The Girl Without a Name Read online

  I have no answer to this. I don’t know any Daisy or if she tends to dawdle.

  “Mr. Gonzalez,” Dr. Berringer says, standing next to the bed.

  The patient looks up like the doctor is in on the joke. “Name, game, same, game, shame. No shame in a name game. Can’t tame the name game, said the same dame.”

  Dr. Berringer looks delighted. “Okay, what type of speech is this?” he asks, turning to Jason.

  “This would be clanging speech,” Jason answers.

  “Clang-a-lang-a-ding-a-dang,” the patient answers.

  “Mr. Gonzalez, have you been taking your medications?” Dr. Berringer asks.

  “Dead meds, Fred said, no meds to the dead dread head.”

  “Jason, get ahold of the wife. See what the pill bottles look like. I suspect our dear Fred hasn’t been taking his meds.”

  “Will do,” he says.

  Dr. Berringer pats the patient’s shoulder, and Mr. Gonzalez looks up at him with a convivial nod.

  “See you tomorrow, Mr. Gonzalez.”

  “The day has a way of making me say,” he answers as if this is his usual good-bye. We exit to the hall, able to breathe freely again.

  “Wow, that was a good one,” Dr. Berringer says, clearly a man who loves his job. “What are his meds again?”

  As Jason reels them off, my eyes wander to the window. The sun glimmers off the cars in the parking lot, tiny boxes in rows. Dew outlines a rectangle on the window.

  “Earth to Zoe,” Dr. Berringer bellows with a good-natured grin.

  “I’m sorry. What?”

  “Top three in the differential diagnosis of mania, I was asking you.”

  “Mania. Right, yes.” I swallow, pause, waiting for a list to lumber into my brain. “Hyperthyroidism.”

  “Good, that’s one.”

  I wait. “Steroid usage?”

  “Excellent. Another one?”

  I try to think. The harder I think, the blanker my brain.

  “Jason? Want to help her out here?”

  Jason takes a sip of coffee that I actually want to steal from him. “ADHD,” he says.

  “That’s right, Jason. ADHD. Can be a tricky one.”

  Alas, the bitter, bitter irony.

  “All right,” Dr. Berringer says. “Let’s see what our Jane is up to.”

  Jane is unchanged, like she’s stuck in a freeze frame. She sits staring on her throne, her toes sticking out of the blue T.E.D. stockings, which travel well above her thighs like a bad Pippi Longstocking costume. She blinks and twitches her nose like a bunny. Dr. Berringer lifts her arm up again, and again it stays there, a macabre party trick, until he gently pushes it back down.

  “No change, huh?” he says, disappointed.

  “No. But we did get some results at least,” I answer, lifting her growing plastic chart out of the rack.

  “Okay, what do we got?”

  “MRI was normal.”

  “How about the LP?”

  “Just done.”

  He folds his arms. “Any stains sent out?”

  “A few things,” I answer. “RPR, India ink, HSV, cytology. That’ll take probably a week, but I can keep bugging the lab.”

  “Yeah, do that, would you?” he says. “Tox screen was negative, right?”

  “Negative,” I confirm. We stand there watching her. “I was thinking, what about a trial of benzodiazepines?” I ask.

  “Which one?”

  “Ativan, or Valium maybe? There have been reports on both.”

  He drops his stethoscope into his bag. “What do you think, Jason?”

  “I don’t know. Maybe we should wait for the LP.”

  Dr. Berringer lifts his hands, his fingers interlaced with his pointer fingers straight up against his lips like he’s shushing someone. We wait for his decision. “Jason’s right. I’m going to say hold off on the benzos for now. Let’s wait on the LP and see what a tincture of time does for our Jane. Jason, got anyone else?”

  “Actually, the rest of mine have all been discharged,” he answers.

  “Okay, good. I’ll catch up with you later then. Zoe, can I have a quick word? If you don’t mind?”

  “Of course.” My stomach does a somersault. I’ve been asked for a “quick word” many times in my life, and it’s never a good thing. First off, it’s never quick, and it’s certainly never someone wanting to take a little time out just to tell you what a damn good job you’re doing.

