damned_institute | Day 46: Doctor's Office 9 [Dr. Weaver] [Second Shift]

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Day 46: Doctor's Office 9 [Dr. Weaver] [Second Shift]

This place had more paperwork to fill out before one could actually see a patient than both Delphi and Saint Francis combined - and that was saying something. Between that and the shifts around to her office...she let out a heavy sigh. That had been frustrating, all right.

Finally, though, Dr. Weaver was ready to see her first patients. She finished writing some notes to herself on the whiteboard: the words 'Savato', 'Bliss', and GUILT' - then took a seat at her desk.

She tapped a few keys on her computer's keyboard, pulling up the young woman's file. Ounishi Kazuko. Age 17, from Tokyo, black hair, green eyes. Nozomi sighed a bit. There wasn't as much information in the patient file as she would have liked. That was a bit frustrating, but she supposed every place had their way of going about things. It didn't mean that she needed to like it; in fact, the opposite was true.

That was all right in the end, though. She didn't much like trusting blindly in others' notes, a lesson she had learned first-hand. She'd take her own history when the girl arrived.

She kept the one tab open, then tapped a few keys, opening up the file for her second patient. Amy Dumas. Age 25, blonde hair, blue eyes. She made a mental note to take a look at the woman's arm, noting the recent injury to it, and also noted the woman's past professional record.

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On the one hand, Hokuto had actually wanted this--after everything she'd been through lately, seeing a shrink sounded like it might be helpful. On the other, she knew very well that she couldn't be entirely truthful with any of the staff, which probably reduced the therapeutic effect of actually seeing a therapist. But she could compromise at least a little, right? Some help was better than none.

Presuming her doctor intended on at least pretending to help.

Not really sure what to do, she gave the woman behind the desk an uncertain smile. "Um... I'm Ounishi Kazuko. Nice to meet you." She could play along, for now. She needed to know how much she could say before the topic of her delusions came up--or medication. And the first session was about establishing trust, right?

"Dr. Nozomi Weaver," she answered, with a single sharp nod, and looked the girl over. She didn't see any obvious visible injuries, which was good. The next part would be easy enough, then: patient history. She made a few notes in her chart and then continued.

"Is there another name you would feel more comfortable going by, Kazuko-san?" It might be catering to whatever delusions they said the girl had, but they could both address that at a later time.

She didn't wait for the answer, instead, asking the next question. "I'd also like to hear a short version of why you think you're here, in your own words."

Eh heh... Hokuto did her best not to wince. I'm here because I couldn't let go of my old life yet, and this way I get to stay me for a little while longer. Even if it kind of is hell on earth. NO.

She went to sit down instead, trying to think. Maybe her file said she'd tried to commit suicide? And thought she'd succeeded? Since her goal in here was honestly getting some help, she sort of had a starting point... "My grandmother was worried about me," she said. "I wasn't... acting like myself. It's hard to when your dreams feel more real than the real world does."

Sorry, Kakyou. But the easiest story she could think of was exaggerating what he took her through.

That wince didn't escape her gaze. A few more keystrokes; the words 'Possible past trauma before arrival. Patient is reluctant to talk about it.' appeared on the screen. Was it that, or was it physical? Nozomi wanted to check.

"Are you hurt? It looked painful for you to take your seat," she commented, watching the way the girl settled into her chair. Muscle pain, an injury that wasn't noted, an infection. The litany of possible causes ran through her head for a moment.

"I see," she said, making a few more notes. "When you say you weren't acting like yourself. Can you tell me more about what that was like from your perspective?"

Hokuto said quickly, "Oh, no, I'm fine." After multiple nights of seeing little or no action, of course she wasn't hurt. "Just nervous." That you're here for your own reasons.

She hesitated again, not sure what to say. She could act well enough--it helped when the emotions were real--but it was hard not knowing how much she could say. At least it made sense for her to spend the first session seeing if she could trust her doctor.

"I got used to being in another world. I'm coming back from it now, but it's hard to let go." There, card on the table--she was grieving, and she wanted help dealing with that.

Dr. Weaver nodded. "There isn't any need to be nervous. But do tell me, if that changes - if you do get hurt. I believe in taking care of a person's physical pain as much as I do their emotional issues." The two were strongly interconnected, after all: controlled by the same neurotransmitters and manipulated by them, as much as anything else.

