Therapy

Mark Krueger

The heavy click of the door handle is followed by a loud rush of air. “Richard is trying to get out!" one of the boys in the back seat shouts. Jeff looks in the rear view mirror. Richard, who is sitting directly behind the driver's seat, is indeed about to step onto Interstate Highway 94 west to Madison – one foot is a few inches from bouncing off the pavement like a handball. His eyes are glassy. “Richard!" Jeff shouts. The boys scream as the wagon swerves right. Jeff turns sideways, grabs Richard's belt, and pulls him back in the car, squashing Tim in the process. As Jeff tries to drive and hold Richard at the same time, Tim helps by pulling on Richard's shirt and leaning into Fred, who holds on to Tim.

On the side of the road, dust and coughs fill the dry air, and everyone sits quietly. There are six: Jeff, the youth worker, and five emotionally disturbed boys. They have been through Richard's seizures before. This one, however, is frightening enough to keep them still, at least for a moment. Jeff holds tight to the belt until Richard sinks back into the seat. “Everything is okay. You're in the car with friends," Jeff says. Faces that look like peering gargoyles work their way through Richard's clouded vision. He smiles sheepishly. The faces begin to giggle and smirk.

"Knock it off," Jeff says and instructs Tim to hold Richard's hand while he steps out to close the rear door. Then after Tony, who is sitting next to Jeff in the front, switches seats with Richard, Jeff pulls back on the interstate highway.

On the ride back to the Wiley Center in Milwaukee, Jeff recalls the first time he saw Richard have a seizure. It was during a baseball game. Richard had wandered away from his position in right field and he ran after him. As he got closer he could tell something was wrong: Richard was weaving and his eyes were glassy. Jeff put both hands on his shoulders and said, “Richard, are you all right?" but Richard didn't respond. He just rolled his eyes like a blind man. It was an eerie feeling at first; to try to communicate with someone who could stand right next to you and not even know you existed. But now Jeff knows what to do: how to keep talking to Richard and stay with him until the effects have subsided.

The Wiley Treatment Center is an old brown brick building that sits on a hill on the west side of Milwaukee. On the outside it still looks like and old orphanage, but the inside has been remodeled like a college dormitory with double rooms and TV lounges. All together 36 boys live here and are cared for by 16 youth workers, most of whom are fresh out of college.

Later, Jeff tries to talk with Richard about the incident. They are standing in the long hallway, which is flanked by bedrooms. Richard's long brown arms are clasped together beneath his twelve-year-old, pot belly. His large round eyes are crystal clear.
"What car ride?" Richard says and bites his lower lip with his crooked teeth. Jeff puts his hand on Richard's shoulder, wonders what it is like to loose portions of one's life like that.
"Let's play some box hockey," he says. “I like box hockey, do you?" Richard asks.
"Yes."

Richard is the main topic of discussion at the 2:00 pm staff meeting which has been switched to the play therapy room because the main conference room is being used by members of the ladies' auxiliary, who are labeling clothes. The toys are all neatly stacked away. The windowless door is closed and the drapes are pulled in front of the one-way observation mirror. Nadine, Arnold, and Jeff, the three youth workers assigned to work with Richard, are present. So is Kathy, a new social worker.

She starts the meeting. “I'm going to recommend that Richard see a psychiatrist."
"Not because of this morning I hope," says Jeff. “That was my fault, I shouldn't have let him sit next to the door."
"I know, but he's been rather bizarre lately. There may be some explanation for his behavior that we don't understand ... I'll make an appointment with Dr. Reed, a new psychiatrist at the medical complex ... Trust me on this one, okay?"

