The Accident

4

4

Approximately a week after the evening at the Hempsteads, I was sitting in my office reviewing a patient file and waiting apprehensively for my initial interview with Lara Stewart. Normally, I’m not tense with new patients but this one was different. This one seduced my good friend, putting his marriage and his practice in jeopardy. I wanted to do right by Win. I glanced at my clock and noticed that Lara was already ten minutes late. More often than not new patients are usually early since they are not familiar with the office and allow extra time for travel. Also, the anxiety of beginning therapy with an unknown therapist generally caused them to arrive early, although too much anxiety can cause resistance resulting in being tardy or in failing to show up altogether. As I watched the minute hand tick away I hoped that Lara would not be a no show. Just as I was beginning to think that was the case, my secretary, Grace buzzed me.

“Lara is here. You want me to sit in the interview with you?”

Grace threw me. Confused, I asked, “Why would I want you in the room?”

“You might want to do a breast exam.”

“I’m not examining her breasts.”

My sixty-five year old secretary did a tsk, tsk. “You haven’t seen hers. Even I can’t turn myself away. Michelangelo couldn’t improve on them.”

I shook my head, amused. I forgot how funny Grace could be. “Stay close to your desk, Grace, so I can call you when I need you,” I said, tongue-in-cheek. I walked to the waiting room to greet Lara. She offered her hand, flashing a broad smile to accompany her showgirl bosom. With her red raincoat draped over an arm, she walked beside me explaining she had gone to the wrong building. She was beautiful and sexy as hell. I could understand why Win was attracted to her. Flowing blonde hair, high cheek bones, puffy lips, and mysterious deep blue eyes, she possessed all of the features of the women Win pursued back in college. She dropped her coat on the far side of the couch, then sat across from me. Only then did I see her sheer silk, pink blouse that did little to hide her white lace bra that showed her n*****s. Grace was right. Michelangelo could not have improved on them. The top three buttons on her blouse were open.

“Would you please button your blouse,” I said, in my fatherly voice. “It is distracting.”

She flashed me an innocent look and buttoned the lowest one.

“One more.”

“You have something against t**s?” Her tone bordered on anger. Reluctantly, she buttoned it.

“This is about appropriate office behavior.” This was my office, my practice, and I needed to retain control, and not be taken in by her charms. She was blonde and beautiful, the perfect 10. I could appreciate how Win could be tempted. I was teased by her scent, a faint, subtle fragrance that hung in the air like an aphrodisiac. Silently, I watched her, allowed her to make the first move.

Uncomfortable, she nervously twisted the hem of her skirt. “I don’t want to be here,” she said.

“Then why are you?”

“Because Win sent me. He won’t see me anymore.”

“Why is that?”

“He’s afraid I’ll attack him.”

“Attack him, how?”

“Don’t act naive, Doc. You know, lure him into my web.”

“Would you?”

“I might. He’s a sexy, powerful man.”

“Dr. Hempstead said that you ran outside naked. Want to tell me about that?”

“I could show you.”

“Just tell me.” I was firm.

“Sure, we had a cabin in the woods on a lake. It was after dark and I went skinny dipping.” She curved an impish smile. “Did Win tell you he joined me?”

She threw me for a loop. I received a distinctly different impression from Win. This was not abnormal behavior. It could even be seen in a positive light, allowing the child within you to come out. “When did the swimming occur?”

“Last summer.”

I’d gotten the impression from Win that the affair was long ago. “Were you seeing Win professionally back then?”

“Come on, Doc. You know that’s not allowed. I stopped seeing Win last spring, about a year ago.” She reached in her purse and lifted out a cigarette pack. “Is it okay to smoke in here?” After I shook my head, she put the package back and emptied a couple of tic-tacs out into her hand and placed them in her mouth.

“Didn’t you recently see him?”

“Only briefly. He was still attracted to me, suggested I see you.”

“Why were you seeing Win…professionally?”

She cast a vacant stare to hide her inside turmoil. Finally, she said, “My black moods.”

“What about them?”

She twisted her legs around each other. “I guess I’ve always been prone to dark moods, a vague sense of foreboding, but they got worse with my job.”

“What do you do?”

“I’m a pharmaceutical rep. I work for Best Biotech.”

I knew that Best Biotech was an aggressive company with many new drugs in the testing stage. They seemed to specialize in pain altering drugs. “Do you like it?”

“The money’s good when I reach my goals, but there’s a lot of pressure. I’ve got to see the doctors, and they’re not always available. I spend hours waiting. Then I may have to make my pitch walking beside him on his way to the next patient. Chances are he’s not focusing on me. Some refuse to talk to me altogether. A big chunk of my salary is getting the doctor to prescribe the drugs to his patients. We’re heavy into opioids. Not the best area to be in right now.”

