A personal letter to the doctor precedes the six month’s appointment. In it the spouse describes the ongoing issues which might be difficult to discuss or take up an extended amount of time.  The doctor read it several times before calling the patient’s home to speak with the husband.  The physician was concerned the family might own firearms.

The patient was convinced her spouse was having an affair with the woman in the adjacent apartment.  The doctor feared the patient might act on her suspicions.  The husband relieved him somewhat, they possessed no arms.  The wife however had verbally assaulted the neighbor during an aqua aerobics class they both attend, accusing her of sneaking into their apartment during the night, to bed with her spouse.  She hurled the flotation buoys at the neighboring woman, before the instructor was able to calm her.  The neighbor woman fled, shouting about her lawyer.  Several days later a letter from the lawyer appeared.  The attorney had filed for a restraining order and warned the couple about continued harassment.  The spouse detailed the events in the letter.  Her paranoia concerned him, as did her ability to lash out at the woman next door.  They had been cordial to each other until the event in the pool. He feared she might fixate on someone else in their life.

In the examination room, the patient appeared composed. With white, shoulder-length hair a subtle tremor shook her index finger and thumb of her right hand.  The nurse noted she had lost five pounds since her last appointment, and she answered she had been too heavy.  While her spouse sat erectly, she slumped, shoulders curling inwards, her gaze drifting into her lap.  She straightened a bit when the doctor asked how she fared.  She was well, nothing very much to report on her condition.  The husband and the physician exchanged glances.  The doctor asked what about her illness concerned her the most, and she replied easily she’d been sleeping poorly.  Nodding, the husband agreed, adding he’s found her awake watching old movies.  The patient spoke over his last words, ‘Montgomery Cliff in A Place in the Sun. . . he adored Elizabeth Taylor.  Young and beautiful, who wouldn’t?’  She directs the question to her spouse, her voice breathy, yet strong.

The new medication the doctor recommends will help her sleep.  When she’s sleeping at least six hours through the night she’ll have less anxiety during the day and the episodes of paranoia will fade.  Her facial features give no indication that she’s felt anxious or paranoid.

written by Kate O’Neill





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