Patient’s name: Meghan Faber
Age: 16
Occupation: High school student
Diagnosis based on initial evaluation: Met with patient’s parents, Craig and Belinda, first. They are concerned about daughter’s “obsession” with getting plastic surgery (last year, she wanted a nose job, now it’s a breast augmentation.) Parents’ refusal to accede to these requests has led to an emotional rift with their daughter. She has become surly, uncommunicative, and disobedient. Diagnosis pending first session with patient, but sounds like typical teen angst caused by body image issues. Peer pressure may be involved.
Goal of therapy: Help patient to achieve more confidence and a healthy body image. Reopen lines of communication between parents and child.
“I hate my mother!” declared the sullen girl who sat in a slumped position on the couch opposite me with her arms crossed defensively across her chest. I considered it something of a breakthrough since up to that point in our session, Meghan had done nothing but stare off into space with a petulant expression on her freckled face while I had a rather uninteresting conversation with myself.
“Why?” I asked calmly in contrast to her violent outburst.
“For starters, she never listens to me. And she doesn’t care what I think or how I feel.”
“She wants you to be happy.”
“That’s a crock,” Meghan said, twirling a fuchsia-streaked strand of her long, dark hair around her index finger. If my mother wanted me to be happy, she’d let me get a boob job. But no, she’d rather I be flat-chested and miserable.”
“Why is having large breasts so important to you?” I queried.
“Well, duh,” Meghan looked at me as though I was a drooling idiot, “being flat-chested sucks! I can’t fill out a bikini top, guys never notice me, I’m embarrassed to get undressed in front of other girls because they’re all so much bigger than me, and they don’t make pretty bras in an A-cup.”
That was a compelling list of reasons.
“It’s not like I’m asking my parents for double-Ds or anything. I just want to go up to a C cup so that I can look normal.”
“Women’s bodies come in all shapes and sizes, Meghan, and they’re all considered to be normal. You’re actually quite lucky to be an Ectomorph.”
“A what?”
“An Ectomorph. That means that your body is long and lean, you have small bones, and very little body fat,” I explained. “You don’t ever have to diet, right?”
“No, just the opposite. I’m always trying to gain weight. I drink protein shakes and eat tons of carbs, nothing ever works. I guess I have a fast metabolism.”
“I would love to have a fast metabolism. Everything I eat goes straight to my butt.” I wasn’t exaggerating. Like most Latinas, I was curvy, and while my rear end had yet to reach the epic proportions of JLo’s, it might if I wasn’t careful.
“Yeah, my friend Amy is the same way. She’s always complaining about her ‘fat ass’ and ‘thunder thighs.’”
“So, see, being an Ectomorph has its plusses. You don’t have to worry about your clothes suddenly being too tight or getting any unsightly cellulite.”
She shrugged. “I still wish I had boobs. A girl can’t be sexy without ‘em.”
“I disagree. Look at all the beautiful actresses who are built like you. Michelle Pfeiffer for instance”
“Who?”
Go younger, I told myself. Think Generation Y. “Keira Knightley.”
“She’s cool,” Meghan decreed as she played with the silver bangles on her right arm. “My friend Ryan likes her. Who else?”
“Um, Kate Hudson. Natalie Portman. Kate Bosworth. The girl who’s in those Twilight movies.”
“Kristen Stewart.”
“Right. They’re all small-busted women and they’re considered to be hot.”
“I guess.” She wouldn’t admit that I’d made a good point, complete with examples she could relate to, but I could tell she was thinking it.
I looked down at my watch and saw that it was 3:47. Since I’d done all of the talking up until the last five minutes, I didn’t feel like this had been a particularly productive session. But, at least, I’d finally gotten Meghan to engage in some sort of meaningful dialogue, and I hoped we could continue with more of the same the next time we met.
“I’m afraid that our time is almost up.”
Acting like a prisoner who’d just been granted parole, Meghan sprung up from the couch, grabbed her backpack, and headed for the door.
“Not so fast.” I stopped the teenager, getting up from my chair and walking towards her. “I want you to think about something and come back with an answer for me next week.”
“Oh, God, are you giving me a homework assignment?”
“It won’t take much time, I promise. Just make a list of three things you like about your body.”
Meghan rolled her large brown eyes. “That is so lame.”
“No, it’s not. You spend a lot of time thinking about the things you don’t like about your body, don’t you?”
