“Absolutely not.” I break my promise to myself, and I’m looking up, first at my mom and then at my dad. “No way am I taking medicine.” I see my brain being bombarded by tiny particles of pills, and instead of doing whatever it is Dr. Adams thinks that they will do, they sprout into millions of miniscule tumors. It’s karma for betraying God or bad luck or another secret of the universe. OCD medicine causes brain cancer. I know it. It’s obvious.
“Well, Dr. Adams really seemed to think this was the right path forward. She said that when you combine therapy and medication, as opposed to just therapy, you tend to see much quicker—”
“I don’t care,” I say through clenched teeth. “I don’t want medicine.” My head is throbbing. Maybe even talking about medicine can cause brain cancer. Stranger things have happened.
My parents exchange a long look, and my dad gives a half shrug. My mom is staring at me, mouth slightly open, but I can’t read her expression. I can tell it’s taking all of her self-control to keep her thoughts to herself. My dad reaches his hand over and places it on her arm. She looks toward him and relaxes slightly. With a sigh, she says, “Okay, then, sweetie. Whatever you want.”
• • •
“Well, Allison,” Dr. Adams says the next day, clasping her hands on top of the papers on her thighs and adjusting her glasses on her nose, “I’m a psychiatrist, and since you aren’t yet interested in taking medication, I don’t know how much help I can really offer you.” She recommends a local psychologist who has spent her entire career treating cases “just like mine” and, recognizing my hesitation, spends the rest of our time together singing my new doctor’s praises. This appointment, like the one a few days before with Dr. Mark, ends with a small white business card:
DR. VIRGINIA NELSON, PHD
SPECIALIZING IN CHILDHOOD AND ADOLESCENT OCD AND ANXIETY
CHAPTER 19
So far I’m not impressed. Even the drive here was ugly. We stayed on the highway until exiting on a ramp surrounded by strip malls and empty factory buildings. There were no quaint parks filled with playgrounds and strollers like on the way to Dr. Adams’s. Standing in front of a row of boring, nondescript brick town houses, I can already tell this is a mistake. Dr. Nelson may have experience and credentials, but something here doesn’t feel right. She doesn’t even have flowers beside the front steps. Just a sad-looking scrubby bush.
I pull at the front door, and it gives with a small sucking sound. My dad is already in the waiting room, sitting awkwardly in a chair that seems somehow too small for him. He looks up and shoots me a small, hesitant wave and smile. He’s uncomfortable. This is the first doctor’s appointment he has been to with me and my mom, and it’s obvious he doesn’t know how he is supposed to behave. His eyes are asking me how he can help—act like nothing is wrong, tell a joke, wrap me in a hug? I give him a tiny shrug. I’m not any better at this than you are, Dad.
I look at the large bay window facing out to the parking lot and scan my eyes across the waiting room. It’s a sea of beige. Beige carpet, beige walls, beige upholstery on the seats. All the artwork is of stately-looking brown horses prancing through fields, jumping over fences. There’s a large bookshelf against the wall, but in front of the books are about a dozen painted horse figurines. There’s a vase holding fake flowers to my left, with a herd of horses running across the porcelain. What the heck? She’s a crazy horse lady. I look up at the empty reception desk. There’s a small, vacant chair with a sweater draped over the back. And she’s her own secretary?
What kind of half-rate therapist did Dr. Adams send me to? No plush couches, no festive Christmas decorations. I glance up at the aged watercolor of a horse posing in front of a barn. No gold-framed oil paintings. I’ve gone from the Ritz to a motel.
My mom is patting the chair beside her, asking me to come sit down, trying not to notice that I’m standing on one leg. As I move toward her, there is a rustling down the hallway, and soon a thin, lanky, middle-aged woman appears in the doorway beside the reception desk. Her straight brown hair is graying slightly, and it’s cropped short above her ears. She’s wearing a plain light-pink cotton T-shirt over loose khakis. On her feet are a pair of Teva sandals that look remarkably like the ones my dad insists on wearing whenever he’s not at work. And, also like my dad, she pairs them with thick wool socks.
