Transcript of 1st Session between Charles Balis, M.D. and Ms. Katherine Lippard, Monday, April 21, 1997 at 4 pm.

Dr. Balis: Ms. Lippard?
Ms. Lippard: Yes. You must be Charles Balis.
Dr. Balis: Yes. Please come in; have a seat.
Ms. Lippard: Thank you. I don't know exactly where to begin.
Dr. Balis: Why don't you tell me why you're here?
Ms. Lippard: Not just yet. Do you know who I am?
Dr. Balis: I gather you work in accounting at SII.
Ms. Lippard: I'm the Accounts Manager. Mostly I manage the pension fund, working directly under Frank Herald. Do you know him?
Dr. Balis: No, I don't think so. Should I?
Ms. Lippard: He's the Chief Financial Officer. I believe you're treating his daughter, Christina.
Dr. Balis: I'm sure you know that I can't discuss my patients.
Ms. Lippard: Then she is a patient.
Dr. Balis: I can't even tell you that. Is that what you came here to discuss?
Ms. Lippard: Would it make it easier if I said that Frank told me his daughter is seeing you?
Dr. Balis: Ms. Lippard, as a psychiatrist, I am not at liberty to discuss any of my patients, even with their family. I just don't speak about my patients at all.
Ms. Lippard: Okay. Good.
Dr. Balis: That was a test?
Ms. Lippard: I hope you'll treat me the same way.
Dr. Balis: Of course. All of our conversations will be held in the strictest confidence.
Ms. Lippard: And there's nothing that will cause you to break that confidence?
Dr. Balis: Well, absent a patient's consent, there are only a few times I can think of. There are certain cases where my professional responsibilities would override the doctor-patient privilege. For instance, if the patient was likely to cause imminent harm to himself or others. And sometimes a psychiatrist can be compelled to testify by court order.
Ms. Lippard: Have you ever had to do that?
Dr. Balis: Not yet. I hope that situation never comes up. Are you concerned about this?
Ms. Lippard: No, not really. I'm no danger to anyone, particularly myself. It's just, for professional reasons, I don't want SII to know I was here.
Dr. Balis: I do, of course, have to bill your medical insurance, but I believe the individual names and services of each employee are kept confidential by the HMO. I assure you that SII won't hear about your treatment from me.
Ms. Lippard: That will be satisfactory. Thank you.
Dr. Balis: Are you ready to tell me why you're here?
Ms. Lippard: It's a little embarrassing, really. A silly thing happened to me last week, and it's been on my mind.
Dr. Balis: Go ahead.
Ms. Lippard: Well, last Wednesday...I should start by saying that I usually have lunch in the same place every day. I go to a sushi bar next to the Embarcadero--Kansai. Do you know it?
Dr. Balis: I've passed by.
Ms. Lippard: Well, I sit at the same stool at the bar, near the end, and the chef knows my name. The waitress always brings me green tea without asking, it's very nice--comfortable, you know? And I eat and brainstorm, and I run a tab. It's part of my routine. Is that strange?
Dr. Balis: Having a routine? Not at all. Please go on.
Ms. Lippard: I'm getting there. Last Wednesday, when I got to the restaurant, there was someone in my seat. So I asked him to move, and he wouldn't. So I explained that this was my regular seat, and he said, "Look lady, I'm here now. What's the difference? Go find another place." And the chef, of course, he wouldn't intervene. He's a businessman. He tried to settle it diplomatically and said "Please, Ms. Lippard, there's a very nice place over here, away from the rest."
Dr. Balis: Did you take the seat?
Ms. Lippard: Yes, I took it, clear at the other end of the bar. Logically, it was just as good a seat: isolated, good view of the door, quiet. But logic didn't enter into it. I was mad, damn it! I was mad at that man I never met for taking my seat, and I was mad at Kenny for not standing up for me.
Dr. Balis: Kenny?
Ms. Lippard: The chef.
Dr. Balis: But you just explained that he couldn't intervene because of business.
Ms. Lippard: Yes, of course, but somehow that didn't stop me from being angry with him.
Dr. Balis: So how was your lunch?
Ms. Lippard: Fine, I suppose. It's always good there. But I really don't remember. I couldn't get any work done, I couldn't enjoy the meal, I just ate and got out. But it bothered me the whole rest of the day--had me all off kilter. I couldn't even go there the next day, I was afraid that man would be back. I worked through lunch, ate nothing. But I got almost nothing done all day.
Dr. Balis: Have you been back since?
Ms. Lippard: Yes, I went back Friday. Everything was back to normal. Kenny had missed me, and made me something special. But this one little thing had me all out of whack for two whole days.
Dr. Balis: That does seem excessive.
Ms. Lippard: That's what I thought. So that's why I'm here. It seems like not getting the right stool at the bar wouldn't be such a big thing, to screw me up for two entire days. I figure something is really wrong with me to be affected that way, and I had heard from Frank about you, so I thought I'd see what you could make of it.
Dr. Balis: I see.
Ms. Lippard: You see what? What do you make of it? Am I losing my mind? I mean, I just have one drink a night, I don't act recklessly, I don't hear voices. This is the most I've lost my cool, the most I've raised my voice, in I don't know how long. So what's going on?
Dr. Balis: I think we'll need a little more information before we can find that out. What do you think it was about this man that affected you so strongly? Was it his manner? Did he remind you of someone?
Ms. Lippard: He was in my seat!
Dr. Balis: Okay, I understand, stay calm.
Ms. Lippard: I'm sorry. I don't know why this is so aggravating. I apologize.
Dr. Balis: That's all right. So it wasn't about the man, it was about the seat.
Ms. Lippard: No, it was about my routine. He blew my routine, and I couldn't recover for two days.
Dr. Balis: Hmm. Do you have many of these routines?
Ms. Lippard: A few, I guess. I mean, I brush my teeth the same way every time, I take the same route to work, I watch the same newscast. Do those count?
Dr. Balis: Well, most people get into routines like that. It helps to stabilize our lives, and lends some predictability. What if one of your routines is interrupted--say road construction forces you to take a detour on the way to work. Does that upset you?
Ms. Lippard: Well, sure, any delay is annoying. But I think I'd recover. What bothers me about this is that it affected me so strongly, for so long. That doesn't seem right.
Dr. Balis: If it's a problem for you, then we can deal with it here. We're almost out of time, but this deserves more work. Can we meet again next week?
Ms. Lippard: Let me check my calendar. Yes, the same time next week works out.
Dr. Balis: Good. I'll see you then.
Ms. Lippard: Okay. Goodbye, Dr. Balis.
Dr. Balis: Goodbye, Ms. Lippard.
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