Sawyer said, "Cocky?" and laughed softly.
The sound was pleasant and lifted my spirits. I tried to recall whether or not I had ever heard her laugh before.
She said, "You think I'm arrogant, huh?" Her tone wasn't defensive, maybe a little mocking, I thought, as though I had badly misjudged her character with an ill-
chosen adjective.
"You're something. Sawyer. I'm not sure what."
With her left hand she reached forward and grabbed the knot on my tie, with her right, she gripped the fabric below. I thought she was going to choke me. Playfully, of course. But instead she began to release the pressure, loosen the knot, and fumble with the button beneath.
I also felt her weight shift on my lap as the soft mass of her spread legs seemed to find cushion against my groin, her breasts were only inches away from my mouth.
"Don't let the residents on the unit fool you, we were all terrified a month ago, too, a month from now you'll begin to feel invincible, too, the terror was unwarranted then, the invincibility isn't warranted now."
"I figured all that. But the bravado is .., is so refined, it's scary."
"We have seminars on conceit in medical school. It's a required course." With these few words. I thought she wiggled just the slightest bit. But it could have been my imagination.
My tie was loose, open all the way to the first button on my shirt.
She had been looking past me while we talked. I captured her hands and slowly released them before I reached up and touched the sides of her face with my fingers. I was particularly gentle as I touched her, as though I were lifting the petal of a rose, her cheeks were soft to my touch, all powder and tender flesh. I traced an invisible line to her jawbones and lifted her face until I captured her gaze in mine.
She permitted me to examine her eyes for only a moment and then she looked away. I moved my face and met her eyes again, maneuvering as delicately as I could, the same way I might try to corral a ladybug.
For an instant. Sawver tried to flv awav from me again, but then, to my surprise, she let me lock onto her dancing eyes for two or three seconds, the light sparkled off her speckled irises like confetti falling to the ground.
Then she was gone.
I felt even more pressure in my groin. This time. I was rather certain it had nothing to do with Sawyer shifting her weight.
She flitted a glance my way and said. "You know, you're making me uncomfortable."
"Ditto." I squirmed on the chair.
She laughed again. "That's not what I mean."
I leaned forward and kissed her on the chin, held the position long enough to begin to memorize the sensation of her skin on my lips.
Abruptly, she turned her face away from mine, but I persisted and I moved my mouth lower and kissed her on
the side of the neck below her ear. My lips were parted and as I touched her with my tongue I tasted salt and inhaled the perfumes of flowers and spice.
In the midst of a protracted exhale, she said. "I have a two-thirty patient in the clinic."
I slid my fingers up and into her hair. It was as soft as down.
I said. "I guess that means we had better hurry."
With my hands on the back of her head, I pulled her face to mine and moved my lips to her mouth. For the first time, we kissed. I tasted her breath and our tongues jousted in the neutral territory between our teeth, after three tantalizing parries, our tongues finally touched and I felt a jolt shoot down my limbs that was pure electricity.
My hands tugged at the back of her blouse and her hands were on my belt and seconds later, it seemed, her weight was off my lap and she was sliding my trousers to my knees. I slid my hand up her thigh and discovered the panty hose were only thigh-high stockings.
This outfit wasn't as preppy as it had looked. Briefly I was aware that this seduction wasn't really mine, the thought vaporized.
She reached between her legs, took me in her right hand, and lowered herself back onto me in one uninterrupted thrust. I felt the moisture and the warmth and the tightness and for an instant felt nothing else in tha world. I couldn't smell. I couldn't taste. I didn't know if I was breathing, the rest of the world was gone.
She pressed down harder, until I could feel the flesh outside of her as well as in. I pulled her body to me with both my hands and tried to raise myself off the chair to meet her.
She whispered. "Don't move." Although the words were hushed, the message was not.
For a moment we were still.
Then I moved.
Her voice sad and desperate, her lips behind my ear, she said. "Please. Please. Don't move. Please. Oh, don't move."