I guess I shouldn’t be surprised. Plain brick town house, monochromatic waiting room. If beige were a person, it would be this lady. I’m biting the inside of my lip, frowning. The tiny light that flickered to life inside me after my visits with Dr. Adams is dimming rapidly.
“Hello, there. I’m Dr. Virginia Nelson. If you wouldn’t mind following me back to my office”—she extends her arm behind her—“I’d like to spend a few minutes talking to you as a family.” With this, she turns in her sandals and walks back down the hallway. Still standing on one foot, I look to my parents across the waiting room. They’re looking between me, each other, and the now empty doorway.
“Okay, then,” my dad says with another shrug as he pushes himself up out of the creaking chair. “Let’s do this thing.” I crunch my face at him. Nice try, but no.
We move together down the beige hallway into an equally beige office. Dr. Nelson is getting situated in a high-backed brown chair in the corner, and she gestures my parents into two seats across from her. The first thing I notice are one, two, three more horse paintings hanging on the wall. But unlike the bare waiting room, the painted walls around the frames are plastered in hand-drawn pictures. The one closest to me was clearly made by a child, probably around eight or nine. It has a small stick-figure boy in the middle thrusting a giant sword into the air. A word bubble near his mouth declares, Take that, OCD!! I move my eyes up to the one above it, also done by a kid but maybe more middle-school-aged. At the top in scrawled letters it reads, Aiden will face his fear of . . . and below is a bulleted list with small illustrations: bumblebees, snakes, airplanes, dogs, sidewalk cracks.
Sidewalk cracks.
“Allison, would you like to sit?” Dr. Nelson points toward the other side of the room. “You can scoot that chair from the corner over here with us.” I follow her finger toward a kid-sized chair tucked under a large wooden table covered in markers, crayons, paper, stickers. The chair doesn’t say anything specific to me, but I can feel its static. It doesn’t seem happy.
“Nope, I’m fine. I like to stand.” My voice comes out peppy and lighthearted like I hoped. I push my right cheek up at her and raise my leg so I’m swaying slightly on the other. She looks down at my stance. I’m watching her face closely, but her expression doesn’t change. As if patients always stand on one foot during their first meeting. My dad is shaking his head slightly.
“Well, I’m glad we were able to fit you all in so quickly. I had a last-minute cancellation, so I’d say you have pretty good timing.” She smiles at me for the first time, but I only stare back at her. You aren’t Dr. Adams. She clears her throat and looks back at my parents. “I spent some time this morning discussing Allison’s condition with Dr. Adams.” Opening a thin manila folder, she pulls out a stack of papers covered in writing. Is there really that much to know about me?
“Based on some of her comments, it seems like Allison is presenting with sudden-onset obsessive-compulsive disorder. But before we get too deep into what that means and some options for moving forward, I’d like to first get your input”—she’s looking at my parents—“and hear a bit more about what you’ve seen since”—she glances down at her paper—“October.” With this, Dr. Nelson puts her notes down and eyes my parents expectantly.
“Oh, um, sure.” My dad. So awkward. “Well, I guess I’ll start. So, uh, this all really began a few months ago. At the start, there wasn’t really anything we could put our finger on. She just wasn’t herself. Always hiding upstairs, acting almost . . . manic?” He freezes here and jumps forward in his seat. “I mean, not like manic manic. Sorry, I know that’s a whole different thing, but just, uh, you know,
she was much more talkative, kind of rabidly energetic. Like she was trying to convince us that everything was fine, or distract us from whatever strange new thing she was doing.” Dr. Nelson is nodding and writing on a white sheet of paper that I can now see is labeled in bold, black letters: INTAKE FORM.
“And from there it all went downhill so fast. She was tiptoeing. She stopped eating. I would find her up in the middle of the night in the den reading the Bible. There’s the counting. Oh, and the standing. She’s always standing.” All three of them glance at me but then immediately try to hide it. “And you know, it was like every week, maybe every day, it got a little bit worse. It was kind of like watching our daughter . . . disappear. . . .” My dad’s voice trails off, and he is looking down at his hands while I stare intently at the carpet. I didn’t realize it but I’ve been picking at the skin on my index finger. The cuticle is completely raw. A line of blood dribbles down to my knuckle and I wipe it on my flannel.
