a letter of love to psychiatry

Students of medical college asked me early this morning about why "I" consider anxiety as a disease. It took me some time to talk about the concept of disease, disorder, illness, pathology, suffering, cost-benefit balance of treatment, and quality of life. I asked them if they consider a "fracture in the leg due to car accident" as a disease. I asked them whether they think "pregnancy" is a disease. Should we call a man with a fractured leg as "patient"? Should we call a pregnant lady a "patient"? And what is disease after all? Can you define it?

Anyway I am sensitive these days from those who are skeptical about psychiatry. I don't feel respected in my daily life. I saw a specialist in ENT (Ear, Nose and Throat) from Hilla today and I like him very much. He likes me very much too. We kissed each others like we usually do in Iraq and started talking about some shared memories. He asked me before we departed:

- Are you STILL with psychiatry?
- …..? with?
- Didn't change … I mean…. Still sure that you want to be a psychiatrist?
- Well, what to do else? I like it.
- God may help you my friend and make success in your way always.
- Thank you dear, same for you. Byebye.
- Byebye.

Soooo he is kind but, like them, what is wrong?

In that small room he said to his companion with a loud voice as if trying to see what would be my comment: "our thesis in psychiatry is just nonsense, do you believe that someone can really work and do a thesis? Just lies". They laughed anxiously while looking at me. I smiled to them and went out to the outpatient clinic.

A teenage with obsessive compulsive disorder was waiting me in the outpatient clinic. He astonished me by his knowledge of his disorder and he told me that he chat online with a psychiatrist from the USA. He told me that he reads websites talking about obsessive compulsive disorder. Dealing with him made me realize that I am not in a world of ignorant.

After him came three clients, one after the other, all having social phobia, all were university graduates and very clever.

Then a lady from a rural area, no schooling, with marked psychomotor retardation, anhedonia, insomnia, early morning awakening and history of resistant depression came alone. She was enough insightful to say: "I really don't want to come to you doctor, but I got to force myself, cause when the episode will go away I would think this is what I should have been done, coming to you". I asked her about whether she finds life worthy. She told me about her suicidal attempts and showed me her previous wrist and neck wounds. I told her she must be treated inside hospital for few days maybe. She asked me to consult her family and that she will come on the next days.

A lady with a card written on it: "paranoid schizophrenia on zyprexa 10mg/day" came to ask me about zyprexa. She said: "I don't want to go back thinking those strange ideas doctor, I have hurt my daughters enough on the last episode, I want to continue on zyprexa, is this dangerous? Is zyprexa addictive?"

The last client was a small family. Father, mother and her, the most beautiful princess with hearing difficulty and attention deficit hyperactivity disorder. She turned the room upside down on our heads. She wrote me a letter and drew me a painting.

When they went I felt I am much better and that I like my profession no matter what. Those people I saw today in the outpatient clinic know about psychiatry more, and respect psychiatry more than medical students, ENT specialist, and some other doctors. It is for their sake, and for my sake, that I will continue enjoying studying and practicing psychiatry. Those ideas were coming in my head while I was preparing to go out of the outpatient clinic. The king, father of the princess came to me with the princess who was frowning at her father who said: "please doctor, can you write something for her, I mean anything in a white paper, I am sorry but she wants to take the prescription paper you already wrote and she might tear it, can you just give her a paper with anything written on so that she stop her temper?".
"sure" I said and took a white paper and wrote something like her lines on it and gave it to her. She smiled and hold it up in the sky and yelled at her father: "hay hay!!". Her father kept saying "sorry doctor" and I kept saying "it is ok" we smiled to each other and went out.