Authors: G. H. Ephron
“Mr. Black, I do take you seriously. I want to help you.”
The session continued to spiral downhill. What had began as an auspicious self-examination had disintegrated, first with Mr. Black feeling attacked and disapproved of, then rising to defend himself. Now it had detoured into whether or not Emily cared about him. It was the kind of thing you expected from a novice therapist, not an experienced post-doc.
I met Emily in the cafeteria a few hours later. It was nearly two, but the cavernous room was still about half-full of staff, visitors, and patients, all dressed in business or casual clothes. Emily was at a table writing in a notebook. She wore tight leggings, and her sleeveless top, molded to her body like a second skin, was cut low. Her hair had come loose. If she'd been leaning casually against the wall and added some eye makeup and red lipstick, she'd have looked like a hooker who'd set up a concession in the middle of the caf.
“Why don't we sit over there,” I suggested, indicating a table in the corner where there weren't a lot of others sitting nearby.
She finished writing and moved while I got myself some coffee. When I returned, she was drinking from a bottle of water.
She looked at me expectantly. “I hope it's okay meeting you in these.” She indicated her outfit. “I'm trying to get my running in during daylight.”
“You're still feeling anxious?”
She didn't answer.
“Has something more happened?”
“I feel so foolish saying this, but I'm pretty sure someone's been in my apartment. There's nothing missing. But some things in my bathroom were definitely rearranged. And my bed. I usually don't make it in the morning, I'm in such a rush. It was made when I got home yesterday. It's got to be all in my head, right? Lenny's dead, so this shouldn't be happening.”
“Maybe you should stay with someone for a while,” I suggested.
“Maybe I will.”
“Did you call that attorney?”
She nodded.
I considered holding back the feedback I needed to give her about her interaction with Mr. Black. She was obviously vulnerable. But she was the one who'd insisted on continuing to work with patients. My first concern had to be their well-being, not hers.
“Do you think the stress is affecting your ability to do your job?”
Spots of pink appeared on her cheeks. “Do you?”
“Why don't you tell me how
you
think it went today with Mr. Black,” I said, sidestepping the question.
At first she seemed flustered. “I think it went fine. Iâ” Then her look hardened and she slammed the notebook shut. “But obviously you don't. If you're going to criticize me, why don't you just come right out and say so instead playing games?” Her voice echoed in the large space. Emily looked around uneasily, noticing that people at tables halfway across the room were staring at her.
I waited. This wasn't a game; it was a test. Self-control and self-reflection were essentials for a therapist.
She took a breath and steadied herself. “Mr. Black. It's going okay.” She looked at me. “Wrong answer, I know. Okay, it's not going okay. I was sure once he tried living without his arm he'd be convinced that amputation was a mistake. But a few minor inconveniences is all, according to him. Then he goes all defensive on me. Accuses me of not caring what happens to him. How can he even suggest that I don't care?”
“Listen to yourself. He disappointed
you
. He goes all defensive on
you
. How could he suggest that
you
don't care,” I said. Emily's mouth dropped open. I'd never been confrontational with her before. Now I was deliberately pressing to see if she was going to break. “It sounds as if you think Mr. Black's therapy is about you.”
“Of course that's not what I think,” she snapped.
“Then you seem to have lost your clinical perspective.”
She took another drink of water, held it in her mouth, and then swallowed.
“And since you asked,” I added, scanning the remaining dozen or so people in the cafeteria, “no, I don't think those clothes are appropriate here.”
“Then I guess I'd better go change.” Emily sat still, blinking back tears. “Why are you being such a shit?”
She stood, gathered up her things, and left.
“G
OOD QUESTION
,” I said to myself, crushing the Styrofoam cup and tossing it in the garbage.
I'd lost it. By attacking her personally, I'd only given her permission to write off the message. She could tell herself I was the one who was under stress, overreacting. And maybe she was right. For the first time in a very long time, I felt unsure of my internal compass.
Instead of heading back to my office, I found myself walking up the hill toward the administration building to Dr. Nelson Rofstein's office. It had been more than a decade since he'd been my clinical supervisor, but even now he served as a touchstone whenever I needed one.
“Peter?” he said, his shaggy eyebrows lifting and his face lighting up when he saw me at his door.
“Got a minute?”
He was up, shaking my hand and patting my shoulder. “Of course, of course. It's good to see you.” A robust man, his face was lined with character and his once brown hair was now fully gray. A sloping right shoulder and a squinty eye were the only evidence of the stroke he'd suffered a few years earlier.