She typed a few more notes on her keyboard, then continued.

"Can you tell me about this other world? What was it like, and who were the important figures there?"

"It was a waking dream, where I could go anywhere," Hokuto replied softly. "Even any time--have you ever seen the day the world began? I did, with Kakyou." That part was a lie, but if they thought of it, they could have. Probably would have, eventually, when she ran out of other things to show him.

Thinking of him still made her want to cry sometimes; this time, she let her eyes fill with tears, but they didn't fall. "I know I can't go back, but even if nothing we did was real... I miss him. I'm trying to let go, but it's so hard..." Her voice was starting to waver for real. "I know I need to move forward, but I left behind so much."

Even if she claimed that she didn't have a lot of sympathy left in her, she nodded, something clouding her eyes for a moment. She took a box of tissues from a desk drawer and passed them across to her patient.

Grief related to traumatic loss. That translates to depression, with some psychotic features. Weaver didn't note that in Kazuko's file, but she kept it in mind.

"You and Kakyou-san had a close relationship in your dream world," she said, echoing her patient's words. "It's normal to grieve for someone that you've lost. I won't invalidate that."

At that point she stood, walking over to the whiteboard. "There is a theory that there are four paths one can take when faced with grief." She uncapped a dry-erase marker, and wrote as she spoke. "The four are resilience, chronic dysfunction, delayed trauma, and recovery. What I think would be useful is to work on moving you from the dysfunction to a state where you can be more resilient."

"It's not just him," Hokuto said softly, taking a tissue to wipe her eyes. "I feel like I left behind everything I knew; after I'm done here, I don't know... what's going to happen to me." Five minutes into the session and if she didn't watch it she was going to break down sobbing.

Wherever she ended up, she knew she would be okay--she could make new friends if she didn't know anyone, and it couldn't be worse than here. But... she didn't want to start over. Even more than saying goodbye to the self she was now, she didn't want to leave the people she knew. Not again.

...dammit. She grabbed another tissue and tried to get her breathing under control.

"Take a few deep breaths, Kazuko-san. Just focus on your breath - in through your nose, out through your mouth." She sat back down in her chair, making a few more notes.

Patient's trauma stems from loss. Guiding her through trajectories of grief, with focus on developing resiliency. She is intelligent and expressive.

She waited for the girl to calm down - for all that she believed in cool efficiency, she also believed in the Hippocratic oath, to never leave a patient worse than when they came in. Letting her calm down was for the best right now.

Hokuto didn't need the guidance to calm down, at least--she had plenty of practice doing that. She cleared her mind as best she could through her own breathing exercises, and that helped.

"It's all just a lot to deal with," she said quietly. She couldn't go into all of it for several reasons, but for the sake of healing, she didn't think she needed to. She'd told most of it to her friends here, and she was doing her best to deal with the rest of it.

Dr. Weaver nodded. "It certainly seems that way. It's normal to feel overwhelmed when you've experienced a loss, or when you're undergoing treatment." Sometimes things did get worse before they got better; it was a fact of life as much as it was a fact of medicine.

"I'd like to ask something, Kazuko-san. You mentioned a moment ago that you weren't sure what was going to happen when you left here. Ideally, what would you like to happen?"

Remember who I am, go back with Momo-chan, and figure out how to sneak into the living world to visit Subaru, Kakyou, and Falis once in a while. The first two were plausible, but the last one... unless she turned out to have some major, awesome, rare talent with kidou, it wasn't likely.

And because she wanted to present as someone who had stopped hallucinating, she couldn't say any of that. "I don't know," she said finally. "And it's--it's too scary to even think about right now." She managed to make her voice shake as she said it; that topic needed to be off-limits.

"I won't force you." This wasn't malingering she saw in Hokuto's face; it was honest anxiety and fear. She noted that in her chart with a few quick keystrokes. "This is still the first session. I don't want to push things too fast."

Last night hadn't been bad, and this morning had started out alright. Considering where she was, being able to think both those things at once pretty much amounted to a good day. Sheena had even smuggled her a bit of fudge during breakfast. Where that girl got it, she had no idea, but she wasn't going to complain; in fact, she wrapped most of it in a napkin and had it hidden in her pant pocket. She was milking that thing for all it was worth.