After a few moments, my mom picks up where he stopped. “Well, and also, Jeffrey, you’re forgetting a few things. Mostly around her appearance.” She gestures toward me but doesn’t look over. “She hasn’t really been bathing. Or brushing her hair or doing her makeup. It’s all very unlike her. She’s stopped getting dressed for the day, and there are only a few items of clothes she is willing to wear. She won’t put on a jacket, even when it’s freezing outside.” My mom is moving her arms broadly as she speaks, like she is trying to make sure Dr. Nelson really hears everything she is saying. “And her schoolwork. Her grades have dropped significantly. She used to be a straight-A student—literally. But now . . .” Her voice, too, trails off, and she stares out the window for a few seconds. “I’m just not sure what happened. And, like he said”—she tilts her head toward my dad—“it was so fast.”
Dr. Nelson continues to nod as she finishes writing out her last sentence. “Okay, good. And, Allison?” Three heads turn to look at me. “Do you have anything you want to add to this?”
My heart is pounding in my head. I’m too embarrassed to speak. Of course they noticed my counting and standing and terrible grades. How could they miss the tangled hair and dinner plates full of food and tiptoeing? While I know they’re still really only scraping the surface of the darker, deeper problem, my stomach tightens in on itself. It was the way they said it. Hello, I’m right here! I can hear you, you know, as you talk about me like your once-perfect child who has now fallen from her pedestal. Like I’m some adolescent freak of nature that you’re scared of, that you whisper about when I’m not around. And after everything I’ve done for you? All the terminal cancers and car wrecks I’ve prevented? My teeth clench together. This feels like an intervention, like the ones I’ve seen on television. Concerned family members and therapists gather around, telling the person how they’re ruining their own life. But I’m not a drug addict or an alcoholic or a criminal. I’m just trying to protect us. I don’t want to die.
“Allison?” It’s my mom. “Do you want to share anything with Dr. Nelson?”
I glare up at her with a look that I hope tells her how much I hate her in this moment. How ridiculous this is. Yes, all the things they said are true. But they don’t get it. They will never understand. In their eyes, I’m now just a failed version of my former self, the girl who could have been so many things, but instead she’s . . . this. Emotion welling in my eyes, I trace the edge of my torn T-shirt with bleeding fingers. I open my mouth and look to the ceiling to try to keep the tears from rolling down my cheeks.
There is a silence and I know they’re all watching me. Dr. Nelson breaks the tension. “Okay, well, what I’d like to do now is talk to you individually. Mom and Dad, we’ll start with you, and then after about ten minutes, we’ll switch and I’ll talk with Miss Allison. Does that work for everyone?” My parents nod, and I keep my eyes focused on my ragged fingers. Dr. Nelson stands up, moves in front of me, and opens the office door. I shuffle past her with my eyes down and she whispers, “It will just be a few minutes, dear. It’s going to be okay.” Without thinking, I raise my eyes up to her face and we hold eye contact. She doesn’t say anything, doesn’t even smile, but the churning waters in my stomach smooth under her gaze. There is something calming about her. Raising her voice back to normal so my mom and dad can hear, she adds, “Help yourself to some bottled water in the fridge. I’ll send your parents to get you when we’re done.”
The door closes gently behind me and I’m in the dark, carpeted hallway. I stop in my tracks and listen to her walking back toward her brown and boring chair. “Okay, so, take me back to October, to the beginning. And try to walk me through the progression of her symptoms.” I hesitate in place. I’m ravenous to know what else my parents might say about me, what else they might know. Do they know about God? Talking furniture? Safe step allotments?
My dad’s voice cuts across the air. “It got out of hand before we even realized that something serious was going on. She . . .”
My entire body clenches at his words. Without realizing it, I find myself shuffling silently down the hallway toward the waiting room. I don’t think this is information I actually want to hear. Kind of like Jenny and Maddie and Rebecca gossiping about my eating habits, sometimes it’s easier not to know the details.
