Transcript of 3rd Session between Charles Balis, M.D. and Ms. Cassandra Evans, Tuesday, August 6, 1996 at 1 pm.

Dr. Balis: Hello, Cassie. I received your letter, thank you for taking the time to fully express your feelings.
Ms. Evans: I am glad you got it. I wasn't sure about leaving it under the door, but figured it would be okay. I have to admit, I was kind of nervous about coming here today. I don't know.
Dr. Balis: Nervous? How so?
Ms. Evans: I didn't really know how things would go, especially after telling you about all the illness stuff. You know, they sent me to plenty of psychiatrists, to see if I was crazy, because they didn't know what was wrong with me, didn't believe me or all the symptoms I was experiencing. Excuse me, Doctor.
Dr. Balis: It's okay, of course. There's a box of tissues to your left. Take a deep breath...whenever you're ready, we can continue.
Ms. Evans: Thank you, Doctor. Sorry I broke down like that.
Dr. Balis: Quite all right. Do you have a primary care practitioner, Cassie?
Ms. Evans: Well, yes, I guess. I really don't like going to doctors any more. I was assigned someone under SII's HMO plan. I've seen him about a dozen or so times since he became part of the panel. He gives me some medication for my allergies, and something for my stomach.
Dr. Balis: Why do you take something for your stomach?
Ms. Evans: It goes back to when I was younger. Like, right after I had that infection-- the yeast infection. These specialists put me on huge doses of anti-inflammatory drugs to help ease the pain in my joints. Well, my stomach wasn't all that great to begin with, but after that, it was horrid. I remember when I was 15 years old, I cried myself to sleep almost every night.
Dr. Balis: Cassie, if you don't mind, I would like to contact your current physician and take a look at your records. Would that be acceptable to you?
Ms. Evans: Yes, I guess so. He doesn't know very much about this chronic illness thing. When I started going to him for help, I would occasionally tell him of my complaints, and he offers me different options for treating each symptom. Been there, done that.
Dr. Balis: Does he have all of your medical records? Your medical history?
Ms. Evans: No, the previous doctor has most of it. I can get you his name and number if you wish to speak to him, but I really don't want SII to know any of this. It could cost me my job!
Dr. Balis: I understand, and yes, I would like to contact your previous physician. Why don't we change the subject for a bit. Tell me, how was your week otherwise?
Ms. Evans: Okay. I had plans to see Brian Saturday night, but had to cancel. I felt so sick all day long, and threw up a couple of times. I just couldn't see putting on make-up and getting all pretty and then putting on the act of having fun and like everything is okay, fine and dandy. My bones and muscles were so achy, which makes me irritable. Anyway, we got into a fight over our plans. He thought I was canceling for another reason. Friday night I had a workshop with "Winging It", and he came to see me. At first, I was glad to see him there. When it was my turn at bat, the audience had me as a flirty woman trying to get out of a ticket from a cop. The guy I was playing against, Tony, he and I have done scenes together before. He is a real sweetheart and knows how to get the scene done without getting too personal, if you know what I mean. So right away, Brian thought it was because I was seeing Tony Saturday night instead of him. So, of course, we got into a whole long discussion about acting and just pretending, that it doesn't necessarily mean anything. Then I tried to tell him I was just tired from a long week, but he said, "I am tired too, we can do something low key." Hey, I was lucky to get out of bed and reheat leftovers, I was so out of it! There was just no way I could be human that evening, forget sociable. I think he was pretty pissed at me. We didn't talk again until Monday, and we normally talk every day.
Dr. Balis: Do you think Brian would be more understanding if you explained your illness and fatigue to him?
Ms. Evans: I don't know, I mean, what would I tell him? I don't know what's wrong with me, how can I explain it to him?
Dr. Balis: Cassie, maybe we should work on finding the origin of this disease or ailment that troubles you.
Ms. Evans: How? Do you know how many stupid medical tests and exams I have taken? I have had more blood drawn than all of Dracula's victims combined. I have swallowed radio transmitters to detect how my stomach digests food. I took MRIs when they were still considered Nuclear Magnetic Resonators, NMRs. Truly, I am so sick and tired of being treated like the human guinea pig! Or "try this diet, and eliminate that from your life, take this supplement"...gross! And it solves nothing or even makes me worse! Instead, these pompous idiots come back and shrug their shoulders, or insinuate that I am doing illicit drugs, or suffering from a bad abortion, or some other idiotic asinine excuse for their lack of knowledge! Damn it!
Dr. Balis: I can see this pains you. Perhaps a review of your records would help. I have a good friend at the University who specializes in rare diseases, we can start there if you wish. Let's talk about the yeast infection you had when you were younger. To your knowledge, have you had an infection since?
