Notes from the Consulting Room

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I’ve always thought of consulting rooms as somewhere mysterious. From my observation, records on such places – such as Notes from Underground, Notes from the Dark Room, etc. – are like those private videos one keeps to oneself. They intrigue me because they involve unspeakable secrets. I’m curious, too, about my colleagues’ consulting rooms. Imagine: a small white room, with white curtains, some simple medical instruments, along with a green plant. Everything points to the fact that it’s a place of concealment and restraint. A doctor sits behind the desk. In front of him is a computer which records the patients’ private matters. Once a person enters the room, the door closes behind them. In a space sealed off from the entire universe, two strangers face each other. You can never tell what happens between them. Once, from next-door, a young woman dashed out of the room, full of tears. I was only passing by, but I glimpsed the new doctor (I didn’t really know him well), head clasped in his hands, sitting there, his shoulders twitching. It was a scene hard for anyone to watch.

However, I like to keep a low profile, and believe it is indecent for things like this to be seen by outsiders. After all, there is an unspoken rule in our industry: you take care of the patient the way you would yourself. If anything happens to the patient, shame on you.

And that’s why when one of my patients told me that she was worried a bug from her house sewer might have crawled into her private parts, I knew that I was in for trouble. Theoretically speaking, it was next to impossible for what she was describing to have actually happened. But I heard years’ of professional experience ringing in my ears: you must never argue with a patient on intellectual grounds. The important thing was to establish the initial conversation.

*

She was twenty-five, had only recently graduated and started working. She had short, curly hair, a small mouth, well-defined lips, some freckles on her fair skin. My intuition told me that she was the type of person that, although young, has already seen too much. But it was easier for one to be in her position than mine; that is, to maintain a simple mind despite one’s age. It seemed to me that the moment she walked in, she already saw everything, cataloging me into her museum of knowledge. It was possible that she even despised me. If she profiled me based on gender, she probably hated men like me, who were unmistakably masculine; if she preferred to think in terms of class, she could likely immediately file me away based on my family background; that left one final sociological category: race—fortunately, we were members of the same race. Nonetheless, how could one’s cultural identity, psychological dependence, and mental tendency come through with just a simple profile? Thinking of all this, I felt suddenly uneasy facing her. She was clearly a rare specimen. To cure her would be difficult.

When did it happen? I asked.

About a week ago, she said, her right-hand fingers playing with the left-hand fingernails. I noticed there were strange patterns on her nails, like some imaginary creepy crawlies. Very few women would have designs like that on their nails.

Have you had your tests done? I asked, typing our conversation into the computer.

Yes, everything was normal, she said. She spoke without looking at me, still toying with a fingernail. Something a patient once said occurred to me: don’t underestimate someone’s subconscious actions. He was talking about the first time he was intimate with his girlfriend: there were some subconscious gestures she made that perturbed him and caused him eventually to be completely turned off.

Tell me from the beginning, I said. Speak slowly.

OK, this is how it started… It started with my sink. No matter how many times I pushed the plug in, it always came out. Strange things started coming out, some kind of bugs. Later, I taped down the plug. And then I saw bugs coming out of the bathroom drain, very tiny ones, black. I’ve heard people say that they find cat fur in their pipes. Have you seen anything like that? She lifted her face, leaning towards me, staring at me.

Wait, I said, the sewer pipe and the water pipe belong to two different systems. You shower with the running water, which comes from the latter and should have nothing to do with the sewer. But I immediately regretted saying it. It was unreasonable on my part to argue with a patient. And this might cause me to lose her trust.

If you don’t believe me, you can ask my boyfriend, she said. When she unlocked her phone, I saw a man’s social media profile. A new form of evidence. I reluctantly jotted down the username, so I could contact him later for more information. I am always adapting to new things. Most patients I have examined show no physical symptoms of pathology, but they experience subtle psychological shifts that affect my diagnoses. For example, they might flee, temporally, to a parallel universe and hide themselves in its ever-spreading folds. That would require me to determine their relationship with the past, so as to track and analyze them. Meanwhile, the constantly updating medium of the internet further complicated my tracking. The virtual world: often, a tool for proving reality. Someone boiled earthworms in hotel kettles. You don’t believe it? Go check the website. A man saw a hammer when he was taking a walk, and just when he was going to pick it up, the hammer started moving, and it turned out to be a two-headed snake. You don’t believe me? I have the video. What I want to say is, these imagined lives have affected my professional judgments. This girl’s habit of saying, “If you don’t believe me…” is perhaps part of today’s popular culture.

My fingers froze on the keyboard. I began to have serious doubts. If I kept typing this information out, given its unreliable quality, what would be the point of it?

I’m afraid to sleep, she said. I close my eyes and see knives everywhere.

Close your eyes now, I told her. Give me your hands.

