The thought occurred to Cassi that maybe she should seek help. But who to turn to? She had no idea. Patricia obviously wasn’t the answer, and if she went to any of the authorities, then Thomas’s career could be ruined. Cassi felt almost too depressed to cry. It was a no-win situation. No matter what she did or didn’t do, it was going to cause trouble. Lots of trouble. Cassi was aware that her relationship with Thomas could very well be at stake.
It took all her strength to finish getting ready for work and make the long drive to the hospital.
Cassi had no more than dumped her canvas bag on her desk when Joan’s head came through the door.
“Feeling any better?” asked Joan brightly.
“No,” said Cassi in a tired, flat voice.
Joan could sense her friend’s depression. From a professional point of view she knew Cassi was worse than she’d been the previous afternoon.
Unbidden, Joan came into Cassi’s office and closed the door. Cassi didn’t have the energy to object.
“You know the old aphorism about the sick doctor,” said Joan: “’He who insists on taking care of himself learns he has a fool for a patient.’ Well, that applies in the emotional realm as well. You don’t sound so good to me. I came in here to apologize for foisting my opinions on you yesterday, but looking at you now, I think it was the right thing to do. Cassi, what’s happening to you?”
Cassi was immobilized.
There was a knock on the door.
Joan opened it and confronted a tearful Maureen Kavenaugh.
“Sorry, Dr. Cassidy is occupied,” said Joan. She closed the door in Maureen’s face before the woman could respond.
“Sit down, Cassi,” said Joan firmly.
Cassi sat down. The idea of forceful direction was appealing.
“Okay,” said Joan. “Let’s hear what’s going on. I know you have your hands full with your eye problem. But it’s more than that.”
Once again Cassi recognized the seductive pressure of the psychiatric interview on the patient to talk. Joan inspired confidence. There was no doubt about that. And Cassi could be assured of confidentiality. And in the last analysis Cassi desperately wanted to share her burden with someone.
She needed some insight if not merely support.
I think Thomas is taking drugs,” said Cassi in a voice so low Joan could barely hear. She watched Joan’s face for the expected signs of shock, but there weren’t any. Joan’s expression didn’t change.
“What kind of drugs?” asked Joan.
“Dexedrine, Percodan, and Talwin are the ones I know of.”
“Talwin is very common among physicians,” said Joan. “How much is he taking?”
I don’t know. As far as I am aware, his surgery hasn’t suffered in the slightest. He’s working as hard as ever.”
“Uh huh,” nodded Joan. “Does Thomas know you know?”
“He knows I suspect the Dexedrine. Not the others. At least not yet.” Cassi wondered how soon Patricia would tell Thomas she’d been in his study.
“There’s a euphemistic term for this,” said Joan. “It’s called the ‘impaired physician.’ Unfortunately it is not all that uncommon. Maybe you should read up on it; there’s a lot of material in the medical literature although doctors themselves usually hate to confront the problem. I’ll give you some reprints. But tell me, has Thomas exhibited any of the associated behavioral changes-like embarrassing social behavior or disruption of his appointment schedule?”
“No,” said Cassi. “As I said before, Thomas is working harder than ever. But he did admit that he is getting less enjoyment from his work. And he seems to have less tolerance lately.”
“Tolerance for what?”
“For anything. For people, for me. Even his mother, who essentially lives with us.”
Joan rolled her eyes. She couldn’t help it.
“It’s not that bad,” said Cassi.
“I’ll bet,” said Joan cynically.
The two women studied each other in silence for a few minutes.
Then Joan asked tentatively, “What about your married life?”
“What do you mean?” asked Cassi evasively.
Joan cleared her throat. “Often physicians abusing drugs will suffer episodes of impotence and actively seek extramarital affairs.”
“Thomas has no time for extramarital affairs,” said Cassi without hesitation.