Finding the Right Doctor - A Memoir Excerpt
In this blog entry, I describe one of the visits to see Dr. Tarnoff, a pdoc I reluctantly stayed with for five years, even though three years into the sessions I toyed with finding someone else.
Next month, I'll post an entry about my first meeting with Dr. Altman, the psychiatrist who engineered the successful drug switch I was so afraid to execute with the other guy.
My contention is that a placebo effect could be at work: I didn't trust the first guy, so how could I believe a cross-titer would work out?
Having the right doctor means everything.
You shouldn't settle for less.
After the compare-and-contrast memoir excerpts, I'll talk about this in more detail.
Dr. Tarnoff's office was in a run-down building on East 32nd Street. He had a tiny room with a lithograph on the wall, done in ink strokes. While he analyzed me, I analyzed the painting. Ever since my first visit, he'd pushed me to switch to an "atypical" drug because there's less risk of tardive dyskinesia, an involuntary movement disorder where people smack their lips uncontrollably, a possible side effect of long-term Stelazine use. I refused, because I prized my rational mind, and though I have a beautiful face, I was willing to take my chances.
Dr. Tarnoff wore polyester pants that looked like they came from a Haband advertisement in Parade, the Sunday news magazine insert. His shirts were permanent press. I first began seeing him when I worked at a law firm library during school, and his office was only five blocks away.
At the end of every visit, he closed with his own version of a "doorknob": he either asked me, "Are you in a relationship?" or "Do you want to switch meds?" The atypicals could make a person gain thirty, forty or even fifty pounds or more. He claimed Risperdal had less of a chance of weight gain, but I wasn't so sure.
"How are you?" He began every session.
"Fine. I've decided I want to write a book about my life, so I've joined a writing workshop. I fear it will bring up long-buried feelings."
"All the more reason to try a new drug." He nodded his head.
"I'm afraid I'll have breakthrough symptoms."
"We could do it slowly, tapering you down on the Stelazine and raising the Risperdal over the course of two years."
What part of no didn't this guy understand? My original drug halted the delusions and paranoia, and ever since I'd gotten out of the hospital the second time, they haven't returned because I took the meds every day, as prescribed.
The picture on the wall looked like a cow or bull, it was hard to tell, and reminded me of the 1960s. I could probably sketch something better than that, even though I haven't picked up a pencil in over ten years. Yes, I would like to do my art again.
"Maybe next month. Not now," I suggested, with no intention of taking him up on the offer. He had what looked like bits of clam on his beard.
He took up a pen, opened my chart, and loudly verbalized what he was writing down: "PATIENT IS TREATMENT-RESISTANT. REFUSES ANY SUGGESTION OF TAKING A BETTER MEDICATION."
This didn't scare me. I asked him, "Do you believe it's possible for other people to do as well as I'm doing?"
"Well now, I can't say." He stroked his beard; there was no longer any clam on it.
I've put him on the spot. More likely, he doesn't want to answer the question, even though he could. Dressed in black, I wore the suit I felt invincible in, that told others I wouldn't budge from my position.
"At some point, you'll have to consider it." He started up again.
The session lasted all of fifteen minutes, and I was glad the insurance paid for it. He wrote out the prescriptions for 5 mgs. Stelazine, and 2 mgs. Artane. I handed him the 10 dollar co-payment, and he set an appointment for two months later. He'd rather see me every four weeks, and I nixed that, too. As I rose to leave, I stole one last look at the picture. I was convinced it was definitely a bull.