USS Malinche NCC-38997-A

Author?s note:
The following is an actual joint post I did with the counselor while on Bravo Fleet?s DS7 (SB Atlantis), where the character of Aaron Steele originated.



On:

Medical Complex/SB Atlantis
Office of Dr. Mitchell
Day 2 09:00

Steele straightened his uniform as he walked into the office of Dr. Mitchell for a "Standard psychiatric evaluation." He walked over to the receptionist's desk.

"Lt. Steele. I'm here for my standard evaluation"

The receptionist confirmed his appointment and asked the scientist to take a seat while she notified the Counselor.

Andy was reading Lieutenant Steele?s Medical and Service Records as his secretary?s voice came through on the communications system.

?Lt. Steele is here to see you, Doctor, shall I send him in? asked Ensign Rollins.

?Please do, thank you, Ensign.?

The Ensign told Steele that he could go in. Taking a deep breath the scientist entered the room.

?It?s a pleasure to meet you, Lieutenant Steele. I have heard quite a few good things about you in the short time that I have been here.? Andy said as he stood to shake the Lieutenant?s hand. ?Have a seat here, in front of my desk and make yourself comfortable. Might I get you something to drink before we begin??

Steele smiled.
"Glad to know I haven't ruined my reputation yet."
He shook the mans hand
"I'll be fine. Thanks for asking"

?All right then, let?s begin; you know why you are here, correct? And what is that reason??

"Standard psych evaluation" he was short and to the point. Leaving out the fact that his sister, also a counselor, had been on his case about it.

?I will be asking you a series of questions and I would like your honest answer to each of these questions. They will be asked in no particular order and no particular answer should be given. Just relax, sit back, talk to me as though we had been friends for many years, and know that anything that is said inside this room will stay here. There are rules, as I am sure you know, of confidentiality that bind me.?

Steele nodded. ?Everything said is confidential, except for any unreported acts of violence or abuse which must be reported to the proper authorities. I made sure to read the confidentiality agreement before signing it."

?Lieutenant, may I call you Aaron??

"Fine by me."

?Good, now are you comfortable, and at least somewhat relaxed??

Steele settled into the chair. ?As much as I can be at the moment. Hopefully it will increase as the session continues."

?First, I?d like to ask just a couple of questions about your medical history. Do you smoke or drink, and if so, how much??

"Never smoked, and never plan on it. The main drinking I do is synthahol and that's usually just at social functions"

?That is a good start.? Andy smiled and hoped he was not about to sound like a broken record. The discussion would come later. Right now he required basic answers about this man's life.

?Now comes the bombardment of questions. Listen carefully and please answer to the best of your ability. Do not be embarrassed by any answer you give."?

?Have you any history of major illnesses or injury or any mental problems??

"Not personally." replied Steele not entirely sure where the Doc. was going with the questions.

?Family history of major illnesses or diseases or mental problems??

He nodded.
"2 Uncles were treated for problems, don't know the specifics I'm afraid."


?Any psychological problems for you in the past or present; any history of depression??

"Not really"
His sister had suggested he seek counseling a few years back, but Aaron never followed through.

?Any mood changes that are out of the ordinary.?

"No unexplained mood changes"

?Any difficulty sleeping or problematic dreams; daytime drowsiness??

"Sometimes. The dreams mainly revolve around a fight with the Dominion, which usually lead to daytime drowsiness." until now Aaron hadn't made the connection.

?Any problems with forgetfulness??

"No, thankfully"

?Suicidal thoughts??

"No suicidal thoughts"

?Any major life transitions?.deaths of family, loved ones, friends, job changes, financial difficulties, et cetera??

"Let's see" began Aaron. "My mother was killed when I was seven. Shortly after the family was moved to the Falcon. Then there was the Dominion war, not long after I got out of the Academy. After that, things were fairly quiet until I transferred here. I was here less then a month when the Bixx invaded. While I wasn't involved on the combat end, it was still stressful"

?We are almost at the half-way point, so I?ll let you relax a few moments while I digest all of this, and then we will continue, is that all right with you??

Aaron nodded.
"I suppose I've given you some things to consider"

?Yes, you have, but nothing extremely problematic right now. It seems that your life is fairly normal, which I rather expected when I first saw you.?

Andy made a few notes on his PADD and then began the last half of his questioning Lt. Steele.

?You told me about your past traumas with your family. How is your relationship with them now??

?I?m closest with Sarah, my twin sister. I guess because we?ve been through a lot together, and both majored in Science at the Academy. Both my brothers are Marines, we try and talk to each other once a month but it usually ends up being every two, three months. Julie calls me up occasionally; but with her being 14 years my elder, we were never that close. Megan calls about once a month; she?s five years older then me. She?s also the family counselor literally. My Father has his hands full, as the Falcon?s XO, but I contact him when I want advice.?

?In regards to social relationships, how do you respond? Are you shy or outgoing or something in between??

?Honestly, somewhat in between. I get along well with others most the time, but I?m not one to attend every social function that comes along.

?Do you work well with others? How about your subordinates??

?As long as they?re doing their job correctly work goes smoothly. But if they are doing things incorrectly or not pulling their own weight, things can get heated. There?s been no major conflicts with my subordinates; I tell them what needs to be done and sometimes how to do it then let them work.?

?Good, now could you describe your relationship with your boss??

Aaron chose his next words carefully. Even though this session was confidential, command could probably view the information if they had a very good reason.

?Lt. Gwellian has only been my boss since about the archaeological dig, during which we disagreed on how things should be run. That?s to be expected though, she seems to be more of a hands on leader then I am. Our specialties rarely overlap, which means we often work on separate projects. All things considered though, we have a decent working relationship, outside of work we see each other even less.?

?And how does that make you feel??

?I?m afraid that?s a question to which I don?t have a definite answer to.?
Replied Aaron, hoping it was an acceptable response.

?What makes you happy? Sad??

