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 Forum index » Archive » Archive: Chasing the Wish » CTW: Interaction
EMAIL: Dr. Kendra
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dmax
Unfictologist

Joined: 09 Jan 2003
Posts: 1387
Location: Location: Location!

 		EMAIL: Dr. Kendra
Taking care of Dale.
I want to make contact, but realize I can't ask for specific details of his case.

Any ideas?

I want to approach it from a medical standpoint, using the big words and stuff.
_________________
That sounds like something HITLER would say!

PostPosted: Fri Mar 14, 2003 1:57 pm
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Newbie
Greenhorn

Joined: 19 Feb 2003
Posts: 9
Location: Charlotte

 		I haven't read the complete diary, so this may be a moot point, but has anyone tried posing as a family member?? i.e., brother, sister, parent.

PostPosted: Fri Mar 14, 2003 2:32 pm
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butterflyer22
Boot

Joined: 25 Sep 2002
Posts: 37

 		I'm posing as a roommate from medical school, that is looking for their roommate after receiving a letter about upcoming college reunion.

PostPosted: Fri Mar 14, 2003 2:37 pm
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dmax
Unfictologist

Joined: 09 Jan 2003
Posts: 1387
Location: Location: Location!

 		Contact from Dr. Kendra
I wrote:
Quote:
Dr. Kendra,

Sorry to trouble you at work. I know every email is another thing to
do...

I'm certain you're aware of the media attention that's been given to
Dale Sprague's recent accident and loss, as well as his need to be
cared for in your facility. I was one of those that Dale asked to help,
as he contended that he was somehow responsible for his family's death.
You already know that his letters suggested that there were
supernatural aspects to his story, which I don't consider unusual in
post-traumatic stress. I was saddened to see that he somehow feels
responsible for the accident.

I wouldn't presume to ask you about your client's case, but in the news
articles reviewing Mr. Sprague's circumstances, they seemed to imply
that there had been an increase in the need for mental health services
in that area. I noticed that Klepsydra and Greatwater General forged an
alliance in the interest of the needs of the community, which suggested
that there had been an increased demand.

One of my informal interests is the epidemiology of mental illness,
particularly in areas that seem to be a locus for a particular type of
diagnosis. Could you take a minute to tell me if there are any unusual
patterns of mental health needs in the Aglaura area and its neighbors?
Specifically, I'm noticing things like Dale's story and the increasing
incidence of graffiti around town. I wonder if they're a manifestation
of something stressful underlying the populace. Perhaps that sort of
situation can translate into increased funding to your facility? You
never know.

Thanks for your time. I know we all have less and less of it these days.

Dan S, MD

and received:
Quote:
Dr. S--

How do you know Dale Sprague? If you're his PCP then I've got a few questions
for you. Frankly, I'm surprised at all the interest in my patient's case.
There was less media coverage of the accident here in Princeton than Aglaura,
of course, or so I have been told, but it still made the news. But I guess
tragedy sells better than good news, unfortunately.

To answer your main question, overall, here in inpatient we see depression and
bipolar most, followed by OCD, panic disorder, GAD, etc. in about equal
amounts, and schizophrenia and other psychoses, in that rough order.
Outpatient runs the gamut--all of the above and throw in things like
borderline, and the average adjustment disorder stuff. This doesn't include
substance abuse and eating disorders--we've got separate clinics to treat
those, and I couldn't speak to that as much. You'd need to talk to somebody
who works in those areas. I don't think that distribution is necessarily
unusual for a large treatment center, but stats isn't really my area. True, we
have seen more patients overall, but there was a big media blitz when we joined
up with Greatwater a few years back, and I think a lot of it has to do with
that.

So are you in private practice, or at a clinic or hospital, or something else?
If you're at NIMH, we could always use more funding (hint, hint)!

-Michelle Kendra


Michelle Kendra, MD
Inpatient & Outpatient Psychiatry
Princeton, NJ Headquarters
Klepsydra Mental Health Facility Network

_________________
That sounds like something HITLER would say!

PostPosted: Fri Mar 14, 2003 4:30 pm
Last edited by dmax on Sat Mar 15, 2003 2:47 pm; edited 1 time in total
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MrDoug
Veteran

Joined: 14 Nov 2002
Posts: 74
Location: On the Outside looking in

 		GREAT GOB!
The part about asking if you are his PCP sounds like an opening for your to say YES I AM! This letter really seems like an opening for more dialouge between you. Posing as his PCP we could get a lot more information.

