Doctor who listened altered a life’s course

By Kim Palchikoff

Monday, Aug. 1, 2016 | 2 a.m.

Anyone who has been to one probably remembers their first visit to a psychiatrist. I have two who are memorable, for opposite reasons. One helped; one didn’t. One knew my name and used it; one didn’t — and had an opening line about bounced checks.

This is what I learned: Psychiatrists don’t deal with bad teeth. A visit to them is super scary, but not going-to-the-dentist-for-a-root-canal scary; root canals and crowns are something patients can understand, visualize and dread, and then after one or two visits to the dentist, the problem is gone.

But psychiatrists deal in the vague, imprecise world of emotions and thoughts, difficult things to explain to patients who never went to medical school. In all of my years, not one doctor has shown me a plastic brain used in medical schools, the creepy cauliflower kind with red plastic blood vessels that comes apart, with an explanation about how the mind works and how things go wrong. That said, it can take years to correctly diagnose a mental illness.

I don’t know if that plastic brain would have helped me. One day, depressed over many years and tired of talking about my childhood and depression with counselors, I impulsively went to the airport in San Francisco and bought a ticket to fly to Los Angeles, where I rented a car and found a hotel for a few days. I had it in my head that the UCLA Medical Center was the best place to go on the West Coast, and I wanted my head fixed, no matter what the cost.

I was petrified. I didn’t know what my problem was, why it wouldn’t go away or what to do about it, and I didn’t have the vocabulary to describe it. Was there something permanently wrong with me? Were they going to give me bad news, telling me there was nothing they could do to make me “normal” like I assumed everyone else on the planet was? I was sure I had Stage 4 brain damage.

I booked an appointment with the chairman of one of UCLA’s psychiatric departments, figuring he’d be good. That feeling ended about two minutes into my meeting with him.

The first question from the psychiatrist, which I will never forget: Was my check good?

I must have looked perplexed as he explained that people with mental health issues often have financial problems, but I was contemplating why he was asking this now. What would he have done if I’d said, “No”?

I did my best to reassure him that my bank account was indeed in order. I was so desperate I was ready to call my bank on the spot to confirm the funds in my account. So much for bedside manner. I don’t recall much of the conversation. He mumbled a lot and didn’t use my name once. He gave me a medication that made my symptoms worse. I never went back. The check cleared.

Still depressed about life in general, two years later, I found myself sitting across from another psychiatrist — one of many — hoping he would be The One To Fix Me. He was roly-poly and looked like Santa Claus with a long, white beard. He was kind, the first one to offer me tea, and said several times that he was a retired pediatric psychiatrist who had worked at length on a Hawaiian island with native children and he wasn’t sure he could help me, a 25-year-old adult.

I don’t remember much of my conversation with him, either, except that I felt comfortable talking with him. He didn’t wear a tie or ask me how my bank account was doing, and we met in his living room. He had no private practice, I had no insurance, and no money was paid; he was just helping me out on a one-time basis. I was so miserable, I begged him to talk to me until he reluctantly agreed.

“Psychiatric problems,” he said at the end of our discussion, “can be complex. A lot of doctors won’t admit to it, but they diagnose by medications. They try prescribing one drug, see if it works, then another, until they find something that helps. Then they know what the problem is.”

At the end of our talk he did something no other doctor had done: He sat for a good, long while without speaking. Finally he said he had a gut feeling, but he wasn’t sure. And given that he had a big gut, I hoped his feeling was just as big. He asked if I had heard of manic depression. I had not. The medication he then suggested became my life’s miracle drug: lithium, a daily insulin of sorts for bipolar disorder.

“If it works,” he said, “it’s going to work fast. Then we know what your problem is.”

Seventy-two hours and 18 lithium pills later, my life changed. I didn’t know anything about how or why, but they finally gave me what had eluded me for 10 years: peace of mind. I finally could stop living with a brain that some days felt like raw eggs in the blender and others like a widow overwhelmed with grief.

They say compassion and empathy can be taught. It also has been said that patience can be learned. I’m not necessarily convinced about any of those. That doctor with a beard and a gut feeling was so kind and congenial. He showed me that psychiatrists can be warm, endearing and truly helpful.

Two doctors. Two experiences. Two memories to live with.

Kim Palchikoff is studying social work at UNR and writes about mental health. Her Facebook page is NVMindsMatter.