Notorious D.O.C. Read online

  I felt bad for her. Robert and I exchanged a look. I wasn't sure if I should try and break the bad news to her or let the staff doctor earn his keep. "Mrs. Turrigan—"

  Her cheeks flamed. "No! I don't know what I'm doing here. It's been a very long day. All I wanted was for his doctor to give him a few pills to calm him down. She made me come to the emergency room and now they're talking about making him stay here? It's ridiculous!"

  "Mrs. Turrigan, I know it's hard." What could I say? She was in denial and I had no good idea how to comfort her. "I am going to talk to the psychiatrist, but Walter is probably going to have to...stay here." That was a good euphemism. "We're going to have to work together to do what's best for Walter."

  She held herself rigid, but tears sprouted in her eyes.

  Robert had been silent up 'til now. It was my case and he was there to observe. But he reached forward and touched her hand.

  She stiffened.

  We all held our breath.

  Then she blinked and tears fell from her eyes, even as she kept perfectly still, her gaze fixed on the coat hook on the back of the door. In that moment, she reminded me of her son.

  That made me think of Mrs. Lee. There's more than one way to lose your kid.

  After admitting Walter, I felt exhausted. Instead of grabbing a coffee, I hit the gym.

  St. Joe's has a little, staff-only gym beside its cafeteria that costs ten dollars per month. Whenever I have a few spare minutes, I put on my running shoes. Since it was just before the lunch hour rush, I had the place nearly to myself. Now I just had to decide if I could go over to Mrs. Lee's house or not.

  I sighed and lowered my stack of weights using my quads.

  There are no fixed rules about interacting with patients, but we went over some guidelines in med school.

  Don't hug. If they hug you, you can accept it, but never initiate. It's better if you just pat them on the arm, at most.

  Don't date.

  But then the question always came up, what if you live in a small town where you're the only doctor and you don't have anyone but patients to hang out with?

  So they made up some more rules:

  Psychiatrists, never. Never date. Certainly don't screw. Nothing. Completely off-limits.

  Emerg, where's it's an in-and-out visit and you'll never see them again, wait six months.

  Mrs. Lee couldn't wait six months.

  I filled up my water bottle at the fountain while another guy blasted CNN and walked the treadmill. The door beeped, signaling another gym rat's entrance.

  I sensed someone behind me and turned.

  Tucker said, "Hey" and gave me a crooked smile. He'd combed his bangs down into his face, Brit-rocker style, and somehow it made him look more contrite.

  My heart thawed. I was supposed to be mad at him for bossing me around, but it felt old. "Hey." For the first time, I noticed his nose was slightly deviated to the left. Born with it, or broken?

  "What are you staring at?" He raised his voice to be heard over the news. An armed robbery in Arlington, Virginia. The suspect is male, estimated to be in his early twenties...

  I lifted my water bottle and took a sip. It was a good excuse to break our gaze. "Nothing." I wiped my mouth with the back of my hand.

  "Liar." He laughed softly and stepped toward me.

  I felt trapped between him, the water fountain, and the trapezius pull machine. It wasn't a bad feeling, except I was totally confused about him, Ryan, and myself. Weren't Tucker and I fighting? Sort of?

  "You're calculating how to do my rhinoplasty, right?" He tapped the side of his nose.

  "Yeah. How much it would cost to repair if I broke it again, if you started ordering me around again."

  He pretended to be shocked. "My mistake. Some girls like that sort of thing."

  His last sentence rang out as the other guy suddenly cut the volume on the TV.

  Ah. Masochism jokes. Way to undermine my physician image. I glanced over at the treadmill to see how the one guy was taking it. He was wiping it down and getting his access card out.

  I swallowed hard. The tiny room smelled of old shoes and antiseptic spray. Not exactly romantic, but Tucker and I were going to be alone.

  Always dangerous.

  I tried to shift the mood and muttered, "Well, save your S&M moves for all your other girls."

  Beep. The other guy passed his card over the reader. The door eased closed behind him.

  When I looked up, Tucker was smiling. "I know. You're a tough nut."

  Why was everyone calling me tough today? Mrs. Lee had said I was pretending to be tough, but still.

