Esprit de Machina

People call me Care, if you can believe it. Short for Carol. There have been plenty of men who have been given the name Carol, and I've never had any kind of problem with it. But people can be uncomfortable using a woman's name when talking to a man, so they shorten it. Or, to be precise--and precision is a must in my industry--they are sometimes uncomfortable using a name that they perceive to be a woman's name, even if, as in my case, that person is a man. So they call me Care.

I'm sitting in a coffee shop, managing a tall black, with the DSM VII on the table in front of me. Brand new, only published a year ago. My bible, as it were. I've been watching the young lady behind the counter, who greets customers in such a variety of ways as to make the casual observer believe she may be schizophrenic. Thankfully, I am not merely casual. It's my job to diagnose and administer. Or, and here comes that precision again, my profession is dedicated to making sure that any given diagnosis eventually comes to fit the person diagnosed. 

I mean, I could look up the criteria for schizophrenia in the book, but why bother. I've more or less memorized the damned thing. The same was true for VI, and V, and even IV. (Perhaps you've heard the joke that compares IV and V to the old and new testaments? If you want to know the truth, I was the one who came up with that joke!) The girl behind the counter is somewhere on the spectrum between 17 and 25, presents with shoulder-length straight brown hair, perhaps a little too much eye shadow, and chews her bottom lip when manipulating the espresso machine. Not schizophrenic? You tell me.

A voice from above and to the right interrupts my reverie. "Dr. Lewis."

I glance up to see a colleague of mine, from the clinic. "Oh, why so formal, Dr. Mint? Call me Care. Have a seat!"

He remains standing. "Indeed, Carol. I just wanted to say, well done on that diagnosis last week. Factitious Disorder? Stroke of genius."

I smile, gently stroking the smooth, pristine leather cover of my book. "Thank you, Franklin. Or can I call you Frank?"

He shrugs. "Or Dr. Mint, whichever you prefer." His suit is pinstriped, his tie screams "Ivy League, but on scholarship," and his haircut says "I flirt with baristas." He holds a briefcase in one hand, a cup in the other, with his own battered and worn DSM VII tucked uncomfortably under one arm. And yet he manages to sip what I assume is some sort of mocha or macchiato or marionberry tea, so I'll give him that. His eyes never leave mine. "How's the client handling her new status?"

I steal a glance at the girl behind the counter. She's refilling the hopper with beans, her lips moving, either whispering a litany of self-hatred in the voice of her abusive mother, or the words of the latest popular hip-hop song. "Well, I'd say. It took some explaining, but I think she gets the gist of it and has adapted accordingly. Please, Franklin, have a seat. It looks like that cement block under your arm is trying to rip your shoulder off."

His eyebrows arch, or, to be precise, his supercilious muscles unconsciously react to a brief emotion of confusion based in an unfamiliarity with the metaphor. "Thank you, Carol, but I can't, I've got a client in half an hour," he says, switching his cup from one hand to the other keeping hold of his briefcase at the same time and using his now free hand to grab the book and sort of waggle it in the air like a wizard with a wand. "I want to make sure she's getting the diagnoses she's paying for."

"Of course," I say. Given that he's the head of our clinic, he should indeed make sure his client gets her money's worth. Ours is not a cheap profession.

"Anyway, just wanted to tell you that." He switches the book back under his arm, retakes the cup in his other hand, and takes another sip. I could diagnose him, right then and there, as having OCD, but frankly, I don't think he could afford it, even on his salary. 

"Thank you again, Dr. Mint. I'll see you at the afternoon debrief."

"See you, Carol." he says, and starts to leave.

"Oh" I say before he takes a second step, "and if you like, I'd be happy to send you my notes on the Factitious, if you're thinking of going that way with your own client."

His eyebrows do the thing again. "What about doctor-patient privilege?"

I shrug. "That would only be a problem if we were actually doctors," I say. "Or even licensed, for that matter."

We both laugh, perhaps a bit too loudly, as the girl behind the counter favors us with a nervous glance.

Dr. Mint pats my shoulder with the briefcase-holding hand as he leaves, and I take a sip of my tall black. The girl is taking another customer's order, smiling at him, doe-eyed and coy. With me, she had been more clinical, hadn't batted an eyelash when I told her the name was Doctor Lewis.

Nymphomania hasn't been in the DSM since IV, but when handing out diagnoses, one sometimes has an opportunity to be creative. That's why I'm so good at my job, you could say.