"There were only five of you in the entire country! You should have had assistants! Taking your histories for you and putting them in a nice convenient format that would only take you ten minutes to skim."

:I know, that would have made things so much easier! The Healers have un-Gifted clerks, although they need a lot of special training and I think mostly they just get trainee students to do the prep. I guess the problem for us was always that there were only five of us, and before the war with Karse we were all on circuit - that means riding around between villages within a certain area, because most patients from small towns or farms couldn't afford to travel to Haven and be away from their families for weeks. I'd been thinking it was a good idea and I did finally manage to get a clerk who could handle scheduling patients, and do at least the very basics of asking them what was bothering them most and then putting it into one of five rough categories for me. ...The Quendi were really quite good about this, to be fair, but I was the only Mindhealer there and responsible for almost fifty patients who had all been tortured a lot by an evil god, so I spent most of the first year entirely running around responding to emergency requests: 

"And what would any of these people have done if you had needed an emergency vacation?? Riding around between villages is a nice idea, don't get me wrong, but it spends a lot of your incredibly scarce time on transit, and it just doesn't sound very efficient, people who are mentally ill in a city aren't less mentally ill..."

:There aren't that many big cities in Valdemar? Even if you'd stuck one of us in each of the top five, that's still - it can't be covering more than one-fifth of the whole population. So instead we'd cover an area, and spend two or three weeks in each town and usually a day or two at most riding to the next town, it wasn't like most of my time was spent on the road. We'd have a planned arrival date so the mayor could put out the word to the nearby smallholders. We think nine-tenths of the people in Valdemar live within a day's walk of the nearest town, and most farmers can afford travel and be away for a couple of days, if they must, but they can't leave their farms for weeks to get to a city: 

Shrug. :It wasn't a great system? Eventually the war with Karse happened and I spent four years in one place and nothing seemed to collapse, so once the war ended I set myself up in Haven. I think that was better - meant that my colleagues on circuit could send any really serious patients who could afford it to stay in Haven for a few months, get more followup. But - I don't think it was a stupid system, given our constraints. Valdemar...is a lot poorer than your world: 

"I guess it must be. Though I think when I was practicing I - I specialized in executive dysfunction conditions, I don't think anybody I was seeing would have been able to make an appointment if they had to walk a day to get to me within a few weeks."

:I think a lot of people didn't make it to see us. Sometimes their families brought them, or - came themselves and begged me to make an extra stop on my way out. I did it when I could but it wasn't as good, right, I couldn't justify sticking around for days at some lonely farmstead so they'd get at best two sessions and then no followup. And I...think most people who were doing poorly but mostly getting by didn't bother: 

She looks curiously at Kelta. :What are 'executive function' disorders? I - I'm getting something off the concept in your thoughts, but I'm not sure we have a word for that in Valdemaran: 

"It's a family of problems where someone will know what they should be doing, and want to do it, and just mysteriously fail to make progress. This happens to most people now and then but some people have it real bad. I made housecalls."

:Huh. That's - definitely a useful word to have, but - is that something you see in isolation? I've definitely seen patients who get it sometimes, and it's something I can help with a little though honestly it's hard to get at directly with Mindhealing especially with my particular Sight-metaphor, it's - very pervasive? Not local to a specific negative thought-pattern? I don't know, I usually see it in patients who are depressed, especially the second kind that's less being sad and more being tired. ...And sometimes people who are traumatized enough will have behaviors that look similar on the outside but it tends to look somewhat different to my Sight and it's actually easier to help with, it just takes a long time. I don't think I've ever had a patient come to me with just that problem, with it not obviously downstream of something else: 

Shrug. :Maybe all the Valdemarans with that problem don't make it off their farm to see me. And we don't have a word for it so maybe their families just think they're lazy and don't see it as a Mindhealer sort of problem: 

"It's sometimes something I see in - not quite isolation, but I think that's because everyone has plenty going on if you spend enough time looking for it? It is often the only thing that rises to the level of clinical significance."

