Right along the edge. You mustn't push me. You just mustn't. You're the one I've got to hold on to."
"So hold on to me," said Step. "Don't push me away. Trust me. Trust me the way I trust you."
"This whole argument, this is just because we're upset, that's all. We're upset and worried about Zap."
"And Stevie," said Step.
"Yes," she said. "And Stevie. I have to go."
"DeAnne," he said, "I have to know. Are you with me on this?"
"On what?" she said.
"On finding out from Dr. Weeks what's happening with Stevie."
"Yes," she said. "Do what you think is right."
"I won't do anything," said Step. "I'll just find things out. The way you find things out about Zap. All right?"
She looked at him steadily "If you can see that Dr. Weeks isn't helping, you can discontinue the sessions.
Without asking me or anything."
"But I won't," said Step. "Not without discussing it with you."
So it was that Step drove alone to Dr. Weeks's office, following the directions DeAnne had given him.
When he went inside, Dr. Weeks stood up and greeted him warmly. "Mr. Fletcher," she said.
"Please, call me Step."
"Step, then. I've been thinking that it was about time I had a session with you and your wife."
"She's at the hospital. Our new baby is in intensive care."
"Oh, I'm so sorry. What's wrong?"
Step explained, briefly, and then said, "That's why I'm here today. We're coasting along without insurance.
The bills for these sessions are quite steep, and we thought it was time for us to evaluate where we stand-what exactly you've found out about Stevie's problems and what you think it looks like for ... you know, down the road."
"Well, we've been making good progress, Stevie and I. He talks quite often during the sessions now. I think he's getting used to me."
Step wanted to say, He talks quite often? You mean we've been paying for sessions in which he hasn't talked at all? After two months he's only now getting used to you? But he remembered DeAnne's concerns about him and curbed his tongue.
"Beyond that," she said, "I'm still in the process of diagnosis. His reticence to speak is, of course, one of the symptoms of his disorder, but it also makes the process of diagnosis rather slow. I think that in another month or two I may be prepared to give you a prognosis. In the meantime ..." She turned over a couple of sheets of paper on her desk.
Trying to keep his voice calm, Step interrupted. "What I'm interested in today, Dr. Weeks, is not a final statement, but an explanation of what you know so far, or what you suspect so far. DeAnne and I have to decide now, not two months from now, whether to continue treatment."
"I'd be happy to work out a payment schedule with you," said Dr. Weeks. "But I can hardly discuss an ongoing process, especially when you are not the patient."
"The patient is eight years old," said Step. "And if I were a fellow psychiatrist, you would have no trouble at all talking with me about what you think the diagnosis might turn out to be."
"But you are not a psychiatrist, Step."
"I have a Ph.D., Dr. Weeks. It's in history, which isn't an exact science like psychiatry, I know, but it does mean that I'm an educated human being, and I think that if you try to explain to me what's wrong with Stevie, I'll understand you." Thinking of what was going on at the hospital with Zap, he added, "For instance, you must have some idea of what his condition isn't. Things you've eliminated."
"It would be much more helpful to the whole process, Step, if you and your wife came in for some sessions with me yourselves. In fact, I suspect that your insistence on hurrying the diagnostic procedure may suggest possible sources for Stevie's abnormal reaction to stress."
I should have expected this, thought Step. The very fact that I want to hold her accountable is proof of my disorder. Well, he was not going to let Weeks establish a doctor-patient relationship with him. "Fine," he said.
"If you explain to us what you think the problem might be and why our coming in for sessions might be helpful, then we might well agree that our joining in the therapeutic process might be the indicated course of action."
"Step," she said, "you seem to feel some hostility toward psychotherapists, along with an apparent fascination that has caused you to learn some aspects of psychological jargon. I wouldn't be surprised if you have unconsciously communicated this hostility to Stevie."
"Dr. Weeks, my efforts to find out what's going on between you and Stevie did not cause his problems."
"I wasn't implying anything of the kind," said Dr. Weeks. "Why do you think you felt a need to defend yourself just now?"
"Dr. Weeks, I think you misunderstand our relationship. I'm here as Stevie's parent. If I had brought him to a pediatrician with a bad cough, I'd have a right to expect the pediatrician to tell me what he thought might be causing the cough and what he intended to do about it, and he wouldn't give me any crap about how I couldn't possibly understand the ramifications of pulmonary function and, by the way, have I been short of breath myself lately? Stevie's been with you for two months, and apparently all you've observed about him is that he's morose and has imaginary friends, which is strikingly similar to what we already knew when we brought him here. I hope you'll understand that I'm not trying to interfere with Stevie's treatment. I simply have a responsibility to know what that treatment consists of and what it's designed to accomplish."
"Let me tell you why I'm reluctant to discuss this with you, Mr. Fletcher. Given the importance of parents in a child's life, it is inevitable that Stevie's parents are involved in the source of his problems. This idea is obviously threatening to you, and I fear that you may withdraw Stevie from treatment in order to protect your own ego. This might cause the boy great harm."
Step recognized that she was attempting to manipulate him into backing off- any objection he raised to her diagnosis could be dismissed as ego protection. But he held his temper and said none of the vicious retorts that came to mind. "Dr. Weeks," he said, "DeAnne and I knew from the start that solving Stevie's problems would almost certainly mean us changing our lives somehow. We're willing to do whatever it takes to help our son, and I'm not afraid to find out flaws in my own parenting. But I can promise you that if you don't tell me what you've learned about his condition, then we certainly will withdraw Stevie from your care."
She regarded him for a while, her expression aloof and uninvolved. She must have spent hours in front of mirrors during graduate school, Step thought, practicing that detached, I'mabove- emotional-engagement-with-mere-humans-and-their-pettyproblems look.
"All right, Mr. Fletcher," she said, "I will tell you what possibilities I am currently considering as diagnoses for your son's condition. First, we may be seeing a simple factitious disorder. Second, we may-
"Factitious disorder?" asked Step.
"Factitious means the opposite of what it sounds like, Mr. Fletcher-"
"I'm aware of the meaning of factitious," said Step. "It's the meaning of the phrase factitious disorder that I'd like you to explain."
"In layman's terms, it means that Stevie might be lying about these imaginary friends because he knows it upsets you and he's hungry for the attention that ensues."
Step stifled his desire to say Stevie doesn't lie, he has never lied, he tells the truth even when it causes him to be embarrassed, even when he's sure that he'll be punished for it. If Stevie says that he's playing with imaginary friends, then that's because he really thinks he's playing with these friends, and it's not some damned cockamamy factitious disorder. Instead, he merely said, "And your second hypothesis?"