The clock read 4:50 and Justin Wright
cursed himself as he watched, from his ground-level office, Park Avenue
fill with pedestrians leaving work early.
Some of them talked vivaciously on
their phones while others smiled as music, a podcast, or possibly an
audiobook played through the pods stuck inside their ears. And then
there were those wearing a pronounced expression of relief, as though
they’d just been released from an eight-hour prison sentence. Others
trudged in exhaustion from the tedium of a daily routine they endured to
pay their bills and barely survive.
Although he felt sympathy for them,
self-induced frustration gnawed at his nerves. The people in the street
were in the enviable position of heading to where they wanted to be.
Justin was not. More than anything, he longed to be on the New Haven
Line train, heading home to Rye so he could sit in the backyard with
Mandy, sipping some iced Johnnie Walker Black while the autumn leaves
flew off the giant maple trees and into their laps.
But his uncompromising benevolence —
Mandy often described it as “you’re what’s called a soft touch,” — had
again gotten the better of him. He agreed to meet a new client, Frank
Devlin, at 5:00 even though Fridays were his one day to leave the office
early.
The man had called two days earlier,
sounding desperate and on the verge – of what, Justin didn’t know.
However, there was something in his gut that made him powerless to say
“no” to this guy. So he extended his hours for a man he’d never met and,
depending on how today’s session went, might never meet again.
As he lowered the delicate muslin
shade halfway down the window, his cell phone rang. He walked to his
desk and saw Mandy’s photo displayed. Blushing, Justin closed his eyes
as he answered. After thirty years this woman could still make his heart
skip a beat.
“Hey, babe,” he said. “Just thinking about you.”
“And me, you. That’s why I’m calling. I
was thinking about those baby blue eyes of yours.” He heard rustling in
the background and then a file drawer slam. At least her workday was over.
“Oh, yeah. I’m sure. My ‘baby blues.’”
“And that soft, thick head of salt and
pepper hair that makes you look so distinguished and professorial.”
Silence. “And those chiseled facial features – with cheekbones I’d die
for, long eyelashes and a dimpled chin that – ”
“Enough!” he said. “If I didn’t have a
five o’clock, I’d let you go on forever. Especially since you’re being
so honest and truthful about my looks.”
Mandy giggled. “I can go on
forever and will continue later, but I’ll stop now because I know you
have a five. I’ll make this quick. First, I wanted to make sure that
sushi was okay for dinner.”
Saliva filled Justin’s mouth as he almost tasted the wasabi and felt its burn permeating his nostrils. “Sushi is always okay for dinner,” he said. “And second?”
“Dylan’s coming for a visit. He’ll probably be here before you!”
Justin rolled his eyes, the flirtatious mood evaporating. “Well, isn’t that nice of him?”
“Justin,” Mandy said a bit sternly. “Please don’t.”
“I’m sorry, Mandy, but you know how I
feel. I work in New York City, our son goes to NYU and I never see him.
Not even for a lunch or dinner. Now that he’s a grad student, is he too
much of an adult to spend time with his father? Is he too busy to invite
us to his apartment for a visit? It hurts my feelings, you know that.
And now he’s coming home and didn’t even ask me if I wanted to ride with
him. I mean…”
“Justin, please. I don’t want you getting upset before your session. We’ll discuss it when you get home. I’ll even have a pre talk with him if you’d like.”
He could visualize the distress on her
face. “No. No. No ‘pre talks.’ I want to be there for everything. I’m
going to get off the phone, take a few deep breaths and wait for my new
client to arrive. I love you.”
“I love you,” she said. “And so
does Dylan. Now good luck and get home as soon as you can, please. Your
spicy tuna rolls, pickled ginger and homemade wasabi will be waiting.”
She knows me too well.
“Can’t wait to see you both – and those rolls, too, of course.”
He heard her laugh right before she hung up and the line went silent.
Sitting in his chair, he picked up the
patient intake forms Frank Devlin had completed online. Other than his
birthdate, which showed he was twenty-five years old, and the statement
that he was working at an accounting firm while studying in a Business
Analytics Master of Science Program, it was obvious the man didn’t want
to provide information – at least in written form. Paranoia?
During their call, Frank did admit
he’d been feeling a bit “off” lately. No details about what “off” meant,
even when Justin asked.
