Wednesday, June 9, 2010

Pending Book Tour and other Musings

Book tour in Florida next week. I will be  doing a reading and signing and talking about the book and all about AD next week. It's weird but I was trying to figure out which sample pages of the book I would read for the book signing. I read a part about some mean laughing on-lookers at my mother's inappropriate social behavior, when I took her to a restaurant when I was seventeen, that one seemed okay. I guess it covers some of those universal concepts of Alzheimer's family members, the ignorance of the fellow human being manifesting as mean-spiritedness-
but then I read one about a patient I had, whose wife had AD. It was quite a few years ago, I actually got choked up reading it. I have had thousands of scenarios like that. You don't get to get choked up as a doctor-ever, no matter how much it goes against your human nature. This is especially true in psychiatry. I guess that is one of the reasons so many people hate psychiatrists- shrinks. I spose oncologists get to cry with their cancer patients and that is cool, but psychiatrist don't get to. 
I know crappy therapists get to cry with and hug their patients, but it does not work in the end, It is boundary less. It looks coll on TV and for Hollywood. But it is not the right thing to do. You get to convey compassion and empathy without crying with your patient, most psychs don't get good at that, easy to throw meds at people. Part of the reason psychiatrists are seen as such heartless bastards. 
So why don't you get to be emotional?  Well it may seem kind and sensitive, but in the end, the patient is not going to know where they and you start and stop, it conveys a pseudo-trust, but ultimately the patient can't trust you, I mean your affect (emotions) will be as sad and anxious and uncertain as theirs. Unconsciously the patient thinks they have to take care of the therapist or doctor. The patient does not feel safe, it feels out of control, for them.  They don't teach boundaries so well anymore, in fact you have to work at it to find good psychotherapy training in this day and age.  Oh and shared experience is not the same as empathy. That is a toughy for most people to get. The ultimate sign of a good doctor, conveying empathy and positive regard to your patient without loosing your emotions and boundaries. 
Yep I hear 200 tragic, painful, anger-provoking, tear-jerking stories a month. you get to be sort of an emotional factory worker, an empathy machine, cause it is the right thing to do. You owe 1,000%, you took an oath, and people depend on you with their lives.
Anyway I am amazed as I read parts of this book I wrote, some of it years before and can still become choked up. 

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Talking about the book with the Lake Superior wind....... a calm day