Patient K163 (Quinten Kearney)

[Doc]

Dr. Charles Nilson sat at his desk perusing the file that an associate had sent him. Normally he would not take a new human patient on. He was a vampire, and the majority of his patients were long standing, or vampire. But he could not say no to Dr. Rebecca Ashby’s request.

Dr. Ashby was a general practitioner, who specialised in family medicine. Rebecca had always been available to him when he needed something. Granted his past requests of her had been minor at best, but it was the manner with which she fulfilled his requests that bought her his respect. She did it without fanfare and without making him wait. Other physicians tended to be like himself, ‘your request will be fulfilled at my leisure, not on your timeline, if you can’t wait, ask someone else’. But not Rebecca. She was of the mindset, that the needs of the patient came first. And if she was being requested to do something for a patient, she did it, right then.

The patient was Kearney, Quinten R. Twenty-three years of age. Occupation, student at Harper Rock University. Possibly suffering from depression due his mother’s medical condition, exasperated by obvious social anxiety and stress due his recent move from New York to Harper Rock, where his mother resided in a managed care facility. Doc closed the file. Elbows on his desk, he linked his fingers and rested his chin against his linked fingers as he pondered the different iterations of how this appointment would go. He would need a course of action for each branch of the iteration, and Mr. Kearney was due to arrive shortly.

[Quinten Kearney (DELETED 6516)]

Quinten attempted to smooth down his hair, a faint tremor in his hands; he felt like his heart was going to jackknife right out of his chest. He wasn’t sure what he was doing here. Correction: he knew but he wasn’t convinced counseling was going to be of any help.

He’d been to see a handful of counselors over the years, most of those sessions in regards to university integration—‘You’re very young. Are you feeling homesick? There’s nothing wrong with missing home. Are your classmates treating you well? They’re not bullying you at all, are they? Your professors speak very highly of you. You can be honest with me, Quinten. This is a safe place.’—and he’d been ecstatic when he’d turned eighteen and the meetings were no longer mandatory.

His doctor had seemed to think it might help to talk with someone—she spoke very highly of Dr. Charles Nilson—and considering his recent blackouts he’d eventually capitulated. There was nothing physically wrong with him. (The alternative was all the more terrifying).

He glanced at the clock from his seat in the waiting room: it was almost time for his appointment.

[Doc]

At the appropriate time Doc stood, walked to the office door, opened it and looked into the lobby to see a young lanky fair skinned male waiting almost nervously. “Mr. Kearney,..” He gestured to the male, to come on back. He held the door open waiting for him.

As one entered the office and looked toward the back, they would see the office had Doc’s desk, filing cabinets, a bookcase filled with books. The only non-book in the bookcase was a paper mache egg. It was hand made and sat in a prominent position in the bookcase. The bookcase was full. There was even a neat stack of books on the floor. Doc’s desk also had several books on it. There was a laptop, but it was closed. However several books that littered the top of the desk were open and set so that a person could easily switch back and forth from book to book.

On the other side of the room were two leather tufted arm chairs and a small end table. One of the chairs had a gold colored cushion resting on it, the other chair was empty. The chairs faced one another. One chair facing the office door and the other chair, with the cushion, having it’s back toward the office door. It was test of sorts. Which chair would he take? The choice of chair would be telling in one way or the other.

[Quinten Kearney (DELETED 6516)]

“Dr. Nilson,” Quinten greeted in return, entering the room. He glanced around the room as he entered, eyes caught momentarily by the paper mache egg, wondering at the significance, before turning his attention to the seating options. It was a test. Or was he being paranoid?

One chair faced away from the door and had a gold-colored cushion. The cushion could be for ease of sitting, or was it meant to be comforting? It offered a softer, more relaxed option; for someone unworried about having their back turned. The other chair didn’t have an extra cushion and faced the door. Was it a test for hyper-vigilance, trust issues, or maybe a denial of comfort? Quinten didn’t know all the theories or statistics; he had been avoiding the study of psychology, outside of his mother’s condition. It would probably help his anxiety, being able to more accurately examine himself and others, but it also might make it exponentially worse.

Quinten forced the tension from his shoulders and chose the chair facing the door, psychoanalysis be damned. He’d never enjoyed dealing with extra cushions.

[Doc]

Doc closed the door softly, and turned to face Mr. Kearney, giving him a polite amicable look. He took the seat opposite, and sat the cushion on the floor, against the side of the chair. He had learned a few things about his client thus far, however, backup proof would be needed for firm confirmation. He relaxed back comfortably in the chair, though it appeared his companion did not come across as easily relaxed.

“Mr. Kearney, I am Dr. Charles Nilson. I took this referral because I respect your GP. I think it is fair that you should know, I am not the typical counselor, that most people think of. I am not going to ask you to get ‘in touch’ with your feelings. I am not going to tell you that ‘it’s all your parents fault; whatever ‘it’ is’. I am of the school of thought that most of us, have the answers we need. Sometimes it is easier to come to those answers by talking to someone not emotionally or financially invested in the outcome.” He crossed his legs and linked his fingers together around his knee.

“What is it, that you hope to get out of our sessions?” Yes. That question was presumptive of the fact that the man would return. Doc believed he would, from what he could about him already, Mr. Kearney didn’t want to be here, but he was here because of a resigned acceptance that something had to be done. What that ‘something’ was, Doc wasn’t sure of. It could be depression; insecurities born from his recent move; or something as simple as how to deal with a parent’s debilitating illness. It was clear he was well aware of his surroundings, that meant he wasn’t lost in himself and his ‘problems’. He had been tense, and yet forced himself to appear relaxed, that meant he preferred to be seen in a position of strength rather than weakness. Whatever Mr. Kearney’s problem, it was not self-absorption or self-pity.

