Thursday, October 21, 2004

The Butterfly Flaps Its Wings

Somewhere along my educational journey, a fool with authority, AKA a teacher, thought it wise to attempt to explain religion and faith in terms of chaos theory. More grounded people tend to theorize about chaos theory in terms of the weather—like a butterfly flapping its wings in Brazil could cause a tsunami in South Africa. Or something like that.

I warn you that this train of thought actually has a destination!

Sometimes I feel like some molecular butterfly flapped its wee wing in my brain and set off this massive chain reaction that has led me to my current existence. That formerly-beautiful-but-now-butt-ass-ugly insect fucked with my brain and set in motion a chain of events that has forever altered the course of my life.

Now, think about this with me, every psychiatric patient knows that every medicine has some kind of side-effect, whether its the death of your libido, constipation, paranoia, irritability, eczema or the ever-ubiquitous weight gain. The pill becomes its own butterfly and it's starting to get windy.

Eventually, the side-effect becomes unbearable, so either a new drug is introduced to deal with the side effect or the old drug is removed. The consequence is more instability.

Do you see where I'm going with this? We keep taking pills until we're popping 10 a day. Makes me feel like a drug addict sometimes.

My pdoc appointment went soooo much better than the last one. Brendan is in town and I dragged him along as a few friends and commenters recommended. Brendan, being the charmer that he is, quickly endeared himself to my shrink by talking about college football. LOL!

I guess, in my mind, the appointment was relatively uneventful. He gave me some samples of Provigil for daytime sleepiness. I don't particularly feel any different, but I only started taking it this morning. :)

There was one wicked cool part of the appt though! My pdoc is interested in developing a sort of virtual office because he knows that people are always moving and traveling and so they constantly have to recreate the wheel in terms of their treatment. So anyway, he needs someone to be the guinea pig for this endeavor so he offered me the opportunity to try it when I move to Indiana. The bitchin part is, since the program is in its trial period, I'd get my appts for free!

How frickin COOL is that?

In the back of my mind, I'm sure the a digital revolution in medicine is too advanced for insurance companies and so eventually, I'll probably have to switch shrinks anyway. But I guess we'll cross the bridge when we come to it.

Of course, virtual doctoring opens up a whole new can of worms. Is the face-to-face interaction between the doctor and the patient more important than the temporal integrity of the patient's treatment? In other words, for someone like me who has lived in Los Angeles, Buffalo, Phoenix and soon to be South Bend within the past three years, is that face-to-face interaction worth losing any semblance of a long-term treatment plan?

I dunno. I suppose if my living situation had any hope of being stable in the next three years, I'd be more inclined to work with someone in person. The shrink I stuck with the longest was able to tell from my clothes and my facial reactions to his questions how I was feeling, although he didn't always know what to do about it.

I'm telling you, if I could combine him and my current doc in terms of their treatment styles, I think I might have the best doctor ever. Niedorf really understood the value of forging an interpersonal connection. He had a touch of old school psychotherapy in him. Sitting in his office felt like walking into the cubby hole of some ancient academic. He had shelves upon shelves of books—but old books like The Naked Ape. He was compassionate. I totally would have stuck with him if he hadn't made a medication error that almost killed me.

My new doc strikes me as very knowledgeable in terms of medications and diagnoses. I feel like he could probably quote the DSM verbatim and he's on the cutting edge of treatment. He probably knew about cymbalta before the FDA did. LOL. But his office is sterile. He has an enormous desk where Niedorf had his cozy rocking chair. He has his medical certifications on the wall; they're like a constant reminder that you are, indeed, in the presence of a doctor. For some reason, whenever I'm in his office, I always have the feeling that I'm a lowly subject who has been granted an audience with some aristocrat. He's not the type you would tell about a major life problem, event, change etc. Then again, I'm relatively certain he won't fuck up in how he deals with my meds.

But man, if I could squish them together and create a doctor with the hard-earned wisdom Niedorf has about people AND the academic acumen and medical expertise of Greenman...that would kick ass.

I guess I've never really given thought to what characteristics I truly value most in a shrink. I suppose when push comes to shove, I intellectually prefer the hard-core medicinal basis of Greenman's care. But emotionally, I'd take Niedorf's questions and stories any day.

Gosh. If any of you find a shrink who has both sides of the psychiatrist coin, you'd better thank your lucky stars. I hear about those patients who feel like they form a team with their shrink and their therapist in managing their mental health. I think they're an anomaly.