Of course, nothing could ever stay good in this dump. Rather than being carted off to the Sunny Room like normal, her nurse told her she was going to be seeing one of the docs. Not the old grump from last time, but a new one. Cause, you know, that was exactly what she needed right then: some hack college-grad who thought memorizing textbook definitions made them a doctor and was more worried about paying bills than actually helping anyone. Sigh. They were all the same.

As soon as the nurse sent Harley in, she gave the woman behind the desk a once over, openly looking her up and down. Young. Stiff. This could be interesting. "Mornin' Doc," she said with a sort of patronizing chipperness. "What's on the agenda today? Word association? The ol' Inkblots? ...New corporate sponsor meds?"

Ooo! Ask her to draw a picture. She was sure she could turn out something that would get this lady nice and expressive~!

Oh, dear. This...was going to be different. The doctor didn't flinch, though, instead, typing a few notes on the patient's...creativity. When she finished, she looked her over.

"Actually, I'd like to start with the basics before we get into therapeutics. First off, I'm Dr. Weaver. And is there a name you'd prefer me to call you?" Second, she really didn't care for corporately-sponsored medicine unless she had the time to do the research on it herself, but Dr. Weaver kept that to herself.

"I'd like to take a look at your arm, too, but before that, I want to hear your history in your own words."

For a few moments, Harley actually thought the 'good doctor' had decided to ignore her in favor of her work, and there was no way something like that was going to go over very well. ~~Unfortunately~~ Thankfully, the woman responded before her patient had time to think of more creative ways of gaining attention. So she wanted to play it casual, did she? Introductions, light conversation, a bit of the ol' buddy-buddy act. Ahhh, good times.

She put a hand to her chest like she was oh-so-touched that the doctor would be so considerate to ask. "Me?" Insert big grin here. "You can call me Harley. Easy enough to remember, right?" As for this Weaver kid, well, 'Doc' would be a good enough name for her.

Harley decided to help herself and plop down into the chair before the desk, bending her leg so one foot was up on the seat with the rest of her, while the other was on the floor like normal. Something flickered in her expression for a moment at the mention of the wound on her arm. What, was that supposed to pass for concern? Was Harley supposed to feel like the doctor cared about her all of a sudden, so she could open up and spill her guts?

She folded her hands on top of her head and she looked up at the ceiling as though deeply contemplating how to answer her question. "We-e-ll, let's see." A whimsical sigh came out. "It all started when I was a child~. My parents were acrobats in the circus. They let me dress up and pretend I was a clown and wander around the circus tents with them. The one day, the lion broke free and ripped them apart. I had to lie in their intestines to keep from being eaten, too. Ever since then, I can't see a yellow kitten without throwing it out a window."

That's not right! The name, perhaps, but...not the history.

"All right, Harley." She thought for a moment. She wasn't well-versed in art therapy - while she had certainly done research into cognitive-behavioral therapy and dialectical behavior therapy, this was...something else. But, Dr. Weaver decided it was worth a shot.

"I...see." Her words were even, careful. "I'm sorry, but can I ask you to draw out your history for me on the whiteboard? I just want to make sure that you're not remembering a movie." Or a delusion.

She handed Harley a set of dry-erase markers. She didn't know how this would go, but she wasn't getting through with simple talking. It was worth a shot.

Wasn't she just precious~? She was really taking her seriously. Skeptical, but still serious. This had the potential of being very entertaining, especially now that the doc had proposed an activity. Harley let out a little excited squeal and took the markers immediately, bouncing up and out of her seat as she did so. She went over to the dry-erase board and looked at it up and down for a few moments, unsure where to start exactly. She glanced over her shoulder and frowned slightly at the doctor. "No peeking, 'kay?"

Harley turned back, unable to see if the doctor was actually respecting the wish or not. She quickly upcapped the markers and got to work, sticking her tongue out one side of her mouth in concentration. For a few moments, the room was completely quiet outside the slight squeaks and thumps of pressure the marker tips made against the board. Finally, she stopped and whirled around on the balls of her feet, stepping to the side to reveal her "work:" a collage of cartoony looking figures, symbols, and images scattered seemingly at random over the wide space. Many of which seemed unrelated to her story.

