The patient sized up the doctor, unsure if to step forward in the office or turn around and run.
“Come in and have a seat, the doctor said with a calm, easygoing smile, pointing to the light-blue armchairs in the middle of the room. She sat down herself and crossed her legs at the ankles. Middle-aged, shoulder-length auburn hair, black frame glasses, dressed in a white silk blouse and charcoal grey trousers.
The patient, a young woman in her early twenties, short, corpulent followed the doctor in the seating area.
"Are we waiting for your friend?" The doctor asked and grabbed a notebook off the coffee table.
"My friend?" The patient, asked with a frown and remained unseated, glancing at the door in confusion.
"Last week I suggested you'd bring a family member or a friend along for our first session," the doctor explained. “It’s alright, we’ll start without them. Please, sit down.”
The young woman sat down in the over-sized chair, placed her purse on the floor, next to her feet and the paper coffee cup on the coffee table. She took in the modern artwork on the walls, the book shelves, the large silver clock above the mantel that read 11:02am, the cold fireplace displaying decorative white-bark wood logs.
“Do you mind if I record our conversation? I’d rather focus on our exchange than take notes."
“Not at all, “ the patient answered, adjusting her position in the armchair. She placed her forearms on the armrests. Immediately she changed her mind and rested her hands in her lap.
The doctor pressed the button of a little device sitting next to her and returned to the patient with a smile. “So, how are you doing?”
The young woman froze for a few seconds. Then she titled her head, a puzzled look on her face. She grabbed her purse.
“I’m sorry, I’m not sure what I’m doing here,” she replied and got up.
“It’s ok,” the doctor said. “You’re safe here. Let me fill in the gaps for you. Have a seat, please. Would you like some water?”
“I got my tea, thank you. What am I doing here?” the young woman asked again, her eyes wide, shielding her chest with her purse.
“You’re here because you suffer from dissociative amnesia,” the doctor explained in a calm, soothing voice.
“From what…?” She asked and her eyebrows shot up in disbelief.
“It’s a temporary mental condition that occurs when a person blocks out memories associated with certain events, like an accident, trauma or abuse – “
“Trauma?” the young woman interrupted and got up again. Her face was flushed and her voice had gone up on octave. “What trauma?”
“That’s why we’re here. To identify the trauma that you must have suffered recently. Or just witnessed, hopefully. And to recover personal memories you’ve lost due to this traumatic event in your life.”
The young woman blinked, the corners of her mouth pulling down, weighing down the doctor’s words. The lines in her forehead deepened.
The doctor leaned forward and reached for her hand, but the patient awkwardly sat back in her chair. “I am going to walk you through this step-by-step. I know it sounds scary, but that trauma is behind you. We’ll take it slowly and we’ll pause as soon as you feel overwhelmed. How does that sound?”
The young woman glanced around at the unfamiliar environment. Then back at the doctor’s calm, placating smile. She slowly put her purse down next to her feet and grabbed the paper cup. She took a few sips of her tea.
“Alright. Let’s start small. Tell me something about yourself. Your name for example. Without checking your I.D.”
The young woman blinked, looked away to her right and frowned, helplessly.
“Take your time.”
The patient grabbed the cup off the coffee table and read the scrawl off the label, “Bella. It looks like my name is Bella.”
“That’s the name you gave the barista, but it’s not your real name.”
“What is my real name then?” the young woman, shifting in her chair and glancing at the door.
“Your name is Madison. Madison James.”
The patient shook her head with derision. “Madison? No way. Rhymes with ‘medicine.’ Can’t be my name,” the young woman replied and snickered.
“And yet, it is. What else can you tell me about yourself? Where do you live, for example?
“Not too far from here, I believe. Maybe two blocks away? I’m wearing my gym clothes, my sneakers. I think my plan is to go to the gym after this.”
“That’s very good, Madison. That’s progress – “
“Don’t call me Madison,” the patient protested in an irritated tone. “That’s not my name.”
“Alright then,” the doctor nodded, graciously. “Tell me about your family.”
The young woman thought for a few seconds and shrugged her shoulders. “Don’t remember if I have any family. I could be an orphan, as far as I know.”
She grabbed her cup and sipped some more tea.
“What about children? A husband?”
“Husband?” She glanced at the fingers of her left hand. “It doesn’t look like I’m married. Thank God. How would I care for a husband and children in my condition? I can barely take care of myself.”
“Do you have a job?”
The young woman grimaced, looking up, then to her right and drew another blank. “Not sure. Must have, though. I got some cash in my wallet. I paid for the tea with a five-dollar bill, I think.”
“That's very good. Do you live alone?”
“Alone, I think. But again, not sure.”
“What about friends?”
The young woman looked at the window, a hard look of concentration on her face. “Let me see. I must have a friend since I was supposed to bring one along today. Correct?”
“Exactly. What happened? They couldn’t make it?”
The young woman grabbed the paper cup and sipped some more tea, mulling the question. The room remained quiet except for the discreet ticking of the clock on the wall. It read 11:13am.
