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Authors: Sandra Block

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BOOK: Little Black Lies
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A cat jumps up on the table in a gray flash. Jean Luc pets her absentmindedly, even though he's allergic to cats, then she flies off the screen again.

“You have a cat?”

“It's Robbie's,” he answers. “Kitty.”

“The cat's name is Kitty?”

“Yes.” He shrugs. “Melanie named her.”

“Hmm.” So Melanie is either a complete dullard or woefully ironic.

Jean Luc glances at his watch, a silver and blue one that I gave him for his birthday. “Zoe, I have to go. We are going
for dinner soon.”

“Okay,” I say, noticing the fading blond in his hair, the summer sun long gone now. “Where are you going?”

“Sushi,” he answers with a grimace. “This is all they eat around here. So expensive for little fish pieces that are not even cooked.”

I lean back in the settee, laughing. Half the time, Jean Luc doesn't even realize he's being funny. “Have fun.”


Je t'aime
,” he says.


Je t'aime
,” I answer. We are taking a break but still saying
je t'aime
. I close Skype, and my gaze wanders back to the window, where some of the raindrops are now freezing in beads. I smooth the book page again.

Patients with antisocial personality disorder are not necessarily sociopaths. Many are nonviolent unless provoked.

The woman with the pumpkin latte is leaving, huddling up against the cold rain. Sleet thuds against the window, threatening actual snow. The flames flicker against the grate on the hearth. I lean my head back against the soft leather and take another lingering sip of coffee before looking down at my book again. Internally I sigh, if this is possible.

Hours to go before I sleep.

T
he psych ward is buzzing as usual. The heater in the resident room clangs away as cold leaks from the window. Patches of last night's snow checker the ground.

How is my little kumquat?
I text and drop the phone in my stiff lab-coat pocket, behind my
Psychiatry Pearls
book, before I have a chance to fret over whether I will get a response or not
.

“Who are you texting?” Jason asks, sneaking up behind me.

“No one.”

“It's your boyfriend, right?”

I don't answer, and he starts jabbing my arm. “Give it up, girl. Pictures.”

“He's not even my boyfriend anymore,” I say, showing him a photo on my phone.

“Holy shit.” Jason grabs my phone to take a closer look. “He's fucking hot. He looks like Beckham.” He pauses to consider. “I'd have sex with him.”

“Oh, thanks, Jason. He'll be so pleased.”

Jason was on call last night and looks a bit bleary-eyed, the gelled, bleached tuft of his bangs starting to droop and the trademark bow tie long gone. He sits down heavily in his chair and leans back, the two chair legs precariously digging into a stain on the rust-brown carpet. The carpet is dotted with such stains, in various shapes and shades, like islands on a map. The resident room is a metaphor for our department: broke and run-down. Psychiatry is a poor man's medical field. The neurosurgery resident room, on the other hand, looks like the Taj Mahal.

Dr. A enters the room and takes a seat next to Jason. “Anything for me?” he asks.

“Yeah,” Jason answers. “You ready?”

“Ready as I'll ever be,” Dr. A says, remarkably not screwing up any part of the phrase.

“Who's yours again?” Jason scans his page.

“Wisnoski, Hillbrand, and Edwards.”

“All right,” he shifts papers. “Wisnoski, Wisnoski, Wisnoski,” he says, pointing to the name. “Still on twenty-four-hour one-on-one. But they're watching him today, may d/c it for the weekend if he's no longer verbalizing clear suicidal ideation. He pretty much still is, though.”

Dr. A nods.

“EEG normal. We upped his Lexapro to fifty milligrams qd and added Abilify at ten. No privileges right now, no phone if he asks, which he will.”

“What's the plan if there is not significant improvement from the medication changes?” Dr. A asks.

“Possibly ECT,” says Jason. He is talking about electroconvulsive shock therapy, one of the last resorts for depression. But this
is Mr. Wisnoski's third suicide attempt in the last five years.

“Ah, that is why they got the EEG,” he says.

“That's the fact, Jack.”

Dr. A looks puzzled and pulls out his idiom notebook. “Who is this Jack?”

“Forget it, man. Just yes, you're right, that's why they got the EEG.” Jason scans farther down the sheet. “Fuck, I need some coffee. Hillbrand is finished with detox and is awaiting transfer to rehab.”

“He's off suicide watch?”

“Yeah, turns out he drank window cleaner to get drunk, not to kill himself.”

“Lack of insight,” I offer.

“Yeah, I'd say,” answers Jason. “And Edwards is stable, awaiting discharge.”

Dr. A pats him on the back and grabs his charts to start seeing his patients.

Jason turns to me. “Who you got?”

“Just two right now. Miles Featherington and Vallano. Tiffany Carlson got discharged.”

