Ben Winters - Bedbugs

According to the degrees covering one wall of his examination room, Dr. Lucas H. Gerstein had obtained his undergraduate degree at Brown University, proceeded to medical school at Cornell, and then done his residency in New York, at Bellevue. Dr. Gerstein was a licensed allergist and a member of the American Medical Association’s Steering Committee on Pollutants and Allergens. He had a receding hairline, a large forehead lined with deep grooves, and mild grey eyes, which he now ran carefully over Susan’s body.

They had chatted for a while first, and he had jotted down her answers in a thin notebook: The bugs had first appeared three weeks ago, she’d reported; yes, she’d seen the bugs — well, only one, actually, and only briefly.

“Hmm.” Dr. Gerstein smiled blandly as his hands passed industriously over her body. “If you could lift your hands for me. Thanks.”

Susan shivered in her paper gown. Her skin was rough and dried out as an old piece of canvas, worn and abraded. There was her wrist, of course, where the original scar, dug up and healed a million times over, was now a crosshatch of suppurated tissue. There was the spot on her left shoulder, similarly dug up, currently red rimmed and lightly oozing with pus.

Dr. Gerstein ran his gloved fingers over these marks and found more: a cluster of bites below her breasts, three or four along her right thigh, scattered bites dotting her arms. Some of the bites were small, barely visible, while others were opened and bleeding like stigmata. Some were sharp, thin, and angled, like paper cuts, others were gaping, obscene, like gashes or bullet wounds.

“Does that hurt?” the doctor asked, probing at a bite on the small of her back. His voice was thin and nasal, fussy.

“Yeah,” she said, wincing. “It does.” Susan’s lips were dry and desiccated, and the skin of her knuckles was rough as sandpaper. When she flexed her fingers, small cracks opened up and bled fresh.

Alex sat in a hard plastic chair in the examination room, leaning forward with a worried expression. When she was pregnant, he had come to the ultrasounds, strained to hear the heartbeat, sitting awkwardly in the small examination rooms with his coat in his lap. Susan tilted her head back and exhaled. On the opposite wall was a picture of Dr. Gerstein and his homely, horse-toothed wife. As his fingertips danced over her abraded skin, they exacerbated the itch at every spot they touched.

“All right.” He was pulling off the gloves. “Are there any marks I have not seen?”

“On my scalp.” She pushed aside her hair, and the doctor stood up on his toes to peer at the top of her skull.

“All right.”

“And — ah — there’s one biting me right now.”

It stung, pinched, at the sole of her foot.

“Really?” said the doctor, raising his eyebrows. “You can feel it? Right now? Bedbug bites do not typically—”

“I feel it! Look.”

She turned her bare foot upward, and Alex shifted forward in the chair and furrowed his brow. Dr. Gerstein bent over the foot, took it in one delicate hand, and then looked up at Susan questioningly. There was no bug, only the faint remnant of an old bite, a pink flap of scab nearly at the point of flaking off.

“Must have …” Susan trailed off, cleared her throat. “Must have escaped. They’re very small, you know.

“I know.” He turned away. “OK, Susan, thank you.”

While she dressed, Dr. Gerstein took a small pad from a pocket of his white coat and made a series of quick notes. Susan was reminded of Dana Kaufmann: the same quiet confidence and efficient motions.

Well, a lot of help she was .

The fresh bite on the sole of her foot itched fiercely. It took all her self-control to keep from scratching it.

Dr. Gerstein’s diagnosis was simple and straightforward.

“I do not believe that the discomfort you are experiencing arises from bedbug bites at all,” he said blandly. “It appears that you are suffering from something called Ekbom’s syndrome.”

Susan stared at the doctor, feeling slightly nauseous.

“Ekbom’s syndrome,” Alex echoed, nodding slowly, gravely intoning each syllable. “And what is that, exactly?”

“It is a condition, sometimes called delusional parasitosis, in which the sufferer comes to believe that he or she is being tormented by small insects, too small to be seen by the human eye.”

At the word delusional , an alarm went off in Susan’s mind: oh no. oh no oh no .

“So there aren’t any bedbugs, then?” Alex said.

“Well, of course, I can’t say for sure. But, I believe you said your house was examined—”

“It was.”

“And—”

“Nothing.”

“No,” Susan interrupted. “No, no. There are bedbugs. I’ve seen them.”

“You’ve seen—” He checked his notepad. “ One , you stated … ”

“Well, I’ve seen—” She clutched her temples, trying to remember. One on her shoulder, in the middle of the night. That disgusting little egg, on her toothbrush. In dreams, thousands of them: an army. “Two. I’ve seen. At least two.”

Dr. Gerstein’s mouth twitched up at the corners, a quick and dismissive smile. His white coat was immaculate. “I know, Susan, that you believe you have seen them.”

“I believe I’ve seen them because I’ve seen them.”

“Susan, honey, let’s just listen,” said Alex. “This actually makes a lot of sense.”

“No, Alex. It doesn’t.” Of course it made sense, for Alex! If there were no bugs, if she were simply crazy, he didn’t have to pay for extermination. Didn’t have to move. Didn’t have to be bothered at all.

“If I might interject,” said Dr. Gerstein, and Susan glared at him. “Your chart indicates that you’ve been taking Ambien on an as-needed basis—”

“Every night, doctor,” Alex interrupted. “She takes them every night.”

“OK. Well, a definite correlation is hard to pinpoint, of course, but antianxiety medications can create rather extreme delusional activity. We would have—”

“Alex!” Susan looked at him, raised her arms high like tree branches. “Look at me. Look! I’m covered in bites.”

“Actually …” Dr. Gerstein raised an index finger, and Susan fought the urge to bite it off. “One or two of these marks may be bites. Spider bites, perhaps, or — it’s best not to speculate. But most of what you perceive as bites, given the patterning and your observable behavior, we can assume to be self-inflicted.”

There was a long silence, during which every bone and sinew in Susan’s body demanded that she scratch at the inflamed spot on her thigh. She sat on her hands. My God — what if he’s right , Susan thought, the shock of it streaking across her mind fiery red, like a comet, followed by another: I fired Marni … I chased her out of the house.…

Susan managed, by enormous effort, to remain still, the stifled urge to scratch traveling up her arms as a series of shudders.

“Ms. Wendt, I promise you, your situation is not uncommon, and it is entirely treatable. Beginning with antihistamines and corticosteroids, just to get the swelling and itching under control. And, most important, a drug called Olanzapine, which will help your mind to understand what is really there, and what is not.”

Susan nodded mutely and slid off the examination table, her head buzzing. As she dressed, she heard Alex and the doctor discussing her in low tones, as though she were a child: the doctor murmuring hmm , Alex asking questions in his hushed, all-business voice.

“And what can we do next … is she in any immediate danger … ”