Settling In [Open]

[Deleted]

Iris is in her office, sorting through her junk for the particular bit of junk she's looking for. The past few days have been hectic - moving into a new apartment, moving into a new office, meeting new neighbors, meeting new patients, trying to not be overwhelmed by the hint of chaos caused by the lingering unresolved problems of the facility pulling itself back together after the FBI left. She's just glad that, as someone who is both new to the facility and new to her profession, she's not expected to know what she's doing and therefore is not expected to help as much.

She'd had a lot of fun getting everything she needs for her new office, small as it is. The decor seems to mark her as a very mellow individual, though that's only because she likes to have every opportunity she can to relax while she's at work. Something that seems to be at a premium in this work place. And, in an attempt to be friendly, she's left the door to her office open, which also seems to not fit the mold of the other staff.

"Found you!" she says to the stapler as she pulls it out of one of the few remaining boxes of supplies she'd brought. One and a half of them to go and she'll officially be fully moved in! But at the moment, what's more important than making that official is getting some of this initial paperwork finished.

[Joan Leland]

News of a new employee spread quickly within the asylum staff, circulated mostly by the morning gathering around the coffee machine in the break room. How Joan had missed the coffee. Well missed might be a strong word, became aware of the dependence she'd built on it while unable to enter the asylum would be a better description. Somehow bad coffee just helped to make work feel like a step back to normality.

While the others continue to gossip, or in some cases perhaps get some work done, Joan decides to head back to her office with the thought that maybe if the new comer is around on the way she'll stop by and see how she's getting along. She had an interest in making sure the new doctors didn't join the ranks of the patiences but also a desire to do anything to put off her pile of paperwork a little longer.

The open door is easily picked out in the corridor of closed off offices, Joan keeps hers close predominately to make sure no one can sneak up on her when she's working.

Open or not Joan still knocked on the door when she saw the woman inside unpacking her things "Hello, finding everything alright so far?" Joan offered a smile, trying to be friendly as she lurked in the doorway.

[Deleted]

Iris isn't known to drink coffee, bad or otherwise, or she easily might have joined everyone else around the machine. While she can't say that she doesn't stray from time to time, she's one to put a lot of thought into what she puts into her body. Then again, perhaps she would have joined them as she drank her morning herbal tea, but she's still getting used to everyone else's routines around here and trying to find her place in it all.

She uses the stapler on a report she just finished writing up, before filing it away into one of her patient's charts. It's a thin one - thus far all the cases she's been assigned are relatively easy ones. She supposes that the idea is that you give the less experienced staff members the easier ones so that the more experienced ones can concentrate on the hard cases. But how is she supposed to get any sort of solid experience that way? Then again, she's heard that they sometimes let a newer staff member try a hard case. Usually disastrously, but she knows that she'll be fine.

At the sound of a knock she glances up and smiles at the woman in her doorway. "Dr. Leland," she greets, before answering the question with, "Yes, just working on some paperwork." Being so new to the facility, she hasn't really done more than introduce herself to her supervisor yet - too many things to juggle around over the past few days, though things are finally beginning to settle down just a little. But she's already developing a somewhat dull impression of the woman, though when she'd looked over her options Dr. Leland had seemed like the least objectionable.

Granted, given to how much she objects to so many of the staff here, that doesn't mean much - not that she's about to let anyone know that. She just hopes that she gets her required clinical hours in very quickly so she can ditch the requirement of having someone reviewing her work with her as soon as possible. She has her own ideas about what the best treatment for her patients is, and she doesn't know that Dr. Leland, or anyone else at this sorry (but prestigious) facility for that matter, will approve of her ideas.

[Joan Leland]

Joan just couldn't do without the coffee, it's that little boost that helps her focus and get through the day. Whether she cares about the rest of her diet just depends on what sort of day she's had, usually she's pretty healthy, it keeps her thin figure.

Perhaps understandably Dr. Leland's a little cautious about what cases new and inexperienced staff members get, even when she's not their supervisor she'll argue against them working with the most dangerous patients. Harley sticks in her mind a lot for the first few months a doctor begins working in the Asylum. Some of them don't take her meddling well if they find out but she still hasn't forgiven herself for the last time, she can't let it happen again.

Potentially career stalling sure but still friendly! Joan offers a smile in return and moves into the room, away from the doorway "Good, don't let it pile up on you. It happens far too easily" the amount of times she's taken her work home it's no wonder she doesn't have a life. She offers a hand out "Mind if I take a look at what you've got so far?" supervising the level of Iris' paperwork is just part of the job.

