The Girl Without a Name (2 page)

I nod, not sure what to say to this canned psychiatrist line.

“Life throws you curveballs sometimes. I know your mom died recently, and that's been tough, I'm sure.”

“Yes. It has.”

“I know how you feel. When my mom died…” He looks down at the table and doesn't finish the sentence.

“It was hard?” I offer. I can't help it; I'm a psychiatrist.

“Yeah, it sure was.” He looks back to me. “And it wasn't easy moving to Buffalo either. I'm a Southern boy like a fish out of water up here, even after three years. My wife is on her last nerve in this place. Or maybe just with me,” he jokes, raising his eyebrows. “Anyway, these things happen, right?”

“Right.” I'm not sure who is treating whom here, or maybe that's not the point.

It does make me wonder, though, how he did end up in Buffalo. When he was hired, the Children's Hospital press release called him the “wunderkind from the Big Easy.” Not yet forty and he's got a publication list longer than my arm. Even Jason will admit he's “wicked-fucking-smart.” So what brought him to the polar vortex then? He clears his throat, and I realize he may be waiting for an answer. But I'm not sure what the question was.

“So I guess what I'm saying is, we all have our troubles, Zoe.” He leans in toward me. “And it sounds like you've had more than your share since you've been a resident.”

I wonder if he's talking about the patient who stabbed me. I didn't think he knew about that. But he probably does. Everybody around here does. I forged my way past whispers and stares for months after it happened. But eventually people's everyday life, real life—messy with its fender benders, cheating spouses, overdue cable bills, all the other quotidian tragedies—intervened, turning even homicidal, psychopathic patients a bit less eventful. Which is to say, everyone eventually forgot about me. Though every once in a while, a hush still falls over the elevator when I step on.

“You ever of hear Leonard Cohen?” he asks, putting his elbows on his knees.

“No, I don't think so.”

“Let me tell you. He's one of my favorite songwriters. A poet, really.”

“Okay?”

“He has a song where he says:
There is a crack in everything. That's how the light gets in.
” He pauses to let this sink in. “Like no one's perfect; we all have our demons. But that's what makes us who we are.” He stares off at the wall, where the sunlight glares on the veneer of light-brown, fake-knotted wooden paneling. He puts his hand on my shoulder and gives it a squeeze. An attagirl kind of squeeze. Like he might give to Mr. Gonzalez, which makes me sad in a way. I really don't want to be his patient.

“I'm doing okay, though,” I say. “I just think my meds need some tinkering is all. I'll be right as rain soon enough.” Right as rain. Something my mom used to say.

“I'm sure you will be,” he answers, standing up. End of the quick word. As he opens the door, the pressurized silence of the room evaporates, the hospital sounds zooming back in. We walk out, and he glances at his gold watch.

“I've got an appointment in a bit.”

I stop myself from asking for what.

“And you're post-call, so get yourself home already!” He gives me another shoulder squeeze. “And Zoe?”

“Yes.” I hear my foot tapping against the tile and stop it.

“Don't forget.” He puts his hand up to his heart in a fist. “
That's how the light gets in.
”

I stand there as he walks away, trying to decide if that was corny or not.

O
kay, my dopamine needs a serious tune-up here.”

Sam cradles his chin, naked pink now without his goatee. (He told me last session his wife thought it made him look old.) It does take ten years off him, but he looks incomplete somehow. Like his brown hair and his brown eyes lost a friend. He also looks less Freudian, though maybe that was intentional. “What do you mean?” he asks.

“I don't know. My brain is sluggish. Like I'm underwater.”

He nods. “And why do you think that is?”

I finger the row of brass buttons on the leather chair. “I don't know. I assume it's my ADHD acting up. It just feels like I'm brain-dead.”

He waits for me to say more. “Can you give me an example?”

