They Called Me In Today

The government psychologist in charge of Fraud Pre-evaluation for Medicaid applicants has his office in the old, gargantuan and abandoned drivers license building on Worley-Worley Street. This was to have been remodeled but some kind soul finally realized a shopping mall would be a nicer location for everyone.

His office was in a far, far corner. Most of the tile ceiling was removed so you could see cables and wires. There were a few remaining tiles near his door, and three or four recessed, circular ceiling lights. The door was like iron, and had a silver, ball-doorknob that looked like it should remain locked (and never touched). The obscuring glass beside the door was grey. It seemed dark inside; surely I was in the wrong place for my appointment.

But I tried the door and it opened into a small waiting room. The receptionist was already standing, probably because she'd heard me making my way, for two minutes.

I told her my name and she said the doctor would be out soon. Then she disappeared forever down the narrow tiled hallway and I never saw her again.

Dr. Walker appeared almost immediately, even before I sat down. He was in a wheel chair, in his late 50's, greying. He ignored me at first as he wheeled to the counter that was too tall for him. He got some papers.

I sat down and he told me to come along, so I stood back up. I followed him rolling toward the open door dead straight ahead, 15 feet. There were no pictures on the wall. No 'chair rail' moldings.

"I'm sorry to be a few minutes late," I said. My appointment was at 11 and I got off work at 11.

"I wasn't expecting you until 11:30," he said. "You called and left a message this weekend."

Under normal conditions I'd have made a joke, then. He got behind his desk and asked me to close the door.

I admired his desk. Usually psychologists like their desks to be cluttered, you know. What did that humorous old wall plaque say, back in the '70? An uncluttered house is a sign of...your inferiority, or something.

All he had was a legal tablet at the ready. The questioning began.

He wanted to know the date. How are a dog and a lion similar? He asked this address where we were (all I remembered was Suite "A", Worley-Worley Street. Corner of Dutch Elm). How are a fly and a tree similar? (They're outdoors, I said.) How do I sleep? Normally, with my new prescription drugs, I said. Count back from 50 by 3's. I wondered whether to stumble or not. I counted back correctly.

Who were the last four presidents? How much coffee do you drink? Who is Dick Cheney? Who is Al Gore? Condoleeza Rice? Who is Colin Powell?

He asked me who Al Gore was again and I answered "a traveling lecturer and recent Nobel Laurette".

"Do you understand why you are here?"

"Yes," I said, remembering that Anonydoc told me to just be myself and he'd pass me as crazy enough. "I want to continue some of my new psychiatric drugs on a trial basis. My life seems to be improving..."

Then he had me review my life. I was truthful. Whenever I do this, it's a new story but still true. I told him about skipping gym for three years in high school and keeping it a secret from my parents that I would never graduate. For three years I lived in abject anticipation of the year 1979. Then I went to the state university via a GED and two months at a community college, but I stayed home, a hermit.

"Why were you afraid of gym? Because you're so skinny? Where you this skinny back then?"

"Yes."

We went over my work history. I side-tracked quickly to the recent past and attributed my new, improved job situation to the stability I have now after starting Cymbalta and Lamictal.

He took me back 20 years and we started over. I lied that my drinking didn't start until my early 20's and left it to him to figure out that was after my commitment for mania in 1984. I jumped back earlier ---to getting a knock on the head when I was 16 and having walking amnesia for a few hours until I fell asleep and came to.

I told the man everything he asked. Four months at a dual diagnosis treatment center. Almost three years sobriety again... I talked about my near-fainting spells, the sort of lightening flashes I'll have that make me stumble or yell. Going *gink!* *goink* in certain panicky situations.
_____
He picked up his DSMV IV and asked:

Are you ever restless?

Yes. I suppose sometimes.

Are you ever excitable?

Sometimes, I suppose. Less and less since grade school.

Do you sometimes have insomnia?

Not since I started seeing Dr. Slaughter.

Any rambling flow of thought and speech?

Oh. Just now talking to you, I suppose!

Gastrointestinal upset?

What, now? Or ever? Yes.

Tremors?

Hmm. No.

Tachycardia?

What's that? Rapid heart-beat, he said.

What, now? Or ever? Yes.

Diuresis?

What's that? Peeing a lot, he said.

When I drank beer, yeah.

Any muscle twitching?

No. In my sleep I guess, maybe. No.

Periods of inexhaustibly?

In June of 1985, yes.

Psychomotor agitation? Twitching?

No. No tics.
___

"With those symptoms I have a diagnosis. Do you want to know what it is?"

"Ah. Fun," I replied.

"I just read you the traits of caffeine addiction."

With that he clapped his book shut and waited for my reaction.

