Through an act of subterfuge, Mandy got Lloyd into emerge. She sat him down in a waiting room of scraped knees and moaning bandaged heads and said she had to go to the counter and request an old x-ray she’d forgotten to pick up. When she stepped to the counter, she passed a note to the triage nurse:
Please help me. My husband is ABSOLUTELY CRAZY. I’ve tricked him to come here, but don’t let on what I’m doing. If he finds out, there’s no telling what he’ll do. I want him admitted for a 72-hour psych evaluation. I know you can do that. I also know that once you examine him, you’ll never let him out again. He’s TOTALLY NUTS!!!!!!
After the nurse had finished reading the note, she nodded to Mandy. She flipped her eyes to the left, indicating a grizzled middle-aged man in flip-flops and a Justin Bieber T-shirt. Mandy nodded back; that was Lloyd. The nurse placed a call and, within seconds, two security guards had positioned themselves by the entrance. Within a few more seconds, a woman in a white coat appeared behind the triage nurse and motioned for Mandy to join her in a consulting room.
The woman introduced herself as Dr. Heimlich, the psychiatrist on call for the night shift. Mandy thought the woman was too young and too hip-looking to be a staff psychiatrist. She wore her hair close-cropped like a marine’s. She had a ruby stud in her left nostril. And there was an ankh tattooed on her neck. Even so, her ID card said she was a psychiatrist (not a resident either, but a full-fledged psychiatrist), and everybody knows ID cards never lie.
— So tell me about your husband.
— Lloyd? Mandy said it as a question, then realized that was silly. Of course the psychiatrist meant Lloyd. Who else would she have meant?
— I see you’re nervous. Just take a deep breath and we’ll ease into things.
— I’ve never done anything like this before. I mean, I love Lloyd.
— Of course you do.
— I’d never do anything to hurt him. But tricking him to come here. This feels like betrayal.
— You want to help him. That’s not betrayal.
— I guess not.
— Are you afraid he might hurt you?
— Oh, no, not Lloyd. He’s a sweet man. I’m worried about HIS safety. Not mine. I’m worried he’ll say something stupid. Get himself into trouble. Get himself beat up or worse.
— What sort of things does he say?
— Oh, he suffers so much. He’s so afflicted. It’s paranoia. He’s obsessed with conspiracies. People watching him, trying to control him.
— Is it anything specific, or more a generalized fear that everybody’s out to get him?
— Oh, it’s very specific. Lloyd believes the world is controlled by middle-aged rich white men.
— Uhhhhhhhh.
The psychiatrist stared at Mandy and blinked a couple extra times to be sure Mandy was for real.
— Uh, here’s the thing, uh, Mrs. uh … The psychiatrist stared at the sheet of paper she’d pulled from the printer in the nursing station.
— Mandy. Just called me Mandy.
— Here’s the thing, Mandy. You can’t say your husband’s suffering from a psychosis if the content of his alleged psychosis actually describes the real world.
— Huh?
— The world really is controlled by middle-aged rich white men.
— No.
A hospital’s emergency ward is a place where medical professionals often deliver difficult news, but Dr. Heimlich had never witnessed a person so troubled by the hard facts of a case. Mandy drifted from the consulting room in a dysphoric cloud and Dr. Heimlich feared that the woman would become dissociative. Dr. Heimlich offered words of reassurance and suggested that, in time, Mandy would come to accept the disturbing news. Maybe it was a matter of empiricism; Mandy should trust the evidence of her own eyes. Mandy shook her head NO NO NO and ran crying toward the entrance. Dr. Heimlich nodded to the security guards and they restrained the patient before she could leave the hospital. Lloyd rose from his seat, mouth wide, and demanded to know what was wrong with his wife.
— Follow me.
Dr. Heimlich led Lloyd down a hallway while the security guards dragged Mandy thrashing behind. They found an empty room with a gurney, and while the guards strapped Mandy onto the gurney, Dr. Heimlich explained:
— Your wife has experienced a psychotic split caused by the shock of a challenge to her world view. I could offer something more technical, but it all comes down to a simple word: grief. Your wife is grieving the loss of something cherished. But she’ll get through it. Don’t you worry. We all do.
Mandy struggled against the straps and screamed:
— Don’t listen to her, Lloyd, she’s a crazy bitch!
Flinging her head back and forth, hair had fallen across her eyes, and spittle was dribbling from the corner of her mouth.
Dr. Heimlich looked at her watch:
— Almost 7:30. Dr. Andrews is coming on shift. I’ll leave it for him to give your wife a sedative.
Lloyd nodded and thanked Dr. Heimlich for all her help.
A couple minutes later, a middle-aged man in a white coat entered the room and introduced himself as Dr. Andrews. When he took up Mandy’s chart, his coat-sleeve fell back to reveal a Rolex.
— Who are you? Mandy demanded.
— I’m the chief of psychiatry.
— You?
— Of course.
— Why not Dr. Heimlich?
— You can’t be serious. She’s only a woman.
Dr. Andrews gave Mandy a cocktail of benzodiazepines, phenobarbital, and Haldol. He didn’t leave the room until she was unconsciousness. While he waited for her eyes to close, he stood in the doorway with Lloyd and they talked about what a hardship it is to get a loan for a new Porsche.