“Doctor Jimmy and mister Jim
When I’m pilled you don’t notice him,
He only comes out when I drink my gin.” Pete Townsend

What makes a good psychiatrist? I know the answer.

I am certain that I have been in the care of more than a dozen psychiatrists. Some for very short periods when I have been a patient in psychiatric wards in hospitals. Others for years. I have suffered from bipolar for over thirty years, so I have gotten to know my doctors pretty well.

Technical ability is a good asset but definitely not the most important quality. Treating mental illness is not like going in for heart surgery. For a heart surgeon, I’d like one with the most skill, ability and knowledge. The hours I’d be in a surgeon’s hands during the operation would be a matter of life and death. A psychiatrist is somebody who helps a person over an extended period of time and thus the analogy fails. The skill sets for a surgeon don’t match the skill sets for a psychiatrist.

Even though mental illness is extremely complicated, exactly what is going on in a patient’s mind chemically is not as important as it may seem.  Psychotropic drugs are really a trial-by-error process. While it is important to know about drug interactions and side effects, such knowledge is not as complicated as it was before today’s computers. Correctly diagnosing an illness is important but often the treatments and drugs used in rehabilitation are similar.

The most important qualification for a doctor is that he (or she) cares for you as the patient as a person. That he will go over and beyond the call of duty if the necessity arises.

My first doctor was an awful doctor, all our visits were all identical. “How are you doing today?” he would ask. “Fine, can I get out yet?” was my reply. “Not yet,” was his answer. The less-than-one-minute interaction was all that happened. So when sixty days later I was released, I didn’t bother to see him in his private practice. After all what good would it do me? Another thing that bothered me is that he refused to shake my hand. However, when I was released he finally acquiesced and shook my hand. I found that offensive and dehumanizing.

Another psychiatrist saw me only once every six months. I was going to college and found this quite convenient. Unfortunately, once I graduated I switched medicines. When things were going wrong I gave my doctor a call. His answer was simply to adjust the dose. He didn’t bother to schedule a visit, let alone put me in a hospital. His lax care was an extreme detriment.

I have found good doctors who have cared about me. Those who take a personal interest in my life. Those who wanted to me succeed in life and prosper.

Doctor G, was definitely one of them. On the outside he acted like a bumbling fool in a comedy skit. At the start of every session he would search for my blood test and never have it. Then he would buzz the secretary, which was his wife, complaining that blood test results weren’t in my chart. After a couple of minutes the blood test would be delivered.

Still Doctor G was a great help to me. He took time to explore my mental illness. In particular, the ‘warning signs’ as to when a fit of mania was approaching. Symptoms such as surges of energy, fewer hours sleeping, grandiose thoughts, fixation with religion. It is a tool I still employ now almost thirty years later. I recall that Doctor G sent me a card congratulating me when I graduated college. He saw my photograph in a local newspaper.

While other doctors haven’t perhaps contributed so dramatically others also took a personal interest in me. They would spend the time when necessary. I know some psychiatrists are overloaded with work and will cut visits short. But if you need the time and they can’t deliver to fill your need, then there is a problem.

I’ve seen good doctors and I’ve seen bad doctors. For a mental patient it could be a matter of life or death. A doctor who cares develops a relationship with his patients where trust can grow.