Charles Balis' Journal for the Week ending 7/11/97

Saturday, July 5, 1997

Sunday, July 6, 1997

Monday, July 7, 1997

12 pm. Eleventh Session with Cassandra Evans. Cassandra came in after about two months of no contact. Other than being a sounding board for Cassandra's frustrations, I'm afraid that I am unable to offer her much in the way of treatment. But I'm glad to be of help, even in a minimal way--perhaps I can help allay her distrust of the medical profession in general. She is still suffering acutely from CFIDS, but has developed a series of coping strategies. Her relationship with David is still strong--he seems to have the ability to make her laugh at her own irritability, which removes a lot of stress from their relationship. Cassandra is still seeing Dr. Halsey, and thinks highly of him. But she has decided to also seek treatment from a chiropractor. I've met very conscientious chiropractors in the past, but the field also seems to attract a number of quacks. From her description, the guy sounded like he might fall into the latter category. She said that, aside from having a general distrust of modern medicine, he doesn't believe in germs, thinking instead that all maladies come from back alignment problems. But Cassie is having back pains, and his treatments seem to help that a little, so I didn't dish the guy. Cassandra is also having problems in getting Social Security to recognize her malady as a disability. Cassandra brought in an article about a 40 year old woman suffering from CFIDS who sought Kevorkian's help to commit suicide. Cassandra clearly identified with the woman, although she evidently has no plans to commit suicide herself. Cassandra is still troubled by recurring dreams, and has taken to keeping a dream journal. After hearing Cassandra's dreams about the black and white rats that she told me about during her last session, David purchased a porcelain figurines representing those rats, and the dreams disappeared. Cassandra notes that the dreams seem to go away when she has learned whatever it is that she thinks she was supposed to learn from them. So that dream has been replaced by a new one, where she is mountain-climbing with some friends, but has inadequate equipment and falls a long distance, finally landing hard. She is blinded by the fall and regains consciousness with unseen things pecking at her. Her screams are muted. She has difficulty dragging herself awake. Cassandra felt that the inadequate equipment was the CFIDS, the falling was despair, the blindness was a feeling of having lost her way, and the pecking was the doctors trying to analyze her medical problem. By the end of the session, Cassandra was clearly getting exhausted, so I ended it a few minutes early.

Tuesday, July 8, 1997

A friend of mine--a pediatric cardiologist--committed suicide today. He had been suffering from cancer of the lymph system, and I guess the prospect of brain cancer was more than he was willing to bear. The last time that I saw him was over five months ago, but everyone had told me that he was doing better--he had gone into remission after the chemotherapy. Then I got this news. Despite his penchant for gallows humor, he was one of the most caring doctors that I knew. His patients were very sick kids with cardiac problems, and he was tireless on their behalf. He volunteered a substantial part of his time at the free clinic in San Francisco. He was famous for throwing elaborate hospital ward Christmas parties--dressed as Santa Claus--and writing witty, acerbic letters to the editor. He was extremely proud of his newly acquired computer skills--proud of putting the lie to the cliché about old dogs and new tricks. He leaves behind a wife and two adult daughters. I will miss him very much, perhaps even more than I now realize.

