howiǝ dǝwitt // D3 [fin]

August 16th

When my newest patient entered through the doorway, the first thing that went through my mind was that there is no humanly possible that this boy is only sixteen. He looked like he could barely fit through the doorframe – perhaps he was six foot six? Six foot seven? And while District Three is not a Career District this boy certainly could pass for one, but the way he carried himself in my presence suggested something else. His bright blue eyes were very kind and his brown hair looked soft to the touch, not like that course greasy look that the egotistical kids possess.

When he sat down I didn’t take very much notice to the fact that the armchair had suddenly appeared so much smaller underneath his hulking frame as I did about his head. Coming to see a therapist for anything was nerve-wracking and I could tell that this boy was anxious: his head was making rather sudden jerking movements – not slow and smooth as if you voluntarily moved your head to look at something, but quick and whiplash-like as if his instinctive reflexes were taking over at the wrong times. I could hear him mumbling something each time the twitching kicked in – it sounded like hup, hup – before he quieted down and looked up at me with those blue eyes of his.

“Howard, right?” He nodded slowly, controlled and fluid movements this time.

”I go by Howie though, miss.”

I nodded and jotted that down quickly on my pad of paper: Howie, not Howard. When I looked back up he had started the head snapping thing again but I tried to not let him know that I had already picked up on that though anyone that has a tic like that already knows that everyone can see it. “So why have you come to see me?”

Howie turned those blue eyes away from me, exposing sharp cheekbones on the side of his face and what almost looked like a slightly sunken cheek. He certainly wasn’t malnourished in any fashion – perhaps just a genetic trait? His head started twitching again and he began speaking, quiet and vulnerable, ”Something’s wrong with me.”

“Hm? What do you mean something’s wrong with you?”

He gestured towards his head. ”I’m sure you’ve noticed the head movements.” The blue eyes glanced back at me. ”I don’t know what’s causing it and I don’t know how to stop it.”

Of course I knew exactly what he had: Tourette’s syndrome. The involuntary movements coupled with the mutterings, inability to suppress them and unknown causes. “How long has your head been doing that?”

”Ever since I can remember, really. I went to the doctor thinking it was just some medical thing but when they found nothing wrong they told me to come see a therapist.”

Some of his brown hair had fallen across his forehead and I could still see the youth in him past the large biceps, broad shoulders, and weathered look. “First let me tell you that there is nothing wrong with you, Howie; what you have is called Tourette’s syndrome. There aren’t very many cases of it in Three but you aren’t alone. You’re not the only person in the District that has this.”

His facial features relaxed. My bet was that he never knew anyone else that had these strange tics and it probably comforted him to know there were more like him. ”Who are they?”

I gave him a sympathetic look. “Due to confidentiality reasons I can’t tell you who, but I can certainly ask them next time I see them if they would be willing to help give advice. Is that what you were asking?” He nodded and a light smile came to my face. One of my other patients also had Tourette’s but she lived on the other side of the District, though I bet if I asked her to give advice to Howie then she would do it. The poor kid probably just needed someone to relate to. “Alright, I’ll ask them then.”

A faint smile flashed across his pale lips. ”Thank you, ma’am.”

August 23rd

”Do you have any siblings?”

Today Howie was much more relaxed, though occasionally he sat rather stiffly as if he suddenly realized where he was. ”Yeah. Three brothers, two sisters, and one of my cousins live with us too.”

I wanted him to open up to me so I decided to stay on the subject of something very familiar to him. “What are they like?”

”Well… Lux is my oldest brother. He’s a really nice guy. He’s twins with Luce and she’s a bit hot-headed, but not arrogant to an extreme degree. Sure, she has her moments of letting her emotions get a hold of her but really she’s nice, too.” His blue eyes looked off to the side. ”Maddy is the smartest person I’ve ever known. It’s incredible how much he remembers – I swear he’s like a walking encyclopedia. I wish I knew as much as he does.” There was a sense of longing in his voice as his words trailed off; he raised a long-fingered hand, rubbing his face for a moment. ”Emilie is actually adopted but she’s just as much of a Dewitt as any of us. She has quite the temper but man, she won’t ever give up. Little fireball, she is. Little Alfie just follows people around and sometimes they use him for dirty jobs, like taking out the trash and doing the dishes. He’s a good kid, really – him and Iggy both. Iggy’s our cousin that lives with us and she’s kind of the same as Alfie, but where he’s like a puppy she’s another little fireball. She’s actually a lot like Emilie.”

