“Alex,” says Kailie. “I am going to illegally gate crash your session with him and make sure you talk, because given the condition you’re in, you’re clearly keeping too much to yourself.”
Dr. Maliki glances at her, then looks at me. “Can she come back with us?”
The fact that he’s asking rather than shutting her down tells me what my answer has to be. I nod.
“Come on back, then.”
I follow him into his office and Kailie stays right on my tail, seating herself on the loveseat next to me, close enough to see my every move, but not close enough to touch me. The office is decorated to exude peace and calm, from the deep, springy cushions of the couch to the photograph of sunrise over a Middle Eastern city on the wall. The opposite wall is all built in bookshelves, full of leatherbound volumes that he once confided to me he got at estate sales and had never read. But they do look cool.
“What’s been going on, Alex?” Dr. Maliki asks. “You been having a rough time, I take it?”
“I’ve had some mild hallucinations. I… wrote down the details, but didn’t bring my notebook. I wasn’t planning to hide it from you.”
“His notebook said he’s heard voices,” says Kailie.
“Yeah, same voices. I’ve got an appointment tomorrow, though. This could’ve waited until tomorrow.”
“And his Bible looks like the shed from A Beautiful Mind. He’s marked it up with colored pencils.”
“You read my scriptures?” I say.
“I leafed through them.”
“No, I take notes and highlight stuff, especially when I can’t sleep.”
“You marked them all up.”
I shrug. “Yeah. I was studying them.”
“Did he write anything odd in the margins or any unusual symbols?” Dr. Maliki asks.
“No, just drew colored boxes around verses and stuff.”
“That’s called highlighting,” I say. “People do it when they study. You should try it sometime.”
Dr. Maliki flicks his gaze to her, then back to me. “I’m going to set that observation aside. Alex has been religious longer than he’s been mentally ill.”
“Aren’t they pretty much the same thing?” quips Kailie.
The doctor’s look is tolerant. I don’t know if he’s a religious man himself; he never talks about that sort of thing. “Statistically, religious people cope with mental illness better than the non-religious, and no, it isn’t because religion is a delusion. It’s an ancient cultural practice that promotes community, charity, and inter-responsibility.”
“And I haven’t been talked to by God,” I say.
“Well, yes, that’s the sort of thing I was going to ask next.”
“No angels. No voices from on high,” I say.
“But voices,” says Kailie, “and those hands. Who could miss those?”
“And yesterday I sensed invisible figures. But I’ve known the whole time they aren’t real, all right? I’m not completely gone. I know what’s what.”
Rather than respond, Dr. Maliki steeples his fingers in stereotypical shrink style and purses his lips. “I thought the voices stopped when you went on your medication.”
“I know, right?” says Kailie. “Kind of a red flag.”
His gaze flicks to her, then back to me.
“They did,” I say. “They just started up again when I came home, but it’s not anything like it was before.”
“But hearing voices is a bad thing,” Kailie presses.
Dr. Maliki looks over at her again. “It’s very common, practically normal for a schizophrenic. Doesn’t necessarily mean anything’s wrong, but you not telling me? That is a problem, Alex.”
“Hearing voices isn’t a problem?” says Kailie.
Dr. Maliki leans forward. “Okay, Alex knows this but I’ll explain some of the basics to you, Kailie. There are three kinds of symptoms associated with schizophrenia that we look out for.” He ticks them off on his fingers. “One is the hallucinations, the psychosis, like those voices. The second is social isolation and a lack of social skills, which is why I’m very happy you’re here. It shows he isn’t alone and the fact that you intervened and brought him in? That’s a very positive indication, that he’s got someone in his life willing to be so proactive. The third is disordered thought, and there I’m very optimistic. In this respect, Alex is lucid.” He turns to me. “You’re all there. Your logic is intact, which means despite the hearing voices, I’d still consider you very high functioning.” He glances at Kailie, then looks at me again. “I’ve told you over and over that you’re condition is manageable, but I’m not sure what you’re hearing when I say that.”
“That with enough work and medication, it’ll take me thirty years to collect Happy Meal toys, not seven.”
He shakes his head. “No. That’s not what I and everyone else on your case is trying to tell you.”
I shrug.
“And we’ve told you the statistics. Are you even listening? Twenty percent of schizophrenics regain full capacity and keep it for the rest of their lives.”
“Yeah but-”
“You are likely in that twenty percent.”
I stare at him.
He nods as if to himself, takes off his glasses and sits a moment, composing his thoughts. “Most of my patients, I have to ease them into the idea that this is a lifelong condition, but I suppose it’s different for you. Let me try this from a different perspective. You need to live your life as if you’re not going to lose your mind. Even a slight increase in hallucinations is something you and I need to work together to get rid of. Your goal is to be the guy you were before this began.”
I shake my head. “I know the condition starts slow-”
“Ah…” he nods as if I’ve said something key. “You think worse is coming? Another psychotic break that makes the first one look like a walk in the park?”
“Well... yeah.”
He rubs the bridge of his nose and puts his glasses back on. “Okay, I get it. I’d like to review your mother’s case with you. We can throw Kailie out if you like?”