PostPosted: Fri Mar 14, 2003 7:14 pm
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dmax
Unfictologist

Joined: 09 Jan 2003
Posts: 1387
Location: Location: Location!

 		pcp
Here's what I sent today. I didn't come up with the concept - it was generated in the unf chat area. Thanks, konamouse!
Quote:
Dr. Kendra-

Thanks for the note. I've got a few minutes to write back to you today, working a Saturday clinic mostly seeing soccer sprains. I work for a really big medical group. I'm salaried, so no hassles with capitation. I give good care and good service, and we keep members (and their premium dollars) because they're satisfied. It's a really good deal, to be honest. I think the folks in the private world have it really rough these days trying to get reimbursed through tightfisted insurance companies.

How do I know Mr. Sprague? Well, I haven't met the guy. But, he chose me and a group of others to receive his email, asking for help. He told us that something supernatural had happened and that he felt responsible for his family's death. I was thinking that the poor guy must've had something traumatic happen and he reacted by confabulating this story.

Working from his letter, he looks to be a real internet geek! Those pages he wrote are really pretty. I've tried to keep up with the internet boom, but he looks like he sleeps and breathes HTML (or is it XML now?). Really impressive!

And that got me thinking: I go completely stir crazy when I go on vacations or whatever and can't get to my email. I'm always certain that the world is all falling down around me and I don't have a sense of connectedness. As I was looking at Dale's site, Synthasia, I figured that whatever dissociation from the real world that he's feeling must be heightened by his inability to get to a computer, a place where he seems to feel very comfortable.

If he's coherent enough, do you think it would be good for him to get limited net access? I would think it would be a mistake to let him send more e-mail willy-nilly - who knows what trouble (and media) it would bring down on you! But if he were able to use the web to make restricted contact with the "real" world, it might help.

I'm not always available (the real world tugs on my sleeve constantly) but I could easily be available to trade some emails or instant messages with him and keep you in the loop at the same time. I know that I do better with a typewriter than a phone or face-to-face dialogue, since it gives me more time to think about what I want to say. Maybe he feels the same and would benefit from a different mechanism to express himself? He could tell his story to someone that heard his message AND who has some training in psych issues. That would be more useful to you than if he just started spouting off to his friends or other random strangers.

Anyway, the poor guy's story got to me and I'm glad to help. Why else are we here but to help others? I suspect that you feel that way, too. The days of being a doctor for money are long gone. It must be because we're driven to do what we can for the ones that we can.

Take care,
Dan

_________________
That sounds like something HITLER would say!

PostPosted: Sat Mar 15, 2003 11:09 am
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ZeusLegion
Boot


Joined: 31 Dec 2002
Posts: 46

 		Just my opinion but I definitely would have followed that up differently and gone for the opening as the PCP. Spilling Dale's business with us and admitting being party to us, well, I can't see how that's going to help at all. We've been summarily dismissed by characters before as just being irrelevant targets of Dale's delusions and I think we will continue to be brushed off time and time again whenever we bring this up.

Time will tell though and its too late now so I guess we'll see how she reacts to that. As they say every chance possible in the Star Wars films though, "I've got a bad feeling about this."

Z

PostPosted: Sat Mar 15, 2003 6:15 pm
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dmax
Unfictologist

Joined: 09 Jan 2003
Posts: 1387
Location: Location: Location!

 		PCP
ZeusLegion wrote:
Just my opinion but I definitely would have followed that up differently and gone for the opening as the PCP.


You still could! Wink
_________________
That sounds like something HITLER would say!

PostPosted: Sat Mar 15, 2003 8:28 pm
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dmax
Unfictologist

Joined: 09 Jan 2003
Posts: 1387
Location: Location: Location!

 		her reply
She's a lot more terse and a lot less likely to help here. Shame.
Quote:
Hi Dan,
You expressed what I believe is a sincere desire to try and help Mr. Sprague. I
can't really share the details of anything we've discussed in the course of his
treatment, and as a doctor I'm sure you understand. I would need Mr. Sprague's
written consent to discuss any details of his care with someone who is not a
family member or not directly involved in his treatment.