“Not myself,” was all Frank divulged.
“A little weird, you know, off-kilter. I’d rather not get into it over
the phone. I just know I need to see someone, to talk with someone who
can help me find out what’s going on. My anxiety is getting worse every
day.”
During their conversation, Frank also
disclosed his recent panic attacks and how he’d been experiencing some
new obsessive and compulsive tendencies. Yet he didn’t indicate any of
these issues on the intake forms. The only online feedback that provided
marginally more information about the patient were the checkmarks in
the “YES” boxes next to “irritability” and “lack of interest in doing
things.” Justin scratched in his notepad: General Anxiety Disorder? Depression?
He read further down the list. Almost
all “YES” and “NO” checkboxes that might suggest trauma, bipolar or
suicidal tendencies were left blank, as were the spaces for any
additional comments. Although Frank did check “NO” to hearing unusual
sounds, he didn’t answer the questions about familiar surroundings
sometimes appearing strange or experiencing peculiar feelings beneath
the skin, like crawling bugs – both potential symptoms of psychosis.
Just about every checkbox up and down
the forms was empty. And that meant, like the papers sitting on his
desk, Justin would have to begin with a close to blank slate. He’d start
with the man’s anxiety and dive deeper from there. From the minimal
information Frank provided, experience told him there was too much to
tackle in one fifty-minute session.
Justin glanced at the clock in the upper right of his computer screen. 5:00.
Great. If he doesn’t show up and I’ve wasted my time, I’ll be…
The soft ring of the bell from the
waiting area provoked a sense of relief. Not only hadn’t he wasted his
time, but Frank Devlin was extremely punctual. OCD? Justin bit his lip. Slow down, man. People are allowed to be on time without having a condition. Look in the mirror, for God’s sake!
***
Justin offered Frank a seat in one of
the two wingback chairs in the center of the room. Covered with an
off-white damask for aesthetics and comfort, each held a square black
velour pillow – an object most patients cuddled or picked at during
their sessions, just one of the many reasons Justin kept a stash of more
than thirty pillows in the office closet.
He sat in the chair across from Frank,
crossed his legs, clipped his pen to his journal and placed it on his
lap. It took less than three seconds to sense the anxiety of the man who
bounced his legs so incessantly that the heels of his blue suede
Reeboks never touched the tufted wool rug beneath his feet.
His charcoal leather vest with the
Ralph Lauren polo horseman logo contrasted with the exceptionally
wrinkled, untucked and oversized green and red plaid shirt beneath. His
thick chestnut hair, though inherently wavy, was trimmed in a crew cut —
styled with such precision, it suggested strength of character which
seemed in direct opposition to the expression of confusion and fear on
his face. His dark brown eyes darted around the room as though trying to
absorb each and every object so he could remember them at a later time,
like when journaling or maybe even providing an alibi.
Although his eyes never settled on
Justin, he did offer a twitch of a nod every now and again. The young
man could have been more handsome if he tried to be, but it seemed Frank
didn’t care about his appearance. The way he was both disheveled on
some levels and very well-groomed on others intrigued Justin, but also
confused him. It was as though he had two people in one body sitting
across from him. As he tried to pinpoint his initial opinion based on
first impression, only one word came to mind: Nerd.
He was about to start the conversation when Frank stopped moving and stared directly into Justin’s eyes.
“No couch for me to lie down on?” he
asked, a slight tremble in his voice. “And where are all your
certificates? I thought they’d be hanging from floor to ceiling. You
know, diplomas, degrees, affiliations. All I see are creative canvasses
and watercolors of landscapes on latte-colored walls – a color, I
suspect, that’s supposed to induce calm. So seriously, how do I know
you’re legit?”
Latte-colored walls? Justin was
caught off guard, his initial assessment torn apart by the tone and
cryptic insinuations of a man he just met – and a person who sought him
out for help. He pursed his lips and lifted the corners of his mouth.
His obligation as a psychiatrist was to show Frank he had control over
both his emotions and the situation, and that was just what he intended
to do.
“Very observant, Frank.” Justin
pointed to the empty spot beside them. “I used to have a beautiful,
cushy sofa right over there. But to be honest, I felt as if it made me
seem authoritative. I set up the office like it is now so when I
have a conversation with someone like you, for example, we’re basically
on even ground… a level playing field, if you will.”
