Since I left the psychiatric prescribing trenches and came south for the winter, I’ve been staying in a beach town within driving distance of a technology metropolis. I take breaks from my writing and walk to the beach. There, I meet and talk with the winners of the American dream. They are intelligent, highly educated and financially successful. They take their beach vacations here.
One woman I meet at the beach calls her kids over from the sand so she can cover them with sunscreen. After we sit near one another for a time, we begin to talk.
She’s a busy professional who drove over with the kids for a few days off. Her father is scheduled for a procedure soon. She’s surprised when I understand the medical lingo. So I reveal that I’m a doctor.
I also tell her I’ve stopped working.
“Medical practice has turned into pills and tests. It’s not medical care any more. There’s no time allowed to talk to patients.”
I watch the calculations behind her eyes.
“That’s a long time in school,” she says. “Expensive to throw away.”
“Yes,” I say. “It is.”
She tells me she’s lucky she has a primary care doctor who doesn’t believe in tests and pills. Her doctor is a rare gem.
We trade mom stories for a while.
“What kind of doctor?” she asks.
“Psychiatrist,” I say. “Pills are the only thing left in psychiatry. So I stopped working.”
“I’m not a pill person,” she says.
“That’s good,” I say. “Our country has the highest rate of antidepressant use in the world.” I shake my head.
“Yes.” she says. “Almost everyone I know takes antidepressants. Even my sister takes antidepressants.”
It must have shown on my face.
“But she has a clinical depression” she assures me. “She needs hers. They had to try all kinds of things to find a combination that would work.”
Then she tells me that almost everyone she knows has a child on psychiatric drugs.
I tell her that there are schools in the U.S. where 40% of the kids have been diagnosed with attention deficit disorders. I tell her how much putting drugs into developing brains frightens me.
Psychostimualants. Methamphetamines. Speed. Antidepressants. Antipychotics. Benzodiazepines.
She smiles and nods.
She’s really not a pill person.
She’s skeptical.
But her son is anxious, has trouble sleeping, needs to be reassured, forgets things. He has an education therapist at school. She’s been told her son has serious problems with his brain connections.
“He has ADHD,” she confides.
They’ve scheduled a consult with a psychopharmacologist. She’s grateful to have access to specialists through her insurance.
“He just needs something to break the cycle,” she tells me.
“Do more reading before you change his brain with drugs,” I suggest. “Drugs are hard to stop. There are serious withdrawal symptoms.”
I review for her the financial conflicts of interest that make it unlikely that she will receive an unbiased medical opinion of her situation: pharmaceutical money in medical education, drug research, FDA drug approval, NAMI and pervasive drug advertising.
Her eyes look increasingly worried as I go through my litany. I sound like a conspiracy theorist. And I’m just some random person she met at the beach.
She will come out of her psychiatry consultation with drugs for her son. She has health insurance. She is among the winners of the American dream.
* * * * * * *
Thanks for reading, thinking and writing.
Alice Keys MD