Staring at the row of three chairs against the wall in the waiting room, I realize that they’re quiet. No static, no anger. A little surprised, I plop myself down on the closest one and it gives a few noisy creaks. Maybe this place will be silent like Dr. Adams’s and Dr. Mark’s after all. That would be nice. Three of my fingers are oozing a mixture of pus and blood, so I press them hard against the fabric of my thin pants. The towering bookshelf is to my left. Moving my head slightly to see around the horse figurines, I spot six shelves jammed full of titles like The Boy Who Couldn’t Stop Washing and Breaking Free from OCD with a smaller, italicized subtitle: A Workbook for Young People.
My eyes scan the shelves. Book after book after book, all aimed to help people who seem to think exactly like me. Maybe Dr. Nelson does know what she’s talking about. Her office is underwhelming, so incredibly beige, but she seems professional. Plus, Dr. Adams trusts her. And I trust Dr. Adams. The tiny light that almost disappeared because of the bland décor and horse paintings is suddenly beaming inside me. This could be my chance. A strange gurgle rises in my stomach. At first I think it’s bile, or a cramp of angry hunger, but . . . it’s hope. Maybe even happiness? I squint my eyes and look around the room, almost suspicious of the feeling. I felt an edge of it at Dr. Adams’s, but now powerful waves are sweeping over my head, and I willingly let myself be pulled under.
And, really, what’s the alternative? Refuse to talk to Dr. Nelson, continue to keep all these thoughts and fears inside me? Looking down at my ragged clothes and gnawed-off nails, I know that isn’t even an option anymore. If I step back from the pressure of pleasing God for just a second, I know that my life has melted into nothing. I’ve ruined my grades, my reputation, my relationships with my parents and friends. I can’t go any further. I don’t want to know what comes after rock bottom.
And this whole doctor-psychiatrist-psychologist process has reached the point of no return, I think as I scan my eyes around the waiting room. I hear the soft mumblings of my parents down the hall. They wouldn’t let me get away with not cooperating. Not anymore, not now that they’ve grasped what’s really going on. Maybe I could weasel out of this specific appointment by pulling another precalculus food poisoning, but I would be back here eventually. And if not here, then at the very least back at Dr. Adams’s.
As much as I want to believe that the Lord is sending me secret messages, as much as it feels powerfully true inside me, this is all too much to be a coincidence. Pervasive, unwanted thoughts and incessant, repetitive actions—images of angry textbooks and clothes flit across my mind. Months of moldy sandwiches. My stubby, unsharpened pencil. Sara’s face as I leaped, counted, and tiptoed to class. Peaches, pennies, potatoes. The computer. My cell pho
ne. Calculators. The seemingly never-ending danger list runs itself in a loop through my mind.
And suddenly, sitting alone in the silent waiting room, blood oozing from my fingers, I know I’m ready to talk.
I’m ready to face this.
CHAPTER 20
My eyes jerk away from the bookshelf when I hear the office door open down the hall. My parents appear in the doorway to the waiting room. The stress is vivid on their faces, pulling their wrinkles deeper into their skin, but as soon as they see me, they both break into forced tandem smiles. “Hi there, big girl! Your turn!” My poor dad, he’s really trying.
Dr. Nelson is standing patiently behind them, her hands clasped casually in front of her. As my parents settle into the seats beside me, I know it’s my cue to stand up, but I can’t move. It’s not that I don’t want to, but something much more powerful than gravity is holding me in place. I’ve decided to talk to her, I’ve decided to give this a try . . . but. But. But . . .
“Ready?” She’s smiling gently at me from about ten feet away.
No.
Five seconds pass. “Allison, honey.” My mom nudges me with her arm. “Come on, sweetie. Go on back with Dr. Nelson. We’ll be waiting right here.” She acts like I’m scared of Dr. Nelson, of being in the quiet office with a stranger. And once again I bristle at how wrong she is. It’s not the doctor or the separation that’s worrying me. It’s tumors and mutating cells and lumps in breasts. Cold graves, beeping hospital beds, God’s wrath. She nudges me again. “Go on.”
I roll my eyes in irritation and halfway through the loop accidentally meet eyes with Dr. Nelson. Her eyebrows are raised and there’s a slight smile curving up at the corner of her mouth. She gives a tiny nod, gesturing me to follow her, and turns down the hallway. I shoot both of my parents an annoyed glance, just so they’re clear how I feel.
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