[21:37] <@Grysar> [Date: Friday June 4th, 2004. It's been rainy all day and quite humid, though the temperature isn't bad for June in Tokyo.] [21:40] <@Grysar> [Kyon has accompanied Katie to a modern clinic in Shibuya. It's located in a skyscraper, visitors check in at the security desk on the first floor, but it's discretely handled and Kyon takes care of that part anyways.] [21:42] <@Grysar> [The clinic is on the sixth floor, so a bit of a huff by stairs but manageable. The name is anodyne as is the exterior. The waiting room is not spacious, but the chairs are arranged with some intentional distance. There's one other woman checking out with an attendent when you arrive. She's wearing shades and a hat and avoids eye contact with you.] [21:44] <@Grysar> [Before too long, right on schedule, a middle aged Japanese woman steps out of the back to invite Katie back.] [21:44] <@Grysar> [Start!] 06[21:46] * Katie looks up from where she was fiddling with her umbrella just in time, almost like she expected it, and then looks back in Kyon's direction before getting up and walking to the back. [21:49] <@Grysar> [Kyon gives a small nod and takes a seat, waiting in the waiting room to back her up.] [21:53] <@Grysar> [Most of the doors in the hall are closed, though if Katie had to guess there are probably two other active clinicians here, each seeing a patient. Some of the rooms look more sterile and could service for a primary care doctor or OBGYN, but for the moment, you're led to a windowed room, venetian blinds obstructing any view from other buildings, that has a small desk, a chair, and chaise lounge [21:53] <@Grysar> with a tall enough back to offer support. The style is not the most up to date, but the pieces are in good shape and it would be the height of style in the 70s.] 06[21:54] * Katie ... steps in? And hovers, not quite knowing what to do. She looks to the woman. [21:58] <@Grysar> * The woman steps in as well, standing by the chair and giving a quick bow. "My name is Dr. INOUE Youko, I appreciate the act of trust it took to give me a chance to talk to you." Her tone is crisp but unhurried. 03[21:58] * Grysar is now known as Inoue 06[21:59] * Katie blinks. And nods. 06[22:00] * @Inoue gestures to the couch. "Please have a seat. Would you like anything to drink?" 06[22:02] * Katie shakes her head and goes to sit on the couch, back straight. She doesn't even try hiding the fact that she's tense. [22:04] <@Inoue> Alright if I shut the door? [22:06] <@Inoue> [The door itself is on the thicker end of normal doors and has a rubber lip at the bottom to close the gap between door and floor. It locks from the inside with no key needed. The sound dampening is pretty good, but not enough to block Katie's ears if she strains a bit.] 06[22:07] * Katie glances at the door, then the window. She hesitates for a second, then says, " [22:07] Please. 06[22:09] * @Inoue does so and then takes a seat. Now that Katie's seated she can see diplomas decorating the wall, one Japanese, another written in German. There's also a wind up clock sitting on a lamp stand by the window. "Do you have anything you'd like to ask at the start?" 06[22:10] * Katie blinks. She twists her umbrella strap between her hands. "I, um." She looks down at the strap, then back up towards the doctor. "Is everything confidential?" 06[22:14] * @Inoue gives a brisk nod. "Yes. Your privacy is my top concern. I have recommended some patients speak to authorities in very specific cases, but it is their choice. It has not been a problem for me in the past, but we are part of a larger clinical group that retains a lawyer if we need to protect your confidentiality against legal authorities." 06[22:15] * Katie hums, and she looks at the doctor again, almost like she's actually seeing her this time. "Really?" 06[22:17] * @Inoue continues. "The exception is if I believe there is an imminent risk to yourself or others. If you'd like to know the exact parameters of that obligation, I can share a pamphlet. But we are prepared to protect any information regarding our patients short of that line." 06[22:19] * Katie nods, still tense in posture but calm (if quiet and scratchy) in voice. "I'd like the pamphlet, please." 06[22:22] * @Inoue reaches into a drawer and removes two, one in Japanese, one in English. "We can pause while you review that if you like. I then can summarise for you some key rights you have as a patient." 06[22:26] * Katie nods. "Sure. Thank you." She doesn't even try for a smile as she reaches for the pamphlets. 06[22:29] * @Inoue gives Katie her space answering any questions matching the level of precision with which Katie asks. Afterward, she shares a guide to patient rights that covers what's mandated by Japanese law but also by the larger international organization that the clinic is a member of, going above and beyond those legal requirements. "...And if at any point, you decide that our plan of care, or 06[22:29] * @Inoue my role in it, is not right for you, you may move on without prejudice and we will seek to aid you in finding a replacement." 06[22:30] * Katie looks at the doctor skeptically, but not skeptically enough to waste a sharp move on her. "Sure, okay." 06[22:32] * @Inoue gives a slightly smile. "My services are in a fair amount of demand." She shrugs. "I am not immune to disappointment, but for me failure is your not getting the help you seek. Who you recieve it from is secondary." 06[22:35] * Katie shifts a bit but doesn't say anything to that. She arranges the pamphlets by their corners so they're neatly on top of each other, then sets them to the side. 06[22:40] * @Inoue gives Katie about a quarter of a minute to see if she has any more questions. "What brings you here?" There's curiosity in her voice and after flitting briefly to the pamphlet pile, she keeps her eyes on Katie. [22:43] I, um. 06[22:44] * Katie looks to Inoue, and then past, fixing her eyes on a spot behind and to the right of her head. "There was an... incident. And I don't... know exactly what happened, but a- someone, she's in medicine, she said I should see someone about it." 06[22:47] * @Inoue nods slowly. "Our clinic is here to help with both physical and mental trauma. Is there any concern you would like me to focus on?" [22:48] Um. If there's- 06[22:49] * Katie takes a deep breath and lets it out. "If there's any chance we can find out if I was actually... raped... I would like to know that but." [22:49] It was over two years ago and that seems unlikely. [22:50] I would like to at least take whatever tests I need for diseases or... 06[22:51] * Katie sort of trails off and switches her attention to the window. Why do the blinds have to be closed? [22:54] <@Inoue> [While the blinds are present, they aren't completely closed. At an upward angle the sky is visible, both directly and via reflection in a neighboring building, though that's more grey than blue given the rainy day. Slightly obstructed by the droplets on the window glass. [22:56] <@Inoue> We have a nurse and physician ready to help and administer test. As you say, after two years, certain answers are hard to come by, but health related questions are easier. Is your concern the legal standard or your own knowledge? 06[23:00] * Katie answers, immediately, "My own knowledge. I don't remember much. Or anything. And that could be because of the drugs, or it could be because of trauma." It's a small lie - Katie doesn't mention powers - but drugs were still involved so it's an extremely easy one to make. 06[23:04] * @Inoue nods and slides her legs left towards the window. "All too common, especially two years ago. But your own knowledge is a standard we have a good chance of meeting. If you feel ready for examination, I can introduce you to my colleague. She's trained to help you with a physical examination and standard tests, though sometimes our clients need to build up to that first." [23:05] <@Inoue> (##-good) [23:05] <@Inoue> (clients->patients) 06[23:08] * Katie glances down at the doctor's leg, then turns up to look at her face. "Okay." 06[23:11] * @Inoue stands and walks over to the lamp desk, which also has a phone with a few interior lines. She presses to make a connection. While she waits for the other end to pick up, she inquiries, "Do you mind if I open the blinds a bit? On a day this rainy, the weather provides anonymity." 06[23:12] * Katie shakes her head. "Go ahead." 06[23:15] * @Inoue opens them and the room brightens a bit and you get a glimpse at a passing pigeon. She then speaks into the phone, saying that she has a patient in need of an diagnostic physical that took place two years ago. [23:16] <@Inoue> [The voice on the other line estimates it will be about five minutes and they'll get the room ready.] 06[23:16] * Katie breathes a bit easier, and her eyes track the pigeon while she listens in on the conversation. 06[23:17] * @Inoue gives a warm quiet "Thanks" to the distaff voice on the other side before resuming her seat. "They're getting the room ready. If you like, I can go over some of the questions we may be able to answer and those that the physical will not address directly." 06[23:18] * Katie nods. "Okay." She tries to focus on the doctor again. "Will you want to see me after?" [23:22] <@Inoue> I'd like to, if you don't mind. You will get some answers today. Other tests will have to go to a lab, with no tie to your name. But I am here to help you figure out what you wish to do with those answers, and to help you identify a path to healing from what was done to you. 06[23:24] * Katie nods and says, again, "Okay." Pause. "How long will the diagnostic take?" [23:28] <@Inoue> A half hour is not atypical, to make sure you understand the process. Sometimes longer depending on the needs of the patient and if there's a desire to collect forensic evidence. I'll be here when needed regardless of the time it takes. 