12 pm. Sixteenth Session with Eliza Raven. Eliza believes that she may be in love with Peter Hossfeld. They got together at Peter's house--which I imagine was a considerable act of bravery for him--when Serena wasn't there. Eliza was shocked at Peter's physical condition--she described him as skeletal--until she found out that Serena is possibly poisoning Peter by having him drink belladonna and datura. I have no idea what the effects of these poisonous plants would be if ingested, although I seem to recall that belladonna has hallucinogenic properties. Peter was suggestible under the best of circumstances. Serena may be tightening her grasp by fiddling with Peter's wits. If Peter would sign out a complaint, or if Eliza could prove that Serena was actually poisoning Peter against his will, then the police could get involved. Eliza said that she would research that avenue. But she is clearly prepared to go to war with Serena. The second part of our session was even more disturbing. Eliza described how she constantly thought about suicide prior to her attempt. In contrast to last week, where Eliza was trying to convince me that everything was fine, this session I got the feeling that Eliza's constant thoughts of suicide was closer to how she actually feels--and it was a scary place to be. She said that, but for the fear of physical pain, she would have tried to commit suicide many previous times. She's contemplated killing herself by asphyxiation, drowning, and by overdose. And she said that she feels like she oscillates between happiness and sadness. The thoughts of suicide she analogized to a cancer and said that she feels her soul dying as a result. She even worries about being consumed by the emotions and becoming sublimated, somehow, to this "emotional bogey-man." She was administered the Wakefield Questionnaire and scored high for depression. Eliza seems to be describing cyclic depressive illness, but I don't think that she's met the criteria for bipolar mood disorder. But I think Eliza is clearly suffering from a major depressive episode. I remember the mnemonic from medical school: "Distraction Is Watching Sweet Midriffs of Erotic Girls Cavort Slowly." The initials are Depressed mood, Interest, Weight, Sleep, Motor activity, Energy, Guilt, Concentration, Suicide. During my next session with Eliza, I'd like to carefully explore her depression with reference to these classic symptoms.

1 pm. Second Session with Kester Langford. Kester and I spent this session talking about the nature of art, the nature of the therapeutic process, and the difficulty of making a living as an artist. He read me one of his poems and showed me one of his paintings--quite nice actually--to me, his marks look reminiscent of Chinese calligraphy. But I get the sense that we are skirting all the issues that are really important to Kester. He seems deeply troubled, and I don't think it is by the difficulty of earning a living as an artist, which is what he'd have me believe. So we skirted around all the important points in his life, with him either fearfully probing me or dishing out elaborate compliments--but never zeroing in on himself. Since Kester is so obviously uncomfortable, I felt that it was better this session to allow him to set the pace--and we danced lightly on subjects as if we were conversing at a cocktail party. But I think I owe it to him to insist on a deeper level of interaction in future sessions. Kester puts himself down quite frequently--he seems to devalue the work that he does until it comes time to sell it, and then he sets wildly extravagant prices which presumably means that the work doesn't sell. My impression was that he almost can't bear to part with any of his work. He mentioned that his work is being held for him by a number of friends--they even hang it on their walls while they wait for him to pick them up. He certainly feels personally invested in each one of the pieces. They represent aspects of himself in some fundamental way. It seems as if he feels that he would be losing that part of himself if he sold or gave any of them away. He read me a poem that he wrote 26 years ago. While my poetry appreciation skills are admittedly somewhat non-existent, his explanation of the poem was certainly more revealing than the poem itself. The poem was almost an apologia to living a life dictated by passion rather than monetary considerations. Kester believes that he has been blessed with clarity of vision which allows him to escape mundane limitations through the attainment of wisdom.

4 pm. Forty-Sixth Session with Sylvia Bows. The schism between the Bows and the Wolfe sides of Sylvia's family has grown substantially wider after an ill-fated July Fourth barbecue at Sylvia's on Friday. Tom's mother wanted to bring Beverly from the mental hospital, but Tom refused--he had seen her that morning and did not think that she was well enough to attend. So Tom's mother arrived with a chip on her shoulder. She obviously knew something about Margarite's malicious visit to Beverly. So while Margarite was playing happily with Grant and Roald, Nina was getting drunk and stewing over her inability to have her daughter with her on the holiday. Nina became more personal, actually attacking Margarite over her accent and the fact that she was French. Finally, Margarite lashed back and told Nina that she would never understand because Grant and Roald weren't really her grandchildren. As Sylvia put it, Nina freaked out. She called Sylvia a whore, called the children fatherless bastards and lashed out at everyone in sight. Tom blamed Beverly's condition on Nina--apparently Nina's racism provoked her to insist on two abortions for Beverly when she was pregnant by Syd, the black man who would become her husband. It is still not clear whether Beverly's subsequent inability to get pregnant stemmed from those abortions or not, but clearly it could have been a factor. So Tom's parents finally left, but not before fracturing the already fragile relations that held the in-laws together. I urged Sylvia to try to take a vacation with the boys and Tom--they clearly need some rest. And Sylvia reminded me that she has been in treatment almost a full year. I met Sylvia on my first day of practice in California on July 15, 1996. It's hard to believe that almost a full year has passed since then.

