Conversations 18 - PM

I nodded, staring at the carpet. I'd tried to end it all, failed in the attempt, and now found myself hugely embarrassed at having done something so immensely idiotic. My death wouldn't have fixed anything -- not for me or anyone else. Shana had created the problem and then saved me from my permanent solution. It was a dichotomy, and I didn't know how to deal with it.

"That care is going to need to be ongoing," Reynes continued. "But actually, you're not my main concern here. Your wife is seriously ill."

I stared at him. I'd attempted rape and then suicide, was now in hospital and had even been restrained, but Shana had the problem?

Shana started to rise in open-mouthed protest, but a stern look from the psychiatrist dropped her back into her chair. He turned towards her.

"Mrs MacLeith, or would you prefer Dr MacLeith? Either way. From what you've told me, I'm convinced that you had a psychotic episode that lasted over six weeks from when you first moved out of your home. Several times you spoke about how your conversations with your ex-husband and your work in the hospital were your real life, and everything else was merely a dream -- essentially experiencing a split from reality. In addition, we discussed how you simply went along with suggestions and requests from your housemates, making few, if any, decisions of your own when away from work.

"When combined with the PTSD you're experiencing, something all too common in every level of health care workers over the last year, and the depression you are currently suffering, that psychotic episode is deeply worrying."

He sorted a few papers on his desk, and I realised he had something unpleasant to say and was unconsciously delaying the moment.

Finally, he looked up at Shana once again. "I've spoken to your hospital administrator, explained the situation, and that I've booked you off from work until further notice."

She sat up, furious. "You can't do that. I have patients who need me!"

"Mrs MacLeith, your condition is affecting your judgement. Over the past week or so, you've stolen medicine from the hospital -- with good intentions, but..."

"I did it for Mac; he needed a vaccine."

"Mac was completely isolated. Until you visited him, he was the safest of any of us -- against the pandemic anyway. Besides, you had no authority to force him to take it."

"Perhaps," she said, fighting back. "Perhaps I made an error in judgement in trying to make sure that Mac was protected. But that doesn't affect my medical skills. You have no right to remove me from my position at the hospital!"

"Mrs MacLeith, you have to know that your trying to treat your ex-husband didn't help at all. And the medication you prescribed simply made it worse, deepening the depression. Medication without treatment is useless; it's a tool, not a cure. And that medication was contraindicated in the first place. It's a great help against anxiety but not the best for your ex-husband's condition at all. Which brings us all here -- taking a closer look at those skills of yours."

He spread his hands, indicating his office.

"You can't practice medicine in this condition. I'm sorry, but that's the bottom line. If you were well, I'm sure you'd be the first to acknowledge it. But, unfortunately, at the moment, you could be disastrously incapable of looking after patients."

Shana stared at him, and for a moment, and I thought she was preparing for a stand-up fight. But then she slumped back in her seat and covered her face with her hands.

My heart wrenched as I looked at her. She seemed destroyed in every aspect of her being. A year ago, I would have celebrated the karmic retribution. Now, I couldn't bear seeing her in such a pitiful state. Why would a psychiatrist, in supposedly helping a patient, destroy them like that?

"Enough!" I said, rising to my feet and going to her side. "That's enough. There was nothing malicious in any of her actions. And if what you've said is true, then there never was. If I'd known she was ill, I'd never have divorced her. I'd never have let her out of the house in the first place."

I felt a small, cold hand creep into mine, and I looked down into her devastated face. The pitifully hesitant gratitude in her eyes almost tore me apart with waves of sympathy, sorrow and guilt.

I wasn't finished with Reynes. "This isn't right. What sort of treatment is this? You seem to be bullying rather than trying to help your patient. "

"Your wife is not my patient, Mac. You are."

I did my fish impression again, trying to come up with something clever that would cut him to the ground. Nothing came. I squeezed Shana's hand, searching for inspiration.

"I thought you guys all took the same oath: first, do no harm!"

"That's true, but it's a non-legal declaration that concerns the physician and his or her patient. After all, must I never harm anyone who is trying to harm me? That doesn't make sense. Perhaps you should ask your ex-wife about that oath. You're the one she harmed, both with her actions and her poor treatment of your illness."