  He motions toward the family conference room. He shuts the door behind us. Photos of baby animals of every ilk (puppies, kittens, baby seals, lion cubs, etc.) hang crookedly in cheap metal frames. The room smells musty, like it was just vacuumed with a bag that needs a change. We sit down side by side at the long table, my heart prancing in my chest.

  “Just let me say, you’re not in trouble or anything,” he starts. “I just want to check in with you. See what’s going on.”

  “Okay,” I say. There is a pause, but I’m unsure how much more to offer. Two psychiatrists reflectively listening to each other doesn’t make for a sparkling tête-à-tête.

  “Is there anything going on?” he asks.

  “In terms of?”

  “In terms of you. Your focus. You just don’t seem…I don’t know…all there lately. We all have off days. And you’re post-call, I know. Maybe that’s all this is. But if there’s more, or if there’s something I can help you out with, I want to know about it.” He leans back in his wooden chair, twisting the ring on his finger.

  “I have ADHD,” I announce. I hadn’t really planned on sharing, but my brain apparently had.

  He nods slowly with a concerned smile. A possibly practiced concerned smile.

  “It’s been a bit of a problem lately. I’m working on it with…well, with my psychiatrist. I know I’ve been off lately, as you noticed. Just so you’re aware. I’m aware of it.” I sound like an ass. Any more awares and I’ll be clanging.

  He crosses his long legs and leans back farther in his chair, staring at the ceiling tiles. “I’m glad you told me, Zoe. I’m glad you were comfortable enough to do that.”

  I nod, not sure what to say to this canned psychiatrist line.

  “Life throws you curveballs sometimes. I know your mom died recently, and that’s been tough, I’m sure.”

  “Yes. It has.”

  “I know how you feel. When my mom died…” He looks down at the table and doesn’t finish the sentence.

  “It was hard?” I offer. I can’t help it; I’m a psychiatrist.

  “Yeah, it sure was.” He looks back to me. “And it wasn’t easy moving to Buffalo either. I’m a Southern boy like a fish out of water up here, even after three years. My wife is on her last nerve in this place. Or maybe just with me,” he jokes, raising his eyebrows. “Anyway, these things happen, right?”

  “Right.” I’m not sure who is treating whom here, or maybe that’s not the point.

  It does make me wonder, though, how he did end up in Buffalo. When he was hired, the Children’s Hospital press release called him the “wunderkind from the Big Easy.” Not yet forty and he’s got a publication list longer than my arm. Even Jason will admit he’s “wicked-fucking-smart.” So what brought him to the polar vortex then? He clears his throat, and I realize he may be waiting for an answer. But I’m not sure what the question was.

  “So I guess what I’m saying is, we all have our troubles, Zoe.” He leans in toward me. “And it sounds like you’ve had more than your share since you’ve been a resident.”

  I wonder if he’s talking about the patient who stabbed me. I didn’t think he knew about that. But he probably does. Everybody around here does. I forged my way past whispers and stares for months after it happened. But eventually people’s everyday life, real life—messy with its fender benders, cheating spouses, overdue cable bills, all the other quotidian tragedies—intervened, turning even homicidal, psychopathic patients a bit less eventful. Which is to say, everyone eventually forgot about me. Though every onc
e in a while, a hush still falls over the elevator when I step on.

  “You ever of hear Leonard Cohen?” he asks, putting his elbows on his knees.

  “No, I don’t think so.”

  “Let me tell you. He’s one of my favorite songwriters. A poet, really.”

  “Okay?”

  “He has a song where he says: There is a crack in everything. That’s how the light gets in.” He pauses to let this sink in. “Like no one’s perfect; we all have our demons. But that’s what makes us who we are.” He stares off at the wall, where the sunlight glares on the veneer of light-brown, fake-knotted wooden paneling. He puts his hand on my shoulder and gives it a squeeze. An attagirl kind of squeeze. Like he might give to Mr. Gonzalez, which makes me sad in a way. I really don’t want to be his patient.

