Chapter 4

Dr. Maggie sat at her desk massaging her temples. It had been a very long day, but at least she was coming up on the last of the interviews of those that were here in Grottoes. She had saved Maddy's interview until last. It had become apparent through all of the other interviews that everyone had their own agenda for making Drew over into Gaby, and all of them in her mind were simply a load of meadow muffins. And in her discussion with Jocelyn, the suggestion of those involved being made to do the same thing as a punishment had come up. Maggie was of two minds about that. While it would be an appropriate punishment, at least certainly in the case of Brit and Deb, she was not confident that it could be done without incurring psychological damage in those being punished.

And those chaperones and teachers. She was stunned that they not only went along with it, but encouraged it for their own personal agendas. They knew that Drew wouldn't turn down an authority figure, but they went ahead and manipulated him anyway. She was contemplating sending a report to the English authorities, but would wait on that until she'd talked to Drew's parents.

The other children involved all seemed to take their lead from Maddy in a lot of this. This was one of the reasons Maggie had left her interview until last. That, and the fact that her mother would soon be arriving with the Bonds, she wanted to have the support there for Maddy. This was likely to be a long session. Before she talked with Maddy though, Dr. Maggie wanted to consult with another doctor she knew, a psychiatrist she had known when she was in med school at Georgetown. Dr. Karen Page had chaired a symposium on gender issues at the medical conference Maggie had been at last year, and given what she had seen of Drew; and given what everyone else had told her, she was out of her depth and wanted some expert advice.

Well, before she phoned Karen, Dr. Maggie started to run through the information sent by Drew's doctors in England. Testosterone levels near zero? Iron deficiency? And she herself had noted the formation of secondary female sexual characteristics. Oh my, there was much more here than meets the eye. “Yes,” she thought, “I definitely need to talk to Karen. I think while Drew is sedated, I will order up some more blood work and an MRI. And I think I'll ask Karen if she'll sit in on my session with Maddy. It will take her an hour or two to get here, so I'll tell them all to get some lunch and then return at 4 pm.” With that thought she went out to the waiting room and the assembled group.

As Dr. Maggie rounded the corner, Maddy looked up at her with some trepidation. “Well, time to come clean and tell her everything I guess” she thought. She stood up and started to head over to the doctor.
“Maddy, I do need to speak with you yet today, but I need to check on Drew and order a few more tests. Could all of you go for lunch and someone bring Maddy back at 4 o'clock? That will give me time to check on Drew and get the tests underway.”

Mrs. W answered in the affirmative, and that they would all be back at 4. She understood that Dr. Maggie only needed to see Maddy now, but they were all concerned about Drew.

“Very well then, I'll see you all at 4” stated Dr. Maggie. And with that she headed off to the ward to check on Drew and Jules, and order up the tests.

On her way back to the ward, she stopped and asked the unit clerk to try and get hold of Dr. Karen Page at University of Virginia Health Sciences Center in Charlottesville, and when she did to page her. When she got to the room assigned to Drew, she peeked in and saw Drew, asleep on the bed and Jules asleep in a chair right beside the bed. She smiled, and marveled at the fact that all children look like angels when sleeping. Well, before she woke Jules up to let her know what was happening, she went over to the nursing station.

“Could I have the chart for Drew Bond, please?” she asked the nurse at the station. She quickly went over the chart noting that all vital signs were fine, and Drew had not woken up as yet. “Well, he shouldn't wake up for about another 3 to 5 hours” she thought, given the dosage of sedative she had given him. “Right”, she said to the nurse “I need to have some other tests run right away. Can you hand me a blood work requisition and please call Radiology and see if we can get Drew in for an MRI right away”.

“Yes, doctor” was the reply as the nurse handed her the requisition.

“Let's see now – CBC, LSH, FSH, Testosterone (Random), dihydrotestosterone, Serum Estradiol, and liver and kidney panels. Oh, and basic genetic karyotyping. That should do for now. Please contact the lab and have them send someone down right away. Oh, and what did Radiology say?”

“Well doctor, they can take her up in about half an hour” replied the nurse.

“Excellent. Wait a minute, did you say her?”

“Well yes doctor, the young lady in 414.”

“Nurse, please look at the chart – Drew Bond is male, not female. Please make sure you get that correct.” Just then Dr. Maggie was paged to the phone. “Must be Karen” she thought.

“Dr. Maggie MacArthur"

“Ah. Maggie – Karen Page returning your call. It's good to hear from you, but I presume this is not a social call. You have a case you wish to discuss?”

“Actually Karen, I have a case I need you to see. Young male from Britain, here on an exchange. Due to a lot of interference, has had to present himself as female for the last 5 weeks. He was found this morning by his sister, virtually catatonic, muttering ‘Who is Drew? Who is Gaby? Who am I?' over and over to himself. I have him sedated right now and his sister is with him. The parents are on a flight over from England. I have been interviewing everyone involved in this sorry mess, and I have saved his ‘girlfriend' for last at 4pm. She seems to be the main instigator pushing Drew to dress and be Gaby, even when he doesn't want to. There are also some serious hormonal anomalies – I have had his medical files sent over from England, and I am running a very full scope of blood work right now. And in about 30 minutes, he will be going for a complete abdominal MRI.”

“I know this is really short notice, but can you be here for the interview with his girlfriend at 4:00? And if you can stay a day or two and assess him I would be very grateful.”

“Certainly Maggie….it sounds like an interesting case. And you obviously have a few hares you wish to run to ground on the physical side of things. I'm done seeing patients for the day now anyways, and I will get another member of the department to cover me for the next couple of days. It'll take me about 90 minutes to get there. Are you sure you don't want to have him brought here?”

“No Karen, his family will come directly here. After you've had a chance to see him and assess him, we can decide that. Anyways, we'll see you in an hour and a half – and thanks, I appreciate you coming out here.”

“Right, see you soon” and Karen hung up the phone.

Maggie hung up the phone and headed back for Drew's room to check on him and Jules. The lab technician was just leaving when she got there. “Please make sure you get a rush on those tests, would you?”

“Of course doctor” replied the tech as she headed for the lab.

Maggie entered the room and found Jules, sitting beside Drew and talking quietly to him. “Ah, Jules. Glad to see you had a bit of a nap earlier. I just wanted to let you know that an orderly will be taking Drew up for an MRI shortly. An MRI is essentially a special type of X-Ray. I want to check a few things before your mum and dad get here.” Maggie then told Jules not to worry as she was simply making sure she had all the information to help make a proper diagnosis in Drew's case. With that she suggested Jules might want to get some lunch in the cafeteria, as it would be an hour or so before they were done with Drew.

Maggie then headed back to her office to call the radiologist supervising the MRI to ensure that everything she wanted checked was looked at. On the way, she too was struck by just how much Drew looked like a young girl. “Hmmmm” she mused “I wonder if ‘Gaby' is just Drew's way of dealing with what is happening to him. Well, I'll find out for sure when Karen and I talk to him later. Oh yes, and I'd better book the interview room with the one way glass so that Mr. and Mrs. Bond can observe the interview without Drew knowing they are there. I think we'll get far more honest answers if he has no pressure from them.”

Maggie was reviewing the medical records sent from England, when there was a knock on her door. “Come in” she said. The door opened and in came the radiologist with the results of the MRI on Drew.

“Maggie, I think you are going to want to look at these. You were right; there are some structures in the lower abdomen that appear to be underdeveloped female reproductive structures. I think we definitely need to do a few more detailed examinations.” stated Dr. Cynthia Winters. “There may be some real serious issues if those structures become active. Conversely, if they stay where they are inactive, there is always the chance that they may become cancerous. So either way, something will need to be done. Bone structure wise, if I didn't know better I would say that we were dealing with a young female as opposed to a male. This boy is facing some serious problems in the future Maggie. I really think something is going to have to be decided fairly soon. I don't think we are necessarily dealing with a fully intersexed patient though – the MRI didn't turn up much more than what look like the ovarian and uterine structures – I didn't see any evidence of a fully or partially formed vaginal canal.”

Maggie pondered the information Cindy had just given her before replying. “Well Cindy, I am still waiting on a bunch of blood test results, but this does throw a whole new perspective on things. I'll keep you up to date on what we find, because you're absolutely right, we may need to do much more detailed examinations before we send Drew home. I have Karen Page coming down from Charlottesville to sit in on my interview with Drew's girlfriend, and she will also be a key part of Drew's own assessment. His parents should be here in about another 3 or 4 hours and we'll start making some decisions then. Thank you so much for looking after this personally and getting it done so quickly.”

“Any time Maggie – keep me in the loop, and let me know what the final outcome is would you?” And with that Dr. Winters left Maggie's office so Maggie could assimilate all the new information.

