MEMO TO THE FILE:
I need to specifically recount that I have, number one, advised Jennifer that she should offer one-half of the life insurance proceeds to Elise Ipswich. Number two, that she will likely wind up paying the legal fees of this Frank Wilder if she insists on no negotiations. Number three, it's going to be expensive for her to hire me to represent her in a family law dispute at the same time as defending her on a criminal case. I'm going to make that clear to her this morning and tell her that I will be sending her a fee agreement to be signed and returned to me before I speak with Wilder. Wilder is a good name for Frank because he is wild. I only wish I could've made Jennifer understand that.
When I first met Jennifer at the swimming pool, I was bowled over by her smile and her warmth and her grace around people. I can see why any medical school would have accepted her as one of its students. She's just that kind of person who's going to make any medical school proud that it educated her.
But something else is developing. It seems to me that since we've gotten into the question of finances in her personal life, there is a different persona lurking just below her surface. She is angry and hurt, and she is being very possessive right now. I'm putting these impressions here in her file because I want to be able to report to any Medical Association or Bar Association what I was seeing at the inception of this dispute with Elise Ipswich.
20
Jennifer
Whenever I’m blessed to take a newborn into my arms during their first office visit, I always come away with tears in my eyes. They are a miracle, the little ones.
My first day back in the office, early in the day before trial began again, my first patient was one of those little ones, a three-month-old named Sara Mae. Sara Mae was feeling “puny,” as we say. She was off her feed and was restless, not sleeping well at night. That was directly from Mom’s intake sheet notes.
“Tell me what’s changed with Sara Mae,” I asked her mother, a pretty twenty-two-ish girl with very short black hair and a nostril ring. She sat her baby on the examination table and, as she held her there, I could see the arrowhead tats running up the inside of the mother’s arm. Tats that meant, in the parlance of today’s youth, that she had been smitten for life by cupid, a pledge of undying love to her husband—or some such thing.
“She’s hot and cranky lately. Am I keeping her too warm? How do I know?”
They were always afraid they were going to break their new thing. Truth was, they couldn’t. The human baby was more resilient than that prehistoric creature still among us and doing well, the cockroach. Babies bested them ten to one.
“Cindy, let’s talk about her nutritional status. Is she breastfeeding?’
“She is. She does very well with breast milk, too.”
“But you wrote on the intake sheet that she’s started pushing your breast away?”
“Exactly. It’s never happened before.”
“Is Sara Mae getting stronger?”
“Yep. Every day she grips my finger harder when she’s in her bath.”
“How often do you bathe her?” I asked.
“Every day.”
“Too much. It’ll dry her skin. Every other, try that.”
“Okay.”
In my fast approach that the mother would never know what was going on, I assessed Sara Mae’s nutritional status, level of consciousness, lack of toxicity and distress, absence of cyanosis, cooperation, hydration, and her mental state. The last one was part of the regimen of the pediatrician and all but impossible. I mean, a three-month-old’s mental state—really? Actually, I really did do that.
I checked our prelims—accurate height and weight. Next I felt her skin and slyly moved into her lymph nodes. This one scares the mother much more than the baby. Next I moved to Sara Mae’s fontanelle and noted the size and shape for the chart. Scalp, hair, and eyes. This was all preliminary, and then I began my gross assessment.
I listed them so you get a good idea what each of these little people get:
Nasal septum, mucosa (color, polyps), sinus tenderness, discharge. Then I moved to that favorite baby place where everything eventually goes, the mouth. Mouth and throat, lips (colors and fissures), buccal mucosa, tongue (color, papillae, position, tremors), teeth and gums (number, condition), palate (intact, arch), tonsils (size, color, exudates), posterior pharyngeal wall (color, lymph hyperplasia, bulging), gag reflex—here’s where she’d start crying. Who wouldn’t?
Then I moved to her neck, thyroid, trachea position, masses, top to bottom, lungs came next and her thorax before inspection of pattern of breathing. I told little Sara Mae’s mom that period abdominal breathing was normal in infants where there was a pause less than fifteen seconds.
Then I moved onto the large muscles: use of accessory muscles, retraction location, degree/flaring.
I looked at the chest wall, noting configuration. Then auscultation, confirming equality of breath sounds. I noted rales, wheezes, and rhonchi. I listened for upper airway noise. Then the heart: auscultation, rhythm, murmurs, and quality of heart sounds. While on that topic, pulses: quality in upper and lower extremities.
Another five or ten minutes, and I’d completed my examination of Sara Mae.
“Perfect,” I told the anxious mother. “In every way.”
“You’re sure?”
“Positive.”
“Thank you!”
“Okay,” I said after my exam and charting, “any questions?”
“How is she again?” A second time around was predictable. The mother’s lip quivered in anticipation. So tender toward her baby.
“How is she? Sara Mae is a healthy, normal, female baby, three months old. She’s good to go until six months when we check her again.”
“Six months? That long?”
I smiled and rubbed Sara’s chubby leg. “Six months is standard. Of course, if anything comes up between now and then, I know you’ll call me.”