Wednesday, July 9, 1997

I received an e-mail message from the Anonymous Faxer. He told me about a "vacation" trip that he took back to Alabama. After it was over, he vowed never to set eyes upon either his mother or his Aunt Isabelle. When he made that decision, he said that he felt like a terrible burden had been lifted from him. And he finally gathered enough courage to ask me the question that's been preying on his mind since his earliest faxes to me: how to go about getting a sex change operation. I've decided to answer him as straight forwardedly as I can--I'll give him the requirements of the Benjamin Standards of Care. But I'll have to answer his message tomorrow or Friday.

12 pm. Eighth Session with Alex Rozzi. Alex's life is crowded with incident. He is becoming increasingly obsessed with trying to find out why Benny has dropped him as a friend. Roly, another friend who knows both of them, seemingly has some information, but he isn't telling Alex. So Alex followed Roly to Benny's house and tried to spy on them through a window. But he slipped and caught his nose ring--I've always thought they were dangerous--on something. It tore the nasal vestibule. Alex said that it looked worse than it felt. When he fell, he alerted Benny and Roly to his presence, and they confronted him outside. Alex demanded an explanation of why Benny wouldn't talk to him, and Benny laughed at Alex. Alex lost control and assaulted Benny, causing him to have a bleeding head injury of some kind. Alex thought that Benny was about to say something, but then Benny's expression changed and he ordered Alex away forever. Alex believes that he has destroyed any chance of reconciliation with Benny. But Alex is tortured by not knowing why Benny is acting the way he is. It's as if the not knowing is worse than the termination of the relationship. Alex took his tour through the California Culinary Academy, and liked it very much. He even speaks a little French. And he had an unplanned conversation with Mark, his father. Mark told him about why he left his mother, and showed Alex pictures of his half sisters in Canada. Alex said that he strongly resembles both Mark and his half sisters.

4 pm. Eleventh Session with Katherine Lippard. Katherine is finding it very difficult to talk about the feelings of loss and abandonment she experienced when her father left. She still has those feelings just barely repressed, and dredging them up attacks the facade of control that she's built up over all these years. It's a painful process, but one which I believe Katherine is committed to. But she is finding it difficult. After her father left, there were a few postcards and telephone calls, but those eventually ended. Katherine is not sure whether he is alive or dead, but she can't believe that he is dead. She wants him to be alive very much--but could only whisper that to me through her tears. She had a magical feeling that he would appear at her high school graduation--a very important moment for her. But he didn't show up. We had to take a break and I judged that it would be appropriate to change the subject. Katherine tried to make light of the situation by talking about soggy tissues, so I made some slight joke about waterproofing the furniture and Katherine gratefully took me up on my diversion. We also talked about Jake. She seems almost defensive about him. She wanted to prove to me that he wasn't all serious and sullen--an accusation I don't remember making. When I called her on it, she averred that it must have been Phil who said it. Jake told Katherine that he is an "adrenaline junkie"--he likes dangerous sports. He has invited Katherine to go either hang gliding or flying in an ultralight aircraft with him, and she is determined to accept. She has a very romantic notion of hang gliding, which doesn't admit for any possibility of danger. When I brought up the danger, she was quite short with me. She made me feel like I was being a nervous Nellie, and ended the session abruptly.

Thursday, July 10, 1997

10 am. I wrote an e-mail response to the Anonymous Faxer. What with my conversations with the Anonymous Faxer and with Peter Hossfeld, I'm starting to believe that I'm gaining a certain expertise with this form of virtual therapy, although I can't say that I like it much. I guess it comes from working with patients in the high tech industry. In any case, I responded to the Anonymous Faxer's questions about how to go about getting a sex change operation by quoting the requirements of the Benjamin Standards of Care. If he wants to go through with it, I think I'll actually have an opportunity to meet Hal when he comes in for regular therapy as mandated by the protocol.