“I don’t remember my friend’s name or why he or she bailed on me this morning. Not much of a friend, now, are they? Abandoning a friend in need?”
“I’m sure there is a good explanation for that.”
“Did I arrange for this session myself?” the young woman asked. “I have no recollection of doing that. Talking with you, or your receptionist.”
The doctor stayed quiet, playing with the little pearl button of her left sleeve.
“My memory is atrocious,” the young woman continued, her voice filled with frustration and revolt. “I remember what I had for breakfast three days ago, but I can’t remember my conversation with my alleged friend half an hour ago.”
“Your brain has blocked any painful memories related to the trauma you’ve suffered or witnessed – “
“Will I ever recover my memories, doctor? Is there a chance I’ll be a normal person again?” she asked and clenched her jaws in an effort to control her quivering voice.
“All my patients suffering from dissociative amnesia have recovered their memories, or most of their memories. It could take a few weeks, months maybe, it depends. A stressful event can also "shake up your brain" and trigger your memories— “
“I think I’m going to pass on the “stressful event,” the young woman sneered and rolled her eyes. "I got enough on my plate, thank you."
“How about we try a simple memory exercise instead, “ the doctor proposed, flashing her disarming smile. “Sometimes familiar objects can trigger memories in the most surprising way. Do you want to try that?” And when the patient seemed intrigued by the idea, she added, “Like the contents of your purse, for example. What we carry around tells us a lot about ourselves.”
“My purse, really?” The young woman fixed the doctor for a few seconds, then grabbed her purse and, in a defiant gesture, emptied it on the coffee table.
“Have at it, " she dared the doctor and crossed her arms, her eyebrows arched high, scornfully.
“Listen, I imagine how frustrating this must for you. But if we want to make any progress today, we must start somewhere— “
“Fine, “ the young woman scoffed and picked at the objects on the table. “I got lip balm, tissues, baby wipes, toiletry bag, a bus card, grocery list, receipts, a book, some type of coffee discount card— “
“Ok, that’s great. What do these items tell you about yourself so far, you think? The baby wipes, for example.”
A shadow of alarm flashed in her eyes, but she blinked it away. “I must use these for personal hygiene. To freshen up after gym, I assume. They’re less expensive than the ones for adults.”
“Are you positive they’re not your baby’s wipes?”
“My baby? What baby? Where’s the baby, if I had one? What kind of mother would I be leaving her behind? Or ‘him’, whatever.”
The young woman’s voice has gone up another octave again. Her fingers shook as she played with the discount card.
“We’re just playing a game. No wrong answers. What about the discount card?”
“I must be a frequent customer of 'Pete’s'. Two more purchases and I win a free beverage.”
“The name tag?” the doctor pointed at the white piece of plastic on the table.
The young woman picked it up. The name tag had a 'Pete’s' logo and the name 'Madison' embossed on it.
“Huh! It looks like I am a barista there. And my name IS Madison. What a shame,” she sighed bitterly.
“Good job so far. What else can you tell from your personal items?”
“Well, it looks like a take public transportation. No car keys. I shop at 'Raley’s'.”
“Not bad. Let’s see the outside pockets now.”
“Wallet, cell phone, house keys, chewing gum.”
The wallet contained forty-three dollars and some change, a few wrinkled receipts, a photo I.D. of Madison James, one ATM card, medical insurance and library cards. Also various business cards: a hairdresser’s, pet crematorium’s, veterinarian’s, dressmaker’s.
“And this must be yours,” the young woman said, glancing at the name on the business card. “'Miranda Sanchez, Psychoanalyst'. Have no idea how I got it, though. My buddy, probably, gave it to me, the one who bailed on me here today.”
“Let’s check the inside pockets now. Unless you want to take a break, “the doctor proposed, glancing at the wall clock that read 11:33am.
“Am I keeping you?” Madison asked, unloading the content of the inside pockets on the table.
“Not at all,” the doctor assured her. We have plenty of time. Let’s see what you’ve got there.”
The inside pockets revealed a dog tag, a baby rattle in the shape of a dumb bell, a medicine bottle, a plush toy, a tiny black velvety bag.
“Quite a treasure there,” the doctor observed with satisfaction.
The young woman didn’t reply. She stared at the objects on the table without saying a word. Eventually she picked up the small velvet bag and dumped the content in her left palm. At once a flicker of recognition gleamed in her brown eyes.
“My old engagement ring.”
She smiled at the glint reflected in the small diamond.
“Any flashbacks?” The doctor prodded, gingerly.
“We were engaged for almost a year before he started complaining about… all sorts of things. I planned to return it one evening, but he stood me up.”
“Do you remember his name?”
The young woman concentrated for a few seconds. The lines on her forehead deepened, but she shook her head. “Don’t care to remember, anyway.”
She then picked up the dog tag and gasped, “Bella.”
“My little dog’s name tag, “she explained in a trembling voice and fingered the worn out metal. “She died of splenic cancer a few weeks ago, “ she whispered and pressed her lips together when her chin quivered. “She was not even nine years old.”