Shana let out a tiny cry and tried to pull her hand out of mine. I clamped down on it.

"She's ill, dammit! You just said so. We've had enough of this. We're leaving!"

Reynes smiled. "Just one more minute, please," he said, rising and holding out a couple of small pieces of paper to me,

"Prescriptions for both you and your wife."

I took them with bad grace, not recognising anything in the description of the three separate drugs detailed on each.

"Shana needs care, you know. As do you," the shrink continued, leaning forward confidentially, as if she couldn't hear every word he was saying. "Unfortunately, what with the pandemic and all, we're snowed under with patients while at the same time being short-staffed. Many nurses and doctors have left the job, are ill or are having to isolate themselves. So we can probably offer only the absolute minimum. Five minutes here and there would be the best we could do -- just about enough time for the district nurse to check blood pressures and temperatures. Not good enough to get you two back into equilibrium."

He stroked his chin in a way that brought a phantom, invisible goatee to mind.

"However, something's just come to mind. Hmm, yes. There is one solution that I think may suit the problem perfectly."

I looked at him, waiting for him to explain it. Then, after a few moments, I raised the hand that Shana wasn't hanging onto and made a face to show I was waiting.

He nodded again, took a sheaf of papers from a cabinet to one side of his desk and held them out to me. "You'll have to take care of each other. Here, this is a detailed description of the care that each of you needs."

He continued more urgently when he saw I was about to object vehemently.

"Shana has to be looked after. The drugs she needs may leave her slightly dazed and confused. Someone needs to be with her at all times. She can't be allowed to become forgetful and either take too many or not enough at the wrong times. The drugs on that prescription are not lightweight, over-the-counter medicines.

"And at the same time, you need some direction in your life that you can control -- something that will move your focus from all those negative emotions within you onto a problem that you can solve."

"But I can't be around her," I protested. "She wouldn't be safe."

"Do you think you might try to force yourself on her again, Mac?" he asked.

After a moment's thought, I grimaced and shook my head.

"No. I don't think so. That was a crazed one-off. I don't normally drink very much at all."

"Shana, you need to look after your husband more carefully this time. He isn't well, and we certainly don't want to see him back in our care -- for any reason. Am I wrong?"

She shook her head, which made her hair float across her face and made me want to kiss it, feel it against my lips, and smell the scent of it once again. I tried to suppress the thought -- but with no more success than any of my innumerable other attempts.

I was thinking about what Reynes had been saying. He had switched from saying ex-husband and ex-wife to speaking as if we were still married, and calling her Shana instead of Mrs MacLeith.

My thoughts were interrupted when he strode around the desk.

"I've made a joint appointment for you both early next week, and if you have any emergency that needs my services, please leave a message with my receptionist. Here's my card."

I took and pocketed it as we turned to leave.

"I'll meet you at the car," I said to her. "I just need to ask Dr Reynes a last question."

She nodded and walked away.

"How much of that was real," I said baldly. "And how much was just psycho-babble to find excuses for people doing bad things?"

He gave a snort -- not a laugh, more a wry reflection on my way of looking at his profession.

"Oh, it's real. Imagine you put everything you have into curing a patient. They seem to be getting better, and you've won -- you've done your job, proved your worth as a doctor. Then, for no rhyme or reason, they die -- and it happens again and again and again. It would and does drive a lot of workers over the edge. And put in words of one syllable, people do fucked up shit when they're crazy. Don't ever quote me on that. I'll deny it."

"Crazy has two syllables," I observed.

"Yes, but calling someone mad is frowned upon in my profession."

I echoed his snort. He had a good sense of humour.

"You set us up," I said. "You planned it, this looking after each other thing -- why?"

He pursed his lips for a moment. "I'm sure I don't know what you mean. But before we address that, I need to ask how much you know about PTSD."

The sudden change of direction threw me.

"Er... not a lot. I always thought of it mainly as something that soldiers got. It's not just them, of course, not if doctors are getting it."

