The Girl Without a Name (20 page)

N
egative,” the woman from the lab says.

“Negative?”

“Yes, negative. Nothing came up on the urine screen.”

“And the blood tox? Did anyone ever find that one?”

“No, sorry,” she says. “But you probably have your answer anyway.”

“Yeah, I guess so. Thanks,” I say, hanging up the phone.

Negative. Which means no Demerol. Which means it's either out of her system or Raymond Donner hasn't actually been running around trying to poison Candy after all. If it's even him in the picture. Maybe Dr. Berringer's right and this is catatonia. I close down her labs on the computer and check my phone again. Five minutes until my meeting with Dr. Connor, the Chair.

My phone rings and I silence it, and see it's Mike calling. I'd love to answer but don't want to be on the phone if the Chair opens the door early. A text pops up.

sorry, left phone at movie theater. Just got it back. Call me later? XO

I'm smiling at the XO—which you probably wouldn't text if you were about to break up with someone, even if you were a conflict avoider—when I realize it's already been the full five minutes and knock on the door. Dr. Connor opens it right away, like she was just standing there waiting.

“Hi, Zoe.”

“Hi,” I answer, out of breath all of a sudden.

She motions to a chair across the desk for me to sit. The chair has dark-gray fabric with odd purple swirls, which doesn't match the room at all. I sit.

“So how can I help you, Zoe?” She tilts her head, and a headful of gray ringlets moves en masse. Her pressed navy suit fits her to within an inch of her life, her matching heels polished to the perfect degree of shine. The woman is wound so tight she probably tracks her calories down to the decimal. I didn't like her even before she put me on probation.

“It's about Dr. Berringer.” My heart flutters.

“Yes.”

“Well, I'm a little concerned about him.”

“Okay.” She pauses. “Can you tell me more about that?”

I nod, scratching at my knee. My other knee itches next but I ignore it. I get itchy when I'm nervous. “It's just about this case we're on together.” I'm still not sure if I'm going to tell her about his drinking. I have to assume she already knows.

“I see. Did you address your concerns with him?” she asks.

“I did. Yes, I did. But I don't think he's really hearing me, and I was hoping to get another perspective.”

“Okay.”

“It's about Candice Jones, our patient. She's only thirteen, and he's thinking about ECT to treat catatonia. But I think he's basing it on the wrong diagnosis. I don't think she's catatonic at all.”

She smooths out a wrinkle in her sleeve. “You think it's serotonin syndrome.”

I can't hide my shock. “So you already know about it?”

“Yes, actually. We've been in very close contact about this case.”

“Oh.” There is an irresistible itch on my scalp.

“And I'm actually glad you called me, because I was planning to speak with you anyway.”

“Oh,” I repeat dumbly.

“Frankly, Zoe, I'm concerned about you.” Her voice oozes warmth, faker than the fireplace in my family room. As she leans over her desk, I catch a whiff of mothball.

“Okay.” I brace myself.

“You understand that I ask the attending doctors to do monthly reports on all residents on probation, right?”

A queasiness creeps into my guts. “No, I wasn't aware of that.”

“Well, it was discussed when you were first on probation.”

That's quite possible. Given my mom just died and I couldn't focus for shit, paired with the utter shock of failing the RITE and discovering your dream of being a doctor may be dwindling fast, I may have missed a few sentences in her lecture.

“I'll admit, you score quite high on most portions of the evaluation, but not so on the PBL.”

“The PBL?”

“Yes, the Practice-Based Learning initiative. Do you know what that's about?”

“Not exactly,” I admit. But I have a strong feeling she's going to tell me.

“Basically, what that refers to is the ability to self-reflect, to realize our limitations.”

“Uh-huh.”

“In short, Dr. Goldman, to admit when we're wrong.” She furrows her eyebrows, looking vaguely like a Muppet. “When I asked Dr. Berringer about your score on this part, he mentioned this case as an example. That you were convinced that this is serotonin syndrome to the exclusion of the more likely diagnosis of catatonia.”