“Sit, sit,” he said, indicating one of cushioned chairs that faced his desk. He sat, too, leaning back in his chair and lacing his fingers over his middle. “So, tell me. To what do I owe the pleasure?” He knew me well enough to know this wasn't a social call.
“I'm afraid I'm losing my perspective,” I said, getting right down to it. I told him about my observations of Emily Ryan and our last interaction. “I lost it, and I'm not sure why.”
“Tell me about her.”
“She's been with us for a few months,” I said. I gave him a synopsis of the work Emily had done on the unit. “She's exceedingly bright but doesn't seem to be particularly self-aware. Like how she looks. Wearing running tights and a skimpy top in the cafeteriaâso completely inappropriate.”
“I seem to recall you were a bit clueless in that department once upon a time,” Dr. Rofstein said with a wry smile.
I was still embarrassed, remembering how I'd washed up on Dr. Rofstein's doorstep, ready to save the world. I'd promptly found myself struggling with my first patientâa woman whose husband was dying of a brain tumorâand my increasing frustration because she'd only talk to me about how she was renovating the house and managing the night nurses. “She's not taking you seriously,” Dr. Rofstein had said to me. And why the hell not, I'd wanted to know.
He'd shrugged and looked up at the sky, a mute prayer for patience. “You can cut your hair any way you want,” he'd said, eyeing my three-inch Afro, “and you can wear anything you like”âhe gave a nod to my open-necked sport shirtâ“but your patients come in with their own
mishigas
and they're going to judge what they see. First impressions. It's not enough to act professional, which you do,” he assured me. “If you want to be taken seriously, look the part.”
Now, a dozen years later, Dr. Rofstein was giving the same heavenward look as he unlaced and laced his fingers. “Yes, you were very green. But a fairly quick learner, as I recall.” He noted my shorn hair and suit and tie. “What else are you concerned about?”
I told him I thought Emily was showing questionable judgment in her work with patients. “I'm worried that she's relying too much on her feelings and not enough on her intellect. I'm trying to keep my perspective. She has been under a lot of stress.” I went on, hitting the high spotsâthe stalker, the death in the MRI lab that might or might not have been her fault, the police surveillance. “It feels as if she's been depending on me, clinging more than I'm comfortable with. I guess it's understandable given what she's going through.”
“And you're sure it's not projective identificationâthat you're not doing something to provoke this dependency?”
I didn't think I was. Though maybe he had a point. Following her home to tell her about a broken taillight. Rushing over to the MRI lab and sneaking in. Maybe whatever Shands had seen in my brain scan was already eroding my judgment.
“I do seem to be constantly trying to rescue her.”
“So you're wondering if there's something going on with you that you're reciprocating this woman's unconscious attentions.”
“I guess I am,” I admitted. Dr. Rofstein sat there, waiting for me to get to the point. “And now I find myself doubting her integrity, wondering if she's made up being stalked. Wondering if she's as innocent as she says she is in her colleague's death.”
“You're worried that these doubts, even though they're unsubstantiated, are coloring your professional relationship with her. Making you doubt her competence.” He pondered for a few moments, peering at me from beneath his eyebrows. “Sounds as if for some reason your view of her has changed.”
I sat up. Hearing him restate my own words gave them a different meaning. Parallax, I reminded myself. If your position shifts, the position of the object you're looking at
appears
to shift. It's why when you're riding along in your car, the moon seems to be moving along with you; when you stop, it appears to be stationary.
There's a similar problem in psychologyâwhat you
expect
to see colors how you interpret your observations. If you think someone is a jerk, actions seem stupid that you might have called inspired if you'd prejudged the person a genius.
So what had changed my perception of Emily?
“I found out that a few years ago she posed for
Playboy
,” I said, feeling a little sheepish.
“And that makes you see her differently. Is it just her judgment this has called into question, or maybe there's something more?”
I'd been at this long enough to know what he was getting at. I'd been attracted to Emily. Flattered by her rapt attention. I'd responded intellectually while suppressing the sexual part. The
Playboy
photos felt like a betrayal. Not unlike someone who finds his lover has been cheating.
Rofstein continued, “Peter, you've got a number of things going on here and it's not surprising that you're feeling confused. You need to pay attention to your gut. It's telling you something, though it may take you a while to figure out what. And from what you tell me, it sounds as if this young woman has got a few things going on as well. No doubt you're right to be concerned.”
“I haven't felt this unsure in a very long time,” I said.
Rofstein sat up and leaned across his desk. “Peter, as long as you remain self-reflective you'll do fine.”
“I should have had better self-control,” I said.
