Dr Psychiatrist:
I’ve been waiting an hour for a 7-minute appointment. 3 minutes to chat and 4 minutes for you to look at my chart and write my prescription. I comment that your office is too hot, and you squint at the thermostat and say something about how you’re waiting for the maintenance man. This is the first step in our prescription dance.
“How are you doing, Brandi?” He asks as he crosses his legs and slowly pulls at the seam of his dress pants. He removes a piece of lint that isn’t there.
This is what I say: “I’m ok.”
This is what I want to say: I can’t make it through one day without crying hysterically and sometimes it looks like the ceiling is stretching like taffy. But I want you to be proud, so I lie. I want you to look at me with a smile that reaches your eyes like you did before I became a complicated patient. Are you still proud of how hard I work to stay stable? Were you proud because you had done a good job or because I had? Please don’t put me in the psyche ward again.
“How’s work?” He asks while distracted by an email that’s popped up on his computer.
This is what I say: “Um. It’s going ok.”
This is what I want to say: I’m barely hanging on at work. When I get really overwhelmed, I have to close my office door and hide under my desk. I cover my ears and repeat to myself that I’m safe until I can breathe again. Sometimes I go home and just sit in my closet and cry. Luckily me and my husband own the business or else I would be fired.
“How’s your sleep?” He asks.
This is what I say: “It’s not great but I’ll be ok.”
This is what I want to say: Each night I struggle to sleep. I’ve tried to plan out the exact time to take my pills so I can fall asleep at 9pm, but not wake up at 3am. Still, I wake up at 12am, then 4am, and it takes me 30-60 minutes to fall back asleep. I get up and move to the couch so that I can listen to a show on YouTube about serial killers or plane crashes because that seems to lull me into sleep.
“How’s your weight?” He asks.
This is what I say: “I’ve lost some weight.”
What I want to say: I wear hoodies to these appointments to hide my bulges because you’ve hurt me in the past with comments about my weight. Of course, I need to lose weight, but first I need you to hear and validate how much I’m struggling. I know your job isn’t to validate, but do you know how much your patients want to hear it? Just a quick, ‘That sounds hard, but I can see you’re really trying.’ Because trust me when I say, most of us are trying our asses off.
“How are you doing overall?” He asks.
What I usually say: “It’s manageable.” Because this is what you want me to say. If I don’t say this, we have a conversation about how I feel my anxiety is unmanageable and you, in a dismissive and frustrated tone, say, “Brandi, you know there will always be symptoms and we’ve tried so many meds with you.”
But, after taking a deep breathe, this is what I said this last appointment: “So, here’s the thing. I’ve tried everything I can think of. Yoga, meditation, decreasing caffeine, eating healthier, more exercise and I can’t make these symptoms leave. I know you say that there will always be some symptoms and I try really hard but at some point, I just can’t do it on my own.”
I don’t think you mean to, but the frustration you have with my complicated case comes across as if I’m failing. As if I’m sitting at home trying to figure out ways to stop the pills from working and excited to try a new cocktail. A new colorful collection of pills that will give me a tremor and nausea but help enough to overlook the side effects. This new cocktail will work for a few months, if I’m lucky, and then we have to adjust them again. The truth is that I’m far more disappointed and frustrated than you are. I’m sure I’m not on your mind when you go home for dinner, but your disappointed voice swims through my head for weeks.
I know the older I get the harder it is to treat me. I don’t know how to fix this. Maybe we take a picture of my brain and see what lights up? Maybe I take one of those GeneSight tests to see what meds would probably work best? Maybe we try decreasing Seroquel, stopping Lamictal, or increasing Wellbutrin? What if I take my meds standing on my head at 4am in a clown costume? I’m willing to try anything at this point. Are you?
From you’re complicated patient,
Brandi
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