Transcript of 35th Session between Charles Balis, M.D. and Ms. Katherine Lippard, Wednesday, February 25, 1998 at 4:00 pm.

Ms. Lippard: Hi, Doctor Balis.
Dr. Balis: Hello, Katherine. Whoa, careful! Are you okay?
Ms. Lippard: Yeah. I'm all right, just a little dizzy sometimes--Post Concussive Syndrome. It's getting better, though.
Dr. Balis: How did you get a concussion?
Ms. Lippard: I got hit on my way to the Austin airport Thursday morning. Good thing I had a full size car, or I'd be hurt worse.
Dr. Balis: Oh, my. How did it happen?
Ms. Lippard: The light turned green, I started to go through and got hit by a pickup truck full of firewood. Right in the driver's door. Firewood everywhere! I have a sore shoulder, a bruise on my left hip that's slowly moving through every color of the rainbow, and a short nap that slightly scrambled my brains. It also made me miss my plane. I was an hour from escaping Texas unharmed.
Dr. Balis: Did you feel unsafe in Texas?
Ms. Lippard: No, no. That line gets a laugh at the office, though.
Dr. Balis: Have you seen a neurologist?
Ms. Lippard: Yes. I got to ride in an ambulance. I don't recommend it. They put me in a neck brace and strapped me to a stiff wooden board so I couldn't move a muscle. Now, that was scary. The guy finally let me move my arms so I wouldn't feel totally helpless. Did you ever have a neurological assessment? Of course you have; you've given them, you're a medical doctor. When I first came to, I actually couldn't remember my name for a minute. So they took me to the high tech trauma center. I got X-rays, I got a CAT scan, I even got an eye exam. I think the doctors were thrilled to get a chance to play with all their toys. They finally let me go Friday afternoon. They gave me this swanky cane, though.
Dr. Balis: How long will you need to use it?
Ms. Lippard: Up to three weeks, they said. My vision is almost better already, so I don't think it'll be that long. I still don't feel good about driving. Jake has been driving me around.
Dr. Balis: On the motorcycle?
Ms. Lippard: Oh my, no. He has an old junker for when it rains. But right now, he's in my Jaguar. Took to it right quick, too.
Dr. Balis: Hmm. Did you have that conversation you were planning?
Ms. Lippard: Uh, no, not yet.
Dr. Balis: No?
Ms. Lippard: Well, the timing never seemed right. You know that Saturday was Valentine's Day. He was so amazingly romantic. He brought over a suitcase full of stuff and made a fondue. It wasn't that good--Jake is no chef--but it's the thought that counts. There was bread, and shrimp, and wine, and all kind of things. It was like that first picnic, remember the Mud Flats?
Dr. Balis: I remember.
Ms. Lippard: And he rented "The American President." It's one of the most romantic movies of all time, in my opinion.
Dr. Balis: So you couldn't bring up your dissatisfaction with the relationship.
Ms. Lippard: No. And now that he's spending so much time taking care of my injuries, it would seem ungrateful. So we'll see. I have been dropping hints, though. We've had some decent conversations lately. I almost told him about you.
Dr. Balis: He still doesn't know you're in therapy?
Ms. Lippard: No. I'm...I don't know. I guess I'm a little embarrassed to be seeing a psychiatrist. It's not the image I have of myself.
Dr. Balis: I understand, many people feel that way. You don't want to admit a weakness.
Ms. Lippard: Exactly.
Dr. Balis: But it's not a weakness to be working on your issues, Katherine. It's a strength. You have the courage and perseverance to tackle the tough issues and work your way through them. You're not showing weakness by coming here; you're showing strength.
Ms. Lippard: Hmm. I can see that.
Dr. Balis: So do you plan on talking to Jake before you go away together?
Ms. Lippard: Uh, I'm not sure. I suppose I should.
Dr. Balis: I agree.
Ms. Lippard: Well, that's a few weeks away, anyway. Jeez, I hope I'm recovered by then. I'd hate to have one of those dizzy spells while I'm skiing.
Dr. Balis: I'm concerned about that, too. I hope you won't push it.
Ms. Lippard: I'll be careful. Oh, shit, there's another one.
Dr. Balis: What? Oh. I can't recall seeing a crow perch on my window ledge before. I get pigeons occasionally, but never a crow.
Ms. Lippard: Hey! Get out! Go! Damn bird.
Dr. Balis: Katherine?
Ms. Lippard: Sorry. The damn crows are freaking me out.
Dr. Balis: Why is that?
Ms. Lippard: I don't know exactly. When I woke up from the wreck, the field was covered with them. I didn't see them before, and I couldn't have been out for more than a minute. They were just sitting there, silent, a shiny black sea of feathers. Several people commented on them, too. No one seemed to have seen them arrive. It was spooky. I felt like they had come for me personally. When the fire truck pulled up, they all flew off at once, a great black cacophony of beating wings and cawing voices. All except this one sitting on a piece of firewood in the road, looking at me. It just stared at me, ignoring the siren. Freaky.
Dr. Balis: Hmm.
Ms. Lippard: And since then, I've seen them all over. I don't remember seeing crows in San Francisco before.
Dr. Balis: I've noticed them once in a while.
Ms. Lippard: Well, this is different. It's like they're following me.
Dr. Balis: I'm sure it's just perception. You first noticed them during a traumatic episode, and they made a big impression on you. Now you're extra sensitive to them, so you're noticing them where they may have been before and just didn't register. Your mind has them linked to the trauma, so their presence is uncomfortable for you. It's a common post-traumatic reaction.
Ms. Lippard: Post-traumatic? Come on, I had a wreck. It's not like I was in Vietnam.
