The one thing they do not tell you in medical school is how much you will cease to care. It is an injustice really, if you think about it. They let you carry on thinking you are the one person who will change it all: medicine, the field of psychiatry itself, and most importantly … peoples’ lives entirely. Then again, one could view it as a kindness. Parents do not tear down their children with the harsh realities of life, or at least we like to think they shouldn’t. They allow their children to learn as they go, and so do the parental mentors that teach each new generation of professions. We decide that we want to mold and shape society through our chosen professional medium, and our parenting mentors prepare us, and then throw us to the wolves of reality.
This dual way of thinking is indicative of the psychiatric professional. They must see things from several viewpoints in order to make a fair and unbiased diagnosis. They take this assessment and turn it into advice and medication so that they can help their patient become a happy, normative-functioning individual. This forming of happy individuals becomes difficult when you cease to care, and Cian O’Callaghan ceased to care about two years ago.
He never wanted to stop caring, but numerous setbacks, backslides, and the culmination of one particular event made Cian despise his chosen profession. Several of his patients had fallen into a pattern. They would come to him initially for help with issues that Cian believed they truly wanted to be rid of: everything from alcoholism to hard drug abuse, from feelings of inadequacies to God complexes, from depression to schizophrenia. Everything came through Cian’s office, and he helped them all. He never could turn away a patient regardless of their medical coverage or ability to pay. Many times he accepted goods in trade, food, or office work. Others he would never see a dime from and reported it as pro-bono work. After meeting with these varied and harrowed faces for many sessions, Cian tried his hardest to help them. He offered advice, prescribed medication, counseled at all hours when they were at their weakest and called him at three in the morning for an impromptu session in an all-night dinner over coffee. His charges would make progress, amazing progress in some cases, but they all inevitably came back full circle. They would slip up, fall off the wagon, and start the vicious self-loathing all over again. Then, the cycle would start anew.
All of these things were on a tumble cycle in his mind as Cian went to work. It took him over an hour to get to work, even though he lived a mere ten-minute walk from his office. It took him over an hour because he would get on the bus and ride a circuitous route to his final destination. Cian used this long bus ride every day to take time to contemplate how to not be a psychiatrist any longer. He had been thinking about this for two years. Two years ago something happened that made him want to quit his job, but one does not simply walk away from six years of patients who either truly rely on him, or have just indoctrinated him into their cyclical ways. No, Cian would have to come up with a way to do things properly, because even if he hated it, he believed in doing things in decency and in order. The end of the line came, and Cian had to physically pull himself from the bus and walk the half block to his office.
The neighborhood was nice enough. Cian was able to get a decent price on an office space with rooms above for consultation on the corner of Fleet and Hanover in the North End of Boston. Being native Bostonians, Cian’s mother told him when he set up shop that he might as well market himself as an anger management specialist because all he was going to get was frustrated Sox fans railing about their team, but that leveled out considerably once they managed to break the Curse of the Bambino.
Cian walked past the restaurant he usually had lunch at next door and went into his office. He was greeted by his secretary, Urora.
“The coffee is made in your office, and I took the liberty of leaving you some danishes as well,” she said in her usual tone, which never conveyed much by way of intentions. Urora stated most things as facts. She handed him a cup of coffee.
“It never bodes well for the day’s work load if you lead with feeding me,” Cian replied with an air of knowing acceptance. Urora shrugged.
“You have a lot of patients, and starting out on an empty stomach isn’t good.”
“Sensible, as always Urora. OK, what do you have for me today?” She returned to her seat behind her desk and began pulling up the agenda she kept on her laptop. As she looked through files, Cian drank from his mug and glanced around the waiting area. When he hired Urora, his place of business looked and felt just that: business-like. His pension for orderliness had designed his office as a very rigid and unwelcoming place. The moment Urora walked through his door, she informed him that it would all have to be changed if he wanted to initially put his clients at ease. She explained that if they felt safe and comfortable while waiting for him, they would be more open from the moment they walk through his door. That way, Cian would not have to waste time trying to get them to relax and open up. Both the logic of this statement and the fact that she had not even interviewed yet made Cian’s job of deciding to hire her very simple.
