Authors: Jennifer Lane
“Aw, c’mon, pussies,” Dr. Moore said as he paced the front of the classroom. A few chuckles rang out. “You scared?” His longish gray hair swept behind him in a chaotic swirl, and his sinewy body never stopped moving. “This is why we have a shortage of psychiatrists in America—you guys don’t understand the beauty and power of easing emotional anguish. But I’ll teach you, starting today. And by the end of this module, I guarantee at least one of you will choose psychiatry.”
Brad shifted in the seat next to me. “Confident bastard, isn’t he?” he muttered.
“More like certifiable,” I said.
Dr. Moore flipped to the next slide on the projector, and I advanced to that slide on my laptop. It was a cartoon of Mickey Mouse on the therapy couch. “What lies at the root of your problems is that you inhabit a fantasy world,” the doctor told him. More chuckles.
On the other side of me, Dave sighed. I followed his gaze to my classmate Josie, who tossed her hair over her shoulder as she laughed. Dave was infatuated with Josie but hadn’t asked her out; Mickey wasn’t the only one living in a fantasy world. I touched my phone in my pocket, longing to text Maddie.
“What happened in nineteen-eighty-seven that rocked the psychiatry world?”
Dr. Moore’s question brought me back to the lecture. Josie raised her hand. “Prozac hit the market,” she said.
Chingar
. I knew that.
Focus
.
“Fluoxetine was indeed the first SSRI introduced to America that year.” Dr. Moore’s eyes glowed. “We lit up the five-HT receptors, and suddenly the severely depressed had hope, without all the nasty side effects of the old tricyclics.”
Brad shifted and grumbled under his breath.
“Selective serotonin reuptake inhibitors,” Dr. Moore continued. “No matter what your specialty, these babies will be powerful weapons in your prescriptive arsenal. Not only for depressed patients, but also for those with anxiety, addictions, chronic pain, PTSD…”
I wondered if Maddie was taking an SSRI for depression. Would she tell me if she was?
“We’ll get into the newer meds soon, but fluoxetine is still around. In fact, it’s
the
medication for adolescent patients. We need more research studying the effectiveness of SSRIs for teens; at this point, fluoxetine is the only FDA-approved medication for teenage depression.”
“What about the black box warning?” I asked.
Dr. Moore’s toothy grin looked maniacal. “You read my mind, Alejandro. Be scared. Be very scared.” He flipped to his next slide, titled
Depression and Adolescents and Black Box Warnings, Oh My!
with an image of
The Scream
by Edvard Munch.
“Now,” he said, “you may have heard the media freak out about antidepressants causing teenagers to commit suicide. Here are the facts. It’s true there’s a risk of increased suicidal urges for a small percentage of teens starting a trial of SSRIs. But since suicidal ideation is symptom of depression, and fluoxetine helps reduce depression, the benefits of the medication
far
outweigh its risks. Just make sure to tell parents to monitor their kids for suicidal urges when you prescribe antidepressants.”
“Sounds dangerous,” another female classmate said. She always seemed worried—maybe
she
needed an SSRI.
Dr. Moore nodded. “No doubt about it, these psychotropic meds
are
potentially dangerous. They can be lifesavers, but they all may have side effects. That’s why we’ll teach you some treatments in addition to medication. One is psychotherapy. Psychiatrists rarely do talk therapy these days, so you need to refer your patients to competent therapists. Also, there’s a treatment for mental disorders that’s as effective as medication, with longer-lasting recovery and no side effects. Anyone know what that is?”
I smiled as I pictured the speed bag I’d punched over and over this morning.
“Exercise,” Josie said.
“Ding, ding!” Dr. Moore raised his arm and hit an imaginary bell. “We’ve already covered how exercise improves physical health, but it’s great for mental health, too. Now, how do we get our screen-addicted patients to exercise? That’s the tough one. The Exercise is Medicine website gives some good ideas…”
I couldn’t imagine how people lived without exercise. It was
my
absolute go-to for stress. In fact, my workouts had taken on an even more intense vibe the past few days, probably due to missing Maddie. My body thrummed with nervous energy every time I thought about her.
