“Did Dr Wilson give you any reasons why he thought it might be helpful for Conor to come here?” James asked.
“No, he just suggested it.” She paused. Her silence was at first expectant, but grew longer and more indistinct.
Then without warning, the mask slipped. Her shoulders dropped in a gesture of despair. “Probably just because I’m so desperate. I know I’m driving Dr Wilson demented with my calls. It’s just that Conor’s so difficult. Home for a month and he’s destroying us.”
Sympathy washed over James. He leaned towards her, his folded arms on the desk, and smiled reassuringly. “Yes, I can understand. Children like Conor can be very demanding,” he said softly. “Don’t worry.”
The muscles along her jaw tightened. She wasn’t teary but James knew she was in that moment just before tears.
“Why don’t you tell me a little bit about how Conor is at home?” he said. “That’ll give us a better idea of whether or not coming here would be appropriate.”
Laura became teary.
He smiled gently and leaned forward to nudge the box of tissues towards the edge of the desk. “Don’t worry. This is a very hard moment. Most parents feel pretty upset.”
“It’s just … just such a nightmare. Like one of those nightmares where you keep doing the same thing over and over and it never works out, it never achieves anything.”
She took a tissue. The tears hadn’t really materialized, so she just clamped it tightly in her fist. James had a strong sense that she was feeling deeply conflicted in that moment, that self-control was a huge issue but that at the same time the burden of this boy was so overwhelming that she was desperate for help.
“Is Conor your only child?”
“No. We have a daughter too, who’s six.”
“When did Conor’s problems first start?” James asked.
Laura let out a slow, elongated sigh. “When he was about two. He seemed all right when he was a baby, although it’s hard to know with your first child. There were things I had always been concerned about. He was very jumpy, for instance. If you came up behind him or there was a loud noise, he’d always startle badly. Dr Wilson said it was just a temperament thing, that it simply indicated he was a sensitive boy, and not to worry about it. Otherwise, he was a good baby. He slept well. He didn’t have colic or anything.”
“Did he seem to develop normally to you?”
“Yes.” Her voice had a plaintive, almost querulous note of bewilderment to it and James wondered how often she’d had to give these details. Or was stopped from giving them. In this era of insurance and accountability, there often was little time spent on collecting psychosocial histories beyond what was needed to prescribe the appropriate drug. James had found listening carefully to the parents’ initial version of events was one of the most valuable thing to do, not only for the concrete information it provided in building up a picture of a child’s problems, but also as a way of cementing that crucial relationship with the parents, because they often felt so desperate and unheard.
“Conor was always timid,” Laura said. “He cried easily. He worried about things. Even as a little, little boy. But he was very bright and interested in things. He talked early. Even by a year old, he could use several words.”
“So you say the difficulties starting showing up after he turned two?”
Twisting the tissue between her fingers, Laura nodded. “It started with his becoming very clingy. He’d always been inclined to be clingy but suddenly it got much worse. He never wanted me out of his sight. I couldn’t even go to the bathroom without him. He began having these terrible temper tantrums. Dr Wilson was still telling us not to worry. Kids have tantrums at that age, he kept saying, but I don’t think he realized how bad they were. Conor would just go frantic and do things like literally rip the wallpaper off the wall with his fingernails. To complicate things, that’s when I got pregnant with Morgana and it was a challenging pregnancy. I had some serious medical problems. And we were having some financial difficulties, which meant the pregnancy wasn’t very well timed – it hadn’t been planned – so a whole lot was going on.”
“Can you describe Conor’s behaviour in a little more detail?” James asked.
“He got really hyper, really agitated. He wouldn’t sleep. He could go days without sleeping. Which, with a new baby …” She let out a defeated sigh. “And the screaming started. He’d be sitting, playing normally with his toys and then suddenly he’d get all panicky, and start screaming and screaming. He had been in a nursery program two days a week, but we had to take him out because his behaviour upset the other children so much. The school wouldn’t keep him.” She put a hand over her eyes for a moment in a gesture of desperation and then rubbed her face. “It just got so distressing to live with. Finally Dr Wilson arranged for him to go into the children’s unit at the university hospital in Sioux Falls to be assessed. That’s when autism was diagnosed.”
James nodded thoughtfully.
“And now …” Laura said. She sighed again. “It’s getting just like that all over again. ‘Difficult’ doesn’t half describe living with Conor. For example, everything has got to be just so. His room, his toys, his food. Everything must be in a special place and in a special order. I can’t do anything for him if it isn’t exactly the same way I did it before. Like at breakfast, I can’t put the eggs on the table if the juice hasn’t been poured first. All these little rituals have to be followed precisely. Like those wires. Did you see those? Those bits of string around his waist? There must four of them. Exactly six feet long. Each with twelve bits of foil. Then there’s that frigging cat. That cat rules everything in the house. It goes everywhere he goes, does everything he does, investigates every molecule that comes in contact with Conor.
“This all makes even the smallest, most ordinary task a trial. Try giving a bath to a kid who must have string, foil and a stuffed cat on his person at all times. Or putting him to bed. It’s like putting Frankenstein’s monster to bed. All those wires have to be attached to the bedpost and crisscrossed over the bed just so. If they’re not just so, he’ll sit there ‘adjusting’. He can be up for hours ‘adjusting’, scanning the cat over them, ‘adjusting’ some more and all the while he is making noises – buzzing and whirring, or worse, meowing. This then wakes Morgana. She goes in to see what’s going on. She means no harm. She’s just being your typical, nosey six-year-old. But if she tries to help him or she touches his cat, he freaks. So then I yell at her for upsetting him and she cries. Then he cries. Like as not, I end up crying too.”
James smiled sympathetically. “That must be very difficult. What about your husband, Alan? Does he help much with Conor?”
Laura leaned back in the chair and expelled a long, heavy breath. “Well, there’s another issue …
“It’s not so good between Al and me at the moment,” she said softly, and James could hear emotion tightening her words. “That’s a whole other story. A long one and I don’t want to go into it right now. But the short answer is: yes, he helps when he can. It’s just I don’t know how long that’s going to last, because we’re splitting up.” She looked over tearfully. “So, see, this is why I can’t cope with Conor at home. Even I have to admit I need help.”
“Laura Deighton, huh?” Lars said, leaning over the appointment book that was lying open on Dulcie’s desk. “So is the boy coming in then?”
James nodded. “I couldn’t get her to agree to three times a week, but we’re going to do Tuesdays and Thursdays.”
“What’s she like?”
“Seems okay,” James