insaine therapy, pt. 2

Thalia wants to believe that the conference will spark more interest, but six weeks have passed, and their funds are still running dry. Funds they desperately need to move Therapist Assist to broader clinical trials.

Their booth seemed like the talk of the conference. She and Greer fielded questions that ranged from practical (How do you protect patient-clinician confidentiality?) to downright condescending (Why in God's name would a patient ever agree to be recorded like that in this day and age? Haven't you seen Black Mirror?).

Greer had shrugged off these questions with a smile. She isn't concerned with the practicality of Therapist Assist because she views the device's central purpose as a training tool for new clinicians. Therapist Assist, in Greer's estimation, is simply how the therapeutic profession would embrace the AI movement.

Thalia has a broader vision. She believes that Therapist Assist can fundamentally transform access to clinically-effective care. It's not that she doesn't share the concerns her fellow scientists expressed at the conference. These same questions keep her up at night. But she really believes that, with the correct precautions and safeguards in place, and of course, open and honest communication with patients about what the device can or cannot do, Therapist Assist will improve care for millions of people. Perhaps she is being naive, but the stakes are too high. What happened to her brother is proof that under-qualified therapists attempting to treat patients is dangerous. Enough is enough.

Thalia estimates that they need at least another $500,000 to execute her research plan. $1 million feels safer, but she isn't crazy enough to think that’s coming. Having applied to hundreds of grants with her team over the past five years, she knows that interest is limited. Maybe she has to accept that the conference was no help. She barges into Greer's office and collapses on the couch with as much dramatics as she can muster.

Greer doesn't glance up from her screen. "Nothing?"

"Nothing."

Greer perches her blue-light glasses on top of her head. They seem to nestle into her curls. "Thalia," she starts. "Stop picking at your nails. There will be nothing left."

Thalia sits on her hands instead — a habit she picked up in grade school when her nosier teachers would raise an eyebrow at her raw fingers. She can't help it. The last few weeks have grated on her nerves. Greer sighs in the way that makes Thalia feel like she's losing patience.

"Look, I didn't want to mention it before, but seeing as we're clearly not getting any traction, maybe now…" Greer's attention drifts to the open window, as if looking for confirmation.

"What?"

"Well, Patel knows a guy."

Thalia lifts an eyebrow. "Patel, Patel?"

"For the last time, we're not dating," Greer snaps.

Thalia lifts her hands in surrender.

Greer levels her with a warning glance before continuing. "They were in the same frat back at Penn. Apparently, he started one of those telehealth therapy services."

Thalia rolls her eyes, leaning back into the couch, "Ugh, no."

Greer continues, "He's realizing the hard way that he can't just let clinicians loose —"

"Oh please, don't even call them clinicians," Thalia interrupts.

"Patel says he has a vetting process that he claims is far more extensive and legitimate than other services."

"Everyone says that!" Thalia jumps to her feet. "Remember Mind-full? They came to us with all their fancy marketing bullshit."

She begins mimicking their CEO's voice, "We are revolutionizing access to therapy. All we're asking for is a few hours of your time to validate our offering — unpaid hours, mind you — and if you could please make sure it's all a glowing review, thank you very much, we might just wink, wink fund your next program."

She laughs bitterly, "And lo and behold, they didn't even have licensed nurse practitioners vetting their new hires!"

Thalia pauses to see if Greer is still listening. Greer knows her well enough to let her get rants out of her system, but sometimes she slyly turns back to her email in the meantime. This time, Greer levels her with a stare.

"Are you done?" she says calmly, hands folded in front of her.

"How do you know it won't be like Mind-full?"

"I don't." She pauses. "All I know is that this guy has some impressive investors backing his company, and given the market saturation that already exists, there must be a reason."

Thalia bites her bottom lip and tries her hardest to hear Greer out.

"Rich — that's his name," Greer snaps with satisfaction. "He's trying to solve for how to scale effective training." She shrugs. "This could be a great use case. We could get the results we need from in-market data to attract more funding."

Thalia sits back down on the couch and drums her fingers against her thighs. Everything in her wants to resist this, but the potential to secure real data…that would take Therapist Assist from theoretical to testable.

"Wait, how does Patel even know this? Don't tell me he told this Rich guy about our project."

"No, no, he wouldn't."

Thalia looks at her expectantly.

"They played golf together last week. Rich was apparently complaining the whole time about his issues, and Patel thought of us."

Thalia pinches the bridge of her nose. "Does Dr. Kelly know about this?"

"No."

Thalia mulls over the situation.

"Listen, you don't have to decide now. Take a few days. Think about it. And let me know when Patel should connect us." Greer smiles.

"If," Thalia corrects.

"Okay, if."

Thalia stands and before reaching the door, says over her shoulder, "Let's keep Dr. Kelly out of this, okay?"

"Noted," Greer says.

