A/N: I know there is a lot going on here. It's the only chapter like this. I have struggle with it how to make it better, and in the end, to get the point across I'm trying to, I don't know what else to cut/edit/make easier. I guess the problem is with my autism, sometimes when you begin researching something, you get caught up in the weeds, and maybe I did this time. Anyway, thanks for sticking it out thus far, and I hope you will continue. I have nothing else written on this at this time. Hopefully I will soon. Again, thank you all for the love and support you've shown me in my time here in Chuck fanfiction.
Disclaimer: I don't own Chuck
Zondra sat patiently, wondering if Chuck was going to answer. Sarah sat there, feeling the nerves radiating from him. This was his moment. She knew she shouldn't speak for him, but the tension was building in the room. She started to speak, when he finally blurted out "Am I ever going to have another seizure?"
There it was.
Zondra gave a slight nod, knowing that was his worry. "The honest answer is, I don't know. If we do nothing, possibly," she told him. Chuck hung his head. "Now. I'm going to give you the good news. I don't believe you have epilepsy."
Chuck's head jerked up, confused. How could he have a seizure again, and not have epilepsy? "I don't understand," he admitted.
"Do you think it's non-epileptic seizures?" Sarah asked. Zondra nodded, and Sarah smiled.
"Why are you smiling? I don't understand," Chuck said, feeling very confused.
"Do you remember our talk the other day?"
"The one where you chewed my ass out?" Chuck asked. "I might have a brain injury Sarah, but trust me, forgetting you getting that pissed at me? No, that's not something I would forget." She squeezed his hand, grinning at him.
"If you two are done flirting," Zondra began.
"I wasn't-" Chuck began.
"Sorry," Sarah said at the same time. Chuck looked over at her, and she just shrugged and giggled.
"Chuck," Zondra said, making him turn back to her. "I need to explain some things, okay?" Chuck nodded. "So first, flashing or patterned effects can make people with – or without – epilepsy feel disorientated, uncomfortable or unwell."
"So, that card could have done that to anyone?" Chuck asked.
"Possibly," Zondra admitted. "Let's just say, I believe that there are other factors at play that I will get to. But you had all the ingredients mixed, and what happened lit up your brain like the house from National Lampoon's Christmas Vacation."
Chuck's eyes widened at that. "Okay," he said, nodding.
"The first thing I wanted to do was check you for Myoclonic seizures. They are brief, shock-like jerks of a muscle or a group of muscles." Zondra paused. "Let me get a little technical here." Chuck nodded. "Myo means muscle and clonus means rapidly alternating contraction and relaxation – jerking or twitching – of a muscle. With me so far?"
Chuck nodded. "I am," he replied. Grinning, he turned to Sarah. "You with us?"
She gave him a flat look. "Watch it, Bub," she said, chuckling. Chuck turned back to Zondra, who was shaking her head.
"Usually, they don't last more than a second or two," Zondra continued. "There can be just one, but sometimes many will occur within a short time." She paused for a second. "Have you ever been almost asleep, and a muscle just spasms?"
"Oh, God yes," Chuck replied.
"That's myoclonus," she explained. "You don't have to have epilepsy to experience it. You can experience myoclonus in hiccups, or in that sudden jerk that may wake you up just as you're falling asleep. These things are normal." She leaned forward. "What I wanted to do was rule out these seizures were because of epilepsy."
"How did you do that?" Chuck asked.
"Remember the night of that test that went all night?" Chuck nodded. "We were watching your brain. If you had myoclonic epilepsy, your brain… it would have lit up, like tiny lightning bolts randomly appearing all over it."
"Did it do any of that?" Chuck asked.
"No," Zondra told him. "And that's what led me to what Sarah mentioned, Non-Epileptic Seizures. Unlike epileptic seizures, non-epileptic seizures are not caused by physical disorders of the brain. Rather, non-epileptic seizures may result from traumatic psychological experiences, or unusual stresses."
