Chapter 35: Friday

Editor’s Note:
The next page is another extract from the notes of Dr Koehler (Snr) dated Friday, December 10th.

Patient interview, Mischa Doeple, 12/10, 9:07am

Dr K: Good morning. How are you feeling today?

MD: I’m feeling really good.

Dr K: Are you ready to leave here?

MD: Yes, totally.

Dr K: Are you over all of your problems?

MD: No, but I know what I have to do.

Dr K: That’s good.

MD: I wanted to say “sorry.”

Dr K: Sorry for what?

MD: I think I was pretty rude to you and the other staff.

Dr K: You were sick and you were in a lot of pain. Different people deal with pain in different ways. I assure you that none of us took your attitude personally.

MD: Even so, I’m sorry for how I behaved. You’ve helped me a lot and I wanted to thank you.

Dr K: You’re welcome. But I haven’t finished with you yet.

MD: I know. I’m going to come in and see you two times next week. But it won’t be the same as being in here.

Dr K: True.

MD: I don’t know how you do it. The kids in here – everyone is so complicated. It must be like trying to untangle a spider’s web with everything sticking to everything else.

Dr K: Sometimes it is. That’s a good way of putting it. But I have a few tricks up my sleeve.

MD: So what happens now?

Dr K: Now you spend the day relaxing and following the usual routine of the unit. Mr Davidson and Liz won’t be here until late this afternoon and we won’t discharge you until they arrive. Until then, you stay here.

MD: That isn’t what I meant.

Dr K: I’m sorry, what did you mean?

MD: I mean am I supposed to go to those meetings where people stand up and tell each other about their issues?

Dr K: Would you like to go to meetings like that?

MD: I don’t think so.

Dr K: Do you think going to meetings like that would be helpful for you?

MD: I don’t think so.

Dr K: Then don’t go.

MD: Oh!

Dr K: There are meetings specifically for young people who are recovering from traumatic events of one type or another so if you change your mind, let me know and I can get you into a group.

MD: Okay. But what I went through wasn’t really normal was it?

Dr K: There is no such thing as normal. Everyone has different experiences. So, from that point of view, your situation was as normal as anyone else’s.

MD: Hnh. But I don’t have to go to those meetings if I don’t want to?

Dr K: Not at all.

MD: Okay.

Dr K: Did you have any other questions?

MD: Um, no, I don’t think so.

Dr K: Okay then.

MD: Wait. I have one. How do I know when I’m cured?

Dr K: Now that is an excellent question. What makes you think you aren’t already cured?

She held her arms out and gestured down her body.

Dr K: I don’t want you to get hung up on the idea that being cured depends on your appearance. The two things are linked but the one does not depend on the other.

MD: But I don’t look normal.

Dr K: There is no such thing as a normal look. Everybody looks different.

MD: You know what I mean.

Dr K: Yes, I do. But your physical appearance does not define who you are. Nor does it define whether you’re cured or not.

MD: So what does define whether I’m cured or not?

Dr K: Do you think you’re cured?

MD: Um ... Wait. Are you saying I’ll be cured when I think I’m cured.

I smiled at her but didn’t respond.

MD: That’s stupid.

I nodded.

Dr K: I agree. Totally stupid.

Dr K: I’ll tell you what. You go and spend the next few days with the Davidson family. Go to school with Liz and her friends. Watch TV, talk to your friends, listen to music, learn to play a new song, do whatever inspires you. And when you get a moment, think about a better way of deciding when you’re cured. Then, when you come in to see me next week, we can talk about that and go from there.

MD: But you’re the doctor. Shouldn’t you be the one to tell me when I’m cured?

Dr K: My normal patients don’t ask me to tell them that.

MD: But you keep saying there’s no such thing as normal.

I grinned at her.

Dr K: You got me there.

End of Session.

Patient interview, Rebecca Freeman, 12/10, 9:50am

Bec: Good morning. How are you feeling today?

Dr K: Er ... fine. How about you?

Bec: So did you sleep well? Have you been having any bad dreams lately?

Dr K: We’re not here to talk about me.

