Gillian Anderson - A Vision of Fire

“All right,” Caitlin said, pulling her prescription pad and a pen from her purse. “I’m going to give you a different prescription—clonazepam. It’s a sedative and a muscle relaxant, less radical than the others, and Maanik can be named the recipient without raising suspicions, in case anyone finds out. Give her the pill on a full stomach and when it takes effect, clean her forearms with the oil, all right?”

Mrs. Pawar nodded.

Caitlin indicated that they should leave the room. Mrs. Pawar followed her into the hall. As Caitlin left the door ajar she asked, “If you’ll excuse me, Mrs. Pawar, I must ask: has Maanik ever suffered any kind of trauma? An attack, abuse at any age? Sexual abuse? Physical or emotional?”

Caitlin watched the woman grow weary under these most difficult of questions. She shook her head no. Caitlin pushed a little further.

“I know that you lived in New Delhi not long ago, and I know that New Delhi is experiencing an epidemic of sexual assault. Is there any chance at all that Maanik could have been assaulted and not told you?”

Mrs. Pawar did not look Caitlin in the eye but Caitlin knew that was cultural, not deceptive. “There is no chance,” Mrs. Pawar said. “We raised a miracle. We raised a safe child. She was unscarred until she saw the attack on my husband.”

Caitlin reached out and held Mrs. Pawar’s hands for a moment. “I believe you,” she said.

“Thank you.”

“Thank you ,” Caitlin replied. “I know this isn’t easy but it’s necessary. We will find the cause of this. We will make her world safe again.”

“How long will that take? Do you have any idea?”

“I don’t,” Caitlin admitted.

“What if—if it happens again?”

“It may very well. I’ll leave you my number. If there is another episode, even a very mild one, call me. I’ll come right over.”

The relief in Mrs. Pawar’s eyes was profound.

The housekeeper stepped forward—a small woman with the first touches of gray in her hair—and showed Caitlin to the door. But Caitlin turned suddenly. She felt goose bumps along her arms, as though cold air was blowing up her sleeves.

“Doctor?” Mrs. Pawar asked. “What is it?”

Caitlin looked down at her arms. Her sleeves weren’t moving. There was no vent on the floor or the wall.

“Sorry,” Caitlin said. “I thought I left something back there.”

Smiling and wishing the women a good day, Caitlin walked into the hallway. The odd feeling passed as the elevator descended and the course of her day resumed and the lives of the patients she had to see crowded Caitlin’s mind.

The rest of the day passed swiftly and without incident. Caitlin attributed her earlier restlessness to Ben’s anxiety, the Pawars’ fear, and the uneasy zeitgeist of a city that seemed to be waiting for bad news. Something about the Kashmir crisis was gripping people who usually forgot about major news events within a day or two. She overheard several conversations about the assassination attempt and whether nuclear war was likely. It was the top trending topic on Twitter, and her colleagues were sharing news articles over e-mail. An Associated Press update mentioned the ambassador’s return to the negotiations and his cold reception. The talks had not recovered from the damage of Ganak’s sudden departure—his “unexplained abandonment,” one Indian delegate had called it.

Ben was right , she thought. They’re just looking for reasons to be petulant. Little girls and boys with very dangerous toys.

Late in the afternoon, Caitlin headed to a café on Twenty-Seventh Street. Jacob’s cooking class, held in a test kitchen one floor up, would be finishing in twenty minutes. She sat in a private corner with a cup of jasmine tea, hunched over her phone for an overdue conversation.

The man on the other end was unhappy and more than a little condescending.

“Dr. Deshpande, I assure you, it is not post-traumatic stress disorder,” she said to Maanik’s physician. “I have never heard of a rapid, cyclical repetition of PTSD symptoms.”

“Perhaps a review of the current medical literature might convince you to revisit that opinion?” the doctor suggested.

Caitlin bristled but decided that methodology was not the battle she should be fighting.

“Yes, of course, I will be doing that,” she said. “But in my experience with crisis survivors locally and globally, this is wholly atypical. Now,” she continued before he could interject another cover-his-ass approach, “are you sure there is nothing in Maanik’s history that could be a precursor to this?”

“Nothing. I am certain you checked for head trauma while you were there, Dr. O’Hara? She was thrown to the sidewalk when the shooting occurred—”

“There were no bruises, no reason to infer nausea, no reaction that would suggest headaches—”

“ ‘Infer,’ ‘suggest,’” he said. “That is why I prescribed what I did. Because you frankly do not know.”

“And you didn’t request an MRI,” Caitlin shot back. “I understand why, I do. But that doesn’t justify nuking her body with that cocktail you prescribed.”

“The ambassador was needed. Another incident had to be averted. And your method did not work, I understand? Not quite?”

This discussion was pointless. Caitlin got back on topic. “What about when she was a child?” she pressed. “I know the Pawars have only been here two years, but you have her records from India?”

“I came to New York with the Pawars,” he said. “The ambassador arranged for my post at the United Nations. As for Maanik, the most serious ailment I have ever treated was a sprained ankle last winter from ice-skating. And before you interrupt me again, no, her head did not touch the ice. She is supremely healthy in every way. Which is why I felt—and still feel—she could handle that ‘cocktail.’”

“What about psychologically?” Caitlin asked. “Has she ever exhibited an extended period of despondency, withdrawal?”

Dr. Deshpande laughed. “Those are words that could never apply to Maanik. She is a precocious, vital, outgoing girl, Dr. O’Hara, and has always been so.”

“The drugs you prescribed. Had Maanik ever taken those or anything like them?”

“No, and I will spare you the discomfort of asking: Mrs. Pawar is concealing nothing about domestic abuse or assault. Her family is strong and loving and Maanik is one of the happiest teenagers I have encountered. I have no doubt that the mental trauma of witnessing her father’s attack altered her body’s chemistry and it is manifesting mentally. We can safely use medications temporarily to remind the body of what normal is, and she will adjust and return to herself.”

“ Or we can look for an approach that addresses the cause and not just the symptoms,” Caitlin replied. She saw no reason to press this further. She thanked the doctor and ended the call. At least he had agreed to stick with just the clonazepam for now, since the immediate crisis had passed.

But Dr. Deshpande was right about one thing: had it passed for good? She flashed to the bloody S-curves on Maanik’s forearms. Every day Caitlin provided therapy to high school students for Roosevelt Hospital. She counseled college students from the John Jay College of Criminal Justice, consulted for international agencies, oversaw the development of a mental health program for refugees, and closely monitored world news for potential hot spots of trauma where she might be needed. This work was her life and her passion. And yet, with all her specialized experience behind her, she was stumped by Maanik. Something about the terror, the scratching, the look in her eyes. To say it unsettled her would be an understatement.