Diagnosis: Axis I: Generalized Anxiety Disorder with Obsessive features
Axis II: None
Recommendations: articulate concerns, identify personal/versus assumed issues, work on areas of conflict and separation/individuation w twin
Referrals if necessary: _______________________________________________________________
Clinical Impression: Patient is a capable, intelligent young man in treatment to work on concerns about twin, anxiety about their relationship and help twin heal from work-related trauma, deal with larger life dilemmas
Treatment Plan: Meet 2x week; b. Begin full diagnostic assessment.
Appointment Scheduled: Yes ___X___ No ________
Elisabeth Reinhardt, PhD Elisabeth Reinhardt, PhD
Date: 6/10/2013
- 49 -
IMPLANTED AND EMBEDDED
Across the Mediterranean on a beautiful Greek Island Boulos met with Sol Aaronson one final time. Seated comfortably on the floral sofa he eyed Sol as he entered the room.
“Good morning, my friend,” he saluted cheerfully.
“Good morning Boulos,” Sol answered brusquely.
“You seem dismayed, my friend. What could be spoiling your mood on this fine sunny day? I hope it is not me who has disappointed you.” he exclaimed.
“Indeed I believe that finally you have told us everything that you know. However you did try to hold out on us, which violated our agreement,” Sol said “so there are now a few slight modifications to our contract.”
Boulos’ face fell and he grew still, watching warily from his seat on the sofa.
“You are to wear this.” Sol said holding up a tiny device no bigger than a housefly. “Well, wear may be a slight misnomer. What I mean is that in order for us to let you leave and in order for us to be sure that you will not again engage in illegal activities, we will need to keep an eye on you.”
“How is it that you plan to do this? With that little thing in your hand?” Boulos asked with a frown. “You wish for me to keep that, say in my pocket?”
“’Fraid not, Boulos, it’s a bit more complicated than that. We will implant it in you. The implantation will be relatively painless. The tracker will be located in an area of your body not easily reached, so it will be impossible for you to simply cut it out of yourself. Oh and by the way, the device is programmed to explode if attempts are made to remove it. Otherwise it is perfectly safe and will not endanger you in any way. Data regarding your location will be immediately transmitted to us so that we will be able to locate you without hesitation. Do you understand my meaning?”
Boulos glared at him. “This was not our agreement, Sol, my friend. You promised me freedom and money and an ongoing contract for more future work.”
“You will have your money. A lot of it by the way. And you will have your freedom. You can go wherever you like and do whatever you like. As long as what you do is not criminal you can do it. As to our working together in the future if you have more information for us, you will be able to reach me at this number,” Sol handed Boulos a business card sealed in plastic. The card read:
Aegan Adventures
800-777-932-4111
We are never far away!
The remains of a feast was scattered across the kitchen table, a demonstration of Hadara’s continued interest in the culinary arts. Hadara, Hakim, Yosef and Abdullah, four of the five childhood friends shared their successes. Jamila and Gamil were still in seclusion at the Olive Grove, Gil had returned to the United States with Ari and Rafi who would be working with Elisabeth. Samira had gone undercover in Damascus with Bayan.
Yosef, reaching for another falafel teased “Hadara, you can always take up catering if you get tired of spy games.” Hakim grinned and blew his wife kiss.
“So,” he continued, “also not bad for a few weeks work, we took down “The Leader” - eradicated The Sword of Justice and with a little help from our American friends caught a Nazi nuclear arms trafficker and his pipeline of death-dealing cohorts. We rescued Saroyah; captured and turned Duquq Boulos into an informer and we sent Bayan back in Syria as an agent in place with Samira as his handler. Not so bad for a couple of old fogies!
Abdullah groaned, “I do not know how you do this all the time, it’s exhausting all this cat and mouse stuff. I’m ready to let you guys handle the spy stuff and go back to my nice ordinary desk job in military intelligence.”
“Yeah, like you have a boring desk job,” Hakim quipped. “Are you back in the field yet?” he asked.
“Not yet, it’s in the works but I am told that full reinstatement with back pay will be soon. Then I will return to my carefree life and my dear sweet wife and children,” Abdullah replied.
“We are all leading such carefree lives,” Hadara commented turning serious.
“What do you hear from the twins?” Yosef asked.
“Oh, they are working on their issues,” was the noncommittal response. The men looked at her questioningly. “They are not doing well; this thing is very complicated. Rafi went too far underground this time and it’s hard for him to shed that identify and return to his own. I am frightened for them. Ari is distressed. He doesn’t understand these emotional entanglements he’s all about the facts. This emotional turmoil is way out of his league.”
“Well,” said Hakim “I think they are in good hands. Look how much Elisabeth helped Saroyah, she’s doing very well now, going to school, making friends. It’s a miracle that she’s recovering so quickly. Thank G-d they didn’t do her more harm.”