As to your suggestion that he be allowed net access, I'll take it under
advisement.

-Michelle Kendra


Michelle Kendra, MD
Inpatient & Outpatient Psychiatry
Princeton, NJ Headquarters
Klepsydra Mental Health Facility Network


Of course, I could ask her to make the request of Mr. Sprague: one of the people he has contacted would like permission to discuss his case. He could be willing to do written permission.

Except he's crazy!!! so why would they allow it? It would likely have to come from Bruce, if Dale is truly being held involuntarily. Which everyone denies. He's just recuperating....
_________________
That sounds like something HITLER would say!

PostPosted: Sun Mar 16, 2003 10:01 pm
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RPGgame
Unfettered


Joined: 02 Jan 2003
Posts: 501

 		what email was used for this message. I am trying to archive it in the Y! Email Files but that cant be done till I have this info

PostPosted: Tue Mar 18, 2003 2:46 am
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dmax
Unfictologist

Joined: 09 Jan 2003
Posts: 1387
Location: Location: Location!

 		letter to kendra
RPGgame wrote:
what email was used for this message. I am trying to archive it in the Y! Email Files but that cant be done till I have this info


Look up a couple of posts, 3/15.
_________________
That sounds like something HITLER would say!

PostPosted: Tue Mar 18, 2003 2:58 am
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dmax
Unfictologist

Joined: 09 Jan 2003
Posts: 1387
Location: Location: Location!

 		Another letter
Thanks to Diandra, I've sent this to Kendra.
Quote:
Dr. Kendra,

Since the last time I wrote, I've managed to find some pretty incontrovertible proof that Dale Sprague's story isn't what we expect. I thought that you'd find it useful in helping him with diagnosis or during his recovery.

Here is the link to movies taken when Dale and his family were at Ash Grove Park on the day his family died -
http://www.ashgrovepark.com/memory.html
and the username: 99746403
Password: 1bf33mx9

The important part of the movie is the time stamp. It shows 4:33, which conflicts with reports that Diana & Meaghan were dead at around 4:30 that day. I didn't believe the veracity of the time stamps, but I've confirmed it with the staff at the park. It's accurate.

Frankly, it's hard to know exactly what this discrepancy means - does it comment on the competency of the medical examiner? Does it mean that Meaghan was at the park during the accident? Does it mean that Dale's story isn't as "crazy" as it sounds? It might be too soon to make a final call, but you can't make a decision without getting the facts.

Do you think Dale would benefit from seeing these? It might help. At least he could confirm that it's Meaghan in the video. It's possible it's not her, isn't it?

Let me know what you think, once you've had a chance to take a look.

Thanks,
Dan S, MD

p.s.

Again, if you're willing, I'd be glad to engage in some limited email or IM contact with Dale with your supervision. He asked for help from me in the first place, and it might be soothing (and enlightening) if he were able to do some follow up on that. (I think there's also some concern in the community for his status in general. It's been a few weeks since anyone's had contact with the poor guy.)
and she quickly replied:
Quote:
Dr. S,
Thanks for the info, and I'll take a look in the next day or two. I certainly
need all the help I can get, and so does Mr. Sprague. It may do him some good
to see pictures of his daughter, especially if they are the last ones he'll
ever get. The time thing seems unusual--I'll have to look into it some more.
I'm sure that somebody somewhere just wrote down the wrong time.

Patients can't get e-mail, unfortunately, or even limited net access. I
thought that perhaps I could set something up temporarily, but our IS dept.
stomped on that idea.

I do appreciate your taking the time to help out, even though I can't offer any
information on my end. Patient confidentiality is obviously a good thing, but
sometimes frustrating.

-Michelle Kendra

_________________
That sounds like something HITLER would say!

PostPosted: Wed Mar 19, 2003 5:39 pm
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dmax
Unfictologist

Joined: 09 Jan 2003
Posts: 1387
Location: Location: Location!

