It’s grammaration.Yeah, they make me say the words.No, I’m not hearing voices, they’re making me say that I am evil…
That’s just another line you might hear if
you were a psychiatrist like me on any given day. You never know what
you’ll run into each day. It can be a zoo, it can be a circus, or it
can be just plain rewarding!
First you have to get to my office. It’s
really not so tough to get to Freudland. Major medical insurance or
green stuff will get you there quick. Call for an appointment and
you’ll be launched into the inner dimension of the psyche.
If you want to just visit, my office is
just a couple blocks away on Bishop Street at the Century Square
building. The building is mirrored all around to give you a great
reflection of yourself to get to know yourself better.
My office is on the 8th floor.
8 is a great lucky number for the Chinese, symbolizing prosperity.
It’s infinity standing up on its end.that’s great for my business. For
those of you who have acrophobia, and a fear of heights, there are
sitting spots outside the building on the ground floor to have a visit.
When you come into my office, you’ll get
to fill out the intake material, some boring stuff, to tell us your
personal information and your medical insurance. I also ask you to
sign a release so that if I really wanted to, I could get just about
any information about you that is available on paper. I admit it’s a
throw back to the old days when I did more workmen’s compensation and
no-fault evaluations for insurance companies. When big money is at
stake, an insurance company wants to know if someone is credibile.
Well, if a patient questions the release of information form too much,
I start to wonder what they have to hide and consider whether their
suspicions were well-founded or simply paranoia.
I’ve got great reading material in my
waiting room. Where else will you find the National Enquirer and the
Star at your fingertips? Well, you might find it interesting to know
that according to my highly informed wife, the National Enquirer has
some of the best medical reporting of any publication. And believe it
or not, many of the stories about the celebs have some basis in truth.
Reading stories about movie stars help some of my depressed patients
realize that even if they’re not rich and famous, their lives may not
be as messed up.
Of course, I also have the latest edition
for Bottom Line Health and other newsletters that I can usually get for
free. I get the free editions and then just write "cancel" on the
invoices to avoid the billing.
In the waiting room also, you’ll find two
pieces of my abstract calligraphy. One is called "USA", blue strokes
on a white background, and another called "OJ", red strokes on a white
background. Their names signify not so much any deep meaning as much
as the way the abstract strokes turned out.
When you walk into my personal office, you
meet a spectacular view of Nuuanu Valley. You’ll see my massage table,
which I don’t use often in spite of my license as a massage therapist.
This serves to give the illusion of relaxation without the actual
massage. Oh, there’s also the foot roller in the waiting room to
loosen yourself up before coming in.
For my patient’s to sit in my office, I
have a Chinese sofa that is my token classic Freudian couch. You are
allowed to lay on the sofa, but most people just sit. I sit behind my
cherry wood desk and type into my computer as I talk. Some patients
actually get annoyed by my typing, but I’ve gotten so good at not
looking at the keyboard that it’s virtually inconspicuous and I can
still give the patient fairly good eye contact.
On one wall to the side, I have a large
painting of a wave breaking, like at Sandy’s beach. This was given to
me by a patient of mine who has other pieces at the New York Met.
Recently I just acquired a little water fountain for the side table,
next to the sofa, that makes a peaceful trickling sound, soothing and
unobtrusive. That fountain I got from a drug company that makes the
antidepressant Paxil. This is one of the benefits of my being the
target for big business. They want me to prescribe their drug and so
they give me things to associate their product with something
tranquil.
On the wall that I look at, above the
patient sofa, I’ve hung a mandala that represents who I am. This was
also painted by one of my other patients. Each part of the mandala
represents something meaningful to me. It’s just there so that I don’t
forget who I am. Sometimes it’s hard to be yourself when you’re
spending time with unusual characters. I’ve also included on the same
wall, a commissioned work of the taichi symbol, like the Town and
Country logo, which was done by an airbrush artist. I’ve transferred
that painting onto the T-shirts for my taichi class.
Let’s move on to a juicier part of my work
and that’s the patients. I do a fair amount of medication management.
People come in for ten minutes, I adjust their medication, and they’re
out the door. Then there’s the psychotherapy patients that spend 20
minutes to an hour with me.
Let’s face it.I deal in drugs. And do we
have the good stuff! Most are covered by insurance, and you don’t have
to pay much or I can just give you samples. Most drugs have been
researched to recognize the side effects and their best application.
Modern medications are streamlined to reduce side effects and maximize
effectiveness.