"Thanks."

Thalia spends the rest of the day attempting to grade papers. She doesn't have it in her to do her own work. She's too distracted weighing what Greer said. Walking home, she decides she needs something to take the edge off. There's a trendy wine bar a few blocks from campus, but it’s a favorite among professors. The thought of a forced conversation makes her turn in the opposite direction. She'll take the long way home.

Nestled underneath an antique store sits a cozy dive bar she used to frequent as an undergrad. Thalia appreciates bars that are aptly named, and she can think of no better name for this place than The Dive. She opens the burgundy door and instantly smells the stale beer caked to the tiled floor. The light inside is so dreary it could be any time of day or night. She can actually see dust particles floating around. It's exactly as she remembers. The perfect place to hide.

Satisfied, she bundles her coat around her and holds her bag close before fully stepping into the bar. She walks over to the bar top, taps it to see how sticky it is, and then settles on top of the cushioned stool farthest from the door. The bartender, who looks like he's never set foot in the light of day, wanders over. He tucks his scraggly hair behind his ears and then halfheartedly wipes down the bar top in front of her with a rag.

Thalia has the urge to offer him the little hairbrush she carries around in her bag for emergencies. She notes his three-quarter length tee that looks well loved, to put it mildly. He’s just the kind of Kurt Cobain-looking guy that her East Coast friends would’ve crushed on in their “wild college days.”

"Can I get you anything?" His voice comes out barely above a whisper, like he's been screaming all day. He clears his throat and tries again, "Sorry." This time his voice comes out at a normal volume. "Can I get you anything?"

"Um, yeah." Thalia glances at the menus scattered on the bar top. One drink catches her eye. "What's a Bulldog?"

Without any self-consciousness, the bartender eyes her wool coat and Louis Vuitton bag. She can practically hear his judgment. "It's a frozen margarita with a Corona dumped in the middle," he says.

Thalia can't help the giggle that escapes her. "Is that what the kids are drinking these days?"

"I usually card anyone who orders that."

Thalia takes a second to browse the menu. There are a couple of regulars skulking in The Dive's dark corners, but no one calls for his attention at the moment. "I'll just take the — well, maybe I'll take the Cosmopolitan." She glances up just in time to catch his faint cringe. "No, you know what? I'll have a beer."

"Final answer?"

"Yes." She smiles. "I'll take whatever the IPA on draft is."

He nods.

"Please," she adds.

Thalia watches as he scoops a pint glass from under the bar and turns to pour her beer. As the golden liquid fills her glass, she instantly regrets not sticking with the Cosmo. The beer would only make her feel bloated and tired. She had wanted to clear her head, maybe catch a light buzz that could trick her into feeling lighter. Then again, maybe the beer is exactly what she needs. Greer's offer is weighing her down. Now at least, her drink matches the mood.

The bartender sets her beer on a coaster and clears the menus in front of her in one easy motion. She envies him. This guy and The Dive. They're a perfect fit. She is sure he has his own problems, like anyone. But something about his relaxed confidence tells her he doesn't take anything too seriously. He seems to linger as if waiting for something, so she looks up at him, eyebrows lifted. He hooks the rag in his back pocket and knocks the bar with his knuckles. "Right, let me know if you need anything."

He walks to the other end of the bar and starts scrolling through his phone. Music suddenly fills the bar. She hadn't realized how quiet the bar was before. Maybe that's why her thoughts were so loud.

Thalia takes a big gulp of her beer. As the bubbles hit the back of her throat, she thinks of her brother. She can't help it. He had loved beer. Had grown one of those big burly beards that seemingly everyone who was "into beer" had grown circa 2016. If Pete were here, he would've been able to name the exact hops the brewery used without even looking. Thalia's chest tightens. She tries to refocus on the music. Forces herself to tap along to the beat.

She notices the bartender look her way, and worries that he's going to come back to check on her. She quickly retrieves her hands and fumbles through her purse to pull out her notebook and pen. Journaling always helps ground her. She rarely writes in public, unless it's something academic, but she can’t handle small talk right now. It's only Monday. Her next therapy session isn't until Wednesday, and her problems aren't big enough to ask for an impromptu session.

Opening her journal where she left off, Thalia clicks her pen a few times before starting to write.

"Let yourself write in free-flow," her therapist had said. "Don't worry about where it's going or try to write for an audience. This is about spitting out your thoughts so you can look at them objectively. Or not at all!" Her therapist had tossed her hand over her shoulder to emphasize this point.

Thalia begins writing everything she can remember about the Rick business. No, she crosses out Rick, remembering Greer had called him Rich. Typical, she thinks. It's like this tech bro was born to manifest wealth.

Something about what Greer said nags at her. It takes her about twenty minutes of steady writing before it reveals itself. In that time, Thalia downs her beer and signals the bartender for another. It isn't really about this Rich guy. It's that Greer withheld the opportunity because she thought Thalia couldn't handle it. They are partners, goddamn it. Thalia underlines this point so she'll remember to discuss with her therapist.

