[lenjan]

I put the trigger icon on because the link I'm giving talks about suicide. But I'm posting it here because I'm furious with the psychiatrist who's quoted. He works at the same clinic my now-former pdoc does, and I have spent many hours in waiting rooms with many of his pissed-off patients. He schedules appointments for 15 minutes and basically runs a factory. My pdoc told me once that at the check-in window of the clinic, out of sight of the patients, the receptionists actually have a board saying "Dr. Burgarino is ____ minutes late," and keep updating it as he gets farther and farther behind. My old T hated him too. I don't know how he gets any business!

I thought this was unconscionable:

</font><blockquote><div id="quote"><font class="small">Quote:</font>
Burgarino, the psychiatrist, says he can understand the friends and family feeling grief. But he feels no remorse. Nor does he think anything could have been handled differently.

"Life is a gift," Burgarino said. "It is fragile. At the end of the day, bad things can happen regardless of the greatest vigilance. Charlie had a very tight safety net. Unfortunately, it could not hold him."

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HOW CAN HE FEEL NO REMORSE?!?!? It took me a solid MONTH to convince my pdoc that it was not his fault that I landed inpatient a couple of years ago, and that he needed to quit second-guessing himself. He would have been devastated if something had happened to me. (His office is on the grounds of the hospital, and on the way over he kept telling me how relieved he was that I was going, and that he should have insisted I go a couple of weeks earlier.) How is it possible to care so little about a human being's life in your care that you feel no remorse?!

Here's the link to the whole
story if anyone's interested. The reporter's sister killed herself years ago and Meg has dedicated herself to writing about mental health.

Sad story. I know when I was switching medications (getting off Lithium due to kidney problems) I was watched very closely & my provider saw me every week until I was stabilized. She also told me to call her any time I started to feel suicidal or manic.

The trouble is sometimes you feel so badly that you don't think you are worth bothering someone with a phone call. You think people would be better off without you & you see no end to the pain.

My mother committed suicide & I always wondered why they kept letting her out of the mental hospital when I was growing up. I knew she was bad off, how come the docs didn't? My dad finally started the process of having her involuntarily committed, but she killed herself before that was done.

This doc doesn't sound very caring. I can see how a doc can get burned out dealing with all the patients with mental illnesses. They are human, too. The family also needs to be educated & perhaps having a family member staying with him during the time of his medication change should have been brought up. --Suzy

[Perna]

I don't know. I agree he's not a nice guy but it isn't his fault his patient committed suicide! That's what remorse is, "an emotion experienced by one who feels they have committed an action contrary to their moral code." He didn't do anything wrong and that is the point he's making. His moral code may not be very deep. . . I'll grant you that. I don't think in an investigation he could have talked about his sadness (if he had any) it would not have been appropriate there. All he's saying is that he isn't a murderer, not that he isn't unhappy that the patient did what he did.

[(JD)]

(((candybear))) It is such a tragedy.

I don't think getting yourself so angry is the best thing for YOU though.

It would be difficult to support the actions of the psychiatrist if it were out of the ordinary. MOST psychiatrists only allow 15 minutes per patient, just for meds checks, script writing... rare is the one who counsels.

From the article:
</font><blockquote><div id="quote"><font class="small">Quote:</font>
But no one suspected that his fears would lead him to kill himself

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How can one person be held responsible when NO ONE??? thought he would have such a problem?

</font><blockquote><div id="quote"><font class="small">Quote:</font>
He had talked to Murray 10 days earlier and Murray had seemed fine, Burgarino said.

</div></font></blockquote><font class="post">

IMO most patients would be pleased with speaking to a psychiatrist this recent.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
Still, Murray's friends and family and his psychiatrist say that he showed no signs of being suicidal.

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Ok, here is a guy who is gad about town, friends, family and none of them suspected...how much closer can you monitor a guy and for how long???

I'm confused that he died from a 3 story fall... doesn't sound like suicide to me at all.

BUT WAIT THERE'S MORE: </font><blockquote><div id="quote"><font class="small">Quote:</font>
Murray's sister said she began getting more frequent and frantic phone calls in the few days leading up to his death.

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Perhaps the sister is throwing blame that she feels (inappropriately) herself? Did she call the doctor? The police? His friends? SHE KNEW of the agitation...the doctor did not.

I would like a better statistical quoting... first "Statistically, Murray was a prime candidate for suicide." How does the writer conclude this?

" Only about 1% of the general population commits suicide."

"But between 30% and 40% of people who are diagnosed with schizophrenia attempt it." This states they ATTEMPT is does not follow with how many complete.

I don't think a fall from a 3rd story window really is much of an attempt...esp when his home is all set for the holidays. Perhaps he fell by accident.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
They say that Murray would be alive today if he had been watched more carefully as he made the transition.

</div></font></blockquote><font class="post"> We can't know this. No one can know this... we can only hope this. By making this statement it makes us all upset, like there was something we could have done... and I'm not sure about that.

But it's still a tragedy.

[lenjan]

My pdoc schedules for 30 minutes and keeps you till he's satisfied that you're OK. The second time I saw him, I was in his office for 90 minutes. People were stacking up outside his office, and when I commented on feeling bad about that, he said, "They'll wait. We're not done yet." Often I was there for 45 minutes or an hour, not just the 30 that had been scheduled. To me, that is the humane way to deal with psychiatric patients in crisis!