Bec: Why else would we be here? So in our last session you confessed you were having strange thoughts about Alice and me. Are you still having those thoughts?

Dr K: Ah! Yes, I am still thinking about putting Alice and you together.

Bec: And how do you feel about that?

Dr K: I feel that the two of you would make a good pairing.

Bec: Is it possible that you’re making a very grave mistake?

Dr K: I try very hard not to make mistakes. The cost is too high.

Bec: So you admit that you do sometimes make mistakes?

Dr K: Yes I do, but this is not one of them.

Bec: I hope you’re aware that that is sheer delusion. Do you often suffer from delusions or is this a rarity?

Dr K: Er ... nice question.

Bec: Do you have any other symptoms? Sweaty palms? Ringing in your ears? An overwhelming desire to conquer small countries?

Dr K: No. I can’t say that I’ve experienced any of those.

Bec: Well that’s something I guess. So why do you think you’re having these delusions about Alice and me?

Dr K: I think that the two of you have something in common.

Bec: Is it possible that I have something in common with just about every individual on the planet? If you picked out any random person do you think we could find something in common?

Dr K: You have a good point. But I really do think you and Alice can help each other.

Bec: Has it occurred to you that if you put Alice and me in a small room for an extended period, one or both of us may end up seriously injured?

Dr K: I don’t think that’s an issue. I have confidence in your ability to manage the situation.

Bec: Your delusion is more serious than I thought. You’ve lost all touch with reality. We may have to start you on some drug therapy, perhaps something with major mind-altering properties. They say that reality is only for the schmucks who can’t cope with the drugs.

Dr K: Is it possible that you’re exaggerating?

Bec: Or we could try electro-shock treatments. That would be a buzz.

Dr K: Definitely exaggerating.

Bec: Or we could do that operation they used to do where they cut out a piece of a mental patient’s brain.

Dr K: Do you mean a frontal lobotomy?

Bec: That’s the one. Your delusions are so serious we may need to perform a frontal lobotomy and cut out the sick part of your brain.

Dr K: Technically they didn’t cut out a piece of brain. All they did was slice through some nerves to sever the frontal lobe from the main portion of the brain. A truly barbaric practice that is thankfully no longer practiced.

Bec: Hmm. That’s a shame. Your frontal lobe appears to be on the fritz. A quick snip up in there might save you from all these weird delusions.

Dr K: If we can leave aside my delusions for a moment, I did want to talk about...

Bec: Oh look, we’ve run out of time. This has been a great session. Very productive. Try to keep those megalomaniacal tendencies under control until we can meet again.

Dr K: Er...

Bec: Maybe in our next session we can talk about the way your left eye twitches when someone makes fun of you. Good bye.

Session ended when Bec walked out of the room.

Comment: I enjoyed that. Anyone who can do that to me with a straight face doesn’t need to be locked up in a place like this. Now I just have to persuade her of that. Something tells me that won’t be so easy. She is clearly still nervous about leaving this secure environment. She knew I wanted to talk about her going home and she cleverly (cheekily?) avoided the discussion.

Comment: How many psychologists does it take to change a light bulb? Only one, but the light bulb must want to change.

Comment: To state the obvious, Bec isn’t over her experience; that will take some time. But she is probably past the point where she needs to be in a secure environment with constant supervision and care. What she needs now is a return to her normal life – home, school, friends, family. Bec knows that. I suspect she found a subtle way of telling me she thinks she needs a few more days to get used to the idea.

Comment: I will put Alice in with Bec. I expect the two will clash some. There could even be sparks. If nothing else it should be entertaining. Alice is too comfortable in her single room, she needs to be provoked a little and Bec will do that for me. Bec will want to cure Alice and that will be a real challenge for her which will stop Bec disappearing into her own head. I will gratefully accept any progress Bec makes in steering Alice down a better path. If Bec gets frustrated, Alice will be able to cope with Bec firing from both hips much better than Mischa could have. And Bec needs to be reminded that they call this a psychiatric unit for a reason. Alice will do that for me. Alice should chase her out of here if nothing else will.