Obsession

CHAPTER 5

Rick said, “No, nothing like that, current or past. In fact, we’re having a nice quiet spell, shyster-wise. And when the vultures swoop, they avoid the nurses. No financial incentive.”

“Did Patty moonlight?”

“Not since she’s worked for me. When she wanted extra money, she double-shifted.”

“Where did she work before she came to Cedars?”

“Kaiser Sunset, but only for a year. Scratch the malpractice angle, Alex.”

“Okay, thanks.”

“How’s Tanya doing?”

“As well as can be expected.”

“Good. Gotta run. Thanks for seeing her.”

Straight to the point. Surgical. Just like his original referral.

“I know you’re not doing much therapy, Alex, but this sounds more like a consultation.”

“Who’s the consultee?”

“Best nurse I ever worked with, a woman named Patty Bigelow. A few years ago her sister dumped a kid on her, then left for parts unknown. Sister died in a motorcycle accident and Patty adopted the girl, who’s now seven. She’s got some parenting questions. Can you see her?”

“Sure.”

“I appreciate it…”

“Anything else I should know?”

“About what?” he said.

“Patty, the girl.”

“I’ve only seen the girl in passing. Cute little thing. Patty’s super-organized. Maybe a little too much for a kid.”

“A perfectionist.”

“You could say that. She fits in great in my E.R. It was hard for her to admit having a problem. I don’t know why she chose me to tell.”

“She trusts you.”

“Could be that…I’ll give her your number, gotta run.”

An hour later, Patty Bigelow had called. “Hi, Doctor. I won’t gab on the phone because you sell your time and I’m no mooch. When’s your next opening?”

“I could see you today at six.”

“Nope,” she said, “on shift until seven and Tanya’s out of day care at eight, so I’m in for the evening. Tomorrow I’m off.”

“How about ten a.m.?”

“Great, thanks. Should I bring Tanya?”

“No, let’s talk first.”

“I was hoping you’d say that. What’s your fee?”

I told her, said I’d be cutting it in half.

“That’s seriously below average,” she said. “Dr. Silverman assures me you’re not.”

We debated for a while. I prevailed.

Patty said, “I don’t usually give in, Dr. Delaware. You might be just the right person for Tanya.”

The next morning, at nine forty-two, I was out on the landing when a blue minivan pulled up in front of the house. The engine switched off but the vehicle stayed in place.

A woman with short brown hair sat behind the wheel, balancing a checkbook. As I approached she put it away.

“Ms. Bigelow?”

A hand shot out the window. Compact, nails cut square. “Patty. I’m early, didn’t want to bother you.”

“No bother, c’mon in.”

She got out of the car, holding a black briefcase. “Tanya’s medical records. Do you have a Xerox machine?”

“I do, but let’s talk first.”

“Whatever you say.” She climbed the stairs just ahead of me. I put her at forty or so. Short and dark-eyed and round-faced, wearing a navy turtleneck over easy-fit jeans and spotless white tennies. The clothes made no attempt to streamline a broad, blocky body. Brown hair streaked with gray was cut in an anti-style as frivolous as a lug wrench. No makeup but good skin, ruddy with a faint underglow and no age lines. She smelled of shampoo.

When we reached the stairs to the front landing, she said, “Real pretty out here.”

“It is.”

No more conversation as we headed to the office. Midway there, she paused to straighten a picture with a fingertip. Hanging back a half step, as if to avoid notice. I noticed anyway and she grinned. “Sorry.”

“Hey,” I said, “I’ll take all the help I can get.”

“Be careful what you ask for, Doctor.”

She scanned my diplomas and perched on the edge of a chair. “I see another couple more crooked ones.”

“Earthquake country,” I said. “The ground’s always shifting.”

“You’ve got that right, we’re living in a jelly jar. Ever try museum wax? Little dab on the bottom center of the frame and if you need to get it off the wall you can peel it without leaving a mark.”

“Thanks for the tip.”