Chuck glanced at Sarah. "So, you'd have asked anyone about their past in that scenario?" Chuck asked.
"Yes, but you're the only one I wanted to hold afterward, and comfort," she replied. She batted her eyelashes at him, making him and Zondra crack up.
"Jesus," Zondra muttered. "Anyway, NES symptoms are most often similar to those of a generalized epileptic seizure." She began to tick them off her fingers as she listed them. "Convulsions. Crying out or making a noise. Stiffening. Jerky, rhythmic, or twitching motions. Falling down. Loss of consciousness. Confusion after returning to consciousness. Loss of bladder control. Biting the tongue."
"Did I piss myself?" Chuck asked.
"No," Sarah replied. "Although, that would have been better than BREAKING YOUR SKULL AND HAVING MORE SEIZURES!"
"When you put it that way," Chuck muttered.
Zondra shook her head some more. "Do you two need some alone time?"
"Am I cleared for that?" Chuck asked. "She doesn't want me to be alone."
"That may not be the doctor in her," Zondra replied. Chuck's eyes widened, and glanced over at Sarah, who was looking at the diploma on Zondra's wall with her lips twisted to the side. He knew that look. He had no idea how his brain knew that when Sarah was amused, she twisted her lips away, but he knew it.
"Back to your broken brain," Zondra continued.
"That's really not nice," Chuck told her.
"I was talking about it being broken because how you feel about her," Zondra replied.
Chuck opened his mouth a few times to retort but nothing came out. "Continue," Sarah piped up. "He can still hear."
"NES can also be similar to partial seizures," Zondra continued, as she began to tick things off her fingers again. "These symptoms may include jerky or rhythmic movements. Sensations such as tingling. Dizziness. Feeling full in the stomach. Repetitive motions. Staring. Confusion. Changes in emotions. Altered senses."
"What about weird-ass dreams?" Chuck asked.
"I'm pretty sure that was your brain trying to protect you, while you were unconscious," Zondra replied. Chuck nodded. "When I reviewed the causes and risk factors of NES, and I literally could find nothing on any test that showed epilepsy, it became quite apparent that it was NES."
"What are the causes and risk factors?" Chuck asked softly.
"May I?" Sarah asked. Zondra nodded. Sarah turned to Chuck. "So, NES is most often caused by mental stress, or a physical condition. So, it could be a heart condition that causes fainting, diabetes or other metabolic disorders, emotional pain." She gave him a look with that one.
"I could see that one," Chuck agreed.
"Mental pain," she continued.
"My mom is a mental pain," Chuck muttered.
"Being bullied." Chuck winced. "Physical or sexual abuse. A major accident."
"Like hitting your head on the bedframe?" Chuck asked. Sarah nodded.
"And I found this part fascinating, especially after what you told me about the Intersect, and why you had trouble 'flashing'," Sarah said, getting excited. "NES is most common in women, and is also more common in people with other conditions such as depression or anxiety. So, think about the talk we had about the corpus callosum and women. Is that a coincidence?"
"Is it?" Chuck asked. Sarah shrugged. "You know that's not the best sign from a doctor, right?" Zondra and Sarah laughed. "What?"
"Chuck, the diagnosis for many things as a doctor is usually ruling things out," Zondra told him. "When someone has a seizure, the first thing we do is run tests for epilepsy. The most useful test in confirming epilepsy is an electroencephalogram (EEG). This records electrical activity in the brain, including abnormal spikes in electrical activity patterns. Different types of epilepsy can be identified with these patterns."
"The lightning bolts?" Chuck asked. Zondra nodded.
"So, a patient with NES will not show unusual electrical activity in the brain on the EEG," Sarah continued. "We may also then run Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scans to look for epilepsy, as well. However, these tests are not very helpful for NES."
"Then," Zondra picked up, "blood tests may be used to look for underlying conditions such as diabetes. I've done everything I can do. If it is NES, and I suspect it is, the next step is for me to refer you to a psychologist for further diagnosis and treatment."