“Yeah,” she admitted sheepishly.
“Then, you should give equal time to focusing on the positive.”
Sighing like she was the most put-upon girl on the planet, Meghan grumbled, “Fine. Whatever.”
I opened the door, and she darted out into the waiting area intent on getting out of my office as quickly as she could.
“See you next week,” I called after her.
“Can’t wait,” the sarcasm in her tone was unmistakable.
“That girl’s got a real attitude problem,” Margo stated the obvious after Meghan had disappeared into the hallway.
“She’s at a difficult age. She’ll grow out of it,” was my prognosis. “That was my last appointment for the day, wasn’t it?”
“Uh-huh. Why don’t you call it a day? I can close up the office.”
Leave early? What a novel concept! Izzy had said that she had plans for the evening, which meant that I would have the house all to myself. I pondered the delicious possibilities . . . I could watch the local news, make some pasta, dance around in my underwear . . . well, probably not that last one, but I might put on a CD, pull out my yoga mat, which was collecting dust somewhere (maybe under the bed?), and do some stretches. It would be heaven to have some alone time to relax and unwind.
“I think I’ll take you up on that, Margo. Thanks!”
I went back into my office to tidy up and collect my purse.
“Enjoy your evening, hon,” my receptionist bid me farewell as I slipped out the front door with a smile on my face.
Humming the tune to some Nicki Minaj song I didn’t know the name of, I headed down the stairs. Just as I reached the landing that divided the steps before they veered to the left, I heard the muffled sound of my cell phone ringing. I stopped and unzipped my purse. Extracting the phone, I checked the Caller ID. Victor. UGH! There went my good mood. I could have just let the call go to voice mail, but I was annoyed that my ex was once again intruding on my life and I suddenly felt confrontational. So, I answered it.
“What do you want?” was my curt greeting.
“To take you out for a romantic dinner at Tantra, mi amor.” Tantra was a Miami Beach hot spot that was known for its sensual environment. Its exotic smells, decor, and cuisine were all designed to enhance and arouse the senses, and there were, in fact, several aphrodisiacs on the menu. When a man took a date to Tantra, it was with one goal in mind.
“That’s not going to happen. Ever,” I said firmly.
“But you love Tantra! Don’t you remember we went there for our one-month anniversary? I hand fed you lobster dipped in bleeding heart truffle vinaigrette and grilled quail with fresh figs.” Mmmmmmm, he was making my mouth water. “Then, we went back to my place and spent hours experimenting with Kama Su—”
“Victor!” I interrupted him before his walk down memory lane became X-rated.
“Okay, you don’t like Tantra anymore. I’ll take you to B.E.D.” Where patrons ate their meals while sitting on large mattresses. A theme seemed to be developing with Victor’s restaurant choices.
“I don’t want to go to B.E.D. with you.” It sounded like I was turning down a proposition much more salacious than dinner.
“Alright, you’d rather not commit to sharing a meal with me. I understand. We can just take a walk on the beach and talk.”
“We are not a couple anymore, Victor.” In my agitated state, I began to pace back and forth on the landing. Three steps towards the wall, pivot, then three steps back to the top of the stairs. “We broke up. And people who are broken up do not spend time with each other.”
“But you said we could still be friends, and friends spend time with each other.”
“Friends give each other space when they ask for it.”
“I’ve given you plenty of space.”
“Then, why do I feel so claustrophobic?” I questioned irritably. “You’ve got to back off.”
“If I do that, you’ll find somebody new, and I can’t bear the thought of you with another man.”
In that moment, I actually felt a pang of sympathy for my former lover. Maybe his campaign to win me back wasn’t all about his over-inflated ego? Maybe he did have real feelings for me?
Softening towards him, I said, “Don’t worry, Victor. It’s not like I’m going to walk out the door tomorrow and run into my soul ma—” I bumped face-first into a hard, flat surface, let out a startled yelp, and staggered back against the wall. My cell phone clattered to the stone floor and I watched dazedly as a leafy green plant toppled off a large cardboard box being carried by a tall man with a square jaw and thick brown hair that was attractively disheveled.
“Damn,” he cursed and dropped the box down on the pile of potting soil that now covered the landing. It hit the ground with a loud thump. “Sorry. The plant blocked my view and I didn’t see you. I shouldn’t have tried to carry so much in one trip. Are you okay?”