  “I’m doing okay, though,” I say. “I just think my meds need some tinkering is all. I’ll be right as rain soon enough.” Right as rain. Something my mom used to say.

  “I’m sure you will be,” he answers, standing up. End of the quick word. As he opens the door, the pressurized silence of the room evaporates, the hospital sounds zooming back in. We walk out, and he glances at his gold watch.

  “I’ve got an appointment in a bit.”

  I stop myself from asking for what.

  “And you’re post-call, so get yourself home already!” He gives me another shoulder squeeze. “And Zoe?”

  “Yes.” I hear my foot tapping against the tile and stop it.

  “Don’t forget.” He puts his hand up to his heart in a fist. “That’s how the light gets in.”

  I stand there as he walks away, trying to decide if that was corny or not.

  Chapter Three

  Okay, my dopamine needs a serious tune-up here.”

  Sam cradles his chin, naked pink now without his goatee. (He told me last session his wife thought it made him look old.) It does take ten years off him, but he looks incomplete somehow. Like his brown hair and his brown eyes lost a friend. He also looks less Freudian, though maybe that was intentional. “What do you mean?” he asks.

  “I don’t know. My brain is sluggish. Like I’m underwater.”

  He nods. “And why do you think that is?”

  I finger the row of brass buttons on the leather chair. “I don’t know. I assume it’s my ADHD acting up. It just feels like I’m brain-dead.”

  He waits for me to say more. “Can you give me an example?”

  I bend over to the coffee table. Sam always has some kind of toy to play with in the office, to put patients at ease. I’ll have to remember that trick when I’m out in practice next year. Assuming I don’t get a fellowship, which I can’t afford anyway. His newest toy is a small box of sand with a miniature rake and three smooth, gray-brown stones. Some Zen thing. “So we have this patient with catatonia, right?” I say, raking away.

  “Right.”

  “She’s probably about twelve or thirteen.”

  “Probably?”

  “The thing is, we don’t actually know her exact identity yet. The police are still working on that one.”

  “Interesting.”

  “And Dr. Berringer asks me for the differential for catatonia. Which should be simple…but it takes me forever.”

  “I see.”

  “Same for the differential for mania. My brain just failed.”

  “So you couldn’t come up with it.”

  “Dr. Berringer actually called me on it. Took me aside and asked if anything was wrong.”

  “Hmm.” He cradles his chin again. “That is a concern.”

  “And then for Jane—”

  “Jane?”

  “That’s what we call our girl with catatonia. Jane, as in Jane Doe.”

  “Ah.” He nods.

  “I just feel like…I can’t help this girl if I’m not firing on all cylinders.” Which makes me wonder exactly how many “all cylinders” entails. Six? A dozen? I couldn’t venture to guess. I rake tic-tac-toe lines in the sand. “So I’m thinking we need to go up on my Adderall.”

  Sam leans forward, resting his elbows on his large, glossy desk. “I can see how you might think that. But honestly, I’m not so sure.”

  “No?” I fill in some X’s and O’s. “We need to do something. I mean, I failed the RITE exam. The RITE exam, for God’s sake. I haven’t failed a test since, like, fourth grade.” I still remember the “64%” in bright red, scarring the top of my math test. I thought my young life was over.

  “Let’s talk about that,” he says.

  I pause. “Well, it was a long time ago—”

  “No, no, not the fourth-grade thing. The RITE exam. Could the fact that you just lost your mother have anything to do with failing the exam? Do you think?”

  “Maybe,” I admit. It was two weeks later after all. Which is why I was put on probation but not canned. “Extenuating circumstances” as per the letter from the Psychiatry chairman. And the glowing, though unexpected, recommendation from Dr. Grant didn’t hurt either. Unexpected because I thought Dr. Grant hated me, but it turns out he was “just challenging me to live up to the potential of a Yale medical graduate.” Rattling my cage, as it were. No worries about that one anymore. The Yale thing has certainly lost its luster by now. And I don’t have Dr. Grant to kick around now anyway. Now I’ve got Dr. Berringer, the esteemed head of Child Psychiatry, for my child-psych rotation, yet another attending to disappoint.

