Friday, March 27, 2015


We had a Schwartz Center Rounds presentation this week.  I was brought in as a pinch-hitter for a staff member who has been out sick all week.  The discussion focused on an older man with Bipolar 1 whose comments to staff and other patients were especially vile, especially insulting, unrelenting, calculated to wound, and - as is often the case with manics - uncannily precise in knowing what hurts others.  Because he is bright, was once wealthy and still has some resources, and hires an attorney almost equally as difficult to deal with, we went months before we could actually get court permission to medicate this person against his will. (That's an interesting but tangential story I won't tell here.)

His wife would come to visit, bringing him things he asked for and sit cowering as he berated her for hours. Guys with Antisocial Personality Disorder, or guys (always guys) with schizophrenia with very little awareness of their surroundings would come up and challenge him about this:  "You talk to your wife like that?  The mother of your children?  Who brings you things and you treat her like this?"

Dealing with him is very draining on staff, and the poor patients are trapped there 24/7, so we talked about how hard it is to take that kind of verbal abuse day after day.  It can't be good for you. We talked about mutual support, coping mechanisms, and how to make this bearable for nearby patients. Near the end someone asked if there are other professions where people regularly receive this level of abuse.  Corrections officers, someone thought.

"Or if you are running for president and your name is Hillary Clinton," said one older, highly-respected psychiatrist grimly. Smiles and nods from his peer group and many others.  I have heard many speak of her with admiration over the last 25 years, especially the last five. They love her.  So there it is among my people. Not really on topic, a bit gratuitous, a bit of a reach - but they cannot refrain from saying it, just has to pop out. Nothing she does will turn them against her - it's all unfair criticism by her vicious opponents. And it has to be brought up in a large public context, because they have to lay down markers of what we are supposed to believe. You have to have a certain amount of power - of privilege, if you will - to speak up in such gatherings and address the crowd unbidden. When I hear discussions of privilege, at one level I agree entirely. That is often how the world works. Some get to speak and others are hushed.

It's just that in most important contexts, the accusations are reversed from reality. Certainly, there are businesses, and churches, and organisations where the opposite privileging obtains.  Maybe you labor under those oppressions, and I agree that's also a bad thing.  I just don't think that's the usual thing.

If you were to challenge them or disagree, even lightly or humorously, you would get taken aside and upbraided for trying to turn the conversation to your politics. Skunk at a lawn party, turd in the punchbowl, doncha know.


Sam L. said...

"Or if you are running for president and your name is Hillary Clinton," said one older, highly-respected psychiatrist grimly.

Or if you were president, and your name is George W. Bush. Stand waaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaay back and watch the venom flow.

james said...

I thought when you were milking venom you had to hold it very close so it wouldn't twist around on you.

SJ said...

"or if you are running for President and your name is--"

"--Obama, Romney, McCain, Bush, Gore, Clinton, Dole, Dukakis, Reagan, Mondale, Carter, Ford, Nixon, McGovern..."

That's probably what I would have said to myself, ten minutes later. And wished I'd been able to say at the moment.

Texan99 said...

It is funny how it's completely OK to discuss politics at work (or on "apolitical" websites, or any other social context) until the discussion becomes about THOSE kinds of politics. All of a sudden it's inappropriate to discuss politics. Because it's divisive.

And it is divisive, of course. The only real way to slip in any heretical politics is to disguise it; it won't be heard otherwise.

RichardJohnson said...

What Texan99 said.

jaed said...

"or if you are running for President and your name is -"

[whisper it] Sarah Palin.

Ralph said...

I don't know that I could respect a psychiatrist that made that statement. This should be someone in the business of objective observation. The first election of Obama ruined a few close relationships for me. Democrats seem to follow and believe in a person, not a system. The person is good or bad. To paraphrase Shel Silverstein, politicians are either good people with bad ways, or bad people with good ways. If you are good, you're good, if you are bad, you are bad irregardless of your actions.