Notes from the office: ten questions psychiatrists hate answering

I recently watched a YouTube video made by an Icelander titled “Ten questions Icelanders hate answering”.* I thought it would be fun to try this myself.  

“Ten questions psychiatrists hate answering”

1 – Are you a real doctor?  Yes, I went to medical school and after I graduated I did a year of internal medicine and then a year of neurology prior to going into psychiatry. I became a psychiatrist because I wanted to, not because I couldn’t make it as a ‘real doctor’. Indeed, I was headed towards cardiology but it was boring. This is more exciting.

2 – Where’s your couch? This is not your grandfather’s psychiatry. The couch was when the only tool psychiatry had was psychoanalysis. It is like walking into your primary care doctor’s office and looking around and wondering where are the blood letting tools.

3 – Is everything due to my mother? Not even Freud believed everything was due to Mother. People and their psychologies are complex. Those looking for a single matter to explain things are going to be disappointed.

4 – Do you do anything besides prescribe meds? I spend most of my time trying to get people to do things and solve their problems by NOT using meds. The irony is I am usually the one on the receiving end of someone who wants a prescription rather than a lifestyle change “gee, can’t I just take a pill for that?”

5 – If I say something crazy sounding, will you lock me up? Unless you are at immediate risk to kill yourself or others it is nearly impossible to get people committed to hospital. Again there is irony I am often asked by a patient’s loved ones pleading with me to ‘lock him/her up’ for their welfare. It is hard explaining to folks one can be bat-crazy and going to heck in a hand basket and I can not prevent this. There are no men in the white coats with straight jackets.

6 – Do you ever ‘turn it off’? Yes I do. One of the first things you learn in shrink school is do not become a therapist to your spouse/friend/child etc.  It is a sure-fire way to ruin your relationships.

7 – (Asked at party or social setting) Oh! I better be careful! You’re analyzing me, right? I either tell these folks “Not for free I won’t” or (if I am being catty) “Hmmm, I sense you are anxious about something, tell me more about your childhood and your relationship with your mother”.  

8 – Are you in the pay of big pharma? No I am not. If a psychiatrist is being paid by a company to do research or talk about their products these doctors are required by law to disclose this up and front so the listeners know this. In thirty years of doing what I do not once has a pharmaceutical company tried to bribe me. There are no handsome stud reps throwing themselves on me in exchange for me to push their product.

9 – Can you prescribe me my( pain meds/blood pressure pills/birth control etc.)? No harm asking I tell them but I won’t. I am not up to date on the proper protocols of treating high blood pressure or menstrual problems, and I am not a pain specialist.  Get these things for your body docs who know what they are doing.

10 – Will you write me a letter for me to take my python on an airplane as a therapy animal? Oh the pain.  I no longer write these letters as there is little evidence I am aware therapy animals work any better at assuaging anxiety than holding a stuffed animal. The use of ‘therapy animals”  is quite abused. I tell folks for every person I’ve written a letter to take Fido on board a plane I have another patient being treated for PTSD from being cooped up in a plane with said animal towards which they have allergies or flashback memories of trauma.

*For thems interested, the six I remember:

Are you a Viking? no

Aren’t you always cold? no

Aren’t you all related? no

Do you know Bjork? no

Do you believe in elves? no

Do you have igloos? no