Kate Heightmeyer's Five Most Difficult Patients

1.) Rodney McKay. She could probably spend her entire career trying to figure out Rodney McKay. Even the great Sigmund Freud would have had trouble. Given enough time, he would no doubt have strode out of a session, muttering angrily into his beard. Rodney had that effect on a lot of people.

The scientists who worked with him were either terrified of him or harbored homicidal impulses. Maybe both. Rodney McKay was a very harsh taskmaster, often throwing out comments like "moron," "idiot," and even, on one memorable occasion, "Fumbles McStupid." (Kate had wished she knew how to speak Czech after that one. She had no idea what Radek was saying, but it sounded positively evil.) But Rodney drove himself as least as hard as his subordinates, if not harder. And on the few occasions when he praised his staff, the grins lasted for hours afterward.

Rodney didn't trust people or make friends easily. When he did, though, he was staunch and loyal. John Sheppard and Carson Beckett were two of the people who had managed to get past Rodney's defenses. They watched over him when he was closeted in the labs, and they nagged, bullied, and cajoled him into spending some time away from his work. The snark that flew between the three men was truly impressive in its creativity and insult potential.

One of Rodney's main faults was that he took the weight of the world on his shoulders. He felt responsible for every detail, every mistake, and every disaster that happened in the city. When a crisis arose, he would panic very vocally and then proceed to address it. So far, he'd succeeded every time, but what would happen when he inevitably came to a problem he couldn't solve? The problem with flying high like Superman was that it was a long way to fall.

2.) Elizabeth Weir. Elizabeth was always walking a fine line. As leader of the expedition, she needed to be detached enough to make life-and-death decisions, yet approachable enough to make people feel comfortable trusting her judgment. Nobody had expected to find a race of life-sucking alien vampires at the other end of the one-way trip, so everyone in the city was understandably under chronic stress punctuated by occasional moments of sheer terror. They unconsciously looked to Elizabeth for guidance, and she needed to maintain an image of self-assurance and competence.

Unfortunately, Elizabeth didn't think such an image was compatible with visits to the resident psychologist. Kate had tried to convince her otherwise, pointing out that she'd be setting a good example for those who might be afraid to seek help, but wasn't successful. Elizabeth, like John Sheppard, was very stubborn once she made up her mind about certain things. She considered Kate a friend, but would not seek psychological help unless absolutely necessary.

Well, Kate could be equally stubborn in her own way. She made sure to sit with Elizabeth in the mess hall once every few weeks. She didn't pry, but made it clear through verbal and nonverbal cues that she was happy to provide a sympathetic ear if Elizabeth needed to vent. Kate also began teaching a yoga class for stress relief and coaxed the expedition leader into participating. Over time, Elizabeth eventually became more relaxed and open to bouncing ideas off the psychologist. Sometimes she would even talk about personal concerns.

If the mountain wouldn't come to Mohammed...

3.) Teyla Emmagan. Kate had never treated a telepath before. (She also never ceased to be amazed that she worked in a place where she could make a statement like that and no one would even bat an eye.) Teyla was understandably nervous about her newfound ability, and Kate had no idea how to counsel her. How could you teach someone to use a sense you barely had words to describe? And how could you reassure her that there was no way the big scary monsters could take possession of her mind when you weren't even sure about that yourself?

Kate had decided to tackle the problem head on. She told Teyla, "I wish I knew how to best help you, but my training doesn't even begin to cover this. Your situation would be... well, pretty damn inconceivable back on Earth." That was a massive understatement. Back home, someone claiming to do what Teyla could do would be considered eccentric at best, and psychotic at worst. "So let's try to learn together. I can definitely teach you basic relaxation and mindfulness techniques that will allow you to maintain a constant awareness of your mind and body. That way, you'll be able to realize quickly if you're experiencing thoughts and feelings not your own."

What to do if that happened was another story. Have someone follow Teyla around all the time with a stunner? Issue her a self-injector of sedative? Throw her out of the city? Kate didn't know, and nobody else had any good ideas, either. Eventually they settled into a posture of watchful waiting. So far, so good.

4.) Sergeant Bates. Of all the military personnel, Kate would have expected John Sheppard to be the most difficult to deal with. It turned out, though, that he really wasn't that bad. Although he had a hard time articulating his emotions (she'd diagnosed mild alexithymia), they shone through in his actions. She could work with that.

But Bates! She remembered when they'd first met at the SGC. He hadn't even wanted her to know his first name. In Atlantis, it had taken three post-mission sessions before she could get him to stop saying "ma'am" after every sentence and several more before he relaxed enough to stop scanning her office for threats every time he walked in. She had found him very intimidating; the feeling was probably mutual.

Kate finally made a breakthrough after the nanovirus incident. He'd been genuinely upset at being placed in the middle of the power struggle between Sheppard and Weir. Kate had used that as an opportunity to push Bates a little, to make him understand his own motivations when it came to chain of command issues or dealing with Teyla and the Athosians. She tried to make him angry enough to let something slip through his tight veneer of control, and it had worked. She didn't remember exactly what she had said -- it had been some Freudian nonsense about going back to childhood -- but he snapped at her. "You don't honestly believe that crap you're spouting, do you?" had been his exact words. From then on, she had been able to work with him to help him channel his innate protectiveness and suspicious nature into positive avenues. After a while, she almost forgot how intimidated she was at first.

And that's when she realized she was attracted to him.

That definitely made things complicated. Professional ethics dictated that a therapist was not supposed to become romantically involved with a patient, but in a very real sense, everyone in the city was a potential patient. Kate had had no intention of taking a vow of celibacy when she agreed to join the Atlantis expedition, so after a good deal of soul searching she had decided that professional ethics needed to be retailored to suit an isolated city in another galaxy.

She and Bates had started seeing each other, and their relationship had briefly reached the physical stage when he was savagely beaten by a Wraith. He had been sent back to Earth with the other wounded, but Kate refused to give up hope that he would eventually recover and return to Atlantis.

Denial really wasn't just a river in Egypt, was it...

5.) Kate Heightmeyer. The problem with being the only psychologist on the base was that there was no one to turn to if she needed someone to talk with. Furthermore, most people were either consciously or unconsciously nervous in her presence, so they weren't likely to look closely enough to notice if she seemed upset or anxious. Usually she was okay with that, but sometimes it made her want to weep.

She always went to Carson Beckett when that happened. Obviously he wasn't a psychiatrist, but he'd had some training as a medical student. More importantly, though, he was just an incredibly nice person who wanted everyone around him to be happy and healthy. Carson could always be counted on to provide a shoulder to cry on, a warm woolen blanket, and sometimes even homemade shortbread. His office was a refuge.

Sometimes a lilting Scottish brogue was more therapeutic than any pill.