?Completing a big project, call from a friend/family member, being nominated for the Spock Medal of Discovery even though I didn?t win. I?ve always been one for a good book. When I was at the Academy foggy days would get me down, I suppose they still do. The death of friends during the Dominion War.?
Aaron paused to gather his thoughts, which prompted Andy to ask his next set of questions.

?Any frustrations? Anger??

?The biggest frustration is when I have trouble translating a document. More so when I have enough to get an idea of what it says but not enough to properly fill in the blanks. I get angry when people tell me how to do something that they have no expertise in.?

Andy kept jotting down notes on his P.A.D.D. as the Lieutenant continued to speak.

?Now, I?d like you to do me a favor Aaron. Would you just close your eyes and talk about whatever come to your mind. It doesn?t have to be related to the previous thought. Just anything that comes to mind.?

Aaron took a deep breath and complied with the request.
He ?rambled on? for twelve minutes or so talking about wide variety of topics. The American Civil War, experiences growing up, briefly touching on his time at the Academy, and his career in Starfleet focusing on the Dominion War, as well as his career after that including SB Atlantis. He also mentioned his date with Hannah the night before and his curiosity over what she had done after the Academy. He stopped and looked around the office.
?Is that good or should I continue??

?Lieutenant that was quite good, but I would like to have you talk more on the loss of your mother and the great loss you endured during the Dominion War. Would you do that for me? You know, I can very well relate to losing friends in that ruthless conflagration, and I do believe it might help if you just went into it a bit more with me.?

Aaron took a slow deep breath, letting it out before responding.

?Like I mentioned, my mother died in an engineering accident when I was seven. Julie was home for a few days while on leave from the Academy. It started like any other day, but we knew something was wrong when Julie pulled us kids out of school. The trip home there was dead silence and when we got home all our neighbors had gathered. Our dad sat us down on the living room couch and gave us a speech, I don?t remember the details but he concluded by telling us that our mother was serious condition after an accident and wasn?t expected to live. She died the next day, I was too young then to understand all the details and even when I got older never pressed for details. To this day I don?t know the specifics. I?m probably making these seem worse then it really was, but that?s how I see things.? Aaron was almost apologetic.

?No, there is nothing worse than losing a parent, I agree. It is an overwhelming burden that affects one for their entire life. Whereas you lost your mother at an early age, I believe that played a great part in the man you are today.?

Aaron could tell the Dr. was sincere which helped put him at ease.
?Maybe, but in some ways I feel the war played a bigger part. I had been out of the Academy not even a year when relations with Cardassia worsened. Since the Thunderbolt was assigned to patrol our side of the DMZ, we found ourselves on the front line of the conflict. At that time the Thunderbolt was an Ambassador class ship, not the Excalibur it is today. Regardless, after they allied themselves with the Dominion we were ordered to DS9 for upgrades. Once the war actually started, we quickly found ourselves on the front lines. Thankfully, we had a good crew, which somehow managed to keep the ship together. *Aaron started up at the ceiling before returning his gaze on the wall behind the counselor.* The only word I can think of to describe it is chaos, ships of all shapes and sizes engaging each other in combat. During one particular battle, I made my way to sickbay for treatment, the sight I saw there is one that I?ll never forget. Sickbay was overwhelmed with the dead and dying. Dr. Kalaya glanced at me and instructed me to find an empty spot to relax; someone would get to me when they could. I think the worst part was the feeling of helplessness. Sickbay needed all the help it could get and there was little I could do, I had no medical training beyond basic first aid. Consequently, I just sat there until I was treated. I returned to duty later that day, to a bridge that looked like someone detonated a bomb nearby. The next battle cause more damage then we could keep up with. The Captain ordered us to abandon ship, which we did. We were picked up soon after by a medical ship, before being given temporary assignments wherever our services were needed. The war ended soon after, but the damage had already been done. I lost 4 cousins, an uncle and numerous friends, many whom I knew from the Academy. On the plus side, if there is one. We got a new ship, which is still in service today.?

Andy shifted in his chair and punched in a few more notes on his P.A.D.D., then he leaned forward somewhat as he asked Aaron to discuss his feelings about Hannah and her post-Academy ?position.? Andy also reiterated that this entire discussion was confidential and would go nowhere. Then he leaned back and listened intently.

Aaron seriously hoped that the information remained confidential.
?I don?t know a whole lot, but I?ll tell you what I know. She graduated early and took a job with Intel. She knows nothing about the Bixx, and little of major events that have happened over the last year. She has some physical scars, which she attributes to her time with Intel. That is all I know for a fact. My speculation is that something went wrong, something which Intel is keeping quiet about. To be honest I?m not sure what to think about it.?

Andy constantly entered information into his PADD. He was impressed with this man, and what he had been through and how he had handled losing his mother at such an early age. That sort of trauma when combined with battle fatigue (PTSD) only compounded potential problems, but it did not seem as though the Lieutenant was unable to manage his feelings without help.

Leaning back in his chair once more, Andy began to make complete eye-to-eye contact with the Lieutenant. He observed the Lieutenant?s actions, how he reacted and if he said anything. Andy was looking deep into the man?s soul, and hoping that Aaron knew that he was someone to be trusted. Then he broke the stare.

?I would like to make a comment about your friend, Hannah. She may be carrying a burden far larger than she can handle. Be there for her. If she needs it, she may always come here. I know nothing, I see nothing, and I hear nothing; remember that. However, I do have another question for you. Do you trust her? And by ?trust? I mean, you don?t ever get the feeling that she is ?on the other side??? Perhaps the Lieutenant felt that was a foolish question and remark, but Andy knew that it was not. Aaron needed to be aware that no matter where he went, someone could be from the other side.

"The other side?" Aaron wasn't fully sure what the Dr. was getting at. "If you mean Intel sent her to check up on things at Atlantis. Our relationship is still in it's early stages, but I trust her as much as I trust most people around here. So far she's given me no reason not to trust her."

