Office Visit

A psychiatrist sat behind her desk, in an elegantly appointed office, reviewing and rewriting her notes from her last patient. This was her favorite moment. Quiet. Thoughtful. The moment was shattered when the next client burst into the room, followed closely by the doctor's receptionist. The new client was very loud. Demanding.

The receptionist; a HUGE, simple man; was very distressed and apologetic.

Receptionist: “I am VERY sorry doctor.”

Patient: “Nonsense! The doctor is VERY happy to see me! Aren’t you, Doctor?!”

The psychiatrist checks her calendar and notes the appointment for this new patient. The patient is 15 minutes early. The doctor opens her billing application on a console in her desk and makes a note of it.

Psychiatrist: “Please take a seat.”

The doctor signals to her receptionist that everything is fine, and he lumbers out of the office, still a bit red-faced, and closes the door.

Patient: “What a morning, eh Doc?!”

The psychiatrist nods and observes her new patient thoughtfully. The new client remains standing.

Patient: “What a shabby office, though, nothing like mine—am I right, Doc?! I guess with the rates you charge this is the best you can do, huh?!”

The psychiatrist reopens the billing application on her console, and doubles her usual rate for this new client.

Psychiatrist: “Please take a seat.”

The patient continues to wander around the office, picking things up and tossing them down again, with something like contempt.

Patient: “Why, my office is HUGE! Spared no expense. Only the VERY best for the founding lawyer in the firm, eh Doc?!”

The psychiatrist checks her file on this patient and notes that he is employed by a mid-sized law firm in the city. She opens a browser on the console set into the desk and pulls up the law firm’s website. Her new patient is listed as an associate, new to the firm.

Psychiatrist: “Please take a seat.”

The new patient walks across the office and looks out the window. It’s a pleasant view from the 42nd floor. The ants in their cars and busses below, busy with their little lives. The sky is clear. the sun shining over the city.

Patient: “Not a bad view, Doc. Nothing like mine, of course. Top floor. One wall is all window! I can see all the way to Washington from my HUGE office overlooking the bay!”

The psychiatrist looks back at the law firm webpages and notes that the firm’s office spaces are located on the fifth floor in a downtown office building. No view of the bay from there. The new client finally sits down. Some of the light goes out of his demeanor, she notes. When the patient next addresses the doctor he speaks more quietly, leaning towards the desk.

Patient: “You see Doc, I keep having this dream.”

Psychiatrist: “Tell me about it.”

The doctor opens a virtual keyboard on her desk, which now that we look more closely, seems to be one, large screen functioning as a desktop and multiple computer screens. The doctor types while her patient relates a troublesome dream.

Patient: “I am an American Fighting Man! A US Marine! Naturally, I am in charge. I have only the best men under me, all highly trained, by me. Just the finest warfighters money can buy, the best gear, and the best leader in all of history. We are at war, in a pitched battle. We are taking fire, there are casualties, but it is a price I am willing to pay—for victory!”

Psychiatrist: “Do you dream of war often?”

Patient: “Yeah, I do. But I have nothing but good feelings about my prior service. The good old days. Great battles, hard-fought victories, good memories. I mean, why wouldn’t I dream about that, Doc?!”

The psychiatrist pulls up another application on her desktop console and does a quick background check on this new patient. No military service.

Psychiatrist: “Is that the whole dream?”

Patient: “Nah, there’s more. See there’s this woman. I think she must have been an instructor at the naval academy. Of course, she fell for me—who wouldn’t?! Am I right, Doc?!”

The patient grins at his doctor in an uncomfortably feral manner. Leers, really, if we are being honest. The psychiatrists taps her keyboard, making notes in her file.

Psychiatrist: “Please go on.”

Patient: “So you see Doc, there’s this woman and we’re married and we have a kid on the way. I am a bit younger in this dream. I am thinking about her and my next namesake on the way while we are taking fire and heavy casualties. It’s a very unusual version of my typical military dream campaigns. We are always winning without much resistance. Lot’s of winning. I have all the ribbons to prove it!”

