Nutcase

by Hughes, Charlotte

  Our session had just ended when Mona appeared in the doorway. “Your mom and aunt are here. They decided to surprise you and invite you to join them for an early lunch.”

  “Did you tell them I had an emergency?”

  “Like it would make a difference?” Mona said. “Oh, and Thad called. He’s still working on that little task you gave him.”

  “I’m going to have to do something nice for him,” I said.

  Mona crossed her eyes. It was a technique she had perfected since coming to work for me. “I’m sure he’ll come up with something.”

  The three of us made our way to the reception area, where I found my mother and aunt thumbing through old magazines. It would have been hard to miss the Junk Sisters. My grandmother had chosen to name them Dixie and Trixie. “Good morning,” I said.

  My mother looked at me. “You’re too thin.” She turned to my aunt Trixie. “Doesn’t Kate look thin?”

  “I think she looks great,” my aunt said.

  My aunt was the peacemaker and spent much of her time trying to smooth out the misunderstandings between my mother and me.

  My mother looked annoyed. “How can you say Kate looks great when she’s practically skin and bones?” She turned to me. “Are you sick?”

  I debated telling her that I had mad cow disease. “I’m fine,” I said instead. I couldn’t really blame her for being concerned about my weight, though. My separation and divorce had whittled me from a size ten to a six. Mona’s housekeeper, Mrs. Perez, had altered a lot of my clothes since I couldn’t afford to buy a new wardrobe.

  “We’re here to take you to lunch,” Aunt Trixie said, changing the subject.

  My mother nodded. “You’ll have to hurry, on account of we’re double-parked.”

  I envisioned her monster pickup truck piled high with junk, blocking half the cars in the parking lot. “I’m sorry, but I can’t go,” I said. “I’ve got an emergency.” I noted Eddie eyeing them curiously, but I wasn’t surprised. People on the street often stopped and stared at them, too.

  “How can you have an emergency?” my mother asked. “You’re not a real doctor.”

  “That’s not a very nice thing to say,” Aunt Trixie told her.

  “We’ve got a serious nutcase in the next room waiting to be transferred to the asylum,” Mona said. “Kate is under a lot of stress right now.”

  I knew Mona was trying to help, so I didn’t bother to remind her that we didn’t refer to our patients as nutcases or that psychiatric wards were not called asylums.

  My mother stepped closer. “I don’t know how you work with these crazies,” she whispered. “No wonder you’re so thin and depressed. I read in yesterday’s paper that the FDA just approved an antidepressant that was guaranteed not to interfere with your sex life. You should look into it.”

  “I’m not depressed, Mom,” I whispered back. “Maybe we could have lunch another time.”

  “Trixie and I could be dead and buried by the time you worked us into your schedule,” she said. “How would that make you feel?”

  “I would feel terribly guilty,” I said and saw the look of satisfaction on her face. She had succeeded in doing her job for the day.

  Eddie stepped forward. “Ladies, why don’t you allow me to escort you to lunch in Dr. Holly’s stead?”

  I opened my mouth in protest, then closed it. I couldn’t warn my mom and aunt that Eddie was a shyster and an ex-con without losing my license.

  “Who are you?” my mother blurted out.

  “Edward Franks, at your service.” He gave a slight bow. “I’m a close, um, acquaintance of your daughter, and I would consider it an honor to take the two of you to lunch. It’ll be my treat.”

  “Don’t you have to get back to work?” I asked Eddie hopefully.

  “I have plenty of time,” he assured me, his tone as smooth and sugary as maple syrup.

  Mona shot me a look. Since Eddie had confided in her, it was obvious she didn’t like the idea of him being alone with my mother and aunt any more than I did.

  “I suppose it’ll be okay,” my mother finally said. My aunt nodded in agreement.

  Eddie opened the door and motioned them through with a flourish while Mona and I watched, open-mouthed. Eddie gave me a hearty wink and followed them out.

  Mona shook her head. “At least I’ll be able to say I was there when it happened,” she said.

  I looked at her. “What do you mean?”

