September 17, 1996
After our appointment a few weeks ago, I would have to be truly insane to let our professional relationship continue. I would have informed you of this on the day of our meeting, but it did not become clear to me until the final minutes of our meeting and God knows I was happy just to get the full fifteen minutes as it was, so I wasn't going to push it.
I cannot see you nor hear your reaction, but it is clear to me that you are relieved. I know that you didn't know what to do with me, and I can fully understand that. However, there are some things that I cannot accept and find disturbing and unethical enough that they need to be brought to your attention - not for my good, but for the good of your other patients.
First, let me say that I truly believe that you have good intentions. I think that you are a very kind person, and really want to help your patients. When you don't know what to do, however, you seem to do more harm than good.
I cannot, for the life of me, see how any psychiatrist could listen to a patient who's saying `Gee, you know, if the same shit that I went through last year happens again, I think I might end up killing myself.' and respond with "That thought really scares me. [5 second pause] Why don't you come back in three months?" - Three months would make the next appointment in December, but gee, didn't I just say I thought I might not make it that long?
And at that point (in our last 3 appointments...) I say, `don't you think that three months is a little long?' to which I am told that I could come back sooner (maybe only two months) if I found it helpful. But what on God's green earth could be helpful about going to see a doctor who says he can't do anything for me and doesn't seem to even want to see me. I mean, wouldn't even a "Well, I'd like you to come back in three weeks or so or at least check in to see how you're doing" be possible?
No, of course not, because I'm sure you'd much rather delegate that responsibility to a therapist, which you tried to set up in our last meeting. That way you wouldn't have to be the only one dealing with me, and I really got the feeling that you didn't think I had any sort of chemical imbalance anyway. (God knows if you had ever seen me off meds completely, you would flush that notion down the toilet in a heartbeat). However, I hope that you had that opinion.
Because if you didn't, then the problem is much worse than I thought - I mean, there are new drugs - i.e. newly approved Remeron (mirtazapine) and the anticonvulsants Gabapentin and Lamotrigine, and to not suggest them, or refer me to someone who would, is blatantly disrespectful to me, as a patient, and clearly a breach of ethics.
So let me offer some friendly advice. First, if you realize that you don't know what to do for some of your patients patient, don't keep stringing them along with this three month shit. Get them to someone who can help them.
Secondly, there's no need to be as conservative as you are in your treatment approach. I'm not saying that you should throw caution to the wind, but, for example, you refused to prescribe lamotrigine for me, and I have the feeling you won't write a script for Remeron for many months. If you can't be confident with the new meds, then I suggest you put a sign on your door saying "Low Maintenance Patients ONLY", because that is the only way that your practice can be run given the way you're doing things.
As of now, I have no psychiatrist. I don't have another one in mind to go see, I really don't have the time or money to shop around, and this is a really rough time of the year for me to be dealing with all this - but I'm still better off.
I am providing you with my phone number, because should you decide to contact me, the numbers you have on file have changed. If the only reason you decide to call me is for some sort of formal closure, please don't bother, because we both know that the case closed six months ago.
Again, despite my critique, I think you are a wonderfully nice person, but the way you run your practice leaves much to be desired. And if you need help building that sign, just give me a call......
Au revoir et bon chance,
Jaimie L. White
Last reviewed: By John M. Grohol, Psy.D. on 15 Sep 2002
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