Wednesday, February 17, 2010

Sunset Shrink

My psychiatrist doesn't know me.

I understand that this is a pretty strange thing to be said about the medical professional with whom I've entrusted my mental health, but nevertheless it's true. I see her very infrequently, perhaps once a year, for less than 15 minutes a visit during which she asks me vague questions and I reply with even vaguer answers while I suppress all the sassy replies that threaten to burst out of my mouth. Then, she writes me a prescription for another year's worth of yellow pills that have chemically balanced my brain since 2002. It's always the same prescription. It's usually the same conversation. The whole exchange is so utterly brief. It has to be. Those 15 minutes cost $110. And that's with the self-pay discount.

"Oh, I know who you are."
"I guess they did find my chart."
"Yes, they did. So how are you?"
"I'm all right, I guess."
"How is your work? Do you still have the same job?"
"I don't know, what was I doing the last time we saw each other?"
"It says here you were moving in with your boyfriend. And traveling a lot Is that right?"
"So your boyfriend, he's a gambler?"

I pondered my potential responses. Should I tell her about the sports betting? Or maybe his tendencies to fall into Mega-Pai Gow tilt? Or how fucking impossible it is to beat the rake at $5-$10 limit hold'em?

"No. He's not a gambler. He's a writer too."
"But do you still gamble?"
"If you call the occasional $11 turbo sit-n-go gambling."
"I'm not sure what that is."
"Don't worry about it. I sure don't."
"So how's your mood?"
"Like, in general?"
"Just day-to-day."
"Well, I only feel really homicidal when I'm driving behind idiots on Pico Blvd. who are texting on their iPhones or when I'm seated next to a crying baby on a plane. But I have Xanax for that."
"You do?"
"Yeah. You prescribed it for me."
"Oh, I see. I did. Do you need a refill on that too?"

My psychiatrist scribbled out the same prescription she's scribbled for me for the last eight years. It ain't broken so why rock the boat, right?

"Nice view," I offered, gazing at the mountain-to-ocean panorama outside her tenth-floor window.

She showed me out her door. A handsome Asian man in a black suit with a drug company name tag sat outside in the waiting room.

"Jason, so good to see you! Come on in."

He disappeared inside with my psychiatrist as her assistant signaled for my attention.

"I need that $110 now. Cash or check only."


nerkul said...

In Britain, where you get all the free shrinkage you want, they take their time to not know you. I realised after a while "I'm younger and less educated than this guy but he's clearly been sitting in an office his whole life. He *cannot* relate to me. I'm alone." Then I realised that doctors are unwitting shills for the pharmaceutical industry. Though I'm sure they help old people.

So I mostly use them to blag free drugs to send to my American friends. I recommend Seroquel for acute freakouts, it empties the mind remarkably well.

Anonymous said...

The UK docs like to fill you fill of pills too. I've been getting prozac for the past few months and I only went in to ask about the chance of speaking to someone about my mental state.

"Here take these you'll be fine"

nerkul said...

True. After getting prescribed Prozac I decided they were nothing more than a dispensory. (I never tried the anti-depressants because I know they ruin lives.)

Only therapeutic drugs I ever had that worked were MDMA and LSD. When will the grown ups take charge of our society?

Lucypher said...

Sadly, prescribing meds they are incentivized to prescribe is largely what the mental health profession has devolved to.
She sure knew the pharm reps name, huh?