In Treatment s03e24 Episode Script

-Amphetamines? -No.
-Corticosteroids, either topical or inhaled? -No.
Excessive alcohol intake? No.
Withdrawal from excessive alcohol intake? No.
And you said you don't drink coffee.
That's right.
I don't.
And you're not currently taking anti-anxiety medication? I'm not.
Do you have any interest in trying anti-anxiety medication? No, thank you.
Okay.
I'm gonna write down some names for you just in case you change your mind.
Larry Friedman, my colleague, is an excellent psychiatrist.
He didn't recommend you, by the way, so you might want to beef up on your contacts at Columbia.
I know you got your degree there, but they seem to have forgotten all about you.
How did it feel to get a second opinion? It sounds as if he confirmed what the first doctor told you.
-Another non-diagnosis.
-Which is what? I'd like to hear you articulate what you heard him say.
"We'll have to wait and see.
" -Which means? -That I'll have to wait and see.
Because you're not exhibiting enough symptoms? Yet.
Not exhibiting them yet.
I mean, what am I supposed to do after an appointment like that? How am l How am I meant to live my life? How am I supposed to make informed decisions about my life when I don't know for certain whether or not I have the goddamn disease or how severe it's going to be? Forgive me for saying so, but that doesn't sound too different from what we all face every day, the general state of being for every person alive.
Well, I asked him for a worst-case scenario, you know, how fast Parkinson's can actually progress.
And he, you know, resisted for a while, but finally he confirmed what I knew myself, that in extreme cases a patient can find himself completely paralyzed with advanced dementia within four to five years.
Did he tell you what percentage of those patients face that accelerated form of the disease? It's a pretty small number but Less than half a percent.
I confirmed it with a bit of research since you first came in.
So let's be clear about the facts.
We're talking about less than half a percent of people who have a disease that you've been told you probably don't have.
Probably.
You just talked about the difficulty of making decisions in your life when faced with what you see as the real uncertainty about your health.
Let me ask you something.
What would you do if you were told with absolute certainty that you were sick? If you only had a few years left to live, how would you choose to live them? If I knew that were true? Well, maybe I'd lock up the office and travel the world.
Maybe I'd move just closer to my kids.
I don't really know.
And what if somebody told you the opposite? Told you with absolute certainty that you were not sick? Would you also lock up your office, leave town, move closer to your kids? Or would you continue with life as it is? Continue seeing your patients, dating your girlfriend? I What point are you trying to make? I think this continued state ofwait-and-see is enabling you to live in a kind of stasis.
It's like purgatory.
I'd say hell is more like it.
Okay, it's hell.
I want you to recognize that in order to get out of this hell, you may have to make decisions about your life, what to change, what not to change, independent of this prognosis.
To take action, or not, without knowing if you're sick.
"Action"? But what kind of action do you mean? No, I'm really asking.
I know that you've got this notion that I'm some kind of Hamlet incarnate, unable to act or unwilling.
And I'm still not really sure what it is that you're referring to, because your evidence keeps shifting.
It's not as if I've been sitting on my ass doing nothing.
I'm seeing doctors.
I brought Max home.
That's true.
I mean, is there something specific you're looking for me to do? You talk about action, but I'm just not sure what you want from me, what exactly is so urgent.
Did I say something was urgent? No, but you did call me at home.
You left me a message at the beginning of the week.
Yes, I did.
I just wasn't clear what it was that you were saying in the message.
-Are you asking why I called? -I am, yes.
Were you encouraging me to act on anything in particular or was there some other reason? I think I left the reason why I called on your voicemail.
I felt we left a great deal unfinished and we ended abruptly last week.
I remember.
I called to offer you another session if you felt you needed it.
Needed it for what? To talk about what? What do you imagine? Don't do that.
Please don't play that game.
You called me.
I didn't call you.
You said that you had lingering concerns at 7:30 in the morning.
I just want to understand what you felt was so pressing.
I thought we should revisit what you told me about Sunil, your reaction to your patient.
-That's why you called me? -ln part.
You're shaking your head.
Because last week you didn't want anything to do with Sunil.
You barely let me get a word in.
I think you're aware of why I was resistant.
You don't want to be my supervisor.
I don't, but I would like us to discuss how you're responding to Sunil, or not responding, for that matter.
If you're in some sort of stasis as with your medical prognosis, a wait-and-see mode.
I'd like to understand what you're trying to accomplish by telling me your concerns or insisting on my involvement.
-Were you trying to alarm me? -I was asking your opinion.
I thought, given the stakes, that you might be willing to engage.
I'm engaging.
I appreciate that.
Certain details you spoke about have stayed with me, beyond Sunil's volatile response to his daughter-in-law.
There are small children in the house.
There's no issue with I mean, l I don't think you hear what I was telling you.
That's why I bring it up now, in order to be clear about what you're telling me.
If there's a genuine risk that needs to be addressed, and if so, to find out why you're not addressing it.
I don't think the children are at risk.
You're certain of that? And Julia? You seemed very alarmed last week, and now I can't tell if you're as concerned.