"Okey dokey! This is the Mommy and this is the Daddy!" she said, drawing a circle around two clownlike figures, one blonde and one with green hair, who seemed to be garbed as astronauts. "And here's the baby" Said baby was an armless version of the female restroom symbol. "These are the tents! They're dirty, see? We lived in a poor circus. It was in the woods where it was really dark, like in red riding hood."

"Mommy~! I'm hungry! Gimme food!" She suddenly shifted her voice to a very horrible attempt at a manly voice. "Nuu, we're not done swinging on things yet. Oh come on, pleeeaaase? Rrrr! Alright fine. Shut up already. Just wait there. Yay~!" Her voice suddenly shifted to a high pitched munckin voice to represent the mother. "Oh hey! Let's walk over here for no reason! Okay, let's do that then. Doo dee dooo. Oh my~! What's that?"

She drew an arrow from the "lion" (which was apparently a big black blob which looked nothing like a lion) to the "parents." Harley suddenly assaulted the parental figures with the red marker, scribbling over it and play acting a scream with her munchkin voice. "Ahhh~! Noooo~! Help me, help meeeeeee~!" Despite the subject matter, she had a huge grin spread across her face and seemed to be having fun.

Edited 2009-12-17 20:22 (UTC)

Dr. Weaver's fingers moved rapidly over the keys, typing up everything that Harley was describing. The wheels began to turn in her head: psychosis, delusions, possible schizophrenic ideation, with fixation on this circus theme. That could wait, though, because she saw a starting point in all of this.

...at the same time, she couldn't help thinking that she needed to prescribe some antipsychotics and possibly something for attention-deficit disorder. It took a lot to push the potential pharmacopeia out of her mind, though.

Some doctors would be thinking of a bullet to the head.

"Were your parents abusive at all? It sounds like that's what you're describing, with the baby crying out and the parents ignoring her. Did that happen a lot before the accident?"

The wide smile and fun atmosphere seemed to fade away and Harley's expression made way for surprise. "Wha...?" She seemed to shrink into herself a little. Her shoulders hunched up and her hands were held together in two loose fists near her mouth, as though she were fighting the urge to hug herself. "How did you...? I-I never told anyone that... I mean--!"

She seemed taken aback by her own words, "N-No. They weren't. They didn't! Not at all!" A brief pause, perfectly timed with a brief look away. "...W-Well. Maybe a little bit. Sometimes. But... Ohhh, I don't know if I can talk about it. It hurts too much to remember!" Her hands covered her face, more like she was blocking her vision than containing tears.

She'd like to thank the academy...

While her features remained cool and calm, the doctor was certainly taken aback by the sudden shift in mood. She noted the way that the woman was covering her face - there was no need to take out the box of tissues. She was hiding her vision, certainly, but not actually crying.

Dr. Weaver normally wasn't one for the idea of medicating a patient more than was necessary. She was used to the cool precision of an operating room, her tools, the satisfaction of a job well-done. While she could certainly handle a sudden change in a patient's condition, which happened more often than she liked but was no less troublesome, a sudden change in their mental state was something else completely.

If she had easy access to an fMRI scanner, she might have used it then, but the hospital lacked one. She frowned at that thought, then spoke again.

"The way you spoke about them just now, particularly the 'Shut up already,' and the way they seemed to neglect you were clues. You expressed quite a bit in your drawing. Do you think it would be easier to draw out a bit more about that than to talk?"

She blinked in apparent surprise at the explanation, fingers touching her lips in a moment of speechlessness. "Oh, wow! You're good! You could tell all that from what I said? That's amazing!"

Harley looked back and forth between the board and the doctor as though contemplating whether it was really okay to continue. What with her being in such a delicate position at the moment. But she finally took up the marker again, a bit more sheepishly than before.

This time, she used only the black marker and quickly sketched out a few images to represent her apparent childhood trauma. One looked like a door with cartoony lines coming from it to indicate sound was coming from the other side. Another was a big, old-fashioned looking oven with an apple sitting on top of it. Then a very angry looking dog-like thing that was supposed to be barking. Last was a clock, hands set to 11:45.

Harley capped the pen, stuck a finger in her mouth, and simply stared at the doctor. She looked as though she was afraid of explaining the images outloud. Inside, she was trying not to laugh. She wanted to see what kinds of conclusions the doctor would come up with by looking these over.

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Day 46: Doctor's Office 9 [Dr. Weaver] [Second Shift]

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