  "Tori and I were talking about you."

  I grimaced.

  "—and if you can't beat 'em—" He paused slightly. I refused to meet his eyes. "—you join, 'em, right? So how can I help you help Mrs. Lee?"

  Now I narrowed my eyes at him. "Are you serious?"

  He shrugged and straddled the lat bench. I felt both relieved and disappointed he'd moved away. "Why not?"

  I struggled to control a smile. "So you admit I'm right?"

  "Never." He started pulling down the bar. I watched the muscles in his arms. Unfortunately, he was wearing a baggy T-shirt. I still admired his forearms. "But, as Tori pointed out, if my chief complaint is that you're working too hard, my job is to cut down your workload, right? So we're going to be your Scoobies."

  "Huh?"

  "Off Buffy. Her sidekicks are the Scoobies." He sighed. "Buffy the Vampire Slayer. You have no idea what I'm talking about, right? Let your education begin."

  I laughed.

  "I'm serious. Once upon a time, there was a blonde chick in Sunnydale, California, who discovered she had a special talent for kicking vampire butt. And demon butt. And, well, evil in general."

  I started doing my triceps. I could see him through our weight stacks, since our machines were facing each other. Nice leg muscles. Hairy but not gross. When I glanced up at him, he was smiling, but he just said, "There will be a test, Buffy."

  If the test was on his legs, I'd probably pass. I cleared my throat. "There probably is something you can help me with." I glanced around one more time to make sure we were alone. "I've never been to Île-Ste-Hélène. Do you want to check it out with me? Maybe this weekend?"

  The smile spread across his face. "I was hoping you'd say that."

  My pager went off. I checked the number. Emerg.

  I sighed. Tucker just waved at me. "Later, Buffy."

  ***

  Nancy half-smiled as she pushed her own chart toward me, swiveling in her chair. "More business. Reena Schuster."

  My heart fluttered in my chest. No. No more panic attacks. I took a deep breath. "Again?"

  "We get a lot of repeat customers." She paused. "I already spoke with her. She said she doesn't want to talk to you."

  I dropped into the chair beside her. It sank down to midget-height under my weight, reflecting my mood. "What happens then? Will the psychiatrist come in?" When I admitted Walter, Dr. Forbes had said he was in the middle of a case and would see him on the ward. I couldn't see the psychiatrist rushing in to interview Reena Schuster.

  "I can give him my assessment. So can the medical student. But it's not unusual for patients to be antagonistic. You could try talking to her. Usually, they're cooperative if you keep trying."

  Of course I would try, but my stomach tightened. I felt light-headed. I pinched my wrist to ground myself. I'd inserted tubes down people's airways and shocked people's hearts. Why did I have so much trouble on psych? "Sure. I just wonder why she keeps coming back here, if she refuses to see me."

  She pointed to the address on the chart. "She's in our sector."

  That made me think of Mrs. Lee again. I rubbed my forehead. Nancy gave me a strange look. "Headache," I said, trying to act as normal as possible. I checked my watch. It was almost 11:30 a.m. I asked Robert to come with me. It would be faster if we did it together, and he could take over if she refused me.

  I
strode in the office. Reena was sitting in the corner with a coat over her shoulders despite the heat outside. The same friend took the chair closest to the door. "Hi, Reena—"

  She put her hands to her mouth and almost screamed. "I don't want to see you!"

  My teeth clenched together so abruptly, I bit the skin inside my lower lip. Why did she hate me so much?

  Robert gasped and almost bumped into my back. "Sorry!"

  I ignored him. I clutched her chart harder to my chest. I would not drop anything this time. "I know you don't want to see me. I'm sorry—"

  Reena covered her eyes. "Oh, God, you're sorry!"

  Jodi slid off her chair and put her hand on Reena's arm, her body blocking me. "Chill."

  Reena shoved her away. "I will not fucking chill, you bitch!" Her face was blotchy, as if she'd been crying or sleeping face-down. Her pupils were dilated and her lips were cracked. I wondered if she was on something. I started to glance at her chart, to check her vital signs, but Reena twisted her hair around her fists again, arresting my eye. Was she going to hit me next?

