Transcript of 3rd Session between Charles Balis, M.D. and Mr. Lloyd Major, Monday, August 4, 1997 at 4:00 pm.

Mr. Major: Charles!
Dr. Balis: Hello, Mr. Major. Roberto. Won't you sit down?
Mr. Christiani: Hello, Doctor Balis.
Mr. Major: Did you hear what those assholes did? You do read the trades magazines, don't you, Charles? In our business it's critical to read everything and to know just how much credibility to assign to it--so many write out of their assholes.
Dr. Balis: I'm sorry?
Mr. Major: It's Ellison, that prick. I mean have you ever heard of anyone doing a take-over by setting up an 800 line to conduct a public opinion poll? What kind of crap is that? At least we tried to do it honestly--you know, investment bankers, raising capital, closed door negotiations. He tried it on fairy dust.
Dr. Balis: Hmm. Would you like to sit down?
Mr. Major: I think better when I'm pacing.
Dr. Balis: We're talking about your effort to take over Apple Computer?
Mr. Major: Look, I'm a realist. When my own financial people wouldn't back me up, I knew I was sunk. But now Apple's putting together a new management team. They're asking everyone around town. They asked Ellison, that insincere dick. They asked Warnock. They asked McNealy. They asked Fisher. They asked Dan Case, for Christ's sake. What am I, chopped liver? They don't even have the fucking courtesy to ask me onto their board of directors. They're trying to put together a think tank so that they can all sit around and watch the company dive into the ground, and the one guy who can really make a difference is left holding his dick.
Dr. Balis: Aren't you a big stockholder? Doesn't that give you a seat on the board?
Mr. Major: Oh, I have less than 5%--it stopped me from having to make some securities disclosures when I was trying my takeover. Frankly, I'm getting killed in my Apple position. But I still want to save that fucking company. It's like I have a mission. But I apparently don't have enough fucking clout to even get a seat on their board!
Dr. Balis: Look, this is a little out of my league. You aren't looking for me to advise you on business, are you?
Mr. Major: Fuck that! I know what my business is. I'm just a little pissed off, that's all. You should be able to recognize venting when you hear it, Balis.
Dr. Balis: Yeah, well I agree that it has all the earmarks.
Mr. Major: Good. But try to get in some of that bedside manner thing, won't you?
Dr. Balis: I was just acknowledging that I recognized that you were using me as a sounding board. Frankly, I'm a bit surprised that you chose me.
Mr. Major: Well, you aren't the only person who I've been snapping at today.
Dr. Balis: So why are you here?
Mr. Major: Oh, it's my fucking septum.
Dr. Balis: You figured out what's wrong with your nose?
Mr. Major: My nose is the most closely photographed and documented part of my body, Doctor Balis. I've known about my deviated septum for twenty years.
Dr. Balis: Oh.
Mr. Major: I've even had the interactive 3-D fly-through software of nose innards created from the latest CT scan technology.
Dr. Balis: Hmm. Any recommendations?
Mr. Major: Don't fly through my nose.
Dr. Balis: No, I meant do the doctors have any recommendations?
Mr. Major: The same thing they've been recommending for the last five years--they've only recently developed surgical procedures to deal with my problem. They want to cut, file, scrape, straighten, and suck out the tissues, cartilage, and bone material that blocks my breathing passages and prevents me from living.
Dr. Balis: That's great news.
Mr. Major: Did you hear what I've just said? They want to do Septoplasty, bilateral endoscopic ethmoidectomy, sphenoidotomy, maxilloethmoidectomy, and frontal recess exploration.
Dr. Balis: Wow. I'm impressed by your command of medical jargon.
Mr. Major: Yeah, you guys love to throw around that stuff.
Dr. Balis: I know that jargon is unheard of in the computer profession.
Mr. Major: Okay, touché.
Dr. Balis: Well, it sounds like you've got a deviated septum and some sinus problems.
Mr. Major: Yeah, that's the upshot. As a kid, I broke my nose. It was left untreated--Hungary was never a great place to get medical treatment. All these years of pain and total frustration and all because my mother wasn't bright enough to set my nose at the time of the injury.
Dr. Balis: Are you angry with your mother?.
Mr. Major: My mother? You know, sometimes I forget you're a psychiatrist and then you ask me about my mother. My mother is clueless. It would be completely unproductive to feel anger towards her. Not to mention, she's been feeling guilty about this for years.
Dr. Balis: I see. So why are you avoiding the surgery?
Mr. Major: It's the breathing issue. I'm afraid of not being able to breathe.
Dr. Balis: But the surgery will improve your breathing--probably quite a bit.
Mr. Major: No, no. I mean, sure. The surgery will fix things after a while. But there will be days and days where I'll have packing in my nose and I won't be able to breathe.
Dr. Balis: You mean breathe through your nose?
Mr. Major: That's right. If I can't breathe through my nose, I'll lose my mind.
Dr. Balis: Have you talked to your doctor about this?
Mr. Major: Sure. They just tell me the same things.
Dr. Balis: Which is?
Mr. Major: Oh, they have some kind of packing that has little straws in the middle--it's supposed to help people breathe through the packing. They say it works about half the time--the rest of the time, it gets clogged up. But I know what they're really saying.
Dr. Balis: What?