I bend over to the coffee table. Sam always has some kind of toy to play with in the office, to put patients at ease. I'll have to remember that trick when I'm out in practice next year. Assuming I don't get a fellowship, which I can't afford anyway. His newest toy is a small box of sand with a miniature rake and three smooth, gray-brown stones. Some Zen thing. “So we have this patient with catatonia, right?” I say, raking away.

“Right.”

“She's probably about twelve or thirteen.”

“Probably?”

“The thing is, we don't actually know her exact identity yet. The police are still working on that one.”

“Interesting.”

“And Dr. Berringer asks me for the differential for catatonia. Which should be simple…but it takes me forever.”

“I see.”

“Same for the differential for mania. My brain just failed.”

“So you couldn't come up with it.”

“Dr. Berringer actually called me on it. Took me aside and asked if anything was wrong.”

“Hmm.” He cradles his chin again. “That is a concern.”

“And then for Jane—”

“Jane?”

“That's what we call our girl with catatonia. Jane, as in Jane Doe.”

“Ah.” He nods.

“I just feel like…I can't help this girl if I'm not firing on all cylinders.” Which makes me wonder exactly how many “all cylinders” entails. Six? A dozen? I couldn't venture to guess. I rake tic-tac-toe lines in the sand. “So I'm thinking we need to go up on my Adderall.”

Sam leans forward, resting his elbows on his large, glossy desk. “I can see how you might think that. But honestly, I'm not so sure.”

“No?” I fill in some X's and O's. “We need to do something. I mean, I failed the RITE exam. The RITE exam, for God's sake. I haven't failed a test since, like, fourth grade.” I still remember the “64%” in bright red, scarring the top of my math test. I thought my young life was over.

“Let's talk about that,” he says.

I pause. “Well, it
was
a long time ago—”

“No, no, not the fourth-grade thing. The RITE exam. Could the fact that you just lost your mother have anything to do with failing the exam? Do you think?”

“Maybe,” I admit. It was two weeks later after all. Which is why I was put on probation but not canned. “Extenuating circumstances” as per the letter from the Psychiatry chairman. And the glowing, though unexpected, recommendation from Dr. Grant didn't hurt either. Unexpected because I thought Dr. Grant hated me, but it turns out he was “just challenging me to live up to the potential of a Yale medical graduate.” Rattling my cage, as it were. No worries about that one anymore. The Yale thing has certainly lost its luster by now. And I don't have Dr. Grant to kick around now anyway. Now I've got Dr. Berringer, the esteemed head of Child Psychiatry, for my child-psych rotation, yet another attending to disappoint.

Sam's hands climb up to play with his goatee, find it missing, and descend back onto his desk. “How are you doing with your mom's death?”

“Which mom?” I ask, a poor attempt at humor. My birth mother died when I was a child. I only found out the whole truth about what happened in the first year of residency, when I first started seeing Sam.

“Your adopted mom,” he answers with a half smile.

My “real” real mom, the one who raised me. “I don't know. I still think about her all the time. Every single day. Sometimes I grab my phone to call her and then remember I can't.”

“Very common,” he says, nodding. “She's still more alive than gone for you right now.”

“I guess.” I catch my reflection in the wall mirror, a huge circle with a dark wooden ship-wheel frame. The room has an overdone nautical theme; he should shoot the decorator for going overboard. (Yeah, I know. Pun intended.) “What happened to the compass?” I ask, noticing it missing, a behemoth of a thing on his desk that always pointed true north even though it faced east. In its place is an anchor paperweight matching the anchor bookends. The paperweight is huge, granite, a plausible murder weapon in a
CSI
plot.

“I don't remember. Let's focus back on your mother, okay?”

“Sure, okay.” I sit up on the couch. “I don't know what more to say. She's gone, I'm sad. That's all.” I drop the rake, the handle resting on one of the stones. “It's been almost a year now. It just seems like I should be further along.”

He takes off his glasses and toys with the temple. “Grief has its own pace unfortunately. There's no shortcut for that.”

“Yeah, I know. But to be honest, right now I'm more concerned about my brain not functioning.”

“Yes, I know you are. But that's the connection I'm trying to make here. I don't think the slowed cognition has anything to do with your ADHD. But I think it has everything to do with your mother's death.”

“As in depression?”

“You could call it that. Or grief. They go hand in hand.”

I catch my reflection again, half a nose in the nautical mirror. “Should we go up on the Lexapro then?”

“Let's see.” He turns to his computer, scrolling to get my medication page. “We have room to increase it if you want. Do you think it's necessary?”

“It's more than necessary. It's mandatory. I'm on probation here. Whatever it takes to get these gray cells jogging again.”

He pauses, then pulls out his drawer with a rumble and starts filling out a script.

“Don't you guys have e-script yet?”

“Next month. At least that's what they told me last month.” We both smile. “Let's try fifteen milligrams. Watch for diarrhea.”

I fold the script in half and drop it in my purse. A bit of hope. Gathering up my things, I run through my list of belongings, a rote routine of mine since an “ADHD Skills Course” my mom dragged me to in eighth grade. Purse, check. Phone in purse, check.

“Hey,” Sam says, standing up. “You figured out next year yet?”

It's almost October, and most people are on top of their fellowship applications. But I'm not quite there yet. Maybe because my brain is in slo-mo. Or maybe because I really don't know what the hell I want to do. Mike's been hinting all summer that I might want to come up with some semblance of a plan. Finally he just stopped talking about it altogether.

“Give yourself some time,” Sam says when I appear stuck on an answer. “You'll figure it out eventually.”

“I guess.”

“And Zoe,” Sam continues. “Work on being kinder to yourself. The RITE, for instance. I know it upsets you, but think about it: Your mom just died, you didn't study. I don't know many people who would actually pass an exam in that situation.” He stands up from his desk. “I don't even think they should have put you on probation, but that's just my opinion.”

“Really?” The thought buoys me. Probation has been a tough label, a scarlet P upon my chest.

“Really,” he says. “See you next week.”

I pull open the door. Cue next patient: the skinny woman I spotted in the waiting room. Perfectly coiffed, makeup on the severe side, whipping through an
Oprah Magazine
like she was being timed. Anxiety, I'm thinking.

And in another year, someone will actually pay me to make that diagnosis.

Later that day, I know I should be studying for the RITE, but I'm hanging out with Mike instead, ambling through the wares at Oktoberfest.

End of September, but they're still calling it that. It doesn't even feel like fall. More like a gorgeous summer day, the air warm, almost sticky. Most of the attendees are wandering around in shorts, lugging Windbreakers they brought just in case. Mike is wearing a frayed polo shirt and cargo shorts. I take his hand and can tell he is pleasantly surprised. I'm not usually the PDA type, but he does look extra-adorable today. We pass by a corn stand, and Mike picks up an ear of dried Indian corn, spattered with shiny russet, black, and white-yellow beads. I try not to think about how many people have touched that same corn and the number of germs amassed on each kernel.

“How much?” he asks.

“One dollar each, five for the bunch,” the man answers, wrinkling his forehead into three distinct lines.

Mike pulls out a five. “I was thinking Samantha might like it,” he tells me.

“She's visiting?”

“Columbus Day.”

“Yeah, she'll love it,” I agree. He dotes on Samantha, his niece, which is wonderful of course. But it worries me a bit. I'm not really the having-children type, and we haven't quite gotten around to discussing that yet. We walk on to the next booth, lined with pumpkins with happy, rouge-cheeked, painted-on faces.

“How much for one of these?” I ask, pointing to one of the pumpkins.

“Five dollars,” the woman answers.

“Okay.” I'm getting out my wallet when a little figurine catches my eye. A ceramic ghost and scarecrow sitting on a bale of hay, their arms around each other. A dizzy memory washes over me then, of Scotty in a white sheet with one eyehole bigger than the other and me dressed as a scarecrow, the straw scratching my wrists. My mom is taking a picture (back when they still used film) while my dad pours the candy out into a big, blue bowl. “Come on, please! Hurry up!” we are begging them. “It'll be over soon!”