Positioning the briefcase so that its front end was flush with a chair leg, she said, “May I?” and got up before I could answer. When the prints were straight, she returned to her chair and folded her hands in her lap. A peachy blush coined the upper rims of her cheeks. High cheekbones, the only bits of definition in the wide, smooth face. “Sorry, again, but it really drives me nuts. Should I talk about Tanya or me?”

“How about both?”

“Any preference as to order?”

“Tell it the way you want,” I said.

“Okay. In a really small nutshell here’s my story, so you’ll understand Tanya. My sister and I grew up on a ranch outside of Galisteo, New Mexico. Both our folks were drunks. My mother was the ranch cook, good in the kitchen but she didn’t give a hoot about mothering. My father was the foreman and when he got plastered, he came into our bedroom and did ugly stuff to me and my sister-I don’t need to go into details, do I?”

“Not unless you want to.”

“I don’t want to. It affected my sister and me differently. She turned wild and chased men and drank and took every drug she could get her hands on. She’s gone, now, motorcycle crash.” Short, deep breath. “I became a Goody Two-shoes. The two of us weren’t very close. As it turned out, I have no interest in men. None. Or women, in case you’re curious.”

“I’m always curious, but that hadn’t occurred to me.”

“No?” she said. “Some folks think I’m pretty butch.”

I said nothing.

“Also, seeing as how Richard-Dr. Silverman-was the one who referred me and how people jump to conclusions, I could understand you thinking I was gay.”

“I work hard at not jumping to conclusions.”

“It wouldn’t bother me if I was gay, but I’m not. I have no interest in anybody’s anything below the waist. If you need a label, how about asexual? That make me crazy in your book?”

“Nope.”

Another partial smile. “You’re probably just saying that because you want to develop whatchamacallit rapport.”

I said, “You’re not interested in sex. That’s your prerogative. So far I’ve heard nothing crazy.”

“Society thinks it’s weird.”

“Then we won’t let Society into the office.”

She smiled. “Moving on: My sister-Lydia, she went by Liddie-couldn’t keep her pants on. Maybe God played tricks, huh? Two girls dividing up one sex drive?”

“Hers on Monday, yours on Tuesday but she got greedy?”

She laughed. “Sense of humor’s important in your business.”

“Your business, too.”

“You know much about my job?”

“Dr. Silverman told me you’re the best nurse he’s ever worked with.”

“The man exaggerates,” she said, but her eyes sparkled. “Okay, maybe just a slight exaggeration, ’cause off the bat I can’t think of anyone better. Last night we had a guy, a gardener, mangled both hands in a lawn mower. Too much empathy and you find yourself depressed all the time…speaking of bad stuff, plenty happened to my sister, but nothing she didn’t earn. She died on back of a Harley on the way to a big bike meet in South Dakota. No helmet, same for the genius driving. He took a turn wrong, they went flying off the road.”

“Sorry to hear about that.”

She squinted. “I cried some but-and this is going to sound cold-the way Liddie lived it was a miracle it didn’t happen sooner. Anyway, the gist of all this is to explain how I came to have Tanya. She’s Liddie’s biologically but one day when she was three, Liddie decided she didn’t want her anymore and dumped her on my doorstep. Literally, middle of the night, I hear the doorbell, go out, find Tanya clutching a stuffed toy, some killer whale souvenir she got in Alaska. Liddie’s parked in a hotwheels at the curb and when I go to talk to her, the car peels out. That was four years ago and I never heard from her again, didn’t even get the death notice until a year after the accident because Liddie was carrying fake I.D., it took the highway cops awhile to figure out who she was.”

“How did Tanya react?”

“She cried for a few days, then she stopped. She’d ask about Liddie from time to time but nothing chronic. My answer was always Mommy loved her, had left her with me ’cause I could take better care of her. I bought a book on explaining death to kids, used the parts that made sense and discarded the parts that didn’t. Overall, Tanya seemed to accept it pretty well. Asked the right questions. Then she went about her business. I kept telling her Mommy loved her, would always love her. After maybe the gazillionth time I said it, Tanya looks up at me and says, ‘You’re my mommy. You love me.’ Next day I started the adoption process.” Blinking and looking away. “This at all helpful, so far?”