  “I’ll be able to say I was present the day your inheritance walked out the door.”

  I was still waiting to hear from Thad when my next patient arrived. I had checked on Marie and found she’d already burned through half the pages in the tablet. I’d scanned several pages, noting that most of what she’d written lacked coherency; then, I asked Mona to fax them and the signed release form to Thad. It would give him a better idea of what we were dealing with.

  I led Arnie Decker to my makeshift office in the kitchenette and invited him to sit. Arnie was a retired marine turned executive chef who claimed he’d been trapped in a woman’s body for as long as he could remember. It was a case of gender identity disorder. In stark contrast to his broad shoulders and a large tattoo of an eagle on one bulging bicep, he was dressed in short shorts and a glittery tee that exposed his pierced navel. Ten painted toenails peeked out from the tops of his beaded sandals.

  “How was your week?” I asked, flipping to a new page in my legal pad.

  Arnie gave a massive sigh. “I’ve decided to tell my family the truth about my, um, gender issues. I’m tired of the lies and deceit. I’m tired of trying to be the person my old man expects me to be. I need to live my life the way I want.”

  I could sort of relate. When I told my mother I wanted to become a psychologist, she had taken me out to the double garage and showed me her world of junk. “This could all be yours one day,” she’d said, as though we were gazing down from the heavens at the entire universe and all its riches. “Why would you turn your back on the family business to become a shrink?” she’d asked.

  Arnie sighed again.

  “How do you think your father will take the news?” I asked.

  “It won’t be good. But in all fairness, I need to warn him of what’s to come.”

  Arnie had decided to pursue gender reassignment surgery. Together, we had researched it carefully, and I had spoken to a couple of professionals. Surgical reassignment was available only for extreme cases of GID. That Arnie had been unable to maintain normal male-female relationships, and had considered suicide more than once because he was so miserable, made him a candidate in my mind.

  Easier said than done. Arnie would have to jump through a number of hoops in order to meet the criteria. He would need to spend months in therapy and actually live and dress like a woman before a doctor would agree to start him on a regimen of hormonal injections that would begin to bring about the changes he desired.

  “I’ve decided to change my name to Arnell,” he said. “Once I tell my father the truth, I plan to start living as a woman full-time.” He clasped his hands together and leaned forward. “Dr. Holly, I want you to be with me when I tell him.”

  My stomach flipped and flopped like a fish pulled from the water. Arnie’s father was a hard-core retired marine who’d gone off the deep end when he found a rag doll in his son’s room. Arnie had been eleven years old at the time. His father had been trying to turn him into a man’s man ever since. Not only did I not want to be in the same room when Arnie told his father the truth, I didn’t want to be on the same planet.

  “Wouldn’t your father feel uncomfortable having an outsider present?” I asked hopefully.

  “I can’t do it alone,” he said. “I’m going to need support. Now that I’ve made my decision, I’d like to get it over with. When is the soonest I can get another appointment?”

  I hesitated. I wasn’t going to have an office after Friday, so it would have to be soon. I checked my appointment book. “How does Wednesday afte
rnoon sound?” I was already dreading it. I wondered if he would fall for my mad cow disease story.

  The ambulance arrived for Marie, accompanied by a police officer, as I was escorting Arnie out. “I’ll need a few minutes to talk to the patient,” I said.

  I found Marie sitting on the sofa, flexing her right hand. She looked at me. “I have writer’s cramp.”

  I took the chair beside her. “Marie, I know how important your country western music career is, but I think you need to put it on the back burner for now.”

  She looked alarmed. “I can’t! My fans will forget about me.”

  I touched her shoulder in hopes of calming her. “You’ve neglected your health,” I said. “You can’t remember when you last slept, and I’ll bet you haven’t eaten a decent meal in days. You’re in no condition to think about a new career.” I paused, knowing she was not going to like what I had to say. “I want you to go into the hospital for a few days.”

  “You can’t be serious!” she said. “What will I tell my fans? What will I tell the press?”

