Page 21 of Cascade

Opal

PAM’S OFFICE IS nearly entirely beige. Even the clock on the wall is beige. I’m probably not supposed to be staring at the clock.

“I caught a breech baby today,” I say after a few minutes of fiddling with the seam on my jeans. Sitting in the overstuffed armchair, I feel so exposed, even though I’m cocooned by the plush furniture.

Pam sits opposite me, her legs crossed at the ankle, a clipboard on her lap. “That must have been exciting,” she says. “You don’t hear about breech babies being…well, aren’t they typically a cesarean these days?”

By the time I finish explaining to her how our midwifery practice partners with an ancient OB who still has the skill set to both catch breech babies and teach other clinicians how to do it safely, Pam is beaming and I can see how people get swept up into therapy. She got me talking about work, about how good it feels to learn new techniques. “Well, really they’re old techniques,” I reconsider.

And with that pause, I’m back to fiddling with my pants, feeling my heart thump in the silence in the room. “So,” Pam says. “On the phone you mentioned that your mind is very busy. I can see that your hands are busy, too.” She gestures her head in my direction and I look at my fingers, then fold them in my lap. But she’s right. I feel a buzzing inside, an urge to twitch. I am uncomfortable here.

“My thoughts are always racing,” I tell her. “I’m never confident that I did everything right—I’m always going back inside to check the stove or make sure Oscar…that’s my cat. I make sure he has water. That kind of thing.”

“And yet you were confident you could bring that breech baby into his mother’s arms today?”

I feel my body pause. The whole thing just halts for a minute. “Well, of course I did,” I tell her. “Nothing ever feels…well when I’m working it always feels fine. My hands…I just know what to do when it comes to babies.”

Pam nods and writes something down in her clipboard. “So it’s only at home that you’re on watch,” she says, her words drifting off as an invitation for me to dig deeper. But I’m rattled.

“I would never put a patient or a baby in danger,” I tell her.

Pam rifles through the papers on her clip board. “Magna cum laude from an Ivy League midwifery program,” she says. “I would think your patients are in very competent hands indeed.” She smiles. “When you go back inside to check the stove and the water dish, do you often find that you’ve left your cat or your home in danger?”

I shake my head and give up trying to keep my hands still. I spend the rest of the hour answering questions minimally, rubbing my fingertips raw on the coarse thread I’ve worried out along the side of my knee. I’ll have to mend the seam later.

For some reason, as I’m leaving the office, I find myself scheduling a regular, weekly appointment with Pam even though I do not experience the sense of relief Sara had promised. I walk out of Pam’s building exhausted, an open wound of emotion, and all I did was consider (as Pam nudged) that my mind has been tricking me into thinking I’m less careful than I am.

SEPTEMBER

For the next two months, I see Pam once a week. I’m sleeping better and breathing more deeply, and I tell myself that’s better than nothing. So I keep coming. I tell her tidbits about my dad, but mostly I tell her about all the many things that worry me. All the ways I zoom to the worst case scenario, whether it’s the low pressure light for my car tires or a billing error at work with a client’s insurance.

And just the idea of Pam time is exhilarating for me. For the first time in my life, I have regular meetings with someone who shows up when she says she will and does exactly what she says she’s going to do: make me think until my head hurts.

When I show up for my first appointment in September, Pam presentsmewith a clip board. “We’re going to do an assessment today,” she tells me, talking me through a list of things she wrote down the first few weeks while I was talking.

“Talk to me about how your life might be changing. Or not. There are no wrong answers.”

There are never answers in here at all. I snort. She asks why. “Everything in here just leads to more questions,” I laugh, looking down the list.

“And why might that be?” I make a face. She grins. “I kid! But seriously, Opal, let’s look at some changes.”

If you’d ask me how therapy has been helping, I probably would tell you it’s not really. But working through the list I see that’s not quite true. “I’ve called Indigo just to chat. A bunch of times,” I tell her. “Oh, and Diana, too. Just the once. She’s not really a chatter.”

We work through the list of changes: a yoga or aerial silks class once a week. Spending money on new clothes for myself even if nothing is tattered or worn through. Switching to a new laundry detergent Abigail showed me at the co-op. “And tell me what happened for each of those changes,” Pam nudges.

“Well…not much, really.” My clothes smell faintly of jasmine. I have some cool new cowl-neck shirts. I text Indigo pictures of Oscar when he judges me for his cat food presentation.

Pam grins. “You’re creating spaces and people in your life who support you and make you feel safe,” she says.

“Hm.” I can’t really deny what she’s saying. I just hadn’t considered that before. “So because there was no catastrophe and I didn’t spiral into poverty, you’re saying it’s good that I bought myself new stuff…”

I look over the list another time. “There’s something not on here that’s been different,” I tell her.

“Would you like to talk about it?”

“There’s this guy I had been—well. I don’t even know what I was doing with Archer.” Pam relaxes into the chair and I set the clipboard aside. “Is it weird if I talk to you about sex stuff? I know you used to date Sara…”

“Trust me,” she says. “If I can figure out why it’s meaningful for you to text a friend pictures of your snobby cat, I can help you sleuth out what’s going on with your sex life.”

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