“No.” Doubtfully.
“Right. Look, my dear, there is an impairment here, and now we know it may have a neurological basis. She had an atonic seizure, yes? Seizure, religious hallucinations, we’re now maybe looking at epilepsy with a focus in the medial temporal lobe, it’s practically diagnostic. What you need to remember isshe is crazy,you are not. Sane, presenting yourself as sane, you pose to her delusional system a serious challenge. You can regard that system almost as a person in its own right. It wants to survive, yes? When you push it, as you did here, it will fight back, or retreat from contact, which is what we just saw. The devil, or whatever, is chasing her, and she can’t talk to you, so she checks out.” Lopez leans back in his chair and bridges his hands, a typical gesture, but here in the plain institutional office and not his well-appointed shrink’s lair, it seems thinner, more ticlike. Is Mickey as confused as she is? She rejects this thought. He continues, “So in these delusional cases, we must do two things simultaneously: one, we encourage the person to spin out their tale, we become confidants without ever actually validating the delusional system.” An admonitory finger: “A subtle point. It separates the men from the boys in this business.”
“So to speak,” says Lorna. “And the other?”
“You tell me.”
Lorna considers this for a moment, grateful for the show of confidence, if that is what it is. “Well, I guess to deal with, I mean, to try to locate the underlying cause, the lesion, or neurosis, or trauma, and help the patient work it through, using appropriate means.”
She is rewarded with a smile for this conventional answer, which goes only a little toward relieving her of her doubts. Mickey was not there in Therapy B, did not see the woman’s eyes. Or her teeth. He says, “Yes. Easy to say, difficult to do, of course. Now, the meds may help.” He checked the file on his desk. “We have her on Haldol, two milligrams tid. How’s she doing?”
“She complains of drowsiness.”
“Yes, well that’s normal the first couple of weeks. We should start her on Dilantin too, for the seizures. But she’s social, not withdrawn?”
“Very social, apparently, the belle of the ward. She calms the place down, I’m told.”
He chuckles. “Yeah, her and the Haldol. Anything else?”
“What if she won’t talk to me anymore?”
“That’s always a possibility, she’s fitting you into her paranoid delusion. Let me know if that happens, and we’ll up her dosage or try another med.”
“I’m not sure that’s indicated, Mickey. There’s something about her…I don’t know, it seems crazy”?here they both laughed?”but, you know what they say, even paranoids have real enemies.”
Now Lopez’s smile cooled. “So, what…you think she’s coming off a genuine trauma? Some abuse?”
“Yes, and I’m concerned that we don’t have a real file on her. She has no background, no relatives to talk to…I don’t know, she seems so…nonimpaired compared to the typical NP remand, really centered and calm….”
“So she’s writing her life story for you, right? You’ll read it and you’ll come to a conclusion. If she’s been to heaven and talked with the angels, that’ll be one outcome, and if she was in with a gang of Colombiandrogeros, that’s another. Meanwhile, she’s safe and warm and we’re in no rush. You have to get your paper out of this, remember?”
Lorna does, with some shame. They talk technicalities for a few minutes and then Lopez says he has another meeting. As she leaves, he speaks: “One more thing, kiddo. Don’t fall in love.”
“In love?”
“Yeah, don’t fall in love with the patient. Everyone knows about transference, but it works the other way too. Obviously something about this woman appeals to you. At some level, you don’t really want to believe she’s crazy, yes?”
A shrug. He says, “Just watch it is all I’m saying,” and gives her a big, warm, Mickey Lopez-faux-Jewish smile.
After this, Lorna drives downtown and meets with a group of retail-chain personnel managers about testing programs that might reveal a propensity for dishonesty in potential employees. She is smooth and cool and much appreciated by the conclave of middle-aged men and women, and she wonders yet again why she does not restrict her practice to such bland services. The environment, an elegant office suite in a NE Fifth Avenue high-rise, is terrifically beige and has a great view of the bay. It is roach free, nor does it smell of Pine Sol, all of these features a nice change from her usual venues. Why, then? A last scrap of youthful idealism?
“Sheer dumb, honey-child,” said Betsy Newhouse when Lorna puts the question to her lightly an hour later at their gym. “I keep telling you that the rich need good done for them just as much as the poor and they pay a lot better. I mean, let’s face it?if they had anything on the ball, they wouldn’t be poor.” Lorna laughs in spite of herself, although not very vigorously, as she is struggling, as always, to keep up with Betsy on the StairMaster. This is one of the pleasures of the freelance life, the two women agree; they can come to the gym when they please, when it is empty. For Betsy, who is in real estate, this means access to whatever machine she needs to hone each muscle group to perfection, while for Lorna it means not having to strip naked in front of many women. Other than them there are only two men and a woman in the place, the latter being, delightfully, in far worse shape than Lorna feels herself to be.
“I have a social conscience,” puffs Lorna. She is streaming sweat despite the artificial chill of the air-conditioning, and she imagines her face looks like prime rib. She casts an admiring glance at her friend, who is stepping easily, dry as a bone, her breasts solid as bisected baseballs in their spandex casing. Lorna does not wish to think about what hers are doing: a pair of pups fighting in a gunnysack is a phrase she once heard on the street in reference to a jogging woman (not her) by a couple of construction workers. Ever since, she has never been able entirely to expunge it from her mind.
“There’s a procedure for that now,” says Betsy. “You could have it removed along with a tummy tuck. Oh, listen, we have to go to De Lite after. They’ve gotpesetje this week.”
“What?”
“It’s this great Albanian goat cheese, unpasteurized and zero fat. Zer-o.” Lorna voices appreciation of the Albanian nation’s cheese-mongers and agrees to the date, although she wishes Betsy would not suggest surgical modifications quite so often. It reminds her of Rat Howie, and also of her late mother, whose body was whittled down to a nubbin by surgery of the noncosmetic variety during her last year of life. Surgerynot, is Lorna’s prayer, or would be, did she ever actually pray. Slow Lorna must keep on climbing the endless staircase (such a symbol of her life so far!) when Betsy completes her allotted generation of ergs.
After this climb, Lorna hits a few other machines, somewhat less vigorously than her trainer would like, and then waves to Betsy and motions upward. Betsy waves back and shows five fingers, meaning she will be along in a notional five. The dressing room is deserted, Lorna happily observes. Moving like a thief cleaning out a bank vault, Lorna strips, grabs a towel, and heads for a shower stall. With a towel wrapped almost around her, for she is too generously built for the stingy gym towels, she weighs herself, although she knows she is not supposed to do this every day, and is pleased to find that she has dropped a full pound since the previous visit, or perhaps a little more, as the towel must weigh half a pound at least. As she steps past the shower curtain, however, she catches a glimpse of herself in the mirror and sees not a figure that would have made Auguste Renoir fall to his arthritic knees in worship, but galaxies of hopeless lard. She does not cry in the shower, although she has before this, any number of times. She dresses, and she and Betsy go to eat. The Albanian goat cheese tastes like library paste and chalk, but Lorna is a good soldier and snaps up far more of it than Betsy does, without complaint. Zero fat.