An Inside Connection

Dr. Cynthia Alford stood at her office window and watched Gerald get into the taxi that would finally take him away. Was her secret safe with him? Five months earlier, she had begun treating him as an outpatient for chronic schizophrenia. When she recommended antipsychotic drugs during one session, Gerald had turned violent. Fortunately for Dr. Alford, two orderlies were waiting in the next room. Since that day, she had been treating him as an involuntarily committed inpatient.

She was head of the hospital's psychiatric department and could have handed him off to one of the other doctors on staff. But she couldn't take that risk. Gerald knew something about her that he should not have known. As far as she was concerned, there was no way he could have known. But he did, and Dr. Alford couldn't deny it. In one of their counseling sessions, Gerald told Dr. Alford that he knew about her secret addiction to a prescription stimulant called Adderall and that she was the prescribing physician. When she denied it, he asked her what she kept locked in her desk's top right-hand drawer. Dr. Alford was dumbfounded. How had he known—not only that she was taking the drug but where she kept it?

In her professional opinion, Gerald was not ready to go home. He still showed signs of rage roiling just under the surface like magma within a volcanic rift. But that was not what she wrote in the discharge notes that morning. In fact, she wrote the opposite. Why had she compromised her professional ethics? Because Gerald had used her secret to blackmail her into discharging him. His exact words had been, I would hate for anyone in the medical center to find out. You are so good at what you do. If that happened, she would lose her license to practice medicine.

#

Dr. Alford paced the floor of her living room that evening, wrestling with the same concerns. She was obsessed with finding out how Gerald had known about the Adderall and where she kept it. A follow-up call to a patient recently discharged would be considered acceptable. She had decided earlier to save his number on her phone just in case she wanted to contact him. She pressed dial.

"Dr. Alford," Gerald said without allowing her to identify herself. "Can I call you Cynthia since I'm not one of your patients anymore?"

"Gerald, My phone number is unpublished. How did you know it was me calling?"

"Maybe I have an inside connection which gave me your number."

"Nobody in my department would give out my phone number."

"No one in your department gave me your number. Relax, Doctor. You sound like you're getting a little worked up."

Dr. Alford breathed deeply and closed her eyes. "You just told me you had an inside connection."

"That was a play on words."

"I want to ask you about something."

"About Adderall, perchance?"

"I was so careful. How did you know?"

"I already answered that one."

"Your inside connection?"

"I've never known her to be misinformed."

"Why do you refer to her as an inside connection?"

"We're going in circles, Doctor; it's a play on words."

"Stop playing games, Gerald."

"Her name is Alexandra. Do you feel better now?"

"How did Alexandra find my phone number?" Dr. Alford's voice was getting louder again. "How could she know about the Adderall."

Gerald began to falter as if he were suddenly unsure about his position. "I—I honestly don't know, and I don't feel like talking anymore." Gerald abruptly ended the call.

If what Gerald had said was true, some woman named Alexandra was snooping around in her personal affairs. Was she a private investigator? Had Gerald hired the woman to dig up dirt on her so he could blackmail her? But that didn't explain why he called her an inside connection.

While Dr. Alford got ready for bed, she analyzed her conversations with Gerald during the past six months. When she came up with nothing, she considered what aspects of schizophrenia they had not discussed. It hit her while leaning over the sink to rinse her mouth after brushing. She lifted her head and looked into the mirror. "Voices."

She was pacing in the living room again. An inside connection was a play on words, Gerald said. It made sense. He had implied that inside his head, in some secret place of his mind, Alexandra had revealed Dr. Alford's phone number and the hidden location of the Adderall. But from that point, it no longer made sense. How could a voice that was nothing more than the disease taunting him reveal anything about her? She grabbed her phone and dialed again. It was after midnight.

"Dr. Alford, you are beginning to get on my nerves." Gerald sounded as though he had been sleeping.

"Your play on words, an inside connection, is a voice you hear inside your head."

"Brilliant, Dr. Alford, you've deciphered the mystery. Now please, let me go back to sleep."

"Alexandra can't be real. I don't fully understand it, but It must be the disease."

"Don't you talk about her that way. She is real."

"There is only one way to know for sure."

"You're talking about antipsychotics again, aren't you?"

"Yes. Just give it a try."

"I don't want anything to do with your hospital or your damned drugs. Stop calling me!"

"Gerald, listen to me. You've got to answer these questions. How did Alexandra know my unpublished phone number? How did she know I was taking Adderall and where I hid it?"

"Alexandra knows everything."

"So she is God, and God talks to you?

"That is not what I said."

"Try the antipsychotics for two weeks. If they don't work, I'll leave you alone."

#

Two weeks later, the voice of Alexandra had grown silent. Gerald sat in Dr. Alford's office.

"Continue taking the medication as you have been. The current dose seems to be doing the job." Dr. Alford wrote notes in his file. She glanced up. Gerald was staring straight ahead through wide-open eyes; his jaw was hanging slack as though he couldn't believe what he was seeing.

The look of utter disbelief on his face caused her to be concerned, but when she heard just his side of a two-way conversation, concern morphed into terror.

"What do you mean, where have I been? I've been waiting for you to talk to me."

—

"Of course, I missed you, Alexandra."

—

"I'm taking these drugs to prove to the doctor that you are real."

—

Gerald rose from his chair and walked to a file cabinet behind her desk. He moved aside a potted plant on top, revealing a key that opened the drawer. He reached in, pulled out a new bottle of Adderall, turned, and set it on her desk.

Dr. Alford backed across the room toward the door. "Gerald, the voices of schizophrenia can't do that. I'm sorry. I was wrong. The voice you are hearing is real. But I have no idea what it is."

Tears welled up in Gerald's eyes. He held her gaze for several seconds before resuming the conversation with Alexandra.

"Who are you?" Gerald whispered.

—

"What are you?"

—

"Stop laughing?"

—

"Leave me alone."

—

"Get out! Get out! Get out!"

A woman's laughter filled the room,

Two orderlies burst in.

Gerald reached out to them. "Help me!" and fell into their arms.

The potted plant flew off the file cabinet. Dr. Alford ducked, but the clay pot glanced off her head just above her ear. She went sprawling onto the floor. Slowly she drew herself up to her hands and knees. Blood ran around her ear, down her neck until it collected in a full drop on her chin and fell onto the grey carpet. A woman's voice spoke inside her head.

"Hello, Dr. Alford."

"Who are you?"

"You can call me Alexandra."

"What do you want with me?"

"I seem to require a new friend. May I call you Cynthia?"