  “We’ll try to keep it quiet, but if anyone should find out, we’ll say you’re suffering from exhaustion.”

  Her eyes suddenly hardened. “I should have known something like this would happen. You’re jealous. It irks the hell out of you that I have all this talent and you have none. You don’t want to see me succeed.”

  “I want to see you healthy,” I said.

  She threw the legal pad on the floor. “Do I have a choice in the matter?” she asked. “Or do they plan to drag me to the psych ward and drug me?” She met my surprised gaze. “This ain’t my first rodeo, lady.”

  “Then I think it’s especially important that we try to cooperate with each other the best we can. There are EMTs out front waiting to take you to the hospital.”

  “What if I refuse to go? Then what?” she added.

  I sat back in my chair and regarded her. “I think you know the answer to that,” I said. “You’ll crash and burn, and there will be nobody to help you.”

  She sat there quietly for a moment, but I could see the anger burning in her eyes. “If they try to cuff me, I’ll kick and scream and bite.”

  “I’ll ask them not to, but you’ll have to cooperate.” We both stood and headed for the door. I opened it and stepped outside with Marie on my heels. “Miss Osmond is ready to go,” I said. “She doesn’t need to be restrained.”

  Mona and I were quiet as Marie was led out. The police officer nodded at me before he closed the door behind him.

  “Boy, am I glad I don’t have your job,” Mona said. “I used to think it would be cool helping people, but it must be awful hearing about other people’s problems day in and day out. I would hate to be you.”

  The door opened, and two teenage girls in slut-wear walked through, followed by their parents, who hoped family counseling would put an end to the hostility that was wrecking their home. It never failed; each session turned into a yelling match. Maybe Mona was right; being me was no picnic.

  Thad and the head nurse of the psychiatric unit, Edith Wright, were waiting for me in a conference room when I arrived at the hospital. Edith was a large woman with reddish orange hair and a multitude of freckles. She’d spent twenty-five years in the psychiatric ward, and she was tough as beef jerky. She was also the only female who didn’t have a crush on Thad.

  “Sorry I’m late,” I said quickly, sitting in a chair across the table from Thad and noting that Edith had chosen to position herself at the head. She obviously wanted to make it clear she was in charge.

  “I’ve already met with Marie Osmond,” Thad said, “and she told me how you are out to ruin her country music career. Frankly, Kate, I’m shocked that you would step all over someone’s hopes and dreams.”

  “I’m envious of her talent.”

  Edith gave a grunt. “I’ve heard her sing. She’s no Reba McEntire.”

  “I think we should let Thad break the news to her,” I told Edith.

  He leaned back in his chair and smiled the smile that had captured a thousand hearts. Thad was an enigma. As always, he was immaculately dressed in a custom tailored suit of Italian silk, and he looked more like the CEO of a Fortune 500 company than a psychiatrist. Oddly enough, between golf games and tennis matches, Thad was damn good at what he did.

  “So, what do you think?” I asked him. “Have you got a diagnosis?”

  “She’s screwed up,” he said.

  “I’ll bet you got that straight out of the Diagnostic and Statistical Manual.”

  “Yep. Good thing this hotel has locks on the doors.”

  “Very funny,” I said.

  Thad looked at Edith. “Kate used to be a barrel of laughs when we were lovers,” he said. “She had a great sense of humor.”

  “Thanks for sharing, Thad,” I said.

  Edith gave him a withering look. “Gee, Dr. Glazer, as much as I would love to hear the minute details of your sexual prowess, I do have other patients.”

  Thad made a tsking sound. “You’re a cold woman, Edith.” He turned to me. “Your diagnosis of bipolar disorder was right on. Marie could barely sit still long enough to talk, and she was hyperverbal. She had also just finished writing a song about an old cowboy that she is certain will earn her a Grammy. I think it’s safe to say she’s exhibiting signs of grandiosity.”

  “Yeah, I noticed.” Grandiose behavior was common in bipolar patients.

  “I’ve already ordered blood work, a thyroid profile, and an EKG,” he said. “I’m going to start her on Vistaril and a new mood stabilizer that’s getting rave reviews. Supposedly, it kicks in much faster than the others.” He grinned. “I also had Edith inject a sedative so the staff doesn’t have to chase Marie all over the unit. Which is why Edith is being so nice to me today,” he added, giving her a hearty wink.

  Edith yawned.

  “Anything else?” I asked.

  “Marie didn’t even try to flirt with me.”

  Sometimes it was best to ignore Thad’s comments. This was one of those times. “Do we have anything like a patient history on Marie, or is that too much to hope for?”

  Edith picked up a file and opened it. “I did the intake. She gave me zip. I take it you noticed the bruises. She refuses to talk about them.”

  “She claims she doesn’t remember how she got them,” I said. I looked from Edith to Thad. “If that’s it, I should probably look in on her.”

  “If you wake her I’ll take you out,” Edith said.

  Thad slid his gaze from her to me. “She means it. I hear she carries a loaded weapon in her purse.”

  “I don’t need a gun,” Edith said. “I have my bare hands.”

  “I’ll come back another time,” I said quickly.

  Thad and I thanked her. She buzzed us through the double doors, and we headed for the elevators. “I think Edith is hot for me,” he said, punching the button to call the elevator.

  “She’s doing a really good job of hiding it, don’t you think?” After several seconds, I stabbed the button for the elevator. “These things move slower than a drunken mule,” I muttered.

  He looked at me. “How come you’re so irritable? Did somebody steal your favorite feminine deodorant spray? What was the brand you used? Fresh Flowers?”

  “Cut it out, Thad.” The elevator door opened and we stepped inside. “I have a lot going on in my life right now.” I pressed the button to the lobby, and we started down.

  “How did your marriage counseling session with Jay go this morning?” I snapped my head around, my surprised gaze meeting his. “Oh hell,” he said, covering his eyes with one hand. “Could we forget I just asked you that question?”

  “Mona told you?” I felt betrayed.

  “It was my fault, Kate. I called the office this morning to ask about Alice Smithers’s medication, and Mona started getting all weird on me when I asked where you were. I used my great charm and people skills. She couldn’t help herself. Please don’t rat me out.”
r />   I tried to hide my embarrassment. “I don’t have to tell you that marriage counseling takes time,” I said. “First sessions are always tense.”

  “That’s why I steer clear of them.” He snapped his fingers. “Hey, I know how to cheer you up. How about I spring for lunch and buy you a chili dog? You love the chili dogs here.”

  “Yeah, but I need to head back to my office.”

  “What’s fifteen minutes out of your day?”

  My mouth was already watering. I grinned. “Extra onions?”

  He winced. “There goes my idea about renting a room afterward.” He pressed the button that would take us to the cafeteria, and soon after we stepped out. “Why don’t you grab a table outside,” he said. “It won’t take me long to go through the line.”

  I pushed through the glass door leading to the court-yard, where white wrought iron tables and flower beds filled with mums looked inviting. The cool November air felt good after a summer that had reached some all-time high temperature. As they did each year, the local news felt compelled to fry an egg on the sidewalk to prove just how hot it was. I’d been tempted to cook a pot roast on my front walk and prove the annual egg thing lame.

  Thad joined me a few minutes later, bearing a tray of chili dogs, salt and vinegar potato chips, and soft drinks. “Just like old times, eh?” he said. “You’re the only woman I know who likes salt and vinegar potato chips.”

  I noted the pile of onions on the chili dogs. “Yum,” I said, reaching for one. I took a bite. “Oh man,” I said.

  “Not bad for hospital food,” Thad said. “Reminds me of that little hot dog stand at Emory,” he added. “Those were the days.”

  That’s where Thad and I had met. I’d been working on my doctorate at the time. “Sometimes I really miss them,” I said.

  He took a sip of his drink, set down his cup, and regarded me. “So, where do you and Jay stand, if you don’t mind me asking?”

  “He wasn’t real happy when he left. It’s just one more thing to worry about,” I added.