Transcript of 11th Session between Charles Balis, M.D. and Ms. Sharon Lough, Friday, March 27, 1998 at 10:00 am.

Dr. Balis: Hello, Sharon.
Ms. Lough: Hello, Doctor Balis.
Dr. Balis: What happened to you these last few weeks?
Ms. Lough: Oh, I'm sorry, Doctor. I've been really sick. I had a bad cold, and it turned into bronchitis. I was really out of it, I could barely get out of bed. I completely forgot about calling you.
Dr. Balis: I'm sorry you've been sick. How are you feeling now?
Ms. Lough: Still a little ragged, but not as bad as I was.
Dr. Balis: There's been a nasty bug going around.
Ms. Lough: Yeah. I don't mind it so much, though.
Dr. Balis: What makes you say that?
Ms. Lough: Well, these past few weeks, I've been focusing on the fact that I feel rotten rather than all my other problems. I think I might have even lost a few pounds. It's worth it to get sick, if it's coupled with weight loss.
Dr. Balis: Hmm.
Ms. Lough: I used to wish I would get pneumonia, or some other terrible illness, just to lose weight. Pretty silly, huh?
Dr. Balis: Do you think you have a weight problem?
Ms. Lough: I have no other diversions, all I have is food. Food is the last refuge of the compulsive-addictive personality. Food and cold medicine.
Dr. Balis: What kind of cold medicine have you been taking?
Ms. Lough: I went to the doctor and got a prescription for that codeine cough syrup. It's really potent. I think I'll start carrying it around in a flask.
Dr. Balis: Some cold medicines can be high in alcohol content. I'd recommend that you watch the dosage and stay away from recreational alcohol while you're taking your medicine. Have you been taking the Prozac?
Ms. Lough: No. I've been so doped up lately, I thought it would be a bad idea. I didn't want to go postal and machine-gun everyone in my workplace. I'm just kidding when I say that; don't put it in my file.
Dr. Balis: Sharon, if you ever have questions about whether you should or should not take Prozac, I would be happy to answer them. Except for possible sleep disturbances, Prozac is fairly safe with over-the-counter cold medications.
Ms. Lough: How about street drugs?
Dr. Balis: Have you been using illegal drugs?
Ms. Lough: I got stoned a few weeks ago. Maybe that's why I got sick. If I believed in god, I'd say it was divine retribution.
Dr. Balis: Hmm. How did you obtain the drugs?
Ms. Lough: If you go to the right part of the city, you don't even have to get out of your car. You just drive up to the street corner to the enterprising young man in baggy pants, tell him what you want, and give him your money.
Dr. Balis: That's hardly a safe thing to do--both the drug use and the driving to bad neighborhoods to get it.
Ms. Lough: Yeah. Well, sometimes, you just got to live dangerously.
Dr. Balis: You know how I feel about illegal drugs, Sharon. And especially considering your history, I...
Ms. Lough: It's the only thing that brings me any happiness. Have you heard of Paul Prudhomme?
Dr. Balis: The chef? Yes, I have. But don't try to change the subject.
Ms. Lough: I'm not trying to change the subject. I have a point here. No, wait. Now I can't remember. See what happens when you smoke marijuana?
Dr. Balis: Not very funny.
Ms. Lough: What I was going to say is Paul Prudhomme pioneered this very rich, spicy, and high-calorie style of Cajun cooking. And he's a pretty big guy, he's definitely got a weight problem. He went on a diet a few years ago and lost some weight. And now he came out with a "light" cookbook. And I thought it was terrible. The recipes weren't as good. And he didn't look good, you know? It was like his soul had been taken away, like all the life had been drained from him. Here was someone who clearly loved food. You could argue he loved food to a point where it was unhealthy. But convert him to a low-fat diet, and you take an essential part of him away. I've seen the before and after pictures, and I like him better fatter. He seemed happier that way, even if he was 500 pounds.
Dr. Balis: How does this relate to your drug use?
Ms. Lough: I'm happiest when I am fucked up.
Dr. Balis: Wasn't it your drug use that led to your mental breakdown and hospitalization a year ago? Are you prepared to go through that again?