The other fact that helped him make that decision was basic, but Cian felt it was important. He was not attracted to her. She was not an unattractive woman, but she was not his type of woman. Strangely, in almost every aspect. She had long, straight, raven black hair, unnervingly pale skin, brown eyes, and a slim figure that would make anyone she met wonder if she had an eating disorder. Ironic, since she spent most of her time trying to make sure Cian was eating adequately. This last thought made Cian smile, which brought her attention back out of the files.
“Something funny?” she asked.
“Uhh no, I’m just remembering a funny thing I saw on TV last night,” Cian covered.
“Well, tell it to your eight o’clock, Mrs. Bordelello. She’s already here.”
“Oh yeah, it’s the first Tuesday,” Cian answered with a sad grin and headed toward the stairs.
“Like clockwork, that one.” Urora added, “Oh, and there is a walk-in up there as well.”
Cian stopped.
“A walk-in?” He asked. There were few things in this world that Cian despised, but walk-ins were one of them. He only took patients by appointment for a reason. It kept things orderly and paced properly so he could get through the day in one piece. Walk-ins were the embodiment of chaos. They “needed him now” so they thought they can just stroll in and demand his attention. Cian hated this because it was a complete disregard for not only the value of his time, but it stated that the walk-in thought themselves more important that the other patients who had followed correct procedure.
“Who is it?” he asked with all the mire he could muster.
“A newbie,” Urora responded while clicking to a different tab on her screen. “A Mr. Clovenhoof. Stuart Clovenhoof.”
“Ugghhh,” Cian groaned, “Let me guess: shows symptoms of extreme paranoia?”
“What makes you say that?”
“Only a delusional paranoid would come to a shrink’s office for the first time and give a fake name,” he shot back.
“And why is his name fake, Cian?”
Rolling his eyes as hard as possible, “Clovenhoof? Are you serious?”
Urora stood up and walked over to him. “Not everyone is a liar, Cian. Automatically assuming they are is a sign of cynicism that could be interpreted as your own paranoia taking form.” Cian opened his mouth to respond, but could just stomp in childish anger and go upstairs. He hated it when she was right, especially about him.
After tending to Mrs. Bordelello, which took extra-long today to teach the walk-in a lesson, Cian went into his private office and pulled up the security camera of the room with this Mr. Clovenhoof in it. Cian used security cameras in each room in case anything happened in his office he would need in legal proceedings. All his patients were aware of them, that there was absolutely no audio involved, only video, and that if Cian or his office were to ever use the footage for anything besides legal proceedings, Cian would be prosecuted to the fullest extent of the law. He laid this out in extreme detail in the Doctor Patient Treatment Agreement each patient is required to sign before being admitted into his care.
The man he saw lounging in one of the big armchairs was even less impressive than Cian’s already low mental image. He was short, paunchy, and greasy-looking, as if water would roll off of him like water on a duck’s back. He had more patchy hair on his face than on his head, which was covered in streaks of sad rivulets of his remaining hair. It looked like ink had been spilled on his head while lying down and he never bother to clean it away. At first Cian thought he was asleep, but upon closer inspection he realized that he was indeed awake. His eyes, however, were so heavily hooded that the organs themselves were almost entirely hidden. He wore, of all things, a bathrobe over a plain t-shirt, stains included. His footwear was a classy affair of the fuzzy house slipper variety and Cian could not tell if his shorts were so old they were just loose fitting, or if this slob of a man was actually sitting in his consultation room in his boxers.
Cian sighed his heaviest sigh of the day, consumed another hot cup of coffee way too fast, and went into the room with his latest ward. Maybe he could pawn this man off on a colleague soon. Cian was trying to get out of the business after all, and taking on new clients was not going to help progress that endeavor.
“Mr. Clovenhoof?” said Cian as he entered the room. As the man looked up, Cian paused for a beat. The man’s eyes obviously got put into the wrong head. They were crystal clear and the purest glacial blue in existence. Where was the dreariness? Where was the blood shot orbs Cian was used to in people of this caliber? According to this man’s eyes, he had real issues to deal with, not just a lack of self-respect. Suddenly Cian felt he was the one being examined as Clovenhoof looked him up and down.
“Hmm. Not exactly what I expected, but then again no one is what you expect these days. Ok then, Doctor. Let’s get started shall we?”