  I stood frozen in the doorway, blocking the medical student, until I heard Nancy's heels tapping toward us.

  I relaxed a smidgen and let her through. She said, "Now, now, Reena."

  Reena pointed at me, her index finger trembling. "You want me to confess. You want me to go crazy. But I won't!"

  Why would I want that? I shook my head.

  "Of course you won't, Reena." Jodi threw her arm around her. "Everything is fine."

  "LIAR!" She launched her head back and I could hear her gnashing her teeth. She was an animal.

  I gulped. Jodi tried to draw her into her arms, but Reena shoved her away, shouting over her shoulder at me, "You should just give me drugs! I'm not fucking talking to you! You can't make me! Do you want me to get suicidal? Is that what you want, bitch? Would that make everything even? Well, I won't!"

  She pounded to the other side of the exam room and wrenched open the door to the hallway. Two people waiting for their X-rays looked up, startled, as she rushed toward them.

  Reena veered sharply to the right, then burst out of the emergency department exit on to the street.

  Chapter 8

  The hospital guards looked shell-shocked. They stared at Reena Schuster, fast-disappearing down Péloquin street, and then back at us for guidance.

  "Oh, my God! Should we call a code?" I asked Nancy. With a code white, they could've wrestled Reena down.

  Nancy hesitated. "It would be the police now. She's off hospital property."

  Jodi snapped, "Don't bother. She's fine." She raced after her, blasting past an old couple hobbling into the emerg. The woman with a cane stumbled. The old man steadied her elbow.

  "Hey!" I called, but Jodi's dirty blonde hair vanished after Reena. At that pace, we'd lose both of them before I could dial 911. I backed into the psych room and reached for the phone.

  Nancy laid her hand on mine. "Wait. She wasn't suicidal during my assessment this morning or when you saw her yesterday."

  "Right, but—"

  "She's off hospital property now," she repeated.

  Robert shook his head and shoved his hands in his pocket. He wasn't getting involved.

  "What are you saying?" All I could think was that my patients were literally running away from me. What was worse, two code whites in two days or one code white and one taking off AMA (against medical advice)?

  "I'll call Dr. Forbes," said Nancy.

  I stepped back. She'd be better breaking the bad news. She claimed the phone and spoke in muted tones.

  "It's not your fault," muttered Robert.

  I rubbed my hand against my forehead. Wasn't it? Should I have sent the medical student in solo, knowing she was unwilling to see me, instead of going in myself to try and hurry up the cases?

  And why did Reena hate me so much? I'd just met her.

  I'd heard of projection and transference and vaguely understood the concept: patients had a lot of crap, and thought the therapist was doling it out, when in fact it was their own fears coming back at them. But I'd thought it only happened after long term therapy, especially Freudian. Reena had hated me on sight. Why did I make her so nuts?

  She definitely seemed more unbalanced today. Why did she think I wanted her to go crazy or kill herself? I didn't even know her. I'd be happy if she stayed at home, eating Corn Flakes.

  Nancy hung up the phone. "Dr. Forbes says there's nothing we can do. She's a borderline and a frequent flyer, and now she's off the premises. He's not going to send the police after her. She'll probably come back on her own."

  Yes, probably tomorrow afternoon, when I was back on psych-emerg. My eyes ached with fatigue. This was supposed to be an easy rotation, but so far, it was worse than straight emerg. The ER was exciting. In, out. Boom, boom. Evening and night shifts took their mental and physical toll, but you got bragging rights and you had a set time to go home. At this rate, my next two months would be non-stop Reena Schuster refusing to see me and making everyone else think I was incompetent.

  Nancy forced a smile. "You two should go eat. I'll call you when someone else comes in."

  As we trudged up the stairs to the residents' room, Robert said, "Are you okay?"

  Miniature golf face struck again. I shrugged. "I don't know why she bothers me so much."

  "That's the borderlines' job, right? They make you nuts, too."

  I hadn't even diagnosed her as a borderline. I had no instinct for psych. She told me she was depressed, so I went through the checklist for depression and thought about a few other diagnoses like bipolar disorder or substance abuse. That was it. But it was true, her chart was covered in borderline personality disorder.

