by Jaime Maddox
“No,” she said, and swallowed some tears.
Annette paused and studied her. “Bad breakup?” she asked.
Jess cleared her throat and accepted the tissue Annette waved in her direction. “It was a combination of things, but mostly my addiction.”
Knowingly, Annette shook her head. “Addiction destroys relationships, that’s for sure.”
Jess shrugged.
“Okay. My notes say you don’t have insurance. Does that mean you don’t work?”
Jess shook her head again. Lying was becoming easier. “I left my job in Philly when my mom became sick.”
“And what kind of work did you do in Philly?”
This was the question Jess had been dreading. Fabricating a profession meant much more than telling a tale; working in a field gave a person a certain amount of knowledge, and she could easily fall into that trap in the coming days. With that possibility in mind, she thought a job in health care was the best way to go, but decided it best if she were on the fringes of medicine, rather than practicing. As the ER director in Garden she’d spent many hours reviewing billing and coding, and had grown familiar enough with the process and the lingo that she could pull off a job in that field. “I worked in a hospital. I code medical charts.”
“Did you attend college?”
“Yes.” Jess admitted to her undergrad work at Pocono Mountains University but fabricated her major and subsequent learning experiences.
“Where do you live now?”
“With my father.” She’d gone home to help take care of her mom, and she was single and unemployed. How could she afford a house?
“How is that relationship?”
“Huh?”
“Is he understanding of your addiction? Supportive of your recovery?”
Her father had no clue about her addiction. “He’s very supportive.”
“And he doesn’t use drugs or alcohol?”
“I’ve never seen my father drunk. He drinks a beer on Friday night with his pizza, but that’s it.” Jess sighed, relieved to tell a truth after so many lies.
“That’s good, that you live with him and he’s behind you. The work we do here can only carry you so far when you leave. You need support outside to maintain your sobriety.”
Jess nodded but felt suddenly queasy. How the hell was she going to arrange that? Other than Ward, no one knew about her addiction. And in a small town like Garden, who could she tell without everyone finding out? It just wasn’t possible.
“Let’s talk about payment for your treatment. Of course, we can’t tell you how much your treatment will cost, because we don’t know how you’re going to respond to your therapy. Some patients respond quickly, but others take years to functionally recover. Insurance companies, in their wisdom, have decided that twenty-eight days is the right treatment time, so we generally suggest that as a reference point. You’re here of your own free will and paying cash, so you really can leave when you see fit. We’ll structure your treatment plan to get you ready to leave in twenty-eight days. Does that sound appropriate?”
Jess nodded.
“You will need to pay by the week, one week in advance. I’ll need a credit card or a check today.”
Jess reached for her purse and pulled out her checkbook. It was a lot of money, but what choice did she have? She couldn’t use her insurance. And if she were dead from an overdose, or went to jail, money wouldn’t matter at all. Why not make a donation to the Hartley Clinic? It was worth a try.
She made out the check and handed it to Annette. It was official. She was in rehab.
Chapter Six
Doctor’s Orders
Jess followed Annette through a series of corridors, following signs that said Medical Wing. The inside of the building was as impressive as the outside, with woods and tiles that warmed the interior, rather than a chilling, sterile hospital decor. They walked through a gathering room, with a vaulted ceiling, its exposed timbering giving the room a strong, masculine edge. The colors were cheerful, though—bright-yellow walls and floral fabrics covering the couches. In the center of the room, a grand fireplace reached all the way to the ceiling, and against one wall, a disproportionately small television played mutely for no one.
“This is one of the patient lounges. The other offers a Ping-Pong table and a card table, but if you want to catch up on news or your favorite show, this is the place.”
“That one television? For everyone to share?”
Annette seemed to expect the remark and brushed it aside without breaking stride. “People here are focused on recovery. Too much distraction from the outside world is, well, distracting. You’ll need to become self-centered. As in putting yourself at the center of your attention. Sure, you can watch a little television, but mostly you’ll attend meetings, and exercise, and write, and read—articles and books about recovery, not romance novels. You’ll find that, at the end of your day, you’re tired. You won’t even miss the television.”