Frank nodded, continuing to look Justin in the eyes, plainly anticipating the second part of his response.
“As for the diplomas and affiliations,
they’re all in the closet over there.” He nodded toward the storage
space by the office entrance, the one that also held the extra pillows.
“I don’t hang them on the wall because, well, there’s no need for me to
flaunt my expertise and education. People come to see me because someone
referred them or they’ve done their research and think we might be a
good fit.”
He waited for a response. Nothing. “I’m sure you did your research, which is how you found me.”
Frank barely bobbed his head, apparently waiting for more.
“If you’d like, I can get the certificates and diplomas so you can take a look. They’re all framed and ready for showing.”
As Justin started to rise, Frank
leaned back in his chair and exhaled deeply. “No. Don’t worry about it.
You’re right. I did my research and checked your background. I’m sorry. I
just didn’t know what to say or how to start the conversation.”
Justin smiled. “Frank, that’s what I’m
here for. There’s no need to concern yourself with those things. The
credentials you asked about? I got them because my calling has always
been to work with people and help them lead happier, more fulfilling
lives.” He looked down and tapped the journal with his index finger. “I
know it sounds corny, but it’s the truth. Well, it’s my truth.”
Frank placed his right foot over his left knee and fiddled with his sneaker laces. “It’s not corny. I get it.”
“I’m glad,” Justin said, opening up
his journal. “By the way, if it’s okay with you, I’d like to take notes
as we talk. It helps me remember things for future sessions… that is, if
you decide you want to have another session.”
“I will.”
Justin tilted his head. “How can you be so certain?”
“Because I can.”
Frank’s words and the tone he used
made Justin feel uneasy. He was like a human pendulum, swinging from
timid and nervous one minute to strong and self-confident the next.
Justin held himself back from wriggling in his chair.
“Okay, then,” he said. “I have the
forms you filled out online right here, but to be honest, there’s not
much to go on. You left a lot of items blank where you could have
checked yes or no. Any particular reason?”
“I don’t like to put private things in writing. You never know…”
“You never know what?”
“Who might see it or get their hands
on it. Like when I was doing my research on you, I found out a lot about
you online. And your son, too.”
Justin flinched inside. Why would this
guy bring up Michael? It’s hurtful, disrespectful and just plain
heartless. Justin was about to stop the session when Frank started to
speak again.
“Seems like he played a lot of sports in college, hugs lots of girls and is studying to be just like his father.”
Christ almighty. He’s talking about Dylan, not Michael. His muscles relaxed as the tension in his body spilled like rain from the fullest of clouds.
It took Justin a few seconds to recover from his erroneous thoughts before he could respond.
“I’ve never been a fan of social media,” Justin said as calmly as possible, his heart beating hard against his ribcage. What else does he know about me and Dylan… my wife… Michael? He’d
have to check Dylan’s Facebook page on the train ride home to make sure
there was nothing on there that crossed his own personal boundaries. He
didn’t want current, or future patients for that matter, to know about
his private life. “There’s way too much personal information shared with
the world. But we won’t get into that right now. You should know that
the portal I use is extremely secure, but I do understand your
hesitance. Do you mind if I ask you some questions before getting into
what you told me on the phone about your increased anxiety? I’ll warn
you in advance that they’re a little personal. Is that okay?”
Frank nodded.
“Can you tell me about your family? Parents, siblings?”
“Father dead. Don’t speak with mother.
Think she’s shacking up with some guy upstate, like in Schenectady. No
siblings. Just me.”
Justin made some notes in his journal. “Any blood relatives you speak with?”
“Nope. Not one.”
“Do you wish you did?”
“Can’t say one way or the other.”
“Why is that?”
“Can’t miss what you never had, right?”
Can’t disagree with that.
Justin tipped his head to the side and scribbled, no family worth mentioning.
“I hear you, Frank. I’m not happy about it, but I hear you.”
Frank turned toward the window.
Reflected in the glass, Justin could see his eyes moving, focused on
nothing in particular, shifting with any outdoor motion he could find.
He clearly didn’t want to get into Justin’s comment any further.
“Can people see in here?”
“No. These are reflective windows. You can see out, but no one can see in.”