?I realize that, Aaron, but I felt you needed to always remember that we are not alone here. From what I have heard, much has happened on Atlantis in the past month, and I simply want you to be aware. You are in a very sensitive position with your job, and many could wish to sabotage Science?.or infiltrate it, at the least.?

Aaron shook his head.
"A lot has happened in the six months I've been here, not just the dig. Trust me I'm more vigilant here then on the Thunderbolt. If Intel wanted to infiltrate Science I'm sure there's better ways, even if she is I don't think I can do much about it."

?In regards to your time on the Thunderbolt, do you feel you need to talk about it in another session? Does it work at you? Are you able to put it out of your thoughts for long periods of time or do find yourself dwelling on it?? Andy needed to know just how badly this stress had affected the Lieutenant.

"It depends. Some days I find myself thinking about the events during the war. My sister calls it 'survivors guilt'. I'm sure she'll be glad I found some besides her to talk to about those events. To answer your question, another session might be helpful; I'll give you the contact info for Megan so you two can swap notes. I'll let her know it's OK.

?All right, that will be fine. I?ll take Megan?s information, but I?d like to see you back here again, oh, let?s say in a week or so. You may make the appointment with my secretary on your way out, but first, let me give you my impressions.

"Go ahead" replied Aaron

?I think you are an accomplished Starfleet officer, quite knowledgeable in your field of study and have a pretty good hold on things. Just don?t forget that counseling is nothing to be ashamed of. Actually, it?s quite the rage in some circles. Nevertheless, it?s completely confidential unless you do as you did, give me permission to speak with your sister.?

"Glad to know I'm not a nut case." Aaron handed the counselor contact info for his sister.

?Good. Now, out of here, Lieutenant, and go enjoy your day, whatever it encompasses. You?ve made a distinct and solid impression. This will be in your record and will not affect it to the negative; far from it, in fact.? Andy wanted to reassure Aaron that he was as normal as one could be after all he had experienced in his short lifetime.

As the two stood up, they shook hands and said goodbye. Andy watched Aaron as he stopped at the secretary?s desk to make his follow-up appointment and smiled to himself.
*Excellent; and an excellent client. He?ll be just fine.* he said to himself.

Aaron stopped by the desk to make the appointment for a week from the next day. As he exited the building he glanced at the sun before hopping on his bike and heading to work.

OFF:

A Joint Post by
Lieutenant (jg) Aaron Steele
Assistant Chief Science Officer

and
Dr. Andrew Mitchell
Chief Counselor

OOC: More of the same. The timestamps might be a little odd since they were done during different missions.


SB ATLANTIS Medical Complex
Dr. Mitchell's Office
Day 3 09:00

Aaron walked into the medical complex uncertain of how events would unfold.
This would be the first time he openly discussed his experiences with anyone besides his sister. In his left hand, the scientist carried a copy of his dreams concerning the Dominion War.

There was no waiting as the receptionist told him to go right in. Aaron took a deep breath, letting it out as he entered the office.

Andy had hoped that Aaron would keep his scheduled appointment for this morning. Many times his patients would cancel due to fears, unwarranted ones, but fears nonetheless. It seemed that the Lieutenant was a man of his word.

Andy swiveled around in his chair, stood and greeted the Lieutenant. ?Good morning, Aaron; so good to see you once again,? he said reaching out to shake his hand. ?Please, make yourself comfortable whilst I prepare the recorder.

Aaron hadn't noticed the recorder last time, but was sure the Dr. kept the records under tight security.

With the PADD accessing Aaron?s previous visit, Andy quickly reviewed the information and switched the recorder to the ?on? position.

?All right, Aaron, are you comfortable and as relaxed as you can be?

Aaron nodded.
?I am, thanks for asking."

?Fine then, how have you been since your last visit??

Aaron's mind quickly replayed the events of the past few days.
"Busy. We had a priority project over at Science. Actually we're still working on it but the hardest part is over."

Andy sensed by Aaron?s body language, that he did not remember the recorder. ?The recording is for my notes, Aaron, and nothing, I assure you, leaves my mouth or my office. Records are kept under tight security and I believe that I mentioned in our last visit that I am bound by law not to reveal anything said to me here in a Doctor-client relationship.?


The Doctor was very perceptive, something Aaron was glad for.
"I wasn't doubting that, I just hadn't noticed it last time. You've given me no reason not to trust you."

?Has this pace at Science bothered you in any way? The reasons for the work, do they affect you psychologically, are you finding enough time for rest?? he asked.

Andy knew Atlantis was in crisis mode, but he would not allow the crew to become so entangled in their positions as to jeopardize their own well-being or that of the project with which they may be engaged. For a brief moment, his thoughts leapt from Aaron to Chen, and were immediately overtaken by Aaron?s comments.

Aaron thought carefully before replying.
"It hasn't bothered me per se. I'm more vigilant then before, but I've accepted that some things are out my control and am not going to worry about the underlying problem unless I'm given reason to."

He paused before continuing.

"I'm not getting as much rest as normal, but that's to be expected when everyone's on a higher alert status."


?If that is the case, then, I shall permit you to bring up the next topic of discussion."

Aaron placed the PADD's on Andy's desk.

"I should of dropped these off earlier, but as you know, things have been somewhat hectic around here. They're copies of my most vivid dreams I've experienced that deal with the Dominion War. I've only had nine of them, and I can usually identify the trigger for the dreams. I'm sure Megan mentioned them during your conversation with her."

?Yes, she did mention a few things to me, Aaron, and I agree with her and her present diagnosis also. However, I would appreciate hearing about these dreams from you directly. I also have Megan?s transcripts and records, but feel that it is better for you to relay your feelings directly to me. I believe that watching your persona during this discussion will also be most helpful. Is that acceptable to you??

