Transcript of 1st Session between Charles Balis, M.D. and Ms. Sylvia Bows, July 15, 1996 at 4 pm.

Ms. Bows: Hello. I am Sylvia Bows. It is nice to meet you in person Doctor.
Dr. Balis: I am glad to meet you too, Ms. Bows. Won't you please sit down.
Ms. Bows: Please call me Sylvia. We will be talking intimately so it is silly to be so formal.
Dr. Balis: I took some notes during our phone conversation. I would like to start by going over them with you, if you don't mind...
Ms. Bows: Not at all.
Dr. Balis: It would help me understand the situation a little better if I had some of your history. You said that you are 38 years old and were born in France.
Ms. Bows: Actually I spent my childhood there and moved to United States with my parents and brother in 1970.
Dr. Balis: That's makes you about 12 years old at the time of the move.
Ms. Bows: That's right.
Dr. Balis: What part of the US did your family settle in?
Ms. Bows: My parents visited San Francisco on their honeymoon, and ever since then they always wanted to live here. When we finally made the move, there was never a question of the final destination.
Dr. Balis: And how was it for you?
Ms. Bows: Well, my teenage years were in San Francisco during the decline of the Flower Power. It was definitely an interesting place to be for a little French girl.
Dr. Balis: If you don't mind, what do you parents do or did?
Ms. Bows: My mom is a chef and worked in a small restaurant in Paris. When she and my dad moved to the Bay Area, they started their own place.
Dr. Balis: Do they still?
Ms. Bows: Oh, yes. Of course it is much different now. My mom spends only two days a week at the Gardens. She and my dad like to travel.
Dr. Balis: During our telephone conversation, you mentioned that you were married and are having some problems with your husband.
Ms. Bows: Some problems. Yeah, I guess that's right. Some problems. I was married to Tom for seven years. When we first met it was like a dream. We both liked the same things. Voted the same way on the political issues. Even my parents liked him a lot. I guess the main problem developed when I decided that I did want to have children after all.
Dr. Balis: You did not want children at first?
Ms. Bows: We both thought that the world was too over populated and there were enough little children and someone had to do the work and keep it all going. Now it all sounds kind of childish but at the time...frankly, I think we were too scared or egotistical or selfish to have children.
Dr. Balis: What changed your mind?
Ms. Bows: Time, I guess. I grew older and realized that being an editor, even for a big city daily newspaper like The Chronicle, just wasn't what it is all about. Not that I had a revelation about the meaning of the universe, but I knew that wasn't it and I felt that it had a lot to do with children. Some people would say my hormones were talking. But I think it is more than that. I spent most of my life pleasing myself and it felt like it was time to please someone else. Not in a sexual or intellectual way like with Tom. But somehow deeper. I am not sure I could put it into words.
Dr. Balis: You're doing fine.
Ms. Bows: When I confronted Tom with my revelations, well he...let's just say he did not take it well.
Dr. Balis: What do you mean?
Ms. Bows: He was a well established and respected businessman at the time. He traveled a lot. And worked even more. There were days when we would barely say hello to each other and we communicated through voice and e-mail. The idea of sacrificing all that for a child seemed too much for him.
Dr. Balis: Go on.
Ms. Bows: Oh, after a while he did agree to have a kid. Although our relationship suffered from that. But I decided to take it one thing at a time. First get pregnant, then have the baby, and then I figured our relationship would get back to normal. Tom was a good man, he was bound to love his child.
Dr. Balis: So what happened?
Ms. Bows: We made love a lot. I even came to his office one afternoon. But six month went by, and then a year. I started to get worried. Sex became more like work. Tom become more irritable. He spent even more time, if it is possible, traveling. I finally decided it was time to seek professional help. I talked to my regular doctor first. She scheduled me for all sorts of tests. I didn't want to get Tom involved, so I just went by myself.
Dr. Balis: What did you learn?
Ms. Bows: That I was perfectly fine. My body was ready and willing to have children.
Dr. Balis: So it was Tom.
Ms. Bows: That was the common belief. My doctor mentioned a few places Tom might go for consultation. So I had to talk to Tom.
