Gail, age 27, was suffering from a case of acute pyelonephritis when
she first came to see us one year ago. She had short brown hair, delicate
features, and was soft-spoken. She was on antibiotics at the time. She had
experienced six episodes of cystitis over the past year, every two months. She
had seen four different doctors without relief. The symptoms of the
pyelonephritis included extreme dysuria (3), nocturia "every five minutes" (3),
chills (2), nausea (2), and faintness (2). She had profuse hematuria (3) and
her kidneys ached (2).
At the time of the initial onset of the cystitis, one year previously,
Gail had been laid off from her department store sales job. She had just begun
a new sexual relationship and had frequent sex after a period of sexual
inactivity. At that time she experienced a sense of urgency, urinary frequency,
urethral pain during urination, and sandy urine.
Gail had a happy childhood. She was sexually active for the first time at 14.
She married at 20. Her husband was 14 years older. She knew it wasn't right
before she married. He had been fired from a job because of drug abuse, which
she did not know at the time. After they married, she attended art school and
worked full time to support both of them. She kept telling herself, "If I love
him enough and take care of him enough, he'll take care of me."
They moved to Alaska. He continued to be out of a job and she threw herself
more and more into her work. He eventually got a job in a porno shop. She
didn't find out where he was working until they filed their tax return. He
lied, used drugs, drank, and probably had affairs. She kept trying to make
things work. He became increasingly threatening and intimidating.
After five years of marriage, Gail was diagnosed with cervical dysplasia. Her
Pap smear was a Class III. She had a lot of resentment at the time, but still
wanted to prove to her father that the marriage could last. She didn't want to
abandon her husband. Six months later, she had a Class IV Pap, which was
treated with conization. She remained on oral contraceptives the entire time.
After another eight months, the Pap remained unchanged. She had laser surgery.
At that time she discovered Love, Medicine, and Miracles, which
inspired her to leave her husband.
She remained with him for two more years, but had a lover. She eventually
moved out secretly because she feared retaliation. Her husband became violent
when he realized she was leaving him.
Gail felt guilty after she left her husband. She visited him regularly because
he would lament about how lonely he felt. She went to counseling with him
because she felt he needed help getting his life together. During this time he
continued to go through her possessions and take money. While he was sorting
through her things, he discovered she was seeing another man.
The next time she visited her husband, she encountered a thunderstorm.
Lightning hit the tree in front of her. The tree caught fire and she became
terrified. She was still guilty about abandoning the marriage and felt she owed
it to her husband to talk to him again. Her husband pulled out a gun and began
to assault her. She let him do it because she feared he'd kill her. He tried to
rape her. Even after this episode, Gail continued to go out to dinner with him
occasionally.
She began to attend Al-Anon meetings and moved to another state without
leaving a forwarding address. She found a new lover who treated her very well.
It was hard to believe how good he was to her. She still feared her ex-husband
would find her and kill her new boyfriend. She continued to feel very anxious
whenever she saw a car like his.