06[23:29] * Katie nods again and looks to the door. 06[23:31] * @Inoue talks through what to expect and within a few minutes there's a knock at the door. A nurse, younger than Inoue and a bit heavyset with a serious expression but bright eyes introduces herself and leads Katie to the exam room. [23:31] <@Inoue> [And switch to offscreen.] [00:09] <@Inoue> [Katie shows definite signs of past trauma from multiple sources. There are no visibile signs of sexually transmitted disease. A fully detailed examination would involve crossing lines she's not comfortable with and nurse Nakano's advice is that she could wait on the other tests and since legal standard is not her primary concern, then it can probably wait.] [00:10] <@Inoue> [Sedation is an option if Katie desires it, now or later, but there are not any overt signs of physical trauma to her reproductive system indicative of sexual assault.] [00:14] <@Inoue> [Dr. Inoue awaits to talk through this information, and lack there of, and what to do about it.] (Part 2) 06[21:16] * @Inoue 's office continues to have the window open. There's more sunlight breaking through the clouds, but a few new drops land on the window each minute. She's seated and patiently giving Katie time to process. 06[21:19] * Katie sat down and is facing the window, very still with a distant look in her eyes. She hasn't said much, though Dr. Inoue probably got the report, so... it's not like she needs to. 06[21:24] * @Inoue gives Katie another minute before asking crisply. "Do you have any questions? I'm sorry we could not give you clearer answers but the absence of more lasting physical complications is some solace I hope." 06[21:26] * Katie starts, slightly, and turns to look in Inoue's direction. Her eyes clear a bit. "I... I don't know. This is..." She shrugs. "I don't know what I was expecting. But that wasn't it." She looks out the window again, then adds, "I guess that wasn't a question." 06[21:29] * @Inoue frowns. "A failure on my part to better prepare you." She hmms for a moment but doesn't elaborate. "You seem to be processing a lot right now." 06[21:32] * Katie shakes her head. "Not really. I guess." She sighs and brings her knees up, setting her feet on the cushion and curling her arms around her legs. 06[21:35] * @Inoue nods. "It's not uncommon for our clients to seek to minimize what they've been through and face self-doubt. After what you've been through, you deserve care just as much as someone's whose trauma is even more physical." [21:36] <@Inoue> (-'s) 06[21:40] * Katie is silent for a moment, then says, "I don't know." She tilts her head, resting her cheek against her knee. "It doesn't matter." [21:40] <@Inoue> Why do you say that? [21:44] Because it's done. I knew I wouldn't get everything I wanted to know. I just have to deal with it. 06[21:47] * @Inoue straightens her leg. "We may not be able to detect more about the past. But we can learn more about your presesent and identify tools that may assist you." [21:47] <@Inoue> (legs) [21:47] (and present?) [21:47] Hm. [21:49] <@Inoue> (Yes) [21:50] <@Inoue> One way forward would be for me to ask questions to help identify symptoms you may still face as a result of the incident. 06[21:54] * Katie blinks. And focuses on Inoue again. It's kind of intense, but she's a doctor. She can take it. "Okay." 06[21:56] * @Inoue keeps eye contact, but when Katie nods she says a quick. "Thank you." And stands to retrieve a clipboard from her desk. The rain outside is intensifying and a pigeon has taken shelter on the windowsill outside. Inoue doesn't seem to have noticed it as she sits down again. 06[21:57] * Katie is distracted by the pigeon. Well, not really; she's still absolutely paying attention to Inoue. But she prefers looking at the pigeon. 06[21:59] * @Inoue glances over to follow Katie's eyeline and blinks at the pigeon, bemused. She then returns her attention to her patient. "Do you feel that you are easily startled or regularly feel fear?" [22:00] I... guess so? 06[22:00] * Katie thinks about it, then says, "Yes." 06[22:00] * @Inoue jots that down. "Did that become more prevalent after the incident?" [22:04] Um. 06[22:06] * Katie takes a bit to answer that. "I... don't know. I think... right after it, I..." She takes a deep breath and lets it out. "I remember everything feeling clearer. Actually." 06[22:06] * @Inoue hmms and jots that down, eyes flitting over the list in front of her. [22:07] <@Inoue> As if you were more alert? [22:08] Maybe. [22:08] Yeah. 06[22:09] * @Inoue leans forward slightly. "Would you describe that clarity as being more like focus and concentration or more being vigilent?" [22:11] Um... I don't know. I... 06[22:11] * Katie hesitates. How does she even explain this without- 06[22:14] * Katie 's brain locks up for a moment longer before she lowers her legs to the floor. She runs a finger over the hem of her shirt and looks directly at Inoue again. "I'd describe it as being so angry I was done being scared." 