And beyond that, Thalia now feels like she doesn't have a choice but to go with this offer. The grant money isn't coming. That, she can finally admit to herself. She had held out hope for as long as she could.

If carrying on Therapist Assist means partnering with a tech company who claims to be doing good for humanity…well, she'll have to look into Rich's company before fully giving in. Thalia feels a little guilty for not trusting that Greer would have vetted that before even bringing it up. And she trusts Patel too. He knows Therapist Assist's power possibly better than anyone — he coded it.

She makes an action plan to schedule a meeting on Thursday with Greer and Patel to discuss approaching Rich. This leaves Thalia enough time to discuss it in therapy, and do her own research on Rich and his company. It won't solve the feeling that she's been backed into a corner, but if Rich really has the investors Greer alluded to, that could be more money than they'd ever dreamed of getting from the available grants this year. They were at a pivotal point in Therapist Assist's development. They couldn't stop now.

———

A week later, Thalia stands outside Patel’s front door. At least I can say I tried, Thalia thinks as she straightens her blazer. She knocks twice, then takes a step back. She hates when she opens her door to guests, and they’re already halfway to barreling their way in.

She checks her watch. If she can get out of here by eight-thirty, then she’ll still have time to finish her session notes and get ahead of tomorrow's prep work. Just as she considers knocking a third time, the door whooshes open.

"Hey, Thalia." Greer smiles at her feet.

Thalia looks at the faded Penn sweatshirt. Knowing Greer proudly went to Yale, Thalia tips her head back and cackles. "It's honestly getting exhausting watching you pretend you're not dating."

"Yeah, well, whatever." Greer laughs. "Come in, come in." She steps aside and ushers Thalia into a dark hallway. "He's just through there," she says, pointing to the lone source of light at the end of the hall.

"Dinner will be ready in about five minutes. Are you hungry? I put the crockpot on this morning before work. It's not going to blow your mind, but it's warm and, anyway, it's easy to make."

"It smells amazing." Thalia wonders if Greer's rambling because she's nervous about the fact that their relationship is finally confirmed or if something is wrong with the project. Stop assuming the worst, she chides herself.

As she enters the kitchen, she sees Patel typing furiously on his laptop at a cute nook just below the window. He pounds the keys and finishes with a flourish more fitting for a spy movie than remote work.

"Our guest of honor has made it, I see." He smiles, his glasses tinted blue from the screen.

"Yes, thank you for having me. I'm sorry I'm late. I didn't expect so much traffic on the East side."

"Yes, yes, always traffic."

"I keep telling him that the commute would be so much easier if he moved, but he loves it here," Greer says.

"Hard to beat having a real yard," Thalia says, gesturing toward the window. Her arm lingers for a beat before she tucks her hands into her pockets, suddenly self-conscious.

"So here's the deal," Greer says.

"Wait, at least let her sit down, Gre," Patel interrupts.

Thalia pulls out the seat across from Patel. It squeaks on their kitchen floor. "Sorry."

"I walked Rich through the code this morning" Patel starts. He looks to Greer for support. She nods. "He's impressed by the technology and certainly sees the value in the clinical sense. But of course, he's ultimately a business guy."

Again Greer nods, then takes Thalia’s hands in hers. "Look, Thalia, I listened to their Zoom call. Basically he wants to test 200 in market by May. And before you say no, think about this: 200 devices, 200 patients. A built-in trial that lets us gather actual field notes. With Rich funding the project, we can put together a team of clinicians —"

Thalia raises her eyebrow. "Real clinicians," Greer goes on, "to track progress. Patel would be on standby to help us make any updates we need."

"That's right,” Patel jumps in, “Rich agreed that I can put aside 20 hours a week on this at first, and then more if we prove the value."

Thalia folds her arms and looks up to the ceiling, noticing an old water stain in the corner.

"That sounds lovely in theory, but come on guys, what's the catch?" She looks between Patel and Greer.

"He wants to bypass insurance and have patients pay out of pocket." Greer says calmly.

Thalia laughs bitterly. "The whole fucking point is better access to real therapeutic intervention for the patients who need it most, i.e., typically the patients who can't afford to pay out of pocket."

Greer and Patel exchange a look. Thalia feels a pang of resentment, and then guilt.

"We're not making any headway on grants, Thalia," she says. "It's noble, really. But that's just not the world we live in right now. Once we get traction, it will be different. We’ll have the evidence to justify better access."

"I know it's not what you had in mind," starts Patel, "but believe it or not, this is a cause Rich really cares about. It's just, he won't commit anything if he doesn't see a way to at least break even."

"And you trust him?" Thalia asks.

"In this context, yes." Patel meets her gaze.