“Not to the
exclusion
of catatonia. But there's more going on here—”

“Zoe, I must tell you, there are multiple physicians involved in this case who agree with the catatonia diagnosis.”

“Okay, but I also just wanted to—”

“And he mentioned you were worried about someone from the outside poisoning your patient? A priest?”

I take a breath. “Yes, I realize that sounds kind of weird, but the individual may be under investigation—”

“Listen, Dr. Goldman, I don't need to get into all the nitty-gritty details.”

I wonder if she ever actually lets her patients speak. It's kind of a big thing in psychiatry, letting your patients speak.

“I know you're just trying to do what you think is right. But I must say, nothing you've just displayed so far in our conversation dissuades me from my apprehension about your PBL skills. I mean, here I am, telling you what several of your attendings think about the case, and yet you're still arguing with me.”

I open my mouth and shut it. There is no way to win an argument that can't be argued.

“Right now, what I really need to hear from you is this: Yes, I understand that I may be wrong. That we are all on the same page here, all on the same team.” She pauses and smiles, revealing a dot of spinach in her left bicuspid. Which seems odd, for breakfast. A frittata maybe? After a minute, her smile grows tense, and I realize I'm supposed to speak.

“Yes, yes. Of course,” I assure her. “We're all on the same team, of course.” I will even lead a cheer to prove it if she wants.

“Good.” She leans back from her desk again. “And just so you're aware, no one is talking about dismissal here. Actually, Tad didn't even want me to bring it up with you. He was really underplaying it, but I felt it was important.”

“Uh-huh.”

“This is not about punishment, truly. We're just concerned about you. Knowing what happened with your patient in the past…and with the ADHD issues.”

The room goes silent then, the buzz from her computer suddenly roaring. I feel my throat tighten, a telltale sign that tears aren't far off.

He told her? He actually told her?

“I appreciate your concern,” I say, and clamp my jaw down tight as a latch. I will not cry in front of this woman.

I can't believe he fucking told her.

“All right. I think we're all done here, then.” She straightens some papers on her desk. I have never seen such an organized desk. “Or was there anything else you want to address?”

There's no way I'm talking about his drinking now. “No, no, I think that's about it.” I stand, my legs loose as jelly.

“Okay then.” Dr. Connor stands up, too. “Thank you for coming, Zoe.” She reaches out her hand for a shake, her pseudo-warmth ratcheting up a notch. “Let's keep in touch.”

We exchange fake smiles, and I'm almost out the door when I turn around. “Just out of curiosity, did you ever examine the patient? Candy Jones?”

Dr. Connor pauses, a shot of animosity piercing through her warm, calorie-counted facade. “No,” she says, “I did not.” Her tone doesn't concede an inch.

“Okay. Thanks,” I say, and walk out, giddy with this littlest of triumphs.

I avoid Dr. Berringer all day, which isn't easy considering he's my attending and I do have to round with him. Jason had a dentist appointment, so he's not even there to defuse the situation.

“Chloe first?” Dr. Berringer asks, piling up charts.

“Sure.”

He glances at me, hearing something in my tone, but then keeps stacking charts, probably figuring I'm just premenstrual. “She's still gaining?”

“Yup.”

He gives me another off look, but I ignore it and walk right into Chloe's room. “So I guess congratulations are in order?” I say.

Chloe does her signature eye roll. If there were an eye-roll competition, she would score straight tens.

“Five more pounds?”

“Looks like it,” she mutters, flipping through a magazine. It's a fashion mag with dangerously skinny models pouting on every page. She whips her overgrown, strawberry-red bangs out of her face, but they slide back again by the next page. Chloe is a pretty girl when she is not skeletal. I never noticed. She creases a corner of a page, and I sneak a look to see a runway model in long, purple military garb. Something no one would actually wear. But maybe it signals something. A life ahead where she might wear a long, purple something. Something pretty and tangible that could be hers, in a life where she eats breakfast, lunch, and dinner, and maybe a snack, and doesn't think much about it. Maybe not today but someday. We exit toward Candy's room.

“Candy's the same?” he asks.

