A Gilmore Girls fanfic

Author: mz lynx

Disclaimer: Don't even own a set of dvd's...

AN: This chapter's been edited and reposted... I'll go through the entire story when I have the time and energy - and when my brain refuses to work on my current story.

At the Heart of Things

Chapter 1: In Serious Need of Professional Help

Dear Dr Marshall,

thank you so much for taking this case. I truly am out of my depth here. The patient in question is, in my opinion, in serious need of professional help – unless some progress is made, and soon, I am afraid that the patient will self-destruct. My own efforts have, I fear, not been enough. The best I can say is that I truly believe I have at least not made things worse.

I first came in contact with the patient at age nineteen, in June 1987, after a call from the family's physician. The patient had just graduated from high school, but missed her actual graduation due to a breakdown – just hours before the event in question.

I was called in largely because the physician in question, a Dr Lewis, was a friend of my family. He told me later that the parents were hesitant to having their daughter see a psychiatrist, and that he got them to agree mainly because of my "other qualifications"; that is, me being a young female knowing how society works. He also told me he personally believed that I would have an easier time connecting to and working with the patient because of this, as it would invoke some sort of sisterhood thing. At the time I agreed. Now, how ever, I have come to believe that this may instead have been an obstacle.

The patient was found in bed the morning of her graduation, curled into a fetal position, crying hysterically yet quietly, something that scared the maid sent to wake her up but (according to what I managed to piece together) annoyed her mother. At first, that is. When it was clear that the patient could not be scolded, threatened or coaxed into calming down, not to mention going to her graduation, the family physician was called. And, as I said, later I too was called.

After several hours, and with the help of drugs, I got the patient calmed down. The situation was disturbing though, and by stressing the fact that I knew how important it was for a society family to keep this quiet I managed to get the parents permission to treat their daughter further. For the following three years I met with her twice a month, trying to break though her depression.

I still have no idea as to the reason behind the breakdown. The real reason that is. At the time I thought it was due to the stress of high school, seeing as the school in question, Chilton, is very demanding and the patient graduated top of her class and was elected valedictorian. The patient agreed to this, but I have since come to believe that there was more to it, considering all that followed.

The patient was clearly depressed, and seemed to be helped by medication. Due to the fact that, as we thought then, her breakdown was brought on by the pressure of school, by the need to perform well and be one of the best, it was decided that she would not attend university during the fall. Instead, her mother found her a part-time job (which the patient called "boring, but a no-brainer"). The patient also studied French – apparently her favorite subject at Chilton./Things were uneventful for almost two years, and I was just about to decrease her medication, when the patient's depression worsened, just a few months ahead of her 21st birthday. When asked, the patient guessed the reason to be "the society shit". I accepted this, knowing that coming from a society family she was probably experiencing pressure to get married, or at least engaged. This is one of the few cases where I still trust my judgment, even though there may have been lesser reasons as well.

The medication was increased instead, for a while. In our sessions we talked a lot about the patient trying to find some other occupation, seeing as she still had the same boring part-time job. She was leaning, albeit cautiously, towards becoming a teacher. The reasons she gave were that she liked children, and that the only thing she was any good at was French. I noted at the time that she looked sad when mentioning children, but when I tried questioning her about the possibility of having a family, with her own children, she immediately closed down. In the fall the patient enrolled at Yale. During the following year she worked hard, aiming for a teacher's degree. Contrary to my fears she seemed to thrive, and it was finally possible to decrease her medication. The patient seemed happy, content, and I seriously believed that after three years we were seeing an end to her treatment.

This made her second break-down even more puzzling, and serious.

Two weeks into her summer vacation the patient was found catatonic. Interviews with her parents gave the following sketchy background: They had all attended a wedding – where the groom was a childhood friend of the patient – which the patient had left early. When the parents returned home they found their daughter on the couch, in her pajamas, passed out they thought. As soon as they realized that her eyes were open, but that she could not be revived, an ambulance was immediately called.

The patient was totally unresponsive for two weeks before coming to, and when waking claimed to have no memory of the events leading up to her breakdown. When asked about the last thing she remembered the patient replied "We were about to go to Chris' wedding, weren't we?"

I saw the patient three times the following week, without getting anywhere. Even though she had not been as open as I would have wished earlier, we had been communicating. After her second break-down however, she shut me out completely. She was released from the hospital after ten days. Two days after her release I was notified that she was no longer my patient, as she had left the country to stay with relatives.

She returned to my practice, on her own, two years later. She was back at Yale, now having abandoned teaching as a possible career. Instead she was taking classes in hotel management, business and economics. The patient still suffered from depression, but there had been no more break-downs, and her medication was much decreased from her earlier time with me. She told me she had worked out a lot of her earlier problems, but realized she still had problems. I felt she had no real interest in being truly open and honest with me, leaving her underlying issues untouched, but that it was better to try and work with her than leave her on her own as she declared that as far as psychiatrists went it was me or no one.

For the last five years I have seen the patient infrequently, as little as twice a year or up to once or twice a month, according to her wishes. I have come to the realization that I cannot treat her properly, and that she in part has been manipulating me – working with my society background and knowledge to keep me from finding out the big issues in her life. I still believe that her society life and the pressure she is under come into play here, and that she needs to deal with these things, but I believe that there is something much more serious here.

The patient's third break-down came just days ago, and even though it was not as serious as the one before the mere fact that she had one is very serious. I am, as I have stated repeatedly, out of my dept here, and hope that you will be able to do better.

I have noticed that the patient seems to have a troubled relationship with her family, something that she has not been willing to get into with me. I believe that you should try this angle, you may have more luck. Also, going through my notes I get a strong feeling that there has been outside reasons for all three break-downs (the latest occurring just days after her grandmothers death), or at least for the timing of them. It is just a feeling, but as I said, it is a strong one, and I am starting to believe that reasons for the patient's depression, her break-downs and state of mind may be found by finding out what else happened at the same time.

I wish you (both) the best of luck.

Laura Jones

To Be Continued

~ * ~ * ~