Chapter 52: ABBA?

February 25, 1985, McKinley, Ohio

On Monday afternoon, after my Russian Literature class, I called Doctor Hoffman to check on Angie.

"She's doing a bit better," Doctor Hoffman replied. "She's taking her drugs, but not willingly, if that makes sense."

"In other words, you don't trust her to take them if you send her home," I replied.

"Correct. We did back off a bit on the dosage of her antipsychotics, and that's helped her lucidity a bit. We're hoping to get her to a point where we can begin proper counseling again and see if we can get her into a frame of mind where she'll take her medication willingly and in the prescribed dosages at the prescribed times."

"I assume Father Stephen visited her?"

"This morning. He gave her Communion and spent about twenty minutes talking to her. I'm not sure how much she actually talked because I wanted to give them privacy because he's her pastor."

"How much damage did I do by coming to see her?"

"It's not that simple, Mike. She has to accept that reality if she wants to leave here and go home rather than to some kind of group home or long-term psychiatric care facility. You had to be the one to tell her; she doesn't trust any of us because of the whole competency question."

"I know the adage 'the truth hurts', but how badly?"

"Badly, but it had to happen. Consider it like surgery to remove a tumor — there is pain and potentially a difficult recovery, but the alternative is that you die. The pain is necessary for healing. You'll learn this, but one of the things doctors often have to do is inflict pain and suffering on their patients to prevent worse pain and suffering or death. For Angie to have any hope of a life outside a facility, she has to accept the reality of her situation."

"That makes sense, but I also got the feeling that coming to see her would be a bad idea, at least in the short term."

"I think you're right about that."

"And long-term?"

"That's an open question, really. Doctor Mercer seemed to think you'll be valuable in helping Angie, but the other doctors here disagree."

"I can see both sides," I replied. "In the end, though, it all depends on Angie. I think, at this point, the best approach for me is to have Father Stephen keep me up to date on her progress and take his counsel as to what to do. I know he's in touch with her parents and her doctors, including Doctor Mercer and whoever Angie's main psychiatrist is."

"You don't know?"

"No. It's really not any of my business. If he wants to talk to me, Doctor Mercer, Father Stephen, or Angie's parents can give him my number."

"You seem pretty calm. Are you doing OK?"

"Resigned, I think, is the correct word. I've had plenty of time to come to terms with it, given Angie has had several incidents in the past, all related to me, basically."

"Remember, Mike, this is not your fault. From everything I know, you've been nothing but supportive and done your best to help Angie, even when she made it very difficult for you to do so."

"I suppose, though I did apply gentle pressure about a relationship before the first incident."

"You didn't know her condition; nobody did. From everything her parents have said and Doctor Mercer has said, you were the model of a supportive friend who was romantically interested. And then, after her incident, when she tried to inappropriately start a physical relationship with you, you resisted despite your deep desire to be involved with her. You did the right thing at basically every step based on the knowledge you had. It's not your fault."

"A perfectly logical answer which doesn't make me feel much better about it."

"I understand. Mental illness takes its toll on family, friends, and loved ones, in addition to the person suffering from it. Everyone wonders if maybe they had just done something different, they could have prevented it. It's my opinion, as a third-year Resident, that the answer to that is there is literally nothing that could have been done to change the outcome in cases which are not the product of some kind of systemic abuse or trauma.

"Neither of those is true for Angie. The incidents with her friend's suicide and with her brother didn't cause this. Seeing her parents copulating didn't cause this. That said, because we don't know exactly what it is that causes schizophrenia or, potentially, borderline personality disorder, it's possible those things contributed to whatever it is that is the root cause of these kinds of personality disorders."

"What's your opinion?"

Doctor Hoffman took a deep breath and let it out.

"Between you and me, she's classic borderline. We haven't come to that formal diagnosis just yet, but I'm convinced this is far more than schizophrenia. Again, between you and me, this is a difference of generations. The older doctors, the ones in their late fifties or older, are pretty much convinced it's schizophrenia. The younger doctors, the Residents, and those in their thirties believe it's the first stages of borderline. Fortunately, the treatment regimens are similar enough that the actual diagnosis doesn't matter at this point. Time will tell if this is a schizophrenic break or a symptom of borderline personality disorder. And we'll adjust treatment as necessary."

"Is there a difference in outcomes between one or the other?"

"Generally, borderline has better outcomes than schizophrenia, BUT it's highly dependent on the individual and their response to therapy. That said, the suicide rate for borderline is more than double that of schizophrenia. I believe Angie has shown the capacity to function that is indicative of borderline, if we can only get her back to that stability.

"This latest incident began when she was told the State of Ohio would not allow her to marry or even engage in sexual relations because they do not believe she has the mental capacity to consent. If we can get her to accept THAT, then I think we have a very good chance at a positive outcome. Well, positive in the sense she'll be able to work and potentially live independently so long as she has a good support network. Basically, we'd just have to manage her depression and feelings of emptiness."

"Thank you for telling me all of this."

"Do a couple of psych rotations, Mike. I think you'll benefit from them, and I think your patients will benefit as well."

"You're the second person who has suggested that."

