An aside note – Spo-Reflections is about to have its 40,000th visitor. I thank anyone and everyone for stopping by; it remains an honor for me!
There remains a generational gap when it comes to seeing a shrink. People over 60 are dragged in kicking and screaming by their relatives. They would rather drop dead than see me. Seeing a shrink means “they are crazy”. They believe I can lock them up at a drop of a hat. This makes me feel like something out of horror movie.
In contrast, 20 year olds come in already self-diagnosed via on-line tests and talks in chat rooms. They are certain of their diagnosis and they already know what medications they want to be on. This reduces me to a cocktail waitress.
A young woman with a bad alcohol and marijuana problem, who does NOT believe any of this is correlated to her complaints of stomach upset and having no motivation. She refused therapy and sobriety; I dismissed her. She came back later to demand her co-pay back. And, she interrupted me seeing another patient!
Several folks recently in hospital discharged to me for follow-up care. They don’t have a clue as to why they were started on their meds, or what the discharge diagnosis was. I see this a lot; I find it incredible people would take something without knowing the reasons why.
On the other hand, people take all sorts of herbals without knowing their contents.
A man who ‘has no time to make appointments’ wants his prescription renewed. Not seen him in a long while, he is annoyed I won’t prescribe until I see him again.
I have a patient who states she sees and talks to Abraham Lincoln. Either she is one of the sickest persons I have seen in a long while, or she is full of BS. The diagnosis of Malingering is a tough one to sort through.
Several elderly folks are coming from nursing homes. Reading between the lines; somebody wants them medicated so they won’t holler or pull at the staff or take off their tops. Medicating someone with demented agitation is controversial; I am in the dilemma that if I don’t ‘do something’ the staff with kick these poor sods out.
Suicide is a permanent solution to a temporary problem. One middle aged man announced he was going to kill himself rather than pay out his lawsuit. Trying to keep him alive has been a challenge. He announced last week there was a mistake in the lawsuit and it is dropped. He didn’t acknowledge any gratitude towards my approach.
Apparently sharing your meds, and dropping them down the drain remains a fun filled activity for people to do. Try it some time; only the Xanax and the Vicodin will go down the sink.
17 comments
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January 16, 2008 at 2:42 am
Zeph
It’s not so hard to understand the concerns of the older folks. It hasn’t been all that long since lobotomies, electroshock, and Thorazine seemed like Pretty Neat Ideas to some people.
I can agree on alcohol being demotivational. Marijuana, quite the contrary, in my own experience. Last time I had a steady supply, which was a long time ago, I went on a diet and exercise program (and lost fifty pounds), and reformed my finances in a sensible way. Damned shame it’s illegal.
Sorry, but no, people won’t thank you. I’ve done tech support. It’s a very rare thing to get a call that doesn’t start off foaming at the mouth, and if and when you’re able to solve the problems that they’ve almost certainly caused for themselves, the most you’re liable to get for your efforts is… the problems are solved, and one more person will leave you alone for a while. On to the next exciting episode…
January 16, 2008 at 4:58 am
DougT
>They believe I can lock them up at a drop of a hat. This makes me feel like something out of horror movie.
>They are certain of their diagnosis and they already know what medications they want to be on. This reduces me to a cocktail waitress.
I prefer to think of you as a cocktail waitress out of a horror movie.
Urspo - just you remember we are soon going to be a large ship together. i see in your future a swim to Cuba.
January 16, 2008 at 5:28 am
BentonQuest
Humm…
Ur-Spo in a cocktail waitress outfit…
*Ben departs momentarily*
OK
*whew*
I am happy that therapy is moving from being though of as caused by a personal weakness to a way of helping us to cope better than we already do. (That was kind of convoluted.)
I do know that when I was in a deep depression, it was hard to say, “Thank you.” But I will say “Thank you” now to you and to them by proxy.
Thanks!
January 16, 2008 at 5:31 am
Lemuel
Being the geezer that I am, I confess my resistance to the professional services of your kind.
For better or worse, I have never seen a therapist, never been in therapy.
Although my rational mind understands the needs and the benefits, I must state that there is a bit of truth to what Zeph has to say. My time is not that far distanced from lobotomies and electroshock, from the “stigma” of being “crazy”, from the attitude that you should be able to handle your own problems and that those who enter therapy are “weak” and “not trying hard enough”. These ideas and others closely associated with them were a part of the culture in which I was raised. For many of us raised in this era, these attitudes are very difficult to overcome.
