Dry Ice
Page 4
“Yes. What a mess. We lost a witness. I know I said I’d get her, but…”
The witness? Misplaced? Defected? Died? I was curious but I knew that Lauren wouldn’t share details, so I didn’t ask. I said, “I’m sorry about your witness. Yes, I’ll get Grace. We’ll take care of dinner too.”
“Thank you.”
“You feeling okay?” I asked.
“Later,” she said. “I’m fine.”
Where Lauren’s health was concerned, “fine” covered a lot of ground. The poignant “later” gave me pause.
I was numb as I cleaned up the blood and replaced the water in the fountain. I did the chores only so that Diane wouldn’t have to.
She didn’t need that.
It had been only a couple of hours earlier that I directed Kol to the small office powder room to clean off the blood before his session. When he emerged five minutes later he no longer looked like a refugee extra from a Wes Craven movie. I could only guess what the bathroom looked like. I followed him into my office.
“This is my parents’ idea,” he said moments after he sat. “Seeing you. Is that where we left off? Am I right?”
Had he forgotten that he’d told me that therapy was his parents’ idea? I waited for a reasonable interval to see if he’d elaborate on his own. Alternately, I thought he might illuminate his decision to remain in the waiting room as some weak vessel in his nose spurted blood like an arterial puncture. He didn’t take either route. Gooseflesh dotted the follicles of the fine hair on his forearms.
“Your parents?” I said, going with the flow.
“They’re insisting. Well, one of them is. Want to guess?”
He uncrossed his legs and leaned forward, his elbows on his knees, his eyes directed toward my feet. I didn’t guess. Didn’t plan to.
“Fifty-fifty. Got to like the odds. Bingo.”
I waited some more.
“If I don’t do this—see somebody—they’re going to make me sell my place and move back home. That’s the deal.”
“They’re going to make you sell your place?” Left unsaid: Didn’t you say you were twenty-six years old?
I was keeping the “one of them is” question on deck. That clarification was significant, but it could wait. He might settle the question on his own. If he didn’t, I’d draw him back to it.
“I live there, but it’s…theirs. May actually be my mom’s technically. The money is hers. He’s at a bit of a disadvantage. You know what that’s like. They don’t see eye to eye on…? But they own it, or she owns it, and I don’t—I mean I’ve never—” He grimaced.
“Worked?” I said. It was a guess. Right or wrong, however, it should have been a silent guess. I regretted speaking the word the moment I could no longer retrieve it.
He was unfazed. “With my problems I’ve never been able to…”
Take responsibility? I thought. But what I asked was, “You have trouble…what?”
“With all that…you get depressed,” he said. “It’s hard.”
You do? He didn’t seem depressed.
“Holding a job. Workin’ on the railroad. All the live long day. Bingo.”
“Are you feeling depressed now?”
“Now? This minute now? What?”
I backed up. I was floundering. What am I missing? “Your parents want you in psychotherapy because they’re concerned about…? That you get depressed?”
Kol sighed. “More ‘her’ than ‘they.’ My father’s not so much in the picture. I mean it’s not like what happened with—” He stopped. Looked up—almost at my face—then back down. “Your dad? Is that right? No?”
My dad? What?
“And the making-a-living thing? How hard is that? For sure they don’t get that. The driving thing is the other part. Those are the current biggies. This week, sí. Next week? Stay tuned.”
“Your dad?” Is that what he said? His dad? Was that a question? Or is he…Could he mean my dad? No. No. He couldn’t.
I refocused on the options he’d just presented. Choice points like the ones he placed in front of me can be tricky ground for therapists. I could have asked Kol about either the “making-a-living thing,” or “the driving thing.” The risk? I would choose the wrong topic, one with little emotional load. As an alternative, I could have waited and let him choose to expound on one of the two parental concerns on his own. The risk there? He might elect to change the subject entirely. If that occurred I would be forced into lassoing him and facing the original clinical dilemma all over again.
There was also the revelation about his depression. And his mama. And whatever he meant about “your dad.”
I waited. I do that a lot in therapy.
“So what do you think?” he said. “We’re cool?”
I had an epiphany right then. Kol wasn’t using the phrase “We’re cool?” in the conversational vernacular of the day. He was using it as a plea. Kol needed assurance that I wasn’t offended by his act.
Huh. “Hardly,” I said to Kol, my voice containing as much padding as I could stuff into it. I didn’t want him to think I was going to accept his proffered clinical road map without question. “I have a hint, and only a hint, about what your parents—or at least your mother—want you to achieve. But I’m still not at all sure what you hope to gain from therapy.”
He sat back on the chair. “My life. My freedom.”
“From?”
“Them. Her.”
Them? I assumed he meant his parents, but I cautioned myself that I didn’t really know him well and that he might have been talking about iridescent blue men who work for the FBI and have a co-op in his armpit. Don’t assume, I reminded myself. Don’t assume. “Them?” I asked.
“My parents,” he said. I was relieved. There were so many other “thems”—the iridescent blue men among them—that would have caused me mighty concern. “It’s a small price to pay. You know what that’s like. God.”
