Good Afternoon My Fellow Introverts
Today, I would like to explore the world of psychiatry....
The human brain is a very complex organ to say the least. It is believed that the average male has approximately 171 billion brain cells. Psychiatry is a medical specialty which focuses on the diagnosis and management of disorders of this intricate and complicated structure.
Now, my next statement may be controversial but, based on my observation and experience, psychiatry is not an exact science. There is no objective means of testing to confirm a diagnosis.
Let me explain further.... if a patient comes to the hospital with a swollen hand after trauma, a clinician may suspect that it is broken. An x-ray can then be performed to confirm whether or not there is a fracture. However, this is not the case with psychiatry. Diagnoses are essentially made by talking to the patient, their relatives and observing the patient's behaviour. But there is one huge problem with this - people can be deceitful. They can also pretend or feign their demeanors.
As usual, I have a story to support my comments
During my training, I had to rotate through the psychiatric service. On day 1, I was asked to take over the care of a 24 year old patient who had been admitted to the ward three weeks earlier but had improved significantly. His story was that three weeks prior, he had confided in a dermatologist who was treating him for an leg ulcer that he had the desire to murder his girlfriend and then kill himself. However, he hadn't performed the act because his girlfriend had been at her job that day, so he had no access to her, hence he just kept his appointment at the clinic. The dermatologist was immediately alarmed and called the psychiatry team who diagnosed him as having major depression with suicidal and homicidal ideations. He was subsequently admitted and commenced on antidepressants and intense psychotherapy.
By the time I inherited him, I was told that he had made a complete 180 turn. He was now very upbeat, and had been leading prayer and group sessions with the other patients. I can clearly recall my first interaction with him. He seemed quite happy, and said he was eating and sleeping well. He stated that he was quite anxious to be released so that he could see his 2 year old son, and be a father to him. Over the next two weeks, this gentleman continued to be the perfect patient. He was interviewed daily, not only by myself, but by the chief resident and the attending (senior doctors), and we all thought that he was doing well.
We determined that he was fit for release at the end of his fifth week. He was picked up by his brother and he was so thankful and cheerful going through the doors.
Well, my friends.....surprise, surprise....we got a call from his brother later that day to say that the patient had intentionally drowned himself. He had written a letter, apologizing for the agony that he was going to cause, but had stated that the pain inside was too much, and had been going on for far too long.
So, essentially....for the better part of a month, this gentleman pretended that he had improved mentally. He told us what he knew we wanted to hear as part of his plan to be released, so that he could finally end his life. He had easily deceived multiple medical professionals, and why do you think that is? Because there was no objective method of confirming his thoughts or feelings.
From that day on, it has been my unwavering belief that Psychiatry is Hokum, and will remain so until we invent a device that is able to decipher a person's thoughts, feelings and behaviours
Until next time
MDsaga signing out
Comments
It is truly impossible to know what an individual is thinking and feeling at all times. The psychiatrist like any other clinician has to make decisions based on the best available data but this can obviously be quite subjective. So, I get your point that it is not a precise science but I think psychiatrists do a pretty good job considering how difficult it is to truly understand human beings.