He was used to hostility, of course. If he noticed hers, it didn’t appear to bother him.
“Hello, Maud. That’s a becoming haircut.” Dr. Straight was seated behind his massive doctor desk.
“Are you allowed to say that?” she asked.
“It’s a compliment.” He grinned.
“Thank you,” she said without sounding pleased.
His brow furrowed slightly, but she maintained a cooperative expression. She needed him. “Have a seat.”
“Oh, okay, thanks.”
Another woman entered the room. Again, Dr. Straight didn’t stand up. Maud swiftly took her in—short, slender, graying hair, an intelligent down-turned mouth.
“Maud, this is Dr. Goodman. I have asked her to sit in with us to get to know you a bit. She has been working with Heidi.”
“Oh. I didn’t know.”
“I hope it is all right.” Dr. Goodman quickly moved to shake Maud’s hand with warm, dry fingers. A swift assessment occurred, and through an ineffable, possibly chemical process, the women reached the conclusion that they liked each other. She retreated to a spot behind Dr. Straight.
“I’m afraid the news isn’t very good, Maud. We can’t seem to lift your mother from her depression. She is on a new medication, but frankly I’m at the point where I think she may need to move into long-term care.”
Dr. Straight tapped his pen lightly against the blotter. He was probably sixty, fit, blue-eyed.
“She was fine last spring,” Maud said. “She made dinner. She took care of her granddaughter. I don’t understand how this could happen.”
“I think hormones are playing a role. There are cases of women having severe adverse reactions to menopause. That may be what this is. She has seen an endocrinologist and is on a cocktail of hormones. It is not obviously helping, but she might be worse off without it. Did she have trouble with her periods?” Dr. Straight asked. He opened his folder and flipped through the pages.
“Yes. She had terrible PMS.”
He nodded at his papers. “Most likely a severe form of it called premenstrual dysphoric disorder. One of the big clues is that she said the only time she felt truly well was when she was pregnant. Under that circumstance she was being flooded with a different level of hormones. Unfortunately we are only at early stages in understanding the interplay of hormones and mental states. Women usually improve when estrogen levels go down. Heidi isn’t following the typical pattern. We aren’t giving up, of course.”
“So what’s the plan?” Maud leaned forward.
“I know you object to ECT. That’s up to you. I’d try it if I were you—”
“Really? You first.”
Dr. Straight paused and looked down at his notes. “It’s not like it used to be, Maud. Not like what you see in the movies. We have come very far with the technique, and I’ve seen it work wonders.”
Maud got a grip. He was trying to help. “I apologize, that was uncalled for. I believe I’ve read that, too, but I don’t want my mother to go through that. She could have had ECT at Payne Whitney.” Maud glanced at Dr. Goodman. Was she imagining things, or was she being given a tiny nod? “So what now?”
“Now things become more difficult. Where do we go next? So far we have had her on the ward with many patients who have come and gone and who are coming and going all day, to therapy and activities. Heidi is unable to participate. She is taken outside for fresh air but is not responsive to the stimulation. She is getting physical therapy, but again she is unresponsive to the work.”
Maud tucked her hands under her legs and rocked as unnoticeably as possible.
“When we have nothing to measure and she cannot tell us how she feels, we have to go by what we see.”
“She might be hearing everything,” Maud said.
“She might be. I assume she is hearing some things, and that she has her thoughts and is aware of them. She has had no brain injury or anything to indicate she might be radically different than as you know her. But her depression has her unable to communicate. In my experience this state becomes intractable after a certain amount of time has passed—and it has passed. In my opinion Greystone is better suited to her condition now. It’s our long-term care unit.”
“I know what it is.”
“Maud, I understand that’s a hard thing to hear, but I promise you she’ll be well cared for there, and comfortable. It’s the best long-term unit in the country.”
“You mean the best ice floe.”
“You don’t need to see it that way.”
“How would you feel if it were your mother?”
“If it were my mother I’d try ECT.”
“You would? You’d make her go through it? With no say?” Heat and anger had risen up in her blood, and she wasn’t hiding it very well. Or at all. Though she knew he meant what he said—they’d tried.
“So custodial care.”
“We don’t look at it that way.”
“But not treatment. Not leaving.”
“Maud, it would be very difficult for you to care for her at home while she’s in this condition.”
Maud refused to wipe at her tears. Let him see.
Dr. Straight regarded her carefully. “Maud, I am not the enemy. I promise we will do our best.”
“She has gotten worse since she’s been here.”
“Yes. That can happen, despite our best efforts. It’s an illness that can progress.”
“Maybe she needs to be home.”
“If I thought so, I would say so.”
Maud’s heart stopped. She finally heard him. Heidi was really, seriously ill. Should she consider ECT? She realized she had to. Dr. Straight was being honest with her. “Okay. Okay. Okay.” She stood up. “Thank you. I’ll think about everything.” She touched her bracelet. “Sorry if I was rude, but this is really stressful. I need her back.”
“Call me with any questions.” Dr. Straight was on his feet, too. Relieved, probably. Or maybe that wasn’t fair. Maud had been the tough one, not him.
Dr. Goodman stepped forward. “I’ll walk you out.”
“Oh! All right.”
Dr. Goodman was about the same size as Maud. She smelled of vanilla. Patients were probably disarmed by that. Dr. Goodman gestured for Maud to follow her down the hall. Neither of them spoke as they walked. Maud listened to the echoes, and distant shouts.
“There’s an empty room just here,” Dr. Goodman said.
She opened the door into a room set up seminar style. “Do you discuss cases here?” Maud asked.
“Yes. Let’s sit.”
An editor at work had taught Maud the rules of power seating in a meeting room. Never mind. She had no power no matter where she sat here.
Dr. Goodman laid a manila folder on the table. “Maud, I have spent a lot of time with your mother. I have gone through her file carefully. Her history is interesting. May I ask you a couple of questions?”
“Yes, though I can’t imagine what I haven’t answered already.”
Dr. Goodman let this go. “Where are her relatives?”
“She doesn’t have any but me and my father—her ex. Her parents died in a car accident—I’m sure that’s in there.”