"The military is where most people think it occurs, and of course it does, but that's just the tip of the iceberg. Anyone can suffer from it. All it needs is trauma. Continual stress will also do it if it's unrelenting. Such as when patients are continually dying despite treatment, while people just as ill are queuing up for beds -- and having that go on for months at a time. Care staff experiencing that then go home and are expected to instantly adjust to the regular routine of their family's life while hoping they don't infect them. Simultaneously, with PTSD, they often feel a deep sense of guilt or shame -- rational or irrational. It's been estimated that almost a third of medical staff in hospitals have the disorder in various degrees at the moment.

"More importantly for you, it has several symptoms that I ascertained in your wife; poor decision making, detachment from those around her, bad sleeping patterns, and that intense feeling of shame or guilt."

I moved uneasily. "I thought Shana felt that way because..."

"Because she slept with a colleague? Yes. But when combined with the other symptoms and possible survivor guilt on top of that, it means that it's unrelenting, stressing her mind continuously. Even the best-built engines break down in those circumstances. All of which means that Shana needs looking after, and I'm afraid you're it. You told me her parents are in a nursing home... an old-age home, and her brother lives in Australia with his own family. So who else is there?

"Of course, if you absolutely couldn't bear to do it, she would have to be admitted to a hospital or institute while she is on the drugs I prescribed."

He looked at me. "So, how much do you hate your ex-wife? Enough to drop her into the maw of a frantically overwhelmed system that will do what it can but might not be enough for her needs?

"After seeing you and her together, I don't think you hate her enough to do that. You hate what she did, and that's completely understandable. You said you still miss her. But I think you still love her as well."

He took my hand and shook it. "I think you're a good man, Mac. I hope I'm right, for both of your sakes. Come and see me next week and bring Shana with you."

"It isn't fair to guilt me into this," I muttered.

"No, it isn't. But my job is to get you both mentally healthy once more. I'm gambling that this will help balance your thoughts, so you can make a rational decision about what you want the rest of your life to be. And whether that includes Shana or not.

"She needs this just as much. At the moment, with all the other mental problems as well, the guilt of what she did to you will end up killing her. And I do mean that literally."

He grinned, for a moment looking way younger. "And with that final layer of pressure, I wish you good luck. Keep me informed if anything changes."

When I got to the parking area, I looked around for my car and spotted it quickly, the only car with a pretty brown-eyed blond standing passively alongside it. I opened her door, and she climbed in automatically.

We took off our masks with sighs of relief and then sat in silence for a moment before I started the engine and drove out of the parking lot. She didn't ask where we were going, and I didn't volunteer the information.

"So, what do you think?" I asked.

"I can't do it," she whispered. "If I can't go to work, I'll be stuck in my flat all day and become like..."

She broke off.

"Like me," I finished the sentence for her.

"I didn't mean it as an insult."

"I know. I didn't take it as one." I shrugged. "It's the truth. It's just how it is."

She sat silent for a while, then looked around. "Where are we going?"

"To your place, you'll have to direct me."

Shana slumped down. "I can't do this alone," she repeated.

"You're going to need to pack some clothes. I imagine it will be a long stay, so choose wisely."

I gave her a neutral smile.

"Okay," she said after a moment and then squeezed my arm. "Thank you."

"As long as you feel safe," I finished. "I hate what I tried to do."

"Mac, I do feel safe. You frightened me, but you were strong enough to stop, despite how I screwed up your meds. That was on me."

"And I got drunk; that was on me. So I won't drink, and I'll get rid of any alcohol left in the flat. You have to make sure I only take what Dr Reynes prescribed. I'll do the same for you."

"So... we're staying together at your flat?"

I looked at her.

"I just wanted to be absolutely clear," she hurried to explain. "I need clarity -- clear and precise directions. I don't seem to be any good with hints and suggestions anymore. Getting the vaccine and coming around to your place was the clearest thought I've had for weeks, and that was to do something illegal. I think Dr Reynes was right about me. Maybe I should just give up medicine; I'm no good to man or beast at the moment."

