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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by wacky on August 1, 2006, at 8:18:38
In reply to Re: YAWNING/Wellbutrin dose too high, SE seizures, posted by Kay Vetter on July 28, 2006, at 11:51:56
Back in 91-2 I was hospitalized and had a very hard time disconnecting from my "professional" image to one of a patient. At the time I was working for the child abuse unit representing social workers in dependency cases. Then I became their patient in a psych ward - and it was VERY hard to overcome my own image problem - switching hats like that.
I too experienced a backlash from my employer due to the stigma associated not only with mental illness, but being "locked up." This competent attorney had a glich - and wasn't stable. Eventually I just left the office - and launched a private practice career. Fortunately for me - I was successful. But I can certainly see where others might not be so lucky.
Just thought I'd share that.
Posted by kylenn on August 1, 2006, at 8:18:39
In reply to Re: YAWNING/Wellbutrin dose too high, SE seizures, posted by wacky on July 31, 2006, at 15:59:48
Could not have said it beter myself!
I had to face nurses as a patient (a "crazy" patient) that I had recently and frequently given orders to!
Later, I had to sit with all the psych patients while a guy I went to med school rounded on his psych patients. Thank God I was not "assigned" to him! I have never been so humiliated in my life.
The Backlash against professionals with mental illness issues apparently is not isolated to medicine!
And, I really, really have a problem with it.
I was, essentially, (and I suppose you were too) punished for being sick.
Lost my job, my house, my reputation, my community standing, respect of my colleagues,
went bankrupt, was turned down for a Texas Medical license 18 months after my SA because,
despite what my treating psychiatrist adamantly felt (as, of course, did I--that I was in remission from my depression) that I was...
what was the wording? That the episode of major depression was too recent for them to give me a license.
So, great, another feather in my hat of shame.You know, that is something I am supposed to report. But, they did (so nice of them) allow me to "withdraw" my application for a license which legally, according to my atty, means I never applied, so I guess that is wiping the slate clean? Who knows.
In Iowa, they were going to give me a license==providing I did 5 (FIVE) years of piss tests and being monitored by other physicians and seeing a shrink for 5 years, with no guarantee at the end of 5 years that it would be lifted.
It would, however, have been a private order, not reportable to the NPDB (Big Brother over physicians)My biggest beef when I went thru all that **&&%E
was that they were trying to label me a drug addict.
I have never been, and most likely never will be, addicted to drugs.The only meds I was taking at the time of my SA were the ones that had been prescribed (Zoloft, Zanaflex, Ambien, Toprol (for MVP) and PRN Xanax (1/2 mg/QHS--very tiny dose)
I had been refilling them myself (instead of calling my PCP for the refills) mainly because it was easier (I had nothing to hide!)
The fact that I tried to OD on my meds does not make me an addict.
They also tried to say that since I had been mentally checking out at night (to get away from the stress; at the time, sleep was my only escape, so I took my pills as soon as I had had a shower and left my 18 yr old daughter to take care of my 8 year old son if my husband wasn't there) that that was considered "abusing" the meds.
I think it was more an extension of my isolation (which is one of my "red flags" for recurrent depression).
To this day, I relegate most of the evening child care (my youngest is 11 now) to my husband when he is home. I am not the "soccer mom" type, and I do not think that is something I should be judged by.
The other issue I have is the overdiagnosis of bipolar disorder. They tried to DX me with that, as well. I had kind of gone along with the DX as an outpatient before my SA, as it wasn't affecting me in any negative way. The quack that was my shrink at the time was trying to convince me I had bipolar II disorder (although I had never had a manic or hypomanic episode) I think because I had told him that when things went well for me for several days in a row, I started to get a feeling of dread, waiting for "the other shoe to drop" and I suppose he thought that meant I was cycling??!! What an idiot. Of course, when I ended up in the hospital, the shrink there moved it up to Bipolar I because apparently, any Bipolar II that gets a psych admit automatically gets "promoted" to Bipolar I!!