Didn’t I know it? I received and answered just about sixty mother calls every day of my life. And that’s on a good day without a bug. When the bugs are out, I might get twice that in one day. Plus treating a full patient load.
“All right,” said the new mother. “Six months, it is. Uh…”
Here it came. I could predict this. Third time’s the charm.
“Are you sure she’s normal and doing okay?”
“Pushing the breast away means she’s getting her strength, and her arms are able to do more. Nothing else. It has nothing to do with feeding time or your milk or you or the stars in the sky. It’s normal.”
I waited while Sara Mae was dressed and buttoned into her sweater before I abruptly exited the examination room and hurried to the next one. Usually, I was trying to duck out quickly for urgent appointments. They came in-between patients and made the next one in the exam room wait and wonder why I was so late. So, after Sara Mae, I all but ran down the hall and stepped into the next room.
And so my day began, then off to my trial for murder.
You can’t make this stuff up.
21
Jennifer
Here's the thing about doctors, especially psychologists. They always want to know how you wound up in their office. Dr. Verona Gresham asked me that question the first time we met.
"How did I find you?" I said. I didn't want to tell her I came to her because she was Michael Gresham's wife. So I sat there and looked around her office as if I were searching for an answer. I was sitting on the loveseat beside a lamp with a table built into its waist. On the table was a box of tissues. I got the idea.
Dr. Verona Gresham was sitting across from me.
Dr. Gresham was a psychologist trained in Russia who had moved to the United States with her husband, Michael. This had happened several years ago. As I said, Dr. Gresham did not know Michael was defending me in a criminal case. And Michael did not know that I was seeing his wife, Verona, about my feelings. Really, my feelings for him. It made me feel close to him to be close to his w
ife. Dr. Gresham's office was my private place to go with my mind and feelings to construct a relationship between blue sky and sunshine and closeness with his wife.
Sometimes, as a woman, it’s hard to admit I feel like that. But I tried very hard not to fool myself. Michael was special. He was brilliant and handsome—although his face was scarred. Someone had said a client tortured him one time and burned his face. But he was way more than looks. He was all man and capable and looked at me a certain way.
“How did I find you? Well—” I thought I would skip the Michael feelings—thoughtful of me, yes? "I found you because I'm a baby doctor, and I know lots of doctors and get lots of recommendations. My husband's death has hit me very hard, and I just need someone to talk to. You should know that they have me on trial right now for my husband's death and have accused me of murdering him."
"Did you murder him?" asked Dr. Gresham. Her face was compassionate and open, yet she was all business.
"Of course not! I loved my husband dearly, the light of my life, my whole reason for being. Joseph and I were as close as any man and woman have ever been. I cannot tell you what it's been like since he died.”
“Well, try telling me what it’s been like. I’d like to know that.”
“Well, I don't sleep, I've lost my appetite, and my children don't even know who I am anymore. We seldom talk to each other; we’re like ships passing in the night. Most of the time I get through my days as a baby doctor almost reactively. I know I'm not thinking straight, and I'm just praying that I don't make a mistake and injure someone. And the depression—unthinkable.”
"It sounds like it might be best if you took some time away from the office and concentrated on your children and yourself. Do you have other physicians in your practice who could share your patient load with you?"
"I could never do that. My little guys love me too much. And their mothers—they think of me as a god. Which I'm not, of course, but they rely on me totally when it comes to their children.”
“Yes, we can begin to feel indispensable. We’re not.”
“Half of my calls every day are from mothers who want advice on child-rearing. There is no way I could break away from all that. Nor is it what I really want. No, I need someone to talk to and get through this time of adjustment. I'm glad I found you, but I will stay involved in my practice and come here to let off steam if you allow me."
Dr. Gresham smiled. “You're always welcome here. Moreover, if you ever need to talk during the day and have a small break, please try my phone. You can leave a message at any time, and I'll get back to you between patients."
"That's very kind of you. I'll try not to bother you with calls as I know how they can start to eat into your patient time. But one never knows."
“Anytime. You’re welcome to share.”
It was my opening, the therapist’s keyword: share. I was so, so prepared to share, so off I went. Also, I had cut my risperidone in half two days running. Sometimes I just needed to elevate, to get my feet up off the goddam ground.
“Do you know what I mean about feelings so deep, so enveloping, for your husband that every day you’re a chrysalis reborn into his light and warmth? Do you have that in your life, Doctor Gresham, so that you can understand me?”
She looked at me, unsure. Was I trying to cross a personal line that she wouldn’t allow? Or was I sincerely seeking to connect with another human being as therapy?
She hesitated, but the therapist always won over the individual. It was their training, trust me, to never self-disclose, but she took a chance this one time. “Yes, I have that. I’m born to my husband every time he enters a room. Each time he touches my hand as I’m stirring our spaghetti sauce, I can feel a part of me recover from the day and melt just enough to want to rub—"
“Well…?“
“I mean, that’s very personal. But I do, I do understand you, Dr. O’Connor. It’s a universal feeling, what a wife might feel for her husband.”
“And what you feel. I can almost feel what you feel for Mr. Gresham.”
If I were a man, I could say I had just undressed her.
