“But why is he imagining another mother?”
“Often such an imaginative fantasy life is caused by events at home.”
“So you say, but we’ve been over that, there’s nothing.”
“No exceptional stress?”
She let out a small, hoarse laugh. Nothing you aren’t causing, Doctor. “Nothing that predates this situation.” The fact was, she was running through her savings. She’d already cashed in her IRA and spent the small inheritance from her mother she’d put aside for Noah’s college education. (Her goal now was simply to get him safely to kindergarten.) She’d had to cancel four meetings with prospective clients this month alone because she couldn’t take Noah to meetings and site visits, and she didn’t have much time anyway, what with all the doctors. She had no work on the horizon, and no way to pay the bills without work, and no answers.
She’d been taking him to other doctors for months: neurologists, psychologists, neuropsychologists. Noah and Janie both hated it, the long subway rides, the endless wait in crowded offices, Noah paging listlessly through Horton Hatches an Egg while she did the same with a year-old copy of Time. The doctors talked to him, they did tests on his brain, they tested his lungs again (yes, he has asthma; yes, it’s mild), then they sent him out to the next room while they talked to her, and in the end she’d been both relieved and frustrated to find they had found nothing and had nothing to offer, except the promise of more tests. And all along she’d been waiting for the sessions with Dr. Remson, who was supposed to be the best.
“I’ve been to three specialists, two psychologists now, and you. And nobody can tell me anything at all. Nobody will give me even the possibility of a diagnosis.”
“The child is four. That’s young for an accurate mental health diagnosis.”
“Doctor, I can’t even bathe my son.” The last time she’d tried, a week before, he had worked himself into such a state that he’d triggered an asthma attack.
It had been his first attack in eighteen months. As she’d held the nebulizer to his face, his ragged breaths amplifying in her ears like the sound of failure, she’d made a commitment to herself: she’d stop waiting for him to get better. She’d do whatever it took to help him now.
“Behavior therapy might help—”
“He’s done that. It hasn’t worked. Nothing’s worked. Doctor—please. You’ve done this for a long time. Haven’t you ever seen a case like Noah’s?”
“Well.” Dr. Remson leaned back, putting his hands on his big corduroy knees. “Perhaps there was one.”
“There was a similar case?” Janie held her breath. She couldn’t look him in the eyes, focusing instead on the toe of his shoe. Dr. Remson followed her gaze, his brows knit together, the two of them watching his black foot tap tapping against the deep crimson squares on the Persian rug.
“It was during my residency at Bellevue, many years ago. There was a child there who spoke often of something traumatic that had happened to him during a war. He drew violent pictures of bayoneting. Rape.”
She shuddered. She could see the drawings as if they were right in front of her, the blood drawn in red crayon, the stick figure with its wide-open mouth.
“He was from a small town in New Jersey, a loving, intact family to all reports. They swore up and down he had never seen any images like the ones he drew. It was very startling. He was only five.”
A case like Noah’s. The puzzle pieces of Noah finally fitting together, forming a picture. She felt relief, and a chill of foreboding.
“And what was his diagnosis?”
The psychiatrist winced. “He was a bit older than Noah. And still far too young for the diagnosis.”
“The diagnosis?”
“Childhood-onset schizophrenia.” He pulled his sweater across his belly, as if his words had caused a drop in temperature. “It’s rare, of course, in a child this young.”
“Schizophrenia?” The word hung high up in the newly cold air for a moment, sparkling like a jagged icicle, before understanding fell. “You think Noah has schizophrenia.”
“He’s too young, as I said, for a proper diagnosis. But we have to consider it. We can’t rule it out.” His eyes watched her steadily beneath the heavy lids. “We’ll know more with time.”
She stared down at the carpet. The crimson pattern was dense, unfathomable, squares within squares within squares.