Patient’s name: Kyle Kotowski
Age: 34
Occupation: Computer systems analyst
Diagnosis based on initial evaluation: Patient was referred by his internist, Dr. Scott Meyer. Dr. Meyer feels that patient’s continual complaints about his health have no basis in reality. An extensive array of medical tests has been run on Mr. Kotowski, and no evidence of illness was found. Rather than alleviating patient’s concern, this clean bill of health has made him even more anxious. He has now taken to diagnosing himself and thinks that he has a different terminal illness every week.
Patient was born prematurely and was sickly as a child, so his current fears about his health relate back to that period of time in his life. As he was frequently isolated in those early years, he developed an overactive imagination, which is now manifesting itself in hypochondria.
Goal of therapy: Help patient break out of his shell and find something to focus on other than himself. Teach him coping mechanisms so that he can handle his fears without letting them control his life.
“I’ve definitely got Arachnoiditis,” said the twitchy man sitting opposite me.
“Arachnoiditis? Does that have something to do with spiders?” I hoped he didn’t think he was turning into one.
“No. It’s a pain disorder caused by inflammation of the arachnoid, which is a membrane that surrounds and protects the nerves of the spinal cord.” Kyle sounded like he was reciting a description out of a medical dictionary. No doubt he’d been on the internet looking up rare diseases again.
“One of the symptoms of Arachnoiditis is the feeling that insects are crawling on your skin.” He made a strange yelping noise and started to scratch his leg like fire ants were swarming up it.
“Kyle,” I reached forward and placed my hand over his in an effort to stop his frantic movements, “there’s a simple explanation for the itching sensation. Either your skin is dry or the fabric of your pants is causing an irritation.” Or it was all in his head. My money was on the third option.
“Dry skin?” He mulled the possibility over for a few seconds. “That could be a sign of eczema or something more serious like psoriasis, right? Can’t a person be born with a genetic predisposition towards psoriasis? My great-aunt Connie suffered from the condition for years. She had these disgusting, rough red patches of skin all over her body. It was horrible! When she had a bad flare-up, she looked like some sort of scabby monster. Oh my God, what if that happens to me? I won’t be able to leave my house! I’ll have to go on Disability and . . .”
“Kyle,” I cut off my health-obsessed patient with a calm, but firm voice, knowing that if I let him continue in this vein, he’d soon have himself banished to the modern-day equivalent of a leper colony, “you do not have psoriasis. There is nothing wrong with you that a little body lotion with Vitamin E or Aloe won’t cure.”
“Vitamin E or Aloe? Let me write that down.” He pulled a small memo pad and a pencil from the breast pocket of his nerdy-looking checked shirt. “Can you recommend a particular brand?”
“Anything for sensitive skin should be fine.”
“Okay, good, maybe if I start religiously applying the lotion now, while the psoriasis is in the early stages, I can avoid . . .” His watch beeped several times. “It must be 11:45. I have to take my immune boosters at the same time every day. I hope you don’t mind.”
“Not at all.” If the herbal supplements would give him peace of mind and make him feel stronger mentally, as well as physically, then I was all for them. I’d recently told Dr. Meyer to start prescribing placebos for Kyle’s faux illnesses. My hope was that receiving treatment (even if it was in the form of sugar pills) would free Kyle from some of his anxiety about the state of his health.
Kyle removed six green caplets that smelled like freshly mowed grass from a plastic baggie, which had also been stuffed into his shirt pocket. He methodically put each pill in his mouth, then swallowed it with two sips of water from the liter of Evian he’d brought with him. This process seemed to take an eternity and by the time it was done, our session was officially over.
I walked Kyle out to the waiting area and had Margo confirm his appointment for the following week. “I’ll be coming in a few hours later than usual because I’m having an MRI done that morning,” he explained.
Frowning, I inquired, “Didn’t you just have an MRI done two weeks ago?”