“Yeah,” I answer. No change, staring, moaning. Even stiffer today, though. I tried to move her elbow, and it was lead.

“I actually got someone lined up to do ECT tomorrow. It's a Saturday, but I convinced him it was an emergency.”

“Hmm.”

“Do you want to come in? I know it's the weekend, but you don't get much exposure to ECT. Have you ever seen it done before?”

I shake my head.

“May be your only chance,” he says, leaning over to grab an orange hard candy from the bowl. “It's four p.m. Only time Dr. Munroe was available.” The candy clicks in his teeth.

“Hmm.”

“Zoe.” He lowers his voice and leans in toward me, his breath exuding tangerine. “Something wrong?”

I stare straight ahead. “Had a little chat with Dr. Connor today.”

“Oh yeah? What about?” He looks nervous, like I might have said something about him.

“Something about problem-based learning?” My throat tightens again, and I feel tears threatening.

“Zoe, come on.” He tugs my elbow, steering me toward the nurses' station, and I allow myself to be led. “Tell me what's going on,” he says softly, once we've gotten to the room.

“Did you tell her about my ADHD?” I ask him, getting right to the matter.

He swallows. “Listen—”

“I told you that in confidence!”

“Zoe.” He shushes me. “I didn't mean it, honestly. She sort of trapped me with this stupid resident competency form and—”

“So you felt you should tell her about it?”

His jaw tightens. “I thought it might help your case, actually. So yes, I did.”

“Oh yeah?” I say, then lower my voice, too. “Well, what about
your
case?”

“My case?”

“Yeah, your case. Me driving you home drunk at three a.m. Ring a bell? You leaving early because you're too damn hungover to see your damn patients?”

He doesn't say anything but scratches at his collar. “I'm working on that, Zoe,” he says, his voice injured.

“I'm sure you are. But in the meantime, Candy is the one suffering.”

“No!” he yells out. Some nurses turn their heads toward the room, and he moves closer to me. “No,” he repeats in a fierce whisper. “You've gone too far there, Zoe.” He stabs a pointer finger on the table. “You're wrong. You might not like that, but you're wrong. Candy is catatonic. And no one is poisoning her. And it's not serotonin syndrome. She's catatonic. Catatonic.” He enunciates every syllable. “And I'm sick and tired of being second-guessed on my every move. Sick of it. I'm not taking it anymore. Not from the Impaired Committee, not from the Chair, and definitely not from you.”

I suck my breath in.

He leans away from me now, his cheeks splotched with red. “Let's just say she is encephalopathic. For the sake of argument. Why? What's the etiology? The tox screen is negative so we can rule out the priest. What else were you planning to look for? Tell me.”

“Well,” my voice wobbles, “infection.”

“Done. CBC normal, CMP normal. Blood cultures sent. Negative. CSF negative. Goddammit, we even checked her for TB.”

“Yes, that's true.” I remember suggesting this.

“So there's one abnormal EEG. Which I missed, because somebody in EEG faxed us the wrong goddamn report. It doesn't change the basic picture, which is catatonia. And the longer we leave her this way, the less likely she is to come out. Is that what you want?” His voice swells again.

“No,” I answer, shaken.

“All right then,” he says, his voice calming. He exhales, settling himself. “I've given you a lot of leeway, Zoe. Because you're still learning, and because of your…issues and because, goddammit, I like you.” A smile flits onto his face and falls. “But it's enough now. It's enough. We're doing ECT tomorrow. And you can come or not, that's up to you.”

“Yes,” I say immediately. “I'll come.”

Probation Girl is skating on ice a millimeter thick.

The drink burns in my throat.

I stare at the glass, and the coppery liquid stares right back at me. My plan to relax just a little bit has turned into three fingers of Scotch. I don't usually drink Scotch, though it was my dad's favorite. He wasn't a big drinker, but every year on Father's Day and his birthday, he'd indulge. I still remember all four of us in a fancy restaurant, me in a dress despite my tomboy pleading, Scotty spilling chocolate milk on the tablecloth, and my dad cradling his glass with reverence. The unadulterated relief of his twice-yearly Scotch.