[Quinten Kearney (DELETED 6516)]

Quinten blinked, taken back by the doctor’s brusque manner.

“I’m looking for strategies, clarity of thought maybe,” Quinten summarized. “I’ve always dealt with some level of social anxiety—I can’t seem to help over thinking everything—more rarely I’ve had depressive episodes. But ever since I moved back it’s gotten exponentially worse and now I’ve started experiencing blackouts; I’ve never gone for a walk and zoned out so completely that I had no recollection of where I’d been. I came to in the woods last time!”

Quinten rubbed at his neck unconsciously, taking a moment to breathe before he continued:

“Dr. Ashby couldn’t find anything physically wrong with me—my iron levels were a little low, but it was within the norm—so it must be a mental component, the result of culminating factors. Lack of sleep, dealing with… my mother…moving back here. I can guess the why of it; I just don’t know how to deal with it. I feel like I’m coming apart at the seams.”

[Doc]

Doc nodded vaguely, as he listened. This was why he did not take new human patients. It was at odds with protecting the masquerade. He was a doctor, a patient came to him for help with a complaint, it was his duty to help him. Yet, to help could put the masquerade at risk. There was a very fine line that had to walked here. Very fine indeed.

“Dr. Ashby did send your records when you agreed to the referral. In addition to your low iron levels,” which Doc had a pretty good idea why that was, “you are underweight for your height. Studies have shown that there is a link between nutritional deficiencies and depression. One such deficiency is Iron, another two are amino acids and Omega 3, or fatty acids.” He paused, “Poor nutrition has been linked to poor sleep as well.” He unlinked his hands and gestured absently, “However, I am inclined to agree with you, that the stressful issues you are currently dealing with in your personal, are most likely the main culprit to your depression; but poor eating and sleeping habits can exacerbate the situation. The blackouts you mentioned are concerning to me. I would like to ask you a series of questions, that may seem simplistic in the beginning; but there are some things, you simply cannot get from a medical file. Are you eating a nutritious and balanced diet? Or have your eating habits changed since you have moved?”

[Quinten Kearney (DELETED 6516)]

Quinten nodded his understanding, not exactly enjoying the feeling of being put under a microscope, but the doctor made a valid point. The body was a complete system and when one unit was out of balance it tended to skew everything else.

“My diet has changed,” Quinten admitted, “I’ve never been great at remembering to eat, but I had a schedule that I kept to when I lived in New York and the people I worked with were fond of dragging me out to eat on a semi-regular basis. Since I moved back I—haven’t really kept to that schedule.”

“I have cut back on my coffee consumption,” he offered, knowing that caffeine consumption was generally not encouraged when a person was suffering from any type of anxiety related issues.

[Doc]

Doc gave him a look, one that said ‘really, you’re trying to win points because you cut back on your caffeine intake’. Clearly he was unimpressed. He leaned forward, his face serious as he began to lecture him, as though Quinten were one of his interns.

“Mr. Kearney.” That dreaded pause that came right before the brutal truth is laid out in front of you. “You are a caregiver for a parent that will need increasingly more attention as time goes on. You do not have the luxury of being ******* stupid.” Doc gives him a pressed lip look, thinking, this man is not stupid, he should be aware of this. He should not have to give him the ‘wake the **** up - 101’ speech.

Doc began to explain, his tone at first being that of someone explaining to a child, “When you fail to eat, or when you eat meals at different times, rather than on a regular schedule, your body goes into stress mode. For example, when you eat breakfast at 7 a.m. one morning and 11 a.m. the next, your body becomes confused about where its next meal is coming from. This causes the secretion of the stress hormone cortisol.

“We need cortisol. It helps to regulate blood pressure, your immune system, how your body handles stress and to balance your insulin. Too much cortisol or high levels of cortisol leads to spikes in your insulin. In a healthy person, the insulin spikes, does its job and the levels return to normal.” Doc gives him a flat look, “You obviously are not a healthy person, regardless of what your tests reveal.” Another dreaded pause. “So If something goes wrong and the insulin levels stay high, it can cause symptoms of dizziness and blacking out. Sound familiar? If this trend continues, it will become a medical emergency.”

His tone now changed to a barely repressed frustrated tone. “A person of your age and intelligence should not have to be reminded to eat. You are a responsible person because you are in University; you visit your parent regularly, and yet you cannot remember to eat? That is ******* lazy. Unless you subconsciously want to have a medical emergency to get you out of your responsibility to your parent. If that is the case, you need to go elsewhere, I refuse to be an enabler.”

[Quinten Kearney (DELETED 6516)]

Quinten’s first reaction was shock. He generally appreciated directness, but this was an attack. Exactly what kind of doctor had he been referred to? And then he started to get angry, an emotion Quinten didn’t often experience; he got irritated, occasionally exasperated, but never angry. (He’d been angry when his father left). Anger tended to make him overly dramatic.

“I didn’t have to come back. If I wanted out I could have stayed in New York, and maybe I should have. It’s not as if I can actually do anything to help her; she has congestive heart failure. She’s dying. As her physical health deteriorates she has more and more relapses, which in turn exacerbates her physical decline. It’s a cyclical reaction that’s only going to end one way, whether I’m there or not.”

He stood, limbs shaking from a different sort of adrenaline than usual. “Just to be clear, academic excellence has very little to do with common sense. And mental health issues generally have very little to do with what is rationale besides, which you should damn well know.”

“I think it’s agreed that I won’t be rescheduling.” He walked out the door.