I wrote down each of his siblings’ names, adding just a single character trait after it that he had mentioned. Lux – oldest; Luce – hot-headed; Maddy – smart; Emilie – ambitious; Alfie – follower; Iggy – cousin. “And they all know about your Tourette’s?”

”Well, yeah, I mean, I can’t hide it.”

“Do they tease you about it?”

Howie went quiet. His blue eyes glanced at me but then kept their gaze downward at the carpet as he spoke. ”When it gets really bad they’ll mention it, but then I always feel stupid when I can’t give them an answer as to why I do it. Sometimes they’ve told me just to quit it but I can’t. The people at school are worse, though, especially during tests or whenever the room is quiet. Some of them have started calling me ‘bitch,’ justifying it by whenever I do the muttering it sounds like barking to them, I guess, and also once they said that my mother must have been a dog.” His head started jerking again and when he recovered I could see a dark scowl on his face.

“Do you tell them to stop?”

”I’ve tried,” he stated flatly. ”They don’t listen, and since the majority of them are scared of me because I’m so much bigger than them I’ve resorted to just glaring and being threatening to make them quit.”

I could certainly see why other students would be scared of him, but so far I hadn’t found any reason to think he would attack anyone. “Have you ever hurt anyone that was making fun of you?”

He shook his head. ”I’ve never hurt anyone that wasn’t hurting me or my siblings first. I don’t go out of my way to make the first move.”

“But have you ever made the first move?”

”No, ma’am, I have not.”

I shifted in my chair, adjusting the clipboard on my lap. “Alright, Howie. I’m going to tell you right now that there are no known cures for Tourette’s, but there is something you can try if you really want to attempt to stop the tics.” He seemed to perk up after I had said that so I continued. “One thing you can try is to distract yourself whenever you feel the urge to do your tic. From what I understand, your tic is just your head moving and the mutterings. You could try to distract yourself – like when you think your head is going to jerk, maybe look to the side or look up. Whatever works for you. Then, for the muttering, perhaps try saying things like ‘My name is Howie, I’m sixteen years old,’ things like that.” Those blue eyes of his just lit up and I was afraid that the one side effect would put a damper on his spirits. “The only drawback is that suppressing your tics may make you very irritable or you may just have a harsher fit of the twitching and muttering.”

I was right: the smile on his face faltered, but he still seemed hopeful. ”I’ll try it anyway.”

I returned his smile. “I hope it works out for you.”

August 30th

”It didn’t work.”

Howie was sitting very tensed and his fingers tugged relentlessly on the threads of a hole in his jeans. I could tell he was aggravated since his head continued to do the involuntary twitching due to the stress he was putting himself under. “What did you try doing?”

”Whenever I felt like it was going to happen I just looked down, tried to read something, and then I’d say ‘My name is Howie, I am sixteen, I am a Dewitt,’ but it didn’t work.”

The irritation in his voice was substantial. I felt bad for him – it really seemed like he wanted to put an end to the “embarrassing” tics and he appeared willing to try just about anything.

”Then Luce heard me and she asked me why I kept saying my name over and over and I just got so embarrassed an—“ his head made a sudden jerk to the left, followed quickly by the barking hup, hups ”—and I didn’t want her to think I’m stupid—“ two more twitches and a bark ”—grah!” He lifted his hands and clutched at his temples, fingers curling around his hair into tight fists. The muscles on his arms showed as he strained to keep his head in one place and he raised his voice: ”I am Howie! I am sixteen! I a—“

”Howie!”

