Between the hospital and setting up my own practice I hadn't realized how much time had passed but here I was, five years in my own practice along with hours at the hospital.
I celebrated five years of a successful private practice first by taking my assistant out to celebrate. She'd been a godsend and ran my office flawlessly.
Then I took my mom and Jim out for dinner, too. I had her to thank for me being here. I had a successful practice, referrals kept coming and I had to decide between hospital hours or office hours. But I liked having the option. Mom joked that we should all have such problems.
Some of my patients were challenging, like Jesse had been. Some were so desperate for help and someone to listen to them that they were like fountains or broken dams. Everything came out.
I was proud of the work I was doing. I felt like I was making a difference. I was known in the community as someone who could and would work with some of the more difficult cases, as well as working with kids in the foster care system.
I dealt with a lot of abused kids. I helped them see nothing they did was wrong or deserving of the punishments they were enduring. Some of my patients learned their own strengths and were able to help themselves out of their situations. I wasn't successful 100% of the time and I internalized each of those perceived failures.
My mother would remind me of the good work I had done, even with some of my "lost" patients. And my new stepfather - Mom and Jim had gotten married two years ago - was just as supportive.
"Jim," I said at Mom and Jim's anniversary dinner. "You've been a very welcome addition to our family and personally, I want to thank you for your support. But I'm sorry, I won't be changing my name again."
Everyone laughed. Mom particularly thought I was funny. After all, I'd already changed my name to honour her first husband. My dad.
I was looking through the file of a new referral, sent over from Nationwide Children's hospital. The patient was a thirteen year old, in foster care but under an emergency protection order that had allowed her new foster parents to become her guardians. Odd.
She had been referred to me because of issues dosing her insulin. Ah. She was a diabetic. Apparently her birth father had been making her ration her insulin along with other abuse, and that had resulted in two trips to the hospital in 24 hours. Her foster parents, according to the file, were very supportive and wanted her to know she could use the proper amount of insulin.
I would meet the girl today at one. Also a strange time. Shouldn't she be in school at one?
I figured that wasn't my concern. I often saw kids throughout the day. I was busy and I liked it.
I wanted to know as much about this new patient as I could so I wouldn't have to keep referring to her chart from the hospital.
I took my lunch break at a small cafe near the office and continued to read through the file I'd been sent.
The poor kid. Her mother had died when the girl was eight. She'd been diagnosed at 10. She'd become known to social services when she was six and had been found wandering in her neighborhood at night.
I thought back to that October night with the little girl in the thin pyjamas. I'd thought she was eight. I hadn't looked in her chart. Could she have been six? Or was it so common an occurrence she was eight when I saw her in the hospital but she'd been there before?
Just before one, I closed the file, went back to the office. My receptionist let me know my new patient and her foster father had arrived.
I went out into the waiting area and looked at the two people sitting there. The girl's eyes were downcast, so I couldn't see them. The foster father looked a little familiar though.
I called her name.
Her foster father stood up with her.
"I'm sure this is unusual," he said, "but Samantha is really nervous about therapy. I've tried to reassure her that I'll be right here waiting, but would it be alright if I came in? I won't say a word. I just want to make the experience a positive one for her," I said.
"It is unusual, but, I've read over what the hospital sent over and I'm alright with you coming in as long as you remain quiet," I turned to Samantha. "Samantha, I don't usually allow parents in with my patients, and I'm making this exception for you. I want this to work for you, too. So we'll try it. But, just this one time, okay? And I promise, nothing you say in my office can be told to anyone without your permission unless I'm worried about your physical safety or the safety of others around you, okay?"
Samantha nodded, but had practically attached herself to her foster father. I led her into my office.
"Samantha," I said. "My name is Doctor David Freud. No relation to Sigmund. I checked. You can call me Dr David, Dr. Dave, Dr. Freud, Dave or Doc. Just don't call me late for dinner. Now, you can choose where you want to sit. We've got the bean bags or the couch. Or the floor, if you'd like. If you like chess, we can play while we talk. Sometimes it's easier to talk when you have something else working your mind.
It's up to you."
Samantha pulled her foster father over to the couch and made him sit down then sat down tightly beside him. She was sort of hiding behind him. She had her arms wrapped around his left arm and was clinging on to him like her life depended on it.
She looked up at me and I saw her eyes. The same blue eyes from all those years ago.
I was getting another chance to help her.