“Okay. Featherington has group therapy in the morning. Going up on Risperdal and Depakote for OCD. Limited to ten-minute showers, and watch that no one gives him a toothbrush or he gives himself a thorough rectal cleaning.” I wince. “Oh, and he gets to look at his stamp collection every Wednesday if he doesn't refuse meds.”

“How about Vallano?”

“No fireworks yet,” Jason says. “She's the model patient, I guess. She has a nail file for her manicures that has to be locked up nightly to prevent someone else grabbing it, and she also has charcoals that have to be locked up.”

“Charcoals?”

“It seems she's quite the accomplished artist,” he says.

“A woman of many talents,” I say, grabbing the charts. “What's her privilege level, by the way?”

“Level three,” he says. “As long as she cooperates in group, which she has been.” Level three is the highest. It means she's allowed magazines or books from the library, makeup and nail polish, one phone call per week (which she never takes), and group outings. Though she's still not allowed off the floor without an aide. I check over the orders from last night before going on to see my charge.

Sofia Vallano is lying on her bed, propped up on her elbows, her hands cradling her chin. She is flipping through another magazine that has a waifish woman telling you “what men really want” on the cover, the sort that casually describe fellatio in an elevator. I would think finding out “what men really want” doesn't come in very handy in a mental institution, but who can tell. She is bouncing her feet together in an absentminded rhythm. She looks as if she could be at overnight camp, were it not for the fact that she is over thirty, on a psychiatric ward, and a probable psychopath. She is just missing the Dubble-Bubble chewing gum and posters of
Teen Beat
heartthrobs taped to the walls.

A couple of small, framed charcoal drawings sit on her bare desk, along with the hospital-issued pink-plastic pitcher of ice water. The pictures are quite impressive, actually. One is a landscape of branches in a night sky, with a moon shining through. The other is a self-portrait, not surprising for a narcissist.

“Did you draw these?” I ask, picking up a frame, starting in safe territory.

“Yup,” she says, eyes still on the magazine. A teenager ignoring her mom, except that she killed her mom. And she's no longer a teenager.

“They're good.”

“Yup,” she repeats, nonchalant. The silence builds as she flips through her magazine, refusing to interact with me beyond monosyllables.

I sit down in the chair next to her bed. “So how are you finding the new place?”

Sofia crosses her legs, still lying on her belly. “It's a variation of the old place.”

I nod, flipping open her chart, and scoot my chair closer to her bed. I wait a long thirty seconds to see if she'll break the silence, but she doesn't. “Do you want to talk about why you're here?”

Sofia's upper lip flinches a millisecond, but she keeps her face buried in her magazine. “Haven't you heard?” she asks.

“Well,” I say, leaning back in the chair, faking a laid-back posture to match hers. Mirroring: another big one in the psychiatry bag of tricks. “I have read through your chart, of course.”

“It's all in there then. You know more than I do.”

“Maybe. But, even stil
l
, I'd like to hear it in your own words. Do you feel ready to talk about it?”

Sofia pauses to consider, looking at the ceiling. “Not really.”

I sigh inwardly. So far this is going really well. Sh
e
flips through the magazine pages, though I can tell she is not reading the words. The branches of an old maple tree sway in the fogged-up window, a few faded orange leaves clinging stubbornly.

“We're talking about releasing you, you know,” I say, to test whether she does know this.

Her shoulders tense, then release. She clears her throat but does not look up. “I heard,” she says. But I can tell she is lying. A piece of black hair escapes into her eyes, and she pushes it back behind her ear. “And who makes that decision?”

“We all do. Dr. Grant has the final say, of course, but it's a team approach.”

“Of course,” she answers, not hiding her smirk.

I tap my foot on a loose tile. “Sofia, do you know why I'm asking you about the release?”

“No,” she says, the glossy magazine page catching the sun's glare as she flips it.

“Do you want to know?” I ask.

“Sure,” she says. “Enlighten me.”

Wow, “enlighten.” Big word. Did you learn that in college? Oh no, I'm sorry, I guess not, that's right: You were confined to a mental hospital. But of course I say none of this. Adderall forces all my best zingers to stay in my mouth. “I won't know if you're ready for discharge until we can talk about the reason you're here.”

She keeps flipping pages and licks her lips, which look chapped. “Guess I'll be here for a while then.”

I shrug but don't stoop to answer.
Grabbing her chart, I stand up to leave, wondering at her purposelessly self-destructive attitude: I won't talk to you, even if it means I'm stuck here forever. “I'll be in tomorrow, Sofia.”

“Okay, Zoe,” she says.

“That's Dr. Goldman, actually,”
I say, feeling for the first time like Dr. Goldman. As I leave the room, my phone sings out:
Dum-dum-dum-dah.
Jean Luc. My heart does a polka. If I were Pavlov's dog, I would salivate.

What is a kumquat?
The text reads.

Fruit. Look it up.
I type.