Sublimation
, Dane had called it. Whatever it was, I had it bad.
On the car ride back to my condo, I glanced at my watch and realized Maddie would likely be between class and practice.
¿Cómo estás, Arroyos?
Having a GOOD day.
“You’re talking to Maddie,” Brad said from the seat next to me.
I looked up. “How’d you know?”
“You’ve got that happy, horny look about you.”
Like you looked after meeting with your supervisor?
I almost asked, but decided to drop it. Brad could do what he wanted. He could do
who
he wanted. All I wanted was Maddie.
Great to hear. Why so good?
Got a 92 on my exam. Set the curve!
Not a surprise. You’re beautiful AND inteligente.
It took her a few moments to respond. Had I embarrassed her?
Thanks to you, Hotajandro.
Lord, I got hard every time she called me that. I swallowed.
Nah, that was all you.
How was class?
Psychiatry’s not bad, actually. Did you know talk therapy changes brain chemistry just like medication?
Awesome. I need some of that.
When she didn’t elaborate, I decided to change the topic.
Hey, how was your brother’s visit?
A whole minute ticked by. I texted:
Maybe you’re busy?
Got 5 min before I have to leave for practice.
Just not sure how to answer.
Hmm
. I typed another message.
Give it to me straight. Braxton doesn’t like me?
Well, he did call you my boyfriend.
I grinned.
But he thinks I’m making a mistake.
He’s mad your dad cut food stamps.
My dad and Congress had decreased funding to quite a few programs—we had to address the debt somehow. I was about to type that when I remembered she couldn’t care less about politics. I didn’t want to bore her or sound defensive. But what if her brother wouldn’t let her see me?
Did he order you not to date me?
Ha ha HA! I’d like to see him try.
Nobody would mistake her for a shrinking violet. Another text came in.
Don’t tell me you forbade Lucia to date Dane.
Uh oh. Minefield ahead
. I would’ve done just that had I known Lucia was with Dane in the beginning. But I hadn’t found out until my parents did, right before the debate. My father had done the forbidding for me. Not that it had worked. How to respond?
Our families are different.
Stop evading the question.
Did you tell Rez to stay away from Dane?
No. But I wanted to.
So Brax doesn’t like his sister’s boyfriend,
just like you don’t like Dane. Ironic, isn’t it?
I groaned. I could imagine Dane laughing. Why did Maddie have to have a big brother?
The irony isn’t lost on me, sweetheart.
SMH. You boys need to learn
to give your sisters RESPECT. )
At least she’d added the smiley face—hopefully she wasn’t too mad. My phone dinged with her next text.
Time to head to practice.
You home from class yet?
No. Bad traffic as usual.
I paused, unsure if I should type the words I wanted to say. But my fingers decided for me.
I miss you, Maddie.
Another long wait for her reply made me think she’d had to leave. Then my phone buzzed.
Estoy loca por ti.
Arousal zipped through me. How did she
do
that? She made me feel like I’d just cured cancer.
I’m crazy for you.
Brad chuckled.
“
Cállate
,” I said, hoping he’d learned enough Spanish to know I told him to shut up.
Brad sat taller as he reached into the pocket of his jacket for his phone. “Yes, sir,” he said when he answered. After a beat, he handed his phone to me. “Hold for the president.”
My eyes widened. “Hello?”
“Alejandro.”
I clutched the armrest. “Hello, Dad. Everything okay?”
“Your mother told me you aced your last exam.”
He was calling about my insignificant test? “It went well, yes. How do you have time to call me?”
“I’ll always make time for
mi familia
. I wish I could see you more often.”
“Me too. How’s Mateo?”
“Better.”
“Better?” My heart rate spiked.
“His sugar was over five-hundred a couple days ago—”
“
¡Por dios
, Dad!”
“—but Karen got his numbers down. He didn’t even need to see the White House doc.”
