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Her Four O'Clock Part 1

Dr. Mary Abbrielle stretched. Her hand went to the small of her back as she rubbed at the ache. "I have got to get back to the gym" she muttered to herself. She glanced at the clock on her desk. It was hidden from the comfortable furniture her patients could choose to sit in. She sighed with relief as she still had six minutes before her last appointment of the day. Maybe she'd go swimming tonight. Yes, she'd definitely get some swimming in, she could use the exercise. Dr. Abbrielle tried to reduce the ache in her back by touching her toes a bit. She tried leaning sideways and it did ease the pain up a bit. She walked over to her desk. 3:57, time to review her notes for her four o'clock. It was a talker.

Dr. Abbrielle divided her patients between doers and talkers. Doers actually worked on their problems. The work might not often benefit the patient, they might not progress every week, but at least they made a good faith effort at resolving their problems. Talkers, on the other hand, were stuck. For whatever reason, usually fear of pain, they refused to budge off the spot. That was why she always scheduled a talker for her final appointment of the day. There was less chance of an epiphany, and less stress on her when it came time to go home.

Mr. Dale was a talker. He had been referred as pro bono. Mr. Dale was 49, overweight (not that the good Doctor couldn't stand to lose a few pounds, she chided herself), and a diabetic. A good work history up to eight months ago, but now he was out of work, and for some reason he couldn't get motivated to look for work beyond a token weekly search on the internet. Dr. Abrielle studied her notes. Then the discrete warning light glowed. The light was also hidden from her patients. It let her know when her office door opened. Her four o'clock had showed up. She let him wait the minute and at four opened her door and invited Mr. Dale into her inner office.

Mr. Dale slid into the large chair. His red jacket sleeve showed evidence of its dual use as handkerchief and napkin while the tomato stain on his yellow pocket t-shirt gave Dr. Abbrielle a hint of his luncheon menu. Dr. Abbrielle greeted him, then sat and waited. Uncomfortable silence was a very useful prod with talkers. But today it wasn't working all that well.

Mr. Dale fidgeted and rubbed his nose. He looked back at the Doctor, then reported as he always did the number of resumes he had e-mailed and faxed that week, then that he had an interview. "And have you been watching your blood sugars?", she asked. Mr. Dale nodded, "I have them down to 176!" her said with pride. "That's not good enough." Dale deflated, then muttered, "I know..." Dr. Abbrielle hesitated. "In fact, I have another issue we need to discuss. How long have we been meeting?"

"I don't know...maybe, what, five months?" The Doctor nodded. "The thing is, you've defined your problem very clearly in those months, but you don't seem to have made significant progress. There may be reasons for that ..." "I AM really comfortable with you Dr. Abbrielle. Honest!" "I know you think that, Mr. Dale. But whereas classic analysis CAN take a long time for the patient to come to grips with their situation, the methodology I use can sometimes identify when a patient cannot or will not take the further steps needed to resolve their issues. And I think that describes your situation." "No Doctor. Please, I'll ... I'll try."


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