"The medical profession, as a whole, is VERY bad about mental health care, both for physicians and for training physicians in other specialties to recognize and deal with mental health concerns. To be blunt, we suck at it as a profession. You can help change that."

"I'm one person."

"Yes, and it always has to start with one person, then a second, and a third, and so on."

"Handwashing," I replied.

Doctor Hoffman laughed softly, then said, "I shouldn't laugh, but yes. It's too bad the profession didn't listen to him, just as they don't listen about mental health. Doctors are a very intransigent group as a whole. Don't be like that."

"I'll do my best. Thanks for the candor."

"You're welcome. Don't hesitate to call if you want to ask questions."

"I won't. Thank you again."

We said 'goodbye', and I pressed the switchhook so I could call Doctor Mercer. I related to her the conversation with Doctor Hoffman, and she agreed, generally, with Doctor Hoffman's assessment and with my belief that not seeing Angie in the short term, at least, was the right course of action. She asked me to keep in touch, and after I hung up with her, I called Father Stephen, who agreed with me that it was best I stayed away from Angie, making it unanimous. He also promised to keep me posted on any changes and confirmed that he and his wife would be at the wedding and would send back their RSVP card in the next day or two. I thanked him and ended the call.

"So what CAN you eat?" Gene asked when we all gathered for dinner around 6:00pm.

"Not much!" Sophia laughed. "Fortunately, we Greeks aren't nearly as serious as the Russians are about fasting. I'll mostly avoid meat, though I'll eat fish and occasionally chicken, but no pork or beef. We don't pay too much attention to the dairy rules. Mike, well, for him, it's no animal products of any kind, which means no meat, fish, eggs, or dairy. He's going to be eating a lot of spaghetti with marinara sauce, salads, and vegetables."

"Just wait for Holy Week!" Jocelyn said. "He'll eat maybe two full meals the whole week. Just very light snacks and juice otherwise."

"Holy shit!" Gene gasped. "Seriously?"

"Seriously," Clarissa replied. "I've seen it a few years in a row now."

"Mike, why?" Gene asked.

"Self-discipline. If I can control one of the most basic desires there is, then I can control others as well. It also helps me focus on what really matters during Great Lent. And I want to make a point — my fasting rule is mine, and mine alone. What Sophia does is between her and her pastor. It really is nobody else's business. That said, she and I will both answer questions when we're asked about it by people outside the church."

"How can you manage school and studying without eating?"

"You mean during Holy Week?" I asked. "So long as I eat a small handful of nuts a few times a day and drink grapefruit juice, I keep my blood sugar from going completely out of whack, and I feel fresh and alert. Think about how you feel after eating a big meal, like at Thanksgiving."

"OK, but that's not normal!"

"No, but have you sometimes felt lethargic after a big meal, even one not as big as Thanksgiving?"

"Sure."

"How well do you study then?"

"Never mind!" he said with a laugh. "I'm just curious: do you also give something up for Lent as Catholics do?"

"Rome's whole 'fish on Friday' and 'give up something for Lent' are mere shadows of the traditional fasting rules," I replied. "We don't usually specifically give something up, though I usually don't drink soft drinks during Great Lent. To me, they're a way of indulging myself, and that's not something I want to do during Great Lent. But having one wouldn't be breaking any rule. And by the way, 'rule' means 'ruler' or 'measuring stick', not 'law'. That's why Sophia's rule and my rule are different — they are spiritual guidance from our pastors."

"So, how does it work when you're married?"

"Elizaveta and I will sit down with Father Nicholas and work out our family rule, which will certainly be less strict than my normal rule. And at that point, trying to follow my stricter rule would actually be spiritually unhealthy. We Orthodox are zealous, but not overzealous!"

"And that rule will change when Elizaveta becomes pregnant and when they have children," Lara added. "Remember, as Mike said, it's guidance for self-discipline, not a law that must be followed."

"So what happens if you break it?" Gene asked.

"I go to confession and pick up where I left off and try again. And it's possible for the priest to adjust the rule if it's causing any issues, be they physical, spiritual, or mental."

"And everyone does this?"

"No, but again, what anyone else does isn't my business because I'm not their spiritual father. I'll worry about me, and soon, my wife, and eventually, my kids. But otherwise? It is literally none of my business. And the moment I compare my rule to someone else's, except for purposes like this discussion, I've defeated the entire point because then it becomes about pride. And that is the root cause of many, many sins."

"I thought money was the root of all evil."

Jocelyn responded quickly, "Before Mike launches into a homily, it's 'the LOVE of money is the root of all KINDS of evil'."

"You're such a sweetheart, Jos!" I said with a grin.

"I didn't pay all that much attention in church growing up," Gene said. "And I quit going when I was about fifteen."

"What church?"

"First United Methodist in Akron. Never went to Sunday School or anything like that."

"Have you been to church with Jocelyn?" I asked.

"She's dragged me there a few times," he replied with a grin.

"Dragged?!" Jocelyn exclaimed, trying to sound outraged but failing.

"Sorry," Gene replied with a smirk. "I went with her because she asked nicely, and I want to keep her happy."

