Jonathan Kellerman - Alex 06 - Private Eyes

by Private Eyes(Lit)

  "Good to see you, too, Dr. Delaware. And thanks so much for doing it on short notice.

  "My pleasure. Any trouble finding the address?"

  "No. I used my Thomas Guide I just learned about Thomas Guides.

  They're terrific."

  "Yes, they are."

  "Amazing how so much information can go in one book, isn't it?"

  "Sure is.

  "I've never really been up to these canyons. It's quite pretty."

  Smile. Shy, but poised. Proper: A proper young lady. Was it for my benefit? Did she metamorphose into something giggly and illmannered when she and her friends hit the mall?

  Did she go to the mall?

  Did she have friends?

  The ignorance born of nine years struck home.

  Starting from scratch.

  I smiled back and, trying not to be obviously analytic, studied her.

  Posture straight, maybe a little stifo Understandable, considering the circumstances. But no obvious signs of anxiety. Her hands remained motionless around her knees. No kneading, no evidence of chafing.

  I said, "Well. It's been a long time."

  "Nine years," she said. "Pretty unbelievable, huh?"

  "Sure is. I don't expect you to sum up all nine of them. But I am kind of curious about what you've been up to.

  "Just the usual," she said, shrugging. "School, mostly."

  She bent forward, straightened her arms, and hugged her knees tighter.

  A sheet of hair fell across one eye. She brushed it aside and checked out the room again.

  I said, "Congratulations on graduating."

  "Thanks. I got accepted to Harvard."

  "Fantastic. Double congratulations."

  "I was surprised they took me.

  "I'll bet there was never any doubt in their minds."

  "That's nice of you to say, Dr. Delaware, but I think I was pretty lucky.

  I said, "Straight As or close to it?"

  Return of the shy smile. Her hands remained clamped on her knees.

  "Not in gym."

  "Well, shame on you, young lady."

  The smile widened, but maintaining it seemed to take effort.

  She kept looking around the room, as if searching for something.

  I said, "So when do you leave for Boston?"

  "I don't know.... They want me to notify them within two weeks if I'm coming. So I guess I'd better decide."

  "That mean you're thinking of not going?"

  She licked her lips and nodded and brought her gaze to rest, meeting mine. "That's what that's the problem I wanted to talk to you about."

  "Whether or not to go to Harvard?"

  "What going to Harvard means. In terms of Mother." She licked her lips again, coughed, and began rocking, very gently. Then she freed her hands, picked up a cut-crystal paperweight from the coffee table, and peered through it, squinting. Studying the refraction of the gold-dusted southern light streaming in through the dining room windows.

  I said, "Is your mother opposed to your going away?"

  "No, she's- She says she wants me to. She hasn't objected at all as a matter of fact, she's been very encouraging. Says she really wants me to go.

  "But you're worried about her anyway."

  She put down the paperweight, moved to the edge of her chair, and held out her hands, palms up. "I'm not sure she can handle it, Dr. Delaware."

  "Being away from you?"

  "Yes. She's... It's..." Shrug. She began wringing her hands.

  That saddened me more than it should have.

  I said, "Is she still Is her situation the same? In terms of her fears?"

  "No. I mean, she still has it. The agoraphobia. But she's better.

  Because of her treatment. I finally convinced her to get treatment and it's helped."

  "Good."

  "Yes. It is good."

  "But you're not sure treatment's helped her enough to cope with being separated from you."

  "I don't know. I mean, how can I be sure She shook her head with a weariness that made her seem very old. Lowered her head and opened her bag. After fumbling for a few moments she drew out a newspaper article and handed it to me.

  February of last year. A "Lifestyles" piece entitled "New Hope for Victims of Fears: Husband and Wife Team Fight Debilitating Phobias."

  She lifted the paperweight and began toying with it again. I read on.

  The article was a profile of Leo Gabney, a Pasadena-based clinical psychologist, formerly of Harvard University, and his psychiatrist wife, Ursula Cunningham-Gabney, alumna and former staff member of that august institution. An accompanying photograph showed the two therapists sitting side by side at a table, facing a female patient.

  Only the back of the patient's head was visible. Gabney's mouth was open, in speech. His wife seemed to be looking at him out of the corner of her eye. Both doctors wore expressions of extreme earnestness. The caption read: DRS. LEO AND URSULA GABNEY COMBINE THEIR SKILLS TO WORK INTENSIVELY WITH "MARY," A SEVERE AGORAPHOBIC.

  The last word had been circled in red.

  I studied the picture. I knew Leo Gabney by reputation, had read everything he'd written, but had never met the man. The camera revealed him to be sixty or close to it, with bushy white hair, narrow shoulders, dark, drooping eyes behind heavy black-framed glasses, and a round, smallish face. He wore a white shirt and dark tie, had rolled his steeves up to the elbow. His forearms were thin and bony almost womanish. My mental image had been something more Herculean.