“Perfect,” I said.

“Maybe you’ll find out something I missed but she really seemed to deal with it okay. She’s a smart kid, her teacher has her at a half year ahead of the class. Got a grown-up way about her, which makes sense, given the years she spent traipsing around with Liddie. My influence, too, maybe. I’m no kid person, don’t have a clue about ’em. So I treat her like she understands everything.”

“Sounds like that’s working.”

“So how come I’m here, huh?” She looked down at her shoes, placed them together. Moved them a foot apart. “You probably noticed I’m a little strange in the neatness department. Need to have everything just so, nothing out of place, no surprises. Maybe because of the things my father did to me, but who cares why, the point is that’s how I am and I like it. Keeps life organized and when you’re busy, believe me, that’s a big help.”

“Making things predictable.”

“Exactly. Like the way I hang my clothes. Everything’s grouped by color, style, sleeve length. Blouses in one section, then jeans, then uniforms, et cetera. Why waste time looking in the morning? A couple of times, when I was working a shift that had me getting up when it was still dark, there were power outages. I’m talking a pitch-black house. I could get dressed, no problem, because I knew exactly where everything was hanging.”

“It works for you.”

“Sure does,” she said. “But now I’m thinking maybe I should’ve kept some of that to myself, not revealed it to Tanya.”

“She’s doing the same things?”

“She’s always been neat for a kid, which is fine by me. We clean house together, have fun doing it. But lately, it’s more than that. She’s got these little routines, won’t go to sleep until she checks under her bed, first it was five times, then ten, now it’s twenty-five, maybe even more. Top of that, she’s got to straighten her drapes and kiss them, goes to the bathroom five times in a row, washes her hands until the soap’s gone. I went in there once and she was polishing the spigots.”

“How long has this been going on?”

“It started right around when she turned five.”

“Two years ago.”

“Give or take. But it wasn’t a big deal until recently.”

“Any recent changes?”

“We moved to a new place-got a sublease in a house in Hancock Park. No problems, there. Tanya’s fine except for the routines.”

“Do the routines always begin before bedtime?”

“That’s the peak period,” she said, “but it’s moved into other times and it’s starting to affect her schoolwork. Not in terms of neglecting her obligations-just the opposite. She’ll tear up her work and redo it, over and over, unless I make her stop. Lately, she started getting real picky about her school lunch. If the sandwich isn’t cut exactly on the right bias, she wants to make another one.”

Reaching down, she touched the briefcase. “Want to see any of her records?”

“Has she had any unusual illnesses or injuries?”

“Nope.”

“Then I’ll read the records later. Do you have information about her birth?”

“Nothing. I had to run titers on her to make sure she’d been vaccinated. She had, I’ll grant Liddie that.” She leaned forward. “You need to understand, Doctor, the only time I met Tanya before Liddie dropped her off was once, when she was two. She and Liddie stayed with me a couple of weeks before heading up to Juneau, Alaska. Like I said, I’m no kid person. But I ended up liking her. Sweet, quiet, didn’t get underfoot. She’s still that way, I couldn’t ask for a better daughter. It’s just these new habits are making me wonder about my approach. I did some reading on OCD in kids and they say it could be genetic, in the brain, serotonin uptake, they’re trying various meds as treatment.”

“Nowadays, most everything is attributed to neurotransmitters.”

“You don’t recommend meds on scientific grounds? Or you don’t like them because Ph.D.’s can’t use them?”

“Meds have their place and if you’re interested in that route, I’d be happy to refer you to a good child psychiatrist. I’ve found childhood OCD to respond well to nondrug treatments.”

“Such as?”

“Cognitive behavior therapy, other anxiety-reduction techniques. Sometimes just finding out what’s making the child tense and remedying it is enough.”

“Tanya doesn’t seem nervous, Doc. Just intensely focused.”

“OCD’s rooted in anxiety. Her habits are doing their job so the tension’s masked, but you’re describing a steadily expanding pattern.”

