2nd Appointment

“You’re back.” Dr. Patterson seemed cheered by my arrival. She sat in her usual seat, which looked less the seat of a clinician than it did a parent’s familiar armchair.

“Did you assume I wouldn’t show?” My words lashed out like a whip, as usual.

“I try my best not to assume anything. But I’m glad you kept our appointment.”

I lowered my gaze as I settled into the chair opposite. It wasn’t the best start to an appointment. In fact, this wasn’t the way I wished to speak to Dr. Patterson, who, based on our last appointment, was doing her best to help me. I sat in silence with her, contemplating an apology that never made it to my lips.

Her voice broke the stillness, “What would you like to discuss with me, today?”

“Aren’t you supposed to pick up where we left off? Maybe give me a little reminder of what I last told you because you need the whole picture, don’t you?”

“Is that what you want to do?”

“I don’t think I finished griping about my other physicians,” I scoffed.

“Okay, I’m listening.”

“Just like that? You’re not going to tell me that I should focus my attention somewhere more productive?” I’m not sure, but I believe my voice moved to a mocking tone.

“If you are still thinking about your bad experiences with other physicians, how are you going to trust a new one?”

I wasn’t looking at Dr. Patterson when she spoke these words. I had learned to divert my eyes many years earlier, focusing more on what I was saying than the way it was received, dodging reassurances any flake could pretend to offer me. It was also a tactic to avoid any lurking judgement that less-trained listeners forgot to conceal. I didn’t expect this doctor to be so careless, but old habits die hard. I was acutely aware that my hair was tucked behind my ears, rather than hanging like a curtain, and wondered how adept she was at reading facial expressions. She had just given voice to my thoughts.

“I don’t think I told you about the medication I was on.”

“Do you remember the name of it?”

I gave a derisive laugh. The bottle flashed in my vision with pristine clarity. I remembered my fingers wrapping around it for the first time, on that fateful day, three years prior. I read the name of it over and over, reeling from the ease with which it was prescribed: Sertraline. Dr. Long had explained SSRIs to me; spouting his knowledge of serotonin and dopamine and other neurotransmitters, of which I knew nothing (nothing at that time, anyway). I had seen him many times over the last ten years and I trusted him; the precise reason I ignored the sinking feeling as I sat in my car after our appointment, reading the label over and over: specific serotonin reuptake inhibitor. Sertraline. I had cried then, realizing the problem was so deeply rooted, I needed this prescription to feel okay. I needed this level of help to feel normal.

Dr. Patterson was waiting for my answer. “Sertraline,” I said, quietly. I watched my fidgeting hands without feeling they belonged to me.

“How long were you on that prescription?”

“Just over two years.”

“When did you stop taking it?”

“Eight months ago.”

Each of her questions came after a pause, as if she were waiting for me to expand upon these simple facts. I was trapped between wanting to pour out my heart and concentrating on containing the burning feeling at the back of my eyes and the base of my throat. I wondered what word would make the tears fall. The coffee table must have had a new book on it. I noticed the green colour swimming in my vision as I tried to blink away my past.

“Do you want to tell me how it felt to take the medication?”

“Um no, sorry, I have to leave.”

I abruptly stood and tried to walk to the door, stumbling over my feet. Suddenly I couldn’t remember where the exit was. How had I gotten here? The earth tilted too far and the walls closed in as I reached out for anything to hold onto. The room went dark.

***

When I came back into my body, I was curled on the floor on the opposite side of the room. Dr. Patterson was sitting next to me, her hand placed gently on my back, between my shoulder blades. Her voice was even-paced and calm, “Just keep breathing. That’s it. Deep breaths.” As she slowly repeated “inhale” and “exhale” I heard her breath following along with her own instructions. I realized the high-pitched accompaniment to her voice was my rapid breath forcing its way through my trachea. Eventually, my breathing began to match hers.

I wiped my face a few times. It seemed to be stained and crusty all at once. When I was able to inhale enough air into my lungs, I asked with a scratchy voice, “What happened?”

Dr. Patterson’s answer drifted to my ears from a faraway place, “You fainted. Has that ever happened before?”

“I can’t remember.”

“Okay. Let’s just stay here for a bit. Keep breathing.” She spoke slowly on purpose, generating an environment she wanted me to enter. She held out a glass of water that my hand was too shaky to grasp. She set it on the floor next to me. “I can explain to you what I believe happened, if you like.”

I nodded.

“It’s called a psychogenic blackout. When someone with past trauma or anxiety faces a stressful situation, or painful memories start to flood in, your brain tries to escape, by fainting. It’s often confused for epileptic seizures. You don’t have epilepsy, do you?”

I shook my head.

“Have you eaten today?”

I gave a small “yes,” as I reached for the glass of water.

“Okay. Remember, this is only what I think happened. We’ll be able to find out more after you’ve been properly assessed.”

My stomach lurched and my knuckles glanced the side of the glass, knocking it over. I barely registered the growing spill on the floor. Hoisting myself into a sitting position, I rasped, “What did you say?”

But Dr. Patterson was already standing, first moving to clean up the spilled water, then whirling when her desk phone rang. I watched her answer through eyes that had forgotten how to see clearly, as though a veil had dropped over my corneas. “Okay, thank you,” she told the caller.

Moments later she opened the door and two paramedics rolled a stretcher into the room.

****

This is part 2 of my series.

If you missed it, here's part 1: