It’s Saturday morning and Dora refuses to leave her room. Dr. Ivy League has just finished telling me, via phone, we can no longer increase her medication dosage because we have now reached full efficacy for a child of Dora’s size and weight.

Furthermore, she notes, this “phone consultation” will cost one and a half times her normal rate due to this being a weekend. She does not want us to be surprised when we receive the bill.

How she can even think about billing when something seems wrong with Dora?  It’s fine, I say. Whatever. I skip ahead to the real question.

How can we be at full efficacy, I ask, when Dora refuses to leave her room? Isn’t she supposed to be fine now, at full efficacy? Smooth-sailing? All systems ‘go’?

“Some kids take longer to adjust to medications than others,” Dr. Ivy explains, “This is all perfectly normal.”

Except that it isn’t.  It is not normal for a nine year old girl to lay on her bed looking sad on a sunny, Saturday morning. I have taken her temperature three times using two different thermometers, but all digits flash back as normal.

Relax, David says. These things take time.

Why is everyone so calm?

Maybe I’m wrong?

What do I really know about children, anyway?  Let alone children with ADHD — let alone children with ADHD who are also on ADHD medication?  My working knowledge draws from a statistical N-count of one.

Perhaps everyone is right.  I will give Dora time.  I will give her until noon when we’ll leave for her weekly swim lesson. Noon is 74 minutes from now. I will give Dora 74 minutes to adjust to full efficacy.

“Swimming always cheers her up,” David reminds me.  He’s right. Dora loves to swim. I really should learn to relax. Maybe take up swimming, or go for a run or something.

I decide to relax and pass the time making chocolate chip cookie dough “for my family.”

At noon, I knock gently on Dora’s bedroom door, two warm, gooey cookies in hand. There’s no reply.

“Dora? Honey?” I open the door gently, peering inside, “Ready to go swimming? I made some cookies.”

Dora starts to cry. She does not want the cookies. She does not want to go swimming. She can’t. She just can’t.

No amount of coaxing will pry her from bed. I resort to insisting that she get into her bathing suit and go swimming, otherwise she will lose screen time for a week.

She is a good girl, my Dora. A true sweetheart by nature, she does as I’ve asked  although her will is clear. She is miserable, miserable, miserable as I help her change.

She’ll change her mind once we get there, I think.

In the car, she places her pink swim towel over her head and sinks down in the back seat.

I feel weird inside, looking at the whimpering lump of pink in the rear view mirror.

Relax. She’ll change her mind once we get there, I tell myself.

Dora refuses to get out of the car until I use my sharp voice, which makes her cry again.

She inches out of the car and velcroes herself to my side. We walk like this, slowly, from the car to the pool with her in tears all the way, refusing to remove the pink swim towel from her head.

It looks like I’m escorting a pink ghost, like we are Michael Jackson and his son Blanket.   One bratty kid in a Superman bathing suit points and laughs.  I scowl at him and draw Dora closer to me,  if that were even physically possible.  I adjust my hand on Dora’s shoulder so that my middle finger stretches distinctly apart from the other fingers, a blanket statement to anyone staring at us long enough to notice it.

We reach the end of the pool, where I convince Dora to sit with me on the warm cement. Dora whimpers, begging me over and over to go home. Dora’s swim teacher appears above us, casting a shadow over us with her body and her concerned expression.  I smile and say all good, Dora’s fine,  just feeling a little timid today, ha ha. Kids!

I wait a few minutes before informing Dora that it’s now time to get into the water. Surely you’ll feel better when you  get into —

— Suddenly, Dora pounces onto to my body in an effort to full-body-cling to me. Her tiny body shakes with fear, she grasps the flesh on my upper arms so tightly that I gasp in a mixture of surprise and pain, which only makes her cry harder.

Oh my God, what the fuck am I doing to this kid? This is wrong, wrong, wrong!

I am done being tough! Done leading her to water.  I lift my baby up to my hip like I used to when she was two and three years-old and I carry her to the car like this, her head and much of her body still hidden beneath the blanket.  I can’t even think straight and I don’t care who stares.  Once we get home, Dora runs upstairs, throws herself on her bed and cries and cries.

I take her temperature again. It is normal.  I tell David everything. He is a wide-eyed as I am.

I leave another message for Doctor Ivy, with David standing next to me in solidarity, punctuating my concern. I read my callback number three separate times.

This cannot be “full efficacy,” I say to David.  I feel strongly we should increase her medication.  David says we must be cautious and first have a deeper discussion. I ignore him instead of exploding, because having a ‘deeper discussion’ means waiting to schedule the discussion, and therefore waiting to give a suffering kid the help she needs. I have already waited 74 minutes today.

For dinner, I feed Dora her favorite soup from the wooden tray I’ve hand-delivered to her room. I feed her with a spoon as if she were very ill, hugging her tight and telling her I love her. I read to her for an hour, anything to keep her from being sad.

When Dora finally falls asleep, David and I don’t even talk. We just sit in the same room, quietly shaking our heads at each other in disbelief.

I take Dora’s temperature again as she sleeps. It is normal.

As I brush my teeth before bed, I notice the beginnings of ten, blue finger-print-sized bruises dotting my upper arms.  I show David, the toothbrush still in my mouth. We have no words.

I  leave my phone ringer on all night in case Dr. Ivy should call.