The next day, Jeff, who is assigned to the therapy appointment, goes to get Richard from the game room.
"Richard, we've got to get going to your appointment." Richard is sitting alone and racing a single checker through an imaginary obstacle course. He cocks his head to the left, sort of like Charley Chaplin, and smiles. As he turns to face Jeff his large eyes dip, then glance into the hallway where Nadine is picking up wet towels.
"Why don't you kiss her?"
"Richard, we don't have time to play games. You have to get ready for the appointment."
"Don't you like Nadine?"
"Of course I do ... Look at you. You're a mess." Richard is wearing a dirty T-shirt, one brown and one blue sock. “Cm'on, let's go to your room" Jeff prods.
As they walk to his room, Jeff pulls tiny lint balls from Richard's hair. “Where's your pick?" Jeff asks.
"Where's your pick?" Richard says.
Jeff helps Richard change clothes and brush the yellow film (a by-product of his medication) from his teeth.
On the way down the stairs, Richard says, “What appointment?"
"The appointment with the new doctor. The one I told you about yesterday.
"Oh ... Guess what I've got?" Richard has both hands behind his back.
Jeff moves one step below Richard, tucks the end of Richard's belt into the first loop, and says, “A dime."
"Nope," Richard says and displays the car keys he has lifted from Jeff's pocket. As Jeff grabs the keys, Richard ducks away smiling.
Jeff makes sure that Richard is safely buckled in before he starts out.
"Turn it down," he says as Richard plays with the radio dials.
Three or four blocks from Wiley Jeff hands Richard a Kleenex “Here, use this."
Richard has messed on his fingers and pants. He wipes his nose as if he's polishing a car and slides down in the seat until the belt buckle is on top of his stomach. After he complies with Jeff's request to sit up, Richard says, “Who's paying?"
"Who's paying what?"
"For this appointment, silly."
"The government, I guess."
"My insurance money is all gone. I used too much. That's what they told me when I lost my glasses."
Jeff suddenly remembers that Richard is supposed to have his new glasses with him, but doesn't bring it up. “The agency will pay somehow," he says.
"Why don't you pay?" Richard asks.
"Because the agency will pay."
"Don't you like me?" Richard asks.
"Of course I do."
"My auntie used to give me money whenever I wanted it."
"Now Richard, you know that's not true."
"How do you know?"
"I've talked with your aunt several times ..."
Although he doesn't expect it to go anywhere, Jeff continues his conversation with Richard. Sometimes it is good to pass phrases back and forth even if they aren't connected in any logical way.

They arrive early for the 2:30 pm appointment and sit in the folding chairs in the hall. This is Richard's third visit to a psychiatrist since he was removed a year ago from the loving but very unstructured home of his aunt and grandmother.
Soon Dr. Reed, eager to start his new practice, steps in the hall and says, “Please come in."
With the exception of a Jackson Pollack print from a recent Metropolitan Museum showing, his office is relatively sterile. Richard sits in a wooden chair with his elbows on the arm rests, forcing his shoulders upwards. Jeff, who is sitting to Richard's left in a similar chair, laughs to himself about how serious the normally slouched Richard looks.
Reed wheels his desk chair across from Richard, forming a semi-circle. He crosses his legs and clasps his hands below his knees. His yellow tie with a small dark blue circular pattern, white shirt, blue suit trousers, and tassel loafers give him the appearance of a confident stock broker.
The initial smile he gives Richard, however, does not hide his concern about getting the interview questions in order.
"So Richard, tell me a little about yourself. What do you like to do. What are your favorite hobbies, that kind of stuff."
Richard, who now also has his legs crossed and hands clasped beneath the knee, says, “Tell me about yourself."
Reed pauses, says, “I'm new here. Just like you. We're not here to talk about me though. I'd like to try to help you. Tell me what it was like living with your aunt and grandmother?"
"Do you kiss your wife?"
"I'm not marr... Richard, are you trying to play a game with me?"
"No, do you want to play a game? Want to see some magic?"
Reed plants both feet in front of him, leans forward.
"Richard, the purpose of this meeting is to talk about you and your feelings."
"I feel fine. Did you ever feel a rabbit? I did"
"How do you feel when you feel fine?"
"I like to watch Dallas, but they won't let me." Richard raises his shoulders up to his ears and pinches his lower lip.
"Well you're probably supposed to be in school or some other activity at that time."
"Don't you like TV?"
"Richard, that's not the point of our visit. Please try to co-operate."
"How much do you get paid?"
Reed gets up and looks out the window. “Let's try something else. Richard, would you walk a straight line from your chair over to that coat rack."
"I'm not drunk" Richard says.
"I know you're not. This is just a little activity that might help me understand why you have some of the spells you have."
"I can spell, can you?"
"Richard, will you please do as I ask?"
"Show me first."
A skeptical Reed gets in front of Richard's chair and begins to walk towards the coat rack.
"You're going crooked," Richard says as he sneaks to Reed's desk. Jeff makes a move to stop him, then sits back in his seat. Richard picks up a silver ball point pen and clicks it in front of his eye several times.
"Do you like that pen?" Reed asks.
"Do you like it?" Richard asks, and begins to draw a face on his thumbnail.
At a loss for words, Reed picks up his appointment book and pages through it.
"Who's coming in next?" Richard asks, “Your mother?"
Reed asks Richard for the pen, tells him to sit down, turns to Jeff and says, “I want to see him again in a week. I think it will take a little while before Richard and I can trust one another."
Reed tells Richard he can have the pen if he likes. Richard thanks him and says that next time he'd like to talk about Dallas.

On the way out, Richard tells Jeff that he likes Dr. Reed because he's silly. With Richard safely buckled in his seat, Jeff smiles and asks Richard if he'd like to play box hockey when they get back.