“Baruch HaShem!” (praise G-d) Yosef said.
“Exactly,” Abdullah replied, “Allahu Akbar (Glorified is Allah)!”
Hadara took her husband’s hand and smiled around the table, “No matter how we say it, we are all deeply grateful for our good fortune.”
His rigid body exuded tension. His handsome young face etched with distress. He sat motionless in an armchair opposite her staring at the floor. The ticking of the clock and the dim backdrop of passing traffic were the only sounds to be heard.
“Rafi,” she prompted softly. “Did you hear what I asked you?”
There was no response.
“Do you miss him, Rafi? Do you miss al Sierawan?”
There was no response.
“How about Ari? Do you miss Ari?” she asked quietly.
Nothing.
“I can’t get a sense of what’s going on with you unless you talk to me.”
Nothing.
“Okay,” she said, “let’s try something else. I’ll just make some statements and if you feel something, anything at all, about that statement glance up at me. Okay?”
Slight shrug. Rafi was about as far away as he could get. He was dangerously close to a break down and she needed to act fast.
She began with “I feel blank…”
Slight eye movement
“I feel confused…”
More eye movement
“I’ll take that as a response, okay” she said.
Tension mounted in the room as Rafi remained mute and Elisabeth’s questions became more intense.
Ten minutes later she said, “Sometimes I think about being dead so I can be with him…”
Rafi raised his frightened eyes and looked at her.
She said, “Okay, you have some feelings about that statement, right?”
Nod.
“I miss him and wish I could talk to him about what happened…is that right?” she asked.
Head shake.
“You aren’t thinking that, right?
Nod.
“If what I say is right repeat it, if it is wrong correct it, okay?” she clarified.
Nod.
“I can’t get the words out, there is so much chaos in my head…” she said.
Nod. “I can’t get the words out…” Rafi repeated.
“Sometimes I can’t understand what I’m feeling.” Elisabeth suggested.
Nod. “I don’t understand my feelings.”
&n
bsp; Rafi’s eyes bore into hers, they seemed haunted.
“I feel like I’m going crazy. My mind isn’t acting right.”
Nod. “I don’t know what’s happening to me.” Rafi clarified.
“I’m scared because I don’t understand what’s happening to me.” Elisabeth repeated.
“Yes, that’s exactly it.” Rafi said making eye contact.
“I am afraid to say what I’m thinking because people will think I’m crazy.” Elisabeth offered, “if that’s right repeat it if it’s wrong correct it.”
Nod and eye contact. Tentatively he said, “I feel crazy and everyone will think I’ve lost my mind.”
“I think I’ll be judged if I say how I feel about The Leader,” she suggested.
“You are right,” Rafi said in a low pained voice. “I cannot possibly say what is in my mind or my heart. I cannot possibly do that. I would betray everyone in my life if I said these things. It would betray my twin, my best friend. Even more than that he’s a part of me. Together we created a unique ‘character’ in the world of espionage. We were astounding. We were unstoppable. But something has happened to me. I am not who I used to be.”
The room was still as Elisabeth leaned forward, “Many things happened to you Rafi. You have not yet returned to your pre-mission reality. We must identify what happened. Are you ready to do that with me now?”
“I think so,” Rafi said hesitantly. “I am … I am …”
“Afraid?” she offered
“Yes…” Rafi answered slowly. “I am afraid…”
Elizabeth Reinhardt, PhD
Great Lakes Bank Building
Suite 315
Chicago, Ill 60601
CLINICAL PROGRESS REPORT
Patient’s name: Rafi E Date of Contact: ___7/1/2013_________
Nature of Contact: Office Visit _X___ Phone Call ______Email ______Other _______
Reason For Contact: Scheduled ___X__ Practical _____Update _____Emergency _____ Other _______
Presentation: Normal _____Depressed/Low Energy _X____ Upset/Agitated _____ Frustrated/Angry ______ Dissociated/Detached ______ Anxious/Panicky ______ Obsessive/Worried/Guilty __X____ Overwhelmed ______ Desperate/Dependent ______ Confused/Conflicted __X____ Guarded/Defended ______ Moral/Spiritual _X_____
Urgency: Suicidal ___x?____ Self-Destructive ______ Homicidal ______ Other _______
Requires hospitalization: a) Yes_____ specify plan_______________________________________
b) No ___thoughts and feelings w/o plan ____________________
Appearance: Neat _______ Disheveled _______ Inappropriate __X__(slouched/mute)__________
Substance Use/Abuse: Yes ______ No ______ Specify __possible residual from use undercover_________
Orientation: Oriented: Disoriented: X Time ________ Place ________Person _________
Appears dissociated or ‘out of touch’
Areas of Concern: Self/Symptoms ___X__ Personal Relationships __X______ Work __X____ Finances ______ Health _______ Safety _______ Functioning __________ Moral/Spiritual ___X_________
Session Narrative: Today pt. presents as confused, depressed, distant, mute. After much effort determined he is not in the midst of a psychotic episode but traumatized by his own feeling and thought processes. Feels cannot speak about feelings for fear of judgment or rejection by others. Confused by his reaction having pervasive self-doubt.
