Psychiatrists I Have Known, and What I Feel Motivates Them
In this short post, I want to talk about some of the psychiatrists who have helped me and some that didn't seem to want to help much, (and how to avoid these)
He that can carp in the most eloquent or acute manner at the weakness of the human mind, is held by his fellows as almost divine.
Benedict [Baruch] Spinoza, 1632-1637
First of all, I want to say that I have a very high regard for psychiatrists. When I was 18, in my first psychosis and very ill, I remember not really understanding what a psychiatrist was or what they did. My doctor, A.G. was early in his career at the time, but seemed to try to be understanding and helpful. He was English, and I liked that. I have often marvelled at the English education system but my relationship to A.G. wasn’t the best at first. I was on a very dirty, old, smoke-stained ward which was intended for people who were less compliant than patients who would go to wards with less security. A.G. had the unfortunate task of acting as the psychiatrist on this ward. People would try to gather near his office at breaks and when the day ended, asking him for a new medication or a day pass or to be released despite there being almost no way for him to address these issues, due to hunger, an overfilled bladder, or simply the fact that he didn’t have the person’s records there. Day after day as I wandered the hallways of this ward, any question asked of A.G. would be responded to with, “We will look into that tomorrow.” I understand why he had to do that now, but at the time, I started to understand there would be no tomorrow for some of the patients. They would stay on the secured ward for a very long time. The interesting part of this story is that A.G. was an incredibly kind an competent doctor, and years later when he took over a small office in the clinic I go to, he was my doctor, and in some ways a friend. I continued to consult with him regarding my mental health until he retired. One of the things I really liked was that any time I wanted, though it may take an hour or more, I could simply come and ask to see him and he would juggle things so he could see me. Without this ability to consult with him and get medication or other issues ‘tweaked’ I don’t know if I would have had this lasting recovery I have experienced.
One thing I do remember was that I first saw A.G. when I was still in high school and I had made a terrible mess of my life. I had badly beaten up a popular student, I had been ranting and raving and was arrested in the principal’s office, later handcuffed and taken to a waiting police car. I recall my dad saying that my doctor was the last friend I had. Some 20 years later, wanting him to convince me otherwise, I told him about my high school reunion and wanted him to convince me to go, but he simply said, well, that’s enough on that subject. He understood I couldn’t go. It would have caused a lot of bad blood and could have only ended badly.
I also want to commend a doctor who I first met early in his career. He was a specialist in addictions counselling, and I saw him for a while when I was quitting smoking. He gave me some tips, some ideas, and also said that it was okay if all I wanted to do in our appointments was to come and tell him I hadn’t smoked. I have now been smoke-free for over 21 years, and I was such a heavy smoker that I don’t know if I would have had this much healthy life in me if I hadn’t quit.
So basically, for those of you who aren’t aware, psychiatrists do the full training of a medical doctor, which includes an undergraduate degree and then medical school. For those who want to become psychiatrists, often their undergraduate degree is in psychology. I took a home study psychology course through a local university and I found it to be simply amazing. It taught me a great deal about the physical aspect of our behaviour, from the anatomy of the eye and how we process visual information, to a chapter I skipped ahead to learn about schizophrenia.
Medical school is another thing that I have always been impressed about. The teaching and studying, and endless amounts of work are incredibly challenging. I heard somewhere that they do this on purpose to weed out those who are doing it for the money. Then, after medical school comes years of specializing in the human brain. Though psychiatrists (in Canada, but more so in the US) are well paid, from what I can gather they only get their full salary or status when they finish school, which can be anywhere from age 30 to 32 or further on up.
Before I get into too much more talk about the training psychiatrists do, I want to toot the horn of a course I took that changed everything about my treatment. It was called WRAP, or Wellness Recovery Action Plan, and what you do with it is map out all of your symptoms, your triggers, what you can do to stop things from getting out of hand. Then you go on to describe everything you want people to do in the case that you become ill again. When I was first hospitalized, I had a great deal of financial troubles. I kept applying for credit cards and paying off old balances with low interest deals on new ones that didn’t last forever. My mismanagement and mental health issues left me unable to do anything but declare bankruptcy, but my dad, who had the same name as me was constantly being harassed by collection agencies. If I had a plan in place, I may have been able to find a way to stop them from calling my father. Some other things you put into a WRAP plan is, which doctor you want to see, which hospital you want to go to, which treatments, (medications, ECT) you do or do not want. It is a very empowering way of planning the best way for you to get treatment when you might not be fully capable of doing so on your own. This plan should be shown to a primary care physician or even your psychiatrist so they understand your wishes should you become ill again. It has also been shown to be very effective for people with substance use disorder.
To go back to psychiatrists, one of the things I feel is admirable about Canadian psychiatrists, is that most of them support an effective drug that is highly underused in the US called Clozapine. It has been around for many years and is believed to be the most effective medication for psychosis. I have talked and read about many people whose life completely changed as a result of this medication. The unfortunate thing is that the patent on this drug ran out some years ago and pharmaceutical companies don’t profit much from its use, causing them to promote newer, less effective drugs as antipsychotics. In Canada, there are many more regulations on medications and how much a company can profit from them which don’t exist in the US. One of the doctors I greatly respect at my clinic said that nearly every Canadian doctor supports the use of Clozapine. I know this first hand because there was a time when a doctor tried to put me on it but eventually we decided it was best to stay with the medication that was already working for me.
So basically, what I wanted to say in this post is that psychiatrists are almost always incredibly well educated, dedicated and hard working people whose main concern is for the betterment of their patients. I did have a hospitalization some 24 years ago and had a doctor I just didn’t get along with. In my diminished capacity, I told him in an impolite manner that I wanted another doctor. He never let me see another doctor or registered my request but instead out of pettiness kept me in the hospital for months without doing anything for me other than to sign a document that took away my ability to handle money.
There were other problem staff members at the hospital. One of them definitely wasn’t, he was a friend I had known from outside of the hospital and he never told anyone I knew about my misdeeds. He was also kind enough to give me half of his cigarette when he would go into the patient smoking room and knew I was out. Then there was a staff member I don’t even want to name. He often spread around private information about me to the other staff and patients, and one time I asked him to stop playing the guitar because it was bothering me, and he responded by telling me that if he ever saw me outside the hospital he would give me the beating of my life. Once I was pacing the halls and I caught him peering in on a female patient in her bedroom.
Looking back, the only way I can think of that I could have changed these situations would have been to find a way to talk to a manager or other psychiatrist, though I have heard that few psychiatrists will speak out against a doctor who abuses their power. I could have also just politely told my doctor that things just weren’t working out and that I would prefer a different doctor. Months after my admission, the bad doctor was on vacation and I saw a different one who was an incredibly kind and intelligent man and he immediately had me transferred off the ward. When I got there, I met the most kind and intelligent doctor I have ever known who spent time with me every day, encouraged me to feel better about myself, and then one day years later went far out of his way to drop in on a class I was teaching at the hospital and purchased the two books I had published.
Well, that is making for a lengthy post. Thanks readers and subscribers for staying with me. I would love it if any of you were interested in purchasing my books. I have actually written and published 12, but only 3 are memoirs of my mental health journey. But for those who can’t afford books or subscriptions, I want to encourage you to visit my website www.edmontonwriter.com where you can download a free copy of my latest mental health book, “Alert and Oriented x3” if anyone is interested in getting more of my writing, my books are available on amazon everywhere or you can order signed copies directly from me at leif.n.gregersen@gmail.com (or you can just write to say hello).