Blood Loss

24

Dr Leonard Lone was in his early fifties, sitting in an office that appeared to have been designed in the decade leading up to his birth.

Next client: brittle housewife with closeted husband.

Dr Lone sat cross-legged in a chair beside his desk. He was dressed in a mauve shirt, a pale green round-necked sweater, ghostly blue slim-fit jeans, and beige sandals with thick gray woolen socks. He pointed Ren toward a seat two feet in front of his.

Men should not cross their legs.

Ren pictured a website of psychiatrists, like a shopping website, where the images sped across the screen, and you could stop briefly and click on an image to get a closer look. She would have scrolled past the priestly Dr Leonard Lone. He smacked of downplaying your sexual exploits.

Ren wondered whether psychiatrists could tell how quickly she summed them up. Or if they cared. It averaged two minutes, but she always stayed for the full session to have her mind changed. She wondered if psychiatrists also noticed when they didn’t click, and did they hope she wouldn’t come back.

‘Hello, Agent Bryce …’ he said, reaching out to shake her hand.

‘Ren is fine,’ she said.

‘And is Ren fine?’ said Dr Lone.

Oh. Dear.

‘I’m … OK,’ said Ren. And not into you enough to feel like telling you otherwise. She slid her chair back a fraction.

‘So,’ said Dr Lone. ‘I’ve gone through your file, and … well, you’re obviously an FBI Agent. That must be quite a challenge.’

‘It can be,’ said Ren. But you’ll never understand exactly how.

Dr Lone waited. ‘So, tell me how is everything at work right now?’

Why are people always interested in my work? Ask me about relationships. I’ll get a gold star: one man. No pressure. No drama. No crime or drug history.

‘You’re smiling,’ said Dr Lone. ‘That must be a good sign.’

Of me entertaining myself. ‘Work is fine, actually,’ said Ren. And I need to get back to it. And I’ve already sent you out of the first round of Shrink Idol. So this pricey hour is a total waste. And I am sick of psychiatrists. And I already found the perfect psychiatrist. And now she’s dead. And it was my fault. And …

Dr Lone tilted his head. ‘How are you coping with the loss of your last psychiatrist?’

La. La. La. La. La. ‘As well as can be expected,’ said Ren. I can not believe I said that.

‘Have you had any grief counseling?’ said Dr Lone.

‘No,’ said Ren. That would be sensible and terrifying.

‘Maybe that’s something you could look at,’ said Dr Lone. ‘Along with your visits to me.’

Internal eyebrow raise.

‘So … what do you hope to gain from coming to see me?’ said Dr Lone.

Zero? A pain in my ass? Weight? ‘Em …’

‘Do you feel that you’re here under duress?’ said Dr Lone.

Ren paused. Be nice. ‘I understand why I’ve been sent to you,’ said Ren. ‘To a degree … actually, I don’t really. Because I’ve been fine.’

Dr Lone nodded. ‘It’s a condition of your employment that you are under a psychiatrist’s care, isn’t that right?’

‘Yes,’ said Ren. Sadly.

‘Well, maybe that’s all this is …’ said Dr Lone. ‘A formality. To keep your boss happy.’

Oh, you don’t believe that.

‘What are your concerns about coming here?’ said Dr Lone.

Let me think: I’m not sure I like you. Or you’re right for me. Or there’s any need for me to be here. ‘I don’t want to be put on medication.’ You said that last part out loud.

‘We’ve only just met,’ said Dr Lone. ‘I won’t be handing you a prescription today.’

‘And … any other day?’ said Ren.

‘I don’t necessarily believe in medication,’ said Dr Lone.

What? But I want you to. Even though I don’t want to take any. I just want to know it’s there. And that you believe there’s a quick fix. If, at some point, I need one. Which I don’t right now.

‘Why do you think I would medicate you?’ said Dr Lone. ‘If everything is fine.’

Damn you.

‘Everything’s great,’ said Ren. ‘Really good. I’m getting a lot done.’

Dr Lone nodded. ‘And are you getting much sleep?’