What is a small price to pay? And what does he mean that I know what that’s like?
I downshifted, reengaged a gear, and slowly let out the clutch. “If I’m hearing you right, Kol, you’re saying you want to be in therapy to keep your parents off your back? Mostly your mother?”
“More or less. Don’t worry, you’ll get paid. They’re loaded. My mom’s family. Pemex? You know it? Black gold? Tehuacán tea? That’s her family. Hey. Bingo.”
I sat silently for a moment, noting his apparent lack of discretion, before I asked, “Is the depression a concern to you?”
“What? No. I don’t really have any problems,” Kol said. “Other than the who-I-am stuff. But that’s nothing special. Been going on a while. Now I have a guide.”
Am I the guide? I didn’t think so. “A guide?” I asked.
“Yes.”
I waited for elucidation. It wasn’t forthcoming. “No other problems?” I said. “The depression?”
“No. My guide has shown me the way.”
“Your guide is…?” More evidence of dependence? I thought.
“Do I look depressed?” Pause. “Cool?”
He was smiling. He had great teeth. White as a new T-shirt. Fine orthodontics or some expensive cosmetic dentistry. Maybe just good genes.
“Looks can be deceiving,” I said.
“Got the right guide? Urges disappear. Problems go away. You know what I mean? Mama doesn’t know. Bingo.”
“About your guide?”
He nodded, arched his eyebrows.
I said, “Your guide is…?”
He shook his head.
Man or woman? Life coach? Mentor? I would have to guess. I took one more stab: “You’re avoiding my questions.”
He shrugged. I took a long moment to consider his gaminess. I was on the verge of confronting it further when instead I said, “In the whole ‘problem’ category, I can think of a couple of areas that might be worthy of your consideration.” I hoped that I hadn’t sounded too sarca
stic. I should have confronted him, not been sarcastic with him.
“Shoot,” he said.
Shoot? As it sometimes did—often out of the blue—the word caused my mind to go into excavation mode. The excavation made my pulse start flying. I felt a conscious urge to purge my lungs of carbon dioxide and to flood my blood with oxygen.
My patient—the one who died on the evening news—had been shot.
Shoot. I tried to recover my balance. I said, “Your parents—your mother, at least—think you need to be in therapy. You don’t agree. From my point of view, that’s one problem.”
His face was impassive.
“And…you seem to be willing to comply with your parents’ intrusion into your life in order to keep the mortgage paid and keep them off your back. I might consider that to be another problem.”
He seemed to think about it all before he said, “Do you know all the places Angelina Jolie has traveled to do humanitarian work?”
What? “No,” I admitted, as I allowed myself to be floated by the tide that was being lifted by Kol’s odd moon. I was wondering whether I was witnessing a conscious diversion on Kol’s part, or evidence of tangential thinking. Tangential thinking wouldn’t be a good sign. The iridescent blue men remained a possibility.
“I do,” he said. “Do you want the list before she was named a Goodwill Ambassador by the U.N. or after? Pre-Brad, or post?”
I shrugged my shoulders.
“Chronologically? Or by continent?” he asked, but he didn’t wait for an answer. He provided the list chronologically, pre-Brad.
It took almost ten minutes. Kol knew the names of airports, villages, refugee camps, and even some coastal resorts where Ms. Jolie had decompressed after her apparently voluminous humanitarian efforts.
I was amazed at the performance. It was like watching a savant recite pi to four thousand places.
Huh.
At the end of the appointment I handed Kol his first monthly therapy bill. Had the session not started with my patient covered in blood, giving him the bill would have been the first event of the session, not the last.
Kol stuffed the paper into his vest pocket without glancing at it.
Since it was the first one I’d given him I said, “It’s a super bill. You can submit it directly to your insurance company.”
“I don’t have an insurance company. I have a madre rica. I’ll give this to her,” he said, tapping at his jacket pocket. “Do good work with me and she’ll probably give you a tip. Maybe your very own oil well.”
He smiled, his eyes following my lips. I didn’t know what to say.
He said, “Bingo.”
SEVEN
MANEUVERING ACROSS town through rush hour I thought about all the things I had neglected to ask Kol about the blood. It was a depressingly long list.
I retrieved Grace from day care with minutes to spare and got her strapped into her car seat for our errand. She wanted to talk about the physics—or magic—that caused hard-boiled eggs to be sucked into soda bottles, so we did. I pretended that I remembered something about the relative effects of temperature and air pressure.
Grace pretended I was a genius. I adored her for it.
Lauren called again just as I was steeling myself for the insanity that was the Whole Foods parking lot at rush hour. My unkind thought: Now what?
“Where are you?” she asked.
“We’re about to try to find a place to park at Whole Foods. If that proves successful we’re going to pick up something for dinner.”
Grace laughed.
“Get enough for Sam. He and I will be working tonight. Do we have beer?”
“Sure. Yes, we do have beer.” In my mind, I doubled the amount of food I would get. Even in his latest, healthy incarnation Sam had an above-average appetite.