06[22:15] * @Inoue waits and listens and jots that down. "Anger often is frowned on by society, but in this sort of situation, it's a very natural response and can sometimes help people get to safety." 06[22:16] * Katie snorts. "I wanted to kill him. That's not really safe." She looks out the window again, thumb still running over the stitching. 06[22:18] * @Inoue nods. Pen moving down the paper. "Does the anger persist? Are you easily annoyed or find yourself more riled up than you want?" 06[22:20] * Katie 's brow furrows. "Not that specific anger, but maybe? I guess?" 06[22:21] * @Inoue nods. "Right, not that specific anger. This question is more about anger in other parts of your life." [22:21] Um... what do you mean. [22:22] <@Inoue> When things don't go your way. When you have bad luck. When people are rude or thoughtless. 06[22:24] * Katie frowns, thinking. "People," she decides. "Sure." 06[22:24] * @Inoue writes that down. "Any trouble sleeping?" 06[22:24] * Katie laughs. "Yeah." 06[22:26] * @Inoue is slightly startled by the laugh and smiles a little. She writes a word and underlines it. "Any self-destructive behavior? Drinking? Thrill seeking?" [22:26] Don't think so. [22:27] <@Inoue> Do you wrestle with guilt or shame? [22:33] Yes. 06[22:33] * Katie resists the urge to add 'don't you', even though she would feel better for .5 seconds. 06[22:35] * @Inoue records that. "What's the magnitude like? Typical for a failable but self aware human or sometimes all consuming?" 06[22:36] * Katie shrugs. How is she even supposed to answer that? [22:38] <@Inoue> Alright. Would you like me to talk through possible diagnoses as we go? Particularly at early stages, there's a real chance I'm wrong. On the other hand, for some patients transparency is most important even if it means more uncertainty. 06[22:40] * Katie blinks, and her eyes shift to the doctor. "Diagnoses?" [22:42] <@Inoue> Part of my job is to identify patterns of behavior. Every person is different, but understanding your symptoms and mental state can help me narrow down treatments that have been shown to help people with similar problems. [22:44] <@Inoue> (narrow down -> hone in on) 06[22:44] * Katie blinks. [22:44] Okay. [22:47] <@Inoue> So you have five of the seven arousal symptoms. Some stronger than others. That's not a very detailed diagnosis, but I like to establish if some of the more day-to-day symptoms are present before moving on to the more challenging ones. 01[22:48] (arousal symptoms?) [22:48] Arousal symptoms? Um. Okay. [22:50] <@Inoue> Those are more about your physical and emotional reactions. The next questions I have will focus more on how you think and your mood. 06[22:53] * Katie nods. "Okay." She straightens a bit. 06[22:56] * @Inoue shuffles her papers on the clipboard. "Negative thoughts about people, society, yourself?" She glances up at Katie as if expecting this might draw a quick response. [22:57] It's hard not to have them, yeah. [22:58] <@Inoue> Hopelessness? [23:02] Um... I used to have more. 06[23:04] * @Inoue writes that down, lips parted as she listens. "More back when the incident was closer?" [23:13] Yeah. And before. A lot before. 06[23:14] * @Inoue nods. "Would you like me to focus more on the incident or also include what came before?" 06[23:15] * Katie shrugs. She doesn't really know what to say about that. [23:15] <@Inoue> Are you comfortable sharing what changed? Why the hopelessness abated? 06[23:19] * Katie sighs. "I got angry." She looks down at her shirt, at the hem, and runs her fingers on the seam. "And a lot of the people who hurt me got... I mean, the ones who were direct about it. They're... gone. Now." 06[23:21] * @Inoue eyebrows raise slightly but her tone is steady. "I've heard that before, with some of was going on two years ago." 06[23:25] * Katie looks at Inoue sharply, for a moment, then she moves her gaze so it's slightly off center and shrugs. 06[23:30] * @Inoue hmms but doesn't follow up. "You already not knowing what happened. Could you tell me more about your how well your memory works?" [23:31] You're going to have to be more specific. [23:33] <@Inoue> So memory in general is fallible, but do you find you have gaps? This could be about the incident itself or often other stressful situations. [23:34] Oh. 06[23:34] * Katie blinks. [23:34] Yes. [23:35] Sometimes, uh... [23:35] There's are some things that are a blur. Not... the latter part of a year, after the- 06[23:35] * @Inoue makes note of that. She had opened her mouth to say something but closes it again with an encouraging nod. 06[23:35] * Katie gestures. "The incident." [23:35] I guess it's not actually the latter part of the *year* but... [23:36] And also after um, after I got out of the closet. Really, starting there, I think. 