She thought about that. “Guess so…listen, no offense meant by that remark about Ph.D.’s.”

“None taken,” I said. “You’re an informed consumer who wants the best for her child.”

“I’m a mother who feels bad because her kid seems to be losing control. And I blame myself because I need for everything to be predictable and everyone to be happy. And that’s about as realistic as world peace.”

“I’m a people-pleaser, too, Ms. Bigelow. If I wasn’t, I could’ve been a lawyer and billed more per hour.”

She laughed. “Now that I fixed your pictures, you do seem like a pretty organized guy. So you think you can help Tanya just by talking?”

“My approach would be to develop whatchamacallit rapport, see if there’s anything on her mind that you’re unaware of, find out if she’s interested in changing, and help her change.”

“What if she doesn’t want to change?”

“My experience has been that kids aren’t happy being bound by all those routines. They just don’t see a way out. Have you talked to her about any of this?”

“I started to,” she said. “Last week or so, when she got into the curtain-kissing. I guess I lost my patience and told her to stop being silly. She gave me a look that cut me right here.” Touching her left breast. “Like I’d wounded her. I immediately felt like a truckful of manure and had to leave the room to do some breathing. When I gathered the gumption to go back in there and apologize, the lights were off and she was in bed. But when I leaned down to kiss her, her body was all tight and she was gripping the covers-with the fingernails, you know? I told myself whoa, Patty, you’re screwing the kid up, time for professional advice. I talked to Richard-Dr. Silverman-and first thing out of his mouth is your name. He said you’re the best. After meeting you, I’m feeling good. You don’t judge, you listen. And those degrees ain’t too shabby, either. So when can you see Tanya?”

“I’ve got an opening in a couple of days, but if it’s urgent, I’ll make time tonight.”

“Naw,” she said. “I think I can handle a couple of days. Got any advice beyond lay off and don’t say anything stupid?”

“Explain to Tanya that you’re bringing her to a doctor who doesn’t give shots and won’t hurt her in any way. Use the word ‘psychologist’ and tell her I help kids who are nervous or worried by talking to them, drawings, playing games. Tell her she won’t be forced to do anything she doesn’t want to.”

She opened the briefcase, found a legal pad, scrawled notes. “I think I’ve got all that…sounds fine except for the games. Tanya doesn’t like games, can’t even get her to use a deck of cards.”

“What does she like?”

“Drawing’s okay, she’s pretty good at that. Also, she does cutouts-paper dolls, she can handle a scissors like a pro. Maybe she’ll be a surgeon.”

“Like Rick.”

“That would be okay with me. So what time in a couple of days?”

We set up the appointment. She said, “Fine, thanks much,” and paid me in cash. Smiling. “You’re sure you only want half?”

I smiled back, photocopied Tanya’s medical records, and returned the originals to her. Five minutes to go, but she said, “We covered everything,” and got up.

Then: “Just talking helps, even if it’s genetic?”

I said, “There may be a genetic component. Most tendencies are a combination of nature and nurture. But tendencies aren’t programmed like blood types.”

“People can change.”

“If they didn’t, I’d be out of business.”

That evening at five, she called me through my service. “Doc, if an appointment tonight’s still an option, I’ll take you up on it. Tanya started in on her homework, tore it up, redid it, then she got all hysterical. Crying that she could never do anything right. Saying I was ashamed of her, she was a bad girl, like Liddie. Nothing like that ever came out of my mouth but maybe I somehow communicated…Right now she’s calm, but not a calm I like. Way too quiet, generally she chatters away. I haven’t told her I made an appointment with you. If you say tonight’s okay, I’ll explain it to her in the car.”

“C’mon over,” I said.

“You’re a saint.”

She showed up an hour later, with a little blond girl in hand. In her other hand was a small white jar.

“Museum wax,” she said. “Long as I was coming here. This is Tanya Bigelow, my beautiful, smart daughter. Tanya, meet Dr. Delaware. He’s going to help you.”