3rd September 2005
Case Notes: 652234BZ
Initial Assessment and Goldberg Depression Questionnaire.
On August 28th, the patient was showering at her mother’s home in Banks Street, New Orleans, close to the Mid City Yacht Club and Jewish Cemetery. The patient’s state of mind is perhaps revealed by the fact that, in spite of national concern and local panic, she refused to be evacuated along with her mother and younger sister. Stating that she wanted to take care of the house and protect it from looters, she remained in the property for three days prior to the hurricane. The dog, a German Shepherd, refused to be separated from her at that time, and even when she was discovered by the army the next day, in the Jewish Cemetery naked and distressed, the dog followed her into the EMS Truck and growled at anybody who got near her.
The patient’s mental history is fractured, she was admitted as a small child aged five when she attempted to push the baby’s stroller down the stairs and again the following year when she carried the baby into the street and left her in a box on the sidewalk. Both times the psychiatrist who examined her, a Mr Frobisher, could find no mental disorder or psychopathology, and she was discharged into the care of her mother. Later at twelve she was called in for guidance counselling at school after she was caught in the locker-rooms with a girl in her class. She begged that it all be kept off the record and vowed that she wouldn’t do anything like that again. The notes on her permanent record suggest that the school kept it away from her parents as they were going through a difficult and messy divorce.
After that, nothing for several years. Up until 2003 when aged twenty-two, she was admitted to a clinic at University Hospital near her home, after being discovered in a back alley, meters from her house wet and dishevelled with torn clothes. Here is another note relating to the family; “The mother was horrified to find her daughter being treated at a free-clinic and insisted that she be transferred to Red Oaks immediately, some six miles away across the river. She insisted that it was all nonsense and that her daughter ‘pulls this kind of stuff all the time’ before flouncing out for a cigarette. Even after we presented her with a positive rape kit she still wanted her in the hands of a psychiatrist, not a physician.”
I believe the mother may have a lot to do with the patient’s current mental state.
Six months later, during the coldest winter that New Orleans had seen in twenty years, the patient took a knife from the drawer of the kitchen cupboard and attempted to cut her wrists. She was admitted with chronic depression and drugged with Fluoxetine for two weeks and then released, once again, into the care of her mother.
My immediate impression upon meeting the patient is that she is depressed but also exhibits the classic signs of Bipolar Disorder, and a personality disturbance. She is an elaborator, and a pathological liar, although having met her mother, I can see that this need to conceal reality may be an attempt to conform to an impossible perfection.
I am passing her care onto Varla Jones for treatment.
Dr Trevor Phillips Psych. MD
It was raining the day I got raped. Heavy rain that killed the silence. I could hear a police siren in the distance, but it never scared him, it never stopped him. The rain was heavy but warm. If I hadn’t been being raped at the time, I would have thought, what a lovely night. In fact, I believe I did, when I was trying to disassociate my brain from my being. The rain that stole my screams, will remain with me always.
It was raining the day I tried to commit suicide. After they looked at my records, they said that I had chosen that day, that weather to tell people who wouldn’t listen the first time round, what had happened. That of course is not true. Had it been true, I would have chosen warm rain. It was icy cold on that bench, my fingers wouldn’t work the knife. Then mum came along, it was like a scene from a really shit movie. The mascara was running down her cheeks and I could see her breath.
Now the sun is always shining, my boss calls it a sabbatical, Mom tells me it’s an extended holiday; but for me, Los Angeles will always be prison. They thought it would be a good idea to send me here, far away from the hot, drenched New Orleans. The hurricane was the last straw. Some people call it insanity. In my opinion, the crazy ones are those who keep their heads when all around them others are losing theirs – I think that’s from a poem. I think I was the sanest of the bunch because I lost it first. I was in the shower when the wind started picking up. It blew in through the bathroom window, hot and wild and then; there I was, back in the alley. They found me naked in a ball, screaming obscenities to statues in the cemetery, Harry, our German Shepherd guarding my honour. Then and there the decision was made. I can see LA in all it’s glory, my cell faces the Hollywood sign. When she tells her friends, Mom calls it detox; when she drinks coffee with the senator and plays bridge with the girls. She picked the place, not just for its connections with the insane elite – allegedly Marilyn stayed here – but for its name; “Blossoming Cherries”. It doesn’t sound like an institution does it? For a moment I can imagine I’m on holiday, taking a break and relax. Then Betty the bulimic will start violently throwing up, making as much noise as possible and I’m snapped right out of it. Luckily for me, this is one of the only places left in LA where you can smoke a cigarette indoors. It’s dangerous to try and stop crazy people taking enjoyment from a still legal form of suicide. It’s the only thing keeping me level.
