I’ve given Richard a schedule with weekly one-on-one sessions with me, as well as several group therapy sessions most days of the week. Patients often respond well to structure, and I want to keep him busy while I figure him out. We have our regularly scheduled Tuesday 11:00 a.m. session this morning, and he is shuffling and wiggling and trying to get comfortable in my patient chair. He is too large for my office. He looks like a doll two sizes too big for the dollhouse. He is holding that stack of newspapers under one arm while shifting his weight back and forth in the seat. When he finally finds a comfortable position, he drops his papers onto the corner of my desk and awkwardly bends his elbow on top of them. His left arm bows at a strange angle, and he holds his wrist rigid, so it looks like he has a prosthetic arm.
“So, now that we’re settled, I’m going to try to get going with your file again. Can you give me a few minutes of attention to get this ball rolling?” Hopeful, positive, maybe even energetic.
“What’s this? Another test?” he asks. He doesn’t take off his hat, which pisses me off because I think it would be polite if he did. I realize that the best way to suppress my fear might be to replace it with anger, so I momentarily dwell on being pissed that he is impolite. It’s still the tweed newsboy cap, like the ones R & B groups made popular in the ’90s.
“I’m not doin’ no more paperwork.” His voice is calm, masculine. He isn’t arguing with me, simply stating a fact.
“Any more…” I absentmindedly correct him while sifting through my files and avoiding eye contact.
“Look, I’m here because I chose to be here, and I know that I don’t have to fill out the forms, and I have confidentiality and privacy, and I don’t have to answer any of your questions, and if you want to kick me out then that’s fine. I know my rights. I heard you were the best counselor here and I didn’t think you’d give me trouble like that last dud they put me with.” He shifts farther away from me as he says this. He wrings each hand individually, as if he were wiping something off his thumbs. He is fidgety. He is nervous.
“You don’t have to do anything you don’t want to do. But you’re going to make it harder on yourself if you avoid me. I am the person you’re going to be working with for the duration of your time here. I am here to help you and to make your stay as painless as possible. If you need anything, I am the person you come to. If you have problems with anyone else on the unit, and you need an intervention, I am the person you come to. But I can’t help you until you help me.” Rehearsed.
I think the masking-scared-with-pissed ploy is working. He says nothing. I am looking at his eyes for the first time and I realize they are blue. For whatever reason I hadn’t expected this. He keeps them squinted. I can’t decide if this is because he is using his scary face or if he has sensitive eyes. They are light blue, much lighter than mine.
He is unfurling his hands now, and I see his fingernails are well maintained. This is notable only in the fact that it is completely opposite from every other patient. Even the women who spend their last dime on a fancy manicure will allow it to get gnarly and grow out so far that they have a quarter inch of real nail visible beneath the green, sparkly talons of a month ago.
But he remains silent. I can’t tell if this is because I have stumped him or he is about to rip my face off for talking to him like that. I know no one else has said as much as this to him, and right now I can’t imagine what gave me the balls to do it.
“Let’s start with something light.” I put on my glasses and I reach for a pen. “Name?”
I want to hear him pronounce his last name, because I am afraid he will be offended if I say it incorrectly. McHugh. I don’t know if you’re supposed to say the h or if it’s silent or what. I’ve got him talking, and I don’t want to compromise my progress.
“Richard McHugh.” Sounds like mah-Q. Okay, now we have that settled. “Am I supposed to call you Doctor, or what?
“You can call me Dr. James, but I prefer Sam.”
“Why do you prefer Sam?”
“Well, Richard, to be honest with you, I prefer Sam because it’s easier to yell down the hallway. Why do you use your full name? Richard has so many appealing nicknames.” Am I being obnoxious? Flippant? Nonchalant? I feel exhausted, like I can’t conjure the energy I need to be a professional here, or to fake it anymore. I feel like there is a miscommunication happening in my brain and I am accidentally betraying my real feelings in a session and not putting on the appropriate mask.
“I like Richard. No one’s calling me Dick.”
“Okay, sir.”
“No, I didn’t ask you to call me sir; I said Richard.”
“Okay, Richard.” I’ve never seen a reaction like that. Who doesn’t like to be called sir? “Moving on— Date of birth?”
“July fourteenth, 1960. It was a Thursday.”
“Really?” Now I’m interested. “How do you know that?”
“My mother told me. She said it was the worst day of her life and that’s why she always hated Thursdays.” I can’t believe we’re getting somewhere. I am afraid of reacting incorrectly and shoving the turtle back into its shell.
“Well, I love Thursdays.” Benign response, please don’t shut down. Please open up to me. “Whole weekend in front of me. And where were you born, Richard?”
“Queens.”
“Ah, right here in New York, huh? Siblings?”
“No.” Back to one-word answers.
“Family history…”
“No.”
“It’s not a question; we are moving to a section regarding your family history, your backgr—”
“No. I’m not answering any questions about family.” He cuts me off again.
“Okay, well, I understand completely if you’re not comfortable, but it’s vital for your treatment, and—”
“No. I said no. I’m not saying anything else.” It’s over; the turtle is back in his shell.
“Okay, you don’t have to do this now; we can come back to it another ti—” He stops me before I can appease him.
“Are we done? I want to leave.” Before he even finishes his request to leave, he is out the door and halfway down the hall. I am facing the bookcase instead of the desk because he brushed my chair and spun it off balance. What just happened? What did I say? How did I lose him?
I’m going to meet Lucas for drinks. We don’t live together, but we spend enough time at each other’s places that sometimes I wear his clothes instead of doing my laundry. Dating Lucas is like dating two people, and I can’t take one of them out in public. The scabs on my scalp are itchy and raised, but I still go to him, and I still tolerate this treatment.
Ninety percent of the time we go to the same bar and meet up with the same people. Some are friends; some are just other bar regulars who have become friends; sometimes David from work comes to the bar. But tonight Lucas and I are going somewhere different because he said he doesn’t have the energy to party tonight.
Somewhere different turns out to be Flatiron Lounge on Nineteenth Street. The drinks are really interesting and expensive, and it’s dark and none of the seats are actually comfortable, and the waitresses are hot enough to make me feel insecure, but Lucas looks really nice in candlelight, so I try not to worry that he might have brought me here to break up with me.
“You look great tonight, honey.” Lucas. His voice sounds