Bunny doesn’t recognize the nurse who escorts her beyond the Group Therapy rooms to the conference room, which is at the far, far end of the hallway. There, Dr. Fitzgerald is seated at an oval table made of the same laminated particleboard as the desk in her office, but these chairs have armrests and padded seat cushions, like chairs in a restaurant; and like a basket of bread, there is a box of tissues on the table. Sitting next to her is a bald man, bald except for the monk-like fringe of hair semi-circled around the back of his head. It is impressively nuanced, the way Dr. Fitzgerald introduces the man as Dr. Grossman, the head of psychiatric medicine, if to say, yes, he is the head of psychiatric medicine, but he’s not really up to the job, as if she, Dr. Fitzgerald, should be the head of psychiatric medicine. But she is not the head of psychiatric medicine, and she has to defer to the chain of command, no matter how unjust.
Dr. Grossman speaks first. “I understand that you’re not comfortable with the advised drug protocol,” he says. “Is that right?”
“Bunny is concerned about the side effects,” Dr. Fitzgerald butts in. “Please explain to her that whatever the side effects are, when compared with . . .” Dr. Fitzgerald doesn’t finish her sentence because Dr. Grossman cuts her off with a look that says, Have you considered urology?
As if he and Bunny are now co-conspirators, as if he were deliberately shutting out his colleague, Dr. Grossman leans in and says, “You’re right. The side effects are not insignificant. Some people can tolerate them. Others can’t.”
Bunny decides she doesn’t hate Dr. Grossman.
Dr. Fitzgerald interjects, “We could try lithium carbonate.” Does she think that Bunny does not know perfectly well that lithium carbonate is plain old lithium?
“How about we table drug protocol, at least for now,” Dr. Grossman suggests. “Let’s take a look at the other options.”
Option one is to do nothing. Over time, the episode could potentially subside on its own. Potentially means that it might subside on its own, but it might not. “And,” Dr. Grossman points out, “you do run the risk of the depression worsening.”
Cognitive Behavior Therapy, which is the preferred form of Group Therapy (MDD) here is a goal-oriented form of therapy that seeks to modify distorted cognitions and change destructive patterns of behavior, is option two.
As Bunny hears it, Cognitive Behavior Therapy could be effective if she were a moron.
“That’s it?” Bunny asks. “There’s nothing else?”
With his fingertips pressed together—here is the church, here is the steeple—Dr. Grossman asks what does she know about electroconvulsive therapy. E-C-T. Because she doesn’t respond, the doctor goes on to explain what it is and how it works, debunking the myths, relating the new methods and greater understanding, and chronicling the efficacy of electroconvulsive therapy; all the while, Bunny is turning the letters E-C-T around and around in her head. E-C-T; T-E-C; E-T-C; C-E-T.
“The anecdotal evidence for recovery is very strong.” Dr. Grossman tells Bunny the truth as he knows it. “However,” he admits, “there is no way to achieve a scientific standard of proof.”
Bunny can’t find a word to be made from these letters. T-E-C. T-C-E.
Despair can’t be monitored like blood pressure or measured in centimeters like a tumor.