“What time does the day start?”
“We wake everyone at seven and expect everyone to finish breakfast by eight thirty. That’s when the first groups and meetings start. If you’re an early riser, you can do morning yoga or exercise.”
Annette pulled the stretchy lanyard around her neck until her ID badge triggered a set of electric doors and they opened, giving them access to the medical unit. In spite of the name, the area also had a warm feel.
A dozen people greeted Annette when they walked in. Some were clearly patients, dressed in jeans and sneakers, and others wore casual work attire. Annette introduced Jess to everyone she met, using only her first name. She was surprised that Annette could remember the names of all the patients. “Good luck,” someone said. “Welcome,” another greeted her. “You’ll love it here,” said yet another.
They rounded a corner and Annette admitted them through another secure door, into an area decidedly more clinical than the rest of the place. Every surface was some shade of gray, medical equipment and monitors crowded every surface, and two women wearing scrubs were seated at computers, their fingers flying across the keys as they undoubtedly documented in charts. Jess felt instantly depressed to think she’d be spending the next few days in this area of the building. Annette introduced the nurses before knocking on one of the two doors at the rear.
After introducing her to the PA, Annette left, carrying Jess’s suitcase and all of its contraband cargo with her. She didn’t have time to worry over her fate, though, as the PA began talking. He explained his role in the clinic; he was a medical practitioner and worked with the family doctor who attended to the medical needs of the clinic’s patients. Since Jess had no medical concerns, he would do a cursory exam to clear her for admission, but assured her that he or the doctor was on call 24 / 7. “What if I need a Motrin or something?” she asked.
“I’ll write an order for you to have just about anything you can think of, just in case. Mild pain meds, cough preps, anti-diarrhea meds, you name it.”
“Okay, great.” Jess had brought all of that, but it was good to know there was a backup plan. What if she ran out? What if they found the stash in the secret compartment of her suitcase?
The exam was by no means cursory, and Jess thought she might learn something from the PA, who checked everything from the texture of her hair to the pulses in her feet. Jess declined the pelvic exam and the rectal, and chuckled as she signed the attestation denying the possibility of pregnancy. He nailed her bulging vein on the first try and withdrew three tubes of blood for testing. He told her he was checking her blood count, chemistry profile, and for every disease known to drug addicts worldwide. After finishing, he covered her wound with a yellow, smiley-face bandage and escorted her to the door.
“Good luck,” he said, and Jess felt he really meant it.
In the nurses’ area, Annette was waiting for her. Shaking her head, she pointed a finger at Jess. “I found your contraband.”
Fuck, Jess thought. Could she reall
y go through with rehab without her stash of necessities? Being socially and intellectually isolated, without emergency oxys and Xanax, not to mention the tweezers for her eyebrows—she didn’t think she could do it. If she called Ward now, she could be back in Garden by nightfall.
“I’m going to let it slide,” Annette was saying as Jess refocused in time to see her wink. “I have a weakness for licorice myself.”
Jess’s heart threatened to erupt through her throat. She’d found the food—which Jess really hadn’t even hidden, but apparently not the real stash. “Okay.”
“Just try to keep them in your room, so no one notices.” Jess nodded mutely. “And, by the way, in all my years in rehab, I’ve never had a patient bring their own bedding. Should I add OCD to your diagnosis?”
Jess smiled nervously, biting her lower lip. Whew! She’d forgotten about the licorice laces and never considered the comforter would be an issue. It hadn’t occurred to her to use a distraction, but it appeared to have worked. Annette hadn’t discovered the important stuff.
“Dr. Gompers is ready to see you,” she said when Jess didn’t respond. “Even though it’s late in the day, she wanted to evaluate you. Are you ready?”