"Psychologist?" Chuck asked. "I thought we just agreed it was because of me hitting my head on the bed?" Zondra gave Sarah a look.
"So, you want me to do this?" Sarah asked.
"No, I just thought maybe you'd rather than me," Zondra admitted.
"Okay," she said blowing out a breath. "Let's walk through the normal treatment." Chuck nodded. "Psychotherapy is the most common treatment for NES. This may include cognitive behavioral therapy (CBT). CBT examines the connection between a person's thoughts, and their feelings and behaviors. CBT and other psychotherapies take several months to work. It is important that the patient continue their treatment plan during this time."
"AKA don't be alone?" Chuck asked her. Sarah pressed her lips together and nodded. "What about medicine?"
"NES does not respond to anti-seizure medications. However, medications for depression or anxiety may be used as part of the treatment plan," Sarah told him.
"Okay, I understand what you are saying. My question is, why do you two think I need a psychologist?"
"Actually, if you need medicine, you'd have to see a psychiatrist," Zondra pointed out.
"You think I need meds?"
"I don't," Zondra replied.
"I don't either, but I think there are some things you need to talk about, and work out," Sarah told him. "Chuck, you are hurt to the core with what your mom did to you. You even told me you felt lost, before the accident."
"I did… I do," Chuck admitted.
"And there's nothing wrong with that," Sarah told him. "You might never have another seizure if you don't go, but you also might."
"Are you about to play the girlfriend card?" Zondra asked.
"How the hell can she play the girlfriend card?" Chuck asked. "She's not my girlfriend."
Zondra didn't say anything… she just sat there, amused. Chuck turned to Sarah, her face a mask. "I didn't mean… I… there's nothing I can say here, is there?"
Sarah burst out laughing. "Stand up," she told him. He stood up, and she did as well. "Okay," she began as she took his hands in hers. "It is your decision."
"This sounds like something Ellie would tell me, before she got me to go do something," Chuck muttered. Zondra chuckled.
"I'm just saying, I would feel better… Zondra would feel better… your sister would feel better…"
"That's just low-down and damn dirty," Zondra commented.
"…if you would go for a few sessions and work on things, just so we know that you have dealt with whatever is going on in your head that may or may not have caused you to have a seizure," Sarah told him.
"If I do, would you forgive me for the earlier girlfriend gaffe?"
"How can it be a gaffe?" Sarah asked. "I'm not your girlfriend."
"It is an old-fashioned term," Chuck began.
"I like it," Sarah said.
"That should be used more," Chuck said quickly. Zondra snorted, and Chuck ignored her. "I will go, but I am concerned about having to have people stay with me."
"Are you literally trying to ask her to spend the night?" Zondra asked, clearly amused.
"No!" Chuck said quickly.
"What if I offered?" Sarah asked. Chuck turned, his eyes wide. "I mean, Carina spent the night."
"That was different," Chuck began. "Listen, I will follow your advice, and thank you. Thank you both," he said, turning to Zondra.
"You're welcome. I'm glad it's not epilepsy."
Chuck turned back to Sarah. "It's not epilepsy," he said, grinning. He threw open his arms. "Hug?"
Sarah shook her head, reached up and, grabbing his shirt and pulling him forward, kissed him. Chuck realized at that moment, that while dream-Chuck might have kissed dream-Sarah, it had nothing on the real thing.
"Wow," he heard Zondra mutter, but she seemed to be a million miles away.
He felt Sarah pull away, and he did the same, blinking.
"What do you think, doc?" Sarah asked. "Is he cleared for some light workouts?"
"I think you already gave him a light workout," Zondra said, laughing. "Yes, absolutely."
Sarah turned to Chuck who was grinning dumbly. "Good," she said. His grin grew.
A/N: There you go, the most technical gobbly-gook chapter that will be written. While I may have some therapy chapters, they won't be anything like this. I'm sorry. I hope I didn't bore you to death. Thank you for following and all your support over the years.
