CHAPTER 8

Form Avoidance, Yoga, and Andy Warhol

Sweat seeped across my palms, and my left eye twitched as I reached for the door knob. My hand encased the chill of the brass. Enter or turn around and go home? I twisted my wrist, opened the door, and crossed the threshold into the office.

The waiting room didn't correspond with the mental image I had conjured over the weekend. The beige-textured wallpaper, the medium brown wall-to-wall carpet, the impressionist reproductions symmetrically placed on the wall whispered, "Generic." But the room screamed, "Relax."

Per Linda's instruction, I arrived twenty minutes early, which seemed like an excessive amount of time to write in a group number, an ID number, and scrawl a signature on the bottom line. Someone had arranged the four empty chairs and two small side tables to resemble a living room. The contrived comfort failed to make me any happier about being inside a shrink's office.

I picked the chair closest to the door--a typical semi-comfortable waiting-room chair, sat down, and opened my bag. My wallet had sunk to the bottom of my big-enough-to-carry-a-newborn-baby shoulder bag.

After fishing it out, I flipped it open to the top slot in the section designed to hold credit cards. As my fingers reached for the insurance card, my gaze wandered to the other side--a picture stuffed into a plastic sleeve--me and Sam, the night he proposed. I closed the wallet, shoved it back into my bag, and dropped it on the floor, next to my feet. Then I expelled the air which was stuck in the bottom of my lungs.

"Maggie?"

On the other side of the room, a woman, leaning through a hole cut out of the wall, beckoned me by curling and straightening her index finger. I assumed it was Linda. When I reached the small countertop, she handed me a clipboard and a pen. "Please, fill out each form, front and back, and do not skip any questions. When you're finished, return it to me."

I handed her my insurance card. Her smile reminded me of the one that I get from my dentist's assistant, friendly, professional and detached.

I signed the HIPPA privacy policy without even skimming it. The second form did not ask for insurance information. My stomach fell when I read the first question. "Do you receive messages, intended for only you, from billboards or your television?"

The same question Linda asked during our phone interview. Maybe it's a trick question, and I'm supposed to get messages from my TV.

Answer to Question #1: Yes, my TV sends me messages all the time. It asks me to buy foreclosed mansions for under a thousand dollars and Boeing airplanes. Why does Boeing advertise on prime-time TV? Who is the target market? 'Mr. Joe America, parked on your recliner, put down the beer, lace up those Nikes, and run to the nearest Jets R Us.' Someone should explain Boeing's advertising philosophy to me.

"Maggie, our policy states the co-pay must be paid with cash or a check. We don't take cards," Linda chirped, through the cut-out wall.

Damn, why didn't she tell me this over the phone? My checkbook was back in the apartment, stuffed into its regular spot, the top drawer of my desk. Again, I pulled my wallet from my bag and jammed my fingers into another one of the credit card slots. Stuffed at the bottom was a fifty-dollar bill--designated for emergency only. This appointment qualified as an emergency. I handed the bill to Linda.

"Is this all you have?"

"Yes."

She crinkled her rather attractive face. "You're the first patient of the day. I'm not sure if I have enough money to make change. Let me check the safe while you meet with the doctor."

"No problem," I said, before walking back to my chair. As I sat down, I decided to scratch out my answer to the TV question and just write, No.

Question #2: Are you or have you ever engaged in reckless activities, such as over-spending, gambling, or sexually irresponsible acts?

I'm not answering that one. My pen skipped to the next question, but my mind floated away...

***

They shuffled onto the stage, dressed in scruffy clothing and the required bored expressions worn by rock bands, fashion models, and other types of cool people. Nick pulled me forward as the band started to play.

"Come on," he said, locking his fingers around mine and pulling me closer to the stage.

The pounding of the drums reverberated off the floor, moving through my feet and up my legs. My brain buzzed and my body gyrated, exhilarated by the music, the lights, but most of all, being with Nick. Blood rushed to my face when I noticed him laughing. Not a bad laugh, but a "This-is-great!" laugh.

With my shoulder, I pushed him away and ran toward the stage, forcing my way through the electrified energy of the over-excited fans. Although winded and sweaty, I climbed the steps to the stage and continued spinning and dancing, until an urge overwhelmed my common sense. Throwing my arms into a T-position, I plunged from the stage into the crowd.

When my feet hit the ground, I felt a hand grasp my upper arm. Nick spun me until our eyes locked. Then his lips merged with mine. Every inch of my body pressed against the front of his. Heart racing and body sweating, at that moment, I knew exactly where Nick was sleeping.