06[23:36] * @Inoue writes a bit and furrows her brow slightly. "That was before the incident?" [23:37] Yeah. By maybe a month or so. 06[23:38] * Katie frowns, considering. "And after, more recently I guess, sometimes I, um... I don't remember things very clearly in... small pieces? Like-" She takes a breath. Right. "Like once I was working on drawing for class and I just- did my assignment but I don't remember actually *doing* my assignment." [23:38] Or another time I was reading something and I kind of... ended up at the top of Waseda's clock tower. 06[23:39] * @Inoue nods and writes quickly. "Have you noticed any patterns on when that happens?" [23:39] <@Inoue> [Meanwhile the pigeon struts back and forth on the sill, shaking off its wet wings.] [23:39] I know I was upset the second time. What I was reading reminded me of the- the closet. [23:40] The first time, I don't know. We had a model for class and were told to draw- I've never had a problem drawing nudes before, so... 06[23:40] * Katie shrugs. 06[23:44] * @Inoue jots down a few more notes, both in the part of the sheet she was filling out and afterwards. "We'll be focusing more on memory soon. But while the specifics vary, what you've experienced isn't shocking for someone that's been through what you have." 06[23:44] * Katie relaxes, slightly. "Cool," she says, and then laughs to herself because for some reason that's funny. [23:46] <@Inoue> Okay so next question, close relation -- actually, Waseda Clocktower. Do you have any sense why? A place you admired when going to classes? 06[23:47] * Katie nods. "Yeah, probably. Not my classes, but I saw it when going to see my boyfriend. I like how high up it is." 06[23:48] * @Inoue nods. "Is that the one with the British architecture?" [23:51] Mmm hmm. 06[23:55] * @Inoue hmms. "I've been longing to go back to Berlin to see the view from reconstructed . It's only so many stories up, but glass in all directions. But it wasn't reconstructed until after I graduated." 06[23:59] * Katie blinks. That's not information she expected. She nods. [23:59] That sounds really cool. [00:01] <@Inoue> I have a photograph book at home, both of the architecture and the views of the city. I could bring it next time, if you like. [00:01] Um. All right, yeah. 06[00:04] * @Inoue blushes. "Sorry, please forgive an old woman her nostalgia for her student days." 06[00:04] * @Inoue looks back at the sheet. "Do you have trouble with close relationships? Not just boyfriend, but also other sorts of mutually supportive ties." 06[00:05] * Katie furrows her brow at that. [00:05] I don't know what you mean. [00:07] <@Inoue> The challenges vary. Difficulty trusting, being open with people, tolerating their weaknesses. [00:07] <@Inoue> And you don't have to grade yourself on some objective scale based on the quality of your friend collection. It's more about whether you have a harder time than before the incident and the closet you mentioned. [00:07] Oh. [00:07] Yes. [00:08] <@Inoue> Which flows into the next question, do you feel detached from them? 06[00:08] * Katie nods. [00:09] It's hard not to. 06[00:10] * @Inoue hmms at that and ventures a guess. "Because they couldn't relate to what you've been through?" [00:14] Kind of... no... I don't know. People are just... awful and stupid a lot of the time, I guess. 06[00:15] * Katie winces. "That's shitty of me to say. Sorry." 06[00:17] * @Inoue shrugs. "It can be true. Psychological health doesn't mandate that you have a positive view of human nature. But sometimes people who have been badly hurt, especially if they lacked support when they needed it, become fixated on the worst of what we do. [00:20] Okay. So I'm probably fixated on that, I guess. 06[00:21] * @Inoue underlines what she wrote. "Had you lost interest in what were once your favorite activities?" [00:22] I don't think so. [00:23] <@Inoue> Are they less people oriented? [00:24] Yeah, always have been. [00:26] <@Inoue> Are you able to experience positive emotions? Not all the time, but when it feels appropriate. [00:26] Yeah, I think so. 06[00:28] * @Inoue jots that down. "Do you often feel numb emotionally? That can mean both positive and negative emotions." [00:29] I... do sometimes, yeah, but I don't know if it's 'often'? 06[00:30] * @Inoue nods. "But more than you once did?" [00:30] Yeah. 06[00:32] * @Inoue makes note of that. "So negative thinking is far more prevelent than the arousal symptoms I mentioned earlier." [00:34] <@Inoue> For the rest of this session, I'd like to talk about memories some, and some techniques that might help if you would like to be able to shift your thinking. 06[00:35] * Katie nods. "Okay." She actually relaxes a little bit. "I'd like to work on the memories thing." [00:36] <@Inoue> [Pause!]