Psychiatrist: “You are not victorious in this version of the dream?”

Patient: “It’s not just that. The enemy has come in under the wire, past our defenses, and entered the HQ. I am just reaching for my sidearm as I see the sentry fall in a hail of bullets. I am hit, and I slump to the ground. The last thing I see is a grenade roll up near me, and I think “What about Leslie and the baby?”

Psychiatrist: “Hmmm.”

The patient is standing again, looking agitated and pacing back and forth in front of the couch.

Patient: “What gives, Doc?! Why am I thinking about a wife and child in that moment?! I mean, it’s just a weird, crazy dream, right Doc?!”

Psychiatrist: “What do you believe your last thoughts should be, in this dream?”

The patient stops pacing and stares at the doctor with incredulity.

Patient: “What kind of question is THAT, Doc?! What should I be thinking about?! What SHOULD I be thinking about?! How could this HAPPEN?! That’s what I should be thinking about. How could this happen to ME?! How could my highly skilled troops let the enemy into camp? How could they FAIL me?! How could they fail ME?! How could I die?! How could the country go on without ME?! When will the country fall?! How will the country honor its greatest hero in defeat?! THESE are the important questions that I should be asking at the end of that dream. You see that don’t you, Doc?!

The psychiatrist makes some more notes, tapping away at her keyboard.

Psychiatrist: “So it bothers you that in this dream, your last thoughts are of your wife and unborn child, rather than of you, yes?”

Patient: “YES!”

The psychiatrist pulls up the background application and with a few keystrokes determines that her patient has been married and divorced three times. No kids. The psychiatrist does a quick scan of some social media entries which suggest the divorces were messy. Some very hateful tweets. #9signsyouaredatinganarcissist

Psychiatrist: “It seems quite healthy to be thinking of loved ones at the moment of death. Do you not think so?”

The patient sits down again, abruptly, and stares at the doctor.

Patient: “No! What about me?! What about the battle?! What about the fate of our country and the American Dream?!”

The doctor and patient stare at each other for some moments.

Psychiatrist: “Tell me about your current relationships. Are you seeing anyone in particular?”

The patient gets a look of defiance and contempt on his face.

Patient: “Doctor, I am a happily married man with six, VERY healthy and happy children. I married my childhood sweetheart who ADORES me. There is no issue at home, Doc.”

Psychiatrist: “I see.”

Patient: “Can’t you help me get rid of this dream, Doc?!”

Psychiatrist: “Is this dream impairing your happiness? Is it interfering with your life?”

Patient: “HEY, Doc! I am VERY happy. On top of the world! I own and operate the most successful law practice in the state... in the country, really... I am married to the most beautiful woman in the world. VERY beautiful. Everyone says so. My children ADORE me, I mean, why wouldn’t they, right Doc?!”

Psychiatrist: “Indeed. If there is nothing wrong in your life, as you describe it then I cannot diagnose you. If you believe there is a problem in your life then we have a basis to move onto treatment.”

Patient: “Fuck you, bitch!!”

Psychiatrist: “And, I think we are done here.”

The patient shuts his eyes tightly, and hugs his shins in a kind of fetal, sitting position. His mouth is closed, jaw clenched. The psychiatrist taps the billing application on her desktop screen and triples her billing rate for this session. Cancels all future sessions. She taps another application and summons her receptionist. As the large man opens the door, filling the door frame the room begins to darken. The psychiatrist stands and walks over to the window. She remembers that there is a full, solar eclipse today. She does not look directly at the sun, but can see the sun becoming more obscured. The room darkens. The patient remains on the couch, eyes squeezed shut, rocking himself to an unheard rhythm.

When the patient finally opens his eyes he is in a courtroom. A keen observer could tell from the proceedings that it is a divorce trial. A very pregnant woman is testifying, painting a picture of life with a classic narcissist. Just another overbearing jerk. Nothing to see here.

The defendant ignores the memory of his most recent dream, “Stupid doctor, what does she know?!”

The end.