[(JD)]

Oh yes, that's true...but MOST psychiatrists do NOT do that unfortunately. I'm glad you have someone who really seems to care. I hope you can not worry about the rest of the world all at once... though I know you are a caring individual.

You must take care of yourself first... righteous anger is ok once in a while... but it wears on the soul.

[lenjan]

We'll have to agree to disagree, apparently, because I think those of us who can do it are obligated to stand up for those who can't. My mental health has been in the dumper for weeks, but I'm not (yet) so incapacitated that I can't get ticked off and translate it into action somehow. If we don't stand up for one another when stuff like this is allowed to happen, who's going to do it? I guarantee you it will not be the social service system, and there are a multitude of stories on this site alone of the ways people's families and friends have dismissed their illnesses.

Even if all you do is write a letter to a legislator, it's doing something positive for people who almost always are denied a voice. To me, that's obligatory, but that's just me, I guess. In the meantime, I reserve the right to continue getting steamed about this kind of stuff.

i agree with Sky and Perna.

and frequently a doctor, they're human, may mis-state their true feelings. just because they have so much education and experience doesn't mean that they are always going to do the "politically correct/emotionally correct" thing.

there's a lot expected of physicians and much more of psychiatrists these days. i was married to a surgeon and i KNOW how much was expected of him, 24/7. and i know how hard he worked to fulfill his duties and i also recognized that his emotional life suffered from his committment to medicine. medical school doesn't prepare physicians for the REAL world.

it's wonderful that your doctor kept others waiting while he dealt with your crisis but he can't do that with everyone. otherwise people would be there for days and nights. Pdocs don't just sit in an office, they make hospital rounds and dictate charts, etc. and then they go HOME to a family.

using your energy on being steamed is okay for you but for me, i'd rather think of something kind and positive that i could do for someone who has needs that they can't meet. but then, we're all different...........

[lenjan]

I do one heck of a lot for people who have needs they can't meet, I just don't believe in telling people about it. And I resent your comment, Pat. Some of us don't believe in tooting our own horns.

It' so sad whenever we lose someone to this damn battle. (((CB)))

Take care, em

[(JD)]

Candybear, it appears that you are so steamed over this you aren't thinking and reading straight. That's when it concerns me...when it is affecting your own health.

I didn't come by this information easily. I, too, injured my own health considerably by becoming "steamed" at things that were, well, out of my hands. I had to learn to allow some things to go by, and allow others who truly could handle them to do so...as it would affect my health too negatively. If you are already in the dumps, it does help to accomplish something, I agree. But to keep getting angry over every injustice won't get you anywhere but ill.

None of us can save the world. We each do our part. But when we have mental unwellness already, it does no good to kick against the rocks. Our precious energies and time are better spent elsewhere... yours, perhaps, in funneling that energy into well written articles about injustices??? Something like that maybe?

I had to learn the hard way not to get so upset over unfairness. My PTSD is what caused the hyper alertness and over-the-top reactions. My T is who has patiently shown me how it is ok to not get angry and irritate myself over things I can't change... and to act purposely and calmly (as I can) over the things I CAN change.

No one is assaulting you for wanting to make the world a better place. We just all want you to focus your energy on something that you can make a difference with, imo. TC!

[wisewoman]

Candy, this topic seems to have punched you in the gut what with losing your Pdoc and all. I worked for close to 20 years in a position where I saw people mistreated by a system on a daily basis and I helped them navigate their way through this. It pisses me off more then I can express. Along the way I worked on what I could realistically do and what I would leave undone. I agree about your letter to a legislator or congressman. That is doing something. Maybe even writing the family of the man is a gesture of comfort you can offer. And then I am going to say something I want you to hear as you know my heart and I would only offer a loving hand to you.

Move on and care for yourself and continue the good deeds you do. That is what it's about is how we live each day. We can spread so much kindness, it's catching. Let one car out into traffic and that car will stop and let someone else in. We all suffer. Live is full of suffering and pain. And it's full of what we can share and leave behind. You are leaving love and kindness in your footsteps.

My brother was diagnosed with schizophrenia at 19. He has been a horrid person and lives like a hermit stuffed in the woods. He has no safety net and no quality of life. He actually tore apart his house piece by piece because of delusions. He had guns until someone finally smartened up and took them. His illness has made him into someone I really don't like. But, no one there checks on him or anything. I would check on him if I were there. I would try to let him know I cared somehow. No one gives a crap about him and he suffers tremendously. Your man had a life of giving and loving. How cool is that? I fully expect my brother will murder someone someday and it will probably be a family member or law enforcement. His delusions are so horrific. He has broken arms and ribs of brothers who are restraining him when he is trying to do damage. He has been bound and driven by ambulance on more then a few occasions to the hospital.

I guess what I am trying to say is that we all do what we can. I share your outrage at the lack of a safety net for this man. And we do what we can and try to focus on that. I am happy this man had a loving/loved life with people. He was not alone.

I hope this makes sense. It's hard for me sometimes to communicate the way I wish.

I think it is a hard one. My guess would be that not all doctors are in it for the people. Some people purposely turn to fields like pathology precisely because they don't really need to have much to do with patients. I guess surgeons don't really have to talk to them much. Anesthetolegists (however you spell that) get to have the pleasure of seeing people go go sleep... (And hopefully wake up again). Some psychiatrists see themselves primarily as medication prescribers.

Even if doctors do start out as people people I guess one fast way to turn from a people person