different from them. There’s no line in the sand. In the end, we don’t have canyons that divide us. We barely have a fissure. I have a key and an office and they don’t. I came here to save them; they can’t save me. But sometimes, the lines get blurred. People say “If you can’t do, teach.” Well, if you can’t save yourself, save someone else.
OCTOBER 19TH, 11:12 A.M. (#ulink_be5a41ef-a2c6-5d60-b340-5a959ffee58a)
There is a new patient starting this week. No one wants to work with him. His file is nearly empty, and the rumors churning among the staff have been filling in the blanks with horror stories and nonsense. (He murdered his last counselor; he refuses to do paperwork; he’ll be a nightmare patient.) Even I don’t want to work with him, and I’m the one who takes all the patients no one wants. No one really knows what he’s all about; what’s true, what’s a rumor. He has one of those charts where nothing is clear. He obviously hadn’t answered the questions during the psychosocial evaluations. Most of what was written was garnered from his physical appearance and intake materials. He was definitely in prison; those records are clear. For twenty-some years, although somehow the charges aren’t written in his file. Then halfway houses for years after prison. And now he’s mandated to treatment as a condition of his probation.
We take so much of our power for granted; it only really exists because our patients aren’t aware of their ability to fight against it. And then this guy comes in and starts unsettling everything. I guess I respect him, in a way. I had been napping in my office hoping that something would change, and I guess this guy may be the one to change it.
OCTOBER 19TH, 1:15 P.M. (#ulink_24e7c637-3905-5c7f-981f-300a6960fab8)
“Okay, guys, what does hereditary mean?” I’m running a group counseling session. This is a psychoeducational group, so I’m supposed to be helping my patients understand their diagnoses. So often psychiatrists will tell a patient that he or she has something and then never explain in plain English what it means.
“It means it runs in your family, right?” This is Tashawndra. She had eleven children. Every single one of them has been removed from her custody by social services. She isn’t sure of the whereabouts of most of them, and she believes that two of them are dead, but isn’t positive. This is her reality.
“That’s exactly right—it means there is a genetic component. So which mental illnesses have a genetic component?” I’m up on top of the desk, where I usually sit.
“Cancer. My mom had breast cancer and I had to go get checked for it because she had it, but I didn’t have it.” Lucy.
“That’s right. Cancer has a big genetic component to it, so it’s important to get checked out if someone in your family has it. But what about mental illnesses? What about the kinds of things we treat here?”
“All of ’em, right? I know that if your parents or your brother is addicted to drugs that you will probably get addicted to drugs, too. And people here are getting treated for that. You treat drug addicts here. And sometimes, if your family is depressed, you could get depressed, too.” Tashawndra.
“Yeah, that’s a big one,” I say, wagging my finger in her direction. “Depression has a genetic component. So does schizophrenia, bipolar disorder and many of the other problems we treat here.”
“So you’re fucked, huh? If your mom is schizophrenic, then you can’t stop it from happening to you, huh? It’s like you’re born fucked over. You’re born to be crazy, right? Ha, like ‘Born to Be Bad,’ that song? Born to be crazy.” Tyler. Tyler has schizophrenia. At twenty-two years old, he’s very advanced for his age. He seems to have a greater understanding of the world that the rest of us missed somehow. He’s at peace with things that the rest of us struggle with. Tyler has forgiven.
“Well, no, not always. And watch your language. When you have a genetic predisposition, which means when someone in your family has a disorder, then sometimes you will get it and sometimes you won’t. It depends on what else happens in your life. It depends on whether or not you are exposed to things that will help you stay well, or things that will make you get sick.” I’m bouncing my heels off the front of the desk.
“What kind of stuff makes you sick? Like drugs and stuff?” Tyler. “Because I know my brother did drugs in school with his friend, and then he was crazy after that. He got locked up but he was crazy, man. He never acted like that before he did those drugs.”
“Drugs, sure. That’s a significant one, actually.” I’m nodding and explaining, bright-eyed. “Also, poverty, abuse, growing up without both parents, not being able to get enough food or go to school. They are kind of like strikes against you. So, if you have the gene in you to get depression or schizophrenia, and then you have these strikes in your life, too, you could end up with the diagnosis.”
“Like three strikes, you’re out, right?” Tyler. He and I talk baseball in the hallways. I’m afraid of running into him one day at Yankee Stadium.
OCTOBER 20TH, 7:44 P.M. (#ulink_20d593b2-1a4a-5041-8e8c-7020b776de9b)
When it’s almost time to go home, I start to look at all the things I’ve been avoiding all day. I don’t have a drink or a cigarette with me to help me look at these things, but I start to peer into the abyss anyway.
I know when I get home and I am alone, and my phone isn’t ringing, I’ll be looking at this, so I may as well get it started now. Maybe it will ease the burden. Maybe I won’t cry so hard when I’m at home. Inevitably, the only thing that happens is I am going to be forced to wear sunglasses on the train home because my face will be swollen with misery and my eyes will be brimming with tears that somehow, every single day, manage to cling to my eyelids until the very second my apartment door swings open.
It didn’t always feel like this. Sometimes things made sense. Back when I felt like I understood what was going on, and I wasn’t just going through the motions.
The subway is down. There is a fire on the tracks on the A/C Line, and I have to get off the train a hundred blocks from my apartment. For whatever reason, I am walking now. I tend to think when I walk, which is probably not a good thing, because I don’t have any cash and I can’t stop somewhere for a drink to help me stop thinking.
It’s cold out. The kind of cold that makes your knees hurt and your lips get solid, so it’s hard to talk. My eyes are watering, but I’m not crying. I’m smoking back-to-back cigarettes, and I don’t have gloves, so I have to keep switching hands.
Even though it’s freezing, there are families out in the street. I’ve seen them since I got off the train. There is a mother pushing a stroller on the other side of the street, and we have been pacing each other for blocks. She looks like me. Well, she looks like my mom, and I guess I look like my mom, too. We’re blonde, and I’m guessing the woman has blue eyes like we do, even though I can’t see that far. She’s small, like my mother is. I’m much taller than they both are; I always thought my dad must have been a pretty big guy. Now I’m stuck thinking about my own family as I walk south in this bitter city.
It was just me and my mom growing up. My dad is somewhere, but I don’t know where. I’ve never met him, but it doesn’t really make a difference because Mom was almost too much to manage on her own. Sometimes she sang his praises—Your father is a wonderful man. And sometimes she shit all over him—He’s just some mick fuck who doesn’t deserve me. I wonder if that baby in the stroller knows her dad.
My name is Samantha because my mom’s name was Samantha. I think that’s why I go by Sam. Our last name is James. So I have two first names. I always told people never to trust someone with two first names.
I can see my apartment now. It’s the only one on the floor with no lights on. It’s in an old limestone walk-up building in the middle of the block. I’ve been living in New York City for a few years. I bounced around different studios and tiny one-bedrooms in Brooklyn and Manhattan after I came here for graduate school. My current apartment has three closets, which is practically unheard-of, and a bathtub. I have a desk and a coffee table and it could pass for a grown-up apartment if I could just buy food to put in the fridge. My couch is brown and I have different pillow covers for different seasons. Now it’s the dark blue ones. I have a carpet that’s mostly sun bleached because my windows face south, so the summer sun is in here for the whole day, and I used to like the colors but now I think it looks like a little girl’s carpet. My kitchen is very clean and has a window above the sink, so I can look out while I’m washing wineglasses and see what everyone else is doing. The radiator makes noise, which is comforting because if it didn’t, there would be no sound in here. I never turn on the TV because it makes me feel small.
The front door to my building has a tricky lock, and it always seems to get stuck right when the wind picks up and starts to make my ears hurt. The dark green tile floors in the lobby always look dusty and I’m afraid I’ll slip on them and crack my skull. The stairs are wide and rounded, from a New York era long forgotten, and as I wind up them to my apartment, I peel off my outside layers.
I’m opening a bottle of wine that I bought at the liquor store across the street last night. I always make sure to be delicate and grown-up about my drinking. I drink every night, but that’s okay because it’s expensive wine that I drink out of expensive wineglasses that I always remember to wash before I go to bed. I also always clean my ashtrays, because even I think it’s gross to have stale butts around the house. I quit smoking a few times, but then I gave up quitting because something else is going to get me first anyway. Desperation makes you hold on to funny things.
OCTOBER 21ST, 8:55 A.M. (#ulink_a4dcfb57-8942-5506-ae28-fdd06d0fedc9)
I’m sipping the acrid, burned coffee from the lounge, waiting for my boss, Rachel, to start the clinical-staff meeting. My nails are grimy and dirty, and the nail polish is mostly peeled off. I look up to catch my colleague Gary staring at me. He immediately looks away when our eyes meet, but then he quickly turns his head back to me.
“Yes?” I ask him, eyes wide.
He brushes the side of his temple with the back of his left hand and juts his chin in my direction.
“What?”
He does it again.
I put down my red pen and coffee cup and wipe the sides of my face. I pull back my left hand to see a streak of unblended cakey makeup across my pinkie. Crispy little bits of scab are dotting the makeup.
Rachel begins the meeting.
“Good morning, team. Nice to see everyone bright-eyed and bushy-tailed this morning.”
Muffled laugher and sarcastic snorts.
“I know it’s been getting a little overwhelming with all the new patients starting, but as you know, there are seasons and cycles that are at play with mental health, and with winter almost here, even though it’s only October—” she shakes her fists at the windows “—with the shorter and colder days come more depression, seasonal affective disorder, hopelessness and the like. I’m not telling you anything you don’t already know. That being said, as you’re already aware, we have another new patient, and he is starting today.”
The staff begins to look around nervously; people start adjusting their shirts, looking down at notepads, trying to disappear into the noise.
“I’ve heard a lot of chatter in the hallways. I understand that it’s natural to speculate, but it’s very difficult to maintain unconditional positive regard, an unbiased attitude and an open mind when rumors are being spread in this manner. You all know what I’m talking about.” She glares at us like we should know better.
“Well, can you give us a little more insight into the story with this guy?” Gary.
“I’m not really privy to any more information than you are, so we’re in the same boat. But I am urging you to put your preconceived notions away, set down these ideas you have about him and focus on the little information that we do have. He is coming here for treatment, for help, and your job is to provide that treatment without making the man into a monster.”
“Look, I’m all for positive regard and unbiased treatment, but isn’t it important to ensure the safety of the staff?” Gary again. “I mean, I heard his file is incomplete because he attacked his last counselor. I heard he refuses to answer intake questions, and won’t discuss his history, and if you pry, he goes ballistic. I mean, he’s forensic, and I’m not sure I’m comfortable treating a patient who is known for attacking his counselor.”
“Well, we are not in the business of turning away problematic patients.” Rachel lowers her head and shuffles out the file. “And there’s nothing in here that indicates he has been violent with staff in the past.”
“That’s because there’s nothing in there at all! The file is nearly empty. It says he is a big dude and wears a hat and doesn’t talk. It says he’s been in jail half his life. But, somehow, it doesn’t say on what charge? Hmm? That’s insane! You can’t have a forensic patient with no history, and no psychosocial, and no diagnosis, and nothing in his file, just waltz in here, and we’re supposed to figure this all out from nothing!” Gary is exasperated. Gary used to be a social worker in the finance world. He worked for a firm that did corporate layoffs, and Gary’s services were offered to those individuals who lost their jobs. He always ended up feeling like the messenger and he couldn’t hack it anymore, so he ventured into something he thought would be cushier, less dramatic, more sustainable on a daily basis. He went from the frying pan into the fire, and he is still looking around, bewildered, wondering how he got here.
“Then what exactly do you think we should do, Gary?” This is David, who usually stays above the fray in these meetings.
“Send him somewhere else!”
“That’s ridiculous. We are the ‘somewhere else.’ This is the last stop. Would you rather he was out on the street? With no treatment? No chance?” Me, wiping coffee stains from the conference table.
“Look, I mean, I just don’t want him on my caseload. I don’t have a lot of extra time on my hands, and being tasked with completing an entire file of pre-intake data in addition to everything else needed for him, for a guy who will probably stab me and doesn’t even talk? No. I’m sorry, but no, thank you.” Gary folds his arms across his chest and leans back in a huff.
“Then why are you working here?” Shirley immediately regrets these words, and she cowers back into her seat, hoping this comment didn’t open her up to the possibility of being the new guy’s counselor.
Rachel jumps in, taking control of the discussion. “It’s important for all of us to have a forum in which we can discuss the concerns we have with the patients, and to bring everything out in the open. These meetings are exactly that forum. We are not here to attack each other. I want you all to talk to me and each other about what you’ve heard and what makes you so nervous about our new patient Richard. But I will continue to caution you—rumors are usually unfounded, and we need to be careful how we color this man.”
Gary slumps farther down in his chair and disengages from the discussion. Julie, the bubbly princess, pipes up that she is fearful for her safety, and she worries that she’s too physically weak and defenseless to effectively treat someone who intimidates her. Other female staff members coo in agreement. Julie has wormed her way out of taking anyone else onto her caseload for weeks.
“Why was he in jail?” Shirley.
“I honestly don’t know.” Rachel. “As I said, I have access to the same records as you, and I don’t have that information.”
“But isn’t that weird? Shouldn’t we know?” Julie.
“What difference does it make?” Me. “If he were in jail for racketeering or armed robbery or whatever. It doesn’t make a difference. It could be drugs. It could be the third offense for something small, and with the ‘three strikes, you’re out’ law, he could have been in jail forever. It’s not a sex offense, because he isn’t registered—I looked it up. It really shouldn’t matter what he was in jail for. But it’s important to know that he was in jail. His perspective is obviously altered, and he has probably been subjected to some pretty horrific stuff in there.” As I say all of this, it occurs to me that I am completely uncomfortable with not knowing why he was in prison for so long.
