Monday, 1:30 PM

Belmont Springs

Ethan

“This is Concord House.” Doctor Choi pointed to the three-story red-brick Georgian behind them. Ethan had heard the grounds of Belmont Springs looked more like a college campus or country club than a psychiatric hospital, but he’d expected nothing like this. Choi, who looked young enough to be an undergrad tour guide, only added to the illusion.

“Concord and Lowell are our two acute care dorms,” she explained. “We house our female patients in Concord and our male patients in Lowell, which you can see peeking through the trees over there.”

The cluster of six medical students turned obediently, necks craning to see the other building, which resembled a large stone carriage house with Tudor features.

“I thought Belmont was co-ed,” a poodle-faced girl asked in a nasal, arrogant voice. Ethan couldn’t remember her name but recognized her as a member of the “gunner gang” – a cutthroat group of classmates who always arrived early to lectures and claimed the front-row seats.  

“Our outpatient programs are,” Choi said, “but acute care is separated by gender. That way, the social environment’s less pressured.”

Brett Sorgen, a red-headed frat boy type who’d been in Ethan’s gross anatomy lab for first year, leaned forward to whisper into his ear. “She means they don’t want any of the nut jobs hooking up.”

Choi flashed them a warning look. “Our census is on the low side right now, which is perfect for you guys. There’s only one medical team per house, so there’ll be three of you per team. Each of you will be following a single patient.”

“You mean we’ll be with the same patient for the entire rotation?” Poodle Girl asked, sounding like she’d just been told she’d be scrubbing toilets for the month.

“That’s right.”

“But what if we don’t get along?”

Brett Sorgen snorted. “Hey, Sara. This isn’t Tinder or Bumble. It’s a friggin’ psych ward!”

“Compatibility shouldn’t be a problem,” Choi said, ignoring the interruption. “Remember, the goal is for you to build up an empathetic relationship with your patient. That way, you’ll be in the best position to help your team.”

When she went over the assignments, Ethan was surprised to learn he’d been paired with a female patient named Emma Browning. He was expecting a man, since the dorms were separated by gender. Choi finished reading the rest of the assignments, then cleared her throat to command close attention.

“As I’m sure you know, we take patient privacy very seriously here at Belmont. That’s why you were asked to sign a strict non-disclosure agreement this morning. Some of our patients have been admitted under pseudonyms to protect their identities. They look to us to keep their personal lives private.”

She paused to underscore the importance of her next words. “I don’t need to tell you how serious an ethical and legal breach it would be if any of you violated that trust.”

Ethan couldn’t help but notice how her eyes had settled on him.

*

Concord House looked like a countryside estate on the outside, but the interior had the typical sterile features of a hospital ward. A sleek, well-endowed hospital ward, but a hospital ward, nonetheless.

From his vantage point at the nurses’ station, Ethan took in the familiar institutional surroundings. Polished white floors awash in fluorescent lighting. Corridors lined with patient rooms, most with their doors closed. A stray gurney parked in the hallway. Ethan closed his eyes and inhaled the standard hospital smell: bleach, fresh paint, and a faint whiff of urine.

He yawned and checked the screen names on the telemetry monitors. No “E Browning,” which meant his patient probably wasn’t a drug addict in detox. He’d already logged into Belmont’s electronic medical record only to discover he didn’t have access to her file yet. Maybe that was intentional. Part of the learning experience.

But that didn’t explain why he’d been left waiting alone for an hour, long after his classmates had gone off to meet their assigned patients. Had Choi forgotten about him?

He was about to question a nearby nurse when Choi emerged from a patient room, accompanied by a tall, ebony-skinned man with silver hair. They drifted toward him, huddled together like a student and college professor engaged in a deep conversation. When they reached the nurses’ station, Choi introduced the man as Doctor Timothy Grieves, the Chief of Psychiatric Services at Belmont Springs.

Ethan did a double take, staring at the elegant man wearing a brown tweed jacket and matching corduroy pants. When it came to stature in the world of psychiatry, Grieves’ name rivaled Jung and Freud. That made sense. To reach such a high status at Belmont, the man had to be a rock star.

“Mr. Chase,” Grieves said in a pleasant, British accent. “We apologize for the wait. It’s nice to finally meet you.”

Ethan jumped up to shake his hand.

“Doctor Grieves runs our acute care program,” Choi said. “He’ll also be your attending physician for this rotation. And I’ll be your resident.”

Ethan looked from one doctor to the other, trying to read their guarded expressions. It seemed odd that both the head psychiatrist at Belmont and his chief resident would be taking care of the same patient. Unless Emma Browning was some big-time VIP.

Grieves motioned for Ethan to take a seat, then pulled up a chair next to him. “Since you’ll be joining our team, I think it best that we go over a few preliminaries. What would you call them, Sophie? Housekeeping items?”

Choi nodded, still standing, body so taut with nervous energy that Ethan wondered if she ever sat down. “We’ve already reviewed our patient confidentiality policy,” she reported. “And Mr. Chase has signed the standard NDA, or course.”

“Fine.” Grieves turned back to Ethan, deep brown eyes probing. “And you understand that means absolutely no discussion of patient details with family and friends?”

“Yes.”

“Not even in the vaguest of terms.”

“I understand, Doctor Grieves. I’d never violate patient confidentiality.”

“Brilliant.” The famous psychiatrist massaged the white stubble on his chin for a long moment before turning to his resident. “So, what do you think, Sophie? Shall we give Mr. Chase some background information on his new patient before they meet?”

Ethan doubted he would have recognized her.

