By Stephen Thom
Unst, Shetland Isles
The attendant helped the old man out of the door. The woman stuffed the paper bags and the newspaper into her backpack, heaved it on, and clipped out onto the forecourt behind them.
'It's fine,' she said. 'It's fine, I can get him from here. Thank you, though, really. I'm sorry for the... '
She trailed off as she slipped her arm around the old man. The attendant stood back. Rain brushed his scalp.
'You're sure?' He said.
'We're fine,' the woman said, glancing back. 'Thank you so much. Really. We'll see you next week.'
'See you next week,' the attendant nodded. He watched the woman help the old man into the passenger seat, walk round the other side, and ease in behind the wheel. The store door blew shut and he flinched.
He raised his hand and smiled as they pulled out. A girl in a wooden deer mask looked out of the backseat window and his smile froze.
Ballenden House. The Consultant Psychiatrist was Dr Arnott. The room was dull and grey. Outside the window Mina could see a high fence and beyond it an empty schoolyard. Everything seemed drained of colour. A desk was squared away in the corner of the room and she sat opposite it, rubbing the tips of her fingers.
Scratching her head. Tapping her foot on the floor. Clicking her fingers. These little rhythmic tics that increased whenever she was anxious. And sometimes when she wanted to relax. She could lie awake all night, rubbing her fingers and toes together, scratching, flexing.
Dr Arnott sat back and crossed her legs.
'Tell me about your childhood,' she said.
Mina rested her left hand on her lap, rubbed her thumb against the tip of her index finger. It felt soft, damp. The tips of her fingers were always sweaty. Her toes rubbed against each other inside her shoes. Her brow furrowed.
'It was... good, I... I had a good childhood... '
Tell me about your childhood. Where do you even start? It wasn't like tell me about your weekend.
Dr Arnott scribbled on her clipboard. It had been over an hour already. It was too long, too much of this type of chat. It was exhausting. Work was about critical thinking, clinical thinking. Research. Knowledge. Honesty and ethics. This type of interaction was draining, confusing.
'There's a lot of stuff in my mum's letter,' Mina said. 'She was very keen that I bring it.'
'I understand that,' Dr Arnott said, 'and I will get to that. I'm just interested in hearing about your own recollections right now, your own words.'
Mina looked down. She closed her eyes tightly together and opened them. I should have prepared more, she thought.
'I know... my mum talked about repetitive play, and I'm still... I'm still like that, in a way. I read the same books over and over, I've been watching the same TV series for fifteen years... she said that I used to dominate play with my sister, that I couldn't... I wasn't good at improvised play. Apparently I found choices difficult and tended towards solitary play at school. I was sensitive to touch and the bustle of school life, I... I found it physically and emotionally demanding. I was extremely trusting of teachers, but I couldn't... I couldn't understand why others disliked me.'
She rubbed her left eye with the ball of her palm.
'I tended to take things literally. Like, if I was told to put a crayon down, I'd... I'd put it on the ground. I think teachers thought I was being deliberately difficult, or immature... '
Dr Arnott clicked her ballpoint pen. 'Okay. I'll definitely get into the letter, it sounds like there's a lot of useful information there. But I would like to try and focus on your own thoughts and feelings, to hear you describe them yourself, as best you can. How is your eye contact? Would you say eye contact is an issue?'
'People have told me that,' Mina muttered. 'I'm not sure... I'm not always aware of it, but yes, people have told me that. I know that it was very poor when I was younger. When I was asked to look at someone, I would stare ahead. I can do it when I... when I know I have to. I understand it's part of my job, how you... project. It's more... people I know, or... '
She looked away and smiled sadly.
'I feel really conscious of it now.'
Dr Arnott nodded. 'Do you ever have any problems reading people?' She said. 'Any problems reading people's expressions?'
Mina stared out the window. A bird trip-hopped forward and flew off the fence. Her head felt hot.
'I wouldn't say... I mean, it's a big part of my job, I... I don't think I have... '
She trailed off. Dr Arnott watched her clicking her fingers.
'I've been told I have problems understanding people's behaviour,' Mina said, quietly. 'I don't... I can recognise when people are upset, or... it just takes me a while, sometimes, to understand why someone might be acting in a certain way, or why they might do something, I'm... I'm struggling to think of examples right now, it's... '
'It's okay,' Dr Arnott said, sliding her chair forward and placing her clipboard on the desk. 'Take your time.'
