Sometimes when I can’t sleep, I’ll lie awake at 2 A.M. on the living room floor, pretending I’m glued to the rug. The room is upside down and the floor is really the ceiling and I imagine that after, oh, say a week or so, my body becomes unglued and flops down. Sort of like counting sheep, except you’re counting the minutes until the skin pulls off your back and you land smack face-first onto the ceiling lamp.
I imagine my whole face is coming off in the shower. With all the soap and suds, just draining through my fingers. I imagine falling to my knees, grabbing at the shampoo, and screaming in agony.
“Some people sing in the shower. I always scream. What does that mean?” This is what comes to mind when Cynthia, my patient, describes her shower terrors. Her weird fright about hygiene. This is what I imagine. My face coming off, my flesh melting like ice cream and running down my palms, pouring down my wrists and dripping out between the creases in my elbow.
“My mother suffered from depression. I think I was left alone a lot, because I feel ignored…” I haven’t slept in two days.
Cynthia starts crying. “Maybe I’m just not meant to be loved. My father, back when he was alive, my father he would always say that …”
Absolutes. Patients with personality disorders always speak in absolutes. They don’t even realize they’re doing it. I like to match personality faults with the drugs I treat them with. For instance, Cynthia has anxiety, so I give her Ativan. Over the years, I’ve devised a method of treating patients by listening to the first three or four sentences that come out of their mouths. Car salesmen use the same method, so don’t judge me. There are keywords I’ll pick up on. Tone and body language are obvious factors as well, but most of the time patients will want to come in and just talk, and I don’t sleep well so listening helps as a co-pilot.
“…when I was molested as a child…” Single women in their forties are huge sympathy diggers. “…feeling worthless for years…” My ankles feel swollen. I bought these new hiking socks from an outdoor outlet just outside of town last week because I thought they’d give me more foot support. All I feel now are squeezed ankles, which makes me wonder what kind of doctors they have over there in – wherever these shitty socks are made – approving these products. Nobody I know or have met endorses these things.
Cynthia grabs a tissue off the windowsill and dabs her eyes, mouth wide open, her fat shiny tongue flicking against the roof. “This morning I was afraid I would swallow my toothbrush, so I didn’t brush my teeth.” You know what they should invent? Sublingual benzodiazepine breath mints. I know it probably isn’t ethical but everybody is so damn medicated these days and there’s a pill for everything, so I wonder when the jump between medicine and aesthetic is going to happen.
“…just the feeling of water on my skin reminds me…”
It’s almost lunch and if I want to get home in time to take these ankle squeezers off and get to the deli to see if the girl is working today, I really need to tell Cynthia to shut the hell up and get out.
I smile and nod. “You have such a brave spirit, Cynthia. I’m always so inspired by your honesty and awareness.” Those terrible brown eyes of hers, those ugly orbs shoot up and I’m repulsed by the eye contact. But I maintain. I always maintain. “If you were crazy you wouldn’t be in here right now cognitively describing your ailments and coherently explaining to me why you think you’re crazy.” I force a carefree chuckle. “But just for your own peace of mind I’ll up your Lorazepam to two milligrams a day, okay?”
She smiles and opens her mouth. I effectively cut her off by checking my watch, which is dead and eternally rests at 4:18. I smile and push a slight blush to the surface as if I’m embarrassed to be ending our time together. “I’m so sorry, it’s been such a hectic day.” I make a silly face and she laughs and acts like her day has been crazy too, which it probably has been because she’s fucking insane. I think deep down I hate her.
“Thank you so much, it feels so good to know that I can…” A silly face can pretty much mean the difference between flying first class to Fuji or going coach to Hawaii. I hate Hawaii. Humor puts people at ease, and when your patients are nervous, they’ll come back to you for that brief levity. This makes my paycheck bigger. They also think it puts me on a person-to-person level with them. It doesn’t and it never will because the second they leave my office, I don’t care what they do. And don’t cross your arms and judge me either. For Christ’s sake, I’m not Jesus, I’m just a doctor. I’m only human.
Karina Sims is a 27-year-old writer from British Columbia, Canada. Her interests include candlelit dinners, long walks to the fridge, and dreaming of one day becoming a tyrant. She lives in a small apartment with two cats and eats all her meals out of cans.
Lead image: “Modern Medicine” (via Flickr user NVinacco)