Dr. Balis: I'm not making a clinical diagnosis. But you did have a psychological trauma, and you're likely to show some symptoms. Probably they'll fade just as your concussion will fade. We could talk about it some, though. It must have been a frightening experience.
Ms. Lippard: It was. I'm sorry; sometimes...lately, I can't think very fast. Could you tell me again why the crows are so scary?
Dr. Balis: No need to apologize; your concussion is likely to affect your cognition, too. I believe that since you woke to the startling view of crows, you've become more sensitive to them--more aware of their presence--so now you notice them more, even though they may not actually be around any more than before. Plus, your mind has linked the crows to the accident--they serve as a trigger: when you see a crow, you're reminded of the accident, if not cognitively, then emotionally. So you notice them more, and you have a strong emotional reaction to them.
Ms. Lippard: So seeing crows makes me feel like I'm in the wreck again?
Dr. Balis: Well, it brings back memories of the wreck.
Ms. Lippard: And I notice them more because of the wreck.
Dr. Balis: Exactly.
Ms. Lippard: Vicious circle, isn't it?
Dr. Balis: It can be. But we can break it, with a little work. Do you want to talk about it?
Ms. Lippard: May as well. But are you going to be able to explain the fact that they're in my dreams, too? And also that visit we just had?
Dr. Balis: I'm sure that crow in the window was just a coincidence. As for the dreams, that's just part of the same syndrome. But that's a good place to start. Tell me about the dreams.
Ms. Lippard: Um, I don't have any real details, just images. This morning when I woke up, I actually said, "Aw, jeez, the fucking crows again." I just...I don't know. It's real vague, like dreams can be. Maybe they're watching me, maybe I just notice them. Maybe I'm really dreaming about the wreck and the crows is all I can remember when I wake up.
Dr. Balis: That's likely. Recurring dreams are common. They'll probably stay with you until your mind is finished processing the event. Why don't you tell me more about the accident?
Ms. Lippard: Okay. I remember noticing this big empty field as I was waiting for the light to change. I thought about how you don't see that sort of thing around here. Texas is so flat. Then the light changed, and I was trying to remember the rest of the way to the airport. Here's a part I'm not sure of: I think I remember seeing the truck coming toward me from the corner of my eye. But then again, maybe I made that part up to fill in the gap.
Dr. Balis: Let's go with that as a true memory for now.
Ms. Lippard: Okay. So I barely had time to register this truck coming straight for me, and the next thing I knew I woke up all fuzzy-headed and not seeing straight. There was a crowd of people all around already. I was real confused, trying to figure out where I was and what had happened. I looked around and saw the truck glued to my door and firewood all over the place. And then, I heard people talking about the crows. So I looked up, and this field was covered with crows. They just stood there, milling around, not going anywhere, for maybe five minutes. Someone got in and was talking to me, and I remember I couldn't carry on a conversation. It was like my thoughts just wouldn't form right in my mind. I couldn't even tell him my name for a while, and I never could remember his. And I'm usually pretty good about that.
Dr. Balis: That was the concussion. Go on, you're doing fine.
Ms. Lippard: So he talked to me for a while, didn't let me get out of the car. I couldn't stop looking at the crows; there were so many of them, and I could still hear people commenting on them. I wanted to get out and get a closer look but the guy didn't let me. Then the fire truck came, sirens blaring. Damn those things are loud. Then the crows took off, and that was louder still. I thought my head would burst--all the sirens and flapping and cawing. God...
Dr. Balis: Here's the tissues.
Ms. Lippard: Thanks. I don't think I cried then. I don't think I was really feeling anything at the time.
Dr. Balis: What are you feeling now?
Ms. Lippard: Um, just overwhelmed, I guess. Scared, maybe.
Dr. Balis: What are you afraid of?
Ms. Lippard: I'm not, really. It's just a scary thing to be in a wreck and have all that going on. I guess I'm just feeling what I didn't feel then.
Dr. Balis: That's good. Go on.
Ms. Lippard: Um, how's our time?
Dr. Balis: Our time is fine, don't worry about it.
Ms. Lippard: Uh...well, then the fireman got in, put that collar on me, and told me not to move. He put a bandage on my head. Then the police arrived--more sirens. Then the ambulance. They put this kind of corset on me to get me out of the car, then onto that board. In the ambulance, I got a pop quiz. I remembered my name, and my birthday, and where I was going, but not my address or my flight number. That was scary--not knowing where I live. So we went to the hospital. The guy, the paramedic I mean, gave me an IV while we were moving. I didn't think you could do that in a moving vehicle, but this guy was pretty good. In fact, everyone was really professional and caring. And I already told you about the hospital.
Dr. Balis: You told me some. I'd like some more details.
Ms. Lippard: Aren't we out of time?
Dr. Balis: Well, yes. But you're doing so well, I didn't want to interrupt the flow. Do you feel you're at a good stopping point now?
Ms. Lippard: Yeah. All the really weird stuff happened before I got in the ambulance.
Dr. Balis: How are you feeling now?
Ms. Lippard: I'm okay.
Dr. Balis: I don't want you to leave here if you're still distressed. You can stay a while.
Ms. Lippard: I'm fine. I'll be okay.
Dr. Balis: Is Jake coming to get you?
Ms. Lippard: No, I couldn't have him come here. Phil's picking me up, we're going out to supper.
Dr. Balis: Okay. We'll work on this some more next week, okay?
Ms. Lippard: Okay. Thank you, Doctor Balis.
Dr. Balis: You're welcome. Good night, Katherine.
Ms. Lippard: Good night.
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