I’ve got my own room, which has all my things in it, but more importantly, I’m left mostly to my own devices. I masturbate so much, people think I’m in for sex addiction. They keep checking on me through the night, because I’m still a suicide risk, but the nurses are used to seeing me writhing on the bed. At first I would stop, embarrassed and apologise as the poor nurse just out of college would back away with a red face. Now I just carry on and she pretends she never saw anything. One night, my room didn’t get checked. Although I was in the throes of wilful abandonment at the time, I did worry! Suddenly the door opened. It was a new nurse, with short hair and big hands. She looked into my eyes as they glazed over and stood for a few moments watching me. As I finally settled she said “checks” and left the room. I never saw her again, and later found out that a dyke with a real sex addiction had heard about my nocturnal activities and bribed Betty to throw up later than usual, leaving the patients unchecked. Betty was moved to another floor.
I have a clinical psychologist who comes to see me three times a week. Her name is Doctor Varla Jones, and she is Russian. She insists on me calling her Varla, probably because Jones, her married name doesn’t quite fit her. I am totally in love with her. She was present at my inception. In all that madness, I managed to fall for her. As she came clicking into the room wearing grey suede Mary Janes and a grey tweed skirt. She looked strict. Her thickly rimmed glasses, circa 1983 slid down her nose repeatedly, and she, with a huff, would push them back up onto her face. I wondered why she hadn’t replaced them. She sat down at the table and the others left. With just me and her in the room, she said “Don’t lie to me and we will get on just fine.” Her smooth, Eastern European accent had me ready to do whatever she wanted me to do. She pulled out a packet of tobacco and some liquorice papers and rolled herself a dainty cigarette which she lit with matches. “Don’t complain about my smoking and we can perhaps get on even better”. My heart jumped to my chest and my skin goosepimpled. I later realised that although her command of the English language was commendable, her musings were often out of context and could be easily misread. I know she will never love me.
No one actually knows me, I’m a compulsive liar. I lie about the most mundane of things. You can choose to believe what I say or not. Everyone is allowed a choice. Someone asked me where I was from, and I told them Seattle, for no reason whatsoever. Eventually they stopped asking me because I couldn’t keep my stories straight. If you ask Betty, I have a maternal grandmother and a paternal godfather. But ask Amanda, and all my grandparents are dead. It’s hard to keep up and sooner or later people talk to each other. I won’t bore you with my life story, because it is pretty ordinary. That is why I lie about mundane things. I am just about the most boring person you will ever encounter. I was an only child, spoiled, precious, precocious! Schooled privately, I watched a lot of American high school sitcoms and was adamant that my life should follow that path. I should be head cheerleader, date the captain of the football team and eventually marry him and we should be ‘Prom King and Queen!’ This ideal lasted until I was thirteen and discovered girls. I had secret love affairs with most of my class and I mean secret. Mom was clueless, despite sending me to an all girls school, despite watching me get my hair cut from shoulder length to a short crop, despite my various medals for lacrosse and tennis. She just accepted the Martina poster and well thumbed copy of ‘The Well Of Loneliness’, although to be fair, I doubt she knew what that book was about. Ok, so I lied again, I told you about my life, it just slipped out.
In the 16 months I’ve been here, no one from my old life has visited me, apart from my mother. She sits on the hard wooden chair in the private visitor’s room, because the deep, plush arm chair is too close to madness, too close to me. When she is here, she tries to distance herself from anything crazy, just in case she catches it. Of course this is impossible, you can’t catch insanity, when you are already insane! I caught it from her. Her infectious mental disorder, which involves an inordinate amount of armour. She is a Stepford Wife. This did not much affect her when she was younger. The epitome of perfection; stay at home mom, cook, cleaner, saint. After Dad left, she went nuts in the expected way. One day I looked up each of her symptoms individually and found answers to all my questions. Attention Deficit Disorder, OCD, Paranoia. She couldn’t cope with being everything, so she slipped into a state of denial, in which she has remained for the past 18 years. Being crazy is like being gay; even when you deny it, renounce it, and go running into the closet, everybody knows. I may be queer, but she is a screaming, closet crazy.
