Saving Meghan(29)

“No, no,” Becky said, shaking her head, her body trembling with anger. “Dr. Fisher has diagnosed her with mitochondrial disease.”

“Those labs were inconclusive,” Dr. Nash said in a matter-of-fact tone. “I understand Meghan is taking a variety of vitamins and supplements as part of her treatment.”

“Yes,” Becky said. “Dr. Fisher called it a mito cocktail. And she’s on a waiting list to be part of a clinical trial for Elamvia, a new drug to treat mitochondrial disease.”

“That’s all well and good,” Dr. Nash said. “But I believe all those treatments are going to perpetuate the problem, which is that Meghan believes she’s gravely ill.”

“But she is sick!” Becky almost jumped to her feet. “Dr. Fisher—”

“Dr. Fisher’s diagnosis, as I said, was inconclusive. I’m the head of GI at White, and very experienced in pediatric care, and my read of Meghan’s medical history and my exam of your daughter tells quite a different story. I would think this would be welcome news, to hear that it’s not something physical.”

“It’s … it’s … not something that I believe.”

“Have you ever heard the term ‘functional disease’?” Dr. Nash asked.

Becky, who thought she’d read about every medical condition under the sun and felt confident she’d do well on a medical school entrance exam if she had to take one, confessed to never having heard the term before.

“What about ‘psychosomatic’?” Nash inquired.

Now, that was a word Becky knew quite well, and the implications made her blood burn. “What are you saying? That it’s all in my daughter’s head? That she’s not sick in the slightest? That I’ve been wasting my time and Meghan’s, shuttling her from doctor to doctor? Is that it?”

Carl’s voice again: I’m not saying you’ve done it intentionally.…

Dr. Nash pulled her lips tight. “She’s not making it up like a lie,” Dr. Nash eventually said, “but I think there are some deep inner conflicts here that need to be explored.”

Becky blinked rapidly. “‘Inner conflicts’?”

“I believe Meghan is exhibiting subconscious behaviors. Because of some external stress, those behaviors are manifesting as bodily symptoms,” Nash explained. “That’s what we mean when we say ‘functional disease.’ There’s a symptom—say, for example, upset stomach or blurred vision, weakness, fainting, general malaise—with no inducer stress, and by that I mean no biological component to explain the symptom.”

Becky strained to get her mind around the implications. Countless doctor visits, innumerable tests, endless worry—all because it was in her child’s head? She refused to accept that Carl could be right, or that her own self-doubt was anything other than wasted worry.

“I’ve never for one second questioned my daughter’s mental health.”

“Well, it’s not something you’d have a window into,” Dr. Nash said. “Which is why I’m recommending Meghan see a pediatric psychiatrist. Quickly, too.”

“A psychiatrist? After she came into my room clutching her stomach, complaining she couldn’t see right, you want her to see a shrink?” Becky’s voice rose sharply.

“It could help us identify the stress that’s causing your daughter’s symptoms,” Dr. Nash explained.

“It’s just your opinion that it’s stress, but you’re stating it like it’s a fact.”

“I’ve read her medical file, and I’ve examined your daughter.”

“And so did Dr. Fisher, and he came to quite a different conclusion.”

“No surprise there,” Dr. Nash retorted with a look and tone that implied some secret history with Dr. Fisher.

“What’s that supposed to mean?” Becky’s pulse spiked. She felt protective of Dr. Fisher, the one person she believed could help, and took Dr. Nash’s tone personally.

“The stress could be from anything,” Dr. Nash said. “Your marriage, for instance.”

“My marriage?” Again, Becky found herself having to tamp down her anger.

“Is everything all right at home?”

“It’s fine,” Becky said, hoping she came across convincingly.

“No issues?” Dr. Nash made it sound like that was impossible.

“Yes, of course there’s stress around Meghan,” Becky said. “Her health and all we’ve been dealing with, but we’re fine. We’ve been together a long time.”

“Length of time doesn’t necessarily translate into a happy marriage.”

“Pardon my candor, but I don’t really think my marriage is any of your concern,” Becky said. “That’s certainly not why I took Dr. Fisher’s advice to have Meghan come see you.”

“No, that happened because Meghan’s symptoms don’t fit with Dr. Fisher’s diagnosis. In fact, they don’t fit with any diagnosis—except mine.”

“That it’s in her head.” Becky made it sound ridiculous.

“Precisely. Which is why we need to stop her vitamin therapy and all supplements she’s taking immediately. In Meghan’s mind, it’s reinforcing the notion that she’s gravely ill. In the meantime, I’ll advise Dr. Fisher to remove Meghan’s name from the Elamvia clinical trial consideration. She needs a psychiatrist, Mrs. Gerard, not another drug or treatment.”