Chapter 31: Tuesday, Dr Koehler

Editor’s Note:
The next pages are further notes taken by Dr Koehler Snr.

Notes of meeting, Nurse Cassandra, Tuesday, 12/7, 8:53am

((notes re other patients deleted))

NC: There have been no major concerns about Mischa but there have been some interesting developments. She became upset this morning because she wanted to use the bathroom but Bec was not aware enough to be her escort. Nereida accompanied them and reported that Mischa showed a high level of care for Bec. I can’t imagine the Mischa we had this time last week showing that level of care for anyone.

Dr K: Yes. Her progress has been significant. She probably no longer needs an escort to the bathroom. I’ll discuss it with her during our session this morning and see how she reacts.

NC: I’m not sure if you were told but yesterday during lunch, Alice ((name changed)) approached and sat with Bec and Mischa. Then yesterday afternoon while you were in the meeting with Bec, Alice and Mischa spent some time sitting together quietly reading magazines. Apparently, they were even discussing some of the articles.

Dr K: Now Alice and Mischa is a pairing I did not predict. I assume Alice approached Mischa and not the other way around?

NC: I believe so. Alice did not go near Mischa during dinner which is just as well because Alice was looking for a fight and took on the afternoon shift nurses. Bec was sedated at the time and Mischa ended up sitting with Trevor and Del ((names changed))

Dr K: Good.

NC: Then Liz Davidson, knowing that Bec was sedated, came in to visit Mischa in the early evening.

Dr K: Now that is interesting. Not out of character for Liz, but still surprising.

NC: Then this morning at breakfast, Alice joined Bec and Mischa again. One of the nurses was walking past and happened to overhear Bec calling Alice out about her attitude.

Dr K: That is something I was expecting sooner or later. How did Alice react?

NC: I was told she stayed there and took it. Then later something was said and Alice stormed off and went to her room.

Dr K: I love it when a plan comes together.

NC: Yes, doctor.

Dr K: That was a quote, Cassandra. It’s from a TV show back in the early 1980s called the A-team.

NC: In the early 1980s I was watching Sesame Street.

Dr K: Now you’re making me feel old.

NC: I’m sorry, doctor. Should I tell the nurses that we need to brush up on our 1980s trivia?

Dr K: (laughs) Thank you, Cassandra. I’m sure that would make me feel better. Now was there anything else?

NC: No doctor, that’s all.

End of meeting.

Transcript of Patient Interview, Rebecca Freeman, Tuesday, 12/7; 9:14am

Dr K: Good morning, Bec.

Bec: Hi Dr K.

Dr K: Have you experienced any symptoms since the meeting yesterday?

Bec: Those pills worked like a charm. I slept through last night without any problems, as far as I know. I think I was a bit shut down this morning. I was stuck inside my head going over the things that happened. The first thing I knew this morning was that I was sitting at breakfast and listening to Alice talk to Mischa. I think Mischa may have gotten me under the shower before breakfast because I remember feeling the water.

Dr K: I’d like to talk about the possibility of you going home. We can continue your treatments as an outpatient for as long as you need.

Bec: I kind of agree with what the detective said yesterday. I think I should be here until I’m not a danger to anybody else. You said you agreed with him. I feel like I’m a very dangerous person right now. I should probably stay here.

Dr K: Do you think you are a danger to your family?

Bec: No.

Dr K: Do you think you are a danger to your friends?

Bec: I don’t think so.

Dr K: Do you think you are a danger to the average person walking down the street?

No response.

Dr K: Is it possible that you are only a danger to people who are trying to hurt your friends and family?

Bec: Yes. I’m dangerous to them.

Dr K: I’ll let you in on a secret. I’m also a danger to people trying to hurt my friends and my family.

Bec: What?

Dr K: A lot of people are. Perfectly sane and ordinary people living normal lives can become very dangerous when their family is threatened. We don’t lock those people away in a psych unit like this because it’s considered a perfectly normal response.

Bec: Yes, but look at what I did to my grandfather.

Dr K: If your dad had been at home when that man had tried to kidnap you and your sisters and ranted about what he was going to do to you, what do you think your dad would have done to his father?

No response.

Dr K: If your brother had been at home when all of this had happened, what do you think he would have done to his grandfather?

She stared at me and blinked, then blinked again.

Bec: It’s probably just as well they weren’t there.

Dr K: Do you think they would have reacted violently?

Bec: Yes.

Dr K: More violently than you?

Bec: Maybe.

Dr K: If they had been there and they had killed the man, do you think they would need to be locked up in a psych unit?

Bec: Probably not.

Dr K: Why is it okay for them to react violently to the situation but not okay for you?

Bec: Oh. (pause) Because I have a weird brain. I have a mental condition. I sometimes have trouble telling the difference between reality and delusion.

Dr K: I listened very carefully to you yesterday. It seemed to me that you had a very clear understanding of which parts of your experience were real and which parts were hallucination.

No response.

Dr K: Let’s leave that thought for now. How do you feel about the meeting yesterday?

Bec: (stretches neck and shoulders then lets out a breath) I thought I got through it okay. I was expecting to shut down half-way through but somehow I kept going to the end.

Dr K: I thought you did extremely well. Telling the story was obviously a strain on you.

Bec: Well, yes. I’m not going to do that again.

Dr K: You may have to tell your family and your friends.

Bec: Yes I know. (pause) But I’ll edit out the worst parts when I do that. I had to say it all to the detective but my friends and family don’t need to hear all the gory details. I didn’t even want Dad to hear the whole story but I had no choice. He had to be there so he got to hear it all.

Dr K: I noticed that you did edit a few places. You were giving a word by word account of your conversation with your grandfather but then you stopped doing that and gave a summary of things he said. Why did you do that?

Bec: He was ranting. He was going on about the things he wanted to do to me and Tara and Angie. Most of it was disgusting. I felt like if I repeated it then everyone in the room would be soiled by his filth. Some things are better off left unsaid.

Dr K: Hmm. Let’s talk about the other man.

Bec: The uncle?

Dr K: Yes. The uncle got away. Do you think he’s a danger to you and your family?

Bec: I suppose he might decide to get revenge for his brother but I don’t think so. He struck me as a follower. I think he was only there because he’d followed around after his brother for all of that time ever since Dad was a child. When I killed his brother he was upset rather than angry. I think he ran away and he’ll keep running away. I doubt if we’ll see him again.

Dr K: How do you feel right now about what you did to your grandfather?

Bec: I said yesterday that I had these two conflicting things going on in my head. Both ideas are still there. I’m horrified that I killed a person. I’m horrified about the way I did it. On the other hand, he was a monster. He wanted to do evil things to me and my sisters. I had to stop him and I’m glad that I stopped him. Those two ideas are both still swirling around in my head.

Dr K: I see.

Comment: Bec frowned and looked down and started fiddling with the fabric covering her knees.

Dr K: Is one of those ideas stronger than the other at the moment?

Bec: (shrugs)

Dr K: We’re nearly out of time and I want to go into this more deeply in the next session. Until then, I want you to keep in mind that those two conflicting ideas are a good sign. Someone who kills without any guilt can become dangerous to the rest of the community. Someone who kills to defend themselves but forgets why they did it and just focuses on the guilt can become consumed by that guilt. Keep both thoughts in your mind. They both belong there. Don’t let one chase the other away.