Kailie folds her arms and dares me.
“She’s fine,” I say.
“You’re sure? Because while you do have the right to allow her to hear your mother’s medical information, you don’t have to.”
“I’m just here to help,” says Kailie. “I’m not going to blab around town, especially not about this.”
I nod.
Dr. Maliki leans forward, thinks a moment, then says, “I’m sorry, Kailie. Just step outside for a few minutes, okay?”
“I said she was fine.”
“You’re also borderline delusional, so I’m going to play this safe.”
Much to my surprise, Kailie gets to her feet and leaves the room without argument.
Once the door closes, the doctor looks at me. “Let me tell you a little about the history of psychiatry. Your mother was diagnosed back when I’d just begun my practice, and we did things differently. She and your father decided to try to use as little medicine as possible, because the medications that we used routinely back then and the dosages that were the norm had a whole host of side effects that would make people do things like twitch and, well, act stereotypically crazy. Also, the research was what it was. We didn’t have a clear idea of whether it was better to use the medication or to take a big risk and try…” he pauses a moment, searching for the words. “…mind over matter, I guess you’d say. Nowadays we know. Medication is the best option.”
“I’m not anti-medication. I take my medication.”
“I’m not done explaining this yet. You’re taking a relatively new antipsychotic that has fewer side effects and has been clinically proven to preserve brain mass.”
“Right.”
“No, I don’t think you understand. You ever seen a scan of your mother’s brain?”
I nod. “Full of holes, practically.”
“That’s not going to happen to you if you do what I say. W
e can’t reverse the damage to your mother’s brain, but we can curb it in yours. That’s where our medical technology is at these days.”
I process that. Therapy has, right from the beginning, hammered home this idea that my life “isn’t over” and I can “manage my condition.”
“Your mother is a one in a thousand case, Alex. Maybe it’s due to brain mass she lost at the outset, or maybe it’s due to the extreme stress in her life, or maybe she’s just one of those cases that nothing could affect. There’s no way to know, but the long, ongoing degradation that she has? That’s extreme.”
“But it’s still a possiblity,” I say.
“Listen, losing your mind isn’t the worst thing that can happen to you. What if you don’t lose your mind and you find you’ve burned all your bridges?”
“Then I go back to being the guy I was in high school. He never had many friends.”
“You may find that harder than you realize. You’re a different person now. Alex, work with me. Find your triggers. Learn to cope. Let me help you.”
I shake my head. Dr. Maliki’s had all kinds of theories about what my trigger is, but I don’t dare tell him the truth. It’s Madison. My first psychotic event happened the day I got that fateful letter from her, and yesterday’s episode was definitely spurred by her impromptu trip together up the coast.
My trigger is loving someone so much that I have to help her move on. It’s knowing that I could never, in a million years, ask her to become my support. It’s the process of disengaging from her so that a worthier man can catch her eye.
“Everything all right?” Dr. Maliki asks.
“It’s a lot to take in.”
“What do you need from me right now?”
“Um, more meds, I guess. You say these hallucinations should go away, let’s make that happen.”
He smiles. “Good. Miss Beale!” he hollers.
Kailie opens the door and peers in.
“Come, sit. Listen, are you willing to keep an eye on this man? Bring him back if he still has problems.”
“Yeah, I can do that.”
I turn to look at her. Kailie Beale is helping me out of a tough spot. That’s not something I ever thought she’d do for me, or anyone.
“Good, because you can’t be the only person who saw what he was doing to his hands. Clearly you’re the only person who was able to spot what they meant, and you caught on nice and early. I suppose next time Grace is in here, I should give Hiroko some pointers on what to look out for.” He says this last part as he jots down a prescription, which he tears from the pad and hands to me.
I take the piece of paper from him with a nod.
“And how are you, Miss Beale?” he asks.
I expect a wisecrack, but instead she looks at me and says, “When you told me I don’t seem normal-”
“I wasn’t saying you needed more treatment. Honest.”
“He probably meant it as a compliment to your unconventional approach to life,” says Dr. Maliki.
She hunches her shoulders.
Definitely not how she deserves to feel. “Kailie, you’re obviously with it. The crazy behavior? Definitely a conscious choice.”
“Whatever.”
“And you jumping out of a second story window? That was actually kinda cool.”
“She jumped out of a window?” says Dr. Maliki.
“She does know how to make an entrance.”
Kailie looks at me, then at the doctor, then chuckles. “He was walking off, and I wanted to talk to him. Stairs take too long.”
“You two are good friends, then? You can look out for each other?”
“Oh, I can watch him,” says Kailie. “This is him. My stupid obsession.”
“What?” I say.
“I’ll tell you later,” she says. “It’s all good now. Come on. Let’s go.”
With a nod goodbye, Dr. Maliki sends us on our way.
Madison is waiting for us when we exit into the parking lot, her arms folded under her breasts, her hair blazing almost white in the sunlight. At the sight of us, she puts her sunglasses on top of her head so she can squint into my eyes. “So what happened?”
