Thursday, January 19, 2006


Next Step: Fooling the Fool

So, where was I? Oh yeah,, losing my mind. So I had full medical coverage through my job. Why would I go to a psychiatrist for which I had to pay out of pocket? Because the way our system works, we have a single medical record for everything. And they are accessible to everyone from the file clerk to my non-medical boss. So, I chose privacy. Go figure. The psych guy I worked with recommended a big name at the local university. I made an appointment, ,and he offered me a professional discount. Only $125/hour. Thank god for professional courtesy.

We met for the first time. And I took an immediate dislike to him. Couldn’t explain it. There was just something condescending about him. And the office was tacky.

We sat down in some uncomfortable chairs, he crossed his legs at the knee (men, so unattractive), and picked up a pad and paper. All he needed was a large Sherlock Holmes-esque pipe. He asked me to explain my current situation. “Well, I’m training to be a surgeon. I was on track and highly motivated. Now, I’m giving vaccinations, doing psych evals on young men who threaten to hurt each other (SHOCKING), and doing more testicular exams than I care to remember (trust me on this one).” “Doesn’t sound so bad to me,” he stated. “You are a doctor and you’re getting paid.” My response? “Imagine, you’re a licensed psychiatrist. Someone takes away your position and makes you work at an STD clinic for 8 hours a day. Or you can explain to people that there is still no cure for the common cold. Time after time. Or people can come in just to get free Tylenol because they’re too cheap to pay for it.” Smug look. “We’re not talking about me, are we? Do you drink?” Aw, for fucks sake.

So over the next several weeks, I explained how I’d always felt like I was fooling everyone. I’d been in the “gifted” class when I was in school. I went to college two years early. I got into grad school and then med school. Yet I always felt like I didn’t deserve it. I knew I had potential, but I had trouble focusing and doing the work that I needed to do. I’d called my mom from med school one day and told here I had decided to go into publishing. “Honey, you can do anything you set your mind to. You’ll make an excellent doctor. Why publishing?” As I wiped snot onto my sleeve, I sobbed into the payphone at the med school library, “Because I can’t kill anyone in publishing.”

This translated, in this annoying, cardigan-wearing psych guy’s mind into undiagnosed ADD. We stopped the Wellbutrin and started Ritalin. I was awake. I was alert. I didn’t care quite so much about food. I got a lot done. Still, horribly depressed. Still wanted to drive my car into a ditch (only faster). Why was I driving a damnably safe Volvo? So we changed doses, added benzos, sampled some low dose anti-depressants. ALL AT THE SAME TIME. Ah-sweep-ay was totally unsupportive. He pointed out (correctly, as hard as it is to say) how unscientific this all was. In any experiment, you should only change one variable at a time. That’s the only true way to know what effect one variable has. I tried to tell him about our sessions and how frustrating they were. How I would explain how I hated myself when I smoked because I wanted to start running again. While I was pointing out how I indulged in self-destructive behavior, he heard, “I have an addictive personality.” When I explained how I sometimes did my best work exhausted or hungover (I was tired enough to focus), he heard “I’m an alcoholic.” I started telling him what I knew he wanted to hear. Why? Who did it benefit? Not me. Ah-sweep-ay pointed out – “It sucks to be smarter than your therapist, doesn’t it?”

I tracked down the very first doctor I’d seen in med school and explained everything that happened. He expressed his embarrassment for the rest of his field, sent me a recommendation for Effexor dosing, and wished me all the best.

Next installment…coming off effexor sucks ass…


I can sympathize with your experience with the arrogant psychiatrist...finding the right therapist is like finding "your one true love." And, I too, have been tempted to go back to an old therapist from years gone by.

I liked your "still wanted to drive my car into the ditch (only faster)"...goto love ritalin.

It sucks soooo bad. I hate that you went through all of this, but it's nice to know there's someone out there I can relate to. :D
Thanks, honey. If there is anything I feel confident I can do, it's relate.
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