Her eyes filled with tears. “I cooked all her meals from scratch, bought her the best bones to chew on, hoping she’d live a longer life, but she died prematurely, anyway. Smaller breeds are supposed to live longer, though.”
“I’m sorry to hear that.”
“I buried her in the back yard. Under the walnut tree, where she loved to cool down after chasing squirrels. I’ve never loved anybody like I loved Bella,” she whispered, tears running down her full cheeks.
“I’m so sorry for your loss.”
The doctor allowed the young woman to calm down for a minute.
“That was her mouse,” the patient added, picked up the plush toy and brought it to her cheek. “We named it George.”
“Does this look familiar at all?”
The doctor picked up the silver baby rattle and shook it gently. The room filled with the cheerful jingling sound.
The young woman clenched her jaws. She grabbed her paper cup and sipped some tea. “No, it doesn’t. Why would I have that in my purse? It makes no sense. I don’t have a baby. I don’t know anybody with a baby, either.”
She picked up the medicine bottle and read the tag on it.
“’Ser-tra-line’. Prescribed for Madison James. What is this for?”
“It’s an anti-depressant, usually prescribed for depression, particularly postpartum depression. Why would you have this in your purse, do you think?”
“I have no idea. It’s prescribed to Madison James, not me.”
“What about this,” the doctor said and picked up the book on the coffee table. “'Beyond the blues – Understanding and treating prenatal and postpartum depression and anxiety.'”
The young woman blinked and shrugged her shoulders. “I have no recollection whatsoever of checking that out at the library. I read historical and women’s fiction. That title wouldn’t interest in me in the slightest.”
“Oh, there is an envelope here, the doctor said and read out loud the address: “'3297 Northwood Road, Sacramento...'”
“Oh, that’s my address. Well, the apartment I rent. I keep that envelope in my purse to remind myself where I live, in case I don’t remember. Which is usually the case.”
“The envelope is addressed to Madison James.”
The young woman rolled her eyes. “My name is not Madison, as I already said. I have no need for that medication, or for books on baby blues or whatever… I don’t have a baby!”
The doctor nodded calmly, placed the envelope back in the book.
“How do you explain the milk stains on your shirt, though?”
The patient scoffed, but lowered her eyes to her chest. Two wet, round circles stained her green T-shirt. Her eyes bulged at the sight.
“You’re lactating,” the doctor said and let that sink in. “You gave birth recently. You can’t deny that, now, can you?”
The young woman gave the doctor a murderous look got to her feet. “There is no baby!”
“Come on, Madison –“
“Don’t you dare call me that name. My name is Bella!” she yelled and reached for her tea cup. She tried to sip, but the cup was empty. She groaned as if in pain, a defeated look on her face.
“That’s your dog’s name. It says here, on this receipt from the pet crematorium. “Bella James, 25 lbs, Jack Russel terrier mix.”
The young woman stared at the doctor, perplexed. She felt for the chair and sat down, blinking, shaking her head, looking lost and overcome with emotion.
“You had Bella cremated three weeks ago, on the 27th.”
The young woman nodded, with a whimper. Tears pooled in her eyes. “I have her ashes in a little urn, on the mantel. I couldn’t bring myself to scatter them in the back yard. I can’t even open that little box and see what’s left of her."
She covered her eyes and sobbed. The doctor handed her a tissue.
“She was so sick the last two weeks of her life. I did everything I could to prolong it. I spent the last of my money on painkillers and medication that was supposed to stop the bleeding from the spleen. It didn’t. When she couldn’t swallow the medication anymore, I put it in her milk and ice-cream. Then I force-fed her with a syringe. I bought some miraculous mushroom extract that was supposed to destroy the cancer cells. It didn’t.”
“It killed me to see her suffering and not be able to alleviate it. I stayed up every night for two weeks and just watch her slowly die,” she continued, sobbing uncontrollably. “And the baby would not stop crying. She wailed and howled day and night, keeping Bella awake, tormenting her with her crying. One night I couldn’t take it anymore. I grabbed the baby and put it in the closet, so Bella could finally get some sleep. And die in peace. Three days later, I lost them both.”
The doctor handed the young woman another tissue. She sat back in the armchair and continued, sighing a deep sigh of relief. “I tried to bond with that poor baby, doctor. I couldn’t. Just couldn't. Bella loved her, though. Brought her toys every day, as sick as she was. She even shared George with her, her favorite toy. She loved everybody, my little fur angel.”
She picked the name tag and kissed the inscription on it. “I had to choose who to care for and I picked Bella. I have absolutely no regrets.”
The office door opened and a man in a police uniform walked in.
“Thank you, detective. We have the baby’s remains,” he announced in a somber voice.
The silver clock on the wall read 12:00p.
“Well played, doctor, “ the young woman said with a rueful smile. She then got to her feet and held up her hands to the police officer who, gently, cuffed her.
“Welcome back, Madison.”