Notes: This fic makes reference to the events of Constant Bearing, Decreasing Range, Delta's Heart and Postscript. For the best experience, read them first.
On with the show!
Transcript Property of Manhattan Psychiatric Center
Session Date: July 9, 1970 10:35 AM
Recording by Dr. C. Tompkins
Names withheld for privacy.
CT: Welcome, welcome! Do come in, make yourself comfortable. Ah...I'm sorry, I hadn't realized. Let me just...
[scraping sounds]
CT: There we go. Is that big enough? Should I…? Oh, you've got it. Right on. Ahem. So...I'm Dr. Tompkins. Friends call me Charlie. If you like-
DK: I'd prefer not to, thanks.
CT: Right. Whatever makes you comfortable. We're all about...comfort, here. Anyway, Mr. K_, right? Do you mind if I get some medical history first? I've got your record here, but...well, it's like swiss cheese, if I'm putting it nicely.
DK: Oh, I was out of the country for a couple decades. I can't imagine that would help.
CT: Ah. I'd say not. Current medications?
DK: Uh...hang on. I think I'm down to three mg of Azathioprine. Five mg Prednisone. Propranolol. That one's...40 mg. Twice a day. I've got Fentanyl if I need it, but I never need it bad enough to justify the dizziness.
CT: Know the dosage?
DK: I forget.
CT: That's okay.
DK: I usually just pop an aspirin instead. I probably shouldn't, but…
CT: 300 mg?
DK: Yes.
[humming]
CT: There we go. Uh...major surgeries?
DK: Oh, that I do have. Here. We're going to be here for hours otherwise.
CT: Oh, good. Let me skim through this real fast.
[recording shuts off]
CT: Fishing accident, huh?
DK: It was a really big bass.
CT: I...see.
[pause]
CT: How about family members?
DK: A daughter. We finally got the adoption finalized last year.
CT: Congratulations!
DK: Thanks.
CT: How old?
DK: Eighteen.
CT: Got it. Spouse? No? Parents? Siblings? Just you and her, then?
DK: That's right.
CT: Uhm-hm.
[pause]
CT: So...now that we've got that out of the way, ah, what is it that you hope to achieve in therapy?
DK: I...well...hmm.
[pause]
DK: I'm sorry, I...don't really have any idea what I'm doing here. It was my daughter who put me up to it, see. She's heading off to LIU in the fall and was...well, overly concerned. About leaving me by my lonesome. It's not that far and she'll definitely be able to stop by on weekends, if she wants, but still...it's been a while since I've lived alone.
[pause]
DK: But I've done it before and I'll do it again just fine, thank you very much, was what I told her. That was how it should have ended. Oh, but then she had to mention it in front of T_ and the next thing I know I'm paid up for six sessions and the both of them are carting me out the door without so much as a howdy-do.
[sighs]
DK: So here I am. I'm sorry again, but...I don't think there's anything you can do for me here.
CT: And why's that?
DK: Why's what?
CT: Why don't you think I'd be able to do anything for you?
[pause]
DK: I don't mean any offense by it. Really. I'm sure you're a fine doctor and all, but...it's not like I can let you in on what happened, exactly.
[pause]
DK: Er...on the...fishing trip. And even if I could, it's not like you or well, anyone would believe me.
[scoffs]
CT: You think so? C'mon, try me. I've seen some wild cases in my day. I guarantee you - ya can't shock me.
DK: Hmm.
DK: The last therapist I saw tried to kill me.
[pause]
CT: Okay.
CT: Emotionally or...?
DK: Oh no, it was bombs.
CT: What…how...? Why on earth...
[incoherent sputtering]
DK: See? And that was a tamer attempt on her part, honestly. There were...a lot of them. She didn't give up easy.
DK: Got me once, too, if you ah...wanted to hear...that bit. Feel like checking me in upstairs now? Or should I just...go? I did have some shopping to do, if you don't-
CT: First off, that's bad therapeutic practice.
DK: What, killing me?
[clears throat]
CT: Second...suppose I do believe you.
[pause]
CT: Suppose that while you are in this room, everything you say is taken as fact, if you believe it to be such. I won't judge.
[pause]
CT: Our sessions will be kept absolutely confidential, of course. What's said in here stays in here. Your records will be sealed and if need be-
[recording cuts off]
CT: Would that be...acceptable?
[pause]
DK: Perhaps.
CT: And if you're not into it by the end of six sessions, hey, feel free to never darken my door again. Deal?
[pause]
DK: But...I still don't know where to start. O-Or...how to explain. It's been so long since I even...
CT: Hey, it's alright. You don't have to spill your guts to me on the first go. We're getting comfortable, remember? Why don't we start with this T_? You implied that he-
DK: She.
CT: ...that she paid for therapy, right? And you didn't seem pleased about it.