“Yeah, but I’m pretty sure that the machine at that outpatient facility was broken. It made this weird noise like eeeeeeeeeeeee,” Kyle affected a high-pitched whine. “And that’s not right. An MRI is supposed to make a low hum and a knocking sound.” He should know since he’d gotten the same test done several times before.
“Hopefully, the test at the hospital will be done correctly so that I can find out what’s causing all of my lower back pain. I think it’s kidney failure. What if I have to go on dialysis?” He turned terrified eyes on me.
“You will not have to go on dialysis. Now, go back to work,” I gave him a gentle shove towards my office’s exit, “and stop worrying.”
Kyle opened the door to leave just as Sara walked up. He stood back so that she could enter.
“Thanks, handsome.” She bestowed one of her dazzling cover girl smiles on him.
His ears turned bright pink, and he scooted out into the hallway. Sara didn’t appear fazed, probably because she was used to getting that reaction from men.
“What brings you by?” I questioned my friend.
“I was struck by inspiration at 3:00 this morning, so I got out of bed and started sketching. I’m really excited about my new ideas and I’m thinking about using a few of them in the show, but I wanted to get your opinion first. Do you have a minute to take a look?”
“Sure. Margo, why don’t you go ahead and take your lunch now?”
“Do you want me to bring you back something?” my receptionist wondered.
“Where are you going?”
“Where else? Jerry’s.”
A deli sandwich did sound good . . . “Get me a turkey on wheat. No onion. Sara?”
“Nothing for me, thanks. You know that I lose my appetite when I’m in the creative zone.” She walked into my office, carrying a large sketch pad under her arm, and I followed her.
“So, let me see what you’ve got.” I held out my hands towards my friend.
Sara flipped the front cover of the pad over, exposing her first sketch. “Prepare to be blown away,” she told me.
No one could ever accuse Sara of being unsure of herself or her talent. With an indulgent smile, I took the book of designs from her.
“A gold bikini? Wow!” I exclaimed when I saw the first of her new suits. “This will definitely be an eye-catcher on the beach.”
“The gold lamé is cool, isn’t it? I’ve also got a suit with silver spangles like a disco ball. They’re part of this whole retro line I want to do. See,” she came to stand beside me and started to turn the pages of the sketch pad, “these others have paisley and tie-dye prints. And I’m going to do some more bikinis with what looks like bumper stickers on the back of the bottoms that say things like ‘Make Love Not War’ and ‘Have a Nice Day.’”
“You’ve really outdone yourself. These are all fantastic. I’m sure you’ll get a lot of attention at the Summer Extravaganza with this line.”
“I need to do everything I can to stand out from the crowd of swimwear designers. You know what they say about only having one chance to make a good first impression. Oh, I also came up with some ideas for cover-ups. Check out these cabana pants, pareos, and sarongs.”
I was ooooing and awwwwing over a plum-colored pareo with fringe when I heard a male voice say, “I hate to interrupt . . .”
Looking up from the sketch pad, I saw Ford hovering in the doorway to my office.
“Hey, what’s up?” I asked.
“I was wondering if you had a hammer? I could have sworn that I packed one, but I’ve been through all of my boxes and I can’t find it. I really wanted to get my diplomas hung today.”
“In case one of your patients wants proof that you’re a real doctor?” I teased him, and he smirked. “Sorry, but I’m not the type of girl to have tools lying around. I think my decorator hung all of the pictures in here. There’s an Ace Hardware about a mile up on Alton though.”
“I’ll take a walk up there then. I could use some fresh air.”
Sara cleared her throat not-so-subtly.
“Oh, I’m sorry.” For a minute, I had actually forgotten that she was there. It had been rude of me not to introduce her. “Sara Reade, this is my new neighbor and colleague, Dr. Fordham.”
“Ah, the infamous Ford,” she said, sizing him up as if he were one of her models and she was wondering how he’d look in a pair of tight swim trunks.
“Infamous?” He lifted a dark eyebrow questioningly.
