Posted by SLS on November 16, 2000, at 20:28:15
In reply to Re: Interesting site: Skeptical Psychiatrist..SLS, etc, posted by JohnL on November 15, 2000, at 5:02:17
Hi John.
How are you?
I would prefer that you address first this question in any reply you may post.
:-)
> This pdoc's insights are interesting. I personally do not appreciate doctors however who take one-sided views of things. I think that's more appropriate in politics but not medicine. Sometimes doctors, like this one, get the two confused. Just my opinion.
Mine too.
In clinical medicine, I am not a big fan of "schools-of-thought" or "philosophies". These are the politics of intellect. They produce a reduction in the eclectic approach that I deem as currently necessary to heal people.
> It seems to me that the doctor's job is to get the patient well. The purpose of a phsycian's job is to use whatever tools he/she has available to end the patient's suffering. Pure and simple. Right?
RIGHT!!!
> If a doctor can do that with pschoanalysis, fine. If a doctor can do it with pills, fine. If one is not working, revert to the other. And vica versa. If conventional psychopharmacology is not working, revert to the Jensen method. If the Jenson method is not working, then revert to conventional techniques. Whatever works. If one tool isn't working, use one of the other tools instead. For any doctor to rule out the use of an available tool is negligent, egotistical, and political in my mind. If they rule out any tools, they have forgotten the entire purpose of their chosen profession. That's just how I see it.
Me too.
> My favorite pdoc, now retired, had this open-minded approach I really really appreciated. He really didn't care what drug or what counseling technique would work, just as long as we eventually found something that worked. Why or how it worked was unimportant to him.
I agree with this when it comes to general clinical practice. CLINICAL medicine is an art, not a science.
> On every visit, he always told me the same thing, "This is as good as anything else.
In my opinion, the current state of clinical psychopharmacology allows for educated guesses as to which treatments have a more favorable potential for efficacy in a particular case and which have less. Even without any source of state-of-the-art information, a good clinician has a basis for choosing one treatment over another based upon his clinical experience.
> "Anything's possible." How true that is, at least in my opinion anyway.
In my way of thinking, not all things are possible.
> He clearly understood the role of his profession...get the patient well utilizing all the tools at his disposal.
Given my experiences in life, this is crystal clear to me as well.
Hopefully, he will do no harm (from the Hypocritical Oath). Medicine, like many other human endeavors, is best practiced with caution.
> The skeptical pdoc's theory of downregulating serotonin receptors makes sense.
It makes sense to me too.
> But I remind myself, it's just a theory. It is no better and no worse than any other theory.
I strongly disagree. All theories are not created equal.
My theory as to why I am able to read this is that there is an expulsion of graviton-compressed spider eggs, the mean diameter of of which is no larger than that of the strange-quark, from the phosphor elements of my video screen; small enough to penetrate my cornea, yet energetic enough to stimulate my rods, and to a lesser degree, my cones (this accounts for why the text appears to me as black and white), the source of which is a wolf spider nest formerly located on an Earth in an alternate universe that was sucked up by a worm-hole and transported into the video-card of my computer.
> It's just a theory.
Yes it is. Prove me wrong.
> The idea that the brain can readjust itself makes sense.
That it does so is a fact.
> My Grandmother suffered a 7 year long depressive bout (7 years, think about it) that suddenly remitted on its own. Poof. All gone. No reason. Just happened.
This is why current psychiatric medicine refers to a bout of depression as an "episode". Very often, an episode resolves without intervention. If episodes recur, the medical term for this scenario is "recurrent depression". This is not at all unusual.
> But to think that everyone's brain is capable of readjusting itself in every case I think is far fetched.
If you mean that not everyone's brain is capable of readjusting itself without intervention is obvious. If you mean that not everyone's brain is capable of a plastic adjustment (good or bad) resulting from its exposure to a specific psychotropic, I have yet to read of a single instance of this.
> Clearly it seems to me that many people's brains are not capable of self adjusting in a degree substantial enough to make a difference. Some yes, some no. Regardless of how psychotherapy of psychopharmacolgy work, they can both dramatically speed up the process. Why take endure 7 years of pain when it's possible to feel better in 2 or 4 weeks instead?
Yes. (sigh)
> There are no clear answers, no fool-proof theories, and no sure-fire remedies for everyone.
Yes. (sigh)
Thanks for your wonderful post.
Sincerely,
Scott
poster:SLS
thread:48803
URL: http://www.dr-bob.org/babble/20001115/msgs/48933.html