Jess nodded, and Annette stood and motioned toward the other room at the back of the nursing area. “Then let’s get started.”
As she heard their approach, a matronly woman of sixty rose from a black leather club chair and shuffled across the room to meet them. Her frumpy, gray sweater matched her hair but did nothing to flatter her. Nor did the black peasant skirt, which brought to mind visions of a whale. Jess tried not to let the doctor’s appearance rattle her. The hospital had a great reputation, and Dr. Gompers was a big part of that. She was probably too preoccupied with complicated medical musings to bother with wardrobe concerns.
Once again, Annette made the introductions and wasted no time on niceties, taking her leave just as quickly as they entered. Jess was confused by the hasty departure, until Dr. Gompers began speaking. She was all business.
“Tell me why you’re here,” she said, after pointing Jess to the chair opposite the one she reclaimed. As she sat, she pulled a laptop into her lap, but rather than opening it, she stared at Jess. It was hard to hold her gaze, knowing she was lying, knowing the doctor specialized in treating the greatest con artists in medical history.
Addicts lied, twisted and turned facts until they could no longer separate their own histories from the ones they fabricated. The doctors and nurses and therapists who treated them were used to this and were experts at finding the holes in their patients’ stories. And Jess’s story looked like someone had taken a shotgun to it. She was lying about her profession and denying she had health-care insurance. Unsure if the hospital would check on her medical records and learn she was a physician, Jess hadn’t told them about the wrist surgery that had seeded her addiction. The final, huge lie had to do with the PTSD. How could she tell the doctors what happened to her without someone figuring out who she was? CNN had broadcast the story of her abduction for days, and thankfully, the only pictures they’d dug up had been dated, when Jess was younger and had much longer hair. Still, if she said Edward Hawk had abducted her and paralyzed her with succinylcholine, someone would figure out she was actually Doctor Jessica Benson instead of a mild-mannered coder. Her house of cards would crumble, and she couldn’t have that.
She’d keep it simple, she decided, and tell Ward’s story instead. Ward’s last night in Garden was something she could never forget.
“I have PTSD. At least I think I do—I’ve never seen a psychiatrist. I’ve been self-medicating with Xanax and oxycodone.”
“And now you think you’re addicted? What makes you say that?”
“I can’t stop taking the oxys. I’ve tried. I just can’t get off them.”
She asked about her addiction and gave her a form called a Drug Abuse Screening Test. It asked about withdrawal, health problems related to drug use, relationship issues, criminal activity, and other questions to gauge the severity of her problem. Out of ten questions, with one point awarded for each positive response, Jess scored nine.
Next, the doctor asked about her withdrawal symptoms and gave her yet another form, this one a Clinical Opioid Withdrawal Scale, or COWS, to measure the severity of her withdrawal symptoms. Jess scored in the mild range. The doctor asked what methods she’d tried to quit, including using other drugs. She asked about prior visits at rehab. Delving deeper into Jess’s drug use, she asked about the escalation of her use and about how she was able to maintain her supply of drugs.
When she’d exhausted the questions about drug abuse, she queried Jess about her PTSD. Jess told her she’d been at a bar and drugged by an unknown person. She’d reacted badly to the roofies and assaulted several people, and would have faced charges if it hadn’t been proved that someone had drugged her. Unlike Ward, Jess remembered everything that happened that night.
“What brought you here? Why now, after three years?”
Finally, a question Jess could answer honestly. “Ward. My ex. I thought she’d always be here for me, even though I treated her like crap and pushed her away. Now she has another girlfriend, and I know she won’t have anything to do with me if I don’t get my act together.”
For the first time in their conversation, Dr. Gompers’s expression changed. Jess couldn’t read it. She seemed almost confused for a moment, with squinted eyes and pursed lips. That quickly, the neutral expression returned and she returned to interviewing Jess. “So Ward has moved on. But you haven’t?”