“I heard he doesn’t talk, at all, and that he is very aggressive. He refuses to follow protocol, he doesn’t get along with other patients, he doesn’t do paperwork.” Shirley.
“Well, I think it’s clear that he’s not cooperative with doing paperwork, but beyond that, I am going to ask everyone to chalk this all up to speculation and the tendency to fill in blanks with drama when we don’t have sufficient information. The fact of the matter is he is here, and he is going to be working with us.” Rachel is no longer looking at anyone and getting ready to drop the bomb. She’s stalling. Everyone starts to shift uncomfortably.
“Sam—” she looks up and tightly smiles in my direction “—and Gary.” He slumps back into his chair, defeated. “I’m going to put Richard with you, Gary, and Sam will be your backup. You can learn a lot from this patient, and I think you’re up for the challenge. And, Sam, you have the best success rate with difficult patients, and you’re a ranking member of the clinical staff. I prefer to start Richard with a male counselor and see how that goes. We will all be here for extra support should you need it, but I’m sure you’ll be able to handle this.”
Shirley and Julie give each other exaggerated looks of relief, and everyone breathes a sigh. David gives me a conciliatory squeeze on my shoulder. Gary huffs up to Rachel and lolls his head to the side as she hands him a copy of Richard’s intake materials. He says nothing, and instead looks to me with wide eyes and an impatient bend in his leg.
“No problem, Rachel. I’m on it.” I gather my papers and coffee, and as we all bleed into the hallway, Rachel hands me my own copy of Richard’s file.
Gary assures me that he has no problem taking Richard’s case, and I will not need to participate in his supervision. Gary is an idiot.
“Well, that’s all well and good, Gary, but I’d like you to come to my office so we can discuss a plan of action. Not because I don’t believe you can manage this, just because I want to stay in the loop if I’m going to be your backup.”
“I really don’t have time right now, and I’d like to get an initial meeting with this guy done today.” He stands at the door to the conference room with his whole body and one outstretched finger pointed toward his office.
“Come on. It’ll only take ten minutes.” He expels a giant, frustrated moan and follows me down the hallway to my door. “Sit down,” I say, waving my hand at my patient chair. He flops down dramatically and lets his Gatorade slosh onto the carpet in front of him.
“I’m going to find him on the unit and bring him to my office for a meeting this morning. I’m going to talk to him like a man, and I’m going to treat him like he’s not scary and no big deal. I’m sure all this crap about him being scary is just because he was incarcerated and prisoners scare people. Well, not me; I’m not scared.” He rubs his Gatorade spill further into my carpet with his shoe.
“This is the extent of your plan? You’re going to talk to him like a man?” I’m not even bothering to write this down.
“Yeah. It’s not rocket science, Sam. He’s a patient and I’m a counselor. So, he has to answer me. I don’t see why everyone had so much trouble before.”
I shake my fragile, hungover head to try to clear the stupidity of Gary’s response. “Can you please give me something a little bit more specific? How do you plan on getting through to him when clearly no one has been able to until now?”
“Like I said, by talking to him like a man.” He slowly enunciates the last three words.
“What does ‘like a man’ mean?” I hover my pen over my notebook and avert my eyes. I can’t look at him for fear of his response.
“You wouldn’t understand because you’re not a man.” He stands up to leave my office and pats me condescendingly on the shoulder as he leans down to add, “I’ll make another meeting with you after I’ve gotten some answers out of him, okay?” And he’s out the door.
OCTOBER 23RD, 11:37 P.M. (#ulink_fdb099dc-b79f-56e6-b91e-53559b5b25cb)
I have been avoiding garbage day for about a week now, and the recycling bin is overflowing. There isn’t much space under the sink in my kitchen, and since I drink more than I cook, I have the big recycling bin between the front door and the fridge. It looks more like a hamper.
The blue see-through bag has been pulled under with the weight of the bottles, and I need to yank it up by the red strings to get it out of the can. The clattering sound it makes is absolutely insufferable. There is a leak at the bottom, and the putrid stench of week-old wine and booze, mixed with the acidic smell of the Tropicana bottle from this morning’s screwdrivers, is making me gag. There’s a reason I always put this chore off until the last possible minute.
The noise the bottles make as I pull it along the carpeted hallway is not as bad as it would be if I were to pick it up and haul it over my shoulder, Santa Claus–style. I will have to carry it that way when I walk down the old marble steps to the basement.
I push open the refuse-room door, and I see skittering bugs as I turn on the lights. They’ve come inside to hunker down for the winter, and this room is a veritable buffet of gnarly shit for them to feast on. I flip over my huge sack of booze bottles into an awaiting plastic can, and it sounds like several of them smash. I feel the ooze that has spilled down the back of my pajama pants, and I try to dry it off with a rag that was hanging on a hook by the door.
I get back up to my apartment and clean up the smears on the floor. I put the two forgotten bottles of beer into a fresh blue recycling bag and line the can with it. I have two bottles of scotch on my bookcase shelf that I never finish. There’s always at least four fingers left in each bottle so if I have company, it looks classy and sophisticated. I usually have a bottle or two of wine in the fridge, too. Not because I’m saving it, but because I buy in bulk.
OCTOBER 26TH, 3:35 P.M. (#ulink_104b5418-eb84-5473-8073-adb1b9d6b295)
Gary is loitering in front of my office door as I return from running a women’s group.
“Hey, Gary. Did you need something?” I can see the desperation in his eyes, and I know what he came here to discuss with me.
“Yeah, I need to talk to you. Do you have a minute?”
“I sure do, come on in.”
Gary slumps low in my patient chair and rakes his sweaty fingers through his hair. “This is making me crazy. I can’t get a word out of this guy, and I’ve had meetings with him every day since Friday.”
“You mean Richard McHugh?” I know exactly who he means.
“Yeah. I brought him in on Friday, like I said, and I tried to start the evaluations and assessments for his patient file, right?” He’s leaning on my desk and waving a meaty paw in my face. “And he doesn’t say a word. Not a word. He just sits there, and I thought he must be deaf or something, because he just didn’t say anything. He didn’t get mad or anything; he just sat there. I kept asking him the same questions, and he just looked at me or looked out my window. So, then I figured maybe he wasn’t ready. I told him about me, tried to relate to the guy, said I would treat him like a man if he treated me like a man, and still nothing.” Gary is genuinely surprised that his presumptuous macho plan didn’t work. Half of me wants to laugh in his face, and the other half wants to be professional and help him develop as a counselor.
“Okay. So, the original plan didn’t work. You said you met with him every day since then. Did you change your approach?”
“Yeah. I mean, I did everything I know how to do. First, I was just trying the ‘talk to him like a man’ thing, and that didn’t work. Monday, I asked him to come back to my office, and he didn’t put up a fight or anything. So, I figured this time I would just be all business and make him answer the evaluation and assessment questions. But he didn’t answer a single question! He started reading the newspaper. He brought this huge stack of newspapers with him to read and wouldn’t even look at me when I asked him questions.”
“Okay, and I imagine the sessions yesterday and today were more of the same?” I’m already tired of hearing this.
“Yeah, total silence. He doesn’t even say hello.” Gary leans back, satisfied that this is my problem now.
“Gary, you’ve made four attempts to talk to a man who apparently doesn’t like to talk much. So, you shouldn’t be surprised or disappointed that conventional methods aren’t working.”
“I don’t think it’s my methods, I think it’s me. I think he just doesn’t like me.” Gary is saying this to appeal to my ego, so that I offer to take over for him and he doesn’t have to ask me.
“How would you like to proceed?” I’m not letting him off that easy.
“I think you should take him. I don’t have this kind of time to waste on someone who doesn’t talk, doesn’t want to be helped.” He is crossing his arms and shaking his head in fast, erratic twitches that make him look like a frightened woodland creature.
“I can’t make that call. You’re going to have to speak with Rachel.”
“Oh, come on, Sam, can’t you just take this one for me?”
“I’ve already taken Shawn for you.” I sigh. “But if Rachel signs off on it, I will take him. Until then, he’s yours.” I close my notebook for effect and open my door, allowing Gary to go find Rachel and deal with this.
OCTOBER 28TH, 9:12 A.M. (#ulink_b536a1f1-ad5b-5c03-9dcd-ff243e5512f6)
We have a 9:00 a.m. staff meeting most mornings to discuss our patients and any administrative nonsense that needs to be addressed. Everyone usually drags ass in the meeting except for me and my boss, Rachel.
Rachel is a linebacker. She is a formidable presence, and her booming voice and sharp intellect scare the shit out of everyone. She was born to run an institution, and her lack of a private life really helps her excel at her job. Her stringy, mousy brown hair is pulled back with a velvet scrunchie and she is always wearing a sweater set and chinos that are too tight in the hips and it makes the slash pockets stick out like little ears.
Rachel likes me because she needs to believe that I really am always energetic and positive and a barrel of sunshine. Whenever I am out on the unit, I am a superhero. I am a troubleshooter, and a problem solver, and the go-to gal to get stuff done. My coworkers hate this about me. Until I cover their groups, or take their patients to the ER, or finish their case reviews/progress reports/treatment plans; then they love this about me. I make self-deprecating jokes as a defense mechanism. I always ask people about their weekend and how they’re doing because people are narcissistic and won’t ask me how I’m doing in response. This way I don’t have to lie to anyone.
“Frankie’s back in the hospital.” Shirley begins her report. “Apparently he was standing in the middle of the street trying to direct traffic. This was an intersection on Broadway, and it’s amazing that he isn’t dead. Supposedly, when the police tried to stop him and arrest him or whatever, he started running away from them, bouncing off of cars, running in between them… It was a mess. Eventually they tackled him, I’m not sure, and they brought him to the psych unit at Columbia University Medical Center. He is on suicide watch right now, and I keep getting calls from the docs telling me that he’s not cooperating. I’m not sure what I’m supposed to do about this.” Shirley is both disengaged and disenchanted and ran out of empathy years ago.
“You go to CUMC, Shirley,” Rachel responds, irritable, frustrated, possibly menopausal. “You talk to the doctors. You make sure they know you’re the point person in his continuing care. Eventually, Frankie is going to be coming back here for inpatient services once he is cleared to go, and he needs to be aware that he wasn’t abandoned in the psych unit at CUMC.
“Remember, all of you.” She is looking at us like bad kids who ate all the cookies. “We are the only resource for many of our patients here. We are their mothers and fathers, their caretakers and confidants…”
I didn’t sign up to work on this unit to be anyone’s mother or father and I resent her for saying this as she drones on with the lecture she has delivered so many times. I sip my coffee and stare out the only window in the conference room. There is construction going on across the street; I can hear it a little bit, but mostly I just watch the men in jeans and reflective vests glide up and down this building as they work the planks and rods of the scaffold, and I wonder what would happen if someone jumped off.
“In other news,” Rachel continues, “I’m announcing a caseload change this morning, as well. Gary has been working hard to reach our newest patient, Richard McHugh, but unfortunately, he hasn’t gotten anywhere. I met with Richard yesterday to discuss a change in his counselor, and he asked for you, Sam, by name. So, tag—you’re it. Good luck.” Rachel told me about this before the end of my shift yesterday, so this is nothing more than a performance for the rest of the staff.
Rachel pulls me aside and thanks me for playing along. I rejoice in being her golden girl, and whenever she has faith in me, it helps me to have faith in myself. She reminds me again that Richard specifically said he wanted to work with me, Samantha James.
Julie is waiting for me outside the conference-room doors. “No wonder Gary couldn’t handle that guy, I’m sure you’re going to do a much better job. I can’t believe Rachel even wasted our time assigning him to someone so incompetent.” Julie, always looking for someone to tell her she isn’t incompetent. She is huddling next to me like we’re girlfriends of twenty years, holding my arm and whispering her hot-coffee whisper into my hair.
“I just think it’s stupid to have these meetings at the ass crack of dawn when everyone is still hungover and can’t even read yet,” I say, trying to lose her.
“You’re hungover?”
“It’s a figure of speech, Julie. I am not literally hungover.” Lies. Lies. Lies. I would be much better off wrapped around a toilet right now, but Julie will offer me no solace.
“Oh—I know—I guess I just thought maybe you went out last night again. When are we going to go out together? Are you doing anything tonight?”
Julie likes me and wants to be my friend, but I find it impossible to like her. As much as I appreciate her for being an idiot who can’t get over high school, I still can’t tolerate listening to her inane musings and cotton-candy problems with her debutante friends and country-club life. David walks past us and gives me a knowing smile and chuckle.
“I never make plans this early in the day. I will let you know, though; we should definitely grab a drink sometime.” I smile broadly and disengage from her grasp as we are getting close to my office. I juggle my coffee and my case files to try to get the keys out of my pocket when I see that my door was left open anyway.
Nothing is amiss. I must have just left it unlocked. Maybe I’m still drunk. My iPod is still sitting tangled in the headphones on top of a stack of books on my desk. That wouldn’t be there if anyone had come into my office. My sneakers are in the corner where I leave them every morning. A couple of months ago, Shirley left her door open during one of her group sessions and the batteries got stolen out of all her electronics.
OCTOBER 28TH, 11:00 A.M. (#ulink_c101af97-0533-5e43-be55-708d7e9f43ac)
My initial meeting with Richard is already happening today, and I have been fixing my desk and my hair and my face and my office for the past hour to prepare for it. I am afraid of him, and I haven’t had this feeling since I started on my first psych unit nearly fifteen years ago. I was barely twenty-two. I never feel like this anymore. I’ve sat across from lunatics and psychopaths, diplomats and dignitaries; it’s all the same to me now. I haven’t been scared like this in ages.