Ms. Lough: No, of course I don't want that. But I'm starting to think it's inevitable. It's my destiny.
Dr. Balis: Many people who have self-destructive habits are able to modify their behavior so it is no longer life-threatening. You can argue that they might not be as happy or as creative. But they usually they live healthier and longer lives. For instance, a person with a tendency towards obesity who has a passion for cooking may never be thin or even reach normal weight. But by making modifications to his diet and lifestyle, he could avoid a host of physical problems, such as heart disease and high blood pressure. Being physically healthy can contribute to your overall sense of well being. The other problem with drug use is that they affect the dopamine levels in your brain. That is the chemical that is responsible for pleasure...
Ms. Lough: Hey, hey, hey--I like being stoned.
Dr. Balis: Please be serious, Sharon. As I was saying, drugs like cocaine, heroin, and marijuana artificially increase the levels of dopamine in your brain.
Ms. Lough: Sounds like a good thing.
Dr. Balis: The effect is that you feel happier, or more in control, or wittier...
Ms. Lough: That's what I'm going for, Doctor.
Dr. Balis: The problem is that there is just so much dopamine per lifetime per person. Once used up, it's gone. And the result is that that person is no longer capable of experiencing pleasure. It's like your whole capacity for pleasure could either be spread evenly over a life time of experiences, or blown in a few weekends of drug use.
Ms. Lough: Hmm. So if one thinks that they are not going to live for a very long time...
Dr. Balis: The brain of the person addicted to drugs is permanently altered. I don't want you to...
Ms. Lough: I'm not really planning of blowing my brains out, Doctor. I just sometimes need to...
Dr. Balis: Do you feel you need drugs as a form of escape?
Ms. Lough: Yeah.
Dr. Balis: And why is that?
Ms. Lough: Why is that? You're a doctor, you should know. Because life sucks.
Dr. Balis: Could you be more specific?
Ms. Lough: My job. My home life. But you don't want to hear about the boring stuff.
Dr. Balis: You had mentioned being unhappy with your job.
Ms. Lough: It's not unbearable. I don't have as much pressure now, that I've been demoted to lowly flunky. What I do is very dull and tedious. And it seems pretty meaningless. For a while, I was really upset that I was demoted, but now I just don't care. Sometimes, when I think about how hard I worked for those stupid engineers, I feel an occasional surge of anger. Now I don't even try anymore. Maybe I'll be fired, or laid off, and then I can collect unemployment.
Dr. Balis: I see. How are things at home?
Ms. Lough: Charlotte and Rob are talking about getting a divorce. It's something they've discussed before. Maybe with Charlotte's extracurricular activities coming to light, they might actually mean it this time. Rob is acting like the walking wounded, moping like a zombie. We make a great pair.
Dr. Balis: Hmm. Do you identify with Rob?
Ms. Lough: He's loser and a reject--we're meant for each other.
Dr. Balis: Hmm.
Ms. Lough: I told him to keep his distance because I have the plague. He seemed a little miffed, but he saw how sick I was and left me alone. That's another great thing about getting sick--it's nice not to have the pressure to be social. I don't think I really need other people. Maybe Rob and I are a fundamentally anti-social subspecies of human beings--like lawyers, real estate brokers, and technical writers.
Dr. Balis: Hmm. You think Rob is antisocial?
Ms. Lough: Not as much as I am. But he seems to prefer staying home, and he expresses the same dread that I do when faced with social situations. It's so much work to be social, to make conversation.
Dr. Balis: I see. Do you still feel that same sense of dread before our weekly sessions?
Ms. Lough: No. I've gotten used to them, I guess.
Dr. Balis: How does it feel to come here after a long absence? It's been two weeks.
Ms. Lough: It's a relief, really.
Dr. Balis: Good. I'm glad to hear that. Do you think you can stay off drugs for long enough to give Prozac a try?
Ms. Lough: I don't really want to.
Dr. Balis: Just give it a try, Sharon.
Ms. Lough: Okay. See you next week, Doc.
Dr. Balis: All right. Goodbye, Sharon.
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