He had a brusque way of speaking that immediately outed him as a New Yorker. There were plenty of retirees in South Florida who hailed from that part of the country, so I knew the accent well.
I blinked hard a few times, trying to reorient myself. “I-I think so.”
“What about your head? Did you bang it when you hit the wall?” There was concern in his eyes, eyes that were the most brilliant shade of blue I’d ever seen. Gazing into them was almost like staring directly into the sun; I felt dazed, woozy, like the back of my head was going to split open and my brain would fall out . . . okay, so it wasn’t the color of this man’s irises that was having such a strange effect on me, I’d obviously suffered a serious cranial injury.
When I didn’t answer him, he moved towards me. “Here, let me take a look.”
“Thanks, but that’s really not necessary.” I pulled away from the wall and felt a sharp jolt of pain shoot through the back of my skull. “Ow!” I placed my hand over the spot that was throbbing, hoping the pressure would make it stop.
“Do you have a lump?” He reached out for me, and I instinctively backed away. Subdural hematoma or not, I wasn’t in the habit of letting strange men touch me.
“It’s okay. I’m a doctor,” he assured me, taking my face gently in his hands and tilting my head back so that he could look into my eyes. I noticed he had some silver strands of hair mixed in with the brown and wondered how old he was? Late thirties, maybe?
“Your pupils aren’t dilated, so you don’t have a concussion.” Threading his fingers through my hair, he began to cautiously inspect my scalp with his fingertips.
“I’m a doctor, too,” I told him for no particular reason as I stared up at him. Even though I was wearing heels, he had several inches on me. “Not a medical doctor, a psychologist.”
“Oh, yeah?” He gingerly touched the area below the crown of my head. “How does this feel?”
I winced. “Pretty tender.”
“Well, there’s no swelling, so I think you’re just badly bruised. An ice pack and a couple of aspirin should alleviate any discomfort.” He let his hands fall to his sides. “A psychologist, huh? You must be my new neighbor, Dr. Alvarez.”
“Neighbor?” I repeated dumbly, still trying to process the fact that I didn’t need to rush to the nearest medical facility for a CAT scan.
“Yeah, upstairs.” He pointed up the flight of steps I’d just come down. “I’m moving into Suite 2-C.”
“Oh, I didn’t realize that that space had been rented.” A handsome male doctor was moving into the office across the hall from me? I couldn’t believe my luck. It looked like all those candles I’d lit at St. Andrew’s over the years had finally paid off.
“I’m Jonathan Fordham.” He held out his hand, and I gave him mine.
“Nice to meet you, Dr. Fordham.”
“Call me ‘Ford’,” he requested after he’d released my hand. “Everyone does.”
Ford, huh? I liked that. Its simplicity suited him.
“If you’ll call me ‘Pilar’,” I countered.
“Okay, Pilar, it looks like your cell phone is busted.” He gestured at the ground where it lay in several pieces.
“Your plant’s not in very good shape either.” The poor thing looked as though it’d been trampled. Ford had obviously stepped on it when he’d come to my aid.
“Yeah, we’ve made a pretty big mess.” He bent down and picked up his box. “Why don’t you bring your phone upstairs, and I’ll see if I can put it back together for you?”
I gathered up the broken phone pieces, as well as another item that was half-buried in the dirt, and followed him.
“Looking for these?” I jangled his keys when I found him standing in front of his office door, patting his jeans’ pockets.
“I was wondering what had happened to those. Thanks.” Ford shifted the box so that its weight rested more firmly on his hip and he could support it with just one arm, then he used his free hand to take the keys from me and unlock the door.
“After you.” He waved me in. We passed through the outer waiting area and entered his office, which was a lot bigger than mine.
“Nice,” I commented as I glanced around. He already had his furniture in place, a large cherry wood desk, matching book shelves and filing cabinets, a green and taupe striped couch, brown leather chairs. It was all very masculine, as opposed to my office, which was light, airy, and neutral-colored.
“Are you a therapist, too?” God, I hoped not. I really didn’t need the competition, especially not from someone older and more experienced.
“A psychiatrist.” He sat down on the edge of his desk. “I was on staff at Mount Sinai for 7 years. I decided to shift gears and go into private practice when we moved here.”
