Here it is. I just blocked that damn finale, and wrapped myself up in my alternative universe. R.
Doctor's Notes: Michael Novotny is BK's oldest friend. They became close when they were thirteen (BK) and fourteen (MN), respectively. While both men are self-identified homosexuals, their relationship is platonic. MN and his mother provided shelter, emotionally as well as physically, when BK was subjected to abuse at the hand of his father. MN is in town visiting BK, so I was anxious to have a session with him. He overslept our first appointment, claiming he was given a drug, Ambien, by BK that caused him to sleep through. I will discuss this with BK, as I am very concerned about his reliance upon prescription drugs to treat an insomnia problem that is emotionally based. I would also like to know where he got this prescription and whether his doctor is aware of the anti-depressants he is taking. I gave MN another appointment, and he was on time for this one. He is a youthful looking man, appearing even younger than he is, small in stature, and engaging. He has never been through analysis and he strikes me as someone with an incomplete education and limited life experience.
MN: No couch?
Doctor: Sorry. I like my patients upright when we're talking.
MN: There's a joke in there somewhere, but I'll let it pass. This is cool. I've never met a shrink, although some would say it's overdue!
Doctor: Are you comfortable talking to me, Michael?
MN: Yeah, but I thought Brian would have a male shrink, if he ever had a shrink at all.
Doctor: Why is that?
MN: You know, a gay man.
MN: He'd just be more at ease. Brian is very suspicious of straight people and their motives. He believes straights are out to hurt us.
Doctor: Do you agree with that?
MN: I think he's a little too suspicious. I've known some really great straight people.
Doctor: How do you feel about Brian seeing a psychiatrist?
Doctor: Why is that?
MN: Of everyone I know, Brian was always the one with the most confidence. He had a kind of golden touch. In school, he made the teachers crazy because he would never just accept what they said as gospel, he would test them a lot. In sports, he was a natural, but his bullshit quotient was so low, he'd quit the team when it became intense. With tricks, well, Brian always pulled the tricks everyone wanted. He's tall and he's gorgeous, and he has a great job and lots of money. Tell me again why he feels he needs to see a shrink?
Doctor: I can't do that, Michael. But let me turn that question around on you. Can you think of anything Brian may need help with?
MN: You mean his fear of commitment?
Doctor: Do you think he has a fear of commitment?
MN: Big time. (Expression of confusion.) Is it because he had such a mean father and a cold mother?
Doctor: Those facts certainly contribute to a person's sense of self worth. Does it make you uneasy that Brian has sought help with his problems?
MN: Why would it?
Doctor: Sometimes when a close friend acknowledges a problem and seeks outside assistance, the other friend feels a bit insecure. First, there's a feeling of helplessness, that you were not enough to solve the problem. Second, there's a fear that the friendship could be threatened by an outsider.
MN: (Grimacing.) I try with Brian, but he blows me off. As for the threat, if we survived Justin, we can survive anything.
Doctor: Tell me why Justin was a challenge.
MN: Because Brian loves him.
MN: You see, Brian never loved anyone else, never even LIKED them, really. I always wanted more with Brian. I wanted to be his lover. I wanted to be with him. But it wasn't happening. I comforted myself with the fact that Brian is closer to me than any other man, and always would be. The others were just sex, we had a real connection. We love each other. Then along comes Justin. Sex AND love. Ouch.
Doctor: Did you encourage that relationship?
MN: Not at first. I have to be honest. I thought he was a little twink, not deserving of Brian. I wasn't sure he wasn't using Brian. Honestly, I'm not one hundred per cent sure he still doesn't use Brian in some ways. Brian's money, at least. But I came around to believing Justin loved him, until he left him for another guy. Then I had to put him on my injured list again. But Brian was so fucking miserable without him. He covered it up, but I know him better than that. He was bleeding internally. I wanted them to fix it, just to make Brian smile again.
Doctor: You didn't want Brian for yourself?