U r calling me a fruit?

U call me cabbage.

:) Je t'aime.

Je t'aime
, I answer and get ready to see my next patient, who I hope to hell doesn't have a toothbrush.

W
arm blood on my hands, my nightgown damp with sweat, buzzing in my ears
.
All day long, jagged pieces of the nightmare creep into my thoughts.

“I'll try anything,” I say.

Sam folds his hands together. “Unfortunately, as you may know, there isn't much research on treating nightmares.”

“Yes, I know.” I tap my heel against the scratchy blue carpet. “What about dream rehearsal? You mentioned that before.”

He nods. “That is probably where I'd start.”

“Okay, let's do it then.” Patience has never been my strong suit. I had the nightmare again last night. So it wasn't a one-off. They could be back for good. And I want this fixed, now.

Sam leans back and uncrosses his legs, his corduroys whisking together. He is wearing brown again, blending into the room as usual. Even his glasses (readers—he only wears them
sometimes) are tortoiseshell. I'm surprised they don't have little anchors on them.

“We have to start by delving into the dream. I need you to tell me every detail, from the very beginning,” he says.

I take a deep breath. My nightmare, not
my favorite topic of conversation. “Okay. Well, it always starts with my hands.”

“All right.”

“They're bleeding. Like I told you, from something that fell off the house, but I don't remember that part.”

“Okay. What happens next?”

“It's me as a little girl, and I'm confused. Or maybe it's me as an adult being confused, I'm not sure.”

Sam squints his eyes. “I don't think I'm following you.”

“Yeah, I'm not sure I follow myself.”

He puts down his yellow pad. “So you're a little girl in the dream.”

“Yes, and I'm hiding, but I don't know who I'm hiding from. I don't even know where I am. But what I'm saying is, I think the little girl knows; I just don't remember.”

“Okay, I see now.” Sam pauses, staring at the wall. “Is it possible you were confused, maybe a little oxygen-deprived, when you were hiding from the fire?”

I feel myself smiling. This is what I love about therapy, both giving and getting these moments of insight. “Yes.” I never considered the possibility of oxygen deprivation before.
Of course
I was confused. The thought is exhilarating.

“So you're hiding,” he confirms.

“Yes, and I hear a whirring noise.”

“What's that from?”

“I don't know,” I say. “And actually, it drives me a little crazy. I'm always trying to place that sound, even in the dream.”

“Okay, so there's a whirring noise.”

“And I'm afraid.”

“Naturally.”

“And I've got my blue teddy bear, Po-Po, who is missing an eye.”

Sam smiles at the image.

“And someone's calling my name, but I'm afraid to come out.”

“Okay. Do you know who that someone is?”

“Not really,” I say, but this is only half-true.

“Go on.”

“Then the person opens the door.” My heart speeds as I recount this. “And that's all.”

Sam nods, digesting this. I catch him glancing at the pewter clock, then down again. “I'm going to give you some homework for next week. I want you to write down the dream, every instant, every little thing you remember. Can you do that?”

“Sure.”

“Sometimes just the act of writing down the words diminishes their power over you.”

“Okay, that makes sense.”

“Then I want you to extend the dream.”

“Extend it? What do you mean?”

“I think part of the problem here is the confusion. The unknown. That may be what's truly scaring you. The lack of a real ending.”

“But how do I extend it? I don't know what happens when the door opens.”

“Right,” he says, “and I think that's the crux of the problem.”

I shift, and the uncomfortable leather couch creaks with me. “So you're saying give it another ending?”

Sam sits up in the chair with a smile. “That's
exactly
what I'm saying. An ending that you dictate. That you control. An ending that's not a question mark.”

“Like?”

“That's up to you to decide. What's a more optimistic, and perhaps realistic, ending to the dream?”

I pause, thinking. “I don't know. A fireman coming?”

“Sounds like a good one.” Sam crosses his legs, the corduroy rubbing again. “You need to bring resolution to the nightmare. I think that could really help.”

“So how does this work? I just hope the fireman shows up in the dream at the right moment?”

“Not exactly,” Sam says. “You need to practice it. That's where the rehearsal part comes in. You run through the dream before you go to bed. Every single moment, especially the end, when the door opens and the fireman enters. You insert your new ending and rehearse that part before you go to sleep.”

I am picturing a fireman, dressed in bright yellow, bursting through the doorway, ax in hand. Face grubby with soot and sweat, helmet tipping down over his forehead. Saving the day. The thought gladdens me. Much better than the alternative—the unknown, or even worse, the suspected. The idea so terrible that I can't let it sneak into my brain for a second without falling into a well of self-loathing and guilt. The idea that I
do
know who was calling me, but I didn't answer her.

And maybe, if I had answered her, she would still be alive.

BOOK: Little Black Lies
3.28Mb size Format: txt, pdf, ePub
ads

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