Mr. Major: Look, Charles, I know people...doctors look at me and sense fear. Fuck, they probably sense insanity when it comes to my breathing. They'll tell me anything to calm me down. I'd bet that those straw things are just placebos--they never work. They're just designed to give people like me hope. But I'm much much smarter and more educated on this issue than most of the doctors that try to treat me. I've done research onto this surgery ever since I've heard about it. I've interviewed patients who've had it done. None--and I mean not a single person I've talked to, Charles--was able to breathe for almost five full days!
Dr. Balis: I see.
Mr. Major: The human nose has more blood vessels than almost any other part of the body except the liver. After the surgery, the nose and all the air passages swell shut. Those straws in the packings are completely filled with blood. In fact, there's so much blood that the blood clots form a sizable mass that block the breathing passages and create unbearable pressure inside the sinuses. I've talked to a guy who had a migraine for the first two days after the surgery.
Dr. Balis: That does sound very bad.
Mr. Major: You're great with the understatements, Balis.
Dr. Balis: So, what can I do for you?
Mr. Major: I'm convinced that I need this surgery. My surgeon said that it will substantially reduce my sinus problems. When I get a cold or an allergy, everything will drain like it's supposed to and I won't get stuffed up so much. Basically, the outcome of this surgery would mean freedom to me.
Dr. Balis: So are you going to do it?
Mr. Major: I've got this doctor to set up all the equipment necessary in my home. She would live with me for the first week after the surgery, or for as long as I feel that I need her to be there. I would be able to get her to drain and suck out the mucous and blood as it forms. But even with all of these measures, I would still be trapped without a breathable nasal air passage for a few days and nights.
Dr. Balis: Sounds like that can't be helped.
Mr. Major: I want you to give me something that would make me not care about the breathing thing. Something to keep me from ripping my nose off my face during a panic attack.
Dr. Balis: You want me to prescribe a tranquilizer?
Mr. Major: I need to be kept sedated for a few days until I can breathe through my nose again.
Dr. Balis: Actually, it's not a good idea, Lloyd. You'll be coming out of anesthesia, and you really don't want any central nervous system depressants--your respiration will really suffer. And then since you'll be only breathing through your mouth, your respiration will be very shallow. I think that using tranquilizers then would really be quite dangerous.
Mr. Major: Hmm. I hadn't thought of that.
Dr. Balis: But perhaps we can work on this phobia of yours. I have to admit that I've never treated someone with the specific problem that you describe, but we can use some desensitization techniques that have worked very well with people with other phobias--including claustrophobics. I mention them because they often have breathing problems associated with their disorder.
Mr. Major: Charles, you told me that you can't prescribe me the tranquilizer, and I respect that. You've got a pretty good reason. But if you think that I'm going to come in here and have you slowly cut off my breathing so that you can desensitize me, you must be taking too many...
Dr. Balis: Lloyd, Lloyd, calm down. You have a problem, and I'm trying to figure out ways that we could solve it without endangering your health.
Mr. Major: Charles, slowly cutting off my breathing would be the same to me as a death sentence. I'm really not exaggerating either. When I try to visualize how it would be, I can understand taking my own life. Do you understand?
Dr. Balis: Yes. Perhaps part of the solution could be pain killers--they also have a CNS effect, but it's probably less than a tranquilizer.
Mr. Major: Yeah?
Dr. Balis: Some narcotics have an interesting property--it's not that they reduce the level of pain, it's that they reduce the attention span for pain. If you ask a person in pain who's taking these drugs if it still hurts, they'll think about it and tell you that it hurts just as much. But after a few moments, they'll be thinking about something else and so the sense of pain will recede into the background. If you have a headache, and you take ibuprofen, the pain goes away. If you took one of these drugs, the pain would still be there, but only when you thought about it.
Mr. Major: Interesting. You mean if I take these pain killers, I would keep forgetting about my breathing difficulties?
Dr. Balis: Sort of. You won't be able to concentrate on thinking about it for long and that might help. It would also help with the pain and might even help you sleep.
Mr. Major: I'll have to do some research into this. What is the name of the medication you're talking about?
Dr. Balis: I'm talking about oxycodone--like Percocet or Percodan.
Mr. Major: Wouldn't straight morphine be better?
Dr. Balis: That's what they'll probably give you in the hospital right after the surgery. But that's only available as an injectable. Percocets are pills.
Mr. Major: I see. Well thank you, Doctor Balis.
Dr. Balis: Hold on, Lloyd. Percocets are only part of the solution. We will need to develop coping strategies for those times when even the Percocets won't keep you from...
Mr. Major: Ripping my nose?
Dr. Balis: Well, yes.
Mr. Major: What do you recommend, Doctor?
Dr. Balis: I recommend we get together in a near future and devote a few sessions to figuring it out. What do you think?
Mr. Major: I'll get back to you on that, Balis.
Dr. Balis: As you wish.
Mr. Major: Yes. Okay, I got to get back to the Apple stupidity. Thank you, Doctor Balis.
Dr. Balis: You're welcome. I hope I can help.
Mr. Major: I do too. Come on, Berto.
Mr. Christiani: Goodbye, Doctor Balis.
Dr. Balis: Goodbye, Mr. Major, Roberto.
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