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  Lieutenant Commander T'Kara & Cadet Kobor Tumar, SD
 
"The Complicated Case of Mr Kobor" (DL T'Kara/Kobor)
 
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“The Complicated Case of Mr Kobor”

DL by Lieutenant Commander T'Kara and Cadet Kobor Tumar

Doctor T'Kara observed the felinoid that was sitting in front of her on the biobed.  It was obvious that he was uneasy, and uncomfortable; especially in the holographic environment.  She raised an eyebrow at his questioning Dr Shan about the reason for the holographic nurses. The cadet's defensive responses to Dr Shan's questions suggested that the cadet did not even entirely understand why he was being evaluated.  

T'Kara had only briefly been informed of the cadet's history prior to seeing him, and she would want to take a more thorough examination of the man's medical and psychological files in order to fully understand the case.  However, her vulcan mind was already working the differential and forming a plan for his work up, treatment, and maintenance.

Based on the way the cadet reacted to the holographic nurses and his history of panic attacks during holo-simulations, T'Kara suspected holographobia.  The fact that the once klingon had been through complete biological changes down to the cellular level into a completely different species--on more than one occasion--could have played a role in his current psychological distress.  Whether the shape shifting trauma caused his holographobia or simply enhanced an already existing anxiety would require further analysis. Regardless of the cause of the holographobia, the syndrome, if not treated, could pose a significant problem to the cadet and his career in Starfleet, since the federation regularly used holograms and holo-simulations for training purposes.

Her face showed no emotion, in the typical vulcan way, but her voice was soft and unthreatening.  “Mr. Kobor. Please tell me when you first started feeling unsettled while in an holographic environment.  Have you ever had this experience prior to joining starfleet?”

"It was after my transformation to what you see before you," he started. "I don't remember anymore if I became this in a simulation or on a real mission. I was Klingon then and realized I had gained some of Cadet McCaffrey's ability." He looked directly at the doctor with his bright yellow eyes. "I felt closed in. I could not breathe and my vision tunneled. Cadet NightWind observed me having an attack and came over to me, holding my arm. The panic did not subside."

Kobor, if he had been his old self, would have perspired. "I clung to her, or she to I, I am not certain. I could feel my blood boil, my bones stretch, and my insides contort. It was very painful and instead of letting her go I held tighter. I panicked more as I was in such pain. I would have rather taken a thousand painsticks then relive that moment." He stopped and looked down at the ground. "I had painfully transformed into her species, even the fur pattern was like hers. Only her colors are shared only by females, so I am sure to stand out among her kind." Once he stopped talking he looked all around at the projections of nurse and sickbay around him.

T'Kara gave a slight nod.  “It is understandable that such a traumatic event should leave you with extreme feelings of anxiety and uncertainty.  The encounter between you and the shape shifting cadet has permanently changed you. Your body has been drastically and completely changed down to the cellular level.  You experienced this excruciatingly painful transformation--not once but multiple times including your initial encounter with Cadet McCaffrey. These transformations were not planned; you had no time to prepare for them.  And each time it happened your mind had to deal with the physical, mental, and emotional trauma that was caused by the transformation.”

She tilted her head slightly; seeing the cadet's continued agitation.  “Cadet Kobor, it is not uncommon for someone who has experienced a traumatic event to have lingering emotional effects.  Panic attacks, nightmares, general anxiety, confusion, and even dissociating from your current situation can all be signs of post traumatic stress disorder.  The mind is strong, and is a powerful tool, but if left unchecked after experiencing a traumatic event-especially repeated traumatic events--it can get stuck in the self preservation mode.  Your mind wants to protect itself; its defensive mechanisms are in overdrive. It can perceive completely normal stimuli as threatening and then cause you to have a panic attack. That's all panic attacks are--your mind's defense mechanism against a perceived threat.”

The vulcan doctor paused a moment and considered the holographic room.  “It is curious though why a hologram should bring you discomfort in this case.  Holograms are not real, and so should not trigger your transformation should you touch them.  They do not have substance; they do not have DNA for your body to copy.” If anything T'Kara would have thought the cadet would feel more comfortable around holograms, as they would not cause him to transform.  Though, she knew, the emotional mind need not be logical--especially a traumatized one. She looked back to the feline Kobor. “Perhaps it is simply the unknown; the uncertainty of a holo-simulation where the unexpected could happen at any moment.  General anxiety with loss of perceived control.”

"I do not understand it myself. On a real mission I had great success with my hand gesture language. Every night I am answering correspondence from these people. I have hundreds of...fans." He thought of the mail yet to answer. "I think some are coming here, but I am no diplomat."

