Sandy, I enjoyed your article and agree with the need to look at narratives and history, and the reason the person is in our office. You are in a great position to model change. I do need to address an important technical error in your piece which parallels the idea of respecting the consumers as well as each other. As an advanced practice nurse, specializing in psychiatry and substance abuse for many years, I just want to remind your readers that not only psychiatrists prescribe psychotropic medications or do psychiatric evaluations. In many states, including Vermont, Advanced Practice nurses are independent practitioners in their specialty areas, often refered to as Nurse Practitioners. We do “med checks” – or not! …as well as psychotherapy, groupwork, education, and supervision. And as we are all too aware, much of the responsibility for psych care falls on our generalist colleagues, NPs and PAs and PCPS. The credit – or blame- goes to many of us, not just the psychiatrist. I have just signed on to MAD IN AMERICA as I have become interested in the genre of medical narrative. Thank you for all your contributions and I look forward to following you.