She's still trying to get an impression of Iris, clearly she's enthusiastic about the job but in Arkham that can be good or bad. Beyond that Joan still knows very little about her. She could snoop in the staff files for a few details but it seems far less creepy to just talk to the woman.

[Deleted]

Iris makes a slight face at the thought of the paperwork piling up. When she decided that she wanted to go into psychology, doing massive amounts of paperwork hadn't been what she had in mind. Still, she knows better than to put it off at all for fear of that problem. Might as well use any spare moment where nothing else is pressing to get it out of the way, such as now.

When Dr. Leland asks if she can look now, there's the slightest of hesitations before she reopens the chart that she put the report in and hands it over what she just wrote. "Sure," she replies. Most of the hesitation is because it isn't for a new patient - Ian Cortez has been at the facility for quite some time, drifting from one therapist to another without much improvement for the past few years. It's understandable in a way - he's a bit of a 'boring' case since he doesn't talk. Doesn't do much of anything, for that matter, which she's guessing why he's ended up being one of her patients as sitting there doing nothing means that one is nonviolent. The report is on her first session with the man.

And it's a well-written one - she's a smart woman and that includes her ability to put words down on paper. But though she read what doctors previous to her did with the man, she treated all of their opinions on him with some skepticism - all of them came to the conclusion that his near stupor was a case of profound depression because of his case history. Apparently other people who knew the man had observed numerous symptoms consistent with depression before he apparently 'snapped one day', murdered his family, and has done hardly a voluntary action since. Iris, on the other hand, has already come to the conclusion that the man more likely has a case of profound schizophrenia, believes that a medication change reflecting that may help him, and said so in her report.

Her session with him had been, as may be expected, very quiet. She'd brought a pencil and paper and offered it to him. As expected, the man didn't react at all to her offer, so she proceeded to doodle on the piece of paper herself, drawing several happy cartoon animals. After awhile she noted that the man was watching her draw, with an expression that she described as 'extremely muted confusion' on his face. It's from that she gets her hypothesis that he's been misdiagnosed since his arrival.

And she hopes that Dr. Leland is open to that idea, especially since she rather toned down her own opinion on the report and tried to keep her wording consistent with the current psychological standard in spite of how broken and useless the current system is. Hopefully she can avoid rocking the boat too much before she gets her license and can do so without worrying about people thinking that she's an idiot who doesn't deserve one.

[Joan Leland]

No one ever thinks of the paperwork involved when they're coming up with their life plans, which is just as well or a lot of people might give up before they started. The more responsibility the worse it gets until the day you give in and either spend the rest of your career never quite catch up or wind up with a filing cabinet at home so at least you're not sleeping in your office.

Just having Iris join the team has increased Joan's pile of paperwork by a few pieces. Progress reviews to write, patients to pick out and monitor on top of her own to see how Dr. Ledford handled them. She wouldn't say she was happy to do it, paperwork wasn't really the high point of her job but if one day it resulted with a competent member of staff then they could really do with the help.

Joan expects hesitation, in most cases though she expects it because she doesn't expect people to like their work being judged but she thinks little on it. An expected and natural response. She just takes the file and sets her coffee on the desk, joining it to perch on the very edge of the table after a few seconds reading.

She's silent, thoughtful. Quietly reading without so much as a twitch to her very well practised neutral expression. It's interesting. Barely begun and Iris was already questioning the opinions of doctors before her. For a moment Joan struggled to remember a session with Ian Cortez. She knew she'd had one but compared to some of the other patients a man who never did much of anything disappeared into her memories easily. She brought to mind the case history and a few details but it was only then she remembered the blank stare and just why the man was so forgettable.

There had been little to go on when the man wouldn't speak or do anything. That in itself was one thing but silence was hardly an open book and the man's history had to taken into account. Second hand information from people who knew him but leading to a logical enough conclusion.

Now Iris disagreed. Dr. Leland wasn't against a difference in opinion so long as it was good for the patient "Explain your conclusion of schizophrenia" she finally says after a while. Yes it was there in the report but she preferred to hear it, discuss the points and see how carefully Iris chose her wording when expressing the diagnosis in writing.