MN: Not happening. And I have someone in my life. Ben. I really love him. I want Brian to have the same thing in his life. If it's Justin, it's Justin.
Doctor: Do you think it is Justin, Michael?
MN: He's the only one who ever got in, but...
MN: There's this other guy, I don't get his place in Brian's life.
MN: Yeah, you know him? What is he to Brian?
Doctor: I can't answer that kind of question. Only Brian can answer that one. Have you met Jeffrey?
MN: Briefly, yesterday. He was coming out of Brian's office when I arrived. They kissed. It was more than a friendly kiss. He's good looking and very slick. If I were Justin, I'd worry.
Doctor: I see. Do you think Brian is capable of loving two men?
MN: Doc, I'm not convinced Brian can love ONE man romantically. He's still fucking things up with Justin. Two would probably create a fatal overload.
Doctor: Michael, Brian tells me you rescued him from a suicide attempt.
MN: ( Winced.) The scarfing thing? That wasn't really a suicide attempt, it was just a really stupid and dangerous way to whack off.
Doctor: Is that what you really think?
MN: That's what I tell myself. It's what I want to believe.
Doctor: If it was suicide, why do you think he was at that point?
MN: He just turned thirty. For a guy who depended so much on his beauty to form his self esteem, he feared it was all slipping away. And then what would he have? That plus the fact a big job he thought he got in New York fell apart. And I was leaving Pittsburgh with my then-boyfriend. He had a lot of pressure and Brian is not good at handling pressure when it involves his private emotions.
Doctor: Do you know why that is, Michael?
MN: Not really. Like I said, what does he have to be insecure about?
Doctor: Brian is insecure about Brian. He doesn't view himself the way you do. To him, what you see is all fašade.
MN: He said you gave him a scrip for depression.
Doctor: That's right.
MN: It seems to have helped. Either that or Justin has. Something has lightened his mood from how he was when he first moved here. But he misses his support structure. Me, my mom, Em and Ted, Lindz, even Gus. He's so isolated here. No wonder there was an open space for this Jeffrey. Now Justin is distracted with his sister's illness, and I know Brian is lonely. Danger, Will Robinson.
Doctor: What do you fear?
MN: He'll go heavily back into tricking which will piss Justin off, or even worse, he'll move this Jeffrey guy up in importance. I guess the one thing I've learned about Brian since Justin left is that he is kind of fragile, despite his cool, fuck you way of acting. And he doesn't handle emotional pain very well.
Doctor: Very perceptive. Are you still in love with him romantically, Michael?
MN: I guess part of me always will be. I loved him too long to just turn away from those feelings. But I love Ben, and if Brian asked me to run off to Mexico to live on the beach with him now, I wouldn't go. I wouldn't leave Ben for him, and that tells me a lot.
Doctor: Good for you, Michael. That gives you a very strong base on which to continue to support your friendship without blurring the boundaries. Good for both of you. I suspect Brian will need your friendship in the future.
MN: That sounds ominous.
Doctor: Not meant to be. Just being factual.
MN: (Pensive silence.) Doc, don't let anything happen to Brian.
Doctor: What do you mean?
MN: Don't let him...hurt himself. Or get so blue that he can't make sense out of things. He can come off like an asshole sometimes, but Brian's a wonderful guy. He's helped out everyone of us at some time or another, and he's never asked for any repayment. I don't know what I would do if I lost Brian.
Doctor's note: At this point in the interview, Michael became teary. We paused for a few minutes so he could regain his composure.
MN: Will he get better?
Doctor: Unfortunately there is no linear path for treating emotional problems, Michael. No antibiotics. It's a slow, tortuous path and so much of the success depends on how badly the patient wants to understand himself. Does that make sense?
MN: I guess. Can you call me if you think he may be getting too depressed?
Doctor: No, Michael, I'm sorry. I can't report on Brian's progress or lack thereof to you or to anyone, really. I don't have that right.