  Robert punched in the code for the resident's lounge and held the door open for me. "I knew someone who worked with borderlines. She said..." He hesitated and lowered his voice. "You can tell who they are because they make you so mad. If you want to strangle them, they're borderlines."

  I half-laughed. "Yeah? The psychiatrist I worked with said to think of Glenn Close from Fatal Attraction." I passed through the door. "Thanks."

  "That's good, too." He stood by the fridge door, obviously mulling over Reena, but more like he was interested instead of irritated. "I don't think she was typical, though. The scars on her arms were old. I doubt she's slashed herself for months, maybe years. Still, she was angry, and I think she had definite abandonment issues, so she does fit the profile."

  He was going through the borderline diagnostic criteria. Anger, fear of abandonment, paranoid or suicidal under stress, a tendency to idealize or demonize people, and more often than not, wrist-cutting. Hey, that sounded exactly like Reena. And I shouldn't take all the hating personally—borderlines either loved you or hated you, and I just happened to end up on the hate list.

  For the first time, I stopped to look at Robert, not as a pudgy medical student in a white coat, but as a human being who was a lot more psych-savvy than I was or ever would be. "Are you planning on doing psych?"

  He smiled, seemingly undisturbed by the rotting food smell emanating from both the garbage can and the refrigerator. "Does it show?"

  They say there are two types of doctors, internists and surgeons. Internists like to pore over books and think deep thoughts; surgeons like to act. I'm obviously a surgeon. I'd classified Robert as an internist, but now I wasn't sure. Maybe psychiatrists are a breed of their own.

  I threw open the fridge door to hunt for my bottle of water. MuchMusic blasted in the background. Someone I didn't recognize, a med student, chewed lasagna with the remote in one hand and a fork in the other.

  Tucker was nowhere to be seen. I glanced at my watch. Forty minutes had passed. No chance he was still in the gym.

  I chugged my bottle and chanted to myself, I am not disappointed. I am not.

  My pager went off. Not emerg, but an outside number with an area code 514. Who would be calling me from outside the hospital but within Montreal?


  "Is it Nancy?" asked Robert.

  I shook my head. I could think of one possible candidate who'd take my mind off of Tucker. I walked to the wall-mounted phone and punched in the number, my pulse already accelerating.

  A familiar male voice said, "Hey."

  "Hi, Ryan," I said, aiming for calm instead of eek.

  "Hard at work?"

  "Yeah. I already admitted one patient."

  "Geez. Is that why you're listening to Britney Spears?"

  I laughed and glanced at the TV, where Britney managed to dance and flash her cleavage with equal abandon. "Something like that. I actually get a lunch break when I'm on psych."

  "Amazing. Listen, I was calling about the thing you asked me." Mrs. Lee. Business before pleasure. "Could I use your computer to start on the modeling? I'm leaving on Thursday, but I've got some ideas."

  I twisted the phone cord around my finger. Hmm. Ryan in my apartment, waiting for me to get home. Business and pleasure? "Aren't you supposed to be on vacation?"

  "It's boring."

  Ha. He'd rather do work for me than score with Lisa. "I should make you do downtime."

  "But."

  "If you come by now, you can pick up my keys."

  "Sweet."

  I wolfed down my sandwich, continually checking my watch. If Ryan was late, he'd interrupt my family medicine clinic. He usually had a good sense of direction, but what if he got lost in a strange city? Or got waylaid by a petite girl with claws?

  Oh me of little faith. Not only did Ryan page me from the parking circle in front of the hospital just over half an hour later, but when I bounced up to him, he handed me a single dwarf sunflower.

  "Oh, Ryan." I surveyed the orange-yellow petals and delicate stamens and wanted to kiss him in the sunflower, if you know what I mean. How did I ever let this man go?

  Still, I had to laugh at the sheer impracticality of me carrying a sunflower, even a dwarf one, around the hospital for the rest of the day.

  He shrugged and smiled. "Better than Britney, right?"

  "Much." I sniffed it. No sweet smell, but still wonderful. I twirled it between my fingers while we stood in the drop-off circle, inhaling exhaust fumes and cigarette smoke and smiling like idiots.