No. I don’t need it, but that’s the wrong answer. ‘Yes.’

‘How many hours are you getting each night?’ said Dr Lone.

None to one. ‘Seven.’

‘And what about eating?’ said Dr Lone.

And the correct answer is: ‘I’m eating well … regularly.’

‘And your caffeine intake?’ said Dr Lone.

Beautifully, wonderfully excessive. ‘Maybe a little more than usual, but we’re on an intense case.’

‘So everything is fine,’ said Dr Lone.

It actually is, people! ‘Absolutely.’

‘Yet, you think I might have put you on medication …’

‘Just … psychiatrists like to medicate.’

‘Not all of them,’ said Dr Lone.

‘So, how else would you correct a chemical imbalance … if you felt there was one?’ said Ren.

‘Assuming a chemical imbalance is what lies behind mental illness …’ said Dr Lone.

‘But-’

‘No study has ever proven that depression, for example, is caused by a chemical imbalance …’ said Dr Lone.

‘But, serotonin,’ said Ren. ‘Dopamine …’

Dr Lone nodded. ‘No study has shown that depression is caused by a lack of dopamine or serotonin.’

‘But … I’ve spent my whole life thinking I had a chemical imbalance,’ said Ren.

‘I would venture,’ said Dr Lone, ‘that you spent a great part of your life not thinking there was anything wrong with you and being oblivious to the field of psychopharmacology … until a psychiatrist diagnosed you in your mid-twenties. And then when you read up on bipolar disorder, you were assaulted with very clever advertising campaigns that reinforced the chemical imbalance theory.’

‘But I’ve read studies … in medical journals …’ said Ren.

‘You may have read that antidepressants raise dopamine and serotonin levels, and yes, that’s true — they do,’ said Lone. ‘But perhaps what you may not have read is that low levels of dopamine and serotonin have never been shown to cause depression.’

What?!

He nodded. ‘One could argue that fevers are caused by too little aspirin …’

‘That’s insane,’ said Ren.

‘It’s easy for someone to feel that they haven’t been treated if they don’t leave a doctor’s office without a prescription. Desperate people want help,’ said Dr Lone. ‘Or at least hope. They like to think there’s a quick fix. And I think differently.’

‘What do you think?’

‘I think medication can work for some people, absolutely. But I think it’s over-prescribed. I think antidepressants can work in the short term to get people back on their feet, but that diet, exercise and talking are the key. The right diet and exercise can work as well, and, in some cases, better than antidepressants. It’s just very difficult to persuade people. Either way, I certainly wouldn’t be prescribing medication after the first consult. All my sessions are typically one-hour long, by the way, not just the first session. They are that length so that we have time to talk.’

Oh. Dear. God. No. How is work even paying for that? Because I’m not worth it. Gary is the one who should be here. He’s lost his mind.

‘For today, Ren, I’d like you to go through some of your history …’

Noo. ‘Normal childhood, happy home, trained with the FBI, went undercover, came out from under the cover, psychiatrist died, here I am.’ She glanced up at the clock behind him.

He noticed. He slid his chair back a little from the desk. ‘I’m afraid that our time has run out.’

Oh. ‘OK,’ said Ren. But … no, it hasn’t. And aren’t you even going to mention the skimming over of the background?

‘Shall I see you again next week, Ren?’ said Dr Lone. ‘What would you think about that?’

No. Way.

‘Two weeks?’ said Dr Lone. He smiled.

‘Yes, that would be great.’ Who said that?

‘Two weeks it is,’ said Dr Lone. ‘Can you please call Betty to confirm? She’s my right-hand woman.’

‘Yes,’ said Ren. ‘And … will it be for a whole hour?’

Dr Lone nodded. ‘Your boss has sanctioned that.’

Ren jogged down the stairs and out to her Jeep. She pulled out her phone when she got there. She texted Ben Rader.

Am in twn. Hav 2 go 2 my place 2 pck up clothes … 5 mins of ur time?

Ben texted right back:

U bet.

Who needs therapy?