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And while she was a rather petite, small-boned woman, Ellen Gatlin carried herself with a rather intimidating air of authority and confidence. She was smartly attired in an expertly tailored navy pantsuit, her dark blonde hair cut in a close fitting cap about her head, and Ian could tell at a glance that her chunky gold jewelry had cost a considerable amount. And it took just one look from those sharp, all-knowing light blue eyes, and one firm handshake as she introduced herself to him and Tessa, for Ian to realize they had found exactly the right person to help Tessa.
“Please, let’s sit, shall we?” said Doctor Gatlin in a carefully modulated voice. “I prefer getting to know my new patients in a more informal manner, so sitting here as opposed to my desk always seems to make things a bit easier.”
She directed her next question to Tessa. “Now, I understand from Patty that you’d like Ian to sit in on this session. Is that correct, Tessa?”
“Yes, that’s correct. Is - is that possible?” asked Tessa uncertainly.
Doctor Gatlin nodded. “It’s fine, if that’s what you prefer. And it might prove helpful to have him here during the diagnosis. There are quite a few questions I’ll be asking over the next ninety minutes, and oftentimes it’s a good idea to hear the observations of someone who’s close to you. Do the two of you live together?”
“Yes,” replied Tessa. “For about a year now. And we work together part of the time as well. I travel with Ian on business trips about one week a month.”
The doctor offered up a smile. “Well, it sounds like you spend a great deal of time together. And that if anything has been - let’s call it off - about your behavior or moods as of late, he would have definitely noticed. Would you agree, Ian?”
“Absolutely,” answered Ian confidently. “And there’s been nothing unusual, nothing at all, Doctor Gatlin. I’m an extremely observant man, given the nature of my business, and there’s been nothing the least bit off about Tessa since she and I began seeing each other over a year ago.”
Doctor Gatlin arched a well groomed eyebrow. “Well, that’s good news, Ian. But let’s reserve judgment until after we’ve gone through all the questions. Not to mention the family history and Tessa’s medical records. The protocol to diagnose bipolar disorder isn’t a simple one, so let’s get started, shall we?”
For the next hour and a half, the doctor calmly and meticulously went through her extensive list of questions, most having to do with behavioral patterns, moods, emotions, thoughts, Tessa’s overall physical health. She had already looked over the medical records sent over by Tessa’s general practitioner, but asked about the episode last September when Tessa’s IUD had perforated her uterus, requiring emergency surgery and hospitalization. Throughout the questioning, the doctor never changed expression, never had any sort of reaction, and merely continued to jot down responses and make notes in the leather portfolio on her lap.
And when one of the questions the doctor posed was “do you find yourself spending, or wishing to spend, significant amounts of money”, Ian couldn’t help himself from laughing out loud, and blurting out, “That is most definitely not a behavior Tessa has ever experienced, Doctor. I assure you.”
Tessa had given him a little eye roll, while the doctor had glared, apparently not appreciating the interruption. So when the next question was “have you noticed an increased interest in sex over the past few months”, Ian covered his hand with his mouth, certain that Tessa wouldn’t appreciate him telling Doctor Gatlin how a year in his bed had turned her into a sex kitten.
And as the questions continued, he began to feel more and more relieved as Tessa’s responses to all of them were negative - no, she hadn’t been doing things that could be termed “outrageous”; she hadn’t felt impatient with the people around her; she wasn’t over-involved in new plans and projects. And she most assuredly hadn’t had any episodes of depression for more than a year now - not counting, of course, the anxiety and stress she’d been experiencing this past week.
The next part of the evaluation, however, seemed to be far more difficult for Tessa as she answered a multitude of questions about Gillian. Ian could see how much she struggled to discuss her mother’s behavior over the years, and it was clear to him how very different Gillian’s personality and actions had been from Tessa’s. Tessa had few answers about her grandmother, since she hadn’t known anything about her - even her first name - until a week ago. Ian, however, had had the foresight to request that a copy of whatever medical records existed for Corinne Pedersen be sent to Doctor Gatlin, so that she would have some idea of what had happened in the past.
Towards the end of the session, when it was obvious how emotionally drained Tessa had become, the doctor finally put down her pen and folded her hands in her lap. Her smile was both kind and reassuring.
“Thank you for all of that information, Tessa,” she told her. “I can tell it was painful for you to relive what you must have gone through with your mother. And from the little you were able to tell me about your grandmother, plus what I read over in her medical file, I’m certain your mother’s life with her must have been a living hell. But, you see, I’m not at all sure that your grandmother was actually bipolar based on her behavior.”
Tessa frowned. “Her actions certainly weren’t those of a sane or mentally stable person. No one could treat a child the way she did my mother and be considered normal.”
“Of course not,” soothed the doctor. “Your grandmother definitely suffered from a form of mental illness. But I don’t believe it was bipolar disorder. I can’t say for certain, of course, not having made a diagnosis of my own or having much information, but I’d be willing to bet Corinne suffered instead from schizoaffective disorder. To explain it in layman’s terms, it’s like being schizophrenic but with certain characteristics of bipolar disorder as well. Your grandmother would have had the mood swings that your mother suffered from, coupled with hallucinations and delusions. It’s a pity her doctors never caught that, because it’s highly unlikely she would have ever regained custody of your mother if they had. It’s a very serious illness, and usually requires intense therapy. So, in summary, I don’t believe that your grandmother and mother suffered from the same sort of mental illness. And I most certainly don’t believe that you, Tessa, are at all likely to develop bipolar disorder yourself.”