 		Dale's out, and Kendra's in?
Received:
Quote:
Dear Dr. S,

You'll be happy to know that Mr. Sprague has been discharged as of this
afternoon. He signed a patient information release before he left, so I can
give you a few more details than I could before. In fact, he was encouraging
me to discuss his case with others, seeming to think they could help.

I don't know how much you know about his case--when he was admitted he was
severely depressed, suicidal, and delusional, as well as having some manic
symptoms--you apparently were one of the recipients of his frantic e-mailing.
Currently he is still depressed, and understandably so after the death of his
loved ones, but denies SI. I wavered on his diagnosis for some time, but I
ended up putting PTSD (309.81) and psychotic depression (296.24) on his
discharge papers. I know we doctors don't like to admit to being uncertain
about a diagnosis, but I had to think a long time about the psychotic
depression. Clearly he is depressed; that wasn't the problem. The problem was
with the psychosis part.

That link you sent me got me to thinking. You've verified the time on it,
apparently, which says 4:33, unless I'm misremembering. The copy of the police
report that's in his chart says 4:30, and that his wife and daughter were dead
at the scene. I spoke with one of Mr. Sprague's lawyers yesterday, and she
confirmed that she sees a lot of police reports in her work, and it is unheard
of for the time on a police report to be off by more than a few minutes. Even
if it is off by a few minutes, how could a little girl be on an amusement park
ride and then in an accident so far away at more or less the same time?

Combine that with the quality of Mr. Sprague's story--it lacks the affective
elements and inconsistencies that I see in delusional patients. To be honest
with you, this verification of his story had more to do with his discharge than
anything else. I know there's got to be a reasonable explanation, but I can't
find it right now. And that's not sitting right with my there's-a-logical-
reason-for-this medical training.

I really don't know what to make of this. And I don't like that feeling.

-Michelle Kendra


Michelle Kendra, MD
Inpatient & Outpatient Psychiatry
Princeton, NJ Headquarters
Klepsydra Mental Health Facility Network

_________________
That sounds like something HITLER would say!

PostPosted: Fri Mar 21, 2003 6:32 pm
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dmax
Unfictologist

Joined: 09 Jan 2003
Posts: 1387
Location: Location: Location!

 		forging ahead
I'm thinking of this:
Quote:
Michelle (can we switch to first names?),

GREAT news about Dale. Thanks for keeping me informed. I'm wondering if you know where he was headed next - home, or Bruce's, or somewhere else. I would guess that he harbors a grudge against Bruce, but you never know: any port in a storm...

You're thinking like me. It has to make sense and it doesn't.

Let me pose two things to you. One may be a tad hard to believe.

1) I still don't know if the girl in the movie is Meaghan. Did he give you any clue to that? As a side note - I still don't know if the two people who died in his car are his wife and child. Can you use your medical connections to confirm that? If it were someone else, well, that would fix the problem with the video at the park - and change the whole story of who died in Dale's car that day.

2) I've managed to make contact with Sam Greene, who is associated professionally with Dale. He relayed messages from Dale's email that I found incredibly interesting - and possibly otherworldly. (If you can muster suspension of disbelief, now would be the time.)

Dale seems to have contacted someone or something called "the guides." So far, they represent themselves with legendary symbols (like a sphinx). I don't yet know what he wanted from them or vice versa. But, their messages are coded, and they clearly want to speak primarily to Dale, and not to people like me.

Combine this with his pseudo-psychotic story about time travel and wishes, and it gets confusing AND interesting.

Want to join me for this ride? I'm not physically there to do any investigation, but perhaps you could use your proximity and title to make some inroads into this story. It seems to involve not only Dale, but the town and some of the people in it.

It's more fun that doing throat cultures, I can tell you that...

Dan


Thoughts on this?

PostPosted: Fri Mar 21, 2003 7:15 pm
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dashcat
Entrenched


Joined: 09 Dec 2002
Posts: 816
Location: Under the bed

 		I like it a lot Dmax. Dr. Kendra would be a great asset to us. And she sounds like she wants to know what's going on. I think it's a great approach.

PostPosted: Sat Mar 22, 2003 12:51 am
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