:That's really interesting. I wonder what the difference is - whether it's mostly that we're not catching and treating those patients in Valdemar, or...something else, where we genuinely have fewer of them: Melody fidgets with her sleeve. :Hmm. Is it - do people tend to have this problem worse if the thing they know they should be doing is more complicated, or involves a lot of small decisions and judgement calls? Because it occurs to me that a lot of people from Velgarth would find your world very very overwhelming. And if the thing you need to do is till your fields or nurse your babies, and you know that if you don't do it your family will die, maybe that's simpler: 

"Huh. That is one hypothesis about the prevalence of executive dysfunction, that it's about our world becoming more complicated over time, though until just now I never thought it was very credible. I mean, there are plenty of things we can treat now that did just kill people in the past, like, oh, premature birth. It seems plausible that when more people were farmers executive dysfunction was just one of those things."

Nod. :I...would've thought being reckless was more likely to kill a kid than just - not tending to do the things they needed to do. But I guess even if someone in that position grew up, they might be less likely to be marriageable, and if they did marry they might not support their family very well. ....I'm suddenly wondering how many of the beggars in Haven have -: 

Her mindvoice catches. 

:- had: she corrects herself, :this problem. I probably wouldn't have known. The House of Healing treats anyone in Haven, regardless of whether they can pay, but - they have to know they can go there, right, and expect to be welcome and expect it'll even help: 

 Great, now she's sad about that. And also about how they're all dead. But, oddly, more sad about the fact that she might have at some point in the past had an opening to help, and failed to see it. 

"Huh, where do you get your funding to do that?"

:...You know, I am not actually sure? I would guess taxes, same as the Heralds. And most of our patients do pay whatever they can, and the wealthy ones sometimes give extra out of gratitude. And it doesn't cost that much to run Healers' - they were able to use the same building for our quarters for four hundred years, and the Palace kitchens for food, and once we're all getting room and board we don't need to be paid that much in coin on top of that. ...When I was on circuit the town major would do a collection of some kind and I'd get handed a pouch of coin, which could be wildly varying amounts, but they'd give me a place to stay and food while I was in town, so it didn't matter hugely if they'd had a bad year and hadn't brought in much silver for it. I'm not actually sure who designed that system, it's not how things work anywhere else: 

"...huh. I wonder if some places used to work like that here."

:...Do you not know? Valdemar has records for the whole past 800 years: 

"Oh, I assume someone does but I don't read much history."

:You know, that's fair. Anyway. I think we got on a digression from - what was it - right, we were talking about my Gift-stamina. I probably cannot give people fun hallucinations at top speed for even six hours, that particular technique requires zero finesse and takes five seconds but requires a good chunk of power. Since I really doubt it's a good use of my time to give people hallucinations, and basically everything useful we do takes more time and care and less power, I'm not especially worried about my Gift-stamina being a limitation. ....Also I'm now very curious if your 'nootropics' can increase that. We know that better diets and sleep quality help, but maybe there are things that help more even once someone is basically healthy: 

"Maybe! Do stimulants help? You're going through that tea."

Melody looks down at her teacup, which is empty again. :Oh. Hmm. Tea definitely helps with something but I'm not sure if it's Gift-reserves, or more just the ability to be patient and calm and reassuring with my patients even when they're frustrating. ...I don't think I'm a very patient person by nature. It's one of my character flaws. And honestly I'm not that good at being soothing even with tea but I fake it as best I can: 

"Huh, I don't think most people find caffeine calming. Maybe you have an executive dysfunction and you're self-medicating."

Melody stares at her, surprised.

:- I don't think I particularly have a problem where I know what I should be doing and mysteriously can't do it? I definitely have some amount of problem where I get bored more easily than would really be ideal for my job, which is often very repetitive. And if I'm underslept or I haven't had enough tea then I get really cranky about it and sometimes don't manage to keep paying attention even when I'm in the middle of listening to my patient tell me a very sad story about something important that happened to them. I....sort of feel like my main problem here is not being empathetic enough or something: 

"- yeah, that's classified here as a member of the executive dysfunction family even though that's not its primary symptom in everyone. Although everyone gets cranky when they're underslept, self-medicating with caffeine about it suggests that your problem isn't empathy! Caffeine doesn't affect empathy!"

:Wow, really? How do you know that? ....I have not done a study on looking at people's minds with or without caffeine so I guess I really have no idea: 

"Well, I can add it to the list of things we could line up for you to look at!" chirps Kelta. "If you'd like I can read a study on caffeine, uh, to you?"