Ms. Evans: No, I don't think so. I haven't been to another gynecologist since then. I know I should go, especially now that I am older and will probably be sexually active.
Dr. Balis: Then why not go?
Ms. Evans: Well, first, I hate, I mean, despise going to doctors. They can be very judgmental, and its something I do not appreciate. Second, I guess it's something I am not really ready to deal with.
Dr. Balis: What is it you are not ready to deal with?
Ms. Evans: The implications. What they may find, what they might say, having to tell Brian about all this. What if he doesn't believe me that I am a virgin and didn't get it through sexual activity? He may think I have other diseases too, especially since I am not exactly the healthiest person in the world.
Dr. Balis: What other diseases? You mean sexual disease?
Ms. Evans: I don't think I have anything, per se. I know I haven't been exposed to HIV. I don't use illicit drugs, I've never engaged in sexual activity with another person, never had a blood transfusion, that pretty much rules that out. But I know there is something terribly wrong with my body, and I don't know what it is or how to fix it. I feel like I am trapped. Please forgive me for crying so much. It's so frustrating and I don't know what to do.
Dr. Balis: What would you like to do?
Ms. Evans: I would like to feel better, have a normal life.
Dr. Balis: I have been doing some thinking about all of this. Have you been tested for Lyme disease, mono, or Epstein Barr?
Ms. Evans: Lyme disease, yes. I even met with the top specialist, and this was all way before Lyme was well known by the general public. I had borderline results when my general practitioner tested for it. The specialist retested me in his lab and said I do not have it. But they said there is obviously something plaguing me. So, that was that. Never been tested for mono. I have heard that Epstein Barr is very common in adults, but when I was tested for that the results were negative.
Dr. Balis: You seem to know an awful lot of medical terminology and protocol.
Ms. Evans: I guess I have had to rely on myself for health care in many ways. I take an "inventory" of my health every day and try to see what is better or worse on any given day.
Dr. Balis: That is good, you should be proud of yourself. I hope you are recording your observations in your journal--that kind of information can be very helpful to your doctors. You have taken an active role in your health, and that is very important. It's true that physicians in general are better at treating one disorder that is well understood than diagnosing something unusual and perhaps compound from a whole range of symptoms. How has your family handled it all?
Ms. Evans: They have been really good about it and support me in many ways. The main reason I moved to the Bay Area was to stay close to them. They really wanted to live up here, and they knew I couldn't make it without their help. So we all moved. They call on a regular basis to check up on me, and have a woman come in to clean the house, straighten up, and prepare some food for me to reheat when I am doing poorly. But they also respect my need for independence, which is nice.
Dr. Balis: Good. And your friends, do they know about it? Do you have other support mechanisms?
Ms. Evans: My high school best friend knows. She is really sweet. But she now lives in New York City. We both wanted to be actresses growing up, but she wanted to conquer Broadway, while I desired the silver screen. Other than that, no. I don't know what to tell people. An ex-friend once said to me, "Cassie, what's wrong with you?" in such a nasty demeaning way, simply because I had to cancel plans at the last minute a few times. People just don't understand, unless you can say you have some specific ailment--say AIDS or Cancer or Arthritis and suddenly they become empathetic again. It is so aggravating!
Dr. Balis: Unfortunately, our time is up. I think the key is to get a handle on this physical ailment. I am anxious to be able to get your complete medical file from your previous physicians and psychiatrists. There are some physical conditions which sometimes look like psychiatric ailments. Those have to be ruled out prior to making an appropriate medical diagnosis. I am also going to want you to consider seeing another doctor, an internist. I will try to make a referral within the HMO. Let me do some research on all this, but I'm going to need a little time. Could you gather the name and address information about your previous physicians and either fax it to me or slip it under my door? And I'm going to need you to sign this medical authorization form that will allow your other doctors to transfer the records to me.
Ms. Evans: Okay, I'll try to get all that together. You'll forgive me if it takes me a while. I haven't really being feeling very strong lately. All my energy is spent trying to do my job.
Dr. Balis: Of course I understand. I will see you next week, same time. That'll be Tuesday, August 13 at 1 pm. And of course if you need to speak to me before then you know how to contact me.
Ms. Evans: Thank you, Doctor. Goodbye.
Arrow, Straight, Left, Earlier Arrow, Straight, Right, Later

Button to Dr. Balis' Notes Doctor Balis' Notes on this Session

Button to Cassandra Evan's Transcripts Transcripts of Cassandra Evans' Therapy Sessions
Button to Cassandra Evan's Patient File Cassandra Evans' Patient File

TCT Bottom Bar Links to Top of Page Pipsqueak Productions © 1996. All Rights Reserved.