MN: (Nodded.) Then it's up to you to take care of my old friend.
Doctor: It's up to HIM, Michael, not me. He has to learn to cope, to have tools to assist himself. Healthy tools.
MN: Thanks for trying to find those tools for him, Doc.
Doctor: Thanks for taking the time to talk to me, Michael.
Doctor's Notes: MN strike me as a young man who is still infatuated with BK, sexually, but who has repressed that infatuation. He harbors anger towards JT, beneath superficial friendliness, and is fearful of new relationships in BK's life. He claims to be in love with another, but I sense he has yet to resolve fully his love for BK. Therefore, MN brings a mixed bag to the table as BK's friend and confidante. He has power with BK due to their longstanding friendship and is one of the few people BK trusts. Based on what I perceive as MN's apparent emotional immaturity, I hope that he does not USE that power to satisfy some selfish goal, and in the process create a set back for BK.
(At this point, Michael exits and Brian enters Lydia's office.)
Doctor's Note: BK is impeccably groomed, but appears tired and slightly agitatied. I immediately ask about the Ambien and he seems surprised.
BK: How did you...oh. Of course. Mikey.
Doctor: Brian, you can't take drugs without first coordinating the pharmacology. Did you tell your doctor about your anti-depressants or did you just conveniently forget about that? Perhaps you didn't even visit a doctor?
BK: Christ, Lydia, it's not fucking heroin! It's just a mild medication to help me over the hump when I can't sleep.
Doctor: I'm aware of what Ambien is, Brian. How did you get the prescription?
BK: From Jeff, okay?
Doctor: I see.
BK: He was just trying to help.
Doctor: By prescribing medications for someone who is not even his patient? Last I heard, you're not likely to be treated by a pediatric oncologist.
BK: Cut him a break. Doctors prescribe stuff for family and friends all the time. He knows I don't sleep well when Justin is away. I need to sleep, Lydia. I get crazed if I go too long without it.
Doctor: You need to know you're having sleep interruptions, and when, and why, and we need to talk about it when you do. Because this is a principal symptom with you of an emotional disturbance. If you medicate that symptom, it loses its efficacy and muddies your treatment. You can tell the good doctor for me that he should coordinate any medication he prescribes for you with either your treating physician, or with me.
BK: ( Sheepish smile.) You guys going to fight over me now?
Doctor: No, Brian. But I want you to take that Ambien, and I want you to flush it down your toilet. Understand? If you can't sleep again, let me know. Expect a little wakefulness now, because you'll be withdrawing from the drug.
BK: Withdrawing? I don't take it everyday.
Doctor: When was the last time you didn't take it, Brian?
BK: (Frowned.) When did Justin leave?
Doctor: I think that says it all.
BK: Shit, does EVERYONE hate Jeffrey? Doctor: Why do you ask that, Brian?
BK: I just think people are being unfair to him, that's all.
Doctor: Let me answer for myself. I don't know Jeffrey, so I have no personal opinion of him, nor would I. I do know his reputation in the medical community. I've read some of his work in medical journals. He's a brilliant physician. His protocols for treating the whole patient, not just the cancer, are considered state of the art today. And he's very young to have established such credibility. If I had a sick child, I would consult Jeffrey Walker. But you're not a sick child, Brian. And Jeffrey is not your doctor. I would prefer that he not medicate you.
BK: I see your point. I'm telling you he was just trying to be helpful.
Doctor: Or perhaps indispensable.
BK: What does that mean?
Doctor: It means, Brian, becoming so important to you that your reliance on him becomes central. He is there for you emotionally. He is there for you sexually. He even treats your medical complaints. You have to decide what is right for you, but do it with your eyes open.
BK: I haven't slept with Jeffrey since Justin's been gone, and he's honored that decision. He hasn't pressured me at all.
Doctor: I see. Has it been difficult?
Doctor: How do you feel about that?
BK: I miss Justin. I'm a little frustrated.
