During the drive to the clinic, Ms. Blue thought about what she would tell her doctor. She didn’t want to come across as whiny, but she also wanted him to understand how she felt. Maybe he could give her something that would take the discomfort away.
Shortly after she was escorted into the examination room, Dr. Fixit walked in.
“Hello, Ms. Blue,” Dr. Fixit said. “How can I help you today?”
“I’ve been really tired lately.” Ms. Blue paused. “My dad died about a month ago. I haven’t been able to sleep.”
“Sorry to hear that,” Dr. Fixit said.
“Yeah. My mom has dementia and he was taking care of her. Since her memory has worsened, we’ve helped each other out. He and I were really close. Since he died… well, I’m not sleeping, I’m tired, I’m not eating, and there’s a lot of stuff I have to do, like take care of Mom. Is there a pill I can take for all of this?”
“Can you tell me more about how you’ve been feeling? Hopeless? Depressed?”
“Depressed? My dad just died. I think it’s normal to feel not so great when that happens. Look, I’m getting over it, but I need to feel a little more energy, a little better. Maybe you can give me an antidepressant for a short while?”
“Yes, some people find antidepressants helpful, though I’d like to know more about your symptoms—”
“Doctor, I appreciate that, but, really, my dad just died and I don’t want to talk about it. I just want to feel better. If there’s a medicine that can help, I’d like to try it.”
Dr. Fixit searched her face for emotion. She looked back at him blankly.
“I understand, but I do need more information. Have you felt hopeless about this? Crying a lot?” he asked.
“Nope.”
“Are you eating?”
“Like I said, not much.”
“Have you lost weight?”
“I wish.”
“Have you had any thoughts about wanting to be dead?”
“Nope.”
Dr. Fixit wrinkled his brow.
“Given what you’ve told me, you might find it helpful to talk with someone about—
“—but I’m not interested in that. When people have the flu, you don’t ask them to talk about it, right? You prescribe whatever it is that you prescribe to treat flu so that they’ll feel better. I don’t feel good because my dad died. I don’t want to talk about it. I just want to feel better so I can get stuff done.”
Dr. Fixit searched her face again. “Right,” he finally said. “But let me listen to your heart and lungs, just to make sure they’re all right.” 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 said, “Everything seems fine.”
After writing something onto his prescription pad, he handed the top sheet to her. “This is an antidepressant. It takes a few weeks for the effects to kick in. It may take less time, it may take more. Some people have problems with dry mouth, feeling sleepy, stomach upset, and sexual difficulties, like a longer time to climax. I’d like to see you in a month to see if things are better.”
“Great. Thanks for the medicine. I hope it helps,” Ms. Blue said, collecting her things.
While walking out of the building, she checked her watch. She hoped that there wouldn’t be a long line at the pharmacy.
Later on in the day, Dr. Fixit pulled Ms. Blue’s chart from the file and reviewed his notes.
It’d be nice if more patients were like her, he thought. They know what they want and they don’t go on and on about their problems. Maybe she’ll even be one of those people who responds to antidepressants in a few days.
After scribbling his signature on the note, he closed the chart and tossed it onto the others across the desk.
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 