She gasped.
I wondered if she was about to cry.
Into her hair. I asked. "What would you like. Sawyer?"
I felt her fingernails hard and sharp in the flesh of mv shoulder, she answered. "Just fill me, okav? Just.., fill me."
The next morning. Sawyer wasn't at rounds. I wondered about her absence until I was distracted by the news that I would be getting my first inpatient that afternoon, a transfer from the crisis unit at the mental health center in Jefferson County.
An hour later. I attended my first Orange Team Community Meeting— Sawyer was there this time— and for the first time I met Arnie Dresser's already legendary patient. Travis, who was fresh out of eight hours in restraints and sixteen more in an isolation room.
Travis was an incredibly skinny man. I guessed he stood around six-two yet weighed no more than one-forty. His blond hair was almost white, he was balding on the crown and his hair had receded so dramatically on his temples that what remained resembled a platinum horseshoe that someone had hammered into place high on his pale forehead. While the other patients and the staff members were finding seats. Travis began to slowly shake his head back and forth while his mouth continuously formed the word "no." The elderly woman next to him stared at him with a dull expression on her face, the whole time making the hand and face motions necessary to apply and reapply lipstick.
Of course, her hand was empty.
A quick assessment of the room found no one else who looked more disturbed than anyone I'd seen on my last crosstown trip on a city bus.
Dr. Oliphant said. "Travis?" in a soft voice. "Would you prefer to be excused from this meeting today?"
He didn't hear her, or he ignored her. I couldn't tell.
More sharply, she repeated his name. "Travis."
He looked up at her, still mouthing the word "no."
"Would you prefer to be excused from this meeting today? Perhaps try again next time when you're feeling a little more in control?"
Travis raised his chin and tightened the tendons in his neck, he said. "I'm sitting here. I'm sitting. I'm minding my own business. My business." He stared at the ceiling tiles for a moment before lowering his chin to his chest.
Dr. Oliphant said. "The Community Meeting isn't about your own business. Travis, are you prepared to pay attention to what's going on and to participate with the community this morning? Or would you prefer some more time alone? It's just fine if that's what you need." Her words were soft, an invitation to withdraw, not a threat of exclusion.
I was impressed at her manner.
Travis looked up once again, this time appearing startled that the room was full of people, he said. "I... I... I'll do whatever it takes. I says. I'll do whatever it takes to makes .., takes to makes .., the nurses think me of a gentleman. Kind man." The form of his words was as mangled as their meaning, as though he were trying to enunciate through a mouthful of yogurt. I remembered all the Navane he was on and assumed the pharmaceuticals were the culprit. Travis was taking enough antipsychotics to stop a marauding bull elephant. Certainly enough to slur his speech.
Dr. Oliphant said. "That's fine. You're welcome to be with us, then." With Susan's approval. Travis was going to be permitted to participate in the Community Meeting.
Attention turned next to Olivia, the woman with the imaginary lipst
ick, a nurse asked her to finish her makeup after the meeting, with an audible huff. Olivia dropped her hands to her lap.
I spent most of the rest of that first Community Meeting wondering whether my first admissions would have any familial resemblance to Travis or Olivia, or whether they would resemble one of the other members of the community, the other patients who lined the dayroom that morning appeared sadder than most, angrier than most, or more medicated than most. But I could see myself sitting down with any of them for psychotherapy.
But if my first patient was as psychotic as Travis or Olivia. I figured I might just as well pack up my briefcase and go home.
I had my pants around my ankles and a length of toilet paper in my hand when I heard the commotion that started on the unit around ten-thirty that morning, the staff rest room was at the end of a narrow hall near the occupational therapy room. I finished up on the toilet, washed my hands, and gingerly made my way back down
the hall toward the unit to see what the heck was going on.
Halfway back to the unit corridor. I stopped in my tracks as I heard Amie Dresser insist loudly that Travis put down the knife.