'It's not my work,' Mina said. Her left eye twitched and she felt a sudden rush of feeling, a hopelessness. 'I'm quite... exact, quite methodical, it's good, it's... it's more... little details, things with colleagues... I might not notice when there's office dramas happening around me. I can seem quite naive, or a bit... sometimes I feel I don't respond the right way, when people tell me things. Things about their lives, personal issues. It happened just the other day. Someone was telling me about something personal, something upsetting for them, and I knew they wanted... I knew it was upsetting for them, and they were sharing it because they felt comfortable sharing it, but I didn't know what to say. It's frustrating. Sometimes I have told be told quite explicitly... I have to have it explained to me why people around me might be acting in a certain way.'
Dr Arnott placed her hands on the desk.
'But you don't feel like this affects your actual role,' she said.
'Well, no, I... I don't know. I sometimes think... because I feel so separate... like, I feel different, separate to other people... it helps me have this distance from certain parts of the job, it helps me... focus, or... '
She blinked rapidly and felt her eyes well up.
'I do... feel these things, I just... sometimes I don't know how to process them, or express it, and I end up... someone told me once that I don't understand human nature. And that scares me. For so many reasons. I know... other kids thought I was weird, or odd, when I was younger, and I know people do now, I just... I think sometimes I come across as a bit detached, a bit... I don't know. I find it hard knowing when to come into conversations. I find it hard knowing when to talk, when it's my turn, and I always get it wrong. So a lot of the time I just don't bother. But then I look rude. I know I look rude. It's just easier when everything's one step at a time. Conversation isn't like that.'
Dr Arnott smiled; soft, understanding. She gave her time.
'You mentioned you've had problems with change,' she said.
Mina swallowed. Her left leg vibrated softly and her fingers clicked.
'Sometimes... my mum... my mum mentions a lot about that in the letter. I've - I've had a lot of problems with relationships, I don't seem to handle them very well. I don't think I actually ever really... enjoy them, I... I feel like I need an abnormal amount of time by myself, but then... when they end, I've been totally distraught, like the world's ending, and three weeks later I'm fine. It's embarrassing, to think back, I... it's more like they're a thing, a concept, and when the thing changes I don't... know how to... '
She scratched furiously at her hair. Dr Arnott was writing. Mina felt confused. She wasn't explaining herself properly. She should have prepared. She always prepared. Conversations, phone calls. Social scripting. Work out in advance everything you're going to say.
She hadn't given the appointment enough credence. The screening questionnaire had come back with borderline results. She'd tried not to think about it in the run-up. It's unlikely. What difference does it even make? Go along. Go along and talk.
It wasn't going well.
'Do you have any issues with noise, or lights?' Dr Arnott asked. 'Any sensory issues you're aware of?'
Mina frowned. Lights?
'I don't... I'm not sure about lights, I'm... my mum talks about bland food preferences, I've always... I basically just eat cheese... '
She paused and rubbed her hand along her thigh. The room suddenly felt too bright, too exposing.
'There may be some issues that you're unaware of at the moment,' Dr Arnott said.
Mina sighed and flexed her hands. Dr Arnott moved her chair closer.
'Listen, I'm going to step out of the room for a while and speak to Dr Benzie. I'd like to go over your mum's collateral information too. I think it's good time to give you a rest, it's been a lot of talking. Is there anything... is there anything else you'd like to add, before I consult with my colleague?'
'I... I don't... I've just always felt like I'm different, and I don't know why.'
Dr Arnott smiled softly again. She picked up her clipboard and left the room. Mina wiped her eyes. Rain pittered at the window. There were children in the schoolyard beyond the fence. She heard shouts, laughter, happy noises. She felt totally cut off from the world. Wandering vacantly through it.
Dr Arnott returned some twenty minutes later. She eased into her seat and looked at Mina.
'Now, I've consulted with Dr Benzie, and it also gave me time to read over your mum's letter. Everything... everything you've said does tally up, it does correspond. That being said, I'd like to direct you to some post-diagnostic support, and - '
Mina felt her stomach lurch. She leaned forward.
'Sorry, did you say 'post-diagnostic'?... '
Dr Arnott turned away from the computer and nodded slowly. She sat in silence, watching Mina. It was a warm silence, an understanding silence.
'I thought... I thought there would be lots of appointments,' Mina choked. 'I didn't think... '
'It does take some bravery,' said Dr Arnott, 'but I prefer to focus on the positives. And it is all relative. All human life is there.'
She smiled again.
'All of us... we all have to consider how 'weird' we are, and what we need to do in order to continue and enjoy life.'
Mina tried to smile, but her bottom lip wobbled. She bit at it and dug her hands into the plastic arms of the chair. Laughter drifted up from the schoolyard.