"I'm afraid I don't quite understand what you're asking."
Aaron asked. It was more the why he didn't understand then the what.

?What I am saying is that I want the evidence directly myself, and not what another has seen or has spoken about with you. If you went to your physician for a second opinion, shall we say, you would have him examine you fully, not take another?s word for face value.?

Aaron nodded.
"Makes sense, where would you like to start?"

?You begin. You mentioned a trigger. What seems to provoke these dreams? If at any time in this hour you wish to stop, please do so; I do not wish for you to put yourself under undue stress.?

"Understood, although I hope it doesn?t come to that."

Aaron gathered his thoughts.
"Well the first time I had the dreams, was just over a week after the war officially ended. I was preparing to attend a funeral of a classmate who had succumbed to injuries suffered during combat. Scared the heck out of me! But on the flip side it made me realize that maybe the war affected me more then I had thought. I mean you always hear about survivors of wars or other catastrophic events having emotional problems, but you never think it could happen to you."

?It is a human trait, Aaron, none of us believes we are vulnerable to anything. Not even minor disruptions in our life, let alone major mind-altering or life-shattering situations. We all feel that nothing shall happen to us, until the day that it tragically does.?

He continued.
"Two other funerals also provoked the dreams. One was an old family friend who had served with distinction during the war. The other I didn't directly attend. We, the Thunderbolt, had returned to Earth for some R&R. I was visiting a friend who was stationed in San Fran, there was a funeral while I was there; while I didn't personally attend it dredged up memories of the funerals I had attended because of the war. Shortly after my brother Steven, received a promotion partly due to his performance during the war."

Aaron shifted in the chair.
"The five year anniversary brought back a lot of memories, both good and bad. I'm sure I wasn't the only one."

Andy was giving thought to having Aaron view some of his memories again, relive them in the safe environment of Andy?s office where his reactions could be controlled. He would question Aaron as to whether or not he would be willing to do so.

?How would you feel about replaying a holograph of a battle of the Dominion War? We need not do it today; in fact, I would prefer that you prepare yourself for it before I subject you to an obvious trigger. There is also another method. We could gradually work up to the holographic viewing by using relaxation techniques and by starting with less upsetting life stresses or by taking the trauma one piece at a time?

It was an interesting proposal. Relive, in a sense, the very events that were causing the stress. There was silence as Aaron gave it some serious thought. Finally, he nodded.
"It's worth a shot; I think building up to the re-creation would be best."

Andy knew this would be extraordinarily stressful for Aaron, but it was an integral part of his therapy. He hoped Aaron would submit to learning relaxation techniques before they began to tear down his mental walls of containment.

"I had friends on Voyager and when they finally returned, we tried to pick up from where we left off but found it difficult. We all had been through trying times and shared some of them. After I transferred here, I found myself thinking about all I'd been through especially the war. Finally our last session triggered a dream."

?I rather expected that to happen, but had hoped that it would not. It seems we have some work to do, Lieutenant Steele. Would you be able to make time in your busy schedule to see me, let us say, perhaps twice per week??

He knew it was serious when Dr. Mitchell used his rank and last name.
"If you think that's best then, I should be able to do that. It will require some rearranging of my schedule but it shouldn't be a problem.

?All right; you check with your Department Head and see what may be arranged. If you require Department Head approval, I am certain that it will be taken into consideration. After all, what good are you if one day in the midst of your work, you have a severe flashback??

Aaron laughed slightly.
"That would not be good. I'm sure Lt. Gwellian will approve it. Besides Doctor's orders when dealing with medical issues override most other concerns." Next step was how to approach her concerning the treatment.

?Good, I shall send you home with a brochure to read on relaxation techniques. Let us see how we may work with that approach, and if by some miracle, you have no nightmares until I see you again. If you require anything, please do not hesitate to reach me.

"I'm willing to give the relaxation a try. I'll contact you to set up the therapy sessions "

?Perfect.? Andy said as he sat on the edge of his desk. ?I do believe that if we start out slowly and work one episode at a time, we may experience more effective results. If you have any difficulty with approval for time off, just contact me and I shall speak with your DH. I have no worries however, nor should you; I will not be telling your life story, but only requesting a medical leave for an hour or so twice a week. All of Starfleet understands why this department is in place, anyhow: to serve them. I doubt a question or objection shall be raised."

"I appreciate it Doc, this could be a big help."

?When you find out your work schedule, just call my secretary and she will set something up that is mutually agreeable." Andy said as he handed the brochure to him.

Andy switched off the PADD as the session had ended for that day, however, it could also be a long road ahead, depending upon Aaron.

?I shall speak with you soon, Aaron, have a good day.?

Aaron shook the man's hand.
"You too, I'll see you around."

As he made the short walk to the Science Complex, Aaron hoped that this would be the start of a new phase in his life. One where his combat experience no longer haunted him.

Off:

A Joint Post by
Lieutenant (jg) Aaron Steele
Assistant Chief Science Officer

and
Dr. Andrew Mitchell
Chief Counselor

SB ATLANTIS Medical Complex
Dr. Mitchell?s Office
Day 5 14:00


For the third time in less then two weeks Aaron found himself making the short walk from Science to Medical. Andy?s secretary, Susan Rollins, smiled as he walked into the outer office.
?You?re becoming quite the regular around here Lt.?

?Is that a bad thing?? Aaron joked.

Susan laughed.
?Now don?t go putting words in my mouth. I didn?t say one way or another. You better go in, don?t want to keep the good Doctor waiting.?

Aaron walked in, remaining standing for the time being.
?So Doc. Where do we start??

Andy had been absorbed in the week?s Journal of Psychiatry, when Aaron walked into his office; swiveling around in his chair, he looked at Aaron,.
?Hello, Aaron, where do you want to begin is more the question? And please, make yourself comfortable.?

Aaron sat down in the chair and got comfortable. He wasn?t fully prepared to start the session but he would do his best.

