Picture perfect

There were days when Dr. George Gleason wondered who was really running the asylum – the doctors or the inmates. Then there were days like this, when he knew it was the patients’ families who were in charge.

The man sitting across the desk from him looked like the typical corporate executive. He wore a tailored suit in an appropriate navy blue shade, paired with a ruby-red power tie and coordinating pocket square. Italian leather shoes, highly buffed manicured nails, and a slicked back pompadour that would be amusing in any other situation, added to the superiority illusion.

Gleason leaned back in his chair, legs crossed and his fingers steepled at this chin. He attempted to appear engrossed in the man’s monologue – and that was what it was, an obviously rehearsed speech detailing the depth of his wife’s mental impairment.

The doctor had coined a sobriquet for these committers, White Coat Mad Men. It was usually men seeking admittance for their wives, or elderly parents, especially wealthy spouses or relatives. They couldn’t divorce their wives without it reflecting poorly on them, which could damage their professional reputations. Committing supposedly mentally incompetent parents could be spun to make them appear like thoughtful and loving sons. It was purely semantic sleight of hand.

All the requisite, legal paperwork was in order, so the narrative was unnecessary. Gleason recognized the soliloquy for what it was  – the man was talking himself into betraying his wife’s trust. Even as the facility administrator and head psychiatrist, Gleason had to follow protocol. Once the woman was confined, he had more autonomy to help her.

In a melodramatic conclusion, the man removed a monogrammed Irish linen handkerchief from his inner jacket pocket, and dabbed at faux tears, careful to keep the damask cloth from being wrinkled.

Gleason almost let the finale cue slip by unnoticed. While focusing on the man’s behavior, the doctor had been taking mental notes on observable evidence of a classic narcissistic personality, and was slow in acknowledging the end of a masterful performance.

He enjoyed this part the most – denying the Mad Men their Münchausen satisfaction. There was never a concession to the suffering the committer claimed experiencing, no empathy, nor response to any potential hardship from being apart from a loved one.

“Mr. Cassevetti, here at Lakeside Rehabilitation Center, your wife will receive the utmost psychiatric care available.” Gleason stood, but didn’t extend his hand nor take the one offered by his new patient’s husband. “She is safe here.”

Gleason’s emphasis on that final word garnered a quizzical look from his guest.

After Cassevetti left, Gleason called his medical assistant.

“Carrie, would you please bring Rochelle into the day room?”

Gleason was sitting at a round table with a young woman when his assistant came in with their new resident. The doctor and girl were drawing with colored pencils. A small stack of blank, white paper, topped with an unopened box of crayons, was on the table in front of an empty chair.

“Tansy, this is Rochelle, she will be staying with us for a while.” Gleason introduced his two patients, helping Rochelle into the vacant seat. “I thought it would be nice if you could help make her feel welcome. She is very sad now, and we need to be gentle with her.”

The younger woman leafed through her drawings until she found a picture of a bouquet of wild flowers, and placed it on the table beside Rochelle.

“Tansy does not speak, Rochelle,” Gleason said. “She communicates through her drawings. The bouquet is her invitation to be friends. It might also be helpful for you to share your feelings through art. It is often easier to put your emotions on paper, than it is to put them into words.”

Rochelle stared at the art supplies for a moment, then opened the box of crayons. Selecting a dark blue color she drew a crude stick figure of a man, then selecting a second color, she drew a red tie around its neck. With a third color, she added the suggestion of hatchet embedded in man’s back. Carefully replacing the crayons into their box, Rochelle pushed the paper across the table to Dr. Gleason

Gleason picked up the drawing, There was a slight lift of one eyebrow in an otherwise unreadable expression on his face.

“Excellent beginning, Mrs. Cassevetti.”