My office is configured the way it’s supposed to be, with the desk chair closer to the front door than the patient’s chair. This is done just in case the patient gets violent and the therapist needs to escape, but we say it’s done so the clinician can obtain emergency services more quickly should the patient need it. I’ve never had a patient get violent in my office; it usually happens out in common areas. I realize I have the scissors closer to the patient’s chair and I move them to the drawer. Sometimes I sit on my desk so I can gaze out the window and pretend I have a different life.
The door knock is so loud and jarring that my already frazzled nerves just explode and lodge themselves in my throat, making it hard to speak. I have to appear calm no matter how scared I am.
“Hi, Richard. Come on in, have a seat.” I remain standing, holding the door open for him. I’m waiting for him to sit, then I close the door and begin to get dizzy. He sits in my patient chair and places a large stack of newspapers at the corner of my desk. “I am going to be your counselor. I wanted to set up this initial meeting so we could get to know each other a little bit, and maybe get started on some of the clinical documentation we need to do.” I sit down as I say this.
Richard doesn’t say anything in response. Instead, he lifts the top paper from the pile and makes a show of opening it up and finding his intended section. He slips off his hat. It’s a brown herringbone newsboy cap. He places it gently on top of the newspapers. As he turns his neck, I notice two small, round scars under his collar.
I rustle the papers of his blank file and begin again. “Why don’t we start with the family history section? This way you can tell me about your family, and we don’t have to dive right into talking about you personally.”
He turns away from me, folds his paper in his lap and focuses his attention on the men climbing the scaffold across the street.
“Okay, no family history. What about goals for treatment? Would you be willing to talk about what you’d like to achieve while you’re here at Typhlos?”
He raises his eyebrows, releases a breath and adjusts his seat to get a better view of the construction workers.
“Okay, that’s a pretty obvious no. How about telling me a little bit about yourself, informally, and I will gather whatever information I need. How’s that?”
Richard glares disapprovingly. “You want me to sit here and tell you all about me? Like a job interview?”
“If that’s how you want to look at it, yes. A job interview would be great.”
“No.” Blunt. Decisive.
I’m barely making more progress than Gary did. It looks like I’m going to have to work on this guy a bit more than I’d anticipated. I feel exhausted just thinking about it.
I sigh an enormous, frustrated sigh, and I intentionally blow it in Richard’s direction. I hope it stinks of booze and vomit and coffee so he knows how much his resistance is pissing me off.
OCTOBER 28TH, 10:01 P.M. (#ulink_5dca1343-60ff-5915-a4f1-812108881026)
I’m on the train, watching the people in front of me arguing. It’s packed, and it’s cold outside, but the body heat from the rest of the riders is making me sweat into my scarf. The sways and jolts of the train are lulling me into a trance, and all I can hear is the woman in front of me telling her boyfriend that she has had enough.
I am currently seeing someone. I don’t know why that is the terminology we use—“seeing” someone; usually, I say “seeing someone” in reference to a therapist, but this is how I describe my relationship because I don’t want to say “relationship.” We have been involved for a while.
His name is Lucas. On paper, he is the type of guy you’re supposed to marry. He does something in finance, and he calls it “finance,” which makes me want to punch him. He knows the difference between Cabernet and merlot and wants me to taste the tannins. He has a King Charles spaniel named Maverick, which of course just makes him wildly out of my league. He went to Cornell, and he actively parts his hair. In the morning, he uses a fine-tooth comb and creates a straight line down the left side of his head, and he tucks stray hairs behind the line. I am anal, but he is crazy. He wears shoes that he keeps shoe trees in. He finds it very important that when he gets home from work and he takes off his shoes he immediately puts the shoe trees into the shoes because they are warm from wear and more susceptible to morphing into an undesirable shape. I care less about shoes than he does. He has dirty-blond hair, is tall and wears suits with pocket squares that he has to have folded just so. He’s prettier than I am.
He talks to me about getting married. I find this completely ridiculous. I am not the girl you marry. The only reason I have stayed with him for such a long time is because I am trying to rescue him. This is a well-known pattern in my life, and I have only recently become aware of it and okay with the fact that this is what I do.
He has all the things that girls are looking for: the stability, the money, the good looks, the education. But underneath it all lies a very damaged, very insecure little man, and that is who I am dating.
I do not want this picture of perfection; I do not want this combed, shoe-treed, elitist, country-club gentleman. I want the broken-down little puppy inside of him who is desperately trying to play pretend. I want to find that puppy, I want to rub his belly and give him a good home, and then, when he’s better, I will leave. This is a project. This is a way of making sure that I don’t get hurt, and making sure that someone values me.
I have no way of getting value from within, so I get value from without. As soon as I see the reserves beginning to dry up, I will walk out of his life and move on to the next well of validity. The truth is, this plan isn’t working, and hasn’t been working, but I’m not ready to give up just yet.
OCTOBER 31ST, 10:25 A.M. (#ulink_28e9f8b0-2f31-5839-8f27-d71e2ccf073c)
Richard is in my group this morning, and I suddenly feel like I am performing more than facilitating a therapy session. He’s sitting next to a relatively new kid named Devon. Devon is my age and surprisingly stylish. Today he’s wearing designer jeans, distressed black leather shoes that extend too far out and look like cartoon cowboy boots, a gray athletic T-shirt and a pretty badass leather motorcycle jacket. Not the kind you pick up at a department store for nine hundred dollars; the kind guys who actually ride motorcycles wear. His long dreads are twisted into a thick ponytail. If I had seen him under different circumstances, I might have said he was hot. Except for the shoes.
Devon is diagnosed with schizophrenia, disorganized type. This isn’t particularly common here; most of the patients with schizophrenia are diagnosed with paranoid type. People outside these walls call it paranoid schizophrenia, but when I’m here I have to say it the right way.
He sits with his legs twisted around each other, at the edge of his seat, constantly wringing his hands together and twisting his arms around one another. At several points during today’s group, he looked like he was about to tip over. After a few groups, Devon began standing up in this position. He would perch on one bent leg with the other leg twisted around it, holding his arms out in front of him and eventually doing something that looked like martial arts. He would shadow box standing like that; he would move his arms in slow, concentrated motions like tai chi. This was both fascinating and distracting.
I’m seeing Devon twitch and perch now, and I’m inwardly terrified of how this is going to affect the other patients—particularly Richard. I’m watching him with one eye while keeping the other eye on the group. Richard is keeping to himself; he’s arranged it so there’s more than one chair between him and any other patient, but he is looking up from his papers over his glasses, and he is noticing Devon. The other patients start to become wary of Devon’s behavior, and some become obnoxious and say they don’t want to be around this weirdo and I should kick him out of the group.
“No one is getting kicked out, Barry. Take it easy.” I lean back on the desk.
“Nah, man, this dude is weird, I don’t want none of his weird getting on me, man. He distractin’ the group! He shouldn’t be in here!” Barry likes to be the peacekeeper while not keeping the peace at all. He frequently causes uproars in the name of justice and the betterment of the group process. I think Barry makes big scenes to distract himself from the voices in his head.
“Barry, since you’ve elected yourself to be the spokesman for this group, why don’t we follow your lead and talk about stigma.” Everyone hates when I do this.
“Aww, Miss Sam, can we not? I’m tired of talkin’ ’bout stigmata.”
“Stigma.”
“Whatever you call it. I’m tired of it.”
“Okay. First of all, what is stigma? What does it mean?”
“Stigma is like prejudice, right? Like when you an asshole to someone because of how they look, or being black or something, right?” This is Lucy. Lucy is seventeen. She wears sexy outfits and too much makeup. She has bipolar disorder. Some days she is so with it, I want to send her to Harvard, and some days she can’t tell you her name.
“That’s right, Lucy. Good job. Stigma is a lot like prejudice. It’s a negative belief that exists about a member of a group that is based solely on group membership. Anyone ever have experience with that?” Sometimes, I’m more of a teacher than anything else. When I get into a good discussion, I start kicking my heels against the front of the desk. We are not supposed to be sitting on the desks; it’s another one of the rules about making sure we keep a proper level of separation between “us” and “them.” The longer I’m here, the less I care about this separation.
Everyone raises their hands to indicate they have been stigmatized in the past. Even Richard has his hand up. Devon is the only one who doesn’t respond. I call him out.
“Devon, you see everyone else has their hands up? This has never happened to you?” I’m trying to involve him, not alienate him, but I fear I’ve made the wrong impression. He looks at me and seems to say something.
“I’m sorry, Devon, I can’t hear you from all the way up here. Can you say that one more time?” He responds again, this time unlocking his chin from his neck and seemingly trying to project.
“I’m sorry, still can’t hear you.”
“He says he stays away from people.” Stephan.
“Thank you, Stephan. Sometimes it’s hard to hear. So, Devon, you stay away from people? Is that to avoid being stigmatized?”
He nods.
“It hurts to be the victim of stigma, doesn’t it?”
He nods.
Everyone else nods.
“What kinds of things do you think other people believe about people with mental illnesses? What kind of stigma have you experienced?”
“People say we’re crazy.” As Stephan says this, I start writing the words on the blackboard behind me.
“Lazy. Uneducated. Stupid.” Barry.
“People say we a burden. Like we don’t do nothin’ to help America.” This is Lucy again.
“Dangerous.” I’m surprised at who this is coming from. Adelle is about a hundred years old. She is as frail as they come, and I wouldn’t imagine she experiences the stigma of being dangerously mentally ill. Then I remember that while off her meds, Adelle once stabbed a man in the chest with a pair of scissors.
“Dirty. Disgusting. People don’t want to stand near us. Even we don’t want to stand near each other.” Darryl says this. Darryl is suffering from a traumatic brain injury that resulted from a self-inflicted gunshot wound to the head. He still struggles with major depression, but he swears he will never attempt suicide again. His wife left him after the incident because she couldn’t bear to look at him with the resulting disfigurement.
“Alright, I’ll say it: they say we’re weirdos.” This is Barry making amends. He looks at Devon. “Sorry, man, you don’t need me calling you a weirdo when everyone else already does.”
Devon nods.
“Thank you for that, Barry; that was very nice of you. What else, guys? What are some other stigmas you’ve experienced due to mental illness?” I see Richard looking at Barry, seemingly approving of his apology.
“People think they could catch it from you. Like if they have sex with you, they could get bipolar.” Lucy.
“Does anyone know if that’s true or not?” Me, I’m trying to teach without making the patients feel like they’re in school. I’m looking at Richard, but his head isn’t in the room.
“Nah, you could get AIDS and shit, but you don’t catch crazy.” Barry.
As I’m writing all the words on the board, I’m beginning to feel guilty because I’ve held every single one of these beliefs. I feel simultaneously sad and defensive.
As the group finishes, I wait for everyone to file into the hallway. I am walking around the room putting the chairs back into a semicircle, picking up the garbage left by the patients. As I walk past the chair that Devon squeezed into the corner, I notice little flakes, like paint chips or confetti, scattered at the base of his seat. I brush them onto the floor and keep walking.
I erase the board, making a mental note of all the words written, wondering how often I’ve felt stigmatized. Wondering how many of these things people think about me. Wondering, not for the first time, if I fit a profile.
NOVEMBER 1ST, 11:11 A.M. (#ulink_2d9ddee4-2deb-5629-b05b-863adc7f221a)
I’ve given Richard a schedule with weekly one-on-one sessions with me, as well as several group therapy sessions most days of the week. Patients often respond well to structure, and I want to keep him busy while I figure him out. We have our regularly scheduled Tuesday 11:00 a.m. session this morning, and he is shuffling and wiggling and trying to get comfortable in my patient chair. He is too large for my office. He looks like a doll two sizes too big for the dollhouse. He is holding that stack of newspapers under one arm while shifting his weight back and forth in the seat. When he finally finds a comfortable position, he drops his papers onto the corner of my desk and awkwardly bends his elbow on top of them. His left arm bows at a strange angle, and he holds his wrist rigid, so it looks like he has a prosthetic arm.
“So, now that we’re settled, I’m going to try to get going with your file again. Can you give me a few minutes of attention to get this ball rolling?” Hopeful, positive, maybe even energetic.
“What’s this? Another test?” he asks. He doesn’t take off his hat, which pisses me off because I think it would be polite if he did. I realize that the best way to suppress my fear might be to replace it with anger, so I momentarily dwell on being pissed that he is impolite. It’s still the tweed newsboy cap, like the ones R & B groups made popular in the ’90s.
“I’m not doin’ no more paperwork.” His voice is calm, masculine. He isn’t arguing with me, simply stating a fact.
“Any more…” I absentmindedly correct him while sifting through my files and avoiding eye contact.
“Look, I’m here because I chose to be here, and I know that I don’t have to fill out the forms, and I have confidentiality and privacy, and I don’t have to answer any of your questions, and if you want to kick me out then that’s fine. I know my rights. I heard you were the best counselor here and I didn’t think you’d give me trouble like that last dud they put me with.” He shifts farther away from me as he says this. He wrings each hand individually, as if he were wiping something off his thumbs. He is fidgety. He is nervous.
“You don’t have to do anything you don’t want to do. But you’re going to make it harder on yourself if you avoid me. I am the person you’re going to be working with for the duration of your time here. I am here to help you and to make your stay as painless as possible. If you need anything, I am the person you come to. If you have problems with anyone else on the unit, and you need an intervention, I am the person you come to. But I can’t help you until you help me.” Rehearsed.
I think the masking-scared-with-pissed ploy is working. He says nothing. I am looking at his eyes for the first time and I realize they are blue. For whatever reason I hadn’t expected this. He keeps them squinted. I can’t decide if this is because he is using his scary face or if he has sensitive eyes. They are light blue, much lighter than mine.