As Maggie began to put the new information together with the reports from Drew's doctors at home, a picture began to emerge. Still sketchy, but she thought she might be on the right track. Definitely needed to be discussed with Karen. This could impact future treatment decisions as well as having life altering implications for Drew. Well, as soon as the blood work came back, she'd have a clearer idea. Maggie looked at her watch and saw it was 3 o'clock. “Hmmm, better get myself a bite to eat before Karen gets here. This is likely to be a long evening.” After stopping at the reception area to inform them where she was, and to send Dr. Page to her when she arrived; Maggie set off for the cafeteria.

Maggie had finished lunch and was mulling over the case with a cup of coffee. From the interviews she had done so far two things were coming through loud and clear. Everyone, without exception, had told her that Drew seemed more comfortable, more free, and more real when ‘she' was being Gaby. And the second thing was that the place where Drew went to relieve stress, get away from things, or just be alone was his bike. Junior National Champion, hill climbs, team racing – if it involved a bike and racing, Drew would be found there. Interestingly that is also where everyone said Drew was truly his most competitive, and they all made reference to taking after his mum, who was an international women's champion. There was a connection that needed to be explored – did Drew want to be just like his mum, both on and off the bike? Did Jenny subconsciously want a daughter to follow in her footsteps? Something else to discuss with Karen. Just then a tap on her shoulder interrupted her reverie.

“Earth to Maggie, are you in there?” teased Dr. Page.

“Karen – wonderful to see you again. I'm so glad you were able to come down on such short notice. I've just been going over the Bond case in my own mind to clarify some things before you got here. Physically, it is becoming very ‘interesting'. We will definitely need to do some further testing and diagnostics.”

Back in her office the two doctors went over all the medical information and interviews that Maggie had accumulated so far, and were preparing for the interview with Maddy.

“Well Maggie, you weren't kidding when you said this was a case I needed to see. Drew could be his own case study for a team of doctors, let alone just the two of us. The physical issues present an immediate challenge to be dealt with, which I think we should discuss with the parents first; then we absolutely must start to delve into ‘Gaby' with him. Even if this is just a way of dealing with what is happening to him, this is not the healthiest expression for it. And I really need a number of sessions with him before we refer him over to the Portman Clinic at St. George's in England. Because if what we have learned so far is correct, that's where we are going to find the right people to help him. And heaven help him, he has a rocky road ahead. Well, we had best talk to Maddy here right away. Right now I simply want to understand her motivations in regards to Drew. And we will need to talk about her sexuality in relation to all of this; as well as try and figure out why she puts Drew into these situations and why she likes making him dress as ‘Gaby'.”

With that Karen pulled a tape recorder and pad from her bag to get ready for the interview. “Yes Karen” Maggie replied, “it's 5 to 4 – I'll go and get Maddy and meet you in conference room 3” Maggie got up and headed out to get Maddy.

As she headed towards the waiting room, Maggie mused that this interview would certainly be the most interesting of the day, as well as the lengthiest. In some ways. Maggie thought that Maddy may be more of a key to it all than any of them realized. As she rounded the corner, she saw them all waiting there for any news of Drew.

“Just so all of you know, Drew is still asleep, and likely will not wake for at least another 2 to 3 hours. Until all of the examinations and assessments are done, there will be NO visitors except for his immediate family.” Looking around, she saw Maddy, sitting on a chair, trying to hold back tears. “Ah, Miss Peters, follow me please.” Maddy stood up and joined Maggie on her way to the conference room.
As they entered the conference room, Maddy saw Dr. Page, and looked inquiringly at Maggie. “Maddy, this is Dr. Karen Page, who I have asked to help me with Drew. She will be sitting in on this interview and will be asking you some questions as we go along. I want to make sure that Drew gets all the help he needs while he is here, and Dr. Page kindly agreed to lend her expertise. Please have a seat, and we will get started.”

As Maddy sat down, her thoughts were going a mile a minute. “What were they going to ask her? How much would she have to tell them? Would her Drewbie be all right? Would Gaby ever come back?”
“Maddy?” asked Dr. Page, “please call me Karen. We are all here to try and help Drew get better. To do that we need to find out everything we can about him, and ‘Gaby', in order to be the most help. All Maggie and I want is what's best for Drew. In order to do that, we need all the information we can get from the people who know him – particularly those who love him. I'd like you to tell us what you remember about events where Drew has been Gaby, and why he became Gaby. I also need for you to talk to us about how you feel about Drew and Gaby and how you see your relationship with him/her. That is equally important, because from the other interviews, everyone agrees that Drew is quite taken with you, but as Gaby is more like your twin sister.”

Tears began to roll down Maddy's cheeks. “This is all my fault!” she wailed.