Karen was a Secret Service agent, and also a nurse practitioner, so my brother had medical care around the clock. Still, I didn’t like hearing such high glucose numbers. “You’re encouraging him to get the insulin pump, right?”
“Yes, though not as stridently as your mother.”
“You have to know Mom’s on the right side of this issue.”
Dad sighed. “I hear you. I also hear your mother. I can’t
help
but hear your mother.”
I laughed.
“But it’s been tough for Mateo. He’s had so many losses from this disease. He’s been forced to watch you and Lucy shine in sports—watch you follow your dreams—while he stays on the sidelines.”
I knew that had to be excruciating. It had killed me to watch another TCU pitcher give up a homerun, knowing I could’ve struck out that batter. It would’ve been awful never to get to play at all.
Dad continued, “He has to be careful about every aspect of his heath. And now with Secret Service, he has someone watching him twenty-four-seven. It’s got to be rough for a seventeen year old.”
China growled at a driver who cut her off.
It’s rough for a twenty-four year old, too.
“I’m hoping he’ll come around to this pump on his own. I want him to have some choice in the matter. And we’re lucky we have the luxury of medical care readily available until he does.”
Why did my dad have to sound so reasonable all the time? “But what if Matty never gets the pump?”
“Hmm. Then you’ll have to develop a cure for diabetes, Dr. Ramirez.”
I rolled my eyes.
“Listen—they’re telling me we’re about to start our descent, and there’s something I want to discuss with you.”
“You’re on Air Force One?” The connection was crystal clear, without any engine noise.
“Yes, on our way to deal with the mudslides in Malibu. I hear you’ve discussed Madison Brooks with your mother, but you haven’t talked about her with me.”
The president wants to discuss my love life?
I shook my head. He wasn’t calling as the president—he was calling as my dad. “She’s pretty great.” My lips tingled as I remembered her soft kisses. “I want you to meet her.”
“I’m not sure I should.”
What?
He cleared his throat. “You should know what you’re getting into, son. The FBI briefed me last week.”
“The
FBI?”
I caught Brad’s curious glance a moment before China’s eyes flicked up to meet mine in the rearview mirror.
“They showed me photos of the Glenville police station, in Cleveland. A group of protestors gathered there, yelling and making threats.” He paused. “The main instigator was Braxton Brooks, Madison’s older brother.”
I exhaled. “Dad, I already know that.”
“You do?”
“Braxton was protesting the shooting of a black man by a white officer.”
“A shooting with no evidence of racial bias. It wasn’t a peaceful protest, Alejandro. Braxton was throwing things, inciting violence. He held a sign that said ‘Black Lives Matter…White Cops Don’t.’ He came this close to being arrested.”
My breath caught in my throat.
“You should see his editorials in the Cleveland State University newspaper. He thinks the Republican party is a vast conspiracy to keep black people down.”
“But, Dad, we all know people say stupid things in college.”
“Are you
defending
him?”
I inhaled.
Am I?
“Abraham Lincoln was a Republican!” Dad added. “The Republicans are the ones trying to ensure equal opportunity for all people—all races. Latinos face racism too, but you don’t see us holding up signs saying ‘Latino Lives Matter.’”
“Okay, but we haven’t had a history of slavery in America like black people have.”
“You
are
defending him. What is up with you? Don’t you believe in individual responsibility? Nothing is given to us—we have to make it happen. We have to earn our way.”
I sighed. “I do believe that. When minorities work hard and get educated, we can have success like anyone else. We can’t expect others to do it for us. But Dad, Maddie doesn’t want handouts! She works really hard. She goes after what she wants, full throttle. Did you know she plans to go to med school, after she tries out for USA Volleyball?”
Dad was quiet for a moment. “I know Lucy thinks the world of her. But what I’ve learned about her brother is alarming.”
“Maddie isn’t her brother. She doesn’t even care about politics.”
“But does she share his views?”
“I don’t know. Issues like this aren’t even on her radar right now. She’s struggling with a lot.”