[sighs]
DK: It's just...T_ pays for everything. The apartment, the groceries, my surgeries, the physical therapy, the speech therapy, E_'s tuition, every single useless, silly thing that brings us a little happiness. If I so much as breathe a word about something, anything at all, I open the door the next day and there it is.
CT: E_ is your daughter?
DK: That's right. You know what it was the other day? A European Fan Palm. Where the hell am I supposed to put a European Fan Palm? It's living in the bathtub now but god knows that's not sustainable.
CT: Oh. That's...huh.
[pause]
DK: I should be grateful. I want to be grateful. We'd...well, we'd be in a lot worse straits if it wasn't for her. But it's not like I can work, right?
CT: As a...oh, you were a Seabee. Had an uncle in there during the war.
DK: An engineer. Submersibles. And I've been a handyman before. And an electrician and a welder...I like working with my hands. If you let me take it apart, I can probably figure out how it works.
DK: I just...I feel so useless now. Like all I can do is wait for...I don't even know what.
CT: Sounds like you're used to taking care of yourself.
DK: Yeah.
CT: It must've been hard, switching over to being cared for by others.
DK: ...yeah.
CT: There's no shame in it.
[pause]
DK: I'm not angry at T_ for helping. She's just frustrating, sometimes. Her way is the only way. I think...she feels responsible for what happened. On the...fishing trip. Oh, it's not all her fault. There's a carousel of blame to go around. But…
DK: She was the one steering the ship. I don't suppose I can entirely forgive her for that. And...she knows that. So she bends over backwards trying to make it right, whatever way she can. My daughter and I - we're not the only survivors. She's got a trust fund for every single one of them she can find. I'm sure we're not the only ones with a European Fan Palm in our bathtub.
CT: Other survivors, you say? Do you keep in touch?
DK: Well...I tried writing one of them, once.
CT: And?
DK: He never wrote back.
CT: That's too bad.
DK: I get it, though. I'm not sure if I'd want to talk to me, if things were the other way around.
CT: Why not?
[pause]
DK: The whole thing's best forgotten. I don't like being reminded of it. I focus on other things. If I got a letter from a person who'd been through something similar to me, I'd have a hard time reading it.
CT: But you haven't forgotten, have you?
DK: No.
[pause]
CT: How do you feel about doing some homework?
[pause]
CT: Write him again. Just one more time. Okay?
DK: Maybe.
CT: Ah, what's next...how about your daughter? LIU, huh? You must be proud.
DK: She's so smart. Even if she did need to spend a year playing catch-up.
CT: Why the catch-up?
DK: She...grew up isolated. Very isolated. There was so much she needed to learn about society, about the world, before she could be comfortable living in it.
CT: But...weren't you the one who raised her?
DK: Not really. At least, not for very long. We were...hmm…assigned to one another when she was young. Like a babysitter. But…more. I can't remember how long, exactly, but it couldn't have lasted more than a year.
CT: It was...some sort of foster parenting program?
[pause]
DK: You could say that. Except...well, it was compulsory, on my part. Uh. On...her part too. Am I making any kind of sense?
CT: This happened when you were out of the country, right? Under a foreign government? So...they pressed you into a compulsory foster parenting program in which care of E_ was assigned to you. Am I on the right track?
DK: Hey, that's not bad. I should use that line myself sometime.
CT: Thank you, thank you. I try to make myself useful.
DK: Anyway...her mother ended up in the bas...uh, the jailhouse and the...the government handed her over to me while she was away. Again, it didn't last long. We only reconnected three years ago. It's been in paper for less than half that time.
CT: Huh. But you do seem to care for her a great deal, despite not having had a choice in taking care of her.
DK: It was her choice to find me again. She…
DK: Well, she chose me over her mother. A real piece of work, that one.
CT: She still in the picture?
DK: Dead.
CT: Ah.
DK: She's the only family I have left.
[pause]
CT: Do you feel like she's leaving you behind to go to college?
DK: What? No! I'm so happy for her. I'm so glad she's moving on with her life and finding places to fit in and...it was such a hard road for her. She's come so far.
CT: But what does home life look like for you once she's moved out?
[long pause]
CT: Why don't you think about that for the next session? And don't forget about your homework!
DK: Right. Uh...see you next week, then.
[recording shuts off]
Session Notes:
The patient is well-dressed, clean and articulate, despite his other eccentricities. Among them, the wearing of leather gloves indoors, in July. The medical record he presented showed no sign of injury to his hands that might justify it.
I am ambivalent about encouraging his delusions. Most worrisome is the claim that he has died before. A possible sufferer of Cotard's Syndrome? This bears further investigation.
However, I found my actions necessary to establish trust in the doctor-patient relationship. I do not believe that he could have been willingly retained as a patient otherwise. He appears to be no danger to himself or others and I see no reason at present to encourage inpatient therapy.