“Yes, you should. So you'll work on it?” He rose. “And in the meanwhile, wait and see.” He walked me to the door.
“So this young woman also works at University Medical Imaging,” he said. “That's the one over on Sidney Street?”
“Right. You know Dr. Shands, don't you? The guru in charge?”
“Guru,” Rofstein said with a soft chuckle. “Dr. Lewy body dementia. Thank heavens for the supervisor who discouraged that young man from going into clinical psychiatry. Some of us are healers and some of us are watchers.”
“Bedside manner is not his forte. Didn't you know him from the Cambridge Brain Bank?”
“He was one of the lead researchers.”
“But no longer?”
“We should all have his drive,” he said.
My ears pricked up. This was an evasion, not an answer. “He and the brain bank parted company?”
“He needed to pursue his own path. The brain bank wasn't founded to support
special
research.”
“And how was his research special?”
Dr. Rofstein had opened his office door. Now he closed it. “He developed a way of looking at cell membrane permeability, but it was a destructive process. Brains were being lost at an alarming rate. He assumed that the brains, not to mention the funding, were at his personal disposal. It was never made public, but it was pretty clear that a percentage of each grant was being skimmed off and funneled into his personal research.”
“How did he manage that?”
“Let's just say that he and the executive director had a very close relationship. They both resigned.”
“Dr. Pullaski?”
He nodded. “But you didn't hear that from me. When they left, part of the agreement was that the details would never be made public.”
Dr. Rofstein opened the door again. He shook my hand, looked me in the eye, and said the same thing he always said when we parted.
“Remember, no good deed goes unpunishedâ”
I finished saying it with him. “âbut do good anyway.”
Late that afternoon as I was leaving to head home, I noticed Gloria and Emily sitting on the side porch of the unit. They were in chairs facing each other, heads together. Emily took a drag on a cigarette and offered it to Gloria.
Please don't
, I thoughtâGloria had had a miserable time kicking the habit a few years back. For a long time she carried around an unlit cigarette that she used as a sort of pacifier whenever she felt the urge.
Gloria declined the cigarette. I wondered if Emily was complaining about me. I hadn't come right out and said I didn't want her working with patients until she sorted her head out, but I was sure she realized I was getting close.
Just then a black Range Rover pulled into the circular drive. It stopped. I recognized the large, dark-haired man who stepped out. It was Kyle, Emily's ex. She waved at him and stubbed out the cigarette. So the white knight was back in Emily's life.
Emily and Gloria stood. Gloria had her hand on Emily's shoulder and they talked, their faces close to one another. They hugged and held the embrace, which surprised me because Gloria wasn't a huggy kind of person. Then Emily pulled away, picked up her briefcase, and ran to the waiting Range Rover.
The next evening I made my way up the wide steps and across the broad courtyard plaza of the Charles Hotel where lights twinkled in the trees. Shands had called and suggested that I meet him for a drink. He was heading over to the bar after work anyway, and he'd had a chance to look at my scan results.
By the time I got to the dim, leathery, cigar-scented bar, I was more in need of a Maalox than one of their exquisite, pricey martinis. I'd spent most of the night before trawling the Web for information on how to interpret functional MRIs. The basic idea was simpleâan fMRI showed you how blood flow was changing the brain. Beyond that, nothing was simple. I'd finally given up, frustrated.
At least there had been encouraging news about Uncle Jack. His fever was down and his lungs were starting to clear. They were talking about moving him out of the ICU and back into a regular hospital room. He might even be back at the Pearce in a few days.
I spotted Shands at a table in the corner. Handsome in his dark suit, his silver hair lustrous, he sat there brooding over his drink. As I approached, I wondered about him wanting to talk to me here instead of at the lab. Maybe he preferred this settingâfirst anesthetize the patient, fill his head with smoke, then whammo, deliver really bad news.
He rose and shook my hand. “Peter. Thanks for meeting me here.”
He gestured the waiter over. I ordered a club soda. He ordered another martini.
“I hope you don't mind coming here. Things at the lab are a littleâ¦tense,” he said.
“I suppose that's not surprising.”
“You know that detective who's in charge?”
“MacRae?”
“He's a pain in the ass.”
I laughed. “Yeah well, that's his job.”
“You think they're looking at this as murder?”
So was this why he'd wanted to meet me hereâto get the inside scoop on the investigation?
How the hell did I know,
I wanted to yell at him. Of course he'd be clueless that I was tied up in knots about what he'd seen in my brain scan.
“If MacRae's still there, you can be sure they're considering it. If it was an accident, then why hasn't that person who carried the oxygen tank into the scan room come forward?”