12 pm. Fifteenth Session with Christina Herald. Christina started the session by saying that she feels like an outcast now. She had a story to tell, and I let her tell it. It seems that Andrew Fraiser, the co-worker for whom she feels some attraction, was more than just a mere acquaintance back in the Medieval Rec Club high school days. He was Christina's first major romantic involvement. But their relationship had its own Iago--Nicole--who was bent not on fomenting jealousy, but rather misunderstanding. Nicole had introduced the two of them, but she was jealous about the relationship they were forging. So, in the manner of high school miscommunications, she told lies to each of them about how the other felt. She tried to redirect Andrew's affection to herself, became pregnant by him, and they married. They had a son together: Duncan, now five. But their marriage is dissolving in what Christina said is a messy divorce, which includes a custody fight. Christina is getting all this information from Andrew, who now professes to have never really loved Nicole the way that he did Christina. And Christina remembers all the old attraction and has some new feelings as well. But she is wary. She is concerned that he might be in rebound--not wanting to be alone--or that he might be searching for a mother for Duncan. And Christina feels cheated by Nicole; she said that she feels that Nicole took more than just Andrew. In some way, she feels that Duncan should have been her child. But while Christina hasn't reconsumated her relationship with Andrew, they've become physically intimate. Anders walked into the apartment without knocking and became aware of that intimacy. He insists that Christina let Malcolm know about Andrew. And Christina believes that she should tell him as well. But it sounds like she doesn't know just how far she wants to take this relationship with Andrew. She sees Malcolm as stability--ironic considering that she was attracted to him initially because of his "bad boy" qualities--and she sees Andrew as passion. But she wants both in the same man. She doesn't seem ready to dismiss Malcolm just yet--as she put it: "Any man who gives you emeralds is not one to be taken lightly." She was sporting a pair of understated emerald studs to our session. So she has some things to sort out. Fortunately, she's decided to go on vacation--to England to stay with her mother and "Thaddeus the Twink." Although they have mostly been in abeyance, Christina has suffered a couple of panic attacks during the last several days. I told her to lay off the caffeine--she was clearly unhappy with that suggestion--and try to relax. I walked her to the door and she just quickly turned and kissed me on the cheek. It startled me, but she seemed to have a bit of sport at my expense as I grew embarrassed. She said that it was her habit to kiss friends goodbye, and I don't think she was testing my reaction--well, maybe a bit. Mostly, it was her calling attention to my embarrassment that was the test, I think. And if it was a test, I don't think I passed. I didn't realize until she'd gone that she'd forgotten to leave her journal.

4 pm. Forty-Eighth Session with Anna Green. Anna wanted to introduce Martin to her parents, so she asked them to invite Martin up for the Fourth of July weekend. Her parents were thrilled--Anna said that she thought her mother was going to start shopping for baby clothes. Martin and Anna arrived late the first night, and Martin made a favorable initial impression. The second morning, Martin and Anna's father hit it off discussing the Pathfinder mission. Everything was idyllic until some mysterious event turned her parents, as Anna put it, into apparent victims of the body snatchers. All their warmth towards Martin suddenly evaporated. It turned out that Kathy, in a fit of jealous pique, decided to alert Anna's parents to Martin's sexual proclivities. She even faxed them a copy of Martin's first whip-wielding, headless drawing of Anna. When Anna finally was confronted about this by her mother, Anna utilized her considerable powers of fabrication and told her mother that Kathy was a paranoid woman who had been recently ill-used by men and that the drawing she faxed was actually an illustration to a science fiction story that Martin and she had read together. Anna's mother bought it and she explained Anna's version to her father. Although things improved, however, much of the earlier warmth Anna's parents had expressed towards Martin disappeared. Meanwhile, Anna feels betrayed by Kathy. Martin says that he understands Kathy's obsessive jealousy, because he said that he felt jealous of Kathy's relationship with Anna just a few weeks ago. Anna is amused by the ironic twists of fate which seem to quickly reverse her life's circumstances.

Friday, July 11, 1997

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