Frank continued looking out the window.
“Would it bother you if someone knew you were here?”
He turned to Justin. “Well, I don’t
want anyone to think I’m crazy or anything. You know, I just want to be
able to calm myself down when I feel all jittery from everything.”
“When you say ‘jittery,’ is that what
you feel when you say you’re having a panic attack? Or do your feelings
and symptoms differ during panic attacks?”
Frank sighed and rubbed his eyes as
though trying to recall his last bout. “I guess I start off jittery and
then things either calm down or blow up.”
“Blow up?”
“Yeah, like I’m all tense and nervous
and then I start to sweat and can’t breathe. I know this sounds crazy,
but sometimes I start pulling at my hair. It helps calm me down a
little. I try taking deep breaths, closing my eyes and doing all the
shit I’ve watched on YouTube. Usually I just end up taking a Xanax and
things slowly get better.”
“Are there any specific times, places
or circumstances that you find might cause these attacks to happen more
often? At school? Work? Home? All the time?”
“No place specific. They can happen anywhere, anytime.”
Justin took a breath and thought
carefully about his next question. The youth across from him was still
very much an enigma. Obviously he was lonely and alone, anxious
and a worrier. But there was also an arrogance at times, like the
challenge over his credentials, an attitude that Justin couldn’t yet fit
with Frank’s character.
“Got it. So you wrote that you have a
job, but are also going for a master’s. Do you like your job? The people
you work with? Your salary?”
Frank smirked. “Worried you won’t get paid, doc?”
“Do I look worried?” Justin smiled. He wasn’t about to get into a war of words.
“My father’s father started a trust
for me when I was born. I could only get hold of it when I turned
eighteen. It’s worth a shitload now and since I’m low man on the totem
pole at work, I use the trust to pay for pretty much everything.” He
looked Justin in the eyes. “And that includes you.”
“When did your father pass away?”
“I was ten.”
“Did your mother take care of you on her own?”
Without answering, Frank again turned toward the window. Justin let it sit for a few more seconds.
“And did your mother take care of you on her own?” he repeated.
Frank placed his thumbnail under his front teeth and began to nibble at it with great intensity.
“She gave me to her brother for a
while,” he eventually said around it. “Said she had to ‘find her own way
first’ or some shit like that before she could take care of me on her
own.”
The mood in the room had changed.
Justin felt it as a dull ache in the back of his head. He wasn’t sure if
Frank sensed it too, but the increased gnawing of his fingernail
suggested he did.
“Did her brother have a wife or family at the time?”
“No, just him.”
“Where is he now?”
Frank shrugged.
“Is he alive?”
Another shrug.
“You said before that you don’t have blood relatives, but this person took you in when…”
“You asked if I have any blood
relatives that I speak with,” Frank interrupted. “I don’t! Can we talk
about something else? You’re supposed to be helping me and I feel like
I’m being interrogated.”
The words hit Justin like a jackhammer: This boy is troubled.
No father figure; a mother who
discarded him at an extremely sensitive time; an uncle who, Justin could
only assume, did something to a young boy that scarred him for life.
And who knew what else he’d been through? He needed more information to
get anywhere with this kid, but he also had to tread extremely lightly.
Everyone who came to see him was distressed in one way or another, but
his intuition was telling him this situation could turn out to be
extreme.
“I promise you, Frank, I am going to
help you. I just need to know a little more about you first. I know
it’ll take time for you to trust me, so you don’t have to talk about
anything you don’t want to. Tell me I’m asking too many questions… tell
me you’re done with a specific topic… tell me to shut up. I promise I
won’t take offense. Got it?”
He nodded. “Yes.”
Justin glanced at the pendulum clock hanging on the wall behind Frank.
“Out of time already?” Frank asked.
“Wow, you don’t miss a thing,” Justin
acknowledged with playful sarcasm. “And no, we’re not out of time
already. Now, can you tell me a little about the anxiety you mentioned
during our call? For instance, is it the same as with your panic
attacks? Does it come from nowhere and just hit you? Are there certain
times of day it’s worse?”
“I always feel it.” Frank paused and picked at the cuticle of his left pinky. “It’s worse after I lose time.”
Justin nodded, feigning indifference
though pleased that Frank broached such a personal topic during their
first session. “Lose time?”
