Doctor Simone's catchphrase, at least as far as Marie could tell, was 'why would anyone want to be anything other than themselves?', which was hilarious, since Marie could think of plenty of reasons. Striding into the clinic for her weekly appointment, she had settled on “Doc, if I was someone else, maybe I'd have someone in my life who cared.”
For starters, Marie knew that the receptionist didn't like her. Any bored middle-aged woman who just shoved a clipboard at her and instructed her to “please fill out this form and wait until your name is called” without even a glance in her direction had to be hostile. Though, it had occurred to Marie: maybe this receptionist was just unpleasant to everyone and needed to be told so, required a moment of come-to-Jesus clarity to snap her out of her belligerent stupor and leave her with a renewed sense of fellow feeling for other human beings.
Or maybe that would just invite more unpleasantness. Today, since Marie had entered the clinic in an already-off state, she decided not to risk it. Someone else would have to deliver the sermon.
People in her life just seemed to exist to either harass or hamper her. Just that morning, as she was rousing herself from her early morning lethargy, Marie's cellphone had started rattling on the kitchen counter, which was right where she'd left and forgotten it after another late night of drinking boxed wine and trying and failing to decide what to watch. Assuming it was Doctor Simone, canceling or confirming or whatever, she'd launched her stocking-clad feet across the hardwood floor, sliding just slightly yet still poised on the balls of her feet, and picked up the phone. But it wasn't her doctor.
“Hey, Marie, it's uh um,” stuttered her brother.
“Oh,” Marie said.
“Marie, hi,” Her brother had never been one for conversation, or for subtlety. “Look, Mom wanted me to call you, wanted to let you know that-”
“Of course she did. You never call otherwise,” Marie said, “Well, I'm not going.”
“Nu-uh, not interested,” and she'd swiped right out of the call. Her mother knew full well that Marie's therapy appointment was in a matter of hours, and it was all too typical for her to send Marie's brother in advance to throw Marie off-kilter, before landing the killing blow herself. And once Marie was off, she was off. Not even admiring her reflection, hearing the phone ring again and ignoring it with smug satisfaction, and turning her razor into a microphone and miming what she imagined her mother's voicemail must be sound like, could recenter her.
“Listen, Marie, just wanted to let you know about, just asking about a little get-together the family is having,” and now her razor was the stupid red licorice her mother was always chewing, “Now, I know you that you've been really down lately, and I know things aren't the best, but just know, we're your family, and we're really behind you. All the way.” It was a fantastic impression; and yet, it felt hollow, inspiring dread rather than cheer, like the acid worming its way through the pit of her stomach.
And so, since Marie had become so decentered, she was late heading out the door and had gotten stuck in traffic, as she always did on the way to therapy. When she finally pulled her car into the clinic, she had missed her projected entry time by ten whole minutes. Another source of irritation for that receptionist, Marie was sure.
But it was a fellow patient who had chosen her as a subject of displeasure today. While Marie crossed one leg over the other, settled into the bony architecture of the waiting room chair, and regarded the evaluation sheet in front of her, all she could do about the burning gaze of the woman across from her was ignore it. After all, Marie thought, it was best to focus on the things in your life that you could control. Another Simone-ism.
“Little interest or pleasure in doing things,” Marie murmured. The glaring woman was pretending, poorly, that she wasn't staring by intermittently glancing into the depths of last month's Women's Health and Home. “Not at all, several days, more than half the days, nearly every day.”
The last few times she'd considered lying on this thing, she'd always concluded it wasn't worth the hassle. She'd have to keep the lies consistent, since she knew the whole point wasn't about treating her depression. It was about confirming their model and proving that their methods of treatment were efficacious; it was about keeping people like Marie in therapy and keeping therapists like Simone paid so they'd get to drive their SUVs to their three story houses with kids who weren't impoverished and went to fancy private schools and pretty boy husbands who brought in six figures; and, ultimately, it was about power. So, she'd try to answer honestly, if only as a good will gesture. Even if everyone else hadn't been willing to grant her any.
As far as interest or pleasure went, it really depended. Marie wasn't sure how the evaluators were defining pleasure here. That was the problem with these tests: they purported to define once and for all how a human being should act and called it objective science, and deemed anyone who deviated ill.
“Doing. Things,” she repeated. What things, precisely, were covered? Her mother perpetually accused her of languishing, but Marie had always enjoyed doing nothing, most of the time. “But is doing nothing doing something?” Marie's pen looped around 'several days,' just to be safe.
“Feeling down, depressed, or hopeless.” Mrs. Woman's Health glared at Marie's full throated laugh. The question nearly made her giddy enough to meet the older woman's gaze, though she wasn't sure if she wanted to give the game, namely that she was aware of Mrs. Woman's judgmental gaze, away.