  His wife was brunette and good-looking in a severe way; Hollywood would have cast her as the repressed spinster, ripe for awakening. She was dressed in a cowl-neck knit top with a paisley kerchief draped over one shoulder. A short perm fit nicely around her face.

  Glasses hung from a chain around her neck. She was young enough to be Leo Gabney's daughter.

  I looked up. Melissa was still turning the crystal. Pretending to be enthralled with the facets.

  The knickknack defense.

  I'd totally forgotten this particular knickknack. Antique French. A real find, rescued from the back shelves of a tiny curio shop in Leucadia. Robin and me... the amnesia defense.

  I resumed reading. The article had the self-consciously laudatory tone of a p.r. release striving to sound like journalism. It recounted Leo Gabney's pioneering work in the research and treatment of anxiety disorders. Cited his "landmark success treating Korean War G.I."s for combat trauma when clinical psychology was still an infant science, pioneering research in frustration and human learning," and tracing his career through three decades of animal and human studies at Harvard.

  Thirty years of prolific scientific writing.

  No blockaroo for him.

  Ursula Cunningham-Gabney was described as a former student of her husband's and possessor of both a Ph. D. in psychology and an M.D. "We joke," said her husband, "that she's a paradox."

  Both Gabneys had been tenured members of the staff of Harvard Medical School before relocating to southern California two years previously and establishing the Gabney Clinic. Leo Gabney explained the relocation as "a quest for a more relaxed life-style, as well as the chance to bring to the private sector our combined body of research and clinical skills."

  He went on to describe the collaborative nature of the Gabney approach: "My wife's medical training is especially useful in terms of detecting physical disorders, such as hyperthyroidism, that present symptoms similar to those of anxiety disorders. She's also in a unique position to evaluate and prescribe some of the more recent and superior anti-anxiety drugs that have come along."

  "Several of the new medications look promising," Ursula Cunningham-Gabney elaborated, "but none is sufficient in and of itself Many physicians tend to view medication as a magic bullet and prescribe without carefully weighing costeffectiveness. Our research has shown that the treatment of choice in debilitating anxiety disorders is clearly a combination of behavior and carefully monitored medication."

  "Unfortu
nately," her husband added, "the typical psychologist is ignorant about drugs and, even if knowledgeable, unable to prescribe them.

  And the typical psychiatrist has little or no training in behavior therapy."

  Leo Gabney claims this has led to bickering between the professions and inadequate treatment for many patients with incapacitating conditions such as agoraphobia-a morbid fear of open spaces.

  "Agoraphobics need treatment that is multimodal as well as creative.

  We don't limit ourselves to the office. Go into the home, the workplace, wherever reality beckons."

  More red circles, around agoraphobia and the home.

  The rest consisted of pseudonymous case histories, which I skimmed.

  "Finished."

  Melissa put down the paperweight. "Have you heard of them?"

  "I've heard of Leo Gabney. He's very well known has done a lot of very important research."

  I held out the clipping. She took it and put it back in her bag.

  "When I saw this," she said, "it just sounded right for Mother.

  I'd been looking for something we'd started talking, Mother and I.

  About how she should do something about... her problem. Actually, we talked for years. I started bringing it up when I was fifteen old enough to realize how much it was affecting her. I mean, I always knew she was... different. But when you grow up with someone and the way they are is the only way you know, you get used to them."

  "True," Isaid.

  "But as I got older, started to read more psychology and understand more about people, I began to realize how hard it must be for her that she was realty sufftring. And if I loved her, my obligation was to help her. So I started talking to her about it. At first she wouldn't talk back, tried to change the subject. Then she insisted she was okay I should just take care of myselfo But I just kept at it, in small doses. Like after I'd done something good gotten a really good grade or brought home an academic award I'd bring it up. Letting her know I deserved to be taken seriously. Finally, she started to really talk.

  About how hard it was for her, how bad she felt not being a normal mother how she'd always wanted to be like all the other mothers but that every time she tried to leave, the anxiety just got to her. More than just psychologically. Physical attacks. Not being able to breathe. Feeling as if she were going to die. How it trapped her, made her feel helpless and useless and guilty for not taking care of me."

  She gripped her knees again, rocked, stared at the paperweight, then back at me. "I told her that was ridiculous. She'd been a terrific mother. She cried and said she knew she hadn't but that I'd turned out wonderful anyway. Despite her, not because of her. It hurt me to hear that and I started to cry, too. We held each other. She kept telling me over and over how sorry she was, and how glad she was that I was so much better than she was. That I would have a good life, get out and see things she'd never seen, do things she'd never done."

  She stopped, sucked in breath.