[Deleted]

Iris herself is pretty neutral as Dr. Leland reviews the report, remaining quite calm as she waits. She does and she doesn't care about what her supervisor thinks of it: on the one hand, she's extremely confident in her her own skills and opinions. To the point that it would hardly influence her opinion of herself if she was laughed out of this job. And it's not Dr. Leland herself that she needs to keep on her side - Dr. Arkham is the one with the power to fire her. On the other hand, Dr. Leland's opinion could influence whether or not the required hours for her license are considered to be completed, is perhaps the most important influence Dr. Arkham, and while she could get a job elsewhere she'd much rather have this one. And you can't pay your bills with good self-esteem.

It isn't until Dr. Leland asks her question that she breaks the silence with her reply. "Well, it's just a theory at this point," she says, starting with that disclaimer before she adds, "And I can't deny that his current diagnosis isn't also plausible - in fact, he may have depression in addition to it - but I think that the possibility of schizophrenia has been overlooked. The symptoms of both are very, very similar when the patient is so unresponsive, and it's all too easy to rely on inexpert reports of what he was like before because of that. But the symptoms visible to friends and neighbors are only so conclusive - it would have been his immediate family that could have give a more reliable report." Her voice is thoughtful as she talks, but very steady, "But what really caught my attention was his confusion at my drawings. I'm not the best artist, but I'm not that bad, and why would a depressed person be confused by a simple drawing? Someone with schizophrenia, on the other hand, could easily have a difficult time grasping the inherent symbolism of a drawing and be confused by it."

"But there's a larger issue," she continues, "Mr. Cortez has been treated here for depression for years, but has shown few if any signs of improvement. His various therapists have tried different things, but mostly variations of the same thing. Perhaps it's time to give something else a try." Her spoken words are just about as careful as her written ones, but that's because she's able to filter her thoughts on the fly pretty seamlessly. Not that she's saying anything that she doesn't think is true, but she's leaving out a lot. And by doing so she's only trying to get what she thinks is best for her patient. If that means carefully crafting what she says just so in order to get it, so be it.

[Joan Leland]

Stating that the idea is merely a theory is the right way to go. To declare everyone else's diagnosis wrong based only on a look would be quite an impression to leave so early in on the job and with her first patient. Joan relaxes some of her scepticism as a result.

Joan listens quietly to Iris' explanation, her eyes still scanning over the report "Have you considered the possibility that he was confused simply because you began drawing during a session?" it's certainly something that's unlikely to have happened before. Still the reaction itself is interesting, Cortez doesn't do a whole lot, perhaps it could mean something.

Just because it could mean something doesn't mean Joan is willing to experiment with medication on a patient based just on a theory taken from a look. She'd need something more to support the diagnosis "It would be impressive to see improvement in a long term patient after such a short time on the case, however we would more evidence would be required to support the diagnosis of schizophrenia. So, perhaps there's some test we can come up with to see if your theory is right without changing his medication. Any ideas?"

[Deleted]

Iris nods to the first question immediately. "Of course," she replies, "That reaction could mean any number of things, but with so little else to go on one has to make their best guess. And when I looked through his records, I noted that though some of his past therapists tried various... unusual things, most of them noted no reaction or a purely involuntary reaction. Confusion was rarely noted, but more often when they tried talking to him rather than doing something more unusual. That too could mean a number of things, but it seems to indicate that the simple fact that I did something he's not used to wouldn't be the cause." She frowns slightly in thought as she speaks. It seems to her like most of the 'therapy' Mr. Cortez received amounted to little more than poking him in various ways to see if they could get him to react. And in a way that's pretty much what she did too, but she'd like to think her method of doing so is more useful.

When Dr. Leland says that they'd need more evidence, Iris groans internally even though she carefully keeps her expression more neutral and thoughtful. "The thought did occur to me that a functional MRI might be enlightening if it showed an abnormal pattern, but his largely unresponsive state would suggest that it would merely show suppressed functioning. Similarly, nearly any test we could give him would likely be ambiguous and inconclusive. That's why I'm suggesting simply changing his treatment and seeing if he improves - it's unlikely to harm him, even if it doesn't work," she replies, her lips pursing in thought of the situation, "But let me think..."

She pauses for a moment to consider the question: evidence... What would it take for her to convince Dr. Leland to let her proceed? "I suppose I could try showing him other things that are symbolic in nature, and some that are less so, and seeing how confused he appears to be by each. That at least would show more evidence of whether or not I'm correct about that aspect of it," she finally suggests, though she extremely confident in that part already and would see doing that as unnecessarily delaying getting Mr. Cortez what he needs. But if she has to do it in order to get it done, there's no real way around that.

