The Doctor Is Out

a-class-act-president:

Sisters by commandmetobewell.

Cover art by @clexxxa-things​.

Listen to the Spotify playlist here.

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Lexa Woods, mother of two and beloved wife, goes on her final tour with her older sister and second-in-command, Anya, in Tagab before she’s to be relieved of active duty. Everything goes as planned until a fateful roadside bombing leaves the two sisters separated. After Lexa and half of their crew are presumed as K.I.A., Anya is honourably discharged and sent back home to New York where Clarke receives the shocking news of her lover’s untimely death. Anya comforts her younger sister’s wife and children in attempts to honour her promise to Lexa. Only, as the years pass, her ‘comfort’ unforeseeably becomes something more to the both of them.

Then – by some miraculous twist of fate – Lexa shows up five years later, changing everything.

No one can ever forget that there are two sides to every family.

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CHAPTER INDEX [WITH SOURCES]:

Chapter One: Prologue [Part One: Lifeline]

Victory stands on the back of sacrifice.

Sources:

1. US Military Ranks, Lowest to Highest.
   

Chapter Two: Prologue [Part Two: Homecoming]

The dead are gone, the living are hungry.

Sources:

1. The Gate Control Theory of Chronic Pain by Various Authors.
   

Chapter Three: Methods and Adjustments

Lexa finally wakes up, Anya fights the demons in her head, and Clarke tries to push down her grief.

Sources:

1. Traumatic Dissociation: Neurobiology And Treatment by Vermetten et al (p. 6-14).
   

Chapter Four: Intoxicated

Anya tries to get help, Clarke deals with denial, Aden steps up, and Lexa’s torture takes a new turn.

Sources:

1. Loss, Grief, and Bereavement by Various Authors.
   

Chapter Five: Making the First Move

Lexa faces her fears, Aden meets a new friend, and Anya and Clarke both rebuild in more ways than one.

Sources:

1. Can Intervention Work? by R. Stewart and G. Knaus (p. x-xxvi)
2. The Worst Scars are in the Mind: Psychological Torture by Hernán Reyes.

Chapter Six: Escape [Part One: Instinct]

Clarke and Anya decide to take the next step in their relationship and Lexa is forced to make a tough decision.

Sources:

1. “Federation as a Method of Ethnic Conflict Resolution” by J. McGarry and B. O’Leary (p. 264-287).
   

Chapter Seven: Escape [Part Two: Realizations]

Lexa escapes, Aden makes a discovery, Anya opens up, and Clarke receives a phone call that changes everything.

Sources:

1. The Wretched of Earth by Frantz Fanon (p.181-233).
   
2. Unintended Consequences of Changing the Definition of Posttraumatic Stress Disorder in the DSM V: Critique and Call For Action by Hoge et al.
3. Mourning and Grief as Healing Practices in Psychotherapy by Henry Olders, MD, FRCPC.
4. On Killing – Episode One: Veterans.
5. Traumatic Dissociation: Neurobiology And Treatment by Vermetten et al (p. 347-350).
   

Chapter Eight: Welcome Home 

Lexa arrives home, Tris meets her other mother, Aden acts out, and Clarke and Anya have to make a decision.

Sources:

1. Dementia and Capgras Syndrome: Handling Behavior and Emotional Fallout by Deborah Bier, PhD.

Chapter Nine: Unsettling Affairs 

Clarke notices something different about her wife, Aden continues to act out, Anya tries to reach out and help her little sister, Abby asks her daughter question, and Lexa meets her physiotherapist.

Sources:

1. That’s Not My Child: A Case of Capgras Syndrome by Jeremy Matuszak, MD and Matthew Parra, MD.
   
2. Deficits in short-term memory in posttraumatic stress disorder by Bremmer et al. (only accessible thorugh university institutions, sorry).
   
3. Haunting photos of soldiers faces taken before and after tours of duty show ravages of war by David Taylor and Anna DuBuis.
   
4. Coping with Traumatic Stress Reactions by the U.S Department of Veteran Affairs’ website.
   
5. Theories on the Overlap of Posttraumatic Stress Disorder With Schizophrenia by Aengus OConghaile and Lynn E. DeLisi.
   
6. The Effect of PTSD When You Have Bipolar Disorder by Matthew Tull, PhD.
7. The approach to patients with “non-epileptic seizures” by JDC Mellers.
   
8. The Truth About How Gun Ownership Impacts Veterans with PTSD
   

Chapter Ten: Silent Treatment

Raven starts therapy, Abby and Clarke discuss Lexa’s test results, Anya begins to spiral, and Lexa asks a question.

Sources:

1. Functional neuroimaging studies of post-traumatic stress disorder by Katherine C Hughes, MD, and Lisa M Shin, MD.
   
2. Stress fracture in military recruits: gender differences in muscle and bone susceptibility factors by Beck et al. 
3. Psychiatry in the Military: The Hidden Enemy by CCHR (Citizen’s Commission on Human Rights) Documentaries.
4. PET tracers for imaging of the dopaminergic system by Elsinga et al. 
5. Thalamic pathology in schizophrenia by Cronenwett et al.
6. A PET Study of Visuospatial Attention by Corbetta et al.
7. Dopamine-Related Disruption of Functional Topography of Striatal Connections in Unmedicated Patients With Schizophrenia by Horga et al.

Chapter Eleven: Homeostasis

Tris is questioned at school, Lexa has her first panic attack, Anya tries to hold it together, Abby tries to make some progress on finding out what’s wrong with her daughter-in-law, and Clarke stumbles upon something horrifying.

Sources:

1. The Psychoactive Effects of Psychiatric Medication: The Elephant in the Room by Moncrieff et al.
2. SSRI Antidepressant Medications: Adverse Effects and Tolerability by James Ferguson, M.D.
3. Differences in prolactin elevation and related symptoms of atypical antipsychotics in schizophrenic patients by Kristina Melkersson, M.D.
4. Psychiatry in the Military: The Hidden Enemy by CCHR (Citizen’s Commission on Human Rights) Documentaries.
5. Fields of combat : understanding PTSD among veterans of Iraq and Afghanistan by Erin P. Finley (the section on War Stories).

Chapter Twelve: Out of Sight (Not Out of Mind)

Abby learns new information about Lexa’s condition, Aden gets picked on by bullies, Clarke struggles to hold her family together, Anya hits rock bottom, Raven receives a chilling phone call, and Lexa visits her past.

Sources:

1. Emerging treatments for PTSD by Cukor et al, p. 3-5.
2. Individual Differences in Psychotic Effects of Ketamine Are
   Predicted by Brain Function Measured under Placebo by Honey et al.
3. The functional neuroanatomy of PTSD: a critical review by Liberzon et al.
4. Capgras syndrome induced by Ketamine in a Healthy Subject by Corlett et al. (this article is amazing and I highly recommend reading it).
5. Brain Imaging Helps Link Specific Symptoms of PTSD with Specific Brain Activity by Alexander Neumeister, M.D., from Brain and Behaviour RF.
6. Snorting Oxycodone: Side Effects and Dangers
7. VA Crisis Call Center – Behind the Scenes.

Chapter Thirteen: We All Fall Down [Part One: Tension]

Anya and Clarke finally get to have their much-needed talk, Jackson and Aden grow closer, Lexa fights her nightmares, Abby deals with hospital politics, and Raven makes a startling discovery about her patient.

Sources:

1. Registration, psychiatric evaluation and adherence to psychiatric treatment after suicide attempt by Merete Nordentoft.
2. Imaging dopamine’s role in drug abuse and addiction by Volkow et al.
3. Drug-Induced Parkinsonism by Shin & Chung.
4. Emotion Effect on Attention, Amygdala Activation, and Functional Connectivity in Schizophrenia by Anticevic et al.
5. Consciousness and body image: lessons from phantom limbs, Capgras syndrome and pain asymbolia by V.S. Ramachandran. 
6. Can we learn from the clinically significant face processing deficits, prosopagnosia and capgras delusion? by Elaine Wacholtz.
7. Capgras-like visual decomposition in Lewy body dementia with therapeutic response to donepezil by Reimers et al.
8. Drug use and childhood-, military- and post-military trauma exposure among women and men veterans by Kelley et al.
9. Reduced autonomic responses to faces in capgras delusion by Ellis et al.
10. Clarifying the role of defensive reactivity deficits in psychopathy and antisocial personality using startle reflex methodology by Uma et al.
11. Exposure to violence reduces empathetic responses to other’s pain by Zheng et al.
12. The comorbidity of reduplicative paramnesia, intermetamorphosis, reverse-intermetamorphosis, misidentification of reflection, and capgras syndrome in an adolescent patient by Arizoy et al.
13. Understanding child abuse and neglect by The National Research Council Staff Commission on Behavioral and Social Sciences and Education, Division of Behavioral and Social Sciences and Education.
14. Measurement of emotion dysregulation in adolescents by Weinburg & Klonsky (this is a study my abnormal prof did and it’s super cool). 
15. Emotion in the Criminal Psychopath: Startle Reflex Modulation by Patrick, Bradley, & Lang.

Chapter Fourteen: We All Fall Down [Part Two: Release]

Anya tries to rebuild the bond with her sister, Raven confronts Clarke, Abby makes a decision, Aden and Jackson have a moment, and Lexa’s worst nightmare becomes a reality.

Sources:

1. The amygdala and ventromedial prefrontal cortex in morality and psychopathy by Blair.
2. A review of the phenomenology and cognitive neuropsychological origins of the Capgras Syndrome by Edelstyn & Dyebode.
3. Peritraumatic and Persistent Dissociation in the Presumed Etiology of PTSD by Briere, Scott, & Weathers.
4. The dissociative anaesthetics, ketamine and
   phencyclidine, selectively reduce excitation of central
   mammalian neurones by N-methyl-aspartate by Berry, Burton, & Lodge.
5. The interactive effects of ketamine and nicotine on cerebral blood flow by Rowland et al.

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Many thanks to my big brother, Blu, for the incredible cover art that he made for this story. It’s definitely more than I could have ever asked for, in all honesty. Y’all need to go and follow him if you haven’t already, and show him all the love for this piece he did for me. He’s the best artist I could ever collaborate with, ever. There’s something in the way he does art, you just… feel things. It’s great.

This is the master post that’ll be re-blogged whenever there’s an update to the story, just so then all the chapters are on one post. Individual updates will still happen, but this is the master post that includes everything. Sources on research for certain chapters will be posted under each of the chapter links, so, if any of you are interested and want to read more about some of the topics brought up during the course of the story, you have accessible links.

Much love to all of you guys that are reading, commenting, and sending asks/kudos upon this fic. Honestly, it means the world to me and I cannot wait to get through and reply to all of y’all. It’s beyond incredible. I am still in awe.

EDIT: this is the new master post because I couldn’t figure out how to edit the other one due to my incapabilities as a human being using basic technology.

It’s back.

In spite of the many necessary warnings on this fic, I do hope you give it a go – it’s such a compelling read, not at all the usual ‘fan fiction,’ but a story quite epic in scope, with so much internalised grief and trauma, it pulls no punches.  

That it is also so thoroughly researched gives you an idea of the novelistic integrity behind it.