When Gracie and I came back out with our takeout supper in tow the upslope winds had stilled, the snow had stopped, and the cloud cover had migrated south along the Front Range. With the blanket of insulation gone the northern air left in the wake of the departed front was chilly. I wondered if there would be a hard freeze. A night in the mid-twenties would be a tough lesson for those gardeners blessed or burdened with enough denial to have already planted their tomatoes.
Thirty blocks across town the stark faces of the Flatirons were bearded in snow. High above the Divide a few stars glistened in the darkness. Closer to me and Grace, across Pearl from the Whole Foods parking lot near Target, the boughs on the northeastern side of the evergreens were straining under the heavy load of wet snow.
Things had been moving fast, meteorologically speaking.
Had I not still been so distracted by the session with Kol I might have recognized the value of the metaphor.
That I had thought that Kol, covered in blood, needed to see a doctor was ironic. I was not yet convinced that he truly needed to be seeing a different species of doctor—that was me—for psychotherapy. It was surprising that I was intrigued by seeing Kol at all—so much of my recent therapeutic work felt like clinical calisthenics.
Any reticence I had about treating Kol wasn’t because he seemed normal. He was definitely peculiar. His name, for example. He’d explained that his given name was actually Cole but that he’d decided that it should be written K-O-L after having gone all the way through high school near San Diego insisting to his teachers that it be spelled C-O-A-L. “That’s me. Anthracite, man—I’m the black panther” had been his explanation for the adoption of the juvenile sobriquet.
I had long before developed a bias that “peculiar” didn’t qualify as a clinical problem. Maturity and experience had convinced me that trying to eliminate peculiarity in the guise of seeking normalcy was not only outside my therapeutic purview, but also a light-year beyond my skill set. I suspected, too, that trying to eliminate peculiarity was an endeavor of dubious value—although that was a philosophical debate more than a psychological one.
Peculiar or not, I remained unconvinced that Kol met my criteria for psychotherapeutic intervention. Over my years in practice the should-this-person-be-in-treatment checklist had evolved to a point that the decision tree was a relatively simple three-step process. First, a patient must have at least one identifiable problem of the mental-health variety. Second, the problem must have a solution that I had the skills to assist in shaping. And third, the patient must demonstrate an interest, however dim, in marrying the solution with the problem and engaging with me in the intervening process.
My assessment with Kol was that numbers two and three on my list were problematic, and number one was no slam dunk—I had reached a tentative conclusion that he might have a workable problem, just not the one he suspected.
During his intake visit a few weeks before he had been one of those thoughtful patients who had announced his DSM-IV diagnosis for my benefit. He’d walked in the door to my office, plopped his narrow frame down on the chair across from me, and—before I’d said a word, let alone asked a single question—spared me the trouble of having to conjure up a clinical tag for him. Kol reported that he and his parents thought he was an “adult autistic with ADHD”—attention-deficit hyper-activity disorder.
“An adult autistic?” I’d asked. The closest I could come to a recognizable label would have been someone with “residual autism,” a nonspecific diagnostic tag for an autistic child who had grown into adulthood hobbled by the echoes of the earlier developmental disorder. As I listened for Kol’s additional diagnostic thoughts I made a tentative decision to proceed as though that was what he’d meant.
“I was a mildly autistic kid. Now I’m an adult.” Kol was twenty-six. “Okay, maybe moderately autistic. Ergo, I’m an adult autistic.” He said it with more pride than ennui. For him it was a badge of honor of some kind, not a limiting label. I was cool with that, though residual autism raised a problem with number two on my need-to-be-in-therapy checklist. I had no ready intervention for that disorder in my clinical toolbox.
That first day I wasn’t prepared to commit to anything diagnostically but my impression of the man sitting across from me would not have placed residual autism high on the short list of disorders I was ruling out. I cautioned myself that children with a history of autism rarely present as adults as simple grown-up versions of the child who had suffered from the early affliction, and that the aging diagnostic formulations reflected little of the rapidly accumulating wisdom about autism.
“Can you tell me a little bit about the autism? When you were younger?”
“I was an animal, man. An animal.” He shot a quick look in my direction, then away. “Skittish. Scared. Didn’t like to be touched. Got fascinated by weird things. Motion. I could go off on something moving for, like, ever. A second hand on a clock? Whoa. A merry-go-round? That’d be a day.”
I sensed he wasn’t done. I waited.
“Did I mention loud noises? They freaked me out. And I was, like, persnickety.”
“Persnickety?” I was pretty sure it was the first time I’d spoken that word in my office.
“Everything had to be just so. I don’t like stuff out of place.” He stuck a slender fingertip into a slit on the edge of the cushion on the chair on which he was sitting. I hadn’t previously been aware that the cushion had any damage. “Like this. I don’t like stuff like this. It’s not right. You should fix it.”
I think he was waiting for me to hop up and pull out a needle and thread and do the job right then and there. I waited for him to continue. When he didn’t I asked, “And the ADHD?”
“Textbook,” he assured me. “I have the attention span of a puppy. I was a little-yellow-bus kid. Only thing was music. Repetitive, techno. You know Moby? Do you?”
He wanted an answer. I said I knew Moby. I didn’t say I wasn’t particularly fond of Moby.