A Vision of Fire

Late in the afternoon, Caitlin headed to a café on Twenty-Seventh Street. Jacob’s cooking class, held in a test kitchen one floor up, would be finishing in twenty minutes. She sat in a private corner with a cup of jasmine tea, hunched over her phone for an overdue conversation.

The man on the other end was unhappy and more than a little condescending.

“Dr. Deshpande, I assure you, it is not post-traumatic stress disorder,” she said to Maanik’s physician. “I have never heard of a rapid, cyclical repetition of PTSD symptoms.”

“Perhaps a review of the current medical literature might convince you to revisit that opinion?” the doctor suggested.

Caitlin bristled but decided that methodology was not the battle she should be fighting.

“Yes, of course, I will be doing that,” she said. “But in my experience with crisis survivors locally and globally, this is wholly atypical. Now,” she continued before he could interject another cover-his-ass approach, “are you sure there is nothing in Maanik’s history that could be a precursor to this?”

“Nothing. I am certain you checked for head trauma while you were there, Dr. O’Hara? She was thrown to the sidewalk when the shooting occurred—”

“There were no bruises, no reason to infer nausea, no reaction that would suggest headaches—”

“ ‘Infer,’ ‘suggest,’” he said. “That is why I prescribed what I did. Because you frankly do not know.”

“And you didn’t request an MRI,” Caitlin shot back. “I understand why, I do. But that doesn’t justify nuking her body with that cocktail you prescribed.”

“The ambassador was needed. Another incident had to be averted. And your method did not work, I understand? Not quite?”

This discussion was pointless. Caitlin got back on topic. “What about when she was a child?” she pressed. “I know the Pawars have only been here two years, but you have her records from India?”

“I came to New York with the Pawars,” he said. “The ambassador arranged for my post at the United Nations. As for Maanik, the most serious ailment I have ever treated was a sprained ankle last winter from ice-skating. And before you interrupt me again, no, her head did not touch the ice. She is supremely healthy in every way. Which is why I felt—and still feel—she could handle that ‘cocktail.’”

“What about psychologically?” Caitlin asked. “Has she ever exhibited an extended period of despondency, withdrawal?”

Dr. Deshpande laughed. “Those are words that could never apply to Maanik. She is a precocious, vital, outgoing girl, Dr. O’Hara, and has always been so.”

“The drugs you prescribed. Had Maanik ever taken those or anything like them?”

“No, and I will spare you the discomfort of asking: Mrs. Pawar is concealing nothing about domestic abuse or assault. Her family is strong and loving and Maanik is one of the happiest teenagers I have encountered. I have no doubt that the mental trauma of witnessing her father’s attack altered her body’s chemistry and it is manifesting mentally. We can safely use medications temporarily to remind the body of what normal is, and she will adjust and return to herself.”

“Or we can look for an approach that addresses the cause and not just the symptoms,” Caitlin replied. She saw no reason to press this further. She thanked the doctor and ended the call. At least he had agreed to stick with just the clonazepam for now, since the immediate crisis had passed.

But Dr. Deshpande was right about one thing: had it passed for good? She flashed to the bloody S-curves on Maanik’s forearms. Every day Caitlin provided therapy to high school students for Roosevelt Hospital. She counseled college students from the John Jay College of Criminal Justice, consulted for international agencies, oversaw the development of a mental health program for refugees, and closely monitored world news for potential hot spots of trauma where she might be needed. This work was her life and her passion. And yet, with all her specialized experience behind her, she was stumped by Maanik. Something about the terror, the scratching, the look in her eyes. To say it unsettled her would be an understatement.

Caitlin lifted her shoulders high and dropped them—a literal effort to shrug off the residue of the afternoon. Ten more minutes before Jacob would be down. She discreetly massaged just above her eyebrows, the tips of her ears, behind her ears, down her skull to her neck. It helped.

Her phone vibrated once—a text from her younger sister, Abby, a surgeon in Santa Monica, California: How was it??

Caitlin sighed. She knew what this was about: last night’s date, which now seemed a hundred years ago. She’d text back later. She signaled the server for the bill, closed her eyes, and listened to the low murmur of conversation around her, cars outside, the flutter of a paper pinned to the wall near a heating vent.