"I've got an interesting new patient for you, Dan," his supervisor's voice said. "I think you will find her very... challenging."
Dan hung up the phone and waited for the file to arrive. Turning his chair, he surveyed the office. The walls were painted a warm cream colour. Wooden bookshelves filled two walls from floor to ceiling, still only partially full, with boxes full of books cluttering much of the floor space. There was a long low couch on the wall opposite the window, and in between stood his desk, with his chair on one side and two quite uncomfortable-looking chairs on the other. The desk was large and made of very sturdy wood, and it held, among other things, his laptop computer, the telephone, and a small lamp.
Still waiting for the electronic blip that meant the file had arrived, he turned again and looked out the window. He watched a gardener tending a flowerbed. The hospital's grounds were extensive, and he had a good view from here. He saw a small group of male patients, accompanied by several nurses, wandering down near the orchard. Watching the men reaching up to touch the blossoms on the trees, Dan allowed his mind to wander.
He had accepted this position at the hospital only a month ago, and had only been in his office for a week. He had already begun seeing patients, and so far he was enjoying this job. It seemed to be everything he had hoped for when he decided to go into the mental health profession.
Suddenly the computer beeped and he immediately opened the email. The file size was larger than he expected but he saved and then printed the document, patiently waiting as page after page spewed from the printer. He collected them all into a neat pile and began to read.
The patient in question was a twenty-one year old female called Claudia. The record started when at the age of four she was dropped off at a Catholic convent and orphanage. She was set on the steps of the church and the bell was rung, and when the nuns found her there she was clutching a small piece of paper containing her mother's last message to her: "I hereby terminate my parental rights..."
Dan looked at the clock and saw that he had only fifteen minutes until she would be arriving to see him. He skimmed the file quickly. Throughout her childhood and adolescence Claudia was variously extremely well behaved and extremely unpredictable. She was sweet and polite and helpful, but also terribly vindictive and, on occasion, violent. From her early teens, she suffered from bouts of depression. At sixteen she had tried to hang herself. That same year she stabbed a male teacher whom she said had been harassing her. The same teacher's house later burnt down due to unknown causes. At seventeen she had cut her wrists.
At eighteen she had been admitted to her first mental hospital after setting fire to a shed in the convent and seriously injuring three children who were playing in it at the time. She had spent two years in that hospital during which she was alternately catatonic and psychotic. Shortly before her twenty-first birthday, Claudia seemed to be coming around. She attended regular therapy sessions and spoke openly with her psychiatrist. The doctors talked of possibly letting her return to the convent so that she might take her vows, which she said she was hoping to do.
Claudia asked for and received permission to wear a nun's habit and this she did all the time, wearing it even to bed. A progress meeting was held where her psychiatrist decided that although she was making progress, she was not ready for life outside of the hospital. Claudia was summoned and greeted this news with equanimity. She said nothing and allowed herself to be led back to her room.
Late that night Claudia had somehow managed to bypass several security measures and had gained access to her psychiatrist's office. She had located and presumably read her own file, then used it to set fire to his couch, desk, computer, and bookshelves. She had locked the door and sat waiting for the fire to consume her. Fortunately the firemen had found her, unburned but suffering from smoke inhalation. She had been transferred to a regular hospital for several weeks and had then been brought to this institution, where she had spent the last three weeks in solitary confinement after hurling her lunch tray at a nurse and threatening another patient with a fork. The file said that Claudia dressed only in her nun's habit and refused to take it off; that she was refusing most of her meals and would not speak to anyone.
Dan looked up from the file and stared into space, wondering what so troubled this girl. He wondered where all her rage was coming from. He especially wondered whether he would be able to get through to her or whether he would arrive one morning to find his office in ashes.
Suddenly there was a tap at the door. He recognized the nurse's measured knock. He hurriedly tucked the file into a drawer and walked around his desk, leaning back against it and hoping he looked approachable. "Come in."
The nurse opened the door and stepped inside, seeming to tug on the arm of the person she was leading. Though he had just read about the black and white nun's habit he was unprepared for the sight of her struggling through the door, her hair tangled and hanging limply over her face, her hands clawing at the nurse's hand on her arm.
Finally the girl was standing in his office and the nurse was escaping through the door, which she closed firmly behind her. Dan stood looking at the girl, who ignored him completely and stared out the window.
Dan swallowed hard. The girl's face, hidden behind her hair, looked faintly bruised, and her eyes were circled with shadows. He cleared his throat. "You must be Claudia."
She didn't so much as blink in response. She ignored him and walked over to the window, standing motionless in front of it. He came up beside her and tried to see where she was looking, but her hair was in the way. Not wanting to touch her or startle her, he backed up a few paces and started talking to her. Random comments about the weather, the gardens, the apple orchard, the hospital. He talked steadily for the entire 45-minute session standing three feet away from Claudia but not looking at her, and when the nurse came to the door and tapped, he was surprised at how quickly the time had gone. He looked at Claudia and found her still standing looking through the window. She had not moved in that entire time. As the nurse took her arm and led her away, he noticed that she wasn't struggling now – just being led.
Over the next week Dan tried to remember everything he had said to Claudia while she was in his office – said at her, really – but he wasn't sure. He wondered what he would say to her at her next session, though it seemed to be a moot point – she was back to assaulting the nurses and was repeatedly being put back into solitary, which meant she was not turning up for her appointments.