Dr. Balis: How did he take it?
Ms. Bows: He was strange.
Dr. Balis: What do you mean?
Ms. Bows: Well you would think a man, even if he did not want to have children, would not take the news of his inability well. But he just shrugged it off and even made a joke about it.
Dr. Balis: Maybe he was just trying to hide his true feelings from you?
Ms. Bows: Tom? No. It was weirder than that.
Dr. Balis: What do you mean?
Ms. Bows: About two years ago when I first started to talk about having kids, Tom went on a one week business trip to New York. I offered to go with him. It would have given me the opportunity to see some friends as well. But Tom said that he would not have any time and he would just feel more stressed and guilty for leaving me in the hotel room by myself day after day. I would have had to beg off from work anyway, so I stayed home. He called me a couple of time from New York. I thought he was kind of distant, but I just attributed it to stress and being away from home. Sleeping on a strange bed and all. When he returned, he was sick and very tired. I figured it was a cold that you get from flying in airplanes. No big deal. In a week or two he was perfectly normal and I did not give it another thought.
Dr. Balis: It wasn't a cold?
Ms. Bows: You are very perceptive, Doctor. And a good listener too.
Dr. Balis: Thank you.
Ms. Bows: It wasn't a cold. Tom had had a vasectomy.
Dr. Balis: How did you find out?
Ms. Bows: It's a small world. Even smaller when you get into infertility problems. Last week I was talking with one of the women in my infertility group that I was using for moral support. She had a brother-in-law who was a urologist in private practice in New York. Tom's name came up and, well, I found out.
Dr. Balis: So it wasn't a business trip that Tom went on?
Ms. Bows: No it wasn't. It seems that Tom planned ahead. Like he always does.
Dr. Balis: What did you do when you found out?
Ms. Bows: I confronted him with it. I wanted him to deny it. But he just stood there. I knew it was true.
Dr. Balis: How are you now.
Ms. Bows: Well, sometimes I want to kill him. Sometimes, I'll just lie there feeling sorry for myself. It seems like such a betrayal. And those last two years when he knew the monthly agonies I was going through--was I pregnant or not. Now I keep getting these anxiety attacks. My heart beats fast. I cannot breath. My stomach hurts. I feel sort of dizzy. And I can't sleep. When I see him I want to rip his face off. He just looks at me with big, sad eyes. He keeps saying that everything was fine before my hormones kicked in. But he feels cold, like a stranger to me. I think I want a divorce. But I thought I needed to talk to someone first. I know I'm not rational right now.
Dr. Balis: Sounds like you're handling it pretty well.
Ms. Bows: Really? Thank you.
Dr. Balis: But handling it is about how you seem to the outside world. What we deal with here is how things are on the inside. Maybe trying to smother your feelings right now is not the healthiest thing for you. Maybe we should work on releasing your rage. I know that you were kidding when you said that you wanted to kill your husband, but I think you were maybe only half kidding. If we can get you to understand your feelings here, maybe you wouldn't feel the need to express your anger towards your husband physically. You also have some physical symptoms that I think we can control with some medication. I'm going to give you a prescription and I want to hear from you after two doses as to how they are making you feel. If they aren't working, we can easily switch to another medication.
Ms. Bows: You really think drugs are the answer?
Dr. Balis: They certainly aren't the whole answer. But they will help with your anxiety attacks and get you to sleep at night. I can give you some literature about the medication.
Ms. Bows: Thank you Doctor.
Dr. Balis: I want to see you again in a couple of days. How about Thursday, the 18th in the afternoon?
Ms. Bows: I have a meeting scheduled then. How is Friday for you.
Dr. Balis: I don't see patients on Friday. Can we pick another time on Thursday?
Ms. Bows: I guess I can skip lunch. I'm not eating anyway. How about noon?
Dr. Balis: Noon will be fine. I'll see you on noon on Thursday, then. And give me a call tomorrow morning about how the drugs feel to you. If something doesn't feel right about the drugs, you can get ahold of me, even after hours. Just call here and the service will page me.
Ms. Bows: Thank you Doctor.
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