She stopped and put aside her pen. She tugged a tissue from the box and cleaned her eyeglasses. Holding them up to the light, I could see her thinking her way ahead of me, trying to get ahead of the patient.
Dr. Gresham bent to her notes and entered her thoughts into my chart. She was sitting with her back to her roll-top desk. On either end were green-shaded lamps, a triptych behind, portraying a river rolling along from a waterfall down to a pool of water beneath a tree.
"Now, Dr. O'Connor, why don't we try to set up a more structured day for you, morning and night?"
Oh, a hard right turn, off through the ether. Come, angle off through the ether with me, she said with that sidestep, that right turn, that phrase following a hard comma.
Ah, yes, structure. We had exhausted our share. Brief but emotional, dare I say, climax? Was that saying too much? Probably.
She had just called me “Dr. O’Connor.” I smiled at her. I had changed my name for the patient records so that Verona would never put two and two together and know that I was Michael Gresham's client. And vice versa. I was Jennifer O'Connor in Dr. Gresham's office and Jennifer Ipswich in Michael Gresham's office. It was a nice play, and I had to congratulate myself on my thinking.
"What do you mean by more structured? You mean like prayer and meditation, jogging, writing my memoirs? What kind of structure would I be looking at?"
Dr. Gresham smiled at me as a parent might smile at a child. "Yes, it might be all of those things, one of them, or something entirely different. Let's start by you telling me what kind of things you enjoy doing in your time away from your medical practice."
"Well, Joe and I have a lakeside home, and I enjoy going there to fish, believe it or not. I never fished in my life until I met Joe, and we spent hours out on the lake in our boat, catching all kinds of fish. I never wanted to keep them, but sometimes we took one or two and ate them that night. Anyway, with Joe now gone, it makes me feel close to him to go throw my line in the water and talk to him as my imaginary partner while we fish. Is there anything wrong with me talking to an imaginary partner? Am I just going crazy?"
Oh, the people I talked to! I didn’t dare introduce her to my entire supporting cast. So I kept it focused on Joe. He was the only cast member she needed to address. At that moment, at least. The rest could be shuffled in and out of our sessions PRN, pro re nata, as the need arose.
"It's only human nature, Dr. O'Connor. It's very natural for people to continue to talk to their loved ones after they passed. I would be surprised if the newly widowed denied doing that. Often, people will ask for a loved one to appear to them and tell them they're okay. Knowing that a loved one who has passed is okay and not in pain anymore is a widespread human experience. So, yes, your talking to Joe is not only okay, it's healthy. I would certainly encourage that. What else might there be besides fishing?"
"Well, both of our young kids now know how to waterski. Joseph and I would take them out and ski them up and down the shoreline just about every weekend in the summertime.”
“I love waterskiing. Michael and I go.”
“Joe would drive, and I would be the spotter. With him gone, now I don't have a driver. And you can't be both the driver and the spotter. It's against the law. So I don't know what I'm going to do. I suppose I'll have to learn to drive the boat and let one of the children be the spotter. I don't even know if that's legal at their age. My God, I have so much to learn, and my life has changed so dramatically."
The baby doctor began weeping softly at that point—I was referring to myself, the baby doctor. “The baby doctor”—me—reached over to the tissues, clutched several and dabbed at her eyes. She was amazed at herself, surprised at how adaptable she was. The tears were real, even though the feelings were not. Joe had been a bastard for what he had done. She would never forget. Note to self: it seems you can only admit your hatred for Joe in th
e third person. Buck up, you can admit this to your real self: he was a bastard for what he did. He broke your heart!
I knew before he died he was involved. What wife wouldn’t know? Then that last time when he tried to unload it on me and ease his guilt. But I didn’t allow it, did I? Ice cubes and whiskey. Next thing, he’s telling his internist he’s not feeling so good. They decided it was exhaustion from working too much.
“Are you feeling better?” Dr. Gresham asked me.
“I can’t stop thinking about Joe. I cry a lot.”
“Of course, and you will.”
I don’t know that I’ll need her yet. But if I do, I’ll nudge Michael, “Michael,” I’ll say, “what if we called my psychologist to testify about my feelings for my husband? Would that make sense?”
Dr. Gresham looked at the clock on the wall and nodded. I looked as well and understood our time together was up.
Dr. Gresham said to me, “Same time next week?"
"Same time. And thank you for listening to me today. I feel much better just being heard by another adult. All right then, I'm off to my practice and a room full of runny noses. Ciao."
Dr. Gresham smiled. "That's right. Until next week, take care."
22
Michael
My investigator is Marcel Rainford. He came to me via Interpol in Europe and the U.S. Army in Iraq where we were friends. He was the most capable, competent finder of lost items—people, places, things—I’d ever known.
It seemed like all I had to do was tell Marcel I needed something and, in the blink of an eye, it was sitting in the middle of my desk. I didn’t remember asking, but I suppose I must have told him I would give anything to see Jennifer's medical records from the psychiatrist she was seeing when she started medical school.
At that time, Marcel spent about half his working days in his office and about half in the field. The field could be anywhere in the world, and he’d be pulling together facts and information that I needed in my litigation practice.
Girl, Under Oath (Michael Gresham Series) Page 8
