Blanche

Blanche

My retirement was only a few weeks away and I was in the process of referring my patients to other psychiatrists. On this day I was meeting with Blanche.  I had been seeing her at approximately 3 month intervals over the past 20 years for treatment of a chronic depression following a hospitalization for a suicidal attempt.  Her affect was always severely blunted and she would look at the floor rather than make eye contact during our brief visits.  She volunteered little if any information on her own.  By her mostly yes or no and frequently mumbled answers to my questions, I was able to determine that she was not experiencing significant side effects from her medication, that she was not feeling sad or suicidal and that she was not experiencing physical symptoms of depression like insomnia, anergia, anorexia, psychomotor slowing, etc. 

I explained to her that I was going to retire soon and suggested that she choose another psychiatrist to monitor her medication.  I told her that two new doctors would be taking over the practices of my partner and myself.  I went on to describe them.  Dr. V was a young man who had just recently completed his psychiatric residency in a prestigious program and was especially well trained in psychopharmacology.  He was outgoing and informal in relating to his patients. He, for example, wore a sweater rather than a coat and tie. Dr. C was in his mid fifties and had graduated from Harvard Medical School.  He was formal and very professional in his dress and manner.  He was soft spoken and some people might find him difficult to relate to, at least initially.  He certainly was experienced, knowledgeable and a competent doctor.

When I asked her which doctor she might prefer there was a long pause and it did not appear she was going to respond.  So I said that based upon the fact that she had done well under my care over the last 20 years and the fact that I was probably more like Dr. V. than Dr. C. she might do best with him. 

For the first time in all the years I had known her, Blanche looked me straight in the eyes and with a firm, measured, clear voice said, “I’ll take the guy with the tie!”

2006