  Sam’s hands climb up to play with his goatee, find it missing, and descend back onto his desk. “How are you doing with your mom’s death?”

  “Which mom?” I ask, a poor attempt at humor. My birth mother died when I was a child. I only found out the whole truth about what happened in the first year of residency, when I first started seeing Sam.

  “Your adopted mom,” he answers with a half smile.

  My “real” real mom, the one who raised me. “I don’t know. I still think about her all the time. Every single day. Sometimes I grab my phone to call her and then remember I can’t.”

  “Very common,” he says, nodding. “She’s still more alive than gone for you right now.”

  “I guess.” I catch my reflection in the wall mirror, a huge circle with a dark wooden ship-wheel frame. The room has an overdone nautical theme; he should shoot the decorator for going overboard. (Yeah, I know. Pun intended.) “What happened to the compass?” I ask, noticing it missing, a behemoth of a thing on his desk that always pointed true north even though it faced east. In its place is an anchor paperweight matching the anchor bookends. The paperweight is huge, granite, a plausible murder weapon in a CSI plot.

  “I don’t remember. Let’s focus back on your mother, okay?”

  “Sure, okay.” I sit up on the couch. “I don’t know what more to say. She’s gone, I’m sad. That’s all.” I drop the rake, the handle resting on one of the stones. “It’s been almost a year now. It just seems like I should be further along.”

  He takes off his glasses and toys with the temple. “Grief has its own pace unfortunately. There’s no shortcut for that.”

  “Yeah, I know. But to be honest, right now I’m more concerned about my brain not functioning.”

  “Yes, I know you are. But that’s the connection I’m trying to make here. I don’t think the slowed cognition has anything to do with your ADHD. But I think it has everything to do with your mother’s death.”

  “As in depression?”

  “You could call it that. Or grief. They go hand in hand.”

  I catch my reflection again, half a nose in the nautical mirror. “Should we go up on the Lexapro then?”

  “Let’s see.” He turns to his computer, scrolling to get my medication page. “We have room to increase it if you want. Do you think it’s necessary?”

  “It’s more than necessary. It’s mandatory. I’m on probation here. Whatever it takes to get these gray cells jogging again.”

  He pauses, then pulls out his drawer with a rumble and starts filling out a script.

 
; “Don’t you guys have e-script yet?”

  “Next month. At least that’s what they told me last month.” We both smile. “Let’s try fifteen milligrams. Watch for diarrhea.”

  I fold the script in half and drop it in my purse. A bit of hope. Gathering up my things, I run through my list of belongings, a rote routine of mine since an “ADHD Skills Course” my mom dragged me to in eighth grade. Purse, check. Phone in purse, check.

  “Hey,” Sam says, standing up. “You figured out next year yet?”

  It’s almost October, and most people are on top of their fellowship applications. But I’m not quite there yet. Maybe because my brain is in slo-mo. Or maybe because I really don’t know what the hell I want to do. Mike’s been hinting all summer that I might want to come up with some semblance of a plan. Finally he just stopped talking about it altogether.

  “Give yourself some time,” Sam says when I appear stuck on an answer. “You’ll figure it out eventually.”

  “I guess.”

  “And Zoe,” Sam continues. “Work on being kinder to yourself. The RITE, for instance. I know it upsets you, but think about it: Your mom just died, you didn’t study. I don’t know many people who would actually pass an exam in that situation.” He stands up from his desk. “I don’t even think they should have put you on probation, but that’s just my opinion.”

  “Really?” The thought buoys me. Probation has been a tough label, a scarlet P upon my chest.

  “Really,” he says. “See you next week.”

  I pull open the door. Cue next patient: the skinny woman I spotted in the waiting room. Perfectly coiffed, makeup on the severe side, whipping through an Oprah Magazine like she was being timed. Anxiety, I’m thinking.

  And in another year, someone will actually pay me to make that diagnosis.

  * * *

  Later that day, I know I should be studying for the RITE, but I’m hanging out with Mike instead, ambling through the wares at Oktoberfest.