He is unfurling his hands now, and I see his fingernails are well maintained. This is notable only in the fact that it is completely opposite from every other patient. Even the women who spend their last dime on a fancy manicure will allow it to get gnarly and grow out so far that they have a quarter inch of real nail visible beneath the green, sparkly talons of a month ago.
But he remains silent. I can’t tell if this is because I have stumped him or he is about to rip my face off for talking to him like that. I know no one else has said as much as this to him, and right now I can’t imagine what gave me the balls to do it.
“Let’s start with something light.” I put on my glasses and I reach for a pen. “Name?”
I want to hear him pronounce his last name, because I am afraid he will be offended if I say it incorrectly. McHugh. I don’t know if you’re supposed to say the h or if it’s silent or what. I’ve got him talking, and I don’t want to compromise my progress.
“Richard McHugh.” Sounds like mah-Q. Okay, now we have that settled. “Am I supposed to call you Doctor, or what?
“You can call me Dr. James, but I prefer Sam.”
“Why do you prefer Sam?”
“Well, Richard, to be honest with you, I prefer Sam because it’s easier to yell down the hallway. Why do you use your full name? Richard has so many appealing nicknames.” Am I being obnoxious? Flippant? Nonchalant? I feel exhausted, like I can’t conjure the energy I need to be a professional here, or to fake it anymore. I feel like there is a miscommunication happening in my brain and I am accidentally betraying my real feelings in a session and not putting on the appropriate mask.
“I like Richard. No one’s calling me Dick.”
“Okay, sir.”
“No, I didn’t ask you to call me sir; I said Richard.”
“Okay, Richard.” I’ve never seen a reaction like that. Who doesn’t like to be called sir? “Moving on— Date of birth?”
“July fourteenth, 1960. It was a Thursday.”
“Really?” Now I’m interested. “How do you know that?”
“My mother told me. She said it was the worst day of her life and that’s why she always hated Thursdays.” I can’t believe we’re getting somewhere. I am afraid of reacting incorrectly and shoving the turtle back into its shell.
“Well, I love Thursdays.” Benign response, please don’t shut down. Please open up to me. “Whole weekend in front of me. And where were you born, Richard?”
“Queens.”
“Ah, right here in New York, huh? Siblings?”
“No.” Back to one-word answers.
“Family history…”
“No.”
“It’s not a question; we are moving to a section regarding your family history, your backgr—”
“No. I’m not answering any questions about family.” He cuts me off again.
“Okay, well, I understand completely if you’re not comfortable, but it’s vital for your treatment, and—”
“No. I said no. I’m not saying anything else.” It’s over; the turtle is back in his shell.
“Okay, you don’t have to do this now; we can come back to it another ti—” He stops me before I can appease him.
“Are we done? I want to leave.” Before he even finishes his request to leave, he is out the door and halfway down the hall. I am facing the bookcase instead of the desk because he brushed my chair and spun it off balance. What just happened? What did I say? How did I lose him?
NOVEMBER 2ND, 10:53 P.M. (#ulink_989e06be-b617-50a2-a18e-16bdcecf2e0c)
I’m going to meet Lucas for drinks. We don’t live together, but we spend enough time at each other’s places that sometimes I wear his clothes instead of doing my laundry. Dating Lucas is like dating two people, and I can’t take one of them out in public. The scabs on my scalp are itchy and raised, but I still go to him, and I still tolerate this treatment.
Ninety percent of the time we go to the same bar and meet up with the same people. Some are friends; some are just other bar regulars who have become friends; sometimes David from work comes to the bar. But tonight Lucas and I are going somewhere different because he said he doesn’t have the energy to party tonight.
Somewhere different turns out to be Flatiron Lounge on Nineteenth Street. The drinks are really interesting and expensive, and it’s dark and none of the seats are actually comfortable, and the waitresses are hot enough to make me feel insecure, but Lucas looks really nice in candlelight, so I try not to worry that he might have brought me here to break up with me.
“You look great tonight, honey.” Lucas. His voice sounds a little bit like what I would imagine a diesel engine covered in melted butter would sound like.
“Well, thank you, my dear. I have been sober for a shocking number of hours, and I’m sure that’s a good look.” I have trouble being serious when I’m nervous. Even though Lucas is a project, it’s not part of my plan for him to break up with me, and it’s not part of the plan for the relationship to end now, so I hope this is about something else. Inevitably, this forces me to remind myself of why I’m with Lucas to begin with and why I continue to put up with this.
“I just didn’t have the energy for all the guys tonight, you know? It can be so exhausting going to Nick’s Bar every night.” He really does look like he has it all together.
“Yeah, I hear you.” I lie. On the inside I really want to be at Nick’s because everyone there knows me only just enough to think that I am fabulous and attractive, and they have no idea that I am actually a mess. That’s the kind of crowd I need to be around. When someone else believes this show, when a whole group thinks this act is real, when scores of intelligent human beings look at Lucas and me together and they see us as stable, rational, healthy adults in a stable, rational, healthy adult relationship, then I can believe it. I need to believe it. This fancy show we put on, this ruse, this bullshit we sling, I need it. I need to make people believe that I am alright, because if they think I am, then maybe I can think I am, too. And that’s why I tolerate it.
Right now, as I’m looking at all these leggy Europeans, I am starting to feel smaller and uglier and more and more in need of alcoholic sustenance, but I am drinking something made with frothy egg white and it isn’t going to cut it.
“Also, I have to admit, that’s not the only reason I wanted to go somewhere quiet tonight.” He is looking at me with what I would describe on someone else as sexy eyes, but on him I just find it comical. He is very handsome, but I’m nervous and I think he looks like a cartoon.
“Oh, yeah? Whassat?” I can feel the sweat starting to bead between my boobs.
“I wanted to talk to you again about the idea of you and I moving in together.” He leans even closer to me, and his elbow takes up the entire cocktail table between us, and I am suddenly aware of how small this bar is, and the lights start to look like they’re pulsing, and I am getting that dizzy feeling where I want to put one foot on the floor, but both my feet are already on the floor, and the music is too loud, and someone is asking me if I want another drink and I think I’m going to pass out. Lucas reaches his hand over to stabilize me, knowing the look I have on my face.
“I’m not pressuring you,” he lies. “I just want to open up these lines of communication again. I know you’re not a fan of cohabitation, and I know you want your independence. But my place is too big for just me, and you would have plenty of space there.” He has leaned back and let go of me.
I’m gesturing to the bartender, so he looks at our waitress and sends her my way. All seven feet of her approach the table and bend down to hear me croak out an order for four shots of Patrón Silver. Lucas gives me a condescending eye that he likes to use on me in places like this because he wants the other guests to believe that he doesn’t binge on booze every single day, and at this club he can keep up that appearance. And Lucas thrives on appearances.
“I like the way things are going with us, Sam. I think we could really make something here.”
“I like us just fine the way we are, Lucas. I don’t think we need to change anything.”
“Why do you have such a fear of commitment?” Crossing his arms, getting defensive. People don’t usually say no to him. I usually say no to him.
“I don’t have a fear of commitment; I’m as committed to everyone in my life as I possibly can be. I’m committed to you, aren’t I? So why can’t I keep my independence?” I may be talking louder than I should.
“You can have your independence and live at my apartment, you know. It doesn’t have to be mutually exclusive.” He can tell that he is getting nowhere. He usually gets nowhere.
The shots arrive, and I throw back two of them before we even have a chance to cheers. Lucas gently picks up the third shot glass, and as I’m reaching for the fourth, he says the same stupid toast he always says: “To being the best at everything, all the time.”
I don’t bother clinking glasses when he leans in, because I think his toast is ridiculous and pompous, and I throw back my third shot. The waitress promptly appears with more napkins and some pretentious artisanal beer, and I wonder if Lucas is living in an alternate universe.
NOVEMBER 3RD, 8:31 A.M. (#ulink_b8f683a6-7b16-5aa1-bdd5-0ba7d7d616e4)
Richard is in my office. He was standing outside my office door when I came in this morning. Something is bothering him. I am just putting my game face on, still stinking of my morning cigarettes, and I’m not sure I am ready to manage this particular crisis.
“Well, I’m not going to be in groups with her anymore,” he says.
“Richard—” exasperated, tired, extremely hungover “—why can’t you be in groups with Julie?”
“She doesn’t know what she’s talking about. She’s telling me that if I eat beets my shit will turn red. What do I care about beets? I’m not eating beets. You don’t give us beets here, so where am I gonna eat them? I don’t need to learn about the color of shit from this woman. I’m not going to her groups. I’m not. Give me something else.”
“It’s a nutrition group. These are topics that come up.”
Eyebrows.
“Okay, fine. What other groups do you want? Who can you tolerate?”
“What do you teach? I mean during that time, what group do you teach?”
“The group I run at that time is not appropriate for you. We have a lot of different kinds of patients here, and many of them require more specialized groups. I run a group like that.”
“Can I have free time? Or computer-room time?”
“Well, I think we should look into what your goals for treatment are and how your time would best be spent.”
“My goals? I certainly don’t need to learn about beets and shit.”
“Excrement, Richard. Feces. Don’t say shit.” Which defeats the purpose, but who’s keeping score anyway? He’s seated in my patient chair now, and he leans back and glares out the window with his arms crookedly crossed over his chest.
“You don’t want me causing a scene and yelling at Julie in group.”
“This is true, but it seems to me that you’re a rational adult, capable of controlling yourself and being respectful. If that group is unhelpful, I will take it off your schedule.” I sit down at my desk and reach into my drawer for his file. “What we need to do is work together to figure out what you need from treatment. That includes you completing the clinical evaluations—” I shake the unfinished sheets at him “—and then I will be better able to recommend a group schedule for you that could help you to reach your goals.”
“Again with the goals.”
“Yes, most people are here to strive toward therapeutic goals.”
“Fine.”
“Fine?” I ask. The hangover headache is gripping my eyeballs, and I want nothing more than to close my eyes and lie down. “Shall we take this time to discuss your goals?”
“I’ll think about what I want to get out of my time here.” He walks out as he says this. I realize that I have achieved nothing but giving Richard the upper hand. Now he doesn’t have to go to one of his assigned groups, and I am not closer to completing his file, or having any clue what he’s doing here. I swallow two Advil with a long pull of coffee and prepare to face the day.
My phone rings before the Advil has the chance to take effect. It’s David.
“Good morning, sunshine,” he says in his happy, sober voice.
“Good morning. Please don’t need anything from me. I’m dying from a hangover.”
“Well, that’s a nice change from every other morning. Did you steal my Advil?”
“Yes. Is that why you’re calling me?” I’m rubbing the bridge of my nose with one hand and turning the volume down on the receiver with the other.
“No, I’m calling because I didn’t bring anything for lunch today, and I want you to come with me to that new place on Riverside.”
“You want me to walk to Riverside Drive?”
“Stupid question, huh?”
“Yes. Very, very stupid. But you should feel free to bring me a sandwich when you come back.” I smile to myself. I don’t know what I’d do if I didn’t have David here to bullshit with.
NOVEMBER 6TH, 6:14 P.M. (#ulink_d67ab1d1-2374-54f3-8703-20f15ce43dd0)
I’m sitting on the roof of Lucas’s apartment building with his dog, Maverick. Maverick is wearing a cashmere sweater, and we are waiting for Lucas to come back up here with a bottle of wine he’s been talking about. Lucas wanted to come up to see the sunset before daylight saving time turns the city dark at 4:30 p.m. It’s Sunday, and other people seem to have had the same idea. Manicured boxwood hedges are separating the section we are sitting in from other seating areas on the roof, and every now and again, I see the plume of someone else’s cigarette smoke.
There are lots of those big space heaters that look like giant silver dildos wearing beanies, and Maverick and I are sitting close to one. He’s on my lap, on top of a huge orange horse blanket with a big H in the corner that Lucas insisted I bring upstairs. If I owned an Hermès blanket, I probably wouldn’t actually use it, let alone bring it to the dirty outdoors.
Lucas rounds the bend from the elevator, carrying a crystal decanter filled with burgundy liquid and two spotless glasses. Maverick doesn’t pay him any attention and instead burrows farther into my lap. Lucas makes a big show of waving away the smoke as he walks by another couple holding cigarettes, as if he were the only one allowed to poison his pristine lungs. He gently lays the two glasses down on the teak coffee table and swirls the wine around in the decanter.
“This is the one I was telling you about when we were at dinner the other night. I’ve been thinking about it, and tonight seems like a good time to bring it out.”
“Sounds good to me.” I wipe some stray hairs out of my eyes and watch as he pours about three sips’ worth of wine into each glass. He hands me one and leans back into his chair with his nose buried in the other as he puts his feet up on the table. He closes his eyes and inhales deeply. He tells me to do the same.
“What can you smell?” he asks, his eyes still closed.
I stick my nose into the glass of wine and swirl it around like he showed me. I smell wine. “Leather,” I say, because I’ve heard him say that before about red wines. I pull out a cigarette and place it between my teeth. “And tobacco,” I add.
“Good. What else?” He is in a different universe, his pretentious wine world, where there’s no such thing as just having a glass of wine. There’s no such thing as drinking. There is only a full-body, total-immersion experience. I light my cigarette. His eyes snap open at the scratch of the flint. He pulls his feet off the coffee table and swiftly grabs the cigarette out of my mouth. The filter sticks to my dry lips, and, as he snatches it from me, he pulls away a piece of skin. “You can’t smoke while you’re having an ’86 Margaux! You’re going to ruin the experience. For yourself and for me. Jesus, Sam. Pay attention!”
His scolding cuts me, like I’m some petulant child who can’t follow directions. His look of disappointment and contemptuous attitude cram me further down into a feeling of emptiness. When I lose his approval, he seems to get so big, and I feel so small. He was being nice today, and I had to go and fuck it up.
