Stephen White - Critical Conditions

The sixth book in the Dr. Alan Gregory series

I hold the hands of people I never touch.

I provide comfort to people I never embrace.

I watch people walk into brick walls, the same ones over and over again, and I coax them to turn around and try to walk in a different direction.

People rarely see me gladly. As a rule, I catch the residue of their despair. I see people who are broken, and people who only think they are broken. I see people who have had their faces rubbed in their failures. I see weak people wanting anesthesia and strong people who wonder what they have done to make such an enemy of fate. I am often the final pit stop people take before they crawl across the finish line that is marked: I give up.

Some people beg me to help.

Some people dare me to help.

Sometimes the beggars and dare-ers look the same. Absolutely the same. Im supposed to know how to tell them apart.

Some people who visit me need scar tissue to cover their wounds. Some people who visit me need their wounds opened further, explored for signs of infection and contamination. I make those calls, too.

Some days Im invigorated by it all. Some days Im numbed.

Always, Im humbled by the role of helper.

And, occasionally, Im ambushed.

Diane Estevez poked her head into my office at twelve-thirty. You free for lunch? she asked.

I try not to schedule appointments on Friday afternoon and had nothing on my calendar until three oclock, when I had to pick up Lauren at the District Attorneys office to drive her to DIA for a flight to Washington. Her mother had just been hospitalized with a suspected heart attack, and my wife was heading home to be with her family.

I answered Diane, Yes, as a matter of fact, lunch sounds great. We havent done that for a while.

I have one call to make, then Im ready. How about Jax? Is Jax okay?

Jax is good.

Diane went to make her call, and I locked away a couple of charts that were on my desk. She and I share an old Victorian house that we had renovated to house our clinical psychology practices. At the time we made the financial leap of faith required to invest in the building, we both had thriving fee-for-service practices that paid the bills and rewarded us handsomely for our labor. Over the last few years, though, changes in health care financing had altered the landscape for most health care providers, us included.

Diane and I had adopted different strategies to confront the revolution in the way health care was provided and paid for. She went into the psychological evaluation business with a vengeance, while I retreated into the narrow oasis of doing only fee-for-service psychotherapy. The commonality between us was that neither of us belonged to any managed care rosters of certified or approved providers if that membership required that we either reduce our fee or agree in advance to limit the care we might provide to our patients.

In the managed-care revolution, we were saboteurs. Fortunately, it was a luxury we could each afford. She had a wealthy husband. I had a working wife and a lot of experience living on lean income.

Jax Fish House, where Diane wanted to have lunch, was on the west end of Pearl Street in Boulder, only a couple of blocks away from our offices on Walnut. She arrived first and settled onto the chair I would have chosen if she had offered me the choice, which she never did.

She snapped open her napkin and draped it over her lap. So, you ready? Cause this is whats going on-I got a call from John Trent today. You know Trent?

I thought I had heard the name. Hes a psychologist, right? I think I may have met him at the IDC luncheon you dragged me to. But I dont really know him. IDC is the Interdisciplinary Committee on Child Custody, a group of mental health professionals, lawyers, and judges intent on making the process of determining child custody more humane. To me, the committees task felt, at best, Sisyphisian, at worst, quixotic. Diane was an officer and a recruiter for the organization. I was one of her recruiting failures.

Yeah, hes the one. Johns kind of new in town, what, eight months, a year, something like that? Maybe not that long. Hes from the Midwest somewhere, Kansas maybe, hes been trying to get established. He does gatekeeping out at Prairie View Hospital, does custody evals, and some forensic work at the jail. Anyway, Im indirectly involved with a custody case with him, nothing special, really, a run-of-the-mill Boulder divorce. She watched me fumble with the bread on the table. You paying attention here? Im not just talking for exercise, you know. The details are important.

Every word, Diane. Im hearing every word.

Okay. This is what it is, then, the custody eval? My psychotherapy patient is the husband-slash-father. Hes a decent guy with some character flaws that I certainly wouldnt put up with for a weekend, but then I wouldnt have married him, would I? Still, he has a heart the size of Bill Gatess wallet and some parental instincts that you just cant train. Okay?

I nodded and kept eye contact. I really wanted to open my menu. I didnt dare.

The wife-slash-mother isnt in treatment with anyone, but I suspect shes a narcissistic personality disorder who sucks Absolut when her kids arent around. Shes been investigated twice by Social Services-once for psychological abuse after she threw a tantrum at her daughters school, once for neglect after she stranded her kids with a babysitter while she slept off a binge.

Im with you so far.

My patient-the father-files for divorce awhile back and asks for custody of the kids. Girl, seven, girl, four. Court assigns the custody eval to John Trent and a social worker named Dani Wu who hes teamed up with to do evals. I know Dani from IDC. Shes good people. Shes good with kids, I like her work.

Our waiter dropped by. Hello, he said, welcome to Jax. May I bring you something to drink?

Before my lips had parted, Diane said, Iced tea? Alan, that okay with you? Lifting her eyes to the waiter, she said, Make it two, no no no, dont leave. Alan, you like specials?

Generally I do, but- I held up the menu forlornly.

She faced the waiter. Good. Well have two specials. And some bread, please, and thank you. She sipped at her water and turned back to me. If that was rude, and Im relatively certain it was, forgive me, but I have to get back for a two oclock and sometimes waiters disappear for so long in this town that I start looking for their pictures on milk cartons.

She wanted me to smile, so I did. When I didnt get a chance to be with Diane for a while, I really missed her.

So back to John Trent. From my point of view, custody determination is a no-brainer. Both my patient and his wife are flawed, but if my patient has a common cold, his once-beloved has Ebola. My patient has warned me from the start that it wasnt going to be easy. His wifes father, it turns out, is connected big-time, like with gold-plated Monster Cable. Hes some super Republican muckety-muck from La Junta, you know, is friends with George and Barbara, golfs with Gerald in Beaver Creek, advises Newt about PR, is on Colins Christmas card list. You get my drift?

Yes. I also got my iced tea. I squeezed a lemon into it and stirred in a packet of sugar. I liked the sweetener that came in either the blue packet or the pink packet but I could never remember which one I liked, so I used sugar unless Lauren was around to remind me whether I preferred the pink or the blue.