Valerie

III: Dr. Bertrand

AUTHOR'S NOTE: I'm not exactly happy with this chapter, but i thought I'd post it anyway. It think it started off well, but I wasn't so pleased with the ending passages. Still, I've been through several times, and I don't think I'll manage to get it much better.

My newest patient sits opposite me on the standard hospital bed. Her face is animated, but it's not my conversation which stimulates her. I talk to her, I ask her questions. Occasionally she responds, but to her I clearly seem vacuous and disinteresting compared to other voices she is hearing. I'm no more than a vapid, droning voice, an endless stream of vague, nonsensical babble, beside the intellectual clarity of those who speak to her.

In spite of this, I still feel that it has been a successful session. I have obtained a greater knowledge of her condition and its severity. It'll be a while longer before she cares to divulge in what are the voices which she hears, but I am hopeful that her friends and family may be able to extract that information. It's always easier with patients who have close family. They are less suspicious, more willing to co-operate. Most of the time anyway.

It can depend, obviously; nothing is certain, not in this field of work.  I am just hoping that  it will be the usual case with Valerie. 

Of course, it's going to be hard for those closest to her. They think she can be cured. That I'll snap my fingers, hand her some medication, and she'll be right as rain. It doesn't work that way. Very, very rarely does a patient make a full recovery. If I'm treating her for schizophrenia then I can provide medication and therapy which will help to control the hallucinations or "voices". But if I am to provide anti-depressants too, then it will be more difficult. There's no telling what the side effects will be, they can differ from person to person, especially if she is on several different drugs at once. 

Her friend is waiting for me outside, sitting with her back to the wall. She looks up as I come out. Her face is tear-stained. I pretend not to notice and offer to take her to my office. She nods once in agreement, and allows me to lead her there. I don't want to be the one who breaks it to her. But I know that I'm probably the best person. I could tell her mum, or dad, or another friend and get them to tell her. But she might not believe them. It's easier if hears it from me. If has questions, I can answer them. 

I sit her down, shut the door, and ask her if she wants a drink. She refuses any refreshment, so I settle myself in the chair across from her. She's nibbling at her lower lip with her front teeth. The soft, tender flesh is already red and inflamed. It must hurt, but this doesn't seem to stop her. It's my job to notice these little things, these tiny details. Observational skills are crucial in my line of work. 

I take a deep breath. I've had to break news like this to hundreds of people in the course of my work, but I don't think I'll ever get used to it. Everyone reacts in different ways. Some sob hysterically. Some cry silently. Some get up and walk out the room without a word. Some get angry. Some furious. I even had one man punch me. The key isn't in how they react. It's how I act with them. Stay calm. Explain the issue clearly. Make them feel as though there is someone in control, someone who they can rely on. And that person has to be me.

Of course, it's slightly with adolescents than adults. I tend to get the parents to help me explain it to much younger children, or leave it to them altogether, but I normally tell teens myself. It's harder with them, because they're more hormonal, more emotional. Less in control of their emotions. But I'm a teenager's psychiatrist. I know how to deal with them.

Emma's lip is almost bleeding.

"Emma - sorry - Em, I just wanted to talk to you, concerning Valerie." God, I'm making a mess of this. "You have been informed of her condition, haven't you?" Concentrate, Joanne. You sound too formal. She won't trust if you sound like this. "Basically..." I sigh. Better just tell her. "Em, she won't get better."

There. I've done it. I've told her.

Emma swallows. Her eyes dart around the room, looking at anything but me. They linger on the ceiling for a while. Then they flash to the floor. Finally they settle on the opposite wall. The irises are a very dark shade of brown, with flecks of gold, and long, almost translucent lashes.

"My mum said that she didn't think you could cure her." Her tone is flat, emotionless. A statement of what happened: no more, no less. "I thought she was lying so that I wouldn't be too upset if that was the case. I thought that there was a chance though. I thought that you not curing her would only be the worse case scenario." She buries her face in her hands. Her fingernails are painted emerald green, but the polish is chipped. They were clearly painted a long time ago. Either that or she bites her nails. Valerie wears the same colour, but her nails are long and the nail polish neat and glossy. It's curious. From what I've seen, Valerie doesn't seem to put much effort into her appearance otherwise.

I wonder what Valerie's said to her.

I wonder if she understands it.

I wonder if she wants to understand it.

***

Lance brings be a cup of tea in my office. He's a trainee psychiatrist, whom I am giving work experience to.

"How's you new patient?" he asks. I think I must have mentioned Valerie this morning.

I don't really know how to respond. If I'm honest, I don't really want to talk about it, or anything else. I just want to review my files in peace.

"As good as one can be when freshly diagnosed with schizophrenia and bipolar, and is hearing voices they don't recognise in their head every other minute can be."  I say, sardonically.

The smile on his face slips.

Oh well done, Joanne. Snap at one who's just being friendly.

"I mean, she's doing a lot better than... before. I made some progress anyway. Thank you." I force myself to smile at him. He grins back nervously, and then reseats himself at his small, corner desk. Selecting a file from the many in is rucksack, he begins to scan the seemingly endless lines of close-typed lettering, and begins to tap the sole of his foot against the linoleum floor as he reads.

I want him to stop. It's annoying me. By I don't want to snap at him again. He doesn't deserve it.

I really ought to make it up to him.  

"Lance..."

He looks up from the document he's immersed in.

"Yeah?"

"How would you like to meet her? The new patient, I mean. Valerie. We could make her your sort of special case. You could work with her."

His face lights up.

"Could I? D'you think I'm ready for it?'

I nod. Digging into my bag, I pull out her file and hand it to him.

"Acquaint yourself with this." I tell him. It's just the basic details it contains really - her birthdate, her parents, her height, her weight, her general diagnosis - but one should always familiarise themselves with a patient before meeting them.

It's growing dark outside. I check my watch. Quarter past seven. What time was it I said I'd be home? Seven thirty? 

I'll have missed the train by now. It leaves at ten past. So I might as well stay and get some more work done. There several unread emails in my inbox, as well as a few I've read, but haven't replied to. I take a thoughtful sip of tea. Mark will probably be home by now. I pull my phone  out of my bag to text him, then replace it again. There's no need. He'll work out where I am.

Logging onto my desktop, I open up my account and begin composing the reply to the first email.