Now, let me tell you, trying to prove a negative is nearly impossible. And I had to prove several negatives: I was NOT an addict or a drug abuser, I was NOT Bipolar II and therefore, not Bipolar I!
I also had to convince them ( the twenty or so mental health workers that I saw during my hospitalization, and the forensic evals) that I did NOT have PTSD, or Borderline Personality Disorder! Not a pleasant or easy task, I assure you. I am certain there are some (arrogance?) that still believe I am one or the other, but when I went before the Louisiana Medical Board to defend and keep my LA medical license, I was able to stand there and tell them that my diagnosis was Major Depression Disorder, recurrent, in remission, and that's it.
Not that that's not a big deal, it is.
But I can handle a label that I agree with, not ones that I adamantly disagree with.
Oh, the Iowa people wanted me to go to AA and Cadaceus Meetings as well.
Can you imagine sitting there in an AA meeting and saying, Hi, my name is X, and I am an alcoholic and drug addict... when you are not?!!
I would never have been able to stand all that smoke, anyway. (They smoke non-stop in those meetings. I had a boyfriend in the 1980's who took me to some open ones.)
I wish there was some way to turn around the current mindset towards mental illness in the medical community. Just because a person is depressed (and in my view, even if it is untreated) does not mean that they are a "danger to the public"
Depression (as a diagnosis) does not predispose a person to negligent or harmful behavior. That is more the domain of Antisocial Personality Disorder, or Paranoid Schizophrenia, and perhaps, psychotic Bipolar Disorder.
I think, generally, the personality disorders are worse since they are the most difficult to treat.
Additionally, if the Medical Board feels the need to get involved when a physician has a diagnosis of a mental illness, it should be kept private (not public information reportable to the National Practitioner's Data Bank as mine was) as long as the person is compliant with the regimen and recommendations of their treating physicians, and once released by their psychiatrist, the Board should not require continuing psych care as long as the physician's DX is in remission.
Posted by wacky on August 1, 2006, at 12:17:46
In reply to Re: YAWNING/Wellbutrin dose too high, SE seizures, posted by kylenn on July 31, 2006, at 20:32:08
Wow - they sure did put you through the ringer!!! What A***holes. I didn't have nearly that horrific an experience. But I sure did get the humiliation from switching from lawyer to patient. If I hadn't known anyone at the hospital (the therapists that is) it would not have mattered. But there were several social workers who worked part time at the hospital that I represented - AH HAH !! There's my lawyer - and she's a patient! Good God. To top it off - I was CRITICIZED by them for having my EGO be in the way!! Hello you idiots! It's a perfectly normal and expected response to react negatively in such a situation.
At the time I was so depressed it just made things all the worse. Needless to say - my opinion as to the benefit of hospital stays is not high on my list.
Posted by kylenn on August 3, 2006, at 19:53:25
In reply to Re: YAWNING/Wellbutrin dose too high, SE seizures, posted by wacky on July 31, 2006, at 15:59:48
I just want to emphasize that my depression caused me significant difficulty in my profession.
I am still under a "consent order" by the medical board; which stipulates that I see my shrink (and I have been on "prn" visits since '04, this ruling was in July '05); nevertheless, I must maintain a relationship with my psychiatrist due to the consent order because he has to send a bi-annual status report to the board.
This information is also available to the public; this is my personal medical information, now.
I am VERY opposed to any joe bloe being able to look up my name and contemplate my "mental illness" This information, by the way, is permanent. It will never go away. No matter how long I am in remission, this information will be public knowledge for anyone who is curious, or just lacking a new gossip topic.