Jess looked up and breathed deeply, trying to control her emotions. Why did the thought of losing Ward forever suddenly bother her so much? She hadn’t cared when she fired her, or broke up with her, or encouraged her to date Abby. Why now? She kept coming back to that question, and she still wasn’t sure she knew the answer. She studied the wall adjacent to Dr. Geraldine Gompers’s desk. She was a graduate of the Philadelphia College of Osteopathic Medicine, just like Ward. What a coincidence. Lately, everything in her life seemed to be circling back to Ward. A good omen, she hoped.
“Ward is such a good person. Dependable. Strong. Kind. I need someone like her in my life. I pushed her away, because with her around I didn’t have the freedom to use drugs. Now that I’m in rehab, it could work again. And I know this can’t be serious with her new girlfriend, Abby. Ward and I have been together a long time. We met during residency, more than ten years ago. She just met Abby a few weeks ago. How could she brush me aside for someone she hardly knows?”
Again, Dr. Gompers’s face moved. But it changed back so quickly Jess might have imagined it. “Wait. Ward is a doctor?”
Jess sucked in a breath as she realized her error. She should have known the lies were bound to catch up with her. But maybe she could still spin this in her direction. “Yes,” she said, enthusiastically. Proudly. Shouldn’t she be proud to date a doctor? “She’s an ER doctor. We worked at the same hospital. That’s how we met.” At least that much was true.
“Does Ward, or has Ward ever prescribed narcotics for you?”
“No! She’s honest and ethical…that’s what made it so hard to be with her when I was…misbehaving. Until a few days ago, she didn’t even know I had a drug problem. And as soon as she found out, she suggested rehab, and she even brought me here. I think that means she still cares.”
“I think I’ll leave your relationship with Ward up to your other psychiatrist and focus on your addiction, if you don’t mind.”
Grateful to have dodged a bullet, Jess nodded.
Explaining how bup worked, the doctor told Jess she needed to have moderate to severe withdrawal symptoms before starting the medication. The treatment they gave wasn’t just bup, a long-acting opioid, but also an antidote to bup. The combination prevented both abuse and overdose. Taking too much caused the naloxone to kick in, sending a person into withdrawal. Timing the first dose was important, she knew. If she wasn’t already in withdrawal when she starte
d the medication, she was likely to suffer violently.
“Considering your history, I think you’re a good candidate for treatment. What do you think?”
Jess nodded. “I think so, too.”
“Since your COWS score is zero now, we’ll play the waiting game.”
She would spend her day unpacking one suitcase, attending a meeting or counseling session, and waiting to feel sick.
Rising from her chair, Dr. Gompers dismissed her and handed her over to Annette, who walked her to her room, pulling the suitcase behind her. “Your roommate’s name is Bonita. She’s very nice,” Annette said as they walked just a few yards down the corridor. “She arrived yesterday and is doing very well. She’ll be able to answer some of your questions better than I or the doctors.”
Pushing open a heavy wooden door, Annette gestured for Jess to enter.
From the assortment of junk piled on the dresser nearest the bathroom, Jess assumed Bonita had claimed it and the adjacent bed. Perfect. It gave Jess the corner, away from Bonita’s prying eyes. She walked that way, looked through the window to an expanse of green field and blue sky. A beautiful day to start her new journey.
“I’ll leave you to unpack, but I’ll catch up with you later. When you’ve settled in, you should go back to the desk and they’ll direct you to the meeting of your choice.”
“Thank you. For everything. You’re very kind.”
She nodded and smiled, then left Jess alone.
The room was actually quite beautiful, though small. Berber carpet lined the floors, a floral-patterned paper adorned the upper walls, and the bottoms were covered in wainscot. The ceiling was a bright white, and a fan hung from the center, its blades shaped like large leaves of a shading palm tree circling the room. The bathroom was luxuriously tiled from floor to ceiling and had a spacious shower, but no tub. It was much harder to drown yourself in the shower.