Mount Sinai? That was impressive. Only the best and the brightest worked at that hospital. Its reputation was unparalleled in the medical community. Wait a minute! Had he just said, “when we moved here?” Oh, crap. My eyes went to the ring finger of his left hand, and sure enough, I saw a gold wedding band there. Why was I surprised? Weren’t all successful, good-looking men over the age of 30 married? Ford probably had a litter of adorable, dark-headed ankle-biters with high IQs at home, too.
“From New York to Miami, huh? You must be experiencing some major culture shock.” I set the assorted pieces of my cell phone down in a pile next to him.
“It’s definitely different here,” he conceded as he picked up a part that looked like a small circuit board and inserted it in an empty slot on the back of the phone. “For one thing, I’m not used to all of this sunshine. 85 degrees in April is just unnatural.”
“We only have one season in Miami . . . summer. So, stock up on shorts and t-shirts and get used to wearing sunblock with a high SPF.”
Ford slid the cell phone’s battery back into its designated compartment. “Does it ever rain here?”
“Oh sure, we get tons of rain in September when all of the tropical storms and hurricanes come through,” I said with a smirk.
“Great. At least, I won’t have to shovel snow in January.” He positioned the back cover of the phone over its exposed guts and popped it into place.
“Okay, that should do it. Let’s see if this puppy still works.” He turned on the repaired phone and was rewarded with a beep. “Looks like you’ve got service and a whole bunch of messages. Eight, to be exact. You’re very popular.”
“I’m sure they’re not important.” I took the phone away from Ford and turned it off. “Thanks for fixing it.”
He smiled; it was a nice smile, one that made the person receiving it feel all warm and fuzzy inside. “It was the least I could do seeing as how I caused you bodily harm.”
I smiled back at him. “Well, since it was unintentional, I won’t hold it against you.”
“Glad to hear it.” His blue eyes twinkled.
The sound of someone banging on my office door ruined the moment. “Pilar! Pilar!”
I pretended not to hear Victor calling me.
“So, when will you be open for business?” I questioned Ford conversationally.
He furrowed his brow. “Is that one of your patients? Maybe it’s an emergency?”
“Pilar! Answer me, Pilar!” Victor was becoming more insistent.
I let out a beleaguered sigh. “It’s not an emergency.”
Backing up a few steps, I yelled out to the hallway, “In here, Victor!”
He came rushing in with a panicked expression on his swarthy face. “Mi querida, thank goodness you’re okay!”
Before I could respond, Victor embraced me with bone-crushing fervor and proclaimed, “I was so worried! You screamed, and then the line went dead. I tried calling you back, but there was no answer. I could only assume the worst.”
“I’m fine,” I mumbled into his silk-covered chest.
He pulled back, his hands still gripping my shoulders. “Are you sure? What happened?”
“Dr. Fordham,” I gestured over at the man who was still perched on his desk, looking bemused by the proceedings, “and I just had a little accident on the stairs.”
“An accident?” Victor’s voice rose with alarm. “Were you hurt? You look pale, mi amor. I should take you to the emergency room.”
“I just bumped my head against the wall when Dr. Fordham and I ran into each other. It was no big deal.”
Victor turned to Ford. “You should pay more attention to where you’re going. You could have seriously injured my fiancée.”
“Your what?” Had Victor lost his damn mind? Not even 15 minutes ago, I’d refused to have dinner with him, and now he was referring to me as his bride-to-be?
Victor held up his hand to silence me. “There’s no need to speak. You’ve obviously been through quite an ordeal. You should eat and get some rest. I’m going to take you home and stay with you all night to make sure you don’t have a concussion.”
“I’ve already checked her out, and she doesn’t have a concussion,” Ford interjected.
“What do you know?” Victor dismissed him.
“I told you he was a doctor.”
“It doesn’t matter. Only I know what is best for you, mi amada.”
What a controlling, chauvinistic jackass . . . if there hadn’t been a third party present, I would have happily told my ex-boyfriend where to shove his imperious tone. But I didn’t want to play out any more of this drama in front of Ford.
“Let’s just go,” I said wearily.
“Bueno.” Victor smiled smugly, thinking he’d gotten his way. Of course, I planned to set him straight as soon as we were alone.
“Thanks again for your help with my phone, Ford,” I threw back over my shoulder as Victor hustled me out into the waiting area.
“Why are you calling him ‘Ford?’” Victor chastised me. “You shouldn’t be acting so familiar with a man you just met. You’ll give him ideas. I didn’t like the way he was looking at you . . .”