Doctor: When your friend, Michael, goes home, go home with him. Spend the weekend in Pittsburgh. Enjoy a change of scenery. See old friends. Visit Justin.
BK: But...his parents...
Doctor: If you really feel your presence would disturb them, visit him away from where they are likely to be. Get a hotel room and have him come there. It's very stressful to be a caretaker when someone is gravely ill. I'm sure a visit from you would be more than welcome by him. I also believe it would help your emotional state. You are experiencing increased anxiety and sleeplessness. Interrupting that spiral is a good thing.
BK: (Smiled.) If I didn't know you better, Lydia, I would swear you were trying to put me together with Justin and remove me from Jeffrey's perimeter.
Doctor: I'm not a matchmaker, Brian. I'm your doctor. If I felt a visit with Jeffrey would assist your progress, I would suggest that.
BK: Man, going back to the Pitt...why is that such a weird feeling for me?
Doctor: Perhaps because of how you felt when you left?
BK: Good point. I was miserable.
Doctor: Yes. And you have made yourself a new life here. You view it as a step back into pain. But it isn't, Brian. It's just a city, one filled with most of your memories. Realizing that now will help remove some of the sting and fear from your associations with Pittsburgh.
BK: I would like to see him.
Doctor: Then go.
BK: I think I will.
Doctor: Brian, promise me you will get rid of that medication.
BK: Yeah, if it's so important to you, I guess I will. I'm telling you it's no big deal.
Doctor: Good, then it should be no big deal to dispose of it.
BK: What if I can't sleep? I don't want to go see Justin feeling all ragged out and exhausted.
Doctor: I'll teach you some bio feedback and relaxation techniques that may help. One thing you can do is limit your intake of caffeine, alcohol and nicotine.
BK: ( Smirked.) Might as well stop breathing, too.
Doctor: I didn't say it was easy, but any one of those drugs can contribute to your sleeplessness. It's up to you. Think about it. Perhaps eliminate them one at a time.
BK: Yeah, well, we'll see.
Doctor: You're stronger than you think. You've overcome much bigger problems than dependencies on common crutches.
BK: That's the first nice thing you've ever said to me.
Doctor: That's an interesting observation, Brian. You don't need my approval. I'm neutral on that point. I neither approve nor disapprove of you. I'm here to help you, not pass judgment on you. Never fear that you could lose my approval with an action or a revelation, because that inhibits your treatment. You aren't seeking my approval. Does that make sense?
BK: Yeah. It's interesting. I have this big act going where I don't give a shit about anyone's opinion of me. But it's bullshit. I worry about what almost everyone thinks. Justin, Jeff, Mikey, Deb, Lindz... it's pathetic. Even my partners at work. Sad.
Doctor: Brian, news flash. That's how most people feel. Everyone wants approval and reassurance. So long as you don't let that need overcome your personal goals and sense of self, it's a healthy quest. I think the fact that you can admit it is great progress.
BK: Every day I see little glimpses of how something that happened in these sessions has given me some personal insight. I know I've got a long way to go, but that's big for me.
Doctor: That's big.
End of Excerpt
Doctor's Notes: BK is suffering separation anxiety due to the absence of his partner, JT. He has developed a slight reliance on Ambien to sleep, which he says he will stop taking. I suggested a visit with JT. Assuming the visit goes well, it should give him the reassurance he needs to continue with less anxiety. At least it should give him the opportunity to confirm if his fears of what could happen during a separation are real or the result of his anxieties. I am concerned about Jeffrey and his prescription of this medication for BK. I presume Jeffrey is aware of BK's analysis and possibly his anti- depressants. I am beginning to wonder if Jeffrey is attempting to insinuate himself into every key aspect of BK's life in order to control him. He appears to be a very strong personality. He is trained, medically, and is quite capable of recognizing and capitalizing on BK's emotional frailties. This is a situation that bears scrutiny.
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July 25, 2004