***

Refusing to allow myself to think about Nick, I forced my focus back to the clipboard and squirmed a bit before writing the word, Yes, in very small letters. In bigger letters, I added the qualification, BUT I CAN EXPLAIN.

My chest constricted. This appointment was a monstrous mistake. What should I say to him? Hi, Doc. I need new drugs. My therapist suspects I'm Bipolar 2. I would prefer to remain chronically depressed, but two weeks ago, she witnessed the end of an episode. Now she thinks I need drugs more than therapy.

Shuddering and refocusing, I decided to avoid the intrusive top questions and give the bottom ones a try. Question #21: Do you sometimes cut, carve, pick, burn or try to suffocate yourself, even though you don't want to kill yourself?

Answer to Question #21: --a definite No.

My brain begged to avoid the prying questions on the paper, but ingrained into my psyche was the elementary school creed: answer all the questions before putting your pencil on the desk and turning the paper over. I continued answering the questions until I reached Question #14: "When you are not using drugs, do you hear or see things that other people do not hear or see?"

What the hell kind of question was that? When I'm not doing drugs--why would they assume I do hallucinogenic drugs? No, I wrote in bold letters. Then in smaller print, I scribbled, I do not use drugs, with two underlines.

"Have you completed the forms yet, Maggie?" Linda asked, again using her chirpy office-assistant voice.

"Sorry, not yet."

A copy of Psychology Today sat on top of a stack of magazines on the table next to me. A blue-eyed woman with high cheekbones gazed at me from the cover. She wore a facial expression that said, "I'm in my happy place." I recognized the look because my yoga instructor wore the same expression every Monday evening, as she tried to stretch and bend us into serenity. The poor woman believed the brain came equipped with an on and off button, which could be activated by sitting cross-legged, on the floor and breathing through your nose. One night, after too many sun salutations, I almost screamed, "It is not a television set. The human brain cannot be 'quieted,' by lowering a volume button or shut off under any circumstance." After a few deep inhalations, I decided against being cruel and kept my mouth shut.

Linda poked her head out of the hole, which reminded me of the carnival game, Whack a Mole--a mole pops out of the box, and the kid bangs it on the head with a mallet.

"Maggie, let me know when the intake forms are completed, because the insurance form must also be signed."

"Okay, Linda, I'm writing as fast as I can," I said, mumbling "Nag," under my breath.

Question 9: Have you ever received or are you currently in therapy?

Great, an easy question, I wrote, YES, in big letters.

My eyes strayed from the questions and back to the Psychology Today. I opened it to the table of contents. Not one article in the whole magazine about Bipolar 2. I closed the magazine and stared at the still smiling yoga lady on the cover.

Pangs of guilt for not answering Linda's questions fast enough, made me put the magazine back on the table.

Intake Question #7: Have there been times when you feel very creative with lots of ideas and plans?

The questions no longer annoyed me. They'd reached the pissing me off stage. I looked up from the clipboard and noticed the small seascape, hanging on the far wall. All wrong--toss out the impressionist landscapes and hang a few Jackson Pollack and Andy Warhol prints and paint the walls exciting colors like Caribbean Sea Blue or Smiley Face Yellow. A room like that would generate a few laughs from the nuts like me.

While weaving the pen between my fingers, it occurred to me that designing office space for shrinks could be a design school major. Lawyers specialized in immigration, real estate or divorce. Doctors trained to be surgeons, gynecologists, or internists--I never did understand that title. Except for skin, wasn't it all internal? Maybe interior designers specialized in hotel lobbies, rich suburban houses, or psychologists' offices. I made a mental note to ask Steph this weekend.

Well, at least the chairs were comfortable, I thought, leaning back into a cozy napping position, until Linda's phone rang and jolted my mind back to the form. I re-read Question #7. Do recall times when you felt very creative with lots of ideas and plans?

I set the pen and clipboard down on the table next to me, raised my arms, and squeezed them against my head. Too much remembering was not a good thing...

***

"Maggie, if we put in a section on British criminal law versus Pennsylvania criminal law, we will never finish this project on time," Tom cautioned. "Besides, I'm not sure if it's appropriate for this assignment."

"We can finish it, and of course, it's relevant. Professor Stiles didn't say it, but I know he wants us to make these types of comparisons. I'll do all the research on the British system over the weekend. I'll type a synopsis and include a working outline. You already know the Pennsylvania system, so your part is essentially finished. Monday afternoon, we can fill in the blanks of the outline. I'll go back to my apartment, type out the draft, e-mail it to you for corrections, and the final draft will be ready to turn in on Tuesday morning. Come on, Tom, we can do it."