“Yeah. Lose time.”
“Can you tell me what you mean by ‘lose time’?”
Frank shuffled in his chair, clasped
his fingers and clenched his hands. He looked around the room as though
someone might be listening.
“That’s really why I’m here,” he said,
just above a whisper. “I definitely have anxiety. Always have. But
lately, I’ve been losing time. You know, like I start off one place and
end up in another without knowing how I got there.” He looked down to
the rug and closed his eyes. “I know. It sounds like I’m a fucking
lunatic. But I don’t know what to do and you’re my last hope.”
Justin clipped his pen onto the top
edge of his journal. “First of all, Frank, you are not a lunatic. Let’s
get that out on the table right away. There are millions of people who
‘lose time’ for thousands of different reasons. So don’t think you’re so
special.” He waited for a laugh or smile from Frank, but received
nothing other than a glower. “Secondly, I’ve dealt with this kind of
thing before and I’m sure we can work together to figure it out and get
you feeling better, okay?”
Frank nodded, still looking down with clasped hands.
“Since you didn’t complete this on
your forms, I need to ask if you’re currently on any prescription
medication? You mentioned Xanax earlier.”
“Nothing other than the Xanax. My primary doctor sends the script in for me.”
Justin wrote in his journal, Xanax from primary doc. “Have you ever been on any type of psychotropic medication?”
“What’s that?”
“It’s a medication used to treat…” Justin searched for words other than a mental health disorder. Frank’s
earlier comment about not wanting people to think he was crazy
suggested he wouldn’t welcome such a term. “…things like depression,
anxiety, panic attacks, ADHD. You might have heard some of them referred
to as SSRIs or mood stabilizers. Maybe even heard their actual names,
like aripiprazole or clozapine. Do any of those sound familiar?”
Frank shook his head. “My doctor once
gave me Prozac. I used for a few weeks, but it actually did the opposite
of what it was supposed to do. I got so depressed, I thought about
jumping off the GW Bridge. I stopped taking it after a week and a few
days later it felt like a giant cloud lifted.”
Justin noted that down and brushed his
top lip with the back end of his pen. “So, is it okay for you to give
me an example of your ‘lost time’ episodes? Just a little more detail so
I get a better understanding of what you experience?”
“Yes.” Frank opened his hands, studied
his palms and then turned them over and examined his knuckles as though
seeing them for the very first time. “Last Friday I was on the subway
going to Midtown. I was meeting Becky. She’s a girl I’d started talking
to online. It’s a rare occurrence – meeting a girl, not going to Midtown
– so I was kind of nervous.”
“Where were you meeting?”
“Anchor Wine Bar. It’s a
bar-restaurant kind of place on Broadway. Anyway, I chose that place
because I figured if things went well after having a few drinks at the
bar, we could have dinner there.”
“Got it. Okay, so you’re on the subway…”
“Yeah. I’m on the subway and look at
my watch. It’s about 6:30. We’re supposed to meet at 7:00, which gives
me plenty of time to get off the train and walk to the bar. So I’m
sitting in my seat looking around the subway car. The lights, as usual,
are flashing on and off like I’m at a dance club or something. There are
weirdos hanging on the poles, twirling around and laughing like idiots.
Most of the people sitting around me have earbuds in so they don’t even
know what’s going on around them.”
“Do you have earbuds?”
“No. I don’t like music. Can’t ever find anything I want to listen to more than once or twice. So why waste the cash?”
Justin made note of the music comment
and remained expressionless, although that point concerned him. He often
used music therapy as a way to help patients with emotional, cognitive
or social problems. Without an appetite for music, he doubted that mode
of treatment would work in this case.
“How about audiobooks? Would you listen to those?”
“No. Bad enough I have to read my books for school. Why would I want to read anything I don’t have to?”
“So if I were to ask you who your favorite author is, would you have an answer?”
“No.”
“Never interested in reading Harry Potter? Psychological thrillers? Fantasy? Romance? Any genre of book?”
“I already said I don’t like to read. Is there something wrong with that?”
“Not at all. Again, Frank, I’m getting a picture of who you are. You know who you are, I don’t. The more I know, the better and faster I can help you. Okay?”
“Okay.”
“How about TV? Do you subscribe to Netflix or another streaming service?”
