Monday, October 13, 2014

Identified

“It’s what I’ve always thought of myself as, I just... eventually, you have to figure out how to be who you are, you know?”

The woman sat back defensively, her chin up defiantly, her arms crossed over her chest. Carlson met her eyes with what he hoped was warmth and compassion, but she looked away.

“Okay,” he said, “Talk more about that. Tell me about when you first felt this way, when you began...”

“I don’t understand why I have to go through this,” she said. “I mean, it’s what I want, and I’m willing to pay, so what’s the problem?”



Carlson sat back, carefully composing his features. This wasn’t a promising direction for the conversation; in his experience, this direction led to more negative interview outcomes than any other; this conversational branch essentially led to a conversation about why they were having the conversation, which was basically a shielding technique, which was a red flag.

He looked down at the semantic map on the tablet in his lap; the branch they were now on was blinking, and it was just on the edge of the yellow zone; which was not bad, in itself, not the end of the world, but not that many branches led back from here to green. He tried an honesty gambit; her profile seemed to suggest that that would be fruitful.

“We’re having this conversation because there’s a high correlation between the procedure you’re asking for and certain types of mental illness,” he said. “It’s not that there’s a cause-and-effect -- wanting this doesn’t make you mentally ill -- but a large percentage of the people who want this are, as it turns out, mentally ill.

“As you know, the Singapore Accord, to which Malaysia is a signatory, lays out some strict guidelines as to what constitutes consent and who can give it; if we perform radical elective procedures on people who are not qualified to give consent, we find ourselves in violation of Malaysian law, and if Malaysia does not sanction us for it in a meaningful way, the nation itself can become subject to...”

The woman sighed. “I understand that,” she said, sounding frustrated. “I just... I wish...” She uncrossed her legs, crossed them the other way. “I’ve always felt like I was... like people thought I was crazy for feeling this way, you know? Now that I’ve decided to take this step, it’s frustrating to be met with more people who think I’m crazy...”

She sighed and leaned forward, uncrossing her arms to put her elbows on her knees. “I feel like going through with this is the first step to not feeling crazy,” she said. “Like, finally being who I am, instead of...” She sat up a bit, waved her hand over her torso. “Instead of who I’m pretending to be.”

Carlson nodded, glancing back at the tablet in his lap; they were back in green, on a branch that could lead to a productive outcome if they stuck to it.

The purpose of this interview was to be presented in court if and when a dispute arose, either between this woman’s future self -- a future self who regrets the decisions she’s making now -- or her legal guardian, after such time as one was declared for her, sometime in the future, after it became clear that she was, in fact, suffering from some sort of delusional disorder. The clinic could present the video of this conversation, which would be mapped, analyzed, talked about by experts on both sides, as evidence that the clinic had or had not taken precautions to verify the woman’s mental state.

Carlson’s job, more or less, was to keep her from saying anything too crazy into the camera. He could sense the rants buried just beneath the surface, could feel the conversational lines that led to places of untapped anger and fear, that would lead to angry outbursts and fearful withdrawal, and he could avoid them. The outcome he was going for here was one in which she got the surgery she wanted, the clinic got paid for it, and any future lawsuit was deflected by evidence that he’d talked to this woman, had in-person verified that she was sane enough to give consent.

“Talk about who you pretend to be,” he said. This would lead, according to a tablet, to a discussion of the most benign of her underlying motivations; good for the camera.

She took a long, ragged breath.

“Well,” she said, “Human. I pretend to be human.”

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