By Liz Dubleman

Dr. Anderson put her notepad down, took another small sip of wine and reflectively rubbed her head.   There was a book of matches on her desk that she unconsciously thumbed.  The matches were from Le Petite Café.  Herbert used to take her there on special occasions.   A lovely French couple owned the restaurant and would let them in back, by the parking lot where they grew herbs in pots.  They would let Herbert smoke his American Spirits after dinner with his demitasse.

The doctor went back to her notes about a patient named Sally, a female, age 63.   Sixteen months ago Sally lost her husband of twenty-four years from emphysema.    Last week her beloved feline had to be euthanized.  Since then Sally “has reported a buzzing in her head.”

Dr. Anderson wrote, “Sally appears to have a high degree of rage and yet appears to be the model patient.  Glimpses of this rage can be seen in her body language during our sessions.  For example, last session when she spoke of a childhood incident in which her frequently violent father had used a kitchen knife to slash her Teddy Bear, her voice was calm and detached.  Moments later she’d reached for a tissue because she had picked furiously at an apparent scab on her elbow until blood had run down her arm and stained her dress.  At this point the patient exhibited undue hostility toward herself.  She said she was ‘a fucking imbecile’ and a ‘stupid cunt.’   She then abruptly left the session, only to return a few minutes later composed and cleaned.”

Dr. Anderson looked over at the bloodstain on the chair.  She finished the glass of wine, emptied the remainder of the bottle into it and walked over to the chair.  She touched the blood and a shudder ran through her body.  She turned over the cushion to conceal the mark.   Without thinking she touched her elbow and felt a sympathetic sting.

She returned to her desk and sat down, thinking for a moment before resuming her writing.  She opened the book of matches, raised it to her nose and smelled the sulfur.  Sometimes strong odors grounded her.   She missed Herbert, but she was a grown woman with responsibilities.   She needed to get back to her notes.

“Sally currently identifies herself as a loner.  Her most vivid memories include a fascination with fire.   In a recent session she confessed to stealing money from her parents and setting it on fire ‘just to watch it burn and smolder.’  This may be part of an aggressive conduct disorder that may have transmuted or is still unresolved.  Her current affect is mild depression.”

Dr. Anderson downed the glass of wine.  The office was quiet.  It was well after eleven.  She was quite sure there was no one else in the small three-story medical building.  She walked over to the cabinet under the bookshelves and pulled out another bottle of Cabernet.   She paused at the black and white photograph that hung on her wall: a naked infant on a bed crying, with its mother in the background, in silhouette against the window.  She had bought that picture just after Herbert’s passing.  She opened the new bottle, poured another glass, and continued with her notes.

“Sally says that she drinks herself to sleep, and that she often needs to consume three or four bottles of wine to do it.  She sometimes lacks the ability to communicate at all.  She will sit for up to fifty minutes without uttering a word.  At one point she asked what the requirements were for hospitalization.  When I inquired further as to her reasons for the question she had no response.  I sense her need to be in a secure environment.”

Dr. Anderson’s pen was running out of ink.  She opened her desk drawer and noticed the heart-shaped tag she had placed there when she’d returned from the vet.   It was all she had left of Millie.  She knocked back another glass.  The wine was amplifying the buzzing in her head.   She fingered the matches.  Her eyes attempted to focus on her medical diploma but her vision was blurred.   She looked down and blinked in an effort to clear her eyes and noticed the red splotch on her dress.

She picked up the notepad that she was writing on so the pages hung down like the limp fingers of a hand.  She shook them and they made a rather pleasant breezy noise.  She placed the pad back on her desk and picked up the matches.  She struck one.  It blossomed.  She dropped it and it went out.  She struck another and used it to ignite the whole book of matches.  She picked up the pad, allowing the pages to fan, and then lit each page.  With the clinical notes ablaze she dropped them on the curtains.  Sally watched for a while and then walked out the door.  She rang for the elevator, noticing the sign: IN CASE OF FIRE PLEASE USE THE STAIRWAYS.

The elevator door opened.  Sally smiled and got in.