This is it, a double-take headline on NPR that is the unholy spawn of social Internet and medical marketing pressures: speed-dating at the Doc Shop.
I have been mulling over the prospect of a new practice; this is exactly the start-up idea I was looking for.
Let us dispense with the longueurs of the 15-minute visit. Even allowing for the luxury of a 5-minute bathroom break, I can envision 11 accelerated diagnostic evaluations per hour. The Adderall scripts will by flying fast and furious.
(Note to DEA: this is a satirical post).
Showing newest posts with label Practice. Show older posts
Showing newest posts with label Practice. Show older posts
Tuesday, May 18, 2010
Thursday, August 6, 2009
Vignette
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.
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.
The Rest of the Story
"How sharper than the serpent's tooth it is to have a thankless child."
Lear
I haven't been inspired to write here the past couple of days, yet here I sit, typing. Why? Because writing is what I have to do; if it weren't here it would be somewhere else. The standard advice for writer's block, or even writer's procrastination, is to sit down, stare at the blank (screen), and write something, anything. As Lear also said, "Nothing will come of nothing." But out of something, something else may come. Granted, this write-at-all-costs mantra was pre-Internet; the adage was never to write something, anything for instantaneous, theoretically global release.
I've always been fascinated by the attractions and repulsions that operate between people--animal magnetism, as it were. Obviously a lot of what folks like me do professionally is to commiserate, if nothing else, with people for the slings and arrows of romantic entanglements. Those are interesting enough, but arguably parent-child relationships are more powerful in the end. Partners come and go, but parents, siblings and children are for life.
Except when they aren't. I'm always intrigued by family secrets of distancing and estrangement. Siblings who grow up sharing so many intense experiences during impressionable youth may turn out to live totally different lives, perhaps to have little to say to one another, perhaps to squabble bitterly over the inheritance or worse. Through what mysterious genetic and social unfoldings does the black sheep acquire his hue?
I've noted before that parenting gone bad seems to engender some of the worst suffering one sees. The divorced father who can't see his children. The dumbfounded mother who sees her boys turn into drug addicts and criminals. And then there is the puzzling torture of the child who won't communicate at all.
I see one every once in while, a middle-aged father or mother whose child is incommunicado. They may seem harmless enough--a woman whose chronic depression may have made her emotionally unavailable to her children, or a man whose alcoholism and workaholism may have left family scars. Their child (or sometimes all the children, or sometimes one child and not the others) not only won't maintain a relationship, but supposedly won't even grant a reason why. Calls and letters not answered, and no forwarding address. The silence is more exquisitely painful than any denunciation.
Was there some unspeakable atrocity of abuse? Most things in life may be atoned for if undertaken with sufficient sincerity, but perhaps not all. Or is this a case of an unforgiving child who has embraced the path of ruthlessness? How much "honor," in the Ten Commandments sense, is owed to the dishonorable mother or father? To the merely inadequate mother or father?
Family secrets. In encountering a person one confronts a subjective world unto itself, and yet there are parallel worlds giving onto a mutual universe. The "history" one obtains one is merely one volume of a potentially infinite library that is a family. The empty chairs in the office may speak alternative volumes. Their would-be occupants may sit in other, similar offices, next to other, similarly empty chairs.
Lear
I haven't been inspired to write here the past couple of days, yet here I sit, typing. Why? Because writing is what I have to do; if it weren't here it would be somewhere else. The standard advice for writer's block, or even writer's procrastination, is to sit down, stare at the blank (screen), and write something, anything. As Lear also said, "Nothing will come of nothing." But out of something, something else may come. Granted, this write-at-all-costs mantra was pre-Internet; the adage was never to write something, anything for instantaneous, theoretically global release.
I've always been fascinated by the attractions and repulsions that operate between people--animal magnetism, as it were. Obviously a lot of what folks like me do professionally is to commiserate, if nothing else, with people for the slings and arrows of romantic entanglements. Those are interesting enough, but arguably parent-child relationships are more powerful in the end. Partners come and go, but parents, siblings and children are for life.
Except when they aren't. I'm always intrigued by family secrets of distancing and estrangement. Siblings who grow up sharing so many intense experiences during impressionable youth may turn out to live totally different lives, perhaps to have little to say to one another, perhaps to squabble bitterly over the inheritance or worse. Through what mysterious genetic and social unfoldings does the black sheep acquire his hue?
I've noted before that parenting gone bad seems to engender some of the worst suffering one sees. The divorced father who can't see his children. The dumbfounded mother who sees her boys turn into drug addicts and criminals. And then there is the puzzling torture of the child who won't communicate at all.
I see one every once in while, a middle-aged father or mother whose child is incommunicado. They may seem harmless enough--a woman whose chronic depression may have made her emotionally unavailable to her children, or a man whose alcoholism and workaholism may have left family scars. Their child (or sometimes all the children, or sometimes one child and not the others) not only won't maintain a relationship, but supposedly won't even grant a reason why. Calls and letters not answered, and no forwarding address. The silence is more exquisitely painful than any denunciation.
Was there some unspeakable atrocity of abuse? Most things in life may be atoned for if undertaken with sufficient sincerity, but perhaps not all. Or is this a case of an unforgiving child who has embraced the path of ruthlessness? How much "honor," in the Ten Commandments sense, is owed to the dishonorable mother or father? To the merely inadequate mother or father?
Family secrets. In encountering a person one confronts a subjective world unto itself, and yet there are parallel worlds giving onto a mutual universe. The "history" one obtains one is merely one volume of a potentially infinite library that is a family. The empty chairs in the office may speak alternative volumes. Their would-be occupants may sit in other, similar offices, next to other, similarly empty chairs.
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