They (the medical baords) expect medical professionals (especially physicians) to "self report" mental illness. Now, tell me, why would anyone in their right mind (pun intended) want to do that? Basically you end up placing your career, your livlihood and your reputation in the hands of 10 or so complete and dispassionate (and perhaps even sadistic) strangers, usually a mix of lawyers, laymen and turncoat physicians. The reason why this is so horrible is that the medical boards are the "self police" of the profession. It is their job to make sure that the public is not endangered by impaired physicians. I can understand the basis for it, but just like any other similar agency, it is terribly flawed. For example, in my own state, physicians with drug addictions that get "caught" are allowed a "first pass" through the system, essentially, the fact that they are "impaired" can be kept private the first time (but not the second time) they are "busted". However, for depression or any other mental illness (in their book there is no difference between paranoid schizophrenia and depression--no gray at all just stark white and midnight black)
There is NO "first pass" option. I found this out the hard way, and I was wishing I had just been a drug addict (and I told them this sad but true fact). In fact, I was essentially initially in the "first pass" pathway, until I convinced "them" that I was not an addict, that my overdose was completely a symptom of my depression. After I convinced them of this fact, I was informed that since I was not a drug addict with depression, but was just a depressed person who took too many pills one night, I would not be allowed the "first pass" and I would automatically be publicly punished for my offense. In other words, if my MAIN diagnosis was drug addiction and my SECONDARY diagnosis was ddepression, it would have been kept private, and not reported to the various agencies that all have beaurocracies (sp?) of their own.
As far as "endangering the public", any one who has ever experienced a major depressive episode can attest to the fact that hurting another person is the last thing on your mind. Most of the time, there is an intense feeling of guilt related to imagined or overblown hurt that you may or may not have caused! The pain is turned inward, without exception.
Additionally, I never, not once, was compromised on the job. I was informed by my physicians that job competency is usually the last thing to be affected by depression; and in my case, I have seen paperwork that I completed THE DAY BEFORE my overdose, and it was completely accurate, concise, and medically sound. I, myself, was amazed to read the things I had written; I could see no hint of the inner turmoil I was experiencing in the notes on patients (and these were extensive notes) I made on that day (or any other day for that matter).
I have survived the worst of it, and am now back at work and in remission from depression for over 2 years now; but I am always wary of how easily my life could change.
I just wish there were some way to really end the wrong way physicians are handled with similar problems that I have had.
More physicians would get treated if there were no serious repercussions to their careers/income/livlihood/and reputations by disclosing (and therefore getting treatment for) their illness. It is said that the number of suicide attempts among female physicians is 20 times higher than that of the
females in the general population. Therefore, there may be 20 times more depressed female physicians than there are depressed female non-physicians.
If the incidence of depression in the population is approximately 2%, that would mean nearly half of female physicians will experience depression?!
I know that the number of "impaired physicians" is listed by the reporting agencies at around 1%. How many physicians out there, then, are depressed (or have some other undiagnosed mental illness) but are not getting treated (or treating themselves, as I was, for the most part)?
Even if the number is not 39% (of untreated mentally ill physicians) which does seem high, why should ANY physician go untreated??
Because to admit it , at this point in time, is nearly career suicide. You do not go to school for 23 or more years just to throw it all away because you suffer from depression. You keep it to yourself, if you are smart, and deal with it in secret. Getting "caught" being depressed is the worst thing that has ever happened to me.
I am glad to be on the other side of this experience, now though. But I sure do not think it should have taken nearly 3 years, with 2 of those years being out of a job and spending over $30,000 jumping through hoops for the various boards.
I filed bankruptcy in 2004, and my mother went through over $100,000 over her retirement money in order to help me through financially during those two years that I had no income (I also had 3 kids to support!).
I love medicine. I don't think I could do anything else (and there are not many jobs out there for physicians who can't practice medicine.
Try getting a receptionist job or a retail job as a middle-aged MD. Wouldn't that raise some eyebrows. You'd have to lie and as a female, I could say I'd been a housewife all these years but my husband left me/ died/ or became disabled and that is why I am 44 and applying for a job at the factory.
What would a male say?
Anyway, if there is anyone out there with any ideas about how to fix this, and especially anyone in some sort of position with some political power, I wish someone would take a serious look at this.
I am not about to make any noise, I am towing the line. Once I get a few years out from this, I might risk speaking out publicly, like at some kind of conference in front of other physicians.
But right now, I am going to lay low.
My tail is tucked for now.
But one day, maybe my experience will help someone else. I wouldn't wish what I've been through on my worst enemy.
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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