"Listen, Maggie, I know you really love this international stuff, but there is no way you can complete the research by Tuesday. Forget any hope of finishing the project on time. Besides, if I recall correctly, you are still reading the last assignment that Professor Fullerton dumped on us, and it's due on Monday."

"Forget about Dr. Fullerton. Please, Tom, I really want to do this. Stiles will be blown away. I'll stay up all weekend if I have to. Just say yes, please?

Tom rolled his eyes.

"I'll take that as a yes. Thank you," I said, and hugged him.

"It better be finished on time, Maggie. I can't believe I'm letting you talk me into this. It's academic suicide."

***

Sickened by the memory, I picked up the pen and wrote, "Yes," beside Question #7. Thank goodness it didn't ask me to elaborate, because it was embarrassing to admit that many of my plans and ideas crashed around me. Nor did I want to mention all the innocent people, who fell victim to my whims.

Rolling my head around to loosen my neck muscles and, while stretching it to the left, I read the small sign affixed to the wall beside the door outlining, Dr. Graham's cancellation policy. Maybe I'll extend my hand to him and say, "Hi, I'm Maggie and there's an evil woman who wants me dead living inside my head."

Stretching to the right, I thought, Who knows? Maybe all of his patients hear mean voices in their heads. No, there can't be other people living like this.

As I tried to decide between completing Question #3, or reading a magazine article about Attention Deficit Disorder in adults, a deep male voice startled me.

"Hello, Maggie?" I turned to face the voice, and he reached forward to shake my hand. "I'm Dr. Graham. Please, follow me."

We walked past Linda's desk. Her expression said, "You didn't finish your paperwork."

I looked at her with lowered eyes, a bowed head, and then shrugged my shoulders in an apologetic fashion. She threw me a somewhat appeased smirk. I followed the doctor into a corner office.

Just like his office, he didn't fit my mental image either. My Dr. Graham appeared professorial, complete with suede patches on his jacket elbows. The real doctor resembled a hippy, left over from the sixties. His gray hair, braided into a ponytail, hung about four inches below his collar. A stack of bracelets--turquoise, rawhide, beads, and silver--jingled when he moved his arm and clashed with the traditional wire framed glasses perched at the very tip of his nose. He had a warm face and a nice smile. If I was about thirty-years older, I would describe him as kind of sexy.

"Please, sit down anywhere you feel comfortable," he said, gesturing to a chair and a sofa. His voice matched his office. "I see from your intake questionnaire that you are here because your therapist, Karen, suggested it."

"Yes," I replied.

"Maggie, the goal of this first session is for me to learn about you. I'll gather information about your symptoms, dig a little into your family history and your medical history. It will take multiple sessions for me to gather all the information necessary to make a diagnosis."

"It's not going to take years, is it?" I asked.

"No, it will not be a year. Let's begin. Maggie, your intake form states that you've been on Zoloft for about two and a half years, but I don't see the name of another psychiatrist anywhere on the form. Did I miss something?"

"No, you didn't miss anything. You're my first psychiatrist."

"If you don't have a psychiatrist, how do you get your Zoloft?" he questioned.

"It's easy, when I run out of refills, I tell my regular doctor to call a new prescription into my pharmacy. The first doctor prescribed fifty milligrams, but now I take one hundred milligrams. I told my last doctor to up the dosage."

"You told the doctor the dosage you wanted, and he gave it to you without question?" Dr. Graham asked, with a concerned look on his face.

"Yes, sort of. He asked me a few questions before agreeing to increase the milligrams."

"Where did you get the first prescription, Maggie?" He asked.

Forgetting the first one was impossible...

***

"Yes, this is extremely urgent. I need to see the doctor today. I can't stop crying and shaking. I have an important final this afternoon, and I can't control myself."

"Maybe you should go to the hospital if it's that bad," replied to the obviously dumb woman on the other end of the line.

"I just told you, I have an important test today that I cannot miss. I am not going to a hospital. I am depressed, seriously depressed. Please give me an appointment," I begged.

"I can squeeze you in at 11:15."

"Thank you so much. I'll be there."

I arrived twenty minutes early and sat in the waiting room, watching the other patients go in and out until finally, a chubby lady dressed in scrubs carrying a clipboard called "Maggie Hovis, next."

The nurse escorted me to the examination room. "In here." She gestured toward a door. Before we were even inside, she started her instructions. "Strip down to bra and underwear. You will find a disposable gown in the top drawer. Someone will be in soon."

"Wait, please, I'm not sick. I'm depressed. Can't I keep my clothes on?"