  I said, "It must have been so hard for you. Hearing that. Seeing her pain."

  "Yes," she said, letting loose a rush of tears.

  I reached over, pulled a tissue out of the box. Handed it to her and waited until she composed herself.

  "I told her," she said, sniffling, "that I wasn't better than she was, in any way whatsoever. That I was out in the world because I'd gotten help. From you. Because she'd cared enough about me to get me help."

  I thought of a child's voice on a crisis line tape. Scented brushoff letters, calls unanswered. that I cared about her and wanted her to get help. She said she knew she needed it but that she was beyond treatment, doubted anyone could help her. Then she started crying harder and said doctors scared her she knew that was stupid and babyish, but her fear was overpowering.

  That she never even talked to you on the phone. That I really had gotten better despite her. Because I was strong and she was weak. I told her strength isn't something you just have. It's something you learn. That she was strong, too, in her own way. Living through everything she'd been through and still ending up a beautiful, kind person because she is, Dr. Delaware! Even though she never got out and did the things other mothers did, I never cared. Because she was better than the other mothers. Nicer, kinder." I nodded and waited.

  She said, "She feels so guilty, but realty she was wonderful.

  Patient. Never grumpy. She never raised her voice. When I was little and couldn't sleep before you cured me she'd hold me and kiss me and tell me over and over that I was wonderful and beautiful, the best little girl in the world, and that the future was my golden apple.

  Even if I kept her up all night. Even if I wet the bed and soaked her sheets, she'd just hold me. In the wet sheets. And tell me she loved me, that everything would be okay. That's the kind of person she is and I wanted to help her to give some of that kindness back."

  She buried her face in the tissue. It turned into a sodden lump and I gave her another.

  After a while she dried her eyes and looked up. "Finally, after months of talking, after we'd both cried ourselves dry, I got her to agree that if I found the right doctor, she'd try. A doctor who would come to the house. But I didn't do anything for a while because I had no idea where to find a doctor like that. I made a few calls, but the ones who phoned me back said they didn't do house calls. I got the feeling they weren't taking me seriously, because of my age. I even thought of calling you."

  "Why didn't you?"

  "I don't know. I guess I was embarrassed. Pretty foolish, huh?"

  "Not at all."

  "Anyway, then I read the article. It sounded perfect. I called their clinic and spoke to her the wife. She said yes, they could help, but that I couldn't arrange treatment for someone else. The patients themselves had to call to set it up. That they insisted upon that, only accepted patients who were motivated. She made it sound like applying to college as if they got tons of applications but only took a few.

  So I talked to Mother, told her I'd found someone, gave her the number and told her to call. She got realty scared started to have one of her attacks."

  "What's that like?"

  "She turns pale and grabs her chest and begins breathing really hard and fast. Gasping, as if she can't get any breath in. Sometimes she faints."

  "Pretty scary.

  "I guess," she said. "For someone seeing it for the first time. But like I said, I'd grown up with it, so I knew she wasn't in any danger.

  That probably sounds cruel but that's the way it is."

  I said, "No, it doesn't. You understood what was happening.

  Could put it in context.

  "Yes. Exactly. So I just waited until the attack was over they usually don't last more than a few minutes and then she gets really tired and goes to sleep for a couple of hours. But I wouldn't let her sleep this time. I held her and kissed her and started talking to her, very quietly and calmly. About how the attacks were terrible, how I knew she felt terrible, but didn't she want to try to get rid of them?

  Not tofrel like that anymore? She starred crying. And saying yes, she did want that. Yes, she would try, she promised, but not right now, she was too weak. So I let her off the hook, and nothing happened for weeks. Finally, my patience ran out. I went up to her room, dialed the number in front of her, asked for Dr. Ursula, and handed her the phone. And stood over he I Like this."

  Rising, she folded both arms over her chest and put on a stern look.

  "I guess I caught her off guard, because she took the phone, began talking to Dr. Ursula. Doing a lot of listening and nodding, mostly, but at the end of it she'd made an appointment."

  She let her arms drop and sat back down.

  "Anyway, that's how it happened, and it seems to be helping her."

  "How long's she been in treatment?"

  "About a year it'll be a year this month."

  "Does she see both Gabneys?"

  "At first they both came to the house. With a black bag and all sorts of equipment-I guess they were giv
ing her a physical. Then only Dr. Ursula came, and all she brought was a notebook and a pen.

  She and Mother spent hours together up in Mother's room every day, even weekends. For weeks. Then finally they came downstairs, walked around the house. Talking. Like friends."

  Punctuating friends with just a hint of frown.

  "What they talked about I couldn't tell you, because she Dr. Ursula-was always careful to keep Mother away from everyone the staff, me. Not by actually coming out and saying it she just has a way of looking at you that lets you know you're not supposed to be there."