CHANGES

He opened the door to his office and poked his head into the comfortable waiting room. There were no typical waiting room chairs; instead, the waiting area looked more like a cozy lounge, with couches and several chairs that one could sink into. Quiet, soothing music filled the room, creating a peaceful environment. A young woman sat on the edge of one of the chairs, moving restlessly, her arms crossed tightly over her chest. She was gnawing at her lips, and he could see where she had pulled the skin away from her lower lip. She had large glasses that took up a good portion of her face, and the sides of her face seemed to be covered with a thick layer of hair that fell on either side of her face. A thick fringe of bangs covered her forehead.

‘She’s nervous and closed off,’ he thought, quickly assessing her body language.

“Good morning, it’s Gwen, isn’t it?” At her nod, he continued. “I’m Dr. Keefer. As Dr. Russ probably told you before he retired, I will be taking over his caseloads. He has filled me in on all his patients, and I am excited to get to know each one of them. He has told me how you love hiking and painting. Those are two of my favourite activities as well. I’m sure we will have a lot in common. Come in and have a seat, and we can really get to know each other.”

Gwen nervously entered the room and looked around at the new furnishings.

“ I know everything is different, but that's okay. Soon, this room will feel very comfortable for you. This is the start of a new relationship between us, and that's new too. I know that when things change, it's sometimes difficult to deal with the change, but let's try to think of this as a new beginning, shall we?

Gwen looked dubious, but at his generous smile, she gave a quick nod. She walked around the room casually, looking at the furniture and noticing there was no standard psychology couch like Dr. Russ always had. Dr. Russ had been old school, and Dr. Keefer was obviously not. In an alcove was a small roll top desk and a file cabinet with a lock, and a key protruding out of it. The main part of the room did look cozy, several chairs sat facing one another, separated by a small coffee table. An ivy plant and a box of Kleenex rested on the table. A small fountain sat on a pedestal in the corner, the water gently gurgling, creating an ambiance of serenity. The room was done in shades of blue and white with tropical landscapes on the walls. All in all, it made for a tranquil setting.

Gwen stood in front of one of the pictures, studying it. “I like it,” she said at last.

“Thanks,” said Dr. Keefer. “I painted it after a trip to the Caribbean.”

“You painted it?” questioned Gwen.

“Yes, I painted all of them,” he gestured around the room with his hand, encompassing all the artwork.

“Ok, I think we will be able to talk,” she muttered reluctantly.

“When you finish looking, you can take one of the chairs.”

“You don't have a shrink's couch,” she stated.

“I think this is more comfy, more cozy, and it makes it easier to talk to one another.”

“We will see,” she said, taking a seat. As she seated herself, he could see the scars on her wrist, marks from her self-harming behaviour.

“How was your week?”

“Okay, I guess. I really don’t remember.”

‘Ah yes,’ he thought, remembering the copious notes Dr. Russ had left him. ‘Gwen often had memory lapses.’

“I'd like to ask you how you feel about the change in doctors?”

“I don't like it,” Gwen said bluntly. “I have been with Dr. Russ for a long time. I don't like change.”

“I understand,” he said using a soothing voice. “This is all new for me too.” How did you feel about coming here today, knowing that you would be meeting a new Psychiatrist?”

“I want Dr. Russ to come back.”

“I understand, but Dr. Russ has retired, so that’s just not possible.”

“But I want Dr. Russ. I need him.” Her voice rose.

“I understand.”

“ No! You don’t understand; no one understands,” she said, burying her face in her hands.

“I'll give you a few minutes to regain your composure,” he said softly over her tears, and pushed the box of Kleenex across the table towards her.

A few minutes turned into a lot of minutes. He glanced at the file that Dr.Russ had left for him, pertinent information on each patient. Gwen’s file was the thickest. It had taken him a long time to wade through the file, reading about Gwen’s childhood trauma. Originally, Dr. Russ had diagnosed her with split personality and then changed his diagnosis to MPD, Multiple Personality Disorder, now known as Dissociative Identity Disorder or DID. The file had indicated that, thus far, Gwen had shown at least four distinct personality states. Her alters varied in personality, age, gender, behaviours, likes, and dislikes.

Gwen had been undergoing Psychotherapy for years, since she was a child and had witnessed the murder of her twin sister.

At last, she raised her head and dried her eyes. Then, she slicked back her hair, and taking an elastic hair tie off her wrist, she pulled her hair back into a sleek ponytail. She took off her glasses and laid them on the coffee table between them, revealing a pair of penetrating blue eyes. Gone was the geeky, bookworm look; a confident woman now sat before him. When she spoke, she spoke in a deep voice with a French accent.

“Is it possible, Monsieur, to obtain a glass of water?”

He was almost caught off guard, but years of training in the field of mental health had prepared him to deal with most eventualities and to hopefully meet the needs of her psychological conditions.

“Yes, of course, Gwen. I have bottled water in the mini-fridge in the corner.” He rose and fetched a bottle for her and one for himself.

“I am sorry, Monsieur, you must have me confused with someone else. My name is Bernadette. I am often confused with other people. C’est la vie!”

“Bonjour Bernadette, je m’appelle Dr. Keefer.” He reverted to English. “I‘m sorry, but my French is very limited, shall we converse in English?”

Dr. Russ was correct; she does seem to switch personalities in the blink of an eye. With some patients, the switch between their alters or various personalities took minutes, hours, or even days, but Gwen had just shown him that with her, the switch was almost immediate. This was very interesting; he had always been intrigued by DID, or Dissociative Identity Disorder. Gwen would certainly prove to be an interesting case.

“C’est dommage, that's too bad, but yes, feel free to speak in English. I happen to speak several languages.” She sat back, relaxed and confident in her easy chair. Her rail-thin arms lay at ease on the armrests.

Another classic symptom, Dr. Russ had also indicated that she suffered from eating disorders as well as sleep deprivation. He reached for his clipboard on the side table beside him and glanced down at his notes.

“So tell me about yourself, Gw … Bernadette? Since you like art, I'm glad you like the way I have decorated the office and that you appreciate my paintings.”

“Non, I actually don’t care for paintings or art.” She laughed boldly, “I’m more into sports.”

“ My mistake,” he said. “Just relax now, don’t be nervous, let's just get to know each other.”

“I’m not nervous,” she claimed boldly.

‘Ah, yes,’ thought Keefer, ‘classic DID, where the patient’s alters often were very different.

Suddenly, the phone rang loudly, breaking the peaceful atmosphere.

“I’m sorry,” said Dr. Keefer as he rose hastily and crossed to the desk in the alcove, and pushed several buttons, quieting the jangling phone. “I’m still getting to know this new phone system. I haven’t figured out yet how to put it on hold, so we aren’t disrupted.”

He turned back towards his patient, only to find her releasing her ponytail and smoothing it back to partially hide her face, almost like a veil. She once again had the ponytail holder on her wrist. She reached over and picked up her thick glasses and crammed them on her face, masking her beautiful blue eyes.

“That scared me,” she said in a subdued voice. Her arms crossed protectively around her body, her shoulders hunched. “It was so loud.”

So the loud ringing of the phone had acted like a trigger, and it was Gwen; she was back.