?Did you do your homework and practice some of your relaxation techniques??


? I was a good student and started my homework. Yes I tried a few relaxation techniques.?
Aaron grinned slightly as he spoke.

?How did they work for you, any relief at all??

Aaron shrugged his shoulders.
?As far as I can tell, although the scientist in me says it?s too early to tell for sure.?

?All right, well, I would like you to continue with them as often as you are able. I realize that it is sometimes difficult to maintain a proper schedule, however, this is for your own well-being.?

?How have you managed with the nightmares since we last met?? Andy hoped that they had subsided somewhat; for if they did not, Aaron might require medication and he was almost certain that the scientist would balk at that idea.

?So far so good, I haven?t had any more. It?s hard to say for certain one way or another if they?re gone permanently. I guess I should be thankful they?re as infrequent as they are.?
Aaron had heard stories of others who had dreams with such intensity and frequency, they required heavy medication to control.

"Good, I am happy to hear that they are settling down somewhat; nevertheless, keep track of them, and write them down if need be. Now, I would like you to begin wherever you wish; whatever is on the top of your list."

?I guess the beginning is as good of a place to start as any.?
Aaron sat back in the chair as he began.


? By my junior year at Starfleet Academy, an invasion by the Dominion was feared and the Maquis were starting to harass the Cardassians. At that point I wasn?t sure what to think of the Maquis. I knew the Federation?s official stance concerning them, but wanted to make a decision for myself. Consequently I spent a fair amount of my free time researching the Maquis. Fearing retaliation, for lack of better word, I promised to publish my findings in the school paper. Since it was considered an, ?official school project?, I had more resources available then I would normally. Myself along with a few other cadets, conducted numerous interviews with those involved in the conflict. We talked with those on both sides, Maquis and Starfleet alike. The article we published was objective in nature, but all of us involved had made our decisions. Some supported Starfleet, some the Maquis, and one brave cadet was determined to stay neutral. I decided to support the Maquis, personally I found Starfleet?s stance towards the Maquis too harsh and somewhat irresponsible.?

?I must say that I have only studied the Dominion war, as I was completing my doctorate on Earth. However it seems to have been a terrible position to be in, considering the Maquis had splintered from the Fleet; and then, of course, there were the Cardassians.?

?Over the summer before my senior year I struggled with a decision; should I join the Maquis or stay in Starfleet? Obviously I stayed in Starfleet, or I wouldn?t be here today. To be honest I wasn?t sure what good it would do to join the Maquis. Also I had literally grown up in Starfleet, and it didn?t seem right to quit to join the Maquis. I stayed in the Academy and was assigned to the Thunderbolt where I soon discovered that I wasn?t the only sympathizer on board. We routinely smuggled supplies to the various Maquis cells operating in the area; replicators, engineering supplies, tricorders, medical supplies and a few weapons. Apparently it wasn?t enough, although I would do it all over again if I had the choice.?

Aaron switched topics slightly.
?I remember when we got notification of the official start of hostilities against the Dominion and Cardassians. I was working on the bridge when Capt. Erickson received a priority message from Starfleet Command. She took the message in her ready room and soon called for a senior staff meeting. Less then ten minutes after the message came in the senior staff came back on the bridge. They all had serious looks on their faces, so the rest of us knew something was up. The captain was short and to the point. ?War has officially began.? From then until the war?s end, even if nothing was currently happening we were at least at Yellow Alert.?

?How do you feel about the stress put upon you when war was declared, and your sympathies lay with the Maquis and then being in the war itself.?

Aaron shook his head.
?The two aren?t as connected as one might think. By the time war was declared, the Maquis had pretty much been defeated. It was easier to deal with the stress of being a sympathizer then that connected to the war. The war was a 24/7 worry, in contrast I only worried about retribution for helping the Maquis when I was actively smuggling supplies. It got to the point where I wasn?t worried about being caught while planning the next shipment, only after I left the ship with a shuttle craft full of supplies would I start to worry. Once I returned to the Thunderbolt there was nothing to worry about.?

?Do you believe that most of your nightmares stem from the Dominion War, Aaron??

He thought that had already been established, but Aaron still answered the question.

?Yes I do believe that most stem from the War.?

?All right then, I would appreciate if you would describe one of your nightmares to me. I do not believe it will provoke flashbacks, however if it does, I want you to tell me exactly what you see and feel.?

?I?ll do my best.?
Aaron closed his eyes and began to speak.

?It?s after the destruction of the Thunderbolt. I?m on the hospital ship, Clara Barton, as a field medic. More specifically, Cargo bay 2, which has been turned into a triage center.?
He stopped describing the dream, to explain some back story.
?I had received field medic training from Dr. Kalaya, so I could be more useful during combat situations.?
He continued with the dream
?I?m helping in the cargo bay when two Jem?Hadar soldiers suddenly appear. The strange thing is, no alarms go off. One of the other medics calls for security just before they get shot.?

Suddenly Aaron became disoriented as he plummeted into a flashback. Aaron distantly heard Andy?s voice softly reminding him to describe everything. Taking a series of slow deep breaths, Aaron began.

?I?m standing on the bridge of the Thunderbolt in front of the turbolift. The alert klaxons are sounding for no apparent reason. I move towards my station just in time to avoid having the Captain run into me, as she exits the turbolift. She calls for a report as she heads to the command chair. Cmdr. Hawkins informs the Captain that a fleet of Cardassian and Breen warships are headed our way, along with a few Jem?Hadar ships. The rest of the fleet is also aware of the situation and is awaiting instructions from the flagship. The flagship has responded and the fleet is moving to intercept. The attack begins, overwhelming the already weakened shields on our ship. I?m working franticly with engineering in an attempt to get the shields back up. The intruder alert sounds, Hawkins checks his console; a squad of Breen have beamed onto the lower decks. Anticipating the Captain?s order, he forms a security detail to deal with the threat. I join the team, which after getting rifles from the armory, head toward the Breen.?