“You mowed my friend down on the stairs, didn’t you?”
“Fortunately, yes.”
“Fortunately?” I repeated.
“We might not have met otherwise, and then how would I know where to find the best burger in South Beach?”
I chuckled. “I’m sure you would have managed.”
Sara removed the sketch pad from my hands. “I’m glad you’re here, Dr. Fordham. I could use a straight man’s opinion.”
“On?”
“My designs, of course. I’m about to debut Serafina Swimwear’s 2013 collection at the Miami Summer Fashion Extravaganza.”
Ford suddenly looked nervous. I thought I saw a bead of sweat forming on his forehead. “I’m just a guy from Brooklyn. I don’t know anything about fashion.”
“Au contraire, you know what you like to see a woman wearing, don’t you? And women buy swimsuits to attract or please men. So, no one’s opinion of my work is more valuable than the average man on the street’s, and that’s what you are. Here, take a look at this.” She shoved her open sketch pad into his hands. “What do you think of that bikini?”
“Well, it’s sexy. I like the way it ties between the uh, the um . . .”
“Breasts,” I supplied the word he was fumbling for.
“I know what they are, Pilar, thank you. Anatomy was my best subject in medical school.”
“Just trying to help,” I said with a feigned innocence that was belied by the twitching of my lips.
“Okay, so you like the way the bikini ties between the breasts. What about the bottom half of the suit? Which of these two styles do you prefer?” Sara pointed to his options.
“The one on the right. It shows less skin, but it’s somehow more provocative.”
“You like the boyshort, huh? Interesting. I thought you’d pick the Brazilian-cut.”
“I can if you want me to.” Ford was nothing if not flexible.
“No, no, I wanted your honest opinion. Now, let’s talk colors.” She turned to another page of her design book. “Classic black, lime green, or watermelon?”
“I like the last one.”
“The watermelon? Any particular reason?”
“The color’s vibrant, and I think it would look good on a woman with any hair or skin color.”
“An excellent point.”
“Glad that I could help. Now I really need to get that hammer.” Ford edged towards the door.
“Just one more thing.” Sara grabbed him by the arm before he could escape. “What are your thoughts on this design?” She pulled a piece of folded-up sketch paper out of her purse and offered it to him.
With a beleaguered expression, Ford exchanged her sketch pad for the drawing, opened the paper up, and studied it for a moment. “I’m not crazy about this suit,” he determined.
Sara pursed her glossy lips. “Why not?”
“The bows, the lacy ruffles, the polka dots, it’s just too cute. I’d expect to see a bikini like this on a little girl, not a grown woman. And the Lolita thing doesn’t work for me.”
I held my breath, waiting to see how Sara would react to Ford’s criticism. Would she curse at him? Throw something? Anything was possible if she went into wounded diva mode.
To my surprise, she burst out laughing. “Oh my God, that was brutal! Thank you! No one else has had the guts to tell me the truth. I knew that that suit was a total disaster, but all of the sycophants who work for me kept insisting that it was ‘darling.’ UGH,” she grunted with disgust. “I should fire all of them.”
A look of concern crossed Ford’s face. He obviously didn’t want to be responsible for anyone ending up on the unemployment line.
“She’s kidding,” I assured him. “Go get your hammer.”
“Okay. Nice meeting you, Sara. Good luck with the show,” he said before departing.
“Ciao.” She waved at him.
When he had disappeared through the door in my outer office, my best friend murmured, “Yummy. Break me off a piece of that.”
“You like him, huh?” Apparently, Ford’s appeal wasn’t just limited to me.
“What’s not to like? He’s got those rugged good looks, he’s straightforward and smart and . . .”
“. . . married,” I reminded her.
“Oh yeah.” Sara grimaced. “Major buzzkill. You need to find out if he’s got a younger brother who’s single.”
“He has two younger brothers, but they’re both in Brooklyn.”
“Then, you should relocate.”
I laughed, although I think she might have been serious.