"Now you sound like about ninety percent of the Greek men!" Sophia declared. "If they can get away with it, they sneak out of the service during the homily and smoke a cigarette, then come back in time to hear the anaphora — when the Eucharist is consecrated."

"Hmm..." Gene hummed.

"Fat chance!" Jocelyn declared.

"Changing topics," Brandon interjected, "what is everyone doing for Spring Break?"

"Mike and I are hanging out here in beautiful, scenic McKinley, Ohio!" Clarissa said, causing everyone to laugh.

"Dona and I are heading to Florida with Pete, Sandy, Sophia, Robby, and Lee," José said.

"Home for the week," Lara replied. "Jack's coming along."

"Home," Kimiko said.

"Same for me," Brandon added.

"Fran and I are going to visit my parents," Jason said.

"And Gene is coming to meet my parents," Jocelyn added.

"Mike," Robby asked, "does that mean Clark's mom has to come all the way here to get him?"

"No. Elizaveta and I are having dinner with my parents on Friday evening, and we'll give Clark a ride as far as my house."

When we finished dinner, we headed back to the dorm to study.

February 28, 1985, McKinley, Ohio

On Thursday afternoon, I met with Doctor Blahnik for my balalaika lesson. She said I was improving and was sure I'd be able to play Lara's Theme well enough by the end of May. When we finished, I put the balalaika in its soft case and slung it over my shoulder.

"Mike, when did you start playing rhythm instead of lead?" Doctor Blahnik asked.

"When José suggested we form a band. He'd play lead guitar, and I'd play rhythm and sing lead vocals. The theory is that it will mean less practice time for me. I haven't agreed as yet, but we're going to get together on Saturday morning the week following Spring Break to see if we click. You know the problem. José and Elizaveta both suggested that given I'm going to practice guitar anyway, why not try with a band."

"Who are the other prospective members?"

"Kim Kimura on keyboards and Randy Kyle on drums."

"I know Kim, and she's a good choice," Doctor Blahnik replied. "Who's Randy?"

"A philosophy major who goes by the nickname 'Sticks'."

"A drummer and a philosopher? That sounds like permanent poverty!"

I chuckled, "Exactly what my friend Jocelyn said! Randy wants to be an ethicist."

"That actually might allow him to afford a family and a chance to play drums!"

"Maybe he's the next Phil Collins," I suggested.

"Or maybe not!" Doctor Blahnik said with a laugh. "What are you going to play?"

"Rock and pop covers from the 60s through current. Wait! How did you know I was playing rhythm?!"

Doctor Blahnik smiled, "I was there, hiding around a corner! I almost gave myself away laughing when YOU played ABBA!"

"And if my little sister ever finds out, I'll get no end of grief about it. She's an ABBA fanatic, and I can't stand them."

"ABBA or Disco?"

"That's like asking if I want to be executed by shooting or hanging!" I chuckled. "Same result in the end!"

"Well, we Europeans like ABBA a lot!"

"You go right ahead! Too much bubblegum for me."

"Do me a favor, please. Listen to Intermezzo No. 1. It's from 1975, and I think you'll be surprised. It really shows off the talent that Björn Ulvaeus and Benny Andersson have."

"I've never even heard of that song; what is it?"

"A classical piece, and I think you'll actually like it. Whatever you think of their 'bubblegum pop' songs, they are very talented composers and musicians. There are other pieces I think you'd like, including Fernando, Lay All Your Love on Me, and Our Last Summer. If your sister has all their albums, which I'm guessing she does from your comment, listen to those, then listen to Waterloo, Rock Me, Does Your Mother Know, and Eagle. Even if you don't like the songs, I think you'll admit that from a musical perspective, Andersson and Ulvaeus have an amazing talent."

"I've heard a number of those songs," I replied. "Repeatedly!"

Doctor Blahnik laughed, "Yes, I'm sure. But this time, I want you to listen to them with a critical ear, the way Milena taught you in her class. Listen to the texture of the music, the tempo, and the instrumentation. I have a question for you — do you know the song One Night in Bangkok?"

"Sure. By Murray Head. I've heard it on the radio."

"Do you know the album it's from?"

"I don't recall, no."

"Do you like the song?"

"I do."

Doctor Blahnik smiled, "The music was composed by Benny Andersson and Björn Ulvaeus, with the lyrics created by Ulvaeus and Tim Rice. You know him, right?"

"I remember from Milena's class — Jesus Christ Superstar and Joseph and the Amazing Technicolor Dreamcoat."

"Yes. Anyway, you just said you like a song by Andersson and Ulvaeus! You should get the album Chess, which is the musical that song is from. It came out last year, and I suspect the music store in town can order it for you if they don't have it in stock. Make sure you get the musical concept album. Trust me; your opinion of those two men will change dramatically."

"You want me to basically do a serious music study of ABBA?"

"I am a professor of music! So, yes, because it's outside your comfort zone! You're having too easy a time with Russian literature because you spent so much time with Russians, and you understand the Russian mindset! Challenge yourself with something new; something that is counter to your usual music. Step out of your comfort zone and take a chance!"

"I positively HATE that song!"