"Now. Travis. Now. Put down the knife. Put it down." I thought Arnie sounded much more frightened than authoritative.
And what the hell was Travis doing with a knife? I figured it must be one of the little flimsy plastic jobs that dietary served with patients' meals.
I continued down the hall to the spot where it intersected with the corridor, poked my head around the corner, and tried to see what Travis was doing. Twenty feet away, his back to me. Travis was holding someone hostage in front of him. Ten or twelve feet beyond Travis, a few doctors and nurses were grouped together trying to coax Travis to release the knife. Behind them, even farther down the corridor, the rest of the staff were busy hustling patients out of their rooms toward the dayroom, away from danger.
From where I was standing. I could only see the back of Travis's head, the skin on his neck was bright red, so brilliantly red it looked sunburned.
Travis cried out. "Frieda. Frieda. Frieda."
With the plaintive voice of a street beggar, arnie said. "That's not Frieda with you, Travis, that's Dr. Sackett.
You don't want to hurt her, and you don't want to hurt Frieda. Put down the knife."
Sawyer?
I looked again and saw some wisps of blond hair protruding above Travis's right shoulder.
He had Sawyer, and he had a knife.
All of Travis's attention was directed at the posse in front of him. Either he had already decided that no one was behind him or in his current mental condition he was incapable of considering the possibility that danger might come from some other direction.
I backed into the hallway and considered my options, a fire exit behind me would sound an immediate alarm if I used it to go for help. But Travis's reaction to an alarm was unpredictable, and that unpredictability would present an unacceptable risk to Sawyer's well-being.
I assumed someone had already alerted hospital security anyway.
Okav. I said to mvself, what do you know about
J * J * J
Travis that might help?
What I knew was that Travis was psychotic. His diagnosis: paranoid schizophrenia. DSM in 295.33. Which meant Travis had a thought disorder, which meant I didn't have a clue about the current reality he might be inhabiting. I could safely assume that it wasn't the same one where I was hanging out.
That Travis had confused Sawyer with Frieda told me he was delusional, at rounds that morning, arnie had reported that in addition to his ongoing delusions about Frieda. Travis had reported hearing auditory command hallucinations—voices telling him that he should accomplish various acts, usually not things like jogging or playing Scrabble. Travis had assured Arnie that he was ignoring the voices.
I also knew that Travis was taking forty of Navane.
All in all, this wasn't a pretty picture.
One of the hallmarks of severe psychosis is thought disorder. One of the trademark symptoms of thought disorder is ambivalence, the inability to choose between alternative actions. I wondered if I could use that to my advantage, to briefly paralyze Travis with ambivalence by giving him an alternative to ponder, anything other than slicing Sawyer with the knife he was holding to her body.
That might give us enough time to disarm him and restrain him.
Or I could do nothing, allow the people with experience to handle this.
The doing-nothing alternative was winning my favor when Wendy Asimoto screamed. "He cut her! Oh, no. Travis, she's bleeding. Don't do that, don't do that. Oh, God."
Arnie's voice shook. "Travis, please put down tha knife."
Travis said. "Blood."
I waited to hear Sawyer cry out.
But the next voice I heard was Wendy's, she screamed, "No, Travis, no, not again! NO! WHERE IS SECURITY?"
Then I heard Sawyer whimper and Travis say, "Frieda; Frieda."
Without further contemplation, I left the sanctuary of the hallway and walked briskly down the corridor as silently as I could and tapped Travis on the shoulder. I adopted a tone that was as close as I could manage to the one I had heard Susan Oliphant use that morning in Community Meeting.
I said. "Excuse me. Travis?"
He turned his head just a little.
"Travis? It's Dr. Gregory."
He turned a little more. I could see the knife now. It was a little red Swiss Army pocketknife, the kind so small you can hang it from a key chain, the shiny steel blade was stained with Sawyer's blood.
I said, "Would you like to go back to your room now? It's a little safer in there, don't you think? I think that might be a good idea."
