Thursday, August 6, 2009


A young guy with no psychiatric treatment history comes in for his second visit. After some initial pleasantries:

I: "How did the medication go?"

(Sheepish look). "Well, I got the prescription filled, but then I got scared and threw it away."

(Later in session, he): "You went to school for ten years to do this?"

"Yeah, it seemed like longer at the time."

(Later in session, he): "Is your job hard or easy?"

"Mumble, mumble, mumble."

Now I can't get it out of my head. Is it dishearteningly hard, or is it laughably easy? I discover that there is no objective way to gauge this. By how many years it takes to obtain society's assent to do it? By how one feels at the end of the day? By "outcome measures?"

What a comedian.


Anonymous said...

I think psychiatry is like a signpostless wasteland where the perpetual darkness is occassionally lit by the spark of a wandering firefly, creating enough illumination to enable one to take a hesitant step in a direction that seems like progress, only to be resmothered in the gloom once again. If one is to make actual progress, it's essential to create one's own light in the form of intuition and reason.

Retriever said...

I imagine that one of the hardest parts must be engaging the half-hearted into therapy (especially when they freak out about meds). Plenty of MDs pontificate that (especially bipolar) patients can't make adequate use of therapy until they are medicated, but in real life, you may have to form a good working therapeutic alliance with a skittish, previously burned person before they are willing to endure the side effects of meds.

fraise said...

Other professions get the same treatment. Seems like anything that deals in the subjective is scorned and categorized as "easy." I'm a translator -- you wouldn't believe the amount of people who think that means I just take one word and replace it with another word. I try to explain that one must have a deep cultural understanding of the languages in question; idioms; false friends... but to no avail.

I also do copyediting -- there are scores, scores! of people who are utterly unable to recognize quality writing in English. "Thats not a misteak! Thats individual expression! You can't crush they're individuality!!" Sigh.