Did he expect I'd be relieved?
___
Suddenly I remembered. I'd heard of this guy! He'd told someone else the same thing and denied them medicaid assistance.

"You told me you drank a pot of coffee a day."
_____
People used to say I was 'mellow'. Then a year ago, my good-night nurse told me "You have a temper, you know that don't you?" I was flabber-gasted and she gave me some examples, from our time together at the treatment center.

I don't know but I became grim and focused and sarcastic now. "Is that page in your DSMV book-marked? Dog-eared?"

"No, it's not. You're upset aren't you?"

Actually we were both bristling now. Just like that.

"If you're playing some sort of gotcha game with me after having me tell my life story, yes I am upset. I don't want to sound rude but it seems you're trivializing my life and you're not logical. Those symptoms must appear under fifty other illnesses."

He said, "I know Dr. Slaughter. I respect him. But like most psychiatrists...Now there's a Mark Twain quote...you're a scholarly man, I'll bet you already know what it is I'll say," he grinned.

"No. I don't know."

"Twain said, 'When all you have is a hammer, all problems start to look like nails'".
____
I began.

"Look. I've resisted psychiatric drugs for years. Now I am diagnosed as bi-polar and I've started taking these medicines and I feel they're working. It's why I'm here. They're expensive drugs I can't afford. I want to continues this trial so I am able to be stable and have initiative and take care of myself. I'm 46 years old, at the age I have to look back and realize that I've never gotten better until now. Not even sobriety improved me much.

"I wake up and I want to get up. When I lost my job, I was up early and applying for new ones the very next day. That's not like me."

"You said you drink a pot of coffee a day."

"If you're advising me to drink less coffee that's fine. Thank you."

He was serious though. It was no aside. For twenty minutes we argued about coffee symptoms.

Then the new medications and the sudden increase of (he finger-quoted) bi-polar disorder since 1998.

"I was committed for mania in 1985," I reminded him.

He drew me into the ridiculous. "Change your notes please. I said a pot of coffee a day but we're always dumping out our luke warm coffee for hot coffee. It's not a pot a day." (Probably is, I thought, but holy crap).

I said, "What about sugar? I've heard that sugar is almost like a drug. There are books about how it changes our behavior, ...it can change everything. You should ask how much sugar I put in my coffee and then you'll really get to the bottom of this."

Every time I was sarcastic or raised my voice, it alarmed me. Holy shit...I've had too much coffee, I need decaf.

"Look, I'm sorry..."

"I cannot leave this out of the top of my report."

"Leave what out?"

"Coffee addiction."

"The top of your report? What does that mean?"

"I think it's primary."

"Using these anti-depressants and mood stabalizers seem to be a god-send to me. I want my life to improve. I'll drink less coffee, I appreciate the advice but why are we arguing. Why didn't you just say, 'I'd drink less coffee if I were you'"?

He drew a Venn diagram that disproved his own point.

He said, "Depressive illness is obsequious. It's over diagnosed, like A.A.D.D."

"Obsequious? Depressive illness is obsequious?"

He looked alarmed and now a little more pale. He picked up a pocket dictionary.

"Wait. No. I meant..." he made circles with his hand...

"Ubiquitous."

"Oh. Yes you're right. Obsequious means servile."

"Aren't there gradations of depression? Don't some people go too far on the scale and need treatment? I need treatment. And I'm sorry but I have an appointment for a job orientation and we've been here an hour."

I stood up but when he wheeled himself back around the desk I sat back down again.

But then jumped up and opened the door for him.

He looked so small I was in shock almost. It was like maybe done more than my part in finishing him off. Correcting his vocabulary, for C.Sake.

People don't like that, in his position especially. Correct a dentist and he'll chuckle.

Once again I was faced with the dilemma. Do I go out the door first? Do I follow him out? If I follow...who knows, maybe he's afraid of me! Doesn't want his back to me.

So I went out first and he wheeled behind me, still talking about hard and soft categories. I didn't get it. I mimicked Anonydoc. "It's an art, not a science." I know.

The secretary was long gone. I said that I was sorry I got upset. I offered my hand to shake.

"I can't touch. My wife has a critical illness."

I said that's too bad. Then something like: I'll be drifting along then.

I walked out, into the exploded old Drivers License office, and made my way over plaster dust toward the exit. I half expected the receptionist to suddenly appear before me like an apparition, maybe to tell me her boss under a lot of stress.

Or, "That was my father you were shouting at!"

My mind went that way all the way to my car and all the way to my job orientation.

Maybe there's radon in our basement. Maybe my thyroid. Maybe I'm a middle child, maybe Jesus wasn't the Christ and our Creator is offended when I pray in Jesus' name.

Maybe I should lay off the bean.