“He-”
“Nothing,” I cut Kailie off. “It’s fine, okay?”
I should have known this intervention was choreographed by Madison. “No,” she says. “Tell me, please. I want to know.”
Kailie gives me an odd look. “We can trust her.”
“Yeah, come on,” says Madison. “I’m the one who sent her through your window last night. I told you it wasn’t wired to the burglar alarm,” she says to Kailie. “He disarmed it ages ago.”
“Madison, stop. Now. End of discussion. Please leave me alone.”
“I just want to know what’s going on.” Her eyes are wide, her expression wounded.
“I know, but it doesn’t matter,” I say.
She looks to Kailie for help, but her friend only shrugs, helplessly.
“Fine.” Madison gives in. “Be like that, but if you ever do need help-”
“No, be angry,” says Kailie. “We went over this.”
Madison rolls her eyes. “You’re a self-centered jerk who doesn’t care how I feel. I totally helped you and this is how you thank me?”
“Better,” says Kailie. “Now storm off.”
“Fine.” She turns and heads back across the street, towards her house.
“And you,” says Kailie, “really were a total jerk just now.”
“I need her to stay away from me.”
She looks me up and down, then says, “Let’s revisit this issue after you’re on your meds for a week or two.”
The pharmacy needs twenty minutes to fill my prescription, and I can’t help but stare across the street at the library. Kailie ignores me and jabbers away on her phone, so I slip outside and cross the street.
Siraj looks up when I shoulder the door open. “If it isn’t my sisters’ crush.”
“Both of them?” I say.
“I don’t want to hear whatever inappropriate comments you have to make about twins.” His look is downright severe, but for the twinkle in his eyes.
“Nah, I don’t have any.” A quick glance around reveals the library has a few patrons, all of whom ignore me.
Siraj chuckles.
“How are things with them?” I ask.
“Well, complicated. I don’t know. Sending them home will break my heart. What’ve you done to your hands, there?”
I fight the urge to hide my fingers from him. Siraj noticing doesn’t surprise me. He’s observant. “It’ll be okay. I went to the doctor this morning.”
“That’s good.”
“So you’re not going to keep them here? Your sisters?”
He shuts his eyes a moment, whether against emotional pain or exhaustion, I can’t tell. Likely both. “It’s not legal, and how do I ask the US government to take in two disabled women whose medical needs will cost far more than any taxes they’ll ever pay?”
“Wish I knew of something you could do.”
“It’s fine. I’ve researched it thoroughly. I don’t think there is.”
I have no idea how to respond to that. “Well, if there’s anything I can do, let me know.”
“Thank you, Alex.”
I turn to leave, then pause, “Um… just a thought? If they were ruled incompetent and in need of a guardian, and your brother didn’t want them back?”
Siraj’s eyes widen as he absorbs that idea. “Interesting.”
“If he would do that. Say he doesn’t want them.”
“Well, that’s essentially the issue. He doesn’t. I’ll have to think about this.”
“I don’t actually know what I’m talking about.”
“Made perfect sense to me. Thank you.”
“I’ll see you later.” I push my way back out the door and head back to the pharmacy.
At church that Sunday, I still feel everyone staring at me with disapproval when I walk in, but I note to mysel
f more sternly that this might be paranoia. A lot of schizophrenics feel like they’re glared at and hated all the time. The voices have been quieter for the last two days, which might mean I’m saner, but it’s hard to say. It’ll take up to two weeks for my increased medication dosage buid up in my system and become effective.
This week, I didn’t catch a ride in with the bishop, but rather asked Hiroko to take me so that I wouldn’t be early. By the time I slip into my seat, the congregation has already begun the opening hymn, and Madison is already in her seat at the front, next to Carson Montrose, who has his arm over the back of the pew, not quite around her, but clearly with that general intention. I avert my gaze, take a deep breath, and vow to stay calm.
Only, once Sacrament Meeting is over she looks back at me, gets up, and comes to my pew. I get to my feet as the rest of the chapel bubbles over with voices greeting each other and laughing at jokes. It’s like passing period in high school with everyone able to catch up on a little gossip before they move on to their next class.
At least with the whole ward animated like this, few people notice me and Madison, I hope. I still feel like everyone stares.
But once I catch sight of Madison’s face, all of that fades to the back of my mind. She’s pale, her mouth drawn down at the corners. None of it makes her any less beautiful and I bet no one else even picks up on all the little signs of stress. Still, she’s so different than the luminous, upbeat person she was in high school. I guess nothing lasts; no one can be that carefree forever. “How are you?” she asks.
“I’m okay.”
“Really? Is that the truth?”
Out of the corner of my eye, I spot John standing in the aisle, watching my every move. “Thank you for caring, and thank you for sending Kailie to look after me.”
“Of course I care.”
“I should have known Kailie wasn’t the one who figured out there was something wrong.”
“She helped. Give her a little credit.”
“I’m lucky to have a friend like you, but I need you to give me more space. Please.”
Madison’s mouth presses into a firm line and she wraps her arms around herself, as if desperate for a hug but aware that she won’t get one. “I’m a friend, huh?”
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