When she started crying quietly again, there was so much hopelessness to it that I reached over and took her hand, squeezing it in sympathy. Then, when I had to change gear, I placed her hand on my thigh. She seemed to take comfort from that slight contact and left it there.

"When I spoke to Reynes after you left," I said hesitantly. "He told me that us looking after each other is pretty much a Hail Mary attempt to get us back to normal again. Together."

"Do you think it's possible?" For the first time since this whole situation began, there was hope in her voice and on her face.

"I don't think it's impossible," I replied, hedging my bets. "Let me put it that way."

We were going to be together in a flat that, while not small, didn't allow many opportunities for solitude. So it was going to be rough at times, even with the best will in the world.

"You need clarity, so here it is. I haven't forgotten what happened a year ago, but I have forgiven you for it. I mean, if you were ill, I can't really blame you. Just don't talk to me about your two 'housemates'." I let go of the steering wheel for a moment to indicate the quotes around that word. I felt my stomach clench as I said it.

She shook her head vehemently. "I won't. I promise."

For a moment, I wanted to lash out at her about her ability to keep her promises but pushed it back down. It wouldn't help either of us, so what was the point? Maybe the new pills were working after all. They were certainly doing better than the ones Shana had prescribed.

"Thank you."

And so Shana moved back into my flat, this time with a whole lot more clothes; so many that I had to, in good conscience, offer half of the wardrobe in my room in addition to the one in the spare room where she would be sleeping.

It wasn't easy. There were times when I would snarl and rake with verbal claws, other times when she would sit alone and weep hopelessly.

But slowly, over the hours, days and weeks that followed, I learned not to lash out at the first setback, and she discovered that life was not eternal misery -- that there were little pleasures on which we could concentrate instead.

We finally got into a comfortable routine. I would get up first and make the tea and breakfast. Then, as I showered, Shana would clear up and wash the dishes and set out the pills we had to take, waiting for me so that we could check each other's before we swallowed them. For a while, it felt silly to be so careful, but over time, there came a comfort from the routines, making me feel better. First, I would work for three hours, strictly to the minute, and then we would don masks and take a walk together. After that, we would make lunch, and while I did another two-hour stint on the share markets, Shana would go out and buy any daily needs of fresh produce and then head down to the library on the way back to check if any new books had come in. She still needed clear direction and was hesitant even to choose books for me, phoning me daily to see whether I wanted some or other title.

At first, I was annoyed at the daily interruption, although keeping it to myself. But then it hit me. She wasn't just asking me for direction; she was also trying to show me where she was. Shana was trying to reassure me that she wasn't with another man.

I didn't know how I felt about that. We were divorced, thrown together again through circumstance, and yet she wanted me to feel comfortable in the knowledge that she wasn't screwing the neighbourhood tomcats. Despite myself, I was touched by that thought and began to look forward to that daily contact.

So when she didn't call one afternoon, I felt my mood grow darker and darker -- an inevitable rollback to the past months. When she returned, I had to struggle hard not to lash out at her. Luckily I managed to control myself as she excitedly handed me a paper bag.

"Look, the new Stephen King is out. I know how much you love them, so when I saw it at the library, I rushed down to the book store and bought the hardback for your collection."

Shana looked so pleased, almost hopping up and down on the spot with excitement like a little girl as I looked it over, trying to pull myself back together. When she hadn't phoned, I'd immediately turned to the dark side, retreating into a state of isolation. And all the while I'd been swearing and cursing up a storm at her, she'd been out thoughtfully buying a present she hoped would please me.

I couldn't help it. Overcome with guilt at my imaginings and the relief that they were so wrong, I reached out and hugged her tight.

And then, without thinking, I kissed her.

It was like our first kiss all over again. I felt a surge of emotion rush up from my belly into my chest as I held the woman I loved. It wasn't a sexual feeling -- just pure emotion.

After a moment, I drew back, fearful that she would see it as the start of another assault. But she quickly drew my head down once more to renew the kiss, hugging me so hard that she seemed to be trying to force her way inside me. At that stage, sexual feeling most definitely entered the equation, and somewhere in the background, I was aware that I'd grown hard -- almost painfully so.