Psychiatric Evaluation

I recently secured an internal memo from the offices of the psychiatric journal, Concrete Visions, titled: “New Market Perspectives on Medication Therapy.” Concerned, I paid (literally) a visit to the editor, retired psychiatrist and maven of market research at Meds For Heads Pharmaceuticals, Dr. Abnorm Drowze, for clarification. He offered me a seat on the couch in his office.

“Relax.” he insisted firmly but affably. He nestled into an over-stuffed leather chair with a notepad. There was no support on the couch, and I was kind of tired so I leaned back. It was kind of curiously juxtaposed to the chair such that he was behind me. I read from the memo:

“Unilateral efforts by the American Psychiatric Agglomeration to boost office visits through discount prescription drug offers have over-extended ad-dollar ratios anent the recent sales stasis, prompting pharmaceutical execs to consider more consumer-friendly strategies. One proposal is to scale back professional jargon to make it less intimidating.”

Dr. Drowse pondered his notepad. “Any history of neurocognitve dissonance?” he asked nonchalantly. I don’t know why, but he stared eerily into my eyes and asked if I was on medication. I wondered if recreational drugs counted. “No.” I continued:

“Recent market revaluations have sparked debate in the scientific community, from the Society for the Obfuscation of Science to The Psychiatric Council for Free Will and Market Control. Will corporate interests restructure the entire medical paradigm?” He asked how I felt about it. (?) Well…

“I spoke with Spin It E-Zine science editor, Ima Loade, and she wondered if science could maintain its credibility without masking basic information in an esoteric vernacular. She insisted that dead languages and foreign neologisms were important deterrents to lay comprehension, as well as crucial reminders of the tedious and repetitive detail required to assess statistical minutiae. She felt it was essential to preserve the emotional dissociation needed for objectivity. She also likened it to working one’s self out of one’s job.” He peered at me curiously; I returned to the memo:

“Consumer advocates are questioning scientific integrity, even as professional organizations from The Need-Invention Conservators to Protect Ur Pet With Brand-Name Pharma are concerned that the market-collusion of science and industry might seriously threaten cultural sustainability.” I waited.

“Have you considered therapy?” I had to admit he was among the most pleasant men I’d ever met. Of course I’d considered therapy. Who hasn’t? “No.” I replied. “Perhaps you should.” He looked disappointed and sad. I tried to clear my head even as a certain hotness began to invade my body.

“Meanwhile, The Center for the Control of Psychic Epidemics is warning of a critical gap between drug production/quality and prescription output. Docs from Bangor to Brussels are bracing for catastrophe as health consumers world-wide demand more effective meds.”

He gazed off as if into an invisible world. “Frankly, I wonder if you might have some cortico-medullary fragmenting going on.” He chortled in a mock German accent, “Tell me about your id ven you vere a kid…” My brain was swimming. Don’t let him get inside your head, I thought. Though I broke into a psycho-galvanic sweat, I was determined to expose this fraudulent miscarriage of the public trust.

Just then, a wave of anxiety flooded me. He appeared as deeply concerned for me as a loved one. Was he a greedy corporate underling enticed by subjective motives to believe, much like a religious zealot, in the only apparent materiality of an unconscious mind/body duality which exceeds rational description — or was he a profound mystagogue inhabiting a future consciousness far beyond the paradoxes of mortal thought? Confused, I continued:

“What began as a simple questionnaire on the social network, FaceTwerp, by an anonymous undergraduate student in pharmaceutical biology is now threatening the very foundations of scientific double-speak.”

Dr. Drowze stated matter-of-factly: “I’m afraid that poor young man had non-bizarre delusions accompanied by a flattening of affect which only exacerbated latent pre-social tendencies. I treated him myself. In fact, you exhibit similar symptoms. Have you ever checked your genetic history?” He suggested a DNA analysis, an MRI, and an Animal Metaphor Test — followed by “ascending medicinal therapies to ensure psycho-neuronal viability into the future.”

I knew enough about psychology to know that if you only thought you had delusions you probably didn’t, but if you did you wouldn’t know it, and if you didn’t know it then you probably had them. I worried, too, that even if I didn’t have them now, I might get some later. I also knew enough about genetics to know there was nothing you could do about it (outside self-medication) without professional help. He looked at me pitifully. I was gripped with fright. “Do you think there’s something wrong with me?”

He peered at his notes, “Hmm…. that’s very difficult to assess at this stage. Do you think there’s something wrong with you?” He looked worried. I thought of the argument I’d had with my wife the night before. Had I over-reacted when I slammed her into the wall and knocked her down the stairs? I felt woozy as I continued reading from the memo that suddenly seemed like an unfair and outlandish indictment of a thoroughly respectable and professional gambit for profit.

“The questionnaire asked students to rate the effectiveness of the meds required for college entrance. While most admitted they were comfortable with the dosages designed to repress tension and allow them to be more effective social participants, many complained of vague feelings of unease; a few had unhappy dreams. Some even reported frightening anxieties. FaceTwerp allowed them to exchange ideas, and many wondered if their prescriptions might not be strong enough.”

It was like he was peering deep into my soul. “Tell me about your support system.” He appeared aloof and detached, objective, though with a piercing empathy. My fists clenched angrily. They felt like striking him. “I’ve got plenty of friends!” I blurted defensively. He was as cool and unfettered as an autumn breeze peeking over his horn-rimmed glasses. “Do you?” I stared at the floor in shame. “No.”

My false posture drained out like one of those toilet tanks in a Winnebago. I felt deflated but somehow relieved. I thought about my deodorant. How effective was it? He handed me a prescription with a printed bill attached. (How did he do that?) “Fill this immediately.” I felt a mix of confusion and gratitude. He looked at me with genuine compassion. “We’ll continue our conversation next Tuesday at three.”

Is psychiatry for you? This could be why — or why not.

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