The behemoth boy stopped talking but his head continued to thrash against his hands. Small whimpers escaped him and my heart went out to him. ”Howie, it’s alright. I told you that suppression might not work and its major side effect is irritation. And even if it was going to work, it would take time. Things won’t just happen overnight.” He nodded slowly and I decided to change the subject and focus his attention elsewhere. ”So what’s something you like to do in your spare time?”

Howie slowly released his fingers from their curled position, running them through his straight hair and ruffling it some. ”I, um…” A short pause. ”Piano. I like the piano.”

Well, he certainly looked like he could play one rather well with how long his fingers were. ”Are you doing anything today once you get home?” He shook his head, blue eyes still downcast at the floor. ”Here’s what I want you to do: take it easy. Go home, maybe take a shower to feel refreshed or something, and then go play the piano. Not the hardest song you know, but just something to relieve you of this built up stress.”

Howie nodded again and dropped his hands as he stood up. ”Would sleeping be okay to do, too?”

”Yes, just make sure you get rid of the stress before you lay down.”

The boy gave a respectful nod of his head, spoke a thank you, and then left.

September 6th

Though Howie’s head wasn’t jerking involuntarily, I knew something was weighing heavily upon him. Dark bags circled under his bright blue eyes and overall he just looked bone-weary. ”Is something bothering you, Howie?” I asked, settling the clipboard against my lap.

”Just family stuff.” He was sitting back against the chair, elbow on the armrest, fingers massaging his temple as if he had a headache.

”Anything you’d like to tell me about?”

The boy hesitated and I could see his jaw tighten. ”N-not really.” He shifted in the chair, keeping his gaze away from me and his fingers rubbing his temple. ”Well… everything I tell you, you keep secret, right?”

”I’m bound by law to keep secret whatever you tell me.”

That seemed to change his thinking; those blue eyes looked over at me and I gave him a light smile, letting him know that he could trust me.

”My family has a sort of, um… a vendetta against this other family,” he began, keeping his voice down. ”I won’t say the other family’s name but they killed my dad. Ever since then there’s been fights and such between them and us.”

A resentful façade came to his face so I had the sneaking suspicion that perhaps he harbored enough hatred for this other family to prompt himself to attack them.

”Have you ever hurt one of them?”

”No but I’ve come very close. Most of the time I’m just bluffing, but if they lay a hand on anyone in my family I’ll rip them limb from limb.”

That certainly was a side of Howie I hadn’t expected to see. I figured he was pretty good at bluffing, considering that was what he did to the kids in his class, but when he had spoken of the students there hadn’t been that nefarious undertone. Howie’s head suddenly jerked to the side and he muttered the hups, putting his temple against a now-balled fist.

”I’m against all of it, though. I don’t like getting into fights and I don’t really hate the other family, but if they’re threatening my siblings or my dad, I’ll be damned if I let them get away unscathed.”

September 13th

Howie sat with the same demeanor I first saw him with: like an over-sized dog sitting awkwardly on a small cushion. He had expressed to me that he wanted to try another method to suppress his tics but frankly I didn’t have another possibility to help him.

”So… I’m basically stuck with it?”

The massive boy sounded so vulnerable, so helpless that it hurt when I slowly nodded in reply.

Howie’s eyes turned downcast, his hands clasped together in his lap. ”Well, thank you for trying to help.”

”You’re always welcome to come back, you know.”

”I know,” he answered, looking at the carpet as if all his answers were threaded there. It was hard to imagine that this was the same boy that was nearly ready to beat a person into the ground just last week. I gave a small sigh, reaching out and lightly putting my hand on his shoulder.

”Howie, just because you can’t get rid of your tics doesn’t mean you’re stupid or anything. You’re a bright young man and you can overcome this but it’ll just take time, and if anything I just want you to promise me that you’ll be patient.”

He lifted his eyes and I could see the hope slipping away with each passing second – each time his head made a jerking movement. ”You’re strong, Howie; don’t let this get in the way of you living your life.”

Luckily my words seemed to stick; he gave a slight nod, even going so far as to try a small smile. A little spark of life returned to his blue eyes but I still knew that in the back of his mind there would always be a self-conscious outlook on his syndrome.

”I’ll try, miss.”