I am but mad north-north-west. When the wind is southerly, I know a hawk from a handsaw.
I think I've identified the source of the nagging cognitive dissonance I've felt at times while writing this blog. The quasi-professional imprimatur implied by the title and by my medical status implies a content for the most part that I am not interested in delivering much of the time. I'm interested in two main things: worthwhile writing in general on whatever topic strikes me, and a constellation of topics--narrative, beauty, and puzzles of identity and existence chief among them--that might be considered the vast penumbra of psychiatry.
I suspect a number of folks arrive at the blog (although often not the ones leaving comments) looking for insight into the nuts and bolts of psychiatry: the meds, the diagnoses, what it's like to be a shrink. And I write on these at times of course, but for the most part I'm content to leave these matters in the office. Most of the things I ever had to say about psychiatry as an entity and a profession I've already expressed in obscure academic contexts.
My natural inclination is to examine the narrow phenomenon of the psychiatric with the much more venerable and flexible tools of the arts, of general moral understanding, and of common sense. So when folks at a social gathering inevitably wonder aloud if I'm examining them, my tacit response (in addition to "Not unless I'm getting reimbursed") is that I need them to help me to better understand the weird undertaking of psychiatry, not the other way around.
So I'm doing a blog because I enjoy writing, and I enjoy it outside of the traditional strictures and pressures of publication (I sacrificed my 20's to the inferno and purgatory of medical school and residency, respectively, partly so that I would not be desperate for funds at this stage of my life). I do not do it to purvey some priceless wisdom that anyone could associate with psychiatry.
What I consider a good post is a kind of micro-personal essay, which doesn't imply that it is primarily about me, obviously, but that it conveys an apprehension of some experience--whether an idea, a cultural entity, or a book--that is refracted through a particular sensibility (mine). If you couldn't care less about the sensibility or the writing, then the wonderful thing about the Internet and blogging is that you have wasted "only" a few seconds of your life. Or not wasted, at least not entirely.
Two questions arise. If this is not primarily a vehicle for professional expression, why not leave it in a private journal, and why include the psychiatric title and implication at all? Well, as I've written before, few are less interested in or expectant of a mass audience than me, yet as I share a basic human message-in-the-bottle kind of aspiration to being known--even if only by a handful among six billion--it seems worth doing for a while. And the psychiatric handle may be somewhat arbitrary--I can think of any number of personal and biographical aspects more indicative of my worldview than happening to be a psychiatrist--but it will have to do, for now.