Tuesday, September 14, 2004

Just Another Paradox

Once upon a time, yours truly spent a night in the ER listening to the old man next to her slur his way through what, to the armchair doctor, sounded like a stroke. I was there for what was labeled "acute suicidal ideation."

Psychiatry is a queer science. A psychologist, those charming and typically useless couldn't-hack-med-school types, came in and talked to me about this whole issue. Poor guy. I felt so bad that I pulled him out of bed in the middle of the night, away from his family, to come and talk to me. I guess it's his job, but it's a crappy part of his job.

Anyway, when push came to shove and we talked about this "acute suicidal ideation," he asked the question I'd been waiting to hear. "Do you think you need to go to the hospital?"

Now, surely rational people can see the irony of asking a person who has obviously lost perspective what they should do in what could be a life or death situation. And yet, I've repeatedly been asked whether I think I should go to the hospital. It's like, retard, if I knew, I wouldn't be here!

In talking to Brendan about this earlier today, I likened this doctor-patient exchange to a cancer doc asking a patient whether or not they think the lump should be removed. 'Well, it could be cancerous and kill you, or it might be benign. Do you think we should remove it?'

Brendan made the point that actually, it would be like a doctor asking the lump if it should be removed. Provocative stuff as the shrinks essentially ask the disease whether or not it is deadly when dealing with suicidal patients.

I feel for docs. I really do. It has to be agonizing to send a suicidal patient home, always wondering if they will be okay. I would make a crappy doctor because I would put these patients in the hospital for my sanity. I don't know if I could ever cope with making the wrong decision.

A dilemma of the worst kind.