ABSTRACT
This last chapter projects somewhat farther into the future. Consider the following vignette;
Paddock, the toadlike Personal Digital Familiar 1 (PDF), would not give up: “Good morning, glory. Up, up, up. Rise and shine. It’s Saturday. All day. Remember your promise. It’s show time.”
Laurie loved a little teasing, but this was too much, especially because the machine was right. The night before, Laurie had told Paddock that in the morning, she was going to inquire about therapy. Laurie fumbled for her polarizing contact lenses in the container next to her bed.
Paddock restarted the streaming video from the point at which it had paused when Laurie fell asleep. “Okay, Paddock, you -win” Laurie grumbled to her PDF. “Ditch the Harold and Maude and hold any phone calls. I’ll call a psychotherapist for my depression.”
As Laurie was splashing water on her face, the PDF erased the picture over Laurie’s bed showing Abu Ammar with his third Nobel Peace Prize and replaced it with an annotated list of clinicians who were connected with Laurie’s insurance plan and who had special expertise in treating depression through psychotechnologies. “There,” said Paddock as Laurie returned to the bedroom, “enjoy.”
Three names were marked as especially favored by Laurie’s primary care physician. She wondered whether those people were Dr. Jelabi’s golf cronies. She scanned through the blurbs, finally pointing her finger at the picture of Dr. Wright, a psychologist. “Let’s try that one.”
When Paddock had connected with Dr. Wright’s office, the lights in Laurie’s messy bedroom dimmed, and the images covering the walls transformed it into a cozy threedimensional virtual office. “And now I bring you a special presentation imaginatively entitled ‘For Any Potential New Client,’ meaning you,” said Paddock, grandly. Laurie saw an ordinary-looking man comfortably seated in an easy chair. He gave the impression of being too 20th century and too educated for Laurie, but he did not appear to be nerdy or pompous. His eyes were sincere, and he had a likable smile. Dr. Wright spoke in a soft voice for several minutes, comprehensively answering many of the questions a new patient might have about starting treatment. Laurie was amused when Dr. Wright mentioned that he did not offer any money-back guarantees. Talk about an old-fashioned therapist! But maybe that retro touch was a good sign, showing that he was less commercial than most shrinks nowadays.
As the presentation ended and Laurie indicated an interest in speaking with Dr. Wright, Paddock informed her that he would be available in 30 minutes. All she had to do was say, “Yes.”
“Yes,” Laurie agreed, and the room lights came up. She fetched a soda from her refrigerator, combed her hair, and began to straighten out her room.
Dr. Wright appeared for the virtual intake appointment in 30 minutes, as promised. This time he was actually “there,” interacting with Laurie. He apologized for not being available at the moment she first tried to contact him. When he responded to Laurie’s gently sarcastic reply in kind, Laurie got the feeling that Dr. Wright might be someone who could tune in to her. He asked whether he could clarify any questions raised by the introductory vignette she had seen, because he needed to have her formal permission on record before he could explore how he might help. After Laurie discussed the virtual preliminary consent form and the Notice of Privacy Policy and endorsed them with her electronic signature gesture, the teleconsultation session officially began.
Laurie agreed to authorize the release of information about her previous health care, to fill out some questionnaires, and to transmit some physiologic data after this preliminary session ended. But first she wanted to talk about her problems.
Under Dr. Wright’s skillful questioning, Laurie sketched out her situation, described her moodiness, and outlined her main relationships. Dr. Wright noticed that when she mentioned her father’s death, Laurie’s eyes reddened, she changed her posture, and she began complaining about her boyfriend.
Dr. Wright asked her about her apparent emotion. They discussed her sadness about her father and her boyfriend, the similarities between the two men, and the feelings she has for each of them. Dr. Wright explained how he was putting together some homework for Laurie to go through before their next appointment. In addition to writing about her feelings for her father and her boyfriend, Dr. Wright wanted her to consider the rationale for, and implications of, his tentative DSM-V diagnosis of dysthymia and to read about it and his recommended treatments on his Web site. They agreed to meet twice during the next week to fill in the outline of the treatment plan Dr. Wright had just assembled. Those sessions would allow Dr. Wright to obtain a detailed personal his tory and to make a thorough assessment. In a gentle but firm tone, Dr. Wright said it was time to end their first session.
Dr. Wright’s office then disappeared and Laurie was again sitting in her room with Paddock and her soda. Paddock informed her that a batch of patient handouts was finished printing, along with a link to Dr. Wright’s Web site, other recommended Web sites, and a preliminary action plan. Her PDF suggested that Laurie might do a few laps on her treadmill, eat the blueberry yogurt due to expire tomorrow, and then put in half an hour working on the assignment from Dr. Wright before showering and getting ready for a 2 o’clock pedicure that Paddock had arranged for her down at Tosies.
