61. The Patient

August 2010

Private Residence — Milford, Connecticut

A few towns over from Sandy Hook, a woman was going through her mail, when she found a bill from her 19-year-old daughter’s psychiatrist. Her daughter happened to be home from WCSU for summer break just then, so she went and knocked on her bedroom door. “What is this? Don’t you see him at the student counseling center?”

“We needed more time.” The campus counseling center only scheduled one 30-minute session per week, the young woman explained, so she had started going directly to the psychiatrist’s community office, in Brookfield.

Her mother closed the door, annoyed. Campus visits were included in the tuition she was paying; the office visits were not. Even worse, this Dr. Paul Fox wasn’t even in-network. He was going to cost them a lot.

Still, she figured it was for the best. Her daughter had serious issues — Borderline Personality Disorder, an eating disorder, as well as “depression and self-harming (cutting)” as her mother would write — and the girl needed help. Her father had hurt her, physically and emotionally. It was very, very rare for her to find male doctors that she could form a bond with. That was why her mother had been hopeful, when she called home early in Fall 2009, to tell her that WCSU had just brought this wonderful new doctor on staff, and that they “clicked so well.” Dr. Fox seemed like an answer to their prayers. At first.

* * *

On the other side of the door, Dr. Fox’s patient was writing in her diary. Looking back over the pages, they reminded her of just how she had gotten into this whole mess.

She had been in a psychology class for her nursing program, shortly after enrolling at WCSU, when the professor introduced a concept called “transference” — what she understood to be “a phenomenon when emotions, feelings and desires, especially of those unconsciously retained from childhood, are redirected and transferred to the therapist.”

She wrote in her diary after that class: “I don’t want to talk to Dr. Fox anymore. It’s unhealthy. I want him to be my father.”

She made a point to bring it up at their next session — “I think transference is happening between us.” As she remembers it, Dr. Fox “didn’t express any concern and dismissed the idea.”

Their sessions continued, and she could feel her and Dr. Fox grow closer. She got him to start talking about himself. “How old is your daughter?”

He told her; roughly the same age she was.

“She’s really lucky to have you.”

The diary pages after that were her fantasies, about Dr. Fox holding her, and kissing her. “I was beginning to think that I loved him. I was very vulnerable and very confused with myself,” she would later say, looking back.

They talked on the phone all the time over break. Late into the evening, sometimes. She knew her mother wondered about them, hearing the muffled conversation as she passed in the hall. Isn’t the man married? Isn’t he at home with his wife right now? Why is he on the phone with you?

But the Patient wanted to hear his voice. Most of all, she wanted to hear him say three little words; she even told him how bad she wanted to hear them. But he wouldn’t say it.

She had called him in the middle of the night a few months before, and maybe the words were what she really wanted to hear then, too — she was abusing her medications in her dorm, and was in a dark place. She told him she had become very dependent on him, and, “If you hang up, I’ll die.” So Dr. Fox stayed up on the phone until the sun had come up, and she had dozed off.

That was April Fool’s day, but it wasn’t much of a joke. And now, looking back on this page in her diary, it seemed strange to her: he didn’t call for an ambulance, or tell her to go to a hospital.

She took out a pen. New entry. “Maybe it’s because he cared so much about me.” She figured Fox didn’t want her to go to a different doctor, one who wouldn’t care about her as much as he did.

* * *

The Patient went back to WCSU for her sophomore year, and brought her diary with her. She talked with Dr. Fox about the way she felt, and the way she wanted him to feel about her. She wrote that Fox “told me that my feelings weren’t wrong, but that it was up to him what he should do to me and how to act towards me.”

During one session, she said she felt a strong urge to hurt herself. She writes that Dr. Fox held her hand, and she felt better. At the end of the session, they hugged. He apologized for “being a human male,” and said “that he had sexual feelings for me, but explained to me that these feelings were not the sole reasons as to why he was hugging me. I remember him acknowledging my vulnerability and promising me that he would not take advantage of me.”

* * *

After one session in September, she couldn’t wait to get back to her dorm. She wanted to record the way it all felt, before the magic started to fade:

He said he loves me. He finally said it…I’m glad he told me. I feel wrong and selfish and I’m worried about him. I’m worried so much….Should I leave him? No, I can’t. I love him. He said we’re going to be friends. He’s going to want to know how I’m doing and what I’m doing for the rest of his life. He wants to be connected to me. He said he won’t leave. I feel safe with him but at the same time I feel wrong.

The Patient went home for Thanksgiving. She told her mother that she had good news: there wouldn’t be any more out-of-network bills from Dr. Fox’s office coming in the mail anymore. No bills from him at all, in fact. She was going to continue seeing Dr. Fox… but just as “friends.”

Her mother couldn’t believe what she was hearing. By then, she knew Dr. Fox was providing her daughter with medication — “pills to go to sleep, pills to stay awake, she was turning into a zombie” — and worse, they were always free samples. No prescription on record at any pharmacy, and so (if indeed the medicine was helping) no way to get more — except through Dr. Fox. Now, with that situation in place, they were going to be “friends?”

She confronted her daughter. “You are dependent on him, and it’s completely inappropriate.”

The Patient was defiant; there was nothing sexual going on, and she could be friends with anyone she wanted.

“Have you met his family?” her mother countered. “Has he met your friends?” She kept going, trying to get her daughter to snap out of it. You’re 19, he’s 59. He’s a doctor, you’re his patient. And he’s married!

But her daughter wasn’t listening anymore. “Why can’t we be friends? Just because society doesn’t accept it!?”