Her and Doctor Simone were having such a fun runaround about depression since Marie had posited its nonexistence three weeks ago. She'd argued it was grief, and that she didn't see any reason for singling out depression from her default state, since unless it was the very very depressed despair she felt on occasion, it all just felt like an intensification of what was already present, and she was certain that wasn't what they testing for. She knew her shrink didn't care about her grief, just what was pathological.
Now, Doctor Simone was on the warpath to prove to Marie not only that depression existed, but that Marie was one of its primary sufferers, opening up whole new vistas for Marie to frustrate her therapist. Last week, the Doc had been reduced to arguing that her insurance of all people needed her to acknowledge her depression.
“Did you know that over a fifth of the world's population has a documented case of depression, Marie?” Doctor Simone had tilted her head forward, to crowd Marie, while also leaning back, to signal professional disinterest.
But Marie had spied a brown winged sparrow perched on the metal fence. “That's real nice, Doc. Real nice.”
“We have studies. Real documentation.”
“I don't believe in it.”
“How can you not believe in depression, Marie?” Doctor Simone was always scribbling on her notepad. “I can show you the studies, you know.”
“If I believe in it, I give it power over me.”
Doctor Simone had tried passing Marie yet another printout, and she'd scanned the squiggles of the graphic and the dry-as-the-grave abstract before staring out at the sparrow stretching its wings and yelling out its twitter.
“Old study. I bet the numbers are different, now. They're always changing, those numbers.” Whenever she needed confidence in her appointments, she'd just stare at the Doc's oversized forehead. “Do all you doctors really believe that the world is made up of numbers?”
“Did you even read it, Marie?”
Sparrows were little brown speckled gremlins and Marie's eyes were cameras, complete with shutter and lens, capturing their flight. She had felt like she could swallow the moment whole. “Sure I did. Statistics level individuals, so I saw the stats, and didn't read anymore, to prevent leveling. I refuse to be leveled. Get behind me, Simone.”
Simone sighed and disengaged the tilt of her neck. “It always goes like this with you. I really do want to clear you out of therapy, you know. I swear I do.”
“Then do it! I'm perfectly fine. Raring and ready to go.”
“But you're not fine, Marie.” She just about slammed Marie's case history on the table, that damned manila folder all wrapped with elastic bands. “That's why you're here.”
“I'm here because I'm forced to be here.”
“That's your perspective, Marie.”
“Did you know, Doc, that I never really understood bird watching,” Marie always enjoyed one particular reaction of Simone's, where she'd tilt her head and her eyes widened while the grip on her pen tightened, and when the weather was warm enough, her forehead glimmered with sweat, “until I started watching birds?”
“What are you talking about now, child?”
“I'm a woman, not a child. Do you think birds get depression?”
“Marie, we've been over this. I need you to take these sessions seriously. This form goes to your insurance. And they have this history on their file too. And your insurance, when paying for these sessions, wants to know what we're doing. And they definitely do not want to hear-”
“Then lie. Actually help me, for once. I'm not crazy anymore. You cured me. Congratulations.”
“I can't lie, Marie. That would be an ethical violation. I could lose my practice.” She had whipped out the green assessment from behind her pad. “I actually read these, you know. I know you think I don't, but I do. Little interest or pleasure in doing things, you've marked more than half the days. Feeling down, depressed, or hopeless, feeling tired or having little energy, you've got nearly every day marked. If you're not sick, then why do you keep scoring so high on these assessments?”
“If I were a bird, I'd be depressed.” Marie stared out the window, chin resting in the palm of her hand. “Do we assess sparrows for depressions? I bet they'd score pretty high.” The sparrow had shuddered on its branch when Marie pointed at its quivering form. “Does that look like someone, or a being, with interest or pleasure in doing things?”
“Seriously. I am being serious, here. What if we turned this around? We could do a study. Multidisciplinary. Do you think sparrows gets depressed; and if so, how many sparrows are depressed versus the entire sparrow population? And we could cross reference the human numbers, to tabulate or whatever whether sparrows are depressed at higher rates than humans. It could be groundbreaking.”
“Marie,” Doctor Simone had snatched the form back. “This is hopeless.” Hopeless. Such a strange concept, to be lacking in hope. In her initial intake, her mother had described her as hopeless, but Marie figured she had plenty of hope. She hoped someone would actually care about her instead of endlessly trying to fix her, for starters.
”Eugene Deter?” chimed the nurse. Marie refocused her eyes on the evaluation in front of her. Her name could be called at any moment and it wouldn't be nearly as much fun if the session started with a lecture on arriving earlier to get the stupid worksheet completed.
“Several days, more than half the days, nearly every day,” she muttered. She hoped her life would change forever. She hoped she would be famous for something worthwhile. Sometimes she even hoped someone else would love her. As far as depression went, Marie decided to circle 'not at all.' She was tired of being chewed out for answering honestly.