I turn the glazed piece in my hands. “This one?”

“Ten dollars,” she answers.

“Is that for you?” Mike asks.

“No.” I hand her the money. “For Jane.”

“Your patient?”

“Uh-huh.”

He pauses, cocking his head. “That's actually really nice.”

“Gee, thanks. I have my moments.”

As we walk on, I spy a cotton candy stand in the distance and enter a full-fledged debate with myself. Pros: I want cotton candy. Cons: sticky hands, uncomfortably full feeling. Pros: all those colors, so fluffy. Cons: no redeeming value whatsoever, pure sugar. I subtly change our trajectory toward the cotton candy.

“What do you think about her anyway?” I ask.

“About who?”

“Jane.”

He answers with a head shake. “Way above my pay grade.”

“Yeah, I guess. I just wish I knew who she was.” I run my fingers over a bright multicolor wool sweater. Bulky golds, eggplant, wine-red threads. Something Mike would never wear. “So I called you this morning. Where were you?”

His sneakers kick up some pebbles. “I don't know. When did you call?”

“Like, eight?” We walk past scarecrows made out of corn husks. “I figured you were at the gym.”

“No.” He crinkles his eyes, trying to remember. “Actually, I
did
get a call, but it was blocked. That was you?”

“Oh yeah, sorry. I forgot. I always block it now. Last week a patient got my number. He was giving me hourly reports on his mood.”

Mike lets out a loud chortle, catching stares. His bearish laugh matches him perfectly, with his broad shoulders that could veer into padding if it weren't for the gym. “He was depressed, I take it?”

“More like OCD. He was just obsessed with his mood. He would give me ten-scale updates, with decimals. Like, ‘I think I'm a 5.4 today, which is better than yesterday. Yesterday I was a 4.8.' He was getting into the hundredths place when I told him my number changed and he had to page me.”

“Zoe, Zoe, Zoe. Always an entertaining viewpoint on life.”

I decide to take this as a compliment. “How about you? What's your mood today?”

“Hmmm.” He pretends to think. “8.2.”

“Not an 8.3?”

“Maybe. Just talking to you puts me at a 9.4.”

“That's called mood elevation. I charge good money for that.”

“Right,” he guffaws. “You're a resident. You're not charging good money for shit.”

Finally we are nearing the cotton candy. “You want any? My treat. Guaranteed 9.5.”

He gives me a look. “Seriously? I just finished breakfast.”

“Your loss. One pink one, please.” I plunk down two dollars and am rewarded with a cloud of pale-pink goodness. We pass more pumpkin faces. “Oh,” I say with disappointment, looking ahead.

“What?”

“Candy apples. I love candy apples.” I pluck off a wad of cotton candy. “Should have held out.”

“Yes, that is tragic. Back to an 8.3?”

Laughing, I slug him, and we head to the next booth, by a clump of coneflowers that are past bloom, the centers rusted and petals scraggly and wilted. The scarecrow-ghost duo crinkles in my plastic bag.

A present for Jane, who doesn't know it's Oktoberfest. Who isn't going to be a ghost, a scarecrow, or even a princess this Halloween. Who is staring in a blank hospital room, not outside at this picture-perfect day with a bright blue sky and not a cloud in sight.

Arthur greets me with a full-frontal attack, socking me in the solar plexus, then latching on to my right thigh and humping me like it's the first night of his honeymoon.

Arthur is my dog, a psychotic labradoodle who came out on the shallow end of both gene pools. Let's just say he misses me
a lot
when I'm away. Arthur was supposed to be my brother's dog. Scotty brought him home from the SPCA when Mom was dying, without having fully researched whether or not his apartment allowed pets. So needless to say, he soon became my hand-me-down. Scotty babysits at least. He walks him on his lunch and sleeps over if Mike and I are both on call.