Sunday, October 12, 2008

Diagnosis, Part I

We sit in the waiting room in the Psychiatry Department, and we wait. Considering that it took us so many months to get this appointment, the waiting room here is not as nice as I thought it would be. It’s actually kind of sad. There is a worn train table, but there are no toy trains or cars to be seen. There is a chipped plastic musical toy that even Secondo, who adores anything with buttons that plays music, only tries out once before he loses interest. I have his favorite book, one about a school bus, in my purse, and I hold him on my lap and read it to him over, and over, and over again. He wanders over to the double doors occasionally, and I follow to make sure no one opens them and knocks him over.

We wait, and we wait. I am sick of the book about the school bus. After about an hour I hear the receptionist whispering animatedly on the phone. Tell her she’s got a patient waiting, she hisses loudly enough for me to hear, then hangs up and tells me the doctor is on her way down.

I can tell you all are really busy, I say, trying to sound sympathetic.

This place is CRAZY, she says, shaking her head, and I nearly start to laugh, considering where we are and all, but she doesn’t seem to realize what she’s said.

Dr. A rushes in, finally, and greets us warmly. She had an emergency upstairs. She disappears in the back for another twenty minutes. I assume she’s reading Secondo’s chart, or at least I hope she is, because filling out all the paperwork was draining and took P and me hours.

She walks back out, this time with an entourage of about four other doctors, interns, who knows. I don’t remember. They all stand in a row holding their clipboards and though she introduces them all, I am disconcerted by their presence and their names don't even register.

We go to the playroom. The carpet is dark and the room is small and bare, except for a table and chairs and one large window, which I later realize is a two-way mirror. Dr. A and another doctor (the others have disappeared behind the mirror, I assume) break out a bin of toys and watch Secondo play even as they’re grilling us. They ask P and me probing questions that throw me for a loop, questions about breastfeeding and baby blues, our marriage, high school. Secondo wanders around, not so much into any of the toys with the exception of a hot pink Barbie convertible. At one point he gets up and starts licking the armrests of every chair in the room. I am so taken aback that I can’t even speak, because I’ve never seen him do this, ever, and it makes me feel deeply uneasy. Absurdly, a clip from the movie Airplane! starts playing in my head: Jim never has a second cup of coffee at home. Secondo never does this at home. But I don’t say that, because he's doing it now. Instead I distract him and he moves on to something else.

Dr. A is full of positive comments. It’s always hard to diagnose children who’ve received good parenting. You have a gentle touch with him. I think your instincts are good. She needs to see Secondo a few more times, she says. She and the second doctor talk for a minute about repetitive behaviors they've noticed. It’s just such a relief, I tell her. It's such a relief to have someone NOT dismiss my concerns. And all of a sudden I am crying so hard I can’t speak. Someone passes me a box of tissues that is on the table. I hadn’t noticed it when we came in. Of course they keep them right there, I think. Duh. And as I try to regain my composure I am reminded of all of the witnesses I’ve ever interpreted for who have cried on the stand as I’ve stood next to them, waiting, sympathetic but detached and professional. There’s always a box of tissues right there, but they never notice it until someone nudges it in their direction.

I know this is hard, Dr. A says gently, and that’s when I stop crying. No, I tell her, wiping my eyes. This isn’t hard. The hard part was taking him in for that very first appointment.

This is what I’ve told people for many months now, and I’ve firmly believed it. And yet, today, even as I’m saying it, I realize it’s not true, at least not this time.

Because it is hard. Even when you see it coming, it’s hard.