We had a very intense session on Monday, and I have to admit that things looked pretty grim at the beginning.
Why was that? Julia came in to tell me that this was gonna be Sunil's last appointment.
She said that they weren't willing to keep paying for it.
-Did she give any explanation? -There was a misunderstanding at home.
Sunil pushed past her and she fell into a bookcase.
She had a bandage on her arm.
He pushed her into a bookcase? Well, he said that he pushed past her.
Honestly, I think it was an accident.
Okay.
But, you know, it was enough for her and Arun to decide that therapy wasn't working.
The fact that Julia showed up in your office with an injury, did you take that opportunity to sit down with the both of them and discuss the potential for violence that you've been so concerned about? Sunil came into the room.
I told him that I believed it would be a mistake ifwe discontinued his treatment, I felt that stopping at this juncture would be wrong.
It took some work, but I convinced him and he's coming back next week.
He's able to pay his own way? No, he can't do that, so I offered to see him pro bono.
Really? You know, I have to say this, it's just curious to me to hear you so suddenly invested in this issue.
Aren't you conscious of the fact that we're now playing out the fantasy that I revealed to you last week? The one that you worked so hard to get me to disclose? What fantasy is that? You know, that we would discuss our patients together, give each other advice about our difficult cases.
You don't remember that? I remember.
You described us as having a dinner, a meal, a glass of red wine while we talked.
I don't think I said "red wine.
" Maybe not, but You must see that what's going on might play into that fantasy.
I do see that.
Did you see it when you picked up the phone to call me on Tuesday morning? I felt I found myself worried that I was negligent last week.
I was concerned the situation might deserve more attention.
-At 7::30 in the morning.
-Sorry? Don't you think that was I mean, don't you think that was kind of early? Were you already at the office? -Why do you ask? -Because I know you weren't.
The caller lD on my phone wasn't your office number.
That's right.
I don't think I'd gone in yet.
So you were at home, having breakfast maybe? Were you hoping to talk over a meal about my patient's dream and what I should or what I shouldn't do about it? Was that the reason you called? Or maybe it's more than that.
Look, l I guess You know, I just want us to be honest about what's happening here.
Tell me what you think is happening.
I I'm sorry.
I thought I'd turned the ringer off.
Sorry about that.
You said you wanted to be honest about what's happening here.
No, no.
It's fine.
It doesn't matter.
Perhaps it does.
Is there anything more you want to say about it? You felt that by my calling in the morning Could we just not? I can see how, given the kind of scenario you envisioned, you might For Christ's sake, please let's just forget it, okay? You're very upset with me.
I probably should have thought more carefully about the timing of my call.
I just asked you if we could stop.
I understand you don't want to discuss that any further, that's fine, we don't have to, but I would like us to go back to the reason I called you.
Frankly, I felt you put me in a difficult spot.
You brought up Sunil in the last minutes of our session and it was hard for me to tell if there was a legitimate danger or ifyou were simply trying to draw me in.
I do wonder if you're trying to hand over your worry to me, to somehow leave me to deal with it so you won't have to.
I gather you disagree.
Can you tell me what you're thinking? I'm thinking I should never have asked you about Sunil in the first place.
I guess I should have known how you'd see it.
-How is that? -You just said it.
You think he's a menace to society and I'm some kind of paralyzed fool.
It's not as if I haven't given serious thought to what to do here.
But I think it's easy from where you sit, to jump to conclusions, to twist the evidence.
You don't see the intricacies.
Do you want to help me with those intricacies? I'd like to hear more about your session this week, why you decided to see Sunil free of charge, what your thinking was.
I'm also curious about what I see as your clear identification with Sunil, how strong it might be.
What does that mean? How much you see yourself in him.
Look, I know what "identification" means.
I'd like to know what you're talking about.
You've spoken many times about his experience as an immigrant, the depth of his alienation, something you've also encountered.
You're both around the same age, lead somewhat isolated lives.
-Do you have any reaction to what I'm saying? -I'm enjoying it immensely.
Just let me know when you're done, okay? I'm done.
Okay, so it's my turn now? Yes, I do have a great deal of sympathy for Sunil.
And I feel that I've got a special window into his struggles.
But it doesn't mean that I've somehow lost perspective.
The truth is, I have an instinct about him.
It's just I can't explain it.
It's a gut feeling that I have sitting opposite him.
I just know I just know he's not a violent man.
And I have to admit, I'm kind of having a hard time following your reasoning.
I know you think that I'm avoiding a decision, that I'm overinvested, that I'm in denial, whatever way you want to put it.
But you see, I see it as me taking a bold step.
I've offered to see this man for free in order to keep him in treatment.
The treatment he desperately needs, which, by the way, it has been working.
And still, you seem to criticize me for it.
Why are you convinced it's working? Because, look, the therapy gives him an outlet for his anger.
I've gotten him to express himself, to reveal these violent fantasies instead of letting them fester inside of him.
The fact that we're openly discussing them means that he is keeping them under control.