Aaron continued to describe what was occurring as the security detail find themselves outnumbered by the Breen. Shortly after the team retook Engineering, Captain Erickson set the self-destruct sequence and ordered all hands to escape pods.

As Aaron came out of the flashback, he was physically and mentally exhausted. Nonetheless, he managed a weak smile.
?Unlike the dream I was describing, that actually happened, give or take some minor details.?

Andy had carefully watched Aaron?s movements and facial expressions during the elucidation of his flashback. Andy knew that he had his work cut out for him, but how to stop these incidents was the challenge they both would work at together.

?Aaron, I realize that you have the Dominion War to blame for these dreams or nightmares and flashbacks, and I realize I asked you more than once. However, the mind game played here is to see if somewhere along the long line, something else presents itself in your mind. So forgive me if I ask the same question repeatedly. It does serve a purpose.?

?Go ahead?

?What is it that most disturbs you in these recollected events? What is the fear that is at the basis of these miserable retrospections? I am not certain that you will have an answer for that, but do try to attempt to find something tangible.?

It was an important question, one Aaron knew could greatly influence future sessions.
There was dead silence for a good three or four minutes as Aaron gave the question serious thought. He thought back to the events during the war, focusing more on his feelings at the time then the events themselves. The initial shock when war was officially declared, anger at the Dominion for provoking the war, anger at SF Command for not doing more to stop the war when the Cardassians allied themselves with the Dominion, the feeling of helplessness during attacks coupled with fear, the grief over the loss of friends & family, the seemingly overwhelming number of casualties, relief when word of a cease fire was confirmed.

Quietly he answered the question.
?I?m afraid I?ll have to get back to you on that question. There?s a lot of emotions I need to sort through.?

Aaron started to stand up, more to stretch then anything, but quickly sat back down as his legs started to buckle beneath him.

?Are you all right? You had a difficult session, I do not wish for you to leave without expressing anything else that may be of significance or importance. There are more sessions remaining of course, but why not sit for a few moments to relax.?

?Thanks Doc. I wasn?t planning on leaving just yet anyway. Yeah, I?ll be all right, I just need a few minutes. There?s no other pressing matter I want to discuss, but thanks for asking.?

?I also wish to be informed if the frequency of your nightmares increase or decrease; write them down, keep a log. I realize this has been touched upon before, but it will help us to decipher the code in your mind. Also, keep up the work on your relaxation techniques; that is very important. If necessary we may move up to the next step if you find that is not helping.?

Aaron had to smile at Andy?s choice of words; ?decipher the code??, he wondered if it was intentional or not.
?I will definitely work on the relaxation techniques and keep track of any nightmares and, or flashbacks I experience. I?m almost afraid to ask, but what is the next step??

Andy stood up and walked away from his desk towards Aaron, who was still in the chair and perspiring quite heavily from his traumatic revelations.

?Never fear the next step, Aaron, I am going to help you through this. What I do not wish to do, however, is instigate a trigger for a while, as you saw what happened here. I truly do not wish to hospitalize you when I believe that we shall be able to work on this here, together. We could attempt biofeedback, and behavior modification or what we call Cognitive-behavioral therapy, also. The alternative is to start you on a small dose of medication.?

?I understand, I?ll do my best to stay away from that. However if push comes to shove, I will follow through with the treatment.?

?You have done remarkably well, Aaron, commend yourself for that. I shall wait for your answer to my question, however, we might attempt working through those feelings in a more controlled situation rather than on your own. I trust you to call me if you have problems or run into any difficulty at all. Are you comfortable with that approach??

Andy hoped that Aaron would not encounter a terror one night, while walking the streets of Atlantis or working on a project in the laboratory, as the consequences could be disastrous for all involved.

Aaron slowly nodded.
?If that?s what you recommend. I guess it would be more beneficial to have some assistance sorting out the feelings.?

?Are you feeling somewhat better, now? Somewhat more steady on your feet?? Andy asked.

Gradually standing up, Aaron answered the question.
?I believe so. I just needed some rest.?

?I am glad to hear that. Now, if you are able, try to get some extra sleep tonight. And keep up with the relaxation techniques. We are going to beat this, I give you my word.?

?I give no guarantees on the extra sleep, but I?ll do my best. As for the relaxation techniques I?ll definitely continue with those, I consider it my personal experiment.?

?That is all I might ask, do your best with the techniques you find most useful, and make certain you make another appointment. We shall continue to work together on this and insure you are able to move ahead easily without further problems.

He shook the doctor?s hand.
?I appreciate your help with this. If you ever need a favor, I?m just across the street in the Science Complex.?

?You are welcome, Aaron, and remember that I am across the street from you also, ? Andy smiled. If you need me, just shout; I am usually available 24/7. Good luck, Aaron.?


Off:

A Joint Post by
Lieutenant (jg) Aaron Steele
Assistant Chief Science Officer

and
Dr. Andrew Mitchell
Chief Counselor

SB ATLANTIS Medical Complex
Dr. Mitchell?s Office
Day 3 09:30

Aaron walked into the outer office glad to be someplace other than the Observatory or the Ancient Documents room. When he wasn?t taking readings of the nebula; Aaron was either examining more documents for clues, or making sure the documents could survive the excessive heat. After talking with secretary Rollins for a few minutes, Aaron made his way into the main part of the office.

?I assume things have been just as busy here??

?Hello Aaron, good to see you again. Yes, fairly busy here and I expect that the workload shall increase. Something to drink or shall we begin??

Aaron sat down in the chair.
?Might as well get started, it seems I can only be away from the Science Complex for so long before they need me for something.?

?All right then, how have you been feeling and what is happening in your life??