She hesitated for a moment and then closed her eyes. I noticed she had long eyelashes. I took her hands. It was nothing, done purely out of professional need. Although she was sensitive and wanted to draw back, she hesitated. She submitted. I put her hands on the table.

I took out a feather and lightly brushed it across her palm. Her nose twitched. She inhaled sharply and let out a little shriek. I took out a small animal clay mold and placed it into her hand.

If a knife is made of candy, will it melt if it’s in your mouth? I asked her.

Yes, she nodded. I noticed she was wearing a pair of gold, rectangular earrings, which had cat’s-eye-green crystals embedded in the middle.

Now, can you make a fist? I put her slowly clenching fist into my palm and closed my other hand over it. Her hand, which a moment ago had been stiff like that of a corpse, relaxed.

All right, I whispered in her ear.

She opened her eyes and smiled wryly. Like a disarming robot, she laid down some of that sharp, worldly demeanor she had upon entering the room.

Take these prescriptions and come back again next week, I told her.

But suddenly I felt sorry to see her go. I worried she would never come back. I’ve seen all sorts of women at the clinic, some of whom didn’t come back as I told them to. Like stars, they disappeared, headed toward their own uncontrollable fates. I still marveled about them after many years. I wished for this woman to come back, to bring me some feedback about my treatment. I’ve constantly adjusted my methods. There have been profound failures, but also happy surprises. This is how I think of this “game”: if I don’t change, then my practice will always stay the same. But changes excite me, and they fill me with anticipation; outcomes that are too predictable terrify me.

A week passed. One day, I returned to the clinic after a short lunch break and saw her waiting in the hallway. Then she walked in, glowing in a bright dress. It was mid-May. She brought in with her the scent of the flowers from the patio.

So, how did it go? I asked her.

I’m sleeping better, she said, taking something out of her handbag. It was an extremely tiny white cat with blue eyes, like the kind of pet one would see in a magician’s pocket. I heard that some animals could remain very small and never grow. She held up the little creature, kissed it on its cheek, and handed it over to me.

I hastily took it. It was the first time an animal appeared in my consulting room. And – forgive my frankness here – I’m generally despondent about life, but surprises like this give me the courage to keep going.

But soon she took the little thing back. She stood, making ready to go. This animal can kill the bugs, she said, so I adopted it.

Her black eyes shone. She looked like the kind of woman charged with keeping an alchemist’s bestiary. At that moment, she was a delightful woman; but such a woman can hardly take care of herself.

Of course, she never came back again, so I could never tell her this secret: when I asked her boyfriend about the problem she was having, he told me that he did see a bug crawling out from her.

So, because men had to share secrets with each other, I informed him that this must have been her particular way of acting out her hatred. There was only one possibility: she collected the bugs from the sewer and put them into her vagina. Of course, the man has now left her, and what’s more, he has hated women ever since then.

At the time, I asked him to do one more thing for me, to honor their relationship, once bound in mind and body: to buy a miniature cat. There was supposedly a new sort of cat, produced by breeders to stay small. I told him to buy it for her, tell her it could kill the bugs, and request that she keep it as a pet.

Of course, she gladly accepted the gift, and believed it was a treasure that could expel filth. That little creature, like the little saint in the tarot, followed her orders, and went everywhere with her.

*

These are but a small portion of my notes from the consulting room. The date of this entry is January 15, 2058. There is no reason to be surprised by them, for my notes include many anticipated pathological scenarios. Their aim is to prepare for possible future epidemics.

Comments

# 1.   

Chinese version: here

Justin, June 8, 2024, 3:39p.m.

# 2.   

If the doctor's patient was Chinese, strange she should have curly hair, I thought

Christopher Williamson, July 9, 2024, 12:37a.m.

# 3.   

One thing that I find strange is the fact that the doctor does not physically examine the patient, and the patient doesn’t seem to expect him to. If I thought I had bugs crawling out of my orifices, I would go into a clinic with every expectation of someone having a close look. He touches her hands, gives her a “small animal clay mold”, some prescriptions, and that’s it. This would make (some) sense if he were a psychiatrist, but then for her to see someone like that would be to admit that she herself doubts that the bugs exist, and she doesn’t seem to. This contradiction chimes with the doctor’s later interaction with the boyfriend. The boyfriend says he’s seen the bugs, so the doctor deduces that the woman is inserting them herself as a way of “acting out her hatred”, presumably without consciously realising it. Why then ask the boyfriend to give the woman a cat? At the end of the story, the boyfriend is scarred for life (“he has hated women ever since then”), and the woman is either still deluded, or still infected. The doctor’s intervention seems unproductive, and somewhat random. At the end of the story we find out that these notes, dated 2058, have been prepared “for possible future epidemics”, with a hint that we should be learning from the last one. Perhaps the last epidemic was one that involved the sort of bugs the woman is describing? Or perhaps it involved hallucinations?

Bill Leverett, July 15, 2024, 4:12p.m.

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