But, she was already out of the room and either didn't hear me or chose to ignore me. Please, let me keep my clothes on. Totally out of my control, my body caved and the horrible thoughts screamed in my head. With no strength left to fight, I gave in. Inconsolable pain racked my body. By the time the doctor walked into the room, I was lying on the exam table facing the wall, shaking and sobbing. I felt a hand on my back and heard the words, "What's wrong?"

"I hate myself."

***

"Maggie, how did you originally get the Zoloft?" Dr. Graham repeated.

"I got my first Zoloft prescription from a regular doctor at the student health center. She gave me a one-year prescription and suggested I make an appointment with the school psychiatrist. I ignored the suggestion. After that prescription ran out, I went to another doctor for a physical, and he gave me a six-month refill. Getting it has been very easy."

"Maggie, diagnosing a mental health issue is like putting information in a funnel. Questions must be answered before a diagnosis can be made. That doctor should have sent you directly to a psychiatric clinic. I will not prescribe anything until I know you. But for now, while we figure things out, please continue to take your Zoloft."

For a few minutes, he completely focused on the clipboard that rested on his lap, as his hand swiftly wrote notes.

As he wrote, I tried to appear occupied and thoughtful. So I let my eyes scan the pictures on the walls. A repeat of the collection hanging in the waiting room--a painted equivalent of a yoga class. Thomas Kincaid prints must have been recommended by the Psych Office Police, because the pictures hung on Karen's walls were the exact same style. Maybe I should mention my discomfort with his artistic choices.

Finally, looking up from the notepad, he asked, "Has anyone in your family ever been diagnosed with a mental problem?"

"My grandma spent some time in a local hospital psych ward."

"Do you know why?" he asked.

Shaking my head, I said, "Not really, I think she hallucinated."

"Anyone else?"

Inhaling and feeling my stomach tighten, I replied, 'My great aunt Ella went into a mental hospital at sixteen and never came home."

"Do you know why she was institutionalized?'

"No, I just learned about her existence a few days ago. No one mentions her name. She's the family secret, and she died when I was a child. According to my other great aunt, Ella went into the hospital after her mother died."

"Sometimes a major life issue can trigger a depressive episode," he explained. "Maggie, have you ever been hospitalized for mental illness?"

"No. But, once during high school, I had a really bad episode. My dad threatened to admit me."

"Why didn't he take you?" he asked, his brows a bit tight.

For a moment, I sat staring through my mind's eye, at a scene from long ago...

***

"Maggie, open the damn door, or I'll take it off the hinges," my dad yelled through the bathroom door.

"No"

"Maggie, I just want to talk to you. Please, let me in."

"I don't want to talk. I want to be dead," I sobbed.

"What are you doing in there? You're not opening the medicine cabinet, are you? Maggie Louise, stay out of the medicine cabinet."

"What do you care? You hate me. I'm ugly and worthless. Admit it, say it--I embarrass you. You don't want me to be your daughter. When I'm dead, you'll never have to be ashamed again. You can't stand having an ugly, stupid daughter. You hate me. I know you do."

"Maggie, if you don't open this door and talk to me, I'll break it down and drive you to the hospital. You don't want to be put on the floor where Grandma goes, do you?"

My chest heaved as I clenched the pill bottle. My dad continued with his tirade through the door.

"Maggie, I know you have the pills. Put them down now."

***

For the very first time, I looked Dr. Graham straight in the eye. In a clear voice, I said, "I suppose he was afraid I would end up like Ella."

"That would make sense from his point of view," Dr. Graham replied. Before I could add anything, he continued. "Maggie, you keep using the word 'episode.' What do you mean by an episode?"

I told him the same thing I had told Karen, concluding with, "I also need to tell you, I can only describe this experience from the perspective of the third person. I'm not schizophrenic, but during these episodes, I have no control over my own thoughts, therefore, I refuse to own them. So I attribute the bad thoughts to an evil woman residing in my head. I hate her, and she hates me. We both want each other dead. She wants me to be dead, physically and figuratively. I want to kill her.

"I don't actually hear 'voices,' but the thoughts become loud, controlling, and, at times, paralyzing. The real me doesn't want to die. That's why I have to make the distinction."

For a few moments, he scribbled notes onto his yellow legal pad. I focused on a dark stain on the carpet under the window--a dark smudge made by a spilled plant or muddy shoes.

Dr. Graham cleared his throat before he switched the line of questioning to my medical history. After twenty minutes, he announced, "Maggie, I'd like you to come back on Monday. Could you be here at ten?"

"Sure," I replied without hesitation.