by Barbara Ebel
She responded: What do you mean by a ‘match?’
I don’t mean a commitment! A hookup match. I’m not relationship material.
I can relate, she responded.
I’ll be in the Cincinnati area this weekend. Let’s text during the week and then perhaps meet?
Let’s. Have to go now. TTY in a day or two.
He didn’t sound that exciting, she thought; not like Jerry, her boat guy. Maybe that last encounter served to spoil her. She rinsed her bowl and brought her drink inside where she opened up her notebook to work on her paper before going to sleep.
-----
Annabel sprang out of bed on Wednesday. She imagined that the double date that night would be well worth the wait, topping off a good morning on the ward and a super afternoon in Victor Blake’s group therapy session. After sliding on a skirt and into a round-neck shirt, she cinched them together with a navy belt.
She walked to her car two blocks away, the morning air with a twist of fog. When she threw her bag on the back floor and positioned herself in the driver’s seat, she checked her hair in the mirror and ran her fingers down the front, smoothing the stray pieces from the walk.
The first few months of her third year were flying by and as she gained more clinical experience by the day, she couldn’t imagine the wealth of practical knowledge she would have by the time she graduated. Residency must be the same, she thought, as she veered into the hospital parking lot.
Upstairs, Bob’s backpack sat on the floor; otherwise she was the only one around so she selected the coffee. Someone had made a generous donation of flavored coffee and she couldn’t pass on the French vanilla. She thumbed through her patient list while it dripped and decided to go see Lillie Carter first since she was a hike across to the medicine ward. Sipping her first cup could wait.
Annabel made sure her pockets held her daily goodies, especially her DSM pocket book and espresso beans. Across the way she hurried to the nurses’ station to fetch Lillie’s chart.
“Good morning, Annabel,” Bob said facing the counter. Karla Weaver sat behind the desk.
“Hey. What are …” She stopped her question. It really wasn’t any of her business what he was doing on the medicine floor although he had no patients here. So why was he carrying on talking to Karla?
“Are you looking for this?” Karla asked, tapping Lillie’s chart.
“Yes. How is my patient anyway … from the medical standpoint?”
“I just told Bob. Sure enough, her sodium and potassium were high as well as her blood urea nitrogen. She desperately needs hydration with the IV fluids. And that’s not all,” she said excitedly, “her concentrated urine shows there’s some bacteria in it, too, so she has a mild urinary tract infection.”
“Thanks for all of that,” Annabel said. She went down the hallway to see her patient. As she turned into the doorway, she looked back at Bob … still hanging over the counter talking to Karla.
Chapter 15
“I hate my parents,” Lillie said. “My mother forced me into this. I should have run away from them a long time ago.”
Annabel cringed; her mother seemed like she had her daughter’s best interests in mind. Lillie needed help and her denial made it worse for Annabel to talk any sense into her.
“Lillie, someday if you do want to move out, you must support yourself.” Annabel sat down on her bed and leaned forward to give Lillie eye contact. “To finish an education and work at anything decent, however, you must be well. The medicine service found an infection which they are treating already so your hospitalization is proving useful within the first day. Trust me; I was your age only a few years ago and I understand the uncertainties and negative feelings and strong desire to be an adult in every which way.”
Lillie scratched at the IV site and made a face. “I guess I can talk to you more than the others.”
“You can confide in me anything you want and, believe me, you can talk to the other team members as well. Were you able to sleep last night?”
“Most of the night. And at least my lips don’t seem so dry this morning,” she said as she smoothed a fingertip along her bottom lip.
“That’s because of the fluids you’re receiving which is like filling up a gas tank almost running on empty. You’re going to perform better now and catch the eyes of onlookers as you walk down the street.” After a few seconds, Lillie smiled.
-----
“Good morning,” Annabel said, walking into Noah Goodman’s room. “Cool shirt,” she added. The orange shirt said ‘I found this humerus’ with a sketch of the upper arm bone beneath it.
Noah wore blue jeans and his clean T-shirt highlighted his interest in gross anatomy because of his first year in medical school. Or at least he had been enrolled in gross anatomy. Annabel frowned because she didn’t know whether anyone had told him they may not let him go back.
He pointed to the picture. “I’m intelligent. I can name almost every bone of the human skeleton but I’ll memorize more body parts when I go back to my cadaver. She’s an old woman. A skinny thing with shriveled up skin. Don’t you think I’m smart besides being handsome?”
“Lots of people are smart; we’re just blessed and lucky while we study to become doctors.” She bit her tongue after the words spilled out of her mouth. “Did someone come in yet to take your blood?”
“Yes. Vampires lurk in hospitals. Did you know that?”
Worried, Annabel shook her head. He wasn’t supposed to be suffering from hallucinations. “Tell me about that,” she asked.
“Staff takes blood from patients all the time because doctors want to examine it, run it through machines, and give it significance. I’m not going to be a vampire doctor later on!”
“Good,” she said. “There’s a shortage of non-vampire doctors these days. How did you sleep last night?”
“Sleeping is overrated; I don’t sleep much. I got dressed for the day at 4 a.m. My roommate brought me this shirt you like yesterday.” He fiddled with the sleeve and plopped down in the chair.
Annabel left while he stopped talking for a minute. She bet his lithium dosage still needed tweaking.
Annabel still had a few minutes before team discussion and rounds so she went to see Victor Blake. Because he was her first patient on psychiatry and the subject of the paper she toiled over, she considered him her favorite patient. As she walked in, he finished organizing toiletries on the sink and turned to face her.
“Making myself presentable,” he said. “But I could use a new toothbrush. Those bristles are shriveled up like one of my previous snakes.”
“Top Gun?” she asked.
Victor smiled more than she’d ever seen him do before.
“You remembered? Did I tell you that?”
“Yes. You mentioned Top Gun and Cat Man.”
A woman with an apron poked her head in the doorway. “Time for breakfast,” she said. “Your choice. In your room or the dining area.”
“Let’s go down there,” Annabel said. “I’ll walk with you and we can continue talking.”
They stepped through the doorway. “Are you still seeing snakes under your bed or anywhere in the vicinity?” Annabel asked.
Victor shot her a glance. “No,” he said emphatically and paused as if a revelation had been made. “Isn’t that strange? Is it weird when I see them or more bizarre when they aren’t visiting me?”
“What do you think?”
He wore a blank expression and shrugged his shoulders.
Annabel nodded. “You’ll soon figure it out. In the meantime, I bet you know what today is.”
“I do. It’s Wednesday and I’m meeting this afternoon with the other patients like me. Bye for now. I’m going to eat the lousy eggbeaters they call real eggs.” He stepped forward towards a table in the small dining area.
Annabel turned and thought about the components of the diagnostic criteria for schizophrenia and the mini-mental exam. Today he was the best she’d seen him: his speech wa
sn’t disorganized; he seemed devoid of hallucinations; he knew time and place; and his affect showed some expression. This morning after rounds, she would write the first positive note in his chart yet. She smiled for her patient and the progress he’d made.
-----
Dr. Keeton was the last one to pull a chair into the group therapy circle at 1 p.m. The team sat with their backs closest to the exit and Selina crossed her ankles. She let her clipboard rest on her knees as she smiled at the full attendance.
“Hello, everyone,” she said. “Does anyone have pressing issues to talk about since last week before we tackle today’s topic?” No one responded; her open-ended questions to start were always meant to warm them up to begin talking and usually her method worked.
“Terrific. No one had a symptom flare-up?”
Jonah hid behind his hoodie and Timmy and Orange shook their heads ‘no.’
Victor sat next to Annabel. “Maybe I’m getting better,” he said. “My thoughts aren’t so cluttered up.” He pointed to his head. “My visitors aren’t clamoring so much for air space.”
After a moment’s silence, Annabel spoke up. “May I ask Mr. Blake about that?”
“Certainly,” Selina said. “Mr. Blake is your patient, too.”