They're just fantasies.
I mean, do I really need to explain this? You're sitting there like I'm trying to sell you a moldy carpet or something.
I'm simply listening to what you're saying.
No, you're sitting there smug, and you're judging, and you are superior and you're remote, Iike a Freudian ice queen convinced that I'm some kind of cripple.
I think we ought to talk about where this anger is coming from.
It's coming from the fact that you won't listen to what I'm saying.
You don't trust me to judge if my own patient is dangerous.
Look, if Sunil wasn't coming back, if he ended his therapy and he was out there, then I'd say sure, there's a problem.
I'd say go ahead and worry.
But he is coming back.
He's talking.
He trusts me.
Somebody who's actually gonna hurt another person doesn't hand you a cricket bat and say, "Take it away from me.
" A man who's actually gonna hurt somebody doesn't say anything.
He just goes ahead and he fucking does it.
Sunil handed you a cricket bat? He gave it to me for safekeeping.
His son was going away, and he felt that I should hold on to it.
Why would he want you to hold on to it? Because he was He didn't want to have it around the house.
And you took this as a good sign? This is kind of pointless, don't you think? I've said I made a mistake bringing Sunil up in the first place.
You've said you don't want to supervise me.
You'd rather not indulge my fantasy.
I'm not sure that I still have it but So why don't we just both respect that? Several minutes ago you were quite happy that I'd engaged with you on this topic.
Please, can we go back to talking about something more pleasant? Parkinson's maybe, Max and Steve, global warming? My pregnancy? How your noticing it earlier might be affecting our discussion? Is this your way of telling me that you are pregnant? I was under the impression you noticed a few minutes ago.
So you are pregnant.
I am.
Are you also planning to tell me where you've registered, so I can send you a baby shower gift? I wasn't planning on doing that.
Am I wrong? Had you not noticed? -When are you due? -March.
-Does it upset you to hear that? -No.
-I have to say, you seem upset, as if -As if what? As if it's some kind of betrayal, as if This is fucking ridiculous.
-What is? -And it's cruel.
It's narcissistic.
You deliberately encouraged me to talk about these stupid fantasies.
I have to wonder if all analysts simply get off on their patients' imagined relationships with them.
Are you? While I sit here and make a fool of myself, spinning out these idiotic tales of having drinks together and dinner and discussing our work and how you might be lonely and how you might understand my miserable fucking life.
And you just sit there and you nod placidly, and you encouraged me to indulge in these delusions.
And all the while you hoard this information that you're in a happy relationship, with a growing family.
-ls that what you assume? -Stop it.
Just fucking stop it, okay? Who cares what I assume or don't assume? It's all a crock of shit anyway.
You know, it's all designed to give power and thrills to the sphinx-like doctor at the expense of the humiliated patient.
-I never intended to humiliate you.
-Well, that's comforting to hear.
Unintended humiliation is much easier to swallow, don't you think? You're really angry with me.
I don't even know you.
How could I be angry with you? -Paul.
-What? Are you gonna encourage me to talk about how furious I am at some self-projected phantasm? How absurd and navel-gazing can one get? I want to go.
There's something I want to say to you before you leave.
I'm worried about you.
I don't think you understand the gravity of the situation you're in with Sunil.
I don't understand the gravity? I don't think that you see the danger in what you're telling me to do.
What it would mean to be wrong, to compromise the confidentiality of a patient like Sunil.
Do you understand what it took to earn that trust in the first place? The time, the care, the Talk about a betrayal.
Paul, he handed you a weapon.
A weapon? You need to take a step back and look at this situation clearly.
You have options.
You don't need to jump to notifying the authorities.
You can include his family first, tell them about his violent impulses.
We just talked about the different ways you identify with Sunil.
I think I'm becoming aware ofyet another connection.
What are you talking about? Sunil's a lonely man in his 50s, attracted to a younger woman who's unavailable to him.
Amazing.
It's amazing, really.
I mean, are you not embarrassed to bring everything back to you? It's really that irresistible? Sunil has obviously shown a tremendous rage towards Julia.
The way you looked at me just now Are you suggesting that I can't distinguish my own anger from Sunil's? -It's a radically different situation.
-lt is, and you're a radically different man.
I can feel how angry you are at me.
It's visceral.
And yet I don't feel worried that you're going to come across this coffee table and strangle me.
I'm not as certain that your patient is as in control of his emotions.
-You don't even know Sunil.
-That's right.
I don't.
Now how well do you know him? Now how clearly, would you say, you're able to see him? You talked to me so many times about feeling dissatisfied in your work.
You called psychotherapy a crock of shit this afternoon, and yet you've done nothing about that dissatisfaction.
Are you secretly hoping this situation with Sunil might explode, that it'll save you from having to make a decision to change your life on your own? Because if it does explode, you will have destroyed your career.
And you will always know you could have done something to protect a woman and her children.
Hello.
Hello? -Hello, is this Julia? -Yes.
Hello, Julia.
This is Paul Weston.
Do you have a minute?