Callahan Perrin looked nothing like the troubled celebrity whose face had been splashed across countless tabloid covers. For one thing, her hair was black and stringy, not California blonde with neon red highlights, and she had the petite, girlish frame of a ballerina. No eye-catching feminine curves. No pouty lips. Nothing about this depressed-looking young woman resembled the bubbly, precocious teen Ethan remembered from her wildly popular reality TV series. What had it been called? Prodigy or something?

Choi introduced Ethan, saying he’d be with them for a month.

The young woman gave him a half-glance, then shrugged and looked down at her shoes, shoulders slouching forward. She had yet to say a word, and Ethan noticed the way she’d withdrawn her hands into the sleeves of her blue cable-knit sweater. The sudden, darting motion made him think of a turtle retreating into its shell.

“Ethan’s really looking forward to getting to know you,” Choi said. “Of course, he’ll respect your privacy.”

Taking his cue, Ethan promised anything they discussed would remain strictly confidential. “Besides,” he blurted, kicking himself even as the words spilled from his lips, “gossip’s not my thing. No offense, but I’ve never even watched your show. Not to say there’s anything wrong with your show. It’s just that I’m not that into reality TV. I mean, who has the time these days, right?”

Miss Perrin remained mute, her eyes fixed on her shoes.

“Ethan.” Choi masked her annoyance with a Splenda-sweet tone. “Why don’t you just observe for now while we perform our exam? ‘kay?”

Ethan agreed and was about to retreat into the background when the girl suddenly looked up at him. It was barely a glance – a lightening flash of green, quickly concealed behind a dark curtain of hair. Their eyes couldn’t have met for more than a split second.

How, then, did he know exactly what she was feeling at that moment? Trapped. Annoyed. Apathetic. Desperate. He’d seen every emotion, laid bare in an instant, in a way that was impossible to explain.

“Tell us,” Choi said. “How did your first DBT session go?”

Instead of answering, the girl stood up abruptly and walked to the window.

“Callie?” Choi followed her. “Is there something wrong?”

When the girl turned back to face them, her skin had gone pale. “I – I can’t deal with this,” she murmured, chapped lips barely moving. “Please. I just want to rest now.”

“Of course,” Grieves cut in. “That’s perfectly understandable.” He turned to address his team. “Why don’t the two of you wait for me at the nurses’ station? I’ll join you in a few minutes.”

Choi’s lips parted to protest, but then she just nodded, motioning with her eyes for Ethan to follow her into the hallway. Once outside, she huffed in annoyance.

“Tough case. I’m not sure this is going to work.”

Ethan pressed his lips into a line. “You’re talking about me being assigned to Miss Perrin?”

“Obviously.” Choi scrolled though her smartphone messages as she spoke. “Doctor Grieves was hoping she’d relate to someone closer to her age. You know, maybe open up a little. Problem is, Callahan Perrin isn’t just your typical young woman going through a rough patch. She has some major pathology.”

“She seems very depressed.”

Choi laughed as she whipped off a text. “If only it was that simple.”

“You mean there’s more going on.”

“Clearly.”

“Such as?”

The psych resident sighed, as if she’d just been asked to explain quantum physics by a five-year-old. “I really don’t have the time to go into it.”

A few months ago, Ethan would have sucked up the insult and moved on, but things had changed since Match Day. With a plum residency spot already secured, he wasn’t looking to impress some condescending resident. 

“Okay,” he said with an easy-going smile. “I appreciate the frankness, so let me be frank too. This month will run a lot smoother without the attitude.”

That got Choi’s attention. She looked up from her phone, eyes frosting over. “Come again?”

“The attitude. It’s so unnecessary. We’re both on the same team, right?”

When Choi answered him with a frown, he continued, “I mean, you want to help your patient, and so do I. Sure, I barely know her, but even without your expertise, I can tell she’s in a lot of pain right now. I’d like to help, but I can’t exactly do that if we’re not working together.”

“O-kaay.” The psych resident thinned her lips. “Since we’re being frank, let me explain my problem with that. We’re dealing with a highly disturbed young woman who’s already tried to kill herself three times over the past four years. It’s a miracle her last attempt wasn’t successful. You’re here to learn some basic principles of psychiatry before you go on to your career in… it’s plastics, right?”

Ethan noticed how she barely contained a laugh when she said this.

“That’s right,” he said, smiling even wider. Laugh it up, Sophie. I’ll be working nine to five and injecting Botox while you’re ducking feces thrown by some dude who thinks you’re an alien come to harvest his brain.

“Fine. But this isn’t an appropriate teaching case. The last thing Miss Perrin needs is a clueless med student.”

“Then why was I assigned to her?”

Choi huffed again. “Don’t ask me.”

“It was Doctor Grieves’ idea?”

“Exactly.”

Before Ethan could respond, the attending in question stepped out into the hallway. “Mr. Chase,” he said. “Why don’t you take this time to review your new patient’s chart? Just the history, please. I’d like you to come up with your own assessment by the end of the week.”

“I –” Ethan looked from Choi to Grieves in confusion. “I thought I was being reassigned to someone else.”

“Why would you think that?”

“Well, um. Judging from the way Miss Perrin reacted, I kind of assumed she doesn’t want a student.”

“Hmm.” Grieves frowned, salt-and-pepper eyebrows merging into a pensive dash. “Funny. I didn’t get that sense at all.”

“Tim,” Choi chimed in. “I think Ethan has a point. Miss Perrin’s not ready to take on a student.”

“Perhaps. But then again, they’ve hardly had a chance to get to know each other. Let’s try again tomorrow, shall we? Oh, and if I may offer you one word of friendly advice, Mr. Chase…”

“Sir?” Ethan looked up at the famous psychiatrist, waiting for his words of wisdom.

“Not all awkward silences need to be filled with chatter. Sometimes, it’s best just to listen.”

***

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