Posted by pseudoname on April 29, 2006, at 23:15:41
This probably isn't interesting to anyone but me, but I just got my records from 2 of my former pdocs. The records match my impressions of them.
“This very interesting 38-year-old man…”
VERY interesting? Why VERY? This was from a pdoc-in-training at a major university clinic.
For every appointment he wrote:
“Mr. _____ arrived 10-15 minutes early for the appointment. He is neatly dressed and well-groomed. He is thin and very pale. His eye contact is furtive. His speech is soft but spontaneous. His insight is fair.”
(Just fair.) That sounds very detailed, but he used the exact same wording for every appointment.
“It will be interesting to determine how much of his social isolation is driven by his depression and how much is driven by social phobia or avoidant personality.”
Why? Why would THAT be interesting? I was interested to know if we could treat my depression at all. His attitude seems twisted to me, like how you'd think about an unusual infection. At the time, I thought this pdoc suffered severely from “medical model” problems, thinking that mental health problems can be classified and attacked like funguses. It's disconnected from real life and common sense. On the basis of a 20-minute interview every 2 months, how could he ever hope to sort out how much of my social isolation was due to his vague, conjectural disorders and how much was due to “depression”, whatever that's supposed to be. “Avoidant personality” isn't a chemical you can measure into a beaker. I like what med_empowered said: personality disorders are moral judgments with code numbers.
“We have recommended very strongly to him that he pursue a course of ECT. He was strongly opposed to this recommendation and essentially left the clinic in Sept 2003.”
I'm glad he was able to put that together: I left because all he talked about was ECT, despite my strong, detailed, even tearful objections. But he's using the royal “we”. There was no one else there, it was just him.
In the notes of every visit I had with him, he insists on ECT and writes down my strong objections. And it never sinks in. There's even a handwritten (and human) note from the nurse: “FYI— Patient expressed a lot of frustration about your ECT recommendation.” But it didn't slow him down. He had ECT on the brain.
The depth of his psychological understanding is shown here, in the PRESCRIPTION part of the summary: “3. I encouraged Mr. _____ to force himself to get out of his house at least once each day.”
Brilliant. Force myself. I never would've thought of that. He even put in the quantity: q.d.
My other ex-psychiatrist, in a private practice, wrote this at our first appointment:
“Insight poor. Judgment poor.”
Ouch. Not even “fair”, LOL. She also said, “He is a very short man.” I dunno... I'm 5'8".
At our last appointment she wrote:
“He looks through the internet, he talks a lot about neuro-receptors…”
I don't know much about receptors, so I doubt I said much.
“…he wants to try something called Nelaxon…”
It was NALTREXONE. Jeepers! Did she have no idea what we were talking about?!
“…which he said in the internet has helped with persistent depression.”
At Babble! Later I got naltrexone from someone else; it didn't work.
It's sad to see so much consistency over years of appointments. Nothing helped, nothing helped, nothing helped. Such brief, superficial notes, but they say so much. In the future, I think I may ask for a copy of the notes after every appointment.
poster:pseudoname
thread:638283
URL: http://www.dr-bob.org/babble/20060429/msgs/638283.html