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.
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