“Actually,” Kate told her, “psychiatrists aren’t supposed to fix people.”
Maddie seemed surprised. “They’re not?”
“No. We don’t have that kind of power. See?” She held up her hands. “No magic wands. No fairy dust. I can’t cast any spells. I can’t fix you all by myself, Maddie. But I can help you fix yourself. And I know for a fact that it works, because I’ve seen it with my own eyes.”
The girl smiled hopefully.
“Can I ask you something?” Kate said. “Do you ever see things other people don’t? Any visions? Angels? Perhaps something scary?”
Maddie shook her head.
“What about voices? Do you hear voices in your head?”
“Only one,” she admitted.
“One voice? What does it say?” Kate asked.
“Bad stuff.”
“Like what?”
“It tells me I’m stupid and dumb and smelly. Stuff like that.”
“Ah.” Kate nodded. “And what does it sound like?”
“Like… um…”
“Is it masculine? Feminine?”
Maddie shrugged.
“Boy? Girl? Soft? Childlike?”
She shook her head mutely.
“More like a grown-up?”
Maddie nodded.
“Grown-up? Okay. But you don’t know if it’s male or female?”
No response.
“Does it sound like a character on TV?” Kate persisted. “Or maybe a person you know in real life? A teacher or relative? Your dad perhaps?”
Maddie said nothing. There were goosebumps on her legs.
Kate sensed the child knew exactly who the voice sounded like, but wasn’t ready to reveal it just yet. “Does the voice ever tell you to hurt yourself?”
“I’m cold.”
“Maddie…?”
“It’s cold in here.”
Kate decided not to press it. Sometimes you had to pick your battles. New patients had a tendency to scare easily, and if you pushed them too hard in the beginning, you risked losing them forever.
She draped a hospital blanket over Maddie’s legs. “We’ll talk about this some other time. You can get dressed now. The nurses’ aide will be right in. Are you hungry?”
Maddie perked up. “My stomach’s been growling,” she said excitedly, putting her hands over her belly. “Did you hear it?”
Kate picked up the patient chart and walked to the door. “The nurses’ aide will take you to the cafeteria. They have pizza and everything.” She turned and left, scribbling notes, but once she got outside the exam room, she realized her mistake. She’d let her patient down. Their one connection— their growling stomachs—hadn’t merited any reaction from her. By not sharing Maddie’s inside joke, Kate had responded like a typical doctor. Worse, she’d responded like her father. And that cut to the bone.
At the same time, you couldn’t get too close to your patients, or they might become confused. Roles merged. Lines blurred. How close was too close? It was up to Kate to maintain a healthy doctor–patient relationship and define the boundaries. But she could just hear the gears in Maddie’s busy brain ticking away. Why didn’t you take me to the cafeteria, Dr. Wolfe? Why are you abandoning me just when I was starting to like you? Kate was supposed to draw the most deeply personal information out of this child, and yet she wasn’t supposed to get too personal. It was a balancing act.
The on-duty aide, Claire, was busy texting her boyfriend in the break room. Kate filled her in on Maddie’s condition and asked her to escort their new patient down to the cafeteria. Then she went upstairs to her third-floor office and called James.
“Guess what? I’ve got a new patient,” she told him. “A cutter. She hears voices. Well, one voice at least. An adult-sounding voice of indeterminate gender. Her mother dropped her off this morning and left her here to fend for herself…”
“So… right back on the horse, eh?” he said thickly.
She could tell he wasn’t happy about it. “She asked for me,” Kate explained. “We met earlier this morning. Turns out she doesn’t like male psychiatrists. They smell funny, among other things. But hey, it’s a good thing, right? It’ll keep me out of trouble.”
“I guess,” he muttered.
She grew defensive. “I can’t just sit around twiddling my thumbs.”
“No one’s suggesting any thumb-twiddling.”
“Besides, she needs me.”
“They all need us, Kate. Don’t get sucked into that trap. Anyway, I’ve got my hands full right now—the plumber’s here.”
“Does he look like he knows what he’s doing?”
“More than me. He’s almost done. Then I’m coming to the hospital.”
“For the team meeting?”
“Yeah. More Agatha drama. We’ll talk about it later. Do me a favor, though. Come home as soon as you get this new patient oriented. Okay? Promise me.”
“I promise.”
“Love you.”
“Later, ’gator.”
*
Kate passed the time waiting for Mrs. Ward by catching up on her paperwork and taking back her regular appointments— they’d been distributed among the other child psychiatrists in the unit, but now that her vacation had been postponed, Kate decided to resume her regular duties. Her overworked colleagues were more than happy to oblige.
Around three in the afternoon, her phone rang. It was Mrs. Ward.
“I’m in the parking lot,” she said in her dry voice.
Kate glanced at her watch. “I thought we said four?”
“Well, I’m here, aren’t I?” Mrs. Ward snapped.
Kate sighed inwardly. “My office is on the third floor. Just follow the signs to a pedestrian passageway and—”
“No. You don’t understand. I’m not coming in.”
“Excuse me?”
“I’m not coming into the hospital.”
Kate stood up from her desk and walked over to her window. Across the well-maintained courtyard was the hospital’s multi-story parking garage. Six glass-walled pedestrian walkways provided safe passage into the west wing from all levels of the garage. “Mrs. Ward, please. We need to discuss Maddie’s case…”
The voice rose a pitch. “I’m not coming in!”
Okay. Nosocomephobia—fear of hospitals. Religious obsession. Yikes. Deep breath. “Where are you now?” Kate asked.
“Second level. North side. Next to a stairwell.”
“I’m on my way.”
She found Maddie’s mother sitting behind the wheel of an idling blue Toyota Camry plastered with Six Flags bumper stickers. The car faced out of the parking space and the motor was running, as if she were primed for a quick getaway. Mrs. Ward wore pink Gap sweats and a confused look. She sat gripping the steering wheel and she seemed oddly familiar to Kate.
“Hello?” Kate tapped on the glass. “Mrs. Ward?”
The window ferried down. The thirty-something woman with short dark hair wore large sunglasses that hid her eyes. She had a gaunt face with a nose that looked as if it had been broken at some point in the past. Kate noticed a few small green bruises on her neck. There was a dryness about her—dry skin, dry hair—that complimented the unusual scratchiness of her voice. She had the crouched, tenuous demeanor of a battered woman, as if she’d taken a pounding all her life.
“Where’s your husband?” Kate asked.
“He works long-haul. He just got back from a three-week stint. He’s out cold on the sofa. I didn’t want to wake him.”
“Not for something as important as this?”
“Not for anything.”
“Why? Would he get angry?”
The woman stared at her. “Look. I came here like you said. It’s just me. End of story.”
“Okay, fine. We can talk in my office,” Kate said firmly. “Follow me, please.”
“No,” Mrs. Ward said, just as firmly. She handed Kate a heavy, rumpled shopping bag through the rolled-down window. “Here. Take this.”
Kate hesitated. “What is it?”
“Clothes. For Maddie. Please.” When Kate didn’t take the bag, Mrs. Ward let it drop to the ground; it landed in a grease puddle.
Kate scooped it up. “You can’t just leave your daughter here, Mrs. Ward. We need to discuss her situation and make an evaluation. And then if we decide to admit her, you’ll need to fill out some paperwork—”