“I’m sorry; you’re right. I didn’t mean to ruin it. What should I be smelling?” I suck my bleeding lip and try to listen to him. I lean forward and hold the glass to my nose, but now all I can taste is the metallic blood in my mouth, and when I sip the wine, it stings. Maverick notices the tension and begins to get restless. He sniffs around my mouth and awkwardly readjusts himself on my lap. As I try to hold him and stabilize his little paws, I tip the glass and spill the tiniest drop onto the orange blanket. The dribble of wine seems to escape my glass in slow motion as I hold Maverick, whose furry paws are slipping off the cashmere blanket, and try to catch the drop back into my wineglass. My ears are hot and full, and I watch helplessly as the drop of ’86 Margaux splashes onto the big H. I look up to catch Lucas witnessing this, and already angry, he drops his head. Before I can apologize and blot the stain with the sleeve of my sweater, he picks up his decanter and walks away. Maverick laps at the wine. I wipe at it furiously with my fingers, but it’s not helping. It’s hardly even visible, but I know that to Lucas, I’ve wrecked the blanket.
I gather my cigarettes and wineglass into one hand and put on Maverick’s leash with the other. My heart is beating in my throat as I fold the blanket the way Lucas likes it folded and tuck it under my arm. I push the chairs back into their original position, and steel myself to go downstairs and face him. He had a perfect plan designed in his head, where we would drink his perfect wine, and watch his perfect sunset, and his perfect dog would sit calmly on his perfect blanket, and I spoiled it all. I shouldn’t have lit that cigarette. I shouldn’t have spilled the wine.
I push the button for the elevator, and my stomach squeezes and flips. I step inside the mirrored elevator and see the fear on my face. Maverick sits on my foot and looks up at me as we descend. The adrenaline is pumping fast now as we walk toward Lucas’s apartment. And then it subsides when I see his front door. My handbag, the contents of which are now strewn around the carpeted hallway, is upended in front of his door. This is my invitation to leave. I bend down and gather my things, shoving everything back into my bag. I hook Maverick’s leash to the doorknob and gently place the wineglass on the carpet. I fear for a moment that Maverick will try to lap at the wine and knock the glass over, so I gulp down the Margaux. Doesn’t taste like such a big deal.
I see a pad of yellow Post-it notes in my handbag, with bits of fuzz and tobacco stuck to the gluey line at the back. I fish a Typhlos pen out of a zipper pocket and write “I’m sorry I ruined your evening” on a bent note with frayed and blackened edges. I peel it off and stick it to the door. I snuggle Maverick’s face as the first tear falls, and I think to myself that this humiliation is better than the alternative. If he had left the door open or invited me in, I would be recovering for days.
NOVEMBER 8TH, 11:03 A.M. (#ulink_4e94be60-4085-584e-8830-58c10d5ef1e7)
It’s Tuesday at 11:00 a.m., and Richard is about to come sit in my office for an hour. To date he has said nearly nothing to me until I ask him to focus on paperwork, and then he squeezes out one-word answers or angry refusals to respond. I am still scared of him, but it’s getting better. I’m trying to show Rachel that I am capable of managing this, that I will be the singular psychologist able to get through to him and eventually give him the help he needs. I need to maintain her approval, keep her A-plus rating. It keeps me functioning.
Despite wanting to save the day, my mind is elsewhere this morning; I’m harping on what could have been on Sunday night, so I am thinking of bailing on the attempt to work on the files with Richard. I haven’t yet made more progress than any of my predecessors, but I can’t handle another issue right now.
I hardly notice as Richard walks through my door and sits down with his stack of papers. He takes his hat off in my office and gently sets it atop his pile of newspapers. Sometimes he wears the tweed newsboy cap; sometimes it’s a gray one. He seems to have gotten more comfortable around me, now that we’ve had a few sessions and groups together. He sometimes says good-morning, sometimes nothing, but today I wouldn’t have heard him if he had greeted me.
After a short while, he speaks. “You’re different today.”
“Nope, I’m the same today. Same old Sam, right as rain.” I’m not even looking up.
“How come you’re reading that same page over and over, then? You haven’t turned that page in twenty minutes.”
“I’m concentrating.”
“On what?” He is incredulous; he is noticing. He is supposed to be crazy and I am supposed to be able to get away with my mind wandering sometimes.
“If you’re not going to work on your file or talk about treatment goals, then please, read your papers and let me do my work in peace.” Calmly, softly, defeated.
“I’ve never seen you in peace.”
What are you, my therapist? You’ll never see me in peace, Richard; stop looking.
We resume ignoring each other, and I sit quietly wondering what I’m doing with my life. Richard is shifting and wiggling uncomfortably in his chair. He reaches his crooked left arm out in front of him, as if trying to straighten it out properly. He huffs, and he’s distracting me.
“Something bothering you, Richard?”
“Yeah, what’s going on with that kid from the group you were running the other day?”
“I’m not sure what’s going on with Devon. Why do you ask?”
“He always does this contortionist act when he’s in group. I find it very distracting. And he always wears a jacket even though it’s practically boiling in here. He leaves confetti wherever he goes. He’s making me uncomfortable. How am I supposed to get better in an environment like this?” It seems it’s his size that’s making him uncomfortable, but I’d rather hear him complain than continue to avoid speaking altogether.
“Okay, what exactly is it that you would like me to do here?”
“I don’t know—you’re the shrink, not me.” Richard waves his hands at me dismissively.
“This seems like more of an administrative problem. Or even a janitorial issue. I can ask that he refrain from contorting in groups. But, you have to remember, this is an institution, and we need to live with the foibles and behaviors of others.”
“Within reason.”
“Yes, Richard, within reason, but a little shadow boxing never hurt anyone. Maybe what we need to talk about is your ability to tolerate frustration.”
“I tolerate it fine. I’m just not interested in being in groups with a man in a leather jacket who leaves confetti and makes himself into a pretzel.”
“Noted. I will follow up, and should I discover anything, I will let you know. Fair?”
He raises his eyebrows at me, unconvinced, and returns his gaze to his newspaper.
“And he stinks, too. Just sayin’.” One last jab and now he’s finished.
NOVEMBER 9TH, 10:00 A.M. (#ulink_6fc5aabb-e910-542a-96f1-41dad67c6146)
Jenni is nervously twisting the hem of her shirt in my patient chair. She has a long history of being abused, and associates anyone in a position of authority with fear and danger. She hasn’t been at Typhlos for very long, and she is still healing physically from the abuse she experienced before she got here.
“How are you getting along with your roommate?” I usually try to start sessions with something light and administrative so patients can get comfortable before we address anything serious.
“Tashawndra? She’s good. We make good roommates, I think. She’s clean and she keeps her stuff on her side, and I try to keep my stuff on my side, too. She’s been here for so long now, she knows all about everything, so she’s helping me get used to stuff. She lets me use her lotion.”
“I’m glad to hear that. Tashawndra is very nice. I’m glad you are comfortable in your living space. How have you been feeling since detox?” Jenni had to go to detox before being admitted to Typhlos because she was addicted to heroin and going through withdrawal.
“Better, but it still hurts. I’d never been so sick before. The smack just takes the life out of you, and when you can’t get any, it takes the life out even more. I thought I would never get better. It’s scary, when you get heroin sick. It’s very scary.” She holds her stomach and rocks back and forth as she says this.
“It is, and you’re very brave for committing to treatment so you’ll never have to have those withdrawal symptoms again. Now that your physical addiction is under control, we are going to be spending more time focusing on the psychological and the emotional components of the addiction. I’ve changed around your group schedule a little bit to include some recovery groups, and some dual-diagnosis groups, as well. You and I are going to spend time in our sessions talking about your addiction, too. You think you’re ready for that?”
“What’s duo diagnosis?” she asks, scraping at the edges of a scab on her head.
“Dual diagnosis. That’s when you have both an addiction to drugs or alcohol and a diagnosed disorder or mental illness. When you’re struggling with both those things at the same time, you’ve got a unique set of circumstances, and we want to make sure that you can get all the support you need.”
“Okay, that sounds good. What are we going to talk about in our sessions with you and me?” Jenni rolls up the sleeves she’d been tugging on and I can see the track marks still dotting her arms, from the crook of her elbow all the way down to between her fingers.
“Well, I wanted to start today by asking you to tell me a little bit about your history of drug use. When did you start, how did you use, those kinds of things. You ready for that?”
“Yeah, I’m ready.” She takes a deep breath and pulls what’s left of her hair into a stringy knot on top of her head. “I started doing drugs when I was really young. I was still in school, and I dropped out in tenth grade, so I must have been twelve or eleven or something like that.
“My mom was always out of the house; she worked two jobs and when she was finished working, she would go to the bars, so my sister and I were alone at home a lot. My sister, Jackie, is four years older than me. She had her friends and boyfriends over to the house all the time, and they would sit in her room and smoke weed and cigarettes and drink alcohol and listen to music. Her room was the garage.
“Sometimes I would come to the garage when she was with her friends, and I would just sit there and watch them, but I wouldn’t smoke or anything. She didn’t mind. Some of her friends were nice to me. There was one boy who came over who liked me, I think. His name was Ronnie.
“One time, he came over and sat next to me while they were all hanging out. I was in the corner next to the garbage cans, and he came over and asked how old I was, and if I had ever smoked weed before. I said yes, even though I hadn’t because I didn’t want to look like some lame kid.”
I silently smile at this notion, remembering being a kid among the older crowd, claiming to have personally experienced adventures I had seen on after-school specials.
“So, he handed me the joint and he told me to prove it. I took a hit that was way too big because I thought it was like smoking cigarettes, and I had smoked a cigarette before. I started coughing really hard, and I knew I was going to get sick, so I ran out into the driveway and I barfed all over the place. Ronnie came out after me and was rubbing my back. He told me I did good, and I could come and sit with them.” She looks at me and smiles a sad, nostalgic smile. “I don’t know why but I remember that night really well. After that, it all sort of gets hazy and blends together. I started sitting with them whenever they came over, and I started smoking weed every day. I was scared at first because I know you’re not supposed to do drugs, but they all told me that weed was a plant from the earth and that made it natural and only the chemical drugs were bad for me. They made it all sound like everything we were doing was okay. It was normal. Ronnie was always sitting next to me and rubbing my legs and my back.
“Sometimes he made me uncomfortable because he was so much older than me, but I liked the attention, too. I knew Jackie would never let anything bad happen to me. Then he started bringing in junk. They said that heroin came from a plant, too, the plant where the poppy seeds for the bagels came from, and they told me that if I was okay having a bagel with poppy seeds, then it’s the same thing.” She snorts and shakes her head. “I can’t believe I thought that bagels and junk were going to be the same.”
Jenni continues her story, telling me about Ronnie tying her arm off with a rubber band because the belts they were using on their own arms were too big for her skinny adolescent body. As with so many other patients here, she tells me of becoming dependent on both heroin and Ronnie, and the tables turning after a while—Ronnie starting to demand something in return. Jenni has been desensitized to all this and retells the story as if she were reciting a grocery list. The word rape has lost its meaning, and she reports that sometimes her sister, Jackie, would step in and offer herself in place of Ronnie raping her twelve-year-old sister.
“Jenni, we are getting to the end of our time today, so I wanted to stop and thank you for being so brave and honest about all of this. I think I’m going to add you to a women’s group that we offer here, where survivors of sexual abuse can work together to manage what happened to them.” Jenni cheerfully nods along as I talk.
As she walks out the door, I look at the scabs on her scalp, I see the missing chunks of hair. I see the track marks on her arms and thank God alcohol leaves less of a trace. I think of Ronnie taking advantage of her, pushing her into a corner with heroin and then not letting her leave. I think of Lucas. I wonder if I can walk away with all of my hair.
NOVEMBER 9TH, 4:46 P.M. (#ulink_9e79f945-e579-581a-a848-56e1f595aea3)
Richard is still complaining about Devon and his jacket; he’s become obsessed, and he isn’t letting it go. He spent half the day today indicating that something must be done about this man and his jacket and his confetti. We didn’t have a session together, but he showed up at my door over and over again, demanding action. I’m going to Shirley’s office. Shirley is Devon’s counselor, so she must know something.
“Shirley, what’s the deal with Devon? The jacket? I have a patient who is completely disturbed by his jacket. Don’t ask me why.”
“What jacket?” Shirley is eating a fruit cup with a plastic spoon.
“Really? Shirley? The leather jacket he wears all day every day. The old, scrappy motorcycle jacket? You can’t tell me you haven’t noticed this. He wears it every day. And what’s up with the confetti he puts everywhere? Every time I have him in a group, he leaves these little brown scraps of paper or paint or something behind. Do you not notice this?” I’m looking at her chair, and it’s covered in the confetti. It’s covered in everything.
“Oh, the shit jacket.”
“What? The what?” I’ve never heard Shirley curse. It’s like Grandma taking a whiskey shot or smoking a blunt—what the hell is this? “Shirley!”
“He wears that jacket as a repellent.”
“A repellent from what? From who?”
“Whom. It’s a people repellent. It’s his shit jacket. He learned this while he was homeless. He was constantly getting harassed while sleeping on the streets. He needed to find a way of surviving out there, so he smeared shit all over the back of his jacket so he would stink and people would stay away from him.” She says this like she is telling me the turkey is done. She is nonchalant and unfazed by this information. I’m fascinated and repulsed.
“Oh, my God, Shirley! They’re shit flakes? You mean to tell me the confetti all over the unit is really a pile of dried shit flakes! Jesus Christ!”
I’m slamming her door; I’m barreling into the bathroom. I’m scrubbing my hands, I’m fuming. I’m shocked. How is it possible that we have all been handling shit flakes, and Shirley never bothered to tell us any of this? Jesus, no wonder Richard was disturbed by the jacket.