“You make me want to be nicer to my drug reps.”

She flashed a half-smile. “Most people don’t realize that we spend long hours and are constantly fighting traffic. Then there’s the boning up on new products and sparring with the competition. Add it altogether and it’s a heaping plate of stress-a-roni.”

I liked the play on words. There was a big thud as if someone, or something, fell. Immediately, I made eye contact with Lara, both of us stunned. I jumped up. “Excuse me, I need to see what that is. I’ll be right back.” I opened the door and raced down the hallway, simultaneously putting my hearing on alert. There were no other sounds. I didn’t see Grace at her desk and began to worry, knowing she hadn’t been feeling well. Only when I was practically on top of her desk did I see her feet sticking out behind it. Scooting around, I saw her lying on the floor, her upturned chair beside her head. She was breathing and had apparently fainted. Gradually, I was able to restore her to consciousness.

“What happened?” she asked, her eyes blinking for clarity.

“It looks like you fainted.” I knelt beside her. “Catch your breath. Then let me know when you’re ready for me to help you up.” I picked her chair up, set it upright.

“I’m good now.” As she began to get up, I placed by hands around her back and under her arms, lifting her to her chair. I placed the phone back on her desk.

“Tell me what happened?”

“I don’t really know. I was checking the schedule. I felt lightheaded, and then the next thing I remember is seeing you. I’m hypoglycemic…low blood sugar.”

Lara peeked out from my office to see what was going on.

“It’s okay. It was my secretary. I’ll be back shortly.”

She nodded and went back into the office.

“Should I see if Bobby will come in?” She looked pale and weary.

“No, at least not yet. I have a candy bar on my desk. I’ll eat it. If that doesn’t help, we can try Bobby.”

I returned to my office, assured that Grace would be alright or would inform me if she wasn’t. Lara stood, examining my posters: Ordinary People, One Flew over the Cuckoos’ Nest, Final Analysis, and Primal Fear. “I’ve only seen Ordinary People,” she said. “I can relate to that mother sometimes. Like her, I bottle up my emotions. Maybe that’s why I use drugs, to take me out of that lonely place.”

I sat and waited for her to return to the sofa. When she had, I said, “You seem to have some insight into your situation.”

“Yes, but I’m not ready to give up the drugs.”

“What do you take?”

“OxyContin for the pain. I have fibromyalgia. And Xanax for my moods. I took the last Xanax and I need the pain pills.”

“I don’t like to prescribe opioids. They can become habit forming.”

“Win prescribed them for me.”

I chose not to respond to her comment and asked her instead, “Doesn’t your company make them?”

“Yes, but that doesn’t mean I can get them without a prescription. You ought to know that it’s heavily regulated.”

I did. I also knew the authorities were clamping down on the doctors who prescribed narcotics too freely. Opioids were addictive and often led to heroin use that was likely to be laced with a lethal dose of fentanyl. “Did Dr. Hempstead prescribe the Xanax?”

“Yes.”

“On your recent visit?”

“No, it was very brief. Outside his office. That’s when he referred me to you.”

“Okay, but I understand you hadn’t seen him for a year. So where did you get your pain pills?”

“From Dr. Osacki, my gynecologist, but she is out of the country and won’t be back for another three weeks.”

I knew the doctor wouldn’t leave her patients without a back-up. Someone had to be covering them. Rather than prolong the discussion, I decided to prescribe her prescription for one time only. I also believed in prescribing medication in the initial interview if indicated. It not only helped with the patient’s symptoms but helped solidify the therapeutic relationship by administering to the patient’s needs. “I’ll write you a prescription for thirty days, one time only. After that, you’ll have to get the meds elsewhere.”

She gave me an appreciative smile.

I opened my top desk drawer for my prescription pad. I didn’t see it. I assumed it was buried between the mess of papers that needed to be organized, a simple task that I procrastinated about doing. I opened my side drawer file, fingered through the files, pulled out a prescription pad and wrote Lara the prescription.

The clock on the wall indicated that our time had ended and that we were now into my next patient’s hour. “We have to stop for today,” I said, handing her a prescription for a low dose one month supply of OxyContin and a prescription for two weeks supply of 4mg of Xanax. “I can slide you into a cancellation I had for tomorrow if you don’t want to wait for another week.”

“About this time in another week will be fine. I realize I was late.”

I checked my schedule and gave her an appointment card for the following week.