Why do smart women do stupid things?  That is the (eternal) question.  Or am I really not very smart and everyone throughout my entire life has just planned a big conspiracy to humor me and make me feel like I am?  Going back to the Greeks, when Plato and Aristotle wrote things (what are now books) which you weren’t “supposed” to be able to understand in school without the help of your Philosophy teacher, but I read in my teens, on my own, and understood perfectly well.

And this isn’t even me being stupid over a guy.  Not in the traditional sense, anyway.

I had my day of neurocognitive testing at the beginning of September.  I have a follow-up scheduled for next week, to discuss the results I got in the mail today and just went over.  I knew, I knew when it was taking the doctor a month-and-a-half to send out a report to me, instead of four weeks, that he was having trouble with my results.  I thought he was just trying to be thorough, and perhaps he was.  But what he sent out to me was instead thoroughly unhelpful and upsetting.

In eight specific areas of testing, I was noted to be “mildly,” or more often “mildly to moderately impaired” twelve separate times.  I knew it would be bad, but this is what they deal with, so obviously they have some kind of reasoning for a causal agent and a direction for improving my functioning, right?  That was the whole point of me doing this.  I already knew I was having problems, or I wouldn’t have undergone the testing.  I wanted to know why and how we could improve it.  Expectations not met, not even marginally.

I quote, “The etiology of the patient’s current pattern of neurocognitive deficits is somewhat unclear at this time and may be multifactorial in nature.”  The rest of the summary says that my “complaints seem to be out of proportion” to what the tests came back with.  Does it never occur to this man (the doctor) that perhaps that has something to do with the fact that two years ago, before the ECT my brain was much more highly functioning than it is now, and I have that as a frame of reference, whereas he just met me?  I’m not upset about the way my brain is functioning compared with the average person’s, I don’t have any idea how the average person’s brain functions, as I don’t live in it and depend upon it daily.  My complaint is that my brain is not functioning in any way like it used to.

He goes on to surmise that my issues arise from “. . . a variety of potential etiologies, including psychiatric symptoms, medication side effects, chronic pain (including migraine pain), and sleep difficulties.”  Nowhere does he account for the fact that I lived for years with all of this without experiencing any issues with cognition.  He then makes the cogent and always greatly appreciated observation that I need psychiatric care.

Apparently his cognitive functioning, memory, and recall are more than a little impaired, as I told him that I was in the process of transitioning between psychiatrists, not that I had ceased to see one.  I would have to fall into the category of severely impaired not to realize that I need continuing psychiatric care, and will for the rest of my life.

I don’t know, I suppose I’m just extremely upset because I’m still trying to negotiate my way out of this minefield of a mixed episode, and after our initial meeting, I had a favorable impression of the doctor.  I was dumb enough to believe he had a good grasp on my specific situation, and further I thought he would actually try to take the time to figure out what was wrong and provide constructive solutions – and maybe he did initially, but when he hit the wall the doctor/God complex kicked in and instead of simply saying “I don’t know,” he had to write it off as a laundry list of other things that didn’t undermine him and his “expertise” in any way.

But you had better believe that I will go in next week with a million questions and demands for explanations such that he’ll wish he had copped to not being able to figure it out to begin with.  I won’t do it out of vengeance or pettiness, I’ll do it because I need to know all of the finer points of the situation.  I’m on my own as far as how to proceed with this, which was a conclusion I had reached once the time stretched and I realized there was no way they were going to be able to classify me, nor stick me in their comfortable little boxes.  And being on my own, I will pick every morsel of information I can from that doctor’s brain, so that I can figure out what best to do with it and where I go with myself next.

And if I can get him to admit that he really doesn’t know, more’s the better.  I would have so much more respect for doctors, and dislike them so much less if they could just man (or woman) up and confess to it when they don’t have the answers.  I never in all of my life believed that doctors were super-human or gods, not even as a small child.  To me saying, “I don’t have an answer for this,” doesn’t hurt my opinion of them, actually it usually improves it considerably.  So few are willing to admit it when that is the case.  My PCP will, which is a major reason why I’ve stuck with him all of these years.

But I guess we’ll see next Friday how impaired this doctor thinks I am.  Generally when I go in prepared, both guns blazing, doctors quickly realize that not just giving me a straight answer in the first place was a big, big mistake.  Ain’t no one knows how to get a person to admit they screwed up like I do.

Moral of the story:  We live in a world where doctors are automatically accorded certain privileges and respects simply because they made it through medical school.  A great paradigm shift needs to take place here, and if I have to dedicate my life to being the impetus for it, don’t think for a minute that I won’t.

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