Freedom of Sketch

In Session

Half an hour and one short nap later, the desk phone rings and Jenny picks up the receiver. "Circle Valley Hospital, this is Jenny. How may I help you?" She pauses and frowns. "Dr. Fox? I can barely hear you - I'm going to put you on speaker and see if that helps."

Dr. Fox's voice crackles from the phone. "Hey Jenny? Can you hear me any better?"

"Yep."

"Listen, the traffic is a nightmare out here. Three-car pileup, complete standstill." The wail of a siren slices through the background. Dr. Fox raises his voice over the sound of rain drumming on the roof of his car. "They've got both sides of I-95 closed off so they can medevac one of the drivers."

"Oh wow," says Jenny.

"Needless to say, I'm going to be quite late. I'd appreciate it if you could let my patients know."

Jenny scribbles something on a sticky note. "Absolutely. Be careful out there."

"Thanks." The line scrambles, then cuts off.

***

Dr. Fox squeezes past the double doors before they snap closed. His soaking hair is plastered flat against his scalp. Rivulets of rainwater trickle down the planes of his face and drip from his chin like tears. "Sorry I'm late," he says, removing his fogged glasses. "It's nasty out there. Monsoon season or something."

"Is it still pouring?" Jenny asks, handing the psychiatrist a tissue so he can clean his glasses.

He sniffs. "Like you wouldn't believe." He folds up a dripping black umbrella and hands it over to Jenny to stash behind the nurse's desk. "Took them forever to clear the wreck."

Jenny wipes droplets of water from the counter with her sweatshirt sleeve. "That's awful," she murmurs. "So I got all your charts together. They're on your desk."

"Thank you! You're amazing."

Jenny chuckles, tucking a strand of hair behind her ear. "Oh, I know."

Dr. Fox turns to me. "Shiloh, I apologize for being so late. We'll still have our session, but we might have to cut into your free time."

I cross my arms. "I could just have a half session," I offer hopefully.

Dr. Fox brushes beads of water from his blazer and attempts to smooth his wrinkled tie. "Wishful thinking." His glasses keep slipping down the wet bridge of his nose. I follow him to his office, keeping a fair distance away because of the small lakes of water trailing behind him on the linoleum floor. His damp shoe treads shriek with every step.

Dr. Fox pulls a set of brass keys from his blazer pocket and unlocks his office door. I follow him in and stand awkwardly behind an overstuffed leather armchair while he slides his sodden briefcase under his desk. "Sorry it's so cold in here," he says with a shiver. "I called the maintenance guys last week and they still haven't been in to fix the heat."

I shrug, watching the psychiatrist open a small drawer. "Let's just get this over with," I say.

He withdraws the extra-large bottle of Tylenol. It rattles as he pours a couple of bright red pills into his palm. "Migraine's on its way," he explains, grimacing. He dry swallows the tablets, then pulls my bulky chart into his lap.

I flop into an armchair and draw my knees to my chest. "Sorry to hear that," I say, hoping I don't sound sarcastic, since I usually am. "Was it the traffic jam?"

"Probably. Anyway, this is about you. Let's discuss you."

"I'd bet money that discussing me would give you an even worse migraine."

"Got any money to bet?"

Me: "Invisible currency."

The psychiatrist flashes me a genuine smile. "You're out of luck, Miss Shiloh."

"Ugh." I withdraw my arms into my sleeves to keep warm. "What are we supposed to talk about? I haven't caused any trouble lately. This whole 'best behavior' thing is getting kind of boring."

He raises a cautious eyebrow.

"Just kidding."

He turns back to his notes and despite him trying to be discreet, I can see the formation of little stickpeople tribes scribbled in the margins. "Let's discuss what you did today."

I hesitate, watching as his stickpeople turn into vicious civilizations, one margin warring with the other. He thinks I don't notice, or that I can't see from where I'm sitting. "I saw Daniel."

"When did he visit?"

"About a half hour before you got here."

"Yikes."

"What yikes?"

The stickpeople start throwing little ballpoint spears. "Poor guy got stuck in that rain."

"Oh yeah, but he left early, so he'll make the movies."

"That's where he's going?" Write, draw, scribble, write.

I scratch my nose. "Yeah, to meet up with friends. Lucky bastard."

Dr. Fox grins despite himself. "And how does it make you feel, knowing you can't go hang out with your friends?"

"Oh, rub it in."

The doctor raises his hands. "Not trying to at all," he says, tone slightly defensive. "I just want to know how you feel. As usual."

"Cheated. Left out. Lonely. It's been months since I've been out with friends."

Dr. Fox nods somberly. "But if you'd followed your Day Pass rules, you could be out with your friends at the movies. With adult supervision, of course."

Me: "And what fun would that be?"

"It would be the responsible thing to do."

"Blechhh."

"How mature," the doctor says with a laugh.

The rest of the meeting is more pleasant than usual. We talk about the possibility of earning another Day Pass, the annoyance of traffic, and friends (although I cut our session short when Dr. Fox suggests that Daniel and I are becoming a couple. I'm not ready to discuss that yet). Some of his stickpeople start dying, lying in the corners of my file with the little ballpoint spears in their chests.

--

Clinical Notes:

Pt seen today at 1630 hrs; session cut short due to pt's dinner hour. We discussed her outside friendships, though she did not want to discuss any possible romantic relationships. Her mood was appropriate to the content of the interview and during several moments she was bright, engaged, and humorous. I believe the pt is benefiting from visitation and socialization with peers, though she does not seem eager to continue her medication, let alone this hospitalization. The tension within her family is also hindering her recovery. This writer is encouraging pt and pt's mother to participate in family-oriented therapy, which will be conducted with pt's therapist, Meredith Loughner. Will continue to encourage pt to participate in her treatment. Pt will continue to work with Ms. Loughner for psychotherapy and with myself for daily check-ins and periodic medication adjustments.