?I?ve been feeling pretty good actually, especially considering the circumstances. I don?t seem to be as stressed out over this storm as others in my department. Like I told Lt. Gwellian yesterday, I guess it?s because I went through so much during the war that the storm isn?t as big of a deal. I like the fact that we know exactly what we?re up against. There have been no nightmares or flashbacks since we last talked, so that?s a good sign.?

?It sounds to me as though the relaxation techniques have been helping you; obviously you have been diligent in practicing them. It is always a good sign when a patient sees improvement, no matter how minor. You say that you are only able to leave the Science Center for a certain period of time before you are required to return? Is that something that is new??

Aaron?s answer was somewhat vague.
?Atlantis has always kept me busy, from the Bixx to the current firestorm.?

Scratching his head, Andy wondered why this bothered Aaron and if it was routine or just due to the situation at hand.

?Has your position always required that you be available when necessary or is this something new for you??

?Being in a command level position within the department requires a certain level of responsibility; especially during a crisis.? Aaron was trying to follow the chain of questions.

?Does it bother you that your talents are needed or do you feel as though you are being overworked? I suppose that I am asking you whether or not your life has always been so, well, let us say, out of your control. In saying that, I do not mean that you are totally overwhelmed nor are you particularly bothered by it, but I would appreciate your comments.?

Aaron settled back into the chair.
?That?s a lot of questions at once; however, I will do my best to answer them. My life hasn?t often been, out of control, as you put it. During the war, when you didn?t know what the next day, much less the next hour, would hold; things were chaotic. In a way things felt that way when we left Mars after my mother?s death. It?s a different type of stress with the present situation. I know almost exactly when the nebula is going to reach its peak and what its effects are. This firestorm has kept me extremely busy, mainly in the Ancient Documents Room or the Sagan Lab. It?s not that I?m bothered by my talents being needed. I hope that?s of some help.?

?Yes, of course, every word you say is helpful, Aaron. I was not attempting to overload you with questions. I wished only to know if the duty schedule for your position was attributing to any new stress. I believe dealing with the Bixx and the Dominion War would be much more stressful, as well as the death of your Mother. I am happy to hear that you are busy and not overwhelmed in your position.? Andy stood to make a replicated cup of espresso. ?Would you care for anything whilst I am up??

?No thank you, I?ll be fine. If things get too hectic at work, I?ll make sure to cut back if possible. Wouldn?t want to be put on medical leave because I couldn?t handle my work load.?

Andy leaned upon the edge of his desk, stirring his espresso and observing Aaron?s demeanor and reactions. He felt that Aaron had achieved great success in his therapy, but Andy felt something was still amiss.

?Aaron, is there any subject you would particularly care to discuss? I care not what, just anything from A to Z works quite well for me.?

Aaron shifted somewhat uncomfortably.
?One of the items I wish to discuss would be somewhat difficult to do so. Or should I say a person I wish to discuss. I?m somewhat concerned about Lt. Gwellian.?

?Dr, Gwellian, why is that?? Of course, Andy knew fully well why Aaron was concerned but was certainly not at liberty to discuss her case with him, and Steele knew this as well, however, his consideration of her was admirable.

?This whole nebula thing has her pretty stressed out. I understand that some of it stems from the archaeological dig, and that she is quite capable of taking care of herself. However it wouldn?t help her or the department if she were to suffer a nervous breakdown.?

?That is true, Aaron, although, if left to her own devices, I would imagine she shall realize this herself and act upon it. If you feel she is not acknowledging a problem, if she has one, then I would suggest you speak to your Executive Officer.?

?Enough about work, I?ve come closer to an answer to your question from the last session. About what bothers me the most about my war experience.?

?All right, that is real progress; let me hear it.?

?I figured it?s either all the death I saw; death which I became somewhat complacent with; or the aftermath of the war on those who survived.?

?Complacency is a very interesting description, Aaron; are you specific that you do not mean denial? Were you denying that death occurred and then develop a laissez-faire attitude for those who survived? Or do you mean the effects upon those who survived the war; how their lives would be forever altered??

?I wasn?t denying that death occurred.? Aaron spoke hesitatingly, trying to put into words the feelings he had experienced. ?It would be hard to do so when you?re surrounded by it. I got to the point where death didn?t bother me nearly as much as it first did. I threw up when I lost my first patient, I took notice of every death that occurred those first few weeks. By the end I barely noticed when one my patients died, much less those around me. Veteran medics told me it?s not uncommon or altogether wrong for that to happen. Regardless I felt, and still feel to an extent, that I should have taken more notice. Maybe that?s not the right word, I noticed the deaths they just didn?t affect me as much. At least not they didn?t seem to. I think you understand what I?m trying to say.?

?Yes, I do; quite well, in fact. A person?s mind can only process and handle a specific quantity of psychological emotion and stress before one does become apathetic. It is a fight or flight response by the brain; pure avoidance. You wall off the pain until it becomes safe, or so you believe it is safe, to stop blocking the pain and suffering. For many, PTSD begins within 20 days of assignment, others, it manifests itself months after the offending trauma. It depends completely upon the person?s ability to cope with what is causing the offending issues.?

?The effects on the survivors hit me pretty hard as well. I can still remember the looks on peoples faces when I told them their loved one wouldn?t be coming home. Especially when it was the mother who wouldn?t be returning When I wasn?t treating patients, I helped notify the families of those who died. Partway through the war, a classmate was assigned to a risky mission. The night before he left, a bunch of us that went through the Academy together went to the mess hall for one last hurrah, so to speak.We swapped jokes and tried to act like their wasn?t a war raging around us. As we were leaving, Robert, the one going on the mission, pulled me aside and handed me three letters. One was to Nancy, his bride of 8 weeks, one for his parents, and the last was for us, his classmates. ?Just in case? he told me and left it at that. Robert didn?t make it back, so I had to deliver the letters. Attached to the letter for those of us from the Academy were instructions for me to take care on Nancy.?
Aaron?s voice betrayed the underlying emotions involved with the memory.
?The night after I delivered the letters, I cried myself to sleep for the first time since my mother died.?

