“Okay, okay,” she said. “According to Paul, symptoms are communications. Because the tic communication wouldn’t be unique anymore, the kid would have to find some other way of working through his rebellion.”
It sounded ill-conceived, potentially cruel, and made me wonder about Dr. Paul Kruse. “I see.”
“Hey, I thought it was bullshit too,” said Aurora. “Going to tell Paul that, next week.”
“Sure you will,” said someone.
“Watch me.” She closed the chart and put it back in her bag. “Meanwhile, this poor little boy’s shaking and twitching and his self-esteem is going right down the tubes.”
“Have you thought of Tourette’s syndrome?” I asked.
She dismissed the question with a frown. “Of course. But he doesn’t swear.”
“Not all Tourette’s patients do.”
“Paul said the symptoms didn’t conform to a typical Tourette’s pattern.”
“In what way?”
Another weary look. Her answer took five minutes and was seriously flawed. My doubts about Kruse grew.
“I still think you should consider Tourette’s,” I said. “We don’t know enough about the syndrome to exclude atypical cases. My advice is, refer the boy to a pediatric neurologist. Haldol may be indicated.”
“Ye olde medical model,” said Julian. He tamped his pipe, relit it.
Aurora moved her jaws as if chewing.
“What are you feeling now?” one of the other men asked her. He was narrow-shouldered and thin, with rusty hair tied in a ponytail, and a drooping, ragged mustache. He wore a wrinkled brown corduroy suit, button-down shirt, extra-wide rep tie, and dirty sneakers, and spoke in a soft, musical voice saturated with empathy. But unctuous, like a confessor or kiddie-show host. “Share your feelings with us, Aurora.”
“Oh, Christ.” She turned to me: “Yeah, I’ll do what you say. If the medical model is what it takes, so be it.”
“You sound frustrated,” said the gray-haired woman.
Aurora turned on her. “Let’s cut the shit and move on, okay?”
Before Gray Hair could reply, the door opened. All eyes drifted upward. All eyes hardened.
A beautiful black-haired girl stood in the doorway, holding an armful of books. Girl, not woman- she looked girlish, could have been an undergrad, and for a moment I thought she’d come to the wrong place.
But she stepped into the room.
My first thought was time warp: She had a dark, wounded beauty, like an actress in one of those black-and-white late-show films noirs, where good and evil blur, visual images vie for control with a sinuous jazz score, and everything ends ambiguously.
She wore a clinging pink knit dress piped with white and bisected by a white leather belt, pink pumps with medium heels. Her hair had been rolled and set, every strand in place, gleaming. Her face was powdered, mascaraed, her lips glossed a wet-looking pink. The dress reached her knees. The leg that showed was shapely, encased in sheer nylon. Her jewelry was real gold, her nails long and polished- the hue of the polish identical to that of the dress but precisely one shade deeper.
And perfume- the fragrance cut through the staleness of the room: soap and water, fresh grass, and spring flowers.
All curves and swells, porcelain whiteness and dusty rose, flawlessly put together. Almost painfully out of place in that sea of denim and deliberate drabness.
“Suzy Creamcheese,” somebody muttered.
She heard it and winced, looked around for a place to sit. No empty spaces. No one moved. I shifted to one side, said, “Over here.”
She stared at me.
“He’s Dr. Delaware,” said Julian. “Alex. He’s endured the rites and rituals of this department and emerged seemingly unscathed.”
She gave a fleeting smile, sat down next to me, folded her legs under. A stretch of white thigh showed. She tugged the dress down over her knees. It caused the fabric to go tight over her breasts and accentuate their fullness. Her eyes were wide and bright, midnight-blue, so dark the pupils blended with the irises.
“Sorry I’m late,” she said. A sweet, creamy voice.
“So what else is new,” said Gray Hair.
“Any more follow-ups to present?” I asked.
No one answered.
“Then I guess we can move on to new material.”
“What about Sharon?” said Ponytail, grinning at the new arrival. “You haven’t shared a thing with us all semester, Sharon.”
The black-haired girl shook her head. “I really don’t have anything prepared, Walter.”
“What’s to prepare? Just pick a case, give us the benefit of your wisdom.”
“Or at least Paul’s wisdom,” said Julian.
Snickers, nods of assent.
She pulled at her earlobe, turned to me, seeking reprieve.
The crack about Kruse helped explain the tension that had accompanied her entrance. Whatever his therapeutic skills at manipulating roles, this supervisor had allowed his group to be poisoned by favoritism. But I was hired help, not the one to deal with it.
I asked her: “Have you presented at all this semester?”
“No.” Alarmed.
“Do you have any case you could discuss?”
“I… I suppose so.” She gave me a look more pitying than resentfuclass="underline" You’re hurting me but it’s not your fault.
Shaken a bit, I said, “Then go ahead, please.”
“The one I could talk about is a woman I’ve been seeing for two months. She’s a nineteen-year-old sophomore. Initial testing shows her to be within normal limits on every measure, with the MMPI Depression scale a little elevated. Her boyfriend is a senior. They met the first week of the semester and have been going together ever since. She self-referred to the Counseling Center because of problems in their relationship-”
“What kinds of problems?” asked Gray Hair.
“A communication breakdown. In the beginning they could talk to each other. Later, things started to change. Now they’re pretty bad.”
“Be more specific,” said Gray Hair.
Sharon thought. “I’m not sure what you-”
“Are they fucking?” asked Ponytail Walter.
Sharon turned red and looked down at the carpet. An old-fashioned blush- I hadn’t thought it still existed. A few of the students looked embarrassed for her. The rest seemed to be enjoying it.
“Are they?” pressed Walter. “Fucking?”
She bit her lip. “They’re having relations, yes.”
“How often?”
“I really haven’t kept a record-”
“Why not? It could be an important parameter of-”
“Hold on,” I said. “Give her a chance to finish.”
“She’ll never finish,” said Gray Hair. “We’ve been through this before- terminal defensiveness. If we don’t confront it, cut it off where it grows, we’ll be spinning our wheels the whole session.”
“There’s nothing to confront,” I said. “Let her get the facts out. Then we’ll discuss them.”
“Right,” said Gray Hair. “Another protective male heard from- you bring it out in them, Princess Sharon.”
“Ease up, Maddy,” said Aurora Bogardus. “Let her talk.”
“Sure, sure.” Gray Hair folded her arms across her chest, sat back, glared, waited.
“Go ahead,” I told Sharon.
She’d sat in silence, removed from the fray like a parent waiting out a spat between siblings. Now she picked up where she’d left off. Calm. Or on the edge?
“There’s been a communication breakdown. The patient says she loves her boyfriend but feels they’re growing distant from one another. They can no longer talk about things they used to be able to discuss.”
“Such as?” asked Julian, through a cloud of smoke.
“Just about everything.”
“Everything? What to have for breakfast? Stuffing versus potatoes?”
“At this point, yes. There’s been a complete breakdown-”
“Breakdown,” said Maddy. “You’ve used that word three times without explaining what you mean. Try clarifying rather than restating. Operationalize the word breakdown.”