“What do you mean, Victor?” she asked. “Do you mean the voices in your head are talking less?”
“Correct, doc.”
He scanned the faces of the other patients. They nodded with understanding and their response gave him confidence. “I feel like I’m getting a rest; a little vacation,” he added.
“Mr. Blake,” Dr. Keeton said, “we are happy to hear it. Beside the fact that you are beginning to understand your illness, the medication you are taking is working wonders. It is the most important component of your care. Think of your risperidone as the key in a lock which opens your mind, setting you free from the paranoia, emotional withdrawal and fragmented thoughts you suffer with from schizophrenia.”
“I’m on that one, too,” Orange said, pushing back her long hair and raising her head for a moment. “I love that drug.”
“I thought most drugs were bad,” he said. “I don’t like to put pills into my body but I guess this one is different.”
“Absolutely,” Dr. Keeton said. “When you go home, take your medicine every day like Timmy, Orange, and Jonah. You will be happy to hear that we plan on sending you home by Friday if you continue on your present course.”
Victor smiled nervously. “I can still come to this group and be your patient as well?”
“That’s the plan,” Selina said.
Victor darted a look at Orange and rubbed his hands together like a kid anticipating a new toy.
“Dr. Washington,” Selina said, “why don’t you mention what we accomplished last week and our agenda for today?”
“Sure thing,” he said. “Last week each of you shared stories about what you do that makes you feel better … like drawing pictures, talking to family members, and baking cookies. Today Dr. Keeton and I have a new, fun assignment.”
“I hope it’s challenging, like engineering school,” Timmy said.
“It’s not too difficult,” Joshua said. “Otherwise, I wouldn’t be here. I can’t process numbers like an engineering student. Even though you did not graduate, you can take credit for being a math wizard.”
Timmy bowed his shaved head with modesty.
“So what’s our task for today?” Victor asked.
“If you noticed what I just did … I gave Timmy a compliment, reaffirming some special ability which he possesses. What I want today is for each of you to praise yourself for something you excel at. When you leave today, go to the mirror each day this week and reiterate that positive thing about yourself.
“It’s called patting ourselves on the back with refreshing ‘positive affirmations,’” Dr. Keeton said. “Each and every one of you is special; your diagnosis is a small aspect of who you are; and you must always understand and give yourself permission to compliment yourself.”
Orange shuffled her feet in place and twisted her hands.
“Orange,” Joshua said, “you seem uncomfortable. I know what you’re good at during these sessions. You share your thoughts freely with others. You made Victor feel better by telling him you are on the same prescription as he is and that it’s a helpful drug. Wasn’t Orange reassuring to you, Victor?”
Victor leaned over and nodded.
“Can you give yourself a positive affirmation, Orange?” Selina asked.
“Dr. Washington made me realize … I guess I am a good sharer,” she said, her head still drooped over.
“How about leaving out ‘I guess,’” Joshua said. “You are a thoughtful sharer.”
“Okay,” she said.
“What else?”
“When I was acting crazy last month, some guy called me a ‘crazy, ugly bitch.’ Sometimes I may be crazy but I’m not ugly. I’m pretty.”
“There you go,” Joshua said. “Doesn’t it feel nice to compliment yourself?”
She stole a glance at the others and nodded.
“Can I say something?” Annabel asked.
“Sure thing,” Selina said.
“Let’s take a vote if Orange is pretty.”
One after the other, the group said ‘yes.’
“See that,” Annabel said. “You’re 100% pretty.”
Orange beamed so much, Annabel could see her white smile from inside her tent of hair.
“I’m going to look in my bathroom mirror this week,” Timmy said, “and say that I’m smart. No matter what anybody else thinks, my brainpower is as good as a university professor teaching engineering.”
“There you go,” Selina said.
“Jonah?” Dr. Washington asked, stretching over to see him.
“I had two girlfriends,” Jonah said. “One after the other. Twice I stood up to guys bullying them. That makes me a fine protector because I have courage to help people in need.”
“You can defend me anytime,” Orange said.
“Nice one, Jonah,” Joshua said. “Thanks for sharing.”
“What about you, Victor?” Dr. Keeton asked.
“Let me think,” he said. “Maybe I qualify as a really good caretaker. Kind of like what the students in this room do helping patients.”
“What do you mean?” Annabel asked.
“Well, a few years ago I had a cat. Her name was Abby. I loved her and took super care of her for two years.” He twisted his mouth with concern. “Only my mom walked out front to get the mail; it’s the most she can do with her shortness of breath. Anyway, sometimes she then visits me since my entrance at the house is different than hers. I wasn’t home; she used her key to come in and Abby slinked by her and went out.” He slowed the pace of his story and narrowed his eyes. “She wasn’t fast enough to grab my cat and I lost her forever.”
“I’m sorry, Mr. Blake,” Annabel said.
“We’re sorry about Abby, too,” Bob said.
“Did you have any other pets?” Joshua asked.
“I already told you about my snakes. Top Gun and Cat Man have a good caretaker in me. Nobody takes care of pets like I do.”
Annabel looked at Selina. One of these days she wished Victor would give up his obsession with snakes.
“Victor, are there any snakes visiting you right now in the hospital?” Dr. Keeton asked.
“No. My head is clearer and I’m not seeing snakes. But I am a good caretaker.”
“You feel good about providing a home, love, and care to other living things, don’t you?” Selina asked.
“Yes, I do,” he said. “Wow.”
“Good for you, then,” she said. “You are special because you don’t only think about yourself. Other species depended on you in the past so maybe that can happen again in the future.”
“Yeah, way to go, Victor,” Orange said.
Annabel clapped her hands lightly. Selina smiled at her gesture, also clapped, and the others followed.<
br />
-----
After Selina gave a recap of their session and asked the patients to repeat their positive affirmations each day of the subsequent week, she adjourned the group.
“See you next week,” Victor said to Orange in the hallway.
“Bye, then,” she said. “You’re getting better, Victor. You can mind my cat whenever you want, especially if your mom isn’t around.” She gave him a thumbs up and left.
Selina carried her clipboard and they all went back to their big room where a tray of cheese, fruit, and crackers had shown up. “I asked the cafeteria to deliver this,” Selina said.
“You’re too kind to us,” Bob said. “Attending doctors don’t need to provide students with doughnuts and food trays.”
“Give yourself a positive affirmation,” she smiled. “Both of you are deserving students and my resident is top-notch.”
Joshua popped a grape in his mouth. “I make a resident’s salary which is better than the nothing that Annabel and Bob make, so next time I’ll spring for the food. Thanks, Dr. Keeton.”
“You’re all welcome. Plus,” she said to Annabel, “I wonder if the breakfast dinner we’re having tonight will be enough, so I’m feeding us a little extra right now.”
“Breakfast dinner?” Bob asked.
“Yes, sorry fellas,” Selina said. “Annabel and I are breaking bread tonight with the two officers that keep showing up in the emergency psychiatry unit. God knows but we’ve needed them.”
Bob’s eyes grew wider and Joshua raised his eyebrows.
“Like a date?” Bob asked.
“No, it can’t be,” Joshua said, giving it some thought. “Breakfast isn’t romantic, plus that isn’t a date. Four is a crowd.”
“I guess you’re right,” Bob said.
Selina cracked a smile at Annabel.
“Well, I don’t know,” Joshua said. “The two of them look a bit suspicious. It’ll be interesting to watch them both walk in tomorrow.” He flew his hand up to his mouth. “Dr. Keeton, I don’t mean to be disrespectful. I’m just adding an air of levity.”
“No disrespect taken. I’m curious about tonight, too. It may be that handsome officer Dustin Lowe with the dimple in his chin can’t keep his eyes off of Dr. Tilson and I may enjoy prying into what makes a policeman tick. I’ve never had breakfast with one. Edgar Banks may have chewed off more than he can handle by asking me out.”
