Sunday, September 24, 2006

A Taste of Our Own Medicine?

I'm prone to rumination and a number of years ago, a shrink friend (but not a shrink rapper) told me I should take Zoloft. No one before or since has ever suggested I should take a psychotropic medication and I dismissed my friend's suggestion with the thought that it was motivated by something along the line of misery loves company. You see, my friend had an anxiety disorder for which she was taking Zoloft, and she found it helpful; while I don't imagine she told everyone she met to take Zoloft, I did think it predisposed her to see whatever my issue of the moment was as psychopathology, not just any old psychopathology, but pathology just like hers that would be helped by Zoloft, just like hers.

So we worry that our practice of medicine will be influenced if we're given pens by the pharmaceutical companies. If we're talking about how that free lunch influences us, might we talk about how the doctor's personal response to medication effects his practice? It's common for psychiatric residents to discuss whether it's necessary to have a personal psychotherapy in order to become a psychotherapist. No one talks about how their own responses to illness and treatment effect their own practices with regard to diagnosis and treatment.

Docs are human, I imagine that if a doctor finds a medication helpful, or has a horrible reaction to it, his practice will be influenced. If I've had a rare but extreme adverse reaction, how can I possibly order such a treatment without fearing my patient might have the same rare but extreme adverse reaction, even if the odds of the same reaction might be a zillion to one? Don't we all get sensitized by our personal experiences?

Plop plop, fizz fizz?