“Dr. Wright, between work and my — my,
well, my issues, there aren’t enough hours in a day to handle what I
already have to deal with. You think I have time to binge watch some
moronic crime series or comedy show?”
No entertainment, amusement, diversions, Justin scrawled in his journal.
“Back to the subway. It’s 6:30, you’re
in a dance club with a bunch of morons pole dancing and…” He tried
adding levity to the conversation but by the look on Frank’s face, it
didn’t work.
“That’s when it happened,” Frank said, now staring out the window into the approaching dusk.
“What happened?”
“I don’t know. I can’t remember. That’s the problem!”
The sudden increase in Frank’s
breathing and a flush creeping into his face made Justin move. He could
recognize the beginnings of a panic attack.
“I want you to take a slow, deep
breath and I’ll count to four as you inhale. I then want you to hold it
as I count to four again. Then you’ll exhale slowly as I count to four
one more time. Got it, Frank?”
“Yes,” he said, his voice quivering slightly.
Together they went through the
breathing exercise until Frank’s breath was back to normal and the
redness had vanished from his face. Justin looked at the clock on the
wall – 5:50. Although it was time to end the session and he wanted
nothing more than to be on his way home, he couldn’t stop things now. An
emotional break like this, and any subsequent actions, could tell him
more in a few minutes than a full twenty sessions. Still, the boy had to
agree to push himself further.
“Frank, do you want to continue or would you like to take a break and talk some more next time?”
“Is our time up? Do I have to leave?”
“Our time is up, but you don’t have to leave. I am more than willing to extend our time together tonight… if you are.”
Frank closed his eyes. Justin watched
carefully as the young man’s lips moved, just barely, but enough to look
like he was talking to someone beside him. And then his eyes jolted
open.
“Just a little while longer. I have to tell you what happened so you can figure it out and fix me.”
“Then by all means, continue,” Justin
said softly. He was relieved that Frank wanted to stay but also
frustrated that he’d be home late… again.
“Like I said, I was looking around the subway car, and then I looked out the window at the cement wall flying by and then boom!”
“Boom what?”
“The next thing I remember, I’m
unlocking the door to my apartment. It was like I woke up from a dream. I
had no idea how I got there or where I was coming from. I was all shaky
and shit. When I walked inside and looked at the clock on the wall, it
was eleven thirty. Eleven thirty! Five hours had passed and I don’t
remember a thing!”
Justin remained calm even though the
story he just heard was very unnerving. He had a few ideas as to what
might be the cause of an experience like this. And none of them were
good. However, he needed to learn a lot more before making any sort of
diagnosis.
“So you don’t remember your date… meeting Becky… drinking… eating… the ride home? Nothing?”
“Nothing. Not a fucking thing.”
“Okay, Frank. I want you to think back. I want to be one hundred percent sure you don’t recall anything. And that includes a sound, a smell, a taste in your mouth from food you might’ve eaten. Anything.”
“Did you hear me? I said nothing! Don’t
you think I tried to remember something? I threw my keys onto the
dining room table, fell onto the couch and held my head, screaming,
‘Remember! Remember!’ I kept trying to remember something. The bar, Becky’s face, food, the noise in the restaurant. But nothing happened. Then I started to wonder if I even went to the restaurant. Did I even meet Becky? And if I didn’t, where the hell did I go? I gotta tell you, I was really losing my shit.”
“And I gather that’s why you called me?”
Frank washed his hands over his face,
then leaned his elbows on his knees. “That wasn’t the worst of it.” He
forced a laugh and fell back in his chair. “While I was lying on the
couch, I felt my phone vibrate in my pocket. When I took it out, there
was a text from Becky.”
He stopped talking, and redness crept back into his face. Justin took a deep breath of his own and exhaled slowly.
“And what did it say, Frank?”
Frank reached into his pocket and took
out his phone. He pressed a few buttons, scrolled a bit, looked at
Justin and then back down to the phone’s display.
“It says, I had a great time tonight. Thank you so much for dinner. I hope we do it again very soon. You’re a very special person – ” He swallowed, then read the final word of the text: “Nathan.”
Rob Kaufman novels are known for
having characters with whom people can relate, while at the same time,
bringing them on a journey from which most people would crumble.