“Every Starfleet officer represents the federation when working with other species--especially in a first contact situation.  You do not have to be an official diplomat to have an influence on those with whom you come into contact.” She raised her eyebrow.  “The fact that you continue to have positive correspondence with this species suggest that you are fulfilling your role as their liaison to the federation.  At the very least the members of this species feel that you fulfill some sort of need for them, and no doubt they are comfortable obtaining information about the federation and the academy from you.  Did you feel anxious or panicked during your interactions with these people on the mission or otherwise?”

"I did not, but I had an ability the other cadets lacked. I was not as enclosed as I was on the other mission, or the one that caused me to turn into..a cat. I felt more in control, the situation was not getting out of hand. In the Klingon Defense Force they teach you warrior ways, but I am no warrior. That is why I am here, at Starfleet."

T'Kara gave a nod.  “Perceived control, especially in a situation where you feel you are contributing helps keep your mind at ease.  That is very common for an individual who suffers from anxiety. Besides having panic attacks and feeling anxious during missions, how have you felt at home?”

"On campus? I either study or rest. I also look after my cat, though I have to make sure it's not Cadet McCaffrey in disguise. With my parents on the homeworld? I don't know if we have time in this sickbay to go over that. It's complicated." He coughed as the nurses of the simulation moved around him.

T'Kara was fully aware that this initial encounter would not be sufficient to address the entirety of the cadet's psyche and inner struggles.  She would however be able to get a general idea of the cadet's mental state.  “Indeed. I just have a few more questions to more fully understand your situation.  How have your sleep patterns been? Have you had any nightmares? Do you feel rested when you wake?”

"I have not slept ideally since the transformation, but if I am with NightWind then I sleep much better." Kobor stopped once he realized what he said. "I, err, I don't do that often, but when I did. Perhaps it's a feline thing."

T'Kara made a mental note of Kobor's answers as she continued to analyze his responses; watching his non-verbal queues as well.  “Have you felt helpless or hopeless? Have you had any feelings of dread?”

Kobor went on. "I try to suppress those thoughts, as any good Klingon would. A warrior," he stopped, then added..."a good Klingon would."

“Have you had any suicidal thoughts?  Have you ever attempted?”

"Certainly not. That's a coward's way out. It would dishonor my family for generations, supposing a generation is to come."

T'Kara's mind categorized and assembled everything she was learning about Kobor and used that information to shape a treatment plan that would be individualized and most effective for the cadet.  “Have you had any racing thoughts or felt like you just could not stop worrying about something? If so, how often?”

"I've lived in worry ever since, but really I have been anxious since I arrived here. My world has been turned upside down, as humans would say."

“How fatigued/drained have you felt since all of this began?”

"If you compound the extra studying I have needed to catch up, then I am drained, but no more than other students I would think."

“Have you ever heard or seen anything that was not really there?”

He looked puzzled. "Daydreams or something more substantial? Both." Kobor stroked his fur. "The transformation altered my mind. I am not as I once was."

T'Kara gave a nod.  “Thank you for answering my questions, Mr Kobor, and I am pleased you have come to receive help.  I know that as a Klingon it is hard to accept help, but even the greatest warrior could use a friend to help fight his worst battles.  I do believe that you suffer from general anxiety and PTSD due to the trauma from your transformations. You have experienced severe panic attacks and dissociations which have affected your ability to function in classes and training exercises.  If left untreated, your mind will continue to attack you in this manner and you will not be able to become a starfleet officer. However, this is not an uncommon condition, and there are several treatments that have been proven effective to manage and cure your condition.

I would like to start you on an anti-anxiety medication that will keep your mind at ease so that you can focus on your missions.  I will also prescribe a short acting anti-anxiety medication which will only be taken as needed at the moment you start to feel a panic attack.  The medication will help your mind break from its fight/flight mode and stop the panic attack.

Reconditioning your mind to accept normal stimuli and handle stress in a more productive way will be paramount in your recovery process.  I would like to see you work with a counselor who specializes in your condition--especially one that would be very understanding of your unique situation.  Combination psychosocial and biochemical therapy has the highest effective rate of recovery for your condition. Are you willing to try these treatment modalities, Mr Kobor?”    

"As my continued training here would involve being able to function I will undergo these...medications."

T'Kara nodded.  “I will order the medications.  I know you have a unique physiology, and I will be sure to give you the medication that will be most effective for you.  Wait here while I order them.” She paused a vulcan moment, and observed the continued agitation in the cadet regarding the holographic nurses.  “Computer end simulation.” The holograms all disappeared; leaving just the biological lifeforms, the biobed and the non holographic physical objects in the room.


   
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