As I have been doing more chronic pain
management, I have come to prescribe a fair amount of narcotics that
are highly controlled. The chronic pain patients have taught me one
important thing: some people lie. They lie straightfaced! I had a
situation with Jenny where she told me she wanted to increase her
medication and that it wasn’t enough for the pain. She had forgotten
that she had told me that same session that during her recent stint in
the hospital, she was taking both the hospital pain meds along with the
medicine that I prescribed for her. How could she be needing more
medication now when she was already taking more pain medicine than
usual? She had pleaded with me that she hadn’t lied. Well, she was
busted, and then she still wanted me to continue treating her as a
patient. Am I just too lenient?
A population of patients, that few
psychiatrists like to treat, but I enjoy a lot, are the developmentally
disabled. These are often the mentally retarded or they may be mute or
deaf. Usually they don’t talk back as much. They take their
medication from their caregivers and there’s little need for deep
conversations. Although many of them are on medication for impulsive
or agitated behavior, after taking medication they can be quite sweet.
Take John, for example, he usually comes in with his guitar or ukulele
and sings an endearing song like..Dr. Yuen, Dr. Yuen, Pizza Hut, Pizza
Hut..(strum, strum, strum)…
The Vietnamese patients are another
interesting and pleasant group to treat with the help of a translator.
I don’t know how I managed to get so many Vietnamese. They’re just
nice people and maybe nice people just flock together. Many of them do
somaticize their emotions; i.e. instead of saying they’re depressed,
they say they have a headache. They seem to have been trained to
believe that medicine will cure everything that ails them. I don’t
agree with that myself, but many are satisfied with what the medicines
can do. They are so respectful, so loving of their families, and don’t
complain a lot about all the atrocities that they’ve experienced in the
Viet Nam War. They just have frequent nightmares.
I do want to talk about the real cast of
characters that most inquiring minds want to know about at the shrink’s
office. I have to tread lightly here because when I did a standup
comedy routine at a hospital Christmas party, I was chastised for being
insensitive.
Some of my patients have distinguished
themselves to the degree that I run tests in my bathroom just to see
what people will stoop to steal. Well, so far in the past year, they
took my wooden and glass showcase which had nothing in it because they
had already stolen the little toy car that was in the case. They took
my wife’s carved apple that was in marble. They have taken the can of
spray deodorant. I’m just waiting to see who will take my pair of
candleholders with half burnt candles.Or my piece of bamboo that stands
like a vase.
Rich is a notable individual. He has come
in dressed in a suit and tie, which didn’t quite fit his size; his coat
is tight and his dress shirt cuffs are showing; his slacks are short
and his socks are showing. He’s over six feet tall, his head is
shaved, his beard is highly manicured. He carries his Book of Mormons
and lately has not been answering my questions. He just looks down,
shakes his head or does some alien gestures with his hands. Yet he’ll
take his prescription when you hand it to him and he’ll shake my hand
at the end of the session.
I’ve been in the business long enough that
I’ve been yelled at by patients, I’ve been walked out on, and I’ve had
doors slammed on me. I’ve been pretty lucky that I haven’t been swung
at but once in my professional career and it was a bad punch. You
think the word is getting around that I’m this hotshot kungfu master?
Actually my wife got bonked when she tried to calm down an ice addict
who was having a bad trip.
I guess being a shrink is a little like
being a bartender, a hairdresser, or even a cab driver, except we are
trained listeners. People tell me things that they’ve never told
anyone in their lives, not even their parents. I’ve heard stories
about alien abductions, cult sexual exploitation, and Gulf War
masterminding.
But aside from the weird, the perverted,
and the extraordinary, I have had an opportunity to be a part of
people’s lives. I’ve dealt with people’s grief and the loss of their
loved ones. I have seen people rise to fame and crash to poverty. I
have been exposed to the whole gamut of human emotion and have been
tempted to succumb to it myself.
I was helping a Vietnamese mother get
along better with her 15 year-old boy and I ended up crying because the
mother gave a glowing report of her son one day. There I was with
tears going down my face uncontrollably and I had to explain to the boy
why a grown man was so happy that things were working out better.
I have been there to see a couple’s love
grow as they worked to resolve their differences. It’s amazing how
some people get it and others seem like they never will.
So you see, a lot of human experience
walks through my office doors. Doing psychiatry might be thought of as
working with the psyche like trying to contain it like the animals in
the zoo, or like trying to train it like the animals for a circus, but
watching the spectrum of human beingness, in all its triumphs and
defeats, is really what it’s like at the shrink’s.