January 16, 2008 at 6:34 am
Brent
I could never understand why anyone would go to therapy until I needed it myself. I just figured you could sort through all your problems yourself. I was young and foolish, now I’m middle aged and know when I need to work things out with the help of a professional.
My mother (78) recently had a bad turn in her health. She threatened to “take poison” just to end it all. Well she got better over the health crisis, good thing she doesn’t have rat poison in her apartment.
Urspo - most people have a period in their life when they think ‘this is it; i can’t go on; there is no way out of this’ but they learn there is a way out, if they only wait. I have had 6 Armegeddons, so I don’t despair when another one happens.
January 16, 2008 at 6:47 am
tigeryogiji
My elderly father, who isn’t in the greatest of health, keeps “joking” that he has a “stash of pills” ready for when the time comes when he can’t take care for himself anymore.
Considering the state of some nursing homes today, I don’t know whether that is such a bad idea…
January 16, 2008 at 9:35 am
Mark H
I, for one, have always wished I had disposable income enough to spend years in therapy. I’ve always seen our human behaviors as so complex I’ve barely been able to figure out why I left religion at all and about a million other questions. I LOVED your revealing post, and got some great laughs. I KNOW some of these people and have often felt sorry for them staying in that confused troubling state of mind. I sympathize with the therapist who hour to hour must dialog so freely and openly in completely opposite situations. OK, Miss Waitress, I’d like to try some Ritalin today and could you order some Xanax and Valium for next week…..I’ll be under SO much pressure then. THANKS…………….
Urspo -why certainly Madam, and do you want fries with that?
January 16, 2008 at 2:09 pm
Maggie
Congrats on 40,0000 visitors!!! WOW!!!!
I love when you post about work Spo. It shows that you are human and not just a Doctor of Psychiatry.
Some people take their field of work so seriously, they forget to stop and
smell the roses. (pardon the cliché )
Eg. “I have a patient who states she sees and talks to Abraham Lincoln.
Either she is one of the sickest persons I have seen in a long while, or she is full of BS”. (I loved that comment)
I believe that in your line of work, if you don’t have a sense of humor, you’re in big trouble.
BTW Don’t you have a gatekeeper to protect you from people like, “a young woman with a bad alcohol and marijuana problem”?
How did she get into your office without anyone stopping her?
That’s scary!!!!
January 16, 2008 at 5:27 pm
Lewis
Hell, you wouldn’t have to drag me….and I promise no kicking or screaming. Do I need an appointment or can I just show up?
January 16, 2008 at 6:34 pm
Tony
HUN…
You just go ahead and put that cocktail waitress outfit on. That will be a guarantee that macho stud bear, Jack R., stays with me for sure. LMAO!!! I got such a laugh out of that commentary Spo. Oh the life of a psychiatrist…you have got to have some interesting stories to tell. Hug.
January 17, 2008 at 3:11 am
sorted
I could not even imagine what a day in the office is like for you. Amazing.
January 17, 2008 at 4:08 am
rcwbiologist
I love these posts about your practice. Until I was in my late 20’s I was one of those who believed that I could sort all of life’s problems out myself and that going to “therapy” was for “weak” people. That all changed after I decided to talk to a therapist during a crisis I was going through in college. I know many people who benefit from it.
January 17, 2008 at 6:32 am
Cliffie
My question is, do you LIKE feeling like something out of a horror movie?
January 17, 2008 at 7:23 am
deweydjb
I love my psychiatrist. I see him every three months, to get my prescriptions. I tell him what is going on and if he should sense a change, he can change what he needs to. Luckily everything is going really well on the meds that I am on. And I have never seen Lincoln. Billie Holiday on the other hand…
January 17, 2008 at 8:03 am
BID
A man who ‘has no time to make appointments’ wants his prescription renewed. Not seen him in a long while, he is annoyed I won’t prescribe until I see him again.
Hubby is famous for this. He just has better things to do! *L* His doctor actually said he can no longer serve him and to find a new one. The man needs a babysitter sometimes. *shaking head* He admits he is at fault though, he isn’t annoyed. I think it a blessing really.
Love when you do this! I wish I could meet the lady that talks with Abe. That would be most entertaining. I’m sick, I know.
January 17, 2008 at 7:57 pm
Brent
Xanax down the sink!! Think of all the medicated bliss that would be lost!
January 18, 2008 at 11:01 pm
Maddog
I almost want to come west to be your patient so that you could have one “normal” patient for a few days. I love my doctor. I see him once a month and he’s changed my life. I know there are people out there that think medication is an easy fix for the problem, but my meds have changed my life. I do think when I see Dr. B. next week, I’ll be sure to tell him how much I appreciate what he’s done for me.