62

PATIENT NAME: Noah Elliot Simon Shaw

AGE: Seventeen

The patient presented as a healthy teenage male of above average height and lean, muscular body build. He appeared somewhat older than his stated age. Rapport was not easily established. Patient was not matter-of-fact or helpful.

Patient has an ongoing pattern of uncooperative, defiant, hostile, and aggressive behavior toward authority figures and peers, according to family and educators. Atypically, it has not affected the patient’s performance in school, where the patient has maintained a perfect GPA. Patient demonstrates neither hyperactivity nor anxiety but has engaged in multiple violent confrontations with others. Parents have reported several callous-unemotional traits and patient has rated highly on all three sub-scales. However, parents state that the patient has never exhibited any cruelty to animals and is in fact an exceptional caregiver to them, demonstrating a particular facility with feral and dangerous animals at his stepmother’s veterinary practice, negating Antisocial Personality Disorder and other sociopathic types as potential diagnoses. Both the patient’s father and the school have reported the patient’s intentional destruction and vandalism of property in the past, however, as well as deceitful behavior (lying) and flouting of social norms. School restrictions are repeatedly ignored and punishments are demonstrably ineffective. Stepmother reported past incidences of alcohol and drug abuse, but nothing in recent history.

When confronted with reports from his parents and educators, questions were met with arrogant, cynical, and manipulative responses, and educators report history of sensation-seeking (renowned sexual reputation) and impulsivity. Patient demonstrates arrogant self-appraisal and superficial charm; inability to tolerate boredom; is self-assured, voluble, and verbally facile.

Continue to monitor for probable Oppositional Defiant Disorder; possible eventual diagnosis of Conduct Disorder or Narcissistic Personality Disorder.

I CLOSED THE FOLDER WITHOUT CEREMONY AND handed it back to Noah.

“Why do you have two middle names?” I asked.

“That’s your question? After reading that?” Noah drew back, searching for something in my eyes. Disgust, maybe. Or fear.

“It’s not you,” I said to him, and softly.

The corner of Noah’s mouth lifted in a slow smile. A sad one. “Yes. It is.”

We were both right, I decided then. Our files were part of us—the parts that people wanted to fix. But they weren’t all of us. They weren’t who we were. Only we could decide that.

I swung my leg over Noah’s waist and straddled him. “Maybe the uncooperative part’s true. You’re very”—I brushed my lips against his—“frustrating.”

Jamie cleared his throat. I nearly forgot that he was there.

“You okay?” I asked him.

“If okay means ‘pessimistic, unstable, and manipulative,’ then sure,” Jamie said cheerfully. “‘Patient demonstrates extreme sarcasm and enduring bitterness; sees things in terms of extremes, such as either all good or all bad. His views of others change quickly, leading to intense and unstable relationships,’” he recited from memory. “‘Patient demonstrates conflict about sexual orientation and is preoccupied with the sexual histories of others. Demonstrates a classic pattern of identity disturbance—an unclear, unstable self-image—as well as impulsivity and emotional instability,’” he said, suddenly sounding tired. He closed his file, chucked it like a Frisbee at the opposite wall, and leaned back with his arms above his head. “Ladies and gentlemen, Jamal Feldstein-Roth.”

I blinked. “Wait, Jamal?”

“Suck it,” he said with a grin. “My parents are liberal Jews from Long Island, okay? They wanted me to have a connection to my heritage.” Jamie made air quotes with his fingers.

“I’m not judging—my middle name is Amitra. I’m just surprised.”

“Amitra,” Noah mused. “Mystery solved.”

“What is that?” Jamie asked me.

“Sanskrit? Hindi?” I shrugged.

“Randomly?”

I shook my head. “Mom’s Indian.”

“What does it mean?” Jamie asked me.

“What does Jamal mean?” I asked him.

“Point taken.”

“I probably have about as much connection to my Indian heritage as you do to your African heritage,” I said. “My mother’s favorite food is sushi.”

“Latkes.” Jamie smiled for a second, but then it faltered. “This is bullshit,” he said suddenly. “We’re teenagers. We’re supposed to be sarcastic.”

“And preoccupied with sex,” I chimed in.

“And impulsive,” Noah added.

“Exactly,” Jamie said. “But we’re in here and they’re out there?” He shook his head slowly. “Everyone’s a little crazy. The only difference between us and them is that they hide it better.” He paused. “It . . . kind of makes me want to burn this place down?” He raised his eyebrows. “Just me?”

I grinned. “Not just you.”

Jamie stood and chucked me on the shoulder. Then yawned. “Rain check? I’m beat. You guys staying?”

I looked over at Noah. We hadn’t gotten what we came for yet. When our eyes met, it was obvious that he was thinking the same thing.

“Yeah,” I said.

Jamie picked up his file and dropped it back in the appropriate drawer. He reached for the door. “Thanks for the fun. Let’s do it again soon.”

I waved. Jamie closed the door behind him.

And then Noah and I were alone.

Загрузка...