History: capable well developed, hi functioning and intelligent. Good family support
Diagnosis: Axis I: PTSD, Depression (situational)_________
Axis II: none
Recommendations: Aid self-expression and encourage resumption of ‘normal’ activities with twin.
Referrals if necessary: ______None_____________________
14. Clinical Impression: Rafi is depressed, has existential issues of far
reaching nature, feels conflicted about self and his relationship w another
person/R/O catatonia/dissociation NOS
15. Treatment Plan: Encourage him to talk about feelings
and experiences which led to problem.
16. Appointment Scheduled: Yes __X____ No ________
Elisabeth Reinhardt, PhD: Elisabeth Reinhardt, PhD
Date: 7/1/2013
- 50 -
TEETER TOTTER
Samira sat at the ornate Louis XV roll top desk with its exquisite marquetry of fine polished woods and stared at the small screen before her as she listened intently to the dialogue in her headset. Bayan was doing well, they thought. He’d been accepted back into the fold by his higher ups and he had been given a hero’s welcome. That fact offered no comfort though, in this country you could be a hero one day and dead in the street the next. The uncertainty of their situation was terrifying and Samira needed all her confidence and training just to get through every day. Things could flip at a moment’s notice. It was her job to ferret out the dangers and get him out the moment his safety was compromised. An orange dot flickered in the corner of her sleek gold Movado indicating the building’s outer door had opened. Her eyes returned to the tablet in front of her; she watched as Bayan entered the outer door to the 10 story brick apartment building. In a flash, she logged off and slipped the tablet into a pocket concealed in the intricate desk. Around her the room gleamed with elegant gilt-trimmed French antiques, Persian carpets and 18th Century oil paintings that rivaled the Louvre’s. The air smelled faintly of peach blossoms and Chanel N°5.
Rising she moved to greet him in the fashion that had become their own. He folded her into his arms, kissed the top of her head and tilted her chin so their eyes met before they kissed. “My love, welcome home,” she said. Tell me have you checked the street and set the alarm?” she asked, as was her habit. “Yes my lovely,” was his usual response but there was a hint of unease in his expression. “What happened?” she asked on instant alert.
He guided her to the window and pointed toward the street. A bearded man wearing traditional Syrian clothing was standing across the street smoking steadily and gazing at their building. A cluster of rough-looking men chatted together in front of a small shop selling snacks and tobacco. They seemed focused on their building and environs. The solo man and the group of men exchanged covert glances. Bayan lived in an upscale section of the city and often vagrants wandered by looking for opportunity. “These are desperate times and people are not predictable,” Bayan said. “These are not vagrants,” Samira told him, “watch them. They are purposeful and organized.” Samira returned to her desk where she opened a channel to her handler. Quickly coding an urgent message she awaited a response. Her mother answered within seconds, “Vacate immediately. Rendezvous with watchers. Await instructions.”
Boulos, who was a hefty man, awoke to find himself naked, face down on a table covered only with a white sheet. His head ached and he was disoriented. The last thing he remembered was a conversation about a chip that would track his movements. An area in the center of his thoracic vertebrae throbbed slightly. He tried to rub it but could barely reach it with his fingertips. This must be the spot, he thought. This is where they put that device. But then there was another spot that bothered him, it was at the top and back of his right leg. Puzzled he focused on the various spots where he felt something different. Another spot on the rim of his left shoulder blade also felt sore. What in the world had they done to him, he wondered. He felt like a pin cushion! How many devices had they planted in him anyway? Then he thought perhaps they cut several incisions just to throw him off base, so he would be less likely to start cutting himself up looking for the implants. Then he remembered the warning. Try to remove the device and it will explode. That seemed clear enough. No he didn’t like it but he would tolerate these implants. At least until he could figure out a way to have them safely removed.
He sighed. This last bit of interaction had him stumped. He thought he could trust Aaronson and now this. He thought he had a good deal going and now for all he knew they would end up sending him to Guantanamo Bay and that wou
ld be the end of him. He lay on the table and thought about his options. If they sent him to Gitmo what could he trade to get out of there. Did people ever get out of there? He wasn’t really the type for that place, he reasoned, I’m not a terrorist after all. I am not committed to any kind of Jihad. I’m just a simple business man doing a day’s work. It is all about supply and demand, he thought. I’m just a supplier.
Seeing Double: An Elisabeth Reinhardt Novel Page 30