?I do not believe there are many tasks more difficult than telling a mother or a spouse that their child or loved one has been killed; no matter the means. You re-live the events of your past and related it to your friend; you then attempt to provide comfort to a grieving family, and in your case were asked to watch over the victim?s wife. I believe the feelings you had were those of inadequacy and ineptitude; you had no idea how to take care of Nancy and that, in turn, only brought back repressed memories of your own mother?s death and your inability to prevent it. Symptoms affect relationships with others: persons with PTSD often avoid close emotional ties with family, co-workers, and friends. At first, you may feel numb, have diminished emotions, and may only complete routine, mechanical activities. Later, when re-living the traumatic event, you might alternate between a flood of emotions caused by the flashback and an inability to feel or express emotions at all.? Andy propped one foot up against the front of the desk to change his position and crossed his arms in front of him.

?Aaron are you telling me everything? Are you certain you are not having difficulty sleeping, nightmares, terrors, hallucinations, problems concentrating, social inadequacy, or depression? Any of them are triggers of a greater event; I should not care to see that happen to you. We have worked with relaxation techniques, and one session of Exposure Therapy, where you watched a hologram of the Dominion War. I believe we need to arrange a few more of those sessions. Right now, aside from the ET, we are doing everything else we can, aside from prescribing drug therapy, and you had said earlier you did not wish to go that route if at all possible, so I shall respect your wishes.



?I don?t pretend to understand everything you just told me, but I understood enough.?
Aaron had come expect, and respect, the frankness of Dr. Mitchell?s evaluations.
?You have an interesting evaluation of events. Some of which I?d consider an insult coming from most others; however I respect your opinion and do not take it personally.
The connection between my mother and Nancy is an angle I never thought of before. I was seven when my mother died; it was a different type of grief then when Robert was killed. My mother?s death was unexpected while Robert?s wasn?t. Yeah I wish I could of prevented both of them but I couldn?t. With all due respect Doctor, I never felt guilty about being unable to prevent them.?

?If you would care for me to go over any of the comments again, I shall, but I believe it may even take you time to digest all of the facts I stated; however, I never intend to insult anyone, therefore if I did, I do apologize. I do know that death consumes a person, no matter what age, whether the person realizes it or not. The events from the trauma manifest themselves at a point later in life. As I said earlier, PTSD does not often become a diagnosable illness until months or years after the occurrence. I am happy to hear that you did not feel guilty about not being able to prevent the deaths, as many do, and then we arrive at a completely different location and go in another direction.?

?To answer your questions, I?m sure I haven?t experienced any more terrors or hallucinations. I?ve occasionally had trouble sleeping and concentrating, but doesn?t everyone? I have been depressed sometimes but it doesn?t last for more then a few days at a time. As for social inadequacy, it?s hard to say. I?m not exactly the life of the party, but I?m not totally withdrawn either.?

?All right, you may be a shy man, that is perfectly acceptable; I do not enjoy parties, especially in official capacities, however, I do attend, but I do tend to shy away. I do not, nevertheless, care to hear that you have had depressive episodes of longer than one day.
Are you able to place a finger on what may trigger these episodes? Do you wish to sleep all day, not get out of bed, or only feel as there is a black cloud hanging over you with no definite reason??


?Actually, I am able to identify the triggers. If I?ve had a really rough day it can ruin the whole week. That and reminders of the war, especially around certain anniversaries regarding the war. Most the time it?s just a black cloud, as you describe it; sometimes though it can be difficult to get out of bed, luckily that had rarely happened.?
Aaron mentally braced himself for the next round of questions.


?To answer your prior question, yes, we all have times where we have difficulty sleeping or the inability to concentrate; these incidents may be caused just by our sleep cycle being off, or something we have consumed that is a stimulant; for example, if I drink too much espresso late in the evening, I shall not sleep well. If it is more than twice a week, however, I would suspect something deeper.?

That wasn?t quite the answer Aaron was hoping for, regardless he acknowledged the fact he understood what had been said.
?I?ll keep a closer eye on any troubles I have regarding sleep or concentration.?

?I would like to work with you on imagery rehearsal therapy. The Imagery rehearsal therapy is similar to what I asked you to do when I first began to see you. This technique calls for you to change the scenario of a recent nightmare anyway you wish, write down the improved version, then mentally rehearse it in a relaxed state, which we would do here. We are presently in cognitive behavioral therapy, where you speak of your trauma and we work on it step by step. And as I stand here, I wonder if we should not place you on a low dose of SSRI? It shall not affect your work, nor tire you or cause you to be lethargic. However, it works on serotonin receptors in your brain. I shall give that more thought, but for now, let us schedule you for another appointment later this week, depending on emergent conditions and all. Are you agreeable with that??

?Imagery rehearsal therapy. Not sure what it will accomplish but I?m willing to give it a try. As for the SSRI, if you think it?s best to prescribe a low dosage, I will go along with the decision. You are the doctor after all.?

?I may be the physician, Aaron, but if you are opposed to any part of this therapy, you have the right of refusal. I would like you to write down any dreams you may have, then we shall review them.? Andy reached for a PADD and scratched out a low dose of SSRI for Aaron and instructions. ?This will arrive at the hospital pharmacy before you are there. It is a very low dose, but it has given good results with combined therapies. If you are feeling less apprehensive and have no major triggers or nightmares, symptoms, and all, for three weeks, I?ll remove you slowly from the SSRI, as then I know we have made real progress.?

?Any further questions for me??

Aaron got up from the chair.
?No I think that?s everything. Thanks again Doc.?

The two shook hands before Aaron left for the Science Complex; but not before setting up another appointment and picking up the SSRI from the pharmacy.

Off:

A Joint Post by
Lieutenant (jg) Aaron Steele
Assistant Chief Science Officer

and
Dr. Andrew Mitchell
Chief Counselor