I sit down at my desk and compose three emails. One to Rachel to ask her to confiscate the shit jacket now that I know it’s a fucking biohazard. One to the head of the maintenance staff asking for a deep clean of the group rooms. And finally, one to the staff to let everyone know that the confetti they have been surrounded with is actually dried shit flakes, and in case we had forgotten, we are surrounded by insanity. With the pressure to keep myself sane—the need to ensure that something exists to keep a line between me and my patients—days like these help me believe that there really is a reason that I have keys and they don’t.
NOVEMBER 11TH, 8:36 A.M. (#ulink_ffc611e5-daff-5b63-863e-17b4e28ccab9)
“Good morning, Rachel,” I say with a sunshiny voice as I saunter through Rachel’s door and sit in her patient chair.
“Morning, Sam. You’re very chipper today.” She clears away a corner of her desk for me to put my files down so we can begin our supervision session. Rachel does very minimal supervision of the staff because she doesn’t have the time, and she is forced to believe that everyone is able to take care of themselves. There’s been a recent influx of new patients, and Rachel is preoccupied with placement and intakes, so she’s been putting off traditional supervision and replacing it with encouragement to call her if we have questions or problems.
“Chipper every morning,” I lie, swallowing my hangover heartburn. I put on my reading glasses and pull out Richard’s incomplete file. “So, I figured since we only have a short time together this morning, I should jump right into business.” Rachel nods, sips her coffee and swivels her chair to face me. She crosses her giant calves and waves me along. “Richard McHugh and I have been meeting weekly on Tuesdays at 11:00 a.m. There was a lot of speculation that he was uncooperative, but he always shows up to our sessions, and he’s always punctual. He seems to like the structure. Now, that being said, he is extremely uncooperative during the sessions. He is absolutely unwilling to complete the psychological assessments and gets very defensive and cagey when I try to pull any information out of him.”
“Do you feel safe in sessions with him?” Rachel asks.
“Sure. He isn’t threatening or violent, he’s just very quiet and guarded. I don’t imagine that he would hurt me. He seems to be protecting himself by staying quiet. He doesn’t like to share his story.”
“Have you been able to determine why he was in prison?”
“No. This is actually one of the other issues with his chart; there isn’t a lot of stuff in his continuation-of-care section. I have the names of the halfway houses he attended, but no contact number or contact person there, no sponsor or mentor. I have the names of the prisons he was in, and the dates he was there, but no further information. It’s all very unclear. There are some xeroxed pages with huge swaths of the page blacked out. There is no information about the charges, so there’s no way to know what he did to end up in prison. And he certainly hasn’t made any effort to tell me.”
Rachel nods. “I was the one who did his intake, actually, and I found the same thing. There was very little information available to us, but he was strangely insistent on coming here. He didn’t tell me much of anything at all, but he was polite, if standoffish. It’s a complete question mark. I got in touch with the teams at Revelations and Horizon House, the halfway houses, but they didn’t have anything on him. The staff turnover at those places is ridiculous, and they don’t seem to keep proper records.” She’s reaching around her desk and pulling at scraps of paper poking out of various in-boxes and out-boxes. She’s looking for something.
“Have you had patients like this before? I’m not entirely sure how best to proceed. He’s a giant question mark, like you said, so I don’t know how to properly place him in groups, and I’m not sure how to draw out the information we need to help him.” Rachel loves it when I ask her for advice.
“I’m looking for his original intake stuff. I gave him a blank sheet to write on when he refused to fill out the intake materials. I asked him about his goals for treatment and that kind of thing. I know he scribbled something down, but I can’t remember what it said.” She pushes her chair around the office, opening file drawers and checking inside a massive disorganized cabinet.
“For now, I’m just going to keep up our weekly sessions,” I reassure her, “keep him in some of the high-functioning, intellectual groups, and see if we can get him comfortable with me, and maybe then he’ll come out of his shell.” Rachel doesn’t seem to be listening to me anymore as she’s seeking this document.
“Here! Here it is,” she says, pulling a page with rolled corners from the back of a notebook. “See if this can be useful to you.”
I take the page from her hands and look over Richard’s handwriting. He was using a dull pencil and the lines of his cursive are blurry and uneven. He made a heading that says “Goals at Typhlos” and he filled in the section with bullet points: “To get better. To forgive. To reenter life.” He specifically writes Typhlos in various places on the sheet. He obviously wanted to come here in particular. There are several other sections, but the pencil lines have been smeared and I can’t read much. Under another heading called “Therapy,” he wrote something that looks like open up and something else that looks like Samantha.
NOVEMBER 14TH, 12:34 P.M. (#ulink_c3fa2681-84f6-5362-ba1a-97bab2eb1563)
It’s snowing outside. I’m up on the corner of my desk, staring out the window. The guys on the scaffold are still working, despite the change in weather. It’s been brutally cold, but for some reason, when the snow starts, it feels warmer. Like the snow is creating a blanket that covers the world and keeps it safe. The flakes are fat and wet and sticking to the cars parked on the street below. In the city, the snow only stays beautiful for a couple of hours. Once the plows come through, the perfect white shroud becomes a thick, gray sludge, sometimes piled to waist height. The only thing I miss about my house growing up is the way the snow stayed untouched.
My door is slightly ajar, and I hear the chatter of patients in the hallway. My office is across from the computer room, a popular spot for patients to try to break into porn sites or gather to chat with each other. There are two dilapidated couches and someone is always asleep in there.
I hear an unfamiliar voice outside my door, probably someone leaning against the wall outside the computer room. It’s a man’s voice, Brooklyn accent, and the hiss of missing teeth. His voice is loud and abrasive, but he hushes it down to a whisper scream to add a conspiratorial air to his story. I move to the crack in the door and listen to him without showing myself.
“It’s women—women get you into these places, man. No matter what you do, you can’t please ’em.”
“A woman got you in this place?” Another male voice I can’t quite recognize.
“Yeah, she did. My ex.”
“What did she do?” Whoever is telling this story is certainly commanding the attention of his listener.
“Well, she broke up with me, first of all. Then she went and started fuckin’ my best friend. Mmm-hmm. And you know that ain’t right. So, I had no choice; I had to get her back. Ain’t nobody gonna disrespect me like that.”
“How’d you do it? How’d you get her back?”
He hushes his voice back down to the whisper scream: “I killed the bitch.”
“You killed her?” The listener gasps.
“Man, shhhhhh! Shut the fuck up, yo. I ain’t gonna tell you nothing you keep hollerin’ like that.”
“How’d you do it?” the listener whispers back. I’m still eavesdropping from my office. I’m not concerned yet—these kinds of grandiose stories are not uncommon here. Some patients treat the unit as if it were prison, and the scarier they make themselves appear, the safer they feel, so bullshit stories about murders are rampant.
“Ha. I’ll tell you how I did it. She had a house in the Bronx, right? And she would let her dog out the back to run around and piss and whatever. So one night, I went to her house, and I waited for her to let that dog out. Once I seen the dog, I jumped the fence and I grabbed him.”
I hear chairs from the computer room scooting across the floor, followed by a few short footsteps. The story is getting more listeners.
“He was some old shaggy piece of shit dog. I had a can of lighter fluid with me, and I dumped it all over that dog. He was so stupid, he started to lick it off. He liked it, too. Just kept lickin’ at that lighter fluid. But he stopped when I lit him up.”
“No shit? You lit the fuckin’ dog on fire?”
“Damn right, I did! And he starts barkin’ and yellin’ and shit, so I pick him up, and I throw his ass through the back window of the bitch’s house. It smashes the window, and the curtains got lit up, too. I could hear the dog, and it was screamin’ and then I heard Alisha, and she start screamin’, too. And she trying to put the dog out, and he dyin’ and the fire just getting bigger and bigger.” His voice is getting loud now, and I can feel my fists clenching.
“So, she says ‘fuck the dog, I gotta get out,’ and she runs out the back door, and where am I? Right there waitin’ for her. And it’s dark out, and she don’t even see me, so she runs right into me. I grab her and turn her around so she has to watch the house burn. I put my hand over her mouth so she can’t scream. You see that?” I can almost hear the craning necks looking to see what the storyteller is showing them. “Bitch started biting my hand. But she stopped biting when I popped her in the mouth.
“The house was going up fast, I mean fast, and it started to get hot and the smoke made it hard to see, so I pulled her back into the alleyway behind the house. She was kickin’ and pullin’ and she knew she couldn’t save nothin’, and so she stopped strugglin’ and just watched it burn. The fire was mad loud, and then when the trucks came, you couldn’t hear nothin’, not even screamin’. So I took my hand off her mouth, and I told her: this is what she gets for fuckin’ with me.”
“And no one saw you? You didn’t get caught?”
“Nah, man. Nobody even knew we was there. And she starts beggin’ and sobbin’ and slobberin’ all over, and that’s when I finished it. I just put my hand around her neck, and I squeezed. Didn’t even take that long.”
I feel my face contort into an angry grimace as I hear this macho bullshit. I find myself overwhelmed with disappointment at the pathetically appreciative response from the listeners. This sociopathic story, this admiration from peers—I’ll never understand this shit. The more I keep hearing it over the years, the more I feel like it’s seeping into me, disturbing my sanity. I keep listening and I hear some of the guys relaying bits of the story to latecomers. I even hear what sound like high fives. And then I hear raspy, almost panicked breaths. I hear a familiar voice now, shaking, furious. Tyler.
“You set a woman’s dog on fire? You threw her dog into her house and her house caught fire?” Tyler has obviously been listening, and he is appalled.
“Yeah, bro, and what?”
“And what? You murdered her? For cheating on you?” His voice is getting higher.
“You got problems, bro?”
“Yeah. Yeah, I got fuckin’ problems.”
“Hi, guys!” I shout as I open my door and pretend I haven’t been listening. “What’s happening? How’s everyone?” It’s clear there’s tension in the hallway, and various patients have fled to the safety of the couches in the computer room. Everyone’s eyes are glued to Tyler and the storyteller.
“Hi, I’m Dr. James. I don’t think we’ve met.” I extend my hand to the storyteller, who has his eyes trained on Tyler. He ignores me. “What’s your name?”
“Floyd.” He still won’t take his eyes off Tyler. Floyd is about a foot shorter than Tyler is, but has probably sixty pounds on him. Tyler is vibrating with anger.
“Miss Sam, I don’t think you should be here right now.”
“Really, Tyler?” Chipper, unaware. “How come?”
“This man got no respect for women.” Tyler is shifting his weight from one foot to the other, clenching and unclenching his fists. Floyd doesn’t move. He stares, unblinking, at Tyler, waiting for him to act.
“Pitchers and catchers report in a couple months, you know.” Talking Yankee baseball with Tyler is my ace in the hole to defuse this without security or backup. “Floyd, are you a baseball fan?” I ask as I move to the space between them, and the air is thick with perspiration and rage. “Tyler and I are huge Yankee fans.” I’m a little taller than Floyd, so when I’m up close to his face, he has to shift his gaze to make eye contact with me. I’m obscuring his view of Tyler, so he’s forced to address me.
“Yeah. I could watch some baseball, miss.”
“America’s pastime. It’s a beautiful thing. Now—” I clap my hands together “—where are you gentlemen supposed to be? I’m sure there’s something productive we could all be doing instead of loitering here in the hallway, huh?”
No one responds to me, but several patients observing from the computer room peel themselves off the couches and move on. Tyler is backing up slightly, but I can still feel his breath at the back of my neck.
“No? Okay. But I’ve got things to do. Tyler? Want to walk me to my next group?” I know Tyler is a gentleman and he wouldn’t let a lady walk by herself if she asked for an escort.
“Alright, Miss Sam.” I hear his teeth grind as he steps in front of me and starts slowly moving down the hallway. I pull my glasses down my nose and glower at Floyd.
Tyler and I walk down the hall, and I again ask him about baseball. Completely distracted, trying to shake the story from a moment ago, he falters and mumbles. When we reach an empty group room, I step inside and ask him to follow me.
“Tyler, when you hear something like that and you react, it just feeds the beast. He was telling that story to get a reaction out of people. Let’s not give him the satisfaction, okay? When you’re disturbed by somebody, you walk away. You don’t engage. Come find me or another staff member if you feel you’re not able to take it, okay?”
“He killed that dog. I just got so mad when he said he killed that innocent dog and that innocent lady.”
“Yeah, me too, Tyler. Me too. But we can’t let it get to us, okay? We have to rise above it.”
“You think it’s bullshit? He’s making it up to scare the other patients?”
“Maybe. Maybe he’s making it up. But even if he didn’t kill an innocent dog or an innocent lady, you and I both know that there are innocent ladies and dogs getting killed every day. But we can’t go to pieces and get in fights because of it. You’re here to take care of you, not to worry about anybody else. Right?”
“Yeah. I know you’re right, Miss Sam. I’m here to worry about me. And the Yankees, because, last season, our pitching wasn’t looking so good.”
“You’re damn right about that.”
NOVEMBER 14TH, 9:21 P.M. (#ulink_0b3515b1-3249-5d6a-8fae-76baa62dc26a)
I’m sitting on my couch waiting for Lucas to show up with takeout. He said he was going to be here an hour ago, but he’s not here yet. I’m trying to read a book, and I have to close one eye to see the words. I’m distracted and hungry, and I keep checking my phone to see if Lucas is going to text me. Nothing. I texted him thirty minutes ago, asking when he’s planning on arriving, but I didn’t get a response. I reread the same page over and over again.