“Trouble falling or staying asleep, or sleeping too much.” Her sleep was mostly under control. Sure, after she'd gotten the news about Dad, that had been the last straw of a kind. She hadn't left her bed for days, the blankets she'd hidden under weighed less than her grief, which weighed down her soul. If she even had a soul. And while this week hadn't been nearly so bad as last autumn, the memories still weighed heavy.
Last night's indigestion nightmare came to mind. So, assuming she answered honestly, this one had to be several days, at least. In the dream, she'd driven back home with a coffin on the roof of her car, convinced only her parents could help her get rid of it or bury it or whatever. Her mother had answered the door, but it wasn't her mother. It was the old woman from the grocery checkout.
“I don't have a daughter,” she'd cackled, “Why should I help you?”
“Do you know where Dad is, then?” but the woman had just laughed and then Marie remembered that her Dad wouldn't be able to help her with anything anymore.
What about Monday night? It had also been pretty restless, she thought. Sunday, then Saturday, Friday. “Shit.” Had she gotten any sleep this week? She circled more than half the days. Or was this another one to lie on? She didn't really want to talk about sleep with the Doc.
“Feeling tired or having little energy.” Another problem with these questionnaires was the repetition. They were all synonymous with each other. Feeling down was clearly the same as feeling tired, right? And how could feeling depressed be a symptom of depression?
“Not at all, several days...” Yes, she was tired, yes, her energy was low, and sure, maybe she was depressed, but the reasons for all of these were obvious: she was grieving and her life sucked. She wasn't sick. That's why she drank coffee and sometimes even swallowed the pretty pink pills they'd given her. SSRIs, antidepressants, or whatever she was on now.
Was there a coffee shop in the building? Her eyes darted around the room, which had the unintended side effect of meeting the older woman's cats-eyed glare.
“Ronald Feldbar?” a nurse chirped out behind her. Marie circled an option without looking. The magazine reader's gaze felt like lasers boring into her scalp.
“Poor appetite or overeating.” Marie wiggled in her chair. These questions weren't particularly fair. Something about the way they reduced her experience into boxes, tabulating the frequency of her various miseries like sports statistics, was so gross and invasive. She pictured her tee-ball coach staring down at the evaluation, like she'd assessed her gangling toddler arms hardly able to hold the aluminum bat, shaking her head and telling her 'you feel bad about yourself too much. Get back on the bench, Fenske.'
When Marie lifted her gaze up again, the woman was still staring at her, now with impunity, without even the illusion of social embarrassment or propriety. Had it been the eye contact, or Marie's previous vocalization that had finally tripped her into open hostility, instead of veiled? Marie hated this kind of older woman. What was it about them, that they couldn't help but mess with her like this?
Stick em up, Women's Home and Health, she thought. This here's a robbery, don't you ever mess with me or my friends again. I'm cleaning this town up. Giddy up. Yeehaw.
Marie didn't feel all that hungry and circled not at all.
“Feeling bad about yourself or that you are a failure or have let yourself or your family down.” Hadn't she already answered this one? She did feel bad about herself, but one of the few sources of joy in her life was letting her family down on a regular basis. Maybe they canceled each other out, she mused as she circled 'not at all.' Oh, she felt bad about herself alright, but she wasn't going to let Doctor Simone have the satisfaction, not this time.
“Geraldine Riebsen?” So Geraldine was Mrs. Women's Health's name. She dropped the shiny sheathe back onto the plastic lacquered coffee table and Marie was so relieved she laughed aloud again and got a particularly nasty parting glare back.
The next time Marie craned up her neck, she watched a particularly pruny specimen wiggle in with her walker and wondered what older people even had to therapize about. It had always struck her as a racket to control the young, especially teenage girls, at least based on her own experience coupled with the news she'd watch which continually complained about the young. She hadn't heard of an elderly mental health crisis, though she wished there was one. Imagining a headline like 'Older Midwest Man Arrested and Forced into Therapy' gave her a brief twinge of glee.
The pen was poised between her finger tips and flipped between her pointer and middle fingers. “Focus, Marie. Trouble concentrating on things, such as reading the newspaper or watching television.” She giggled. Wasn't she hilarious?
“Thoughts that you would be better off dead, or of hurting yourself.” Ah, yes. The big one. The S-word. Marie was pretty sure they checked this one. Not at all was always the answer to this question, or else you'd get written up as a flight risk from this plane of existence, a jail-broken jailbird, and once your name was tied up in all that, it was the beginning of the end of any imagined future freedom. No, she'd be mandated into therapy for life; even more than she already was. Not at all was the correct answer, here.
“If you checked off any problems, how difficult have these problems made it for you at work, home, or with other people?” That one was easy. Not at all.
“Marie Fenske?” chimed the nurse.
Just in time.