He seemed to be considering my presence, or my words. Or something, he dropped his hand— the one that was holding the knife— until it came to rest at least six inches away from Sawyer's flesh. Doing so exposed his chest and upper body to me for an instant.
I didn't hesitate. I drove my shoulder into the small opening as hard as I could, lifting his thin frame away from Sawyer and off the floor, he came down hard against the wall, looking stunned.
Seconds later, he was being restrained by the staff
Immediately after tackling Travis. I had grabbed Sawyer, she felt heavy in my arms as I eased her down to the floor, her blood was running down my fingers, down my arms, and she felt to me as though she were melting into a puddle on the floor.
When I looked up again, the staff had Travis in restraint, preparing to move him toward the isolation room.
He was moaning, yelling about his shoulder hurting, asking about Frieda.
Wendy Asimoto was a board-certified internist who was retraining in psychiatry, she took over Sawyer's care.
Sawyer's two wounds were to the side of her neck, and in the seconds that it took Wendy to get pressure bandages over the lacerations, they appeared, to my untrained eye, to be superficial.
But nobody wanted to take any chances, and tha moment a gurney arrived on the scene Sawyer was helped onto it and transported with haste toward the elevators and the emergency room.
Wendy Asimoto went with her.
Arnie Dresser wanted to talk to me in the nursing station.
With a somber look on his face, he said. "Thank you so much. I can't believe what you did out there. I'm so grateful. I don't know what I would have done if Travis had, you know—"
I stopped him and tried to be reassuring. "Arnie. Travis is your patient, not your kid. You're not responsible for what he was doing out there." The reality was that if one of my first patients had attacked another doctor. I would have been so humiliated I would probably have resigned my internship.
Arnie wasn't listening. "Maybe Travis needs different meds, maybe more isolation. I don't know. I don't know."
"Susan approved his being back on the ward, we can all learn something from this, right?"
"Whatever I can do to repay you, anything. You let me know. You'll let me know, right?"
>
I didn't have the courage to tell him that I hadn't been brave for him. Or for Travis. I'd done it for Sawyer.
I had my back slapped by a lot of people in the next few minutes. I was told I was a hero. I was hoping my accidental gallantry would earn me some credits I could cash in when I screwed up, which I knew was inevitable, the whole time I was fighting the urge to run downstairs to the ER to check on Sawyer.
TWELVE
Lauren was cool to me the morning after our Thai dinner party.
The night before, after I'd begun to tell her about Sawyer, we'd lain in bed and she'd posed a few questions that I knew she didn't really want to ask and that she knew I didn't really want to answer.
The first came after a pregnant moment when she kissed me on one of my nipples, she asked. "Did you love her? Sawyer?"
Of course. I'd considered the question many times on my own over the years. Had I loved Sawyer? The answer was that I adored Sawyer Sackett so long before I discovered whether or not she was deserving of my adoration that I probably never got enough emotional distance to love her in any manner that approached what I'd developed with Lauren.
I didn't want to admit to my wife that my adoration of another woman had been so blinding, though, so I said. "I wasn't real mature back then. I thought I loved her. Knowing what I know now. I know I didn't really. It's not anything like what we have."
I had only the dimmest hopes that those words would be palliative. So I wasn't surprised that they weren't.
She was slowly tracing her index finger up and around one of my breasts and then under and around the other, and then again. I realized she was forming the mathematical symbol for infinity.
She asked. "Do you still have feelings for her?"
"Feelings? No. I don't even know her now. I probably didn't even really know her then."
Lauren shifted her weight, and I could smell the conditioner she used in her hair. I inhaled more deeply, hoping for perfume. No.
"But there's something there, isn't there? She could still push your buttons, couldn't she? If you saw her tomorrow, it would still stir something up?"
With my fingernails. I began scratching long gentle lines from the crack in her ass to her shoulder blades. This particular caress usually made her purr.
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