The Doctor is Out
Dr. Carter Burke really believes in his role in helping first responders in dealing with job related stress caused by having to deal with the results of human suffering. The responders that visit him live every day with war injuries. Maybe not the same as the men and women dealing in the battlefields overseas. But dealing with the urban battlefields at home. The battlefield of the streets. Car accidents, victims of fires, victims of shootings, robberies, and other violent crimes. These responders who need to decompress so they can cope with the ugly world that they see around them everyday.
He occasionally sees a first responder also as a patient One who is at the same time, a victim of a violent crime This time, the victim is Detective Katherine Beckett NYPD. She was suffering from PTSD after being shot. At first she refused to admit to the diagnosis. Then, as she spiraled out of control, she recognized it herself. When she finally regained control of that situation, she admitted to another issue that she was burning thru her soul. The new issue was actually a long standing one. One that began several years before. That issue was more of dealing with a person. That person was Richard Castle. A man who loved her. A man who loved her despite any and all of her shortcomings. A man who loved her in spite of the fact she was doing everything she could to shove him away. The man who told her he loved her while she lay dying on the ground with a bullet in her heart. The man she wanted to love but was refusing to admit it even to herself.
When she finally realized she was ready to move into that relationship and to be with him, she realized that it might be too late. He had started dating other women. Then he started shadowing other cops. He was pulling away from her.
But Dr. Burke was able to convince Kate that she needed to make her move. After the last time she left his office, he had not seen nor heard from her. He was not sure what might have transpired good or bad. He was hoping that for her sake what ever happened that it turned out for the best. He was hoping that the lack of visits from her was good news.
His assumption that for Kate Beckett it was good news was confirmed by a comment from another patient when she referenced Katherine Beckett as Katherine Beckett-Castle. With that name he is accepting that Beckett and Castle did in fact get over any and all obstacles in the way of them having a relationship and in fact got married.
However, his happiness that Kate was no longer in need of his help was dashed by the very patient who named Kate, Beckett-Castle. This patient, a federal employee, had issues of her own. Deep seeded issues that seemed to culminate with her desire to emulate Kate and in fact seemed to threaten Katherine's relationship with her new husband. She was correct that she even looked like Katherine Beckett. Dr. Burke had avoided questioning the apparent similarity between the two women. His records gave their ages and they were too close to be sisters, yet were not the exact same day indicating twins. However this patient and Kate could easily be identical twins.
But mental health professionals have a code of conduct they must live by. At the very top of that code is patient confidentiality. They can never ever disclose information about a patient. Even if that information might affect another patient in a negative way. Silence is paramount. This confidence naturally places all the weight on the shoulders of the therapist.
Sometimes they might come upon information that they know can be harmful, but the law is clear as to when and under what circumstances information must be given to law enforcement and when the therapist must keep patient privacy sacred .
Even considering the confidentiality of the patient therapists do sometimes need to talk to one another and unload. Dr. Burke is no different. He likes to visit with a specific colleague and peer.
This is one of those times Carter Burke visits with his best friend Dr. Charles Bourke over coffee or a meal. These two met each other in graduate school. Carter Burke decided to become a therapist specializing in adult mental health and was able to contract with the government to help with "Critical Incident Stress Management" while Charles Bourke choose to go into marriage and family practice. At least in choosing different specialties, they tried to keep the confusion as to who was who to an absolute minimum since their names were even pronounced the same.
To add confusion to the situation when they set up their practices, they rented space in the same professional building on the west side of Manhattan. On was on the 4th floor, the other on the 8th.
Today, Carter calls Charles and they plan to meet for dinner at a small steak house just a block from their offices.
After they are seated, Carter speaks up "Charles, have you ever had a patient state that they wanted to die?"
"Of course!" He chuckles "Most teenagers want to die just because their parents drop them off at school. Why?"
"I have a patient who said she wanted to die"
"You told her that you couldn't help her right?"
"Oh yes, but she revised her statement that she wanted to die on paper so she could disappear. I told her I could help her mentally, just not physically."
"That makes sense. How did she take it?"
"It was a bit unusual. She said she wanted to become someone else"
"Again, that is not unusual"
"Only, this time she has a specific person she wants to become"
"Some important movie star, TV actress?"
"Actually, she has a specific person she wants to become. The problem is that she could be a twin to this person. Her comment to me was that she could even fool the woman's husband"
Dr. Bourke laughs "I think that imitating a man's wife would be the hardest thing to impersonate. Don't you?"
"Absolutely! But I think in almost every other area, this woman could substitute for my other patient"
"That is scary. By the way, have you asked either patient of they knew of a possible sister?"
"No, because according to their records they are 6 months apart in age. That makes it completely impossible to be siblings"
"Of course if that is the case. That is a very interesting case. So Calvin, any other interesting cases we can cure over a nice filet minion today?"
"No Charles. How about you?. Any unruly teenagers giving you extra grief today?"
"No, but it is making me burn the midnight oil keeping up with my therapy notes. I am going to have to go in to the office after we leave here and finish some paperwork"
"Well, I don't envy you. I have had to do that myself more than a few times"
The two finish their dinner and say their good nights. Dr. Calvin Burke heads up town to his apartment while Dr. Charles Bourke heads back to the west side to his office. He wants to finish before 10:00PM so he can get home at a decent hour and go to bed. He likes to get up early on Sunday morning to go to the 8:00 AM services at his church.
He takes a cab to his office.
Just as he enters the elevator and the doors start to close a tall distinguished gentleman enters the cab and presses the button for the top floor. During the ride the man looks over and speaks
"Excuse me? Are you Doctor Burke?"
Without knowing what spelling the man was using, Dr. Charles Bourke answers "Why yes. Yes I am" These are the last words Charles Bourke ever speaks
A note to my readers
Critical Incident Stress Management
Is Real! It is in fact being used in several cities around the country to help our first responders.
The men and women who respond from the police and fire departments see the worst of the worst everyday
and eventually they need to decompress. If they don't get to unload. it builds up inside them and sooner or later
they burn out and can no longer do the job that they once loved. I have met several of them who got burned out
And I also got to meet those who help them "get it off their chest" so to speak.
Remember these great men and women who face the worst so you and I get to see the best in our respective communities