Dr. Jamal Jeffries froze with indecision, perspiration beginning to form on his forehead.
The scientist’s large, brown eyes stared in disbelief while the steady click/hiss of the respirator repeated in his ears. Slack-jawed and motionless, he took in gulps of air as the sensory overload threatened to overwhelm him. He felt a pressure above his eyes and heard a faint buzzing in his ears. The 38-year-old African-American man absent-mindedly reached out with his right hand, grasping at the air like an infant, trying to make sense of what he was seeing. All around him, the cascading lights seemed like living entities, consciously assaulting his body in paralyzing waves. A tear escaped his glazed, bloodshot, left eye slowly winding down his cheek.
An unexpected spasm caused him to jump involuntarily as fear filled his heart. Was this the end? Was it all over? He searched for any plausible alternatives, desperate to deny the scenario before him, but his logical brain kept coming back to this terrible reality. Despite his best efforts, the cold, hard facts threatened his consciousness with madness. He panicked, his body in distress as any hope of relief faded away. No matter what you tell yourself, no matter the rationale, no one could prepare for something like this. It all seemed so alien, so completely impossible, like a bizarre dream from which he couldn’t wake. A white light played about the edges of his vision and he knew his mind was about to shut down.
“Focus, damn it, focus,” he thought as his reality ebbed and his breaths grew shallow. He frantically tried to think of another place, another time. “Focus on how this happened…where it all began.”
Two days earlier, Jamal fidgeted uncomfortably on the oversized sofa, avoiding eye contact. Dr. Madeleine Strouder watched him curiously, seated seven feet away in her comfortable, beige, wing-back armchair. For the past two years, each session began the same way: the doctor placed two relatively innocuous options in front of Jamal from which he had to choose. They played out this simple scenario before beginning their time together in earnest. Today, the choices were a bottle of water or a can of iced tea. During his treatment for aboulomania and other anxiety disorders, Jamal had made great progress with his decision making. It had been almost a year since his last serious episode of indecision. Dr. Strouder believed he’d turned a significant corner some months ago but this morning, everything was different.
From the moment Jamal entered the office, the psychiatrist could tell something was off about him. The fact it took him almost a full 30 seconds to choose the same spot on the couch where he always sat only confirmed her suspicions. He reached for the water bottle but stopped, bringing his hand up to his chin as his face displayed a series of tics, including squinting, demonstrably frowning and moving his lips back and forth. Seeing her patient revert to behavioral patterns he hadn’t exhibited since their early sessions vexed the doctor and gave her pause. She knew something must’ve happened in the past week to trigger this recurrence of old habits.
Jamal’s regression prompted Dr. Strouder to revert back to her original, tried-and-true techniques as well. She watched him silently, eschewing any note-taking or other distractions. She didn’t want to help him with his decision-making process, either verbally or non-verbally, so it would eventually force him to overcome this renewed paralysis by analysis. He’d been able to independently overcome a few hiccups in the past so she wanted to give her patient the chance to work through it on his own. It usually only took a few minutes for him to break through. It was imperative for him to decide without prodding. Otherwise, this regression could snowball and erode all their hard work.
Jeffries’ eyes darted around the room before fixing on his doctor, who remained motionless and impassive. For long moments, he pleaded with his eyes for some assistance but Dr. Strouder remained unfazed. When he returned his gaze to the two simple options before him, his mind spiraled out of control. Jamal fought back tears. The frazzled physicist finally reached into his sports coat and retrieved a white handkerchief. He dabbed his eyes before wiping his brow, taking deep, long breaths as he struggled to focus past his anxiety. He started to put the cloth back in the pocket of his sports jacket but hesitated, his eyes growing wide.
What if I need it again? There’s a good chance I will. Should I leave it out? But, if I leave it out, where do I put it? Maybe just lay it beside me? No, that wouldn’t work. What if I forget it later? I could just hold it. But my hands are starting to sweat so that’s no good either. I could lay it across my leg but it could fall and then I’d feel stupid. I need to relax and breathe. Just breathe. Now, put it in your pocket, Jamal. Just do it. For God’s sake, it’s not that hard!
His hand trembled slightly, unable to move as his brain swirled in an endless loop of possibilities. Dr. Strouder decided to intervene, finally admitting this setback was more severe than the other momentary lapses in the past. It seemed obvious he needed a nudge, like a scratched vinyl record skipping repeatedly.
“Have you renewed your prescription, Jamal?” she asked gently.
The question broke the cycle of uncertainty in his mind and Dr. Jeffries quickly placed the handkerchief on the couch next to his right leg before looking up at the psychiatrist. He glanced back at the cloth for a moment, biting his lower lip gently. Jamal went to pick it up again but stopped himself. Instead, he placed his hands near his abdomen, rubbing them together awkwardly.
“It…expired three days ago,” he said with embarrassment. “And, no…I-I…obviously, I haven’t refilled it yet.”
“Why is that?”
“I don’t know,” Jamal answered tersely, using his favorite cop-out response while his eyes repeatedly ping-ponged from the legs of the desk across the room to his doctor and back again.
“Yes, you do,” Dr. Strouder said calmly but firmly. “Just as you know why it’s important to keep up with your meds, Jamal. I’ve told you numerous times. The prescription calms your mind and helps you focus.” She shook her head slightly, making sure to show no judgement on her face. “The only way you wouldn’t have refilled it is if you stopped taking it days before…if you’d already allowed your condition to worsen. So, I guess the real question is: why did you stop taking your meds?”
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