Transcript of 4th Session between Charles Balis, M.D. and Ms. Cassandra Evans, Tuesday, August 20, 1996 at 1 pm.

Dr. Balis: Good day, Cassie. How are you doing, any better?
Ms. Evans: Not particularly, though I have been going to work again. I just crash at night. I spoke to the leader of Winging It; I don't want them to depend on me for a performance if I can't make it. I just told them I have family responsibilities that I must attend to. Really bums me out, but I don't know what else to do. I think Ms. Bows was slightly upset with me for calling in sick last week. She gave me the cold front for awhile. I guess work really piled up while I was gone. You'd think they would realize how much I do around here and show some appreciation. But no such luck.
Dr. Balis: I am glad you're able to get back to work. Did you get a chance to speak with Dr. Halsey?
Ms. Evans: Yes, I have an appointment to see him next week. I wanted to get an appointment late in the day, so I don't have to take off work, and he was pretty booked up. He seems nice enough, and that is such a relief!! Are you certain that SII won't be able to get any of the information that I tell him. I can't afford to lose my job or my health insurance.
Dr. Balis: SII has the right to find out that you're seeing him, and any diagnosis that he makes, but there is always the doctor-patient confidentiality that you can rely on. You must sign a release form for him to talk to them. If you express your concerns, I am sure he will be happy to help you out.
Ms. Evans: Good.
Dr. Balis: How are things with Brian?
Ms. Evans: A bit better, actually. He called one day, I can't remember when it was exactly. Anyway, he was very upset because I had to cancel plans again, and he thought I was doing something suspicious. I just started crying and crying. Well, he wound up coming over that night, and he held me, comforted me. I tried to tell him that I just wasn't doing very well, physically. He said he didn't realize that I had been ill, and wanted to know more about what was going on with me. I really wasn't able to talk much more about it, but I was glad to get some of it out in the open. He stayed the night with me, which was nice.
Dr. Balis: Hmm.
Ms. Evans: We were up late talking and then crashed on the living room floor. It was sweet and nice. And he didn't make any stupid comments about having sex. Or not having it, rather. It was the first time in a long while that we didn't argue a lot; and we actually talked about stuff. Meaningful things. It was like when we first started going out.
Dr. Balis: I'm glad you're starting to open up to Brian. He is understanding about your fatigue?
Ms. Evans: I think so. I was even thinking of asking him to come with me to see this new doctor. Since I really hate doing these things, it would be nice to have the moral support. And maybe he would get some insight into all this. Of course, it is possible that he freaks out and then dumps me.
Dr. Balis: Either way, don't you think it will be better to know how he deals with your realities? You haven't told him your entire medical history yet.
Ms. Evans: No, not everything. Especially not about the yeast infection. That would be like opening Pandora's Box, I think. Even though I told him before that I'm a virgin, I don't think he really believes me--that I've never been intimate with a guy before.
Dr. Balis: I really don't think that the yeast infection is a very significant part of your medical history. It doesn't indicate sexual activity at all. Really, yeast infections can strike very young girls. I've even heard about newborn babies having yeast infections. And yours has cleared up completely years ago if I remember properly. In fact, they're so common that you can now buy over the counter treatments for them and the cream is advertised heavily on television. Your medical history is complex and you have really been suffering for years. But you can set your mind to rest about the yeast infection part.
Ms. Evans: I don't know. I was so ashamed of having to go to a gynecologist, I guess I've always associated the yeast infection with a sexual disease. You know, I spoke with Michelle last week. You remember, she's been really a good friend since high school, letting me lean on her proverbial shoulder when times are tough. And she can make me laugh no matter how low I am. She's met Brian, and thinks he is nice and all, but I think she would like to see me with someone else.
Dr. Balis: Why is that?
Ms. Evans: Well, he can be impatient at times, and she knows I need a little more patience and nurturing than the average person. There was one time.... We went on an overnight trip together and her family, and I got sick in the car. We were probably like 16 years old. She stood with me beside the road, holding my head as I puked up breakfast. It's almost funny thinking back on it. Anyway, we have always been more like sisters than just friends.
Dr. Balis: Do you think Brian would hold your head when you are ill?
Ms. Evans: I don't know. I'd like to think so. He hates hypochondriacs and hates anything to do with sick things. Odd, isn't it? That of all the people I could be involved with, I chose someone who doesn't deal well with illness.
Dr. Balis: Why do you think he feels this way about sickness? Did you feel this about him when you started dating?
Ms. Evans: I had no idea. He seemed so sweet, so I had no reason to conclude otherwise. I found out when his uncle fell ill. He said his uncle would whine all the time, and really wasn't as sick as he claimed. Brian comes from the "bite your lower lip and get on with it" school of life. And there are many more clichés where that came from!
Dr. Balis: And yet you said he seemed supportive this week.
Ms. Evans: Yes. Doctor, do you think I can ask him join me in a session with you, to tell him about things. Maybe if there is another person present...I don't know. I told Michelle it would be easier to get over him and just start from the beginning again, this time telling the guy up-front. Though, why can't there be a beginning again when I tell Brian? It's all this thinking that gets me so frustrated! I hate feeling sick. I hate not being able to have a normal life, do things like other people do. Tell me, do you think this new doctor will figure out what is wrong with me? If I could just know what is going on inside my body--how to fix it. It would be such a relief!
Dr. Balis: I think seeing him would certainly be a step in the right direction. Let's see what he says. I have nothing against you bringing Brian to a session. However, I think you need to talk with him first. I'm happy with the direction that you're headed in your relationship. Sharing your experience this week with him was a good first step. And, if it seems too much all at one time, don't feel the need to tell him everything all at once.
Ms. Evans: That makes sense. I guess I feel like all this is building up inside of me and when I let a little out, I am going to explode. How do I remain rational, explaining and providing information, when it's such an emotional subject for me?
Dr. Balis: There is no reason to hide your feelings from him, Cassie. In fact, it is important that he knows how sensitive you are. This way, you both can determine if he can meet your needs as well as how he copes with your limitations.
Ms. Evans: I guess I am afraid of sounding like a cry-baby. Sheeesh! This is like having to take off a Band-Aid. It's best to rip it off quick. But you know it's going to hurt, so the temptation is to pull it off slowly. Do some, take a rest, do some, take a rest, and so forth. It's just too much.
Dr. Balis: Do what's most comfortable. You don't have to plan it all out. Let it flow and be comfortable with it. If he really does care for you, as it seems he does, then he'll be supportive and allow you time. I am sure he will have many questions. Try to remember that he is trying to understand the situation, not questioning you. If you need to cry, then cry. Let him see who you really are.
Ms. Evans: Oh, man. This is going to be so hard for me. Okay, I can do this. I've done tougher things in my life, right?
Dr. Balis: Positive thinking is always helpful. And you are correct. I am sure it is much harder to hide your illness and pretend there is nothing wrong, then to share what ails you. Good luck with it. And if you need to talk to me, remember that you can always call.
Ms. Evans: Thanks.
Dr. Balis: Okay, our time is up for this week. Our next session is a week from today. That's Tuesday, August 27th at 1 pm. Does that work for you, Cassie?
Ms. Evans: That's fine, Doctor.
Dr. Balis: Good, I'll see you next week then. Bye, Cassie and good luck.
Ms. Evans: Goodbye.
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