My glass is empty now, and so is the bottle next to it. When I’m anxious, I drink faster than I should. Even though it’s cold outside, colder than the last few Novembers, I’m still drinking white wine. I carefully wipe up the condensation on the coffee table with the sleeve of my sweatshirt and tiptoe to the recycling bin. I plop the still-sweaty bottle into the bin and crack open the twist-off lid of another one. It’s better if Lucas doesn’t know that I already drank a whole bottle. As I’m tiptoeing back to the couch, my phone buzzes and my foot catches the leg of the coffee table.
It’s Lucas. Buzz me in, forgot my key.
I write back, You have to push the button first; it won’t work if you don’t buzz.
The buzzer blares a long and angry scream into my apartment, and I depress the button to release the door. I can see Lucas’s bad mood on the grainy security camera. He slaps the up button for the elevator. He usually takes the stairs, because I’m only on the third floor, but when he’s pissed, or drunk, or carrying something, he takes the elevator. Tonight, it seems he’s all three. I leave the front door ajar and return to the couch. I pour a small glass of wine and clutch it as I wait. I pull my knees up to my chest and hunker down into my pillows.
Lucas marches in the front door and promptly dumps the take-out bag on the floor. He shoves it into the kitchen with his foot and angrily peels off his coat.
“Well, you could offer to give me a hand.” He huffs at me. I pop up off the couch and greet him with a kiss on the cheek. I pick up the take-out bag, which is filled with something that has gone cold, and I lift it onto the kitchen counter. Lucas is very obviously on drugs. His hair is matted down to the back of his neck and his collar is soaked with sweat. He is clenching and unclenching his jaw, and he has thick white spit gathered in the corners of his mouth. Cocaine. He doesn’t say anything else to me and instead walks to the bathroom to tidy himself up. As I hang his coat on the back of a barstool, I reach into his pockets to see what I can find.
A half-smoked pack of cigarettes next to an unopened pack. A black Bic lighter with gouges at the bottom from using it to open bottles. A crumpled credit-card receipt from First Wok with today’s date on it. The time stamp was from two hours ago. I stuff the contents back into his pockets and reach into the breast pocket. A rolled-up fifty-dollar bill with one end wet and the other end powdery, and a tiny empty bag that used to house a gram of cocaine. Adrenaline burns in my stomach as I drop the contraband back into his coat.
I sit down on the couch and take a big gulp of wine. I light a cigarette and wait to hear the toilet flush. He usually muffles the sounds of his snorts by flushing the toilet. He probably has another bag in there with him. My building is old, and so is the plumbing. He overflowed the toilet once from flushing too many times because he was snorting so many lines. Somehow, he still thinks I haven’t figured out what he’s doing in there. I hear the telltale flush, and then he appears outside the bathroom door.
“Whew, sorry about that,” he says as he plops down on the couch next to me. “Been a long day, and I’m lugging this Chinese food here, and I can’t find my keys, and I just got frustrated. Hi,” he says, turning to me and kissing me on the mouth. “How was your day?”
I can taste the coke and it immediately makes my lower lip numb, so I pull away from him and wipe my mouth. “My day was fine. How was your coke?”
“Oh, Sam. I don’t want to get into this.” He rolls his eyes and flaps his hands at me. “I had a long day and I needed a pick-me-up. Brian from the office was holding and he gave me a bag as we were leaving. We were working on a very important merger, and it was sort of a celebration. I’m sorry I didn’t tell you, but I knew you would make a big deal out of it.” He reaches down and takes a sip of my wine. He is leaning forward on the couch, hovering over the coffee table, picking at the label on the wine bottle. He’s not looking at me. I’m not responding. Instead, I stand up and walk to the kitchen to get him his own wineglass. The adrenaline kick sobered me, and I feel like I haven’t had anything to drink at all.
He keeps picking at the label until I sit back down and pour him a glass of wine. I refill my own glass and lean back, silent. I know the coke isn’t going to let him stay quiet for long, so I wait and give him the rope to hang himself.
“I’m not trying to lie to you,” he implores me. “It’s just that we’ve had this coke conversation so many times, and I told you that I was going to cut down, but honestly, it just comes with my business.”
“This isn’t the ’80s, you know.”
“Maybe not wherever you live, but in the finance world, the ’80s are the revered decade. Everyone is hoping to get back to that, and sometimes, we behave as if we are back to that. It’s not a big deal; it’s not about you.”
“Lying to me is about me.” We are both smoking cigarettes now, and the smoke is hanging in the air like a gray aurora borealis.
“I shouldn’t lie to you, you’re right.” He turns to look at me and squeezes my knee with his left hand, his cigarette tucked between his fingers. He holds his wineglass with the other hand and continually slurps tiny, noisy sips. He is looking at me with wild eyes between his little sips, and he begins rubbing my thigh.
“Why were you so late tonight?” I ask.
“Because Brian and I were doing drugs, Sam. How many times do I have to explain this to you? You don’t need to punish me; I’ve already admitted it. Can’t get anything by Detective Sam.” He pulls his hand back, and his cigarette leaves ashes on my pants.
There were about thirty seconds when I had the upper hand as he was apologizing, and now I see it falling out of my grasp and rolling under the couch. Of all the things that Lucas does and then lies to me about, for some reason I have attached myself to the cocaine. The Serenity Prayer has taught me that there are some things I cannot change, but for some reason, I think his coke use is one of the things I can. Baby steps. I’m chipping away at the vices. One day I’ll have the strength to stop him from all the other damage he does, to me and to himself.
Lucas is reeling now, angry that I caught him. I’m contemplating my exit strategy when he suddenly pops up to his feet and offers me a hand to help me off the couch.
“Why don’t we eat something? There’s all this Chinese food in the kitchen; let’s just have a bite to eat and forget this shit ever happened, okay?” He is clenching my wrist and pulling me into the kitchen. He takes two plates out of the cabinet above the sink and slaps them both down on the counter. He reaches into the First Wok bag and pulls out two white cardboard containers. Lucas drops my wrist and it falls to my side with a thud, and he begins unloading lo mein and sesame chicken onto the plates. I can see him getting angrier and angrier with each shake of the to-go containers; I start slowly backing out of the kitchen.
“Where the fuck are you going? You asked me to come over and bring dinner, and here I am, preparing dinner for us. Don’t sneak out of here and pretend you didn’t ruin our evening together with your accusations and your detective work. Here—” he shoves a plate of cold Chinese at me “—eat this. It’s what you wanted, isn’t it?” He leaves his plate on the kitchen counter and stalks toward me with his head bowed and his eyebrows clamped in rage. I’m holding my plate between us with both hands, backing up.
“Thank you for bringing Chinese food, but I didn’t ruin our evening. You’re the one who came over hours late and coked up.” I keep backing up.
“So, I ruined the evening?” he growls.
“Look, the evening doesn’t have to be ruined at all—” I implore him, but as soon as he’s close enough, Lucas slaps the plate out of my hand, and sesame chicken and lo mein and broken shards of plate scatter on the floor around us. He pushes the mess out of his way with his foot and keeps lumbering closer to me. I hold my hands up against his chest and try to push him off me, but he is too big, and too angry, and already nearly on top of me.
“Hit me,” he says calmly, with a twisted grin. “Hit me, since I fucked everything up. I ruined dinner, didn’t I? So hit me.” He starts yelling and chest bumps me, sending me stumbling back into the wall. “Hit me!” He points to his jaw and chest bumps me again, and now I’m pinned between him and the wall, and I can’t find the room to squirm out. I feel the handle to the closet door with my left hand, and I try to pull it open, but Lucas’s big arm is over my head, holding the closet door closed. “Hit me,” he says again as his other hand rises up and grips me by the throat. “Hit me!”
NOVEMBER 16TH, 9:14 P.M. (#ulink_3c828b00-612d-5eae-bd91-17181f590812)
I’m at Nick’s talking to a friend, and although I’ve been told that he’s very sexy and charming, I haven’t noticed it until right this minute. He’s standing in front of me, and we’re flirting. Everyone else we know here is behind me, jammed in near the DJ booth. He’s looking at me with a pair of eyes that I have never seen in his head, and I feel like the universe is shifting and my stomach is flipping. He is devouring me and I don’t want him to stop.
He’s a player—we all know it; I have always known it. I watched him hook up with a prepubescent neophyte yesterday and he has been picking the low-hanging fruit for years. I see every woman fall for him; I laugh at them and silently hope they remember to wrap it up, and I giggle at the girls who are mad at him for the fuck-and-run. I’ve always considered him a decent soul, and at the same time I don’t see any of this right now. All I see is man. Man who can take my whole world and turn it upside down, just by paying me the slightest bit of attention.
Someone has taken out their camera phone, and of course this is a problem because everyone here knows Lucas, and I’m dating Lucas, and I should be thinking about Lucas, but I can’t even remember his name right now. I’m absentmindedly pulling my scarf up around my neck to keep the bruises from the other night obscured. We are all crammed together, taking pictures that someone will inevitably post on Instagram, and then all infidelity will be exposed and I’ll be the bad guy and Lucas will run from me and I will be alone and I can’t have that.
So I pose and I smile and I pretend that all the feelings I have rushing through me—the fire, the heat that’s pulsing in my veins, in my stomach, in my pants—all of this is not happening. And of course, he comes to stand next to me for the pictures, and he is almost in front of me, and he is kissing my cheek for the photo.
The group is closely huddled together, and without anyone else seeing, while we’re no more than a quarter inch from all our friends, he reaches his hand behind him, between us, and holds my breast. He’s killing me and he knows it and I love it and all I want to do is stay and take more pictures and have him keep his hands on me and all over me and take me away from here and make me something better and never, ever, ever leave me.
Somehow it’s all over and in a whirlwind, I’m on the street walking home. When we said goodbye he kissed me on the lips, but we all kiss each other on the lips, so this didn’t mean anything to anyone witnessing it. But we had never kissed on the lips before and mine are burning with man all over them, and I am walking home toward Lucas and I want to turn back and run into the arms of man, but Lucas will leave me and I can’t have that. But I need to see this guy again. When will we be able to do this? This is a mission and I must accomplish it, and I will have him no matter what it takes. His name is AJ. I don’t even know what it stands for.
NOVEMBER 18TH, 12:03 P.M. (#ulink_021b5226-7120-5956-8eea-4f34fad987e6)
David and I are sitting in his office, avoiding the world, eating our lunches. He usually brings something in, and I end up stealing half of it, or we go to one of the sandwich shops down the street. There’s a halal truck on the corner, and today we both got chicken over rice. We usually eat when the patients get their lunch, whether we’re hungry or not—that way we’re less likely to have visitors or intruders.
“Did you see Julie in the meeting this morning?” I ask, plastic fork between my teeth.
“Yeah, I saw her. Why? What’d she do?”
“She was doing her makeup in a Chanel compact at the fucking conference table.”
“Is that a big deal?”
“She works in a mental institution. Why does she care so much about how she looks? It’s pathetic.”
David laughs at me. “You really hate her, huh?”
“I don’t hate anybody. I just think she’s incredibly silly and she doesn’t belong here. She should be working at Bloomingdale’s.”
“You ever sat in on any of her groups?”
“No, have you?” David rarely engages in Julie shit-talking and gossip with me, because he’s mature and above it all, so I love when he descends to my level.
“Yeah, I was at the one that your patient stormed out of. The new guy, big dude.”
“Richard? The thing with the beets?”
“Ha!” David opens his mouth to laugh and a single grain of rice flies past me and sticks to the window. “Yeah,” he says, wiping his lips, “she was trying to delicately explain that some foods can change the color or consistency of pee and poop, and he just bolted. I think she wanted to get the message across that people panic when their shit turns red, thinking it’s blood, so she was trying to preemptively quell the anxiety.”
“Sure, which would make sense if anyone ever had beets here. What an idiot! Such a princess. I told you she shouldn’t be here.”
“Yeah, Rachel asked me to keep an eye on her because she’s been racking up complaints.”
“Really? How wonderful! Maybe Typhlos will give me an early Christmas present and fire her!” I joyfully scoop another forkful of chicken into my mouth.
“Yeah, don’t hold your breath. How is the new guy, by the way? Last we talked you were getting nowhere.”
“I’m still getting fucking nowhere. It’s confusing. He’s so high functioning, seems to be completely normal, so what is he doing here? Why is he in treatment?”
“What’s his diagnosis?”
“Oh, right. Like there’s a diagnosis in his chart. That would be too easy.”
“Do you think he’s diagnosable?”
“If I were to slap something on him, like for insurance purposes, I’d say adjustment disorder. And that’s a stretch. There’s got to be something that I’m completely missing. It’s too weird for this guy to be admitted to a mental institution. Aside from being uncooperative and stubborn, he seems normal.”
“You want me to meet with him? See if I can figure something out?” David is always incredibly helpful, always willing to go the extra mile for me.
“No, thanks. But keep an eye out if you notice anything.” David smiles his sweet, protective smile at me and clumsily pats my knee with his free hand. I try to examine his thoughts as he turns toward the window; I’m looking for a place inside him where I could fit.
NOVEMBER 22ND, 11:06 A.M. (#ulink_26140e17-9c2e-5b87-b833-947407be0e88)
Although we haven’t made progress with his file, it seems that Richard is getting more comfortable with me. He may even be developing a foundation of trust. He’s speaking now, not about anything relevant to his mental health, but he’s saying words out loud. He tells me about books he’s read, or ones he’s heard of that he hasn’t had a chance to pick up yet. I tell him about what’s happened in the music industry, and he’s never happy to hear it. Today is another session with us just warming up to each other.
“You have a cell phone?” he asks me. He hasn’t shaved this morning, and I can see the prickles of a pale beard poking out of his fat pores.
“Yes, I have a personal phone. Why do you ask?” I’ve got my legs crossed and I’ve twisted my chair to face him. We usually sit this way, even if the sessions are uncommunicative. It’s a therapeutic technique. People are uncomfortable with silences, so often if a therapist faces a patient like they’re talking, the patient will feel obligated to fill the silence.
“That was a shock to me. I was away when those things came out. Now even the homeless people have them.”
“You were in prison when cell phones became popular?” This is the first time he has acknowledged his incarceration to me, and I want to draw more information out of him.
“We didn’t even have personal computers. Now everyone has a supercomputer in their pocket.”
“Did you have computers available to you in prison?”
“Well, the phones are even more advanced than the computers now.” He’s not going to engage on this with me.
“It’s true. They really do make communication much easier.” Hint.
“Not just communication—everything. It’s got a camera now, the internet, the emails. You can read books on those things! It used to be you had to have a whole suitcase worth of stuff to have everything that these phones have now. And they’re this big.” He holds out his wide palm to indicate the size of today’s cell phones.
“A miracle of technology.”
Richard shakes his head in wonder and returns his attention to his newspapers. Maybe I can draw him further out of his shell if I tell him that I addressed the issue with Devon and his shit jacket.
“Before you disengage completely, I wanted to let you know that I looked into the issues you were having with Devon.”
“Oh?” He raises his eyebrows in anticipation.
“I put in a request with his counselor to take up the issues that you conveyed to me, including the hygiene problem and the disruptive behavior in groups. It has since been addressed with Devon personally, and I hope you will show some patience and tolerance as he adjusts.”
“Well. Thank you.”
“Is that a commitment to give the guy a break?”
“Not exactly.”
“What is it, then?”
“It’s a thank-you. I haven’t said thank-you to anyone in a long time. I appreciate that you followed through.” Richard bows his head to me.
“Maybe since I’ve shown you the respect of following through, you’ll show me the same, and we can work on completing your file.” Once last try for today.
His eyes return to his papers and he brushes his cheek with the back of his hand, as if he’s brushing away my request.
My chest tightens as I draw in another disappointed breath. It’s been almost a month now and all I have are his basics. I’m running out of ways to get through to him.
NOVEMBER 23RD, 2:14 P.M. (#ulink_23248ab7-3dda-59fa-8264-fab4ca5c84d1)
Julie is buzzing the intercom looking for me. Her shrill, piercing voice is making my eardrums explode, so I pick up the phone as quickly as I can and hold the receiver about a foot from my face.
“Yes, Julie?” I grumble from a safe distance. “What do you need?”
“Hi, Sam!” I can hear the syrupy ooze of her voice falling down the telephone line, threatening to come trickling onto my neck through the receiver. She pauses, waiting for me to return the cheerful greeting. I say nothing. “Um, I wonder if you have a moment to come to my office? I’m meeting with one of your patients right now; we had a little incident in group.” She says little incident like she’s talking about a kindergartner who wet her pants during nap time.
“Which patient?”
“I’m with Tashawndra.” She enunciates each syllable slowly, fearful that her inability to properly articulate Tashawndra’s name will indicate she’s racist, or out of touch, or not relatable.
“Give me a minute.” I hang up the phone before she inundates me with more pleasantries, and begin the slow walk to Julie’s office.
I knock loudly on her door and realize that though we’ve worked together for several years, I’ve never seen the inside of her office before. She pulls it open, and I see Tashawndra with a shamed expression on her face, sitting on a blue plastic group-room chair. Looks like there weren’t enough office chairs for Julie. She invites me in, and I take in my surroundings.
She doesn’t have books or files or anything visible that would indicate this is a clinician’s office; instead she has a large stuffed bear wearing a green Ralph Lauren sweater sitting on her bookshelf. She has pictures of her family with quotes about sisters etched into the white wooden frames. As she closes her door, I hear the plink of bells, and I turn to see she has two coat hooks, one with her pale camel-colored coat with a pink plaid scarf over it, and the other with a stuffed fabric wreath with lacy edges and bells hanging off it. The final straw is a framed plaque of faux reclaimed wood with intentionally worn writing and painted flowers that reads Live, Laugh, Love. I can feel the bile and undigested lunch rising in my throat, and I hesitate to stop myself from projectile vomiting directly into her perfectly combed hair. The look of disgust on my face must be apparent because Julie reaches out to touch my arm and ask me if I’m okay.
“Sam? You alright?” I yank my arm away from her and nudge her out of the way as I take a seat in Julie’s desk chair. There’s a scent diffuser somewhere in here, and it smells like baby powder.
“Tashawndra?” She hangs her head, and I lower mine to catch her eyes. “You wanna tell me what happened?”
“Can’t Miss Julie tell you?” She hides her face in her hands. Her hair is twisted in ropes and dreads of various lengths and rigidity, some poking straight up out of her scalp and others falling forward into her eyes. She twists them when she gets nervous, and when she’s feeling happy, she ties ribbons and strings to the ends. She’s pulling at one of the strings now, a yellow piece of yarn tied to a dread on the left side of her face.
“I’d like to hear it from you, if you’re willing to tell me. I want to know what you think happened.” The yarn pops off between her fingers.
Tashawndra releases a snort like a bull about to charge. “I was in Miss Julie’s group, minding my own business, and out of nowhere, I look over and I see that Barry is staring at Miss Julie, and his mind ain’t right, and I know what he’s thinking.”
“What was he thinking?” I ask. Julie is hovering over us, blushing as her name is mentioned.
“He was thinking he like to sink his teeth into those legs!” She gestures toward Julie’s panty-hosed legs, exposed beneath her admittedly work-appropriate skirt. Julie involuntarily bends and covers her knees with her hands.
I can’t help smiling as I listen to this. “And then what did you do?”
“I threw my coffee cup at him.” Tashawndra leans back and crosses her arms over her chest. She is braless as usual and her pendulous breasts fall into her armpits.
“Was there coffee in your coffee cup?” I’m nearly laughing as I ask.
“No! It was empty. I should have slapped his face.”
“What’s going on between you and Barry?”
“Well, nothing now! But before he decided to get all inappropriate with the counselor, we was seeing each other. Been a couple of weeks. He brung me flowers from the table in the lunchroom last week. And before that, he gave me the rest of his pack of cigarettes. He told me I was the most beautiful girl he ever saw, and we had lunch together and we smoked on the smoking balcony together, too. But all that over now!”
“Anything else going on between the two of you?” Sexual contact between patients is strictly forbidden at Typhlos, although it’s nearly impossible to enforce. With the growing number of patients, it’s hard enough to keep track of where everyone is all the time, let alone try to figure out what everyone is doing. Patients have sex with their roommates at night, whether they’re gay or not, in the bathroom stalls, out on the smoking balcony in broad daylight. Sometimes right in the open in the hallways and group rooms. Tashawndra has lost privileges and been isolated because of sexual misconduct many times before, but Barry has never been her partner.
“Nah. I know I’m not allowed to bang nobody while we doing treatment here.” She fiddles with the yellow string, and I believe her that they weren’t having sex. She seems to care about him, and she rarely has sex with people she cares about.
“Good. I’m glad we’re making progress on that front. And you know you can’t throw anything at anyone, whether they’re looking at another girl or not, correct?”
“Yeah, I know.” She shoots her arm out in an aw-shucks gesture and throws the yellow string onto the floor. “He gave me these yarns for my hair, too.”
I pick up the string and hold it in my fist. “Tashawndra, I know it hurts when someone you like looks at someone else, but it’s important to react appropriately. Do you want to say anything to Julie?” Julie’s been leaning over us like an eager water boy during the halftime huddle. Her mouth hung open as she observed our interaction, and now that she’s being addressed, she pops up straight and composes herself.
“I’m sorry I got jealous in your group, Miss Julie. I know people gonna look at you because you beautiful, and I know it don’t mean that I can throw things at anybody.” She tugs at her dreads.
“Thank you, Tashawndra. And I think you’re beautiful, too.” Tashawndra blushes as a shy smile spreads across her face, and she pulls her shoulder up to her chin.
“You gonna talk to Barry about this?” I ask her.
“Yeah, I guess I could forgive him.”
“I’m glad to hear that.” I hand her back the yellow string, and she ties it into one of the dreads flopping down over her eyes. We walk out of Julie’s office together, and I take a deep breath of institutional air to clear my nose of the insufferable scent from her diffuser. It’s days like this that make me feel like a zookeeper, and I’m in awe of the level of shit I can continue to tolerate.
NOVEMBER 26TH, 12:45 A.M. (#ulink_79194289-aad4-537f-80a8-e6600c2a3c20)
I find myself at Nick’s again, waiting for David to show up. Lucas and I came together, but he is too drunk to function, so he parked himself at one end of the bar, staring at his phone, while I schmooze with our buddies. Everyone at Nick’s thinks that Lucas and I are the perfect couple, and it’s a very delicate dance, because we know this perception, and without speaking, we do everything we can to uphold it. Even if I’m afraid he might end up killing me when we are alone, in front of others, we put on the show that we need to put on to pretend to ourselves that each of us is fine, and that together we are the ideal couple: the beacon of domestic bliss that shines amid the crumbling failures of their past. It gives hope, and I am in the business of giving hope.
If I told them that he beats me, or that he had sex with a faceless hooker in the back room of a porn store earlier today, or that he is currently wolfing oxycodone in the bathroom, it would ruin their night, and I certainly don’t want that. This perception that Lucas and I are perfect…it helps me believe it. And it’s one of the last strings I have holding my life together.
David just walked into the bar, and he’s scanning the room trying to find me. I’m waving with one hand while drinking a Jack and Coke with the other. He’s probably the only person who knows the truth about me, the truth about Lucas and some truth about me and Lucas. Our offices share a wall, which means he can hear everything that goes on in mine. When I’m throwing up in the garbage can, or crying into my coffee, he tends to ask questions. Over the years, instead of lying to him, I’ve let him in, and he hasn’t used it against me yet.
David is my best friend. Not just my work best friend, but the closest thing I have to a real-life best friend. I’ve never slept with him, although maybe I should. He has a crush on me, I can tell, and I flirt with him and humor him just enough to make the crush continue, but I’m careful to never allow it to turn into something that would require reciprocity. Just the way I like it. He walks over, we look at each other, and without saying anything, he drinks from the straw in my drink. I signal to Sid, the bartender, for another round.
David and I stand too close together and gossip. We find safety in our bubble and use that safety to dismantle the other people around us. David pretends not to notice Lucas. I can’t tell if he’s being polite or defensive.
Lucas is in a state now. His tie is partially loosened and partially tight, one of the middle buttons of his shirt is undone, his jacket is strewn in a booth somewhere, his glasses are all greased and cockeyed on top of his head, and he needs to lean on the bar for support. Despite this, he’s become even more disarming and lovable to everyone in the room. The cocktail waitresses are huddled in the corner talking about him, and he has his hand on the panty-hosed leg of someone else’s girlfriend. No one seems to mind.
When I approach, his hand slides back into his own lap.
“Act like you love me, you stupid asshole,” I say with a smile.
“I do love you, you dirty whore,” he replies, and he might not be joking. “But I’m tired, and I have a long week coming up, so I’m going home.” He pulls his coat into his hands and makes a show of looking around the bar for his suit jacket. “If you see my jacket, will you bring it home with you? I don’t have time to go searching for it now.”
“No problem,” I say, hiding the cigarette and lighter I have clutched in my fist, as if I wasn’t about to step outside. If I give him a seamless exit, I can save myself from another one of his drunken attacks.
“You don’t have to come with me. I’ll get home fine,” he slurs, and I give the panty-hosed girl a side-eye. We perform our saying-goodbye act, with big hugs and kisses, and after he doesn’t bother to pay his tab, he stumbles out the door. I pretend not to notice the panty hose follow him out.
“You gonna be okay if I go, too?” David asks, joining me in pretending he didn’t see anything.
“Yeah, I’m probably only going to have one or two more.”
After tugging his coat over his shoulders, he leaves a fifty on the bar and wraps me in a bear hug. “I’ll see you on Monday, but call me if anything stupid happens, okay?”
“Thanks, David. I’ll see you Monday. Home safe.”
Now that David and Lucas are both gone, I can turn my attention to AJ. He’s been sitting at a booth with some people I don’t know, but from the looks he’s been giving me, I know that we’re both waiting for the moment—the moment in time when it’s going to be okay and we can run into the other room, the other world, the other universe where we can wrap up in one another and not worry what anyone else thinks, what anyone else knows, what anyone else can see, but at the same time, we know that that’s never going to happen. So we have to live in between the lines. We have to be somewhere only he knows, and only I know, and no one says anything, because there’s nothing to say. Where we can walk in daylight and hear no voices.
Even though it’s the same bar we’re always at, somehow the walls seem new to me. All the things around us seem to be brighter. The cheeky quotes written in chalk on the blackboard behind the bar are funnier. The music sounds like something I haven’t been listening to for the last two months. There’s something about the way he looks at me that takes down every single wall I have ever erected in order to keep people out.
He’s standing at the DJ booth now, putting on a song and pointing at me across the bar. I’m doing everything I can to stay as far away from him as possible. He sees this and he sees me, and he puts on my favorite song and mouths to me, This is for you.
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A.F. Brady
Тип: электронная книга
Жанр: Современная зарубежная литература
Язык: на английском языке
Издательство: HarperCollins
Дата публикации: 16.04.2024
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О книге: ‘Taut and intelligent’ Prima‘Utterly addictive’ Lisa HallEvery morning, psychiatrist Sam James gets up at six forty-five. She has a shower, drinks a cup of coffee, then puts on her make-up.She ignores the empty bottles piling up by her door.On this particular morning, Sam is informed of a new patient’s arrival at Manhattan’s most notorious institution. Reputed to be deranged and dangerous, Richard is just the kind of impossible case Sam has built her reputation on. She is certain that she is the right doctor to treat such a difficult patient.But then Sam meets Richard. And Richard seems totally sane.Let the mind games begin.