“The IT Guy”

by Barbara E. Magera, MD

Steve, a recent MIT graduate in computer science, came to see me because of ear congestion.

He told me, “I’m here because of allergies. Nothing I took worked."

After taking a complete history and physical examination, this 32 year old single male lived alone and landed a high-paying position at a computer software company. 
 
He quietly told me, “My job used to be fun because I got to travel the world and meet a lot of interesting people. When Covid came, that all changed. I was forced to work from home. Worse, I thought I was talking to a real person but after several days, I realized I was talking to a computer."

I was confused. I urged him to explain more details about his work environment. 

Nearly choking back tears, he quietly said, “There’s AI or artificial intelligence software out there that learns your voice and speech. It is nearly impossible to know if you’re talking to a person or computer. I live alone and I work long hours. I got so very lonely. I went out and bought a Cavalier King Charles Spaniel from a breeder. You gotta help me doc because if I’m allergic to Brie and if you tell me to get rid of her, I would rather die”.

I reassured my patient that my special interest is helping allergic patients live comfortably with their furry pets. I told him that I certainly would not be the physician, even as an Allergist, to demand he get rid of his dog. 

After a few sessions with Steve, his evaluation for allergic disease was unrewarding. His symptoms certainly were not due to his dog. As our conversations grew, I discovered that this man graduated cum laude at MIT with a masters in mathematics and computer science. He was enrolled in a PhD program but his demanding work schedule precluded him for completing even the initial work of his doctorate program. Upon further questioning of his family history, Steve told me he did well in the sciences especially mathematics and abstract thoughts however; he related his aversion to the humanities.

He explained to me, “I just don’t think like others do. I don’t like situations where I have to carry on discussions with people. Maybe it has to do with me being an only child.” 

Steve told me he was born prematurely with a low birth weight . As a baby, toddler and young child, he suffered many ear infections requiring multiple surgeries and (myringotomy) tube placements

He told me, “For a young guy, my hearing is bad. Going to a bar or restaurant is particularly difficult because I can’t hear anything to have an enjoyable conversation. Trying to meet a girl is nearly impossible because I end up saying something off the wall which causes her to run”. 

Steve indeed had a mild speech impediment which is commonly seen with deaf or near deaf patients. After a few visits, his inability to effectively verbally communicate was obvious to the point that I deliberately scheduled extra time to decipher exactly what was troubling this young man.

I discussed his case with my good friend who is a Psychiatrist in private practice and specializes in patients who find themselves in unusual stressful conditions. With some gentle coaxing, Steve agreed to be evaluated by my friend..but only once.

After his first session with her, she immediately phoned me to tell me yes Steve definitely had mannerisms of social phobias causing near panic attacks when placed in situations where interaction with groups of people were required. She also identified serious insomnia a tendency towards self criticism and situational depression. She noted that he felt inadequate about his job performance. She continued that this patient’s Cavalier was his only source of interaction and bonding. She explained to me that this man’s Cavalier meant much more to him than a girlfriend or even family members. He was particularly concerned that his job would require his physical presence  in the office and require working late nights, weekends and holidays because of the volume of work placed upon him. She explained that he was offered a high salary promotion to work in cybersecurity. 

She explained that, “ His work environment is a highly secure office with little interaction with other people. He has a high level of security which limits his infrequent social interaction with only a few other high level security people. He is very concerned about the time he spends working and away from his beloved Cavalier. He hired a dog sitter who comes to his condominium to play, groom, walk and feed Brie. He says his dog person cares deeply for Brie.”

Steve didn’t return to my office until nearly a year later. He explained to me that after intense soul searching and psychological counseling, he decided not to pursue his cybersecurity career rather he accepted a job with a local IT company. When I asked what factors changed his mind, he promptly explained that his bonding with Brie completely changed his attitude. 

Energetically, Steve announced, “I got hearing aids and now when I go for walks with Brie I can hear conversations. Brie has introduced me to many people I would never even thought of speaking with. I now have a girlfriend and I am in a serious relationship. My Cavalier was life-changing for me. In fact, after we’re married we plan to get a second Cavalier”.

We both agreed that Steve did not require a followup visit with me; however, he did agree to introduce me to his Cavalier, Brie. After observing the interaction with Brie, Steve and his fiancée it was clear to me that this Cavalier was an important family member of this young couple. Brie was an exceptional example of the perfect Cavalier companion who transformed the life of a lonely young man to a joyful and grateful dog owner and a soon-to-be husband. I wished this them much happiness and blessings in their marriage.

Barbara E. Magera MD, PharmD, MMM (Caracaleeb) is a Cavalier fancier, exhibitor, breeder, photographer and writer who lives and practices medicine in Charleston, SC.