[Joan Leland]

Joan closes the file at last and looks back to Iris, quietly listening while the fellow doctor gives her opinion. Slowly Joan nods, in the case of Cortez a lot of guess work has been involved along with whatever random quick tests the doctors could think of to try and get him to do anything. It's a tough but very dull case, perfect for off loading on the newbie and it seems as though Iris has taken to it well even if it's not the high profile sort of patient so many people seem to come to work at Arkham for.

Joan lets Ledford continue, considering the options as Iris talks though outwardly she remains perfectly neutral in expression. Sticking every patient into an MRI would be lovely but she can just imagine the budget on that one and Mr. Cortez isn't exactly high on priority, perhaps if there were sufficient reason to but for now she's more inclined to go with Iris' cheap and easy option "Though it wouldn't provide concrete evidence that we are dealing with schizophrenia we rarely would be able to find such things anyway. It would be interesting to see if it does cause a response and could support your theory. Use the idea to test him more thoroughly, if it provoke a reaction we'll revisit the idea of changing his medication" she offers the file back to Iris "I'm disinclined to play around with such things on a whim but with proper backing to your hypothesis I would support the suggestion test a change in treatment"

"If it does work it would be quite a step forward, however I imagine it will be just the beginning on a very long road to recovery" the man did snap and murder his family, he may not be grateful for being pulled from silence and insanity when it would mean dealing with that.

[Deleted]

Iris carefully suppresses the irritation boiling deeply inside of her enough to keep it from her features. Dr. Leland thinks that she's asking for this on a whim? Really? What does she know? If she learned anything while jumping through all the hoops required to get her doctorate, it's that so many people in their field don't have the slightest idea what they're doing no matter how which or how many letters are behind their name or the number of years of experience they have under her belt. In fact the ones who have been at it the longest are the worst.

But as she accepts the file back, her smile is genuine. She knew that having to deal with a supervisor would be frustrating, but this is nothing a little meditation won't cure and it could be a lot worse. All it means is that there will be a delay. That's it! She can cope with a delay... "In that case, I'll do that during my next session with him and let you know what the results are," she replies with a nod. But does she ever wish that she could skip this whole supervisor nonsense altogether - she knows what she's doing, for pete's sake!

"And of course - it's not like the right medication or therapy will just make him snap out of it. My only goal with a patient like him is improvement," she comments with a slight frown. Which is a lofty enough goal for a patient who seems prepared to remain stuck. Of course, if it works she doesn't know that the man will thank her, but she's definitely not the type of person that would argue that it's better to be a near-vegetable of a person than it is to have to possibly face what he did. The latter can be overcome, while the former doesn't quite count as living.

[Joan Leland]

It's been a long time since Joan really considered a new doctor in the asylum to know what they're doing. It's not because she expects little from them, there's just so many things that can go wrong around the place that it's going to take Iris a while to improve that impression and until then Joan may just continue to find nice, safe cases, like Mr Cortez.

Lifting herself off the edge of Iris' desk Joan takes another sip of her rather dismal coffee and nods lightly to Dr. Ledford's words before she responds "Any improvement, no matter how small, would be an accomplishment in the case of Mr. Cortez" she offers a reassuring smile "I'm sure you'll do him good" she seems to have no fear of disagreeing with the diagnosis of other doctors, perhaps a new outlook on a few of the patients would do Arkham some good "Let me know how it goes and I believe you're aware where my office is if you need anything?"

[Deleted]

It doesn't help that Iris is fully aware that she's being given safe cases to handle. She feels fully ready to dive right into the more challenging ones, and how is she supposed to prove herself when she's loaded down with cases that would be difficult to mess up? Mr. Cortez is a prime example: about the only way she could accidentally make his case worse is if he died somehow. Then again, helping him improve at all would also be extremely difficult so she's hoping that he will for her career's sake just as much as she is for his sake.

But she's highly optimistic that she'll be able to succeed with him, in spite of his long history of stagnation. And she smiles and nods when Dr. Leland expresses her own confidence. At the very least, given how easy many of the rest of her cases are she has the time and energy to pour a lot of focus into his rather than putting it on the back-burner so that she can attend to something more urgent.

She nods easily as Dr. Leland mentions her own office. "Of course," she says with a smile. Yes, if she needs any advice from someone up to their armpits in 'established methods', her supervisor will be the first to know. Iris has no intention of going there any more than the bare minimum required to avoid giving off the impression that she's avoiding it.