While driving to the clinic, Ms. Blue thought about what she would tell her doctor. She didn’t want to come across as needlessly anxious, but she wanted him to understand how unwell she felt. Was there something wrong with her?
Shortly after she was escorted into the examination room, Dr. Distress entered the room.
“Hi, Ms. Blue,” he said. “What’s wrong?”
“Well, I think I might—well, you see, I’ve been really tired lately.” Ms. Blue paused. “My dad died about a month ago. I haven’t been able to sleep.”
“That’s terrible. I’m so sorry to hear that,” Dr. Distress said.
“Yeah, it was unexpected. I guess no one ever expects someone to die, but he was actually training for his first half-marathon. He was running regularly! Eating healthy! The stress of caring for Mom was high, of course, but he was taking care of himself.”
“Uh huh, uh huh.”
Ms. Blue’s face began to distort. Her voice sounded tremulous. “It was so sad to see Mom look at him and have no idea who he was. She’d get up in the middle of the night, insisting that she had to go to work. She hadn’t worked in almost ten years! She’d get so upset when he tried to get her back in bed. ‘It’s okay,’ he’d say, ‘the work will be there for you in the morning.’ He was so gentle with her and she would scream at him, calling him all sorts of names for getting in her way. He spent the last four years of his life devoted to this woman and she had no memory of his efforts!”
The tears collected in the corners of her eyes before spilling onto her cheeks. She tried unsuccessfully to stifle her sobs.
“Oh, it’s okay, it’s okay,” Dr. Distress blurted, his eyes frantically darting around the room for a tissue box. Unable to find one, he abruptly got up and pulled several paper towels from the dispenser.
“Here, take these,” Dr. Distress said, trying to put them into Ms. Blue’s hands. Using the back of her hand to wipe her face, she looked up, wincing.
“I’m sorry,” Ms. Blue said. Another wave of tears came bursting forth.
Dr. Distress began to tap his foot quietly on the tiles. His fingers rotated the earbuds on his stethoscope. He looked at her, looked away, looked at her again, opened his mouth, then said nothing.
“I miss him a lot. And now Mom lives with me and… it’s hard,” Ms. Blue said.
“Yeah, yeah. Yeah, I can see that.” Dr. Distress suddenly stood up and said, “Let me listen to your heart and lungs, just to make sure they sound okay.” His gaze settled into the middle distance as he moved his stethoscope first across her back, then over her chest. After pushing on her belly, he declared, “Everything’s fine.”
“I feel terrible, Doctor. I just don’t know what to do. I can’t sleep, I don’t want to eat—I mean, I am eating and I eventually fall asleep, but I’m tired all the time and I just miss him so much and I want to take good care of her and keep her out of a nursing home but I’ve got to work and—”
“Here, here,” Dr. Distress blurted. He had scribbled something onto his prescription pad, tore the top sheet off, and was flapping it at her, insisting that she take it. “This will help you feel better. You might have some side effects—headache, dry mouth, things like that—but it’ll help you feel better. You’ll feel better.”
Ms. Blue wiped her eyes and looked at the prescription. “What is it?” she asked.
“It’s an antidepressant. It’ll help you feel better. Just try it. Come back in a month and we’ll see how you’re doing.”
“Um, okay,” Ms. Blue said. “I’m sorry that I cried. I’m just—”
“It’s okay, it’s okay, you’ll feel better, it’ll get better. I’ll see you soon, okay?” He walked to the door and began to open it. She quickly wiped her face again and took a deep breath.
“Okay, good-bye,” Dr. Distress said, walking out. In the hallway, he heaved a huge sigh of relief.
She walked out of the office, feeling tired and embarrassed. What did he give her again? Oh, she could look at it later. She just wanted some time alone.
“Recurrence of leukemia… new diagnosis of HIV… hospitalized for complications related to diabetes… father passed away….”
Dr. Distress was going through his charts at the end of the day. He sighed again. Ms. Blue looked so sad. What could he possibly do to help her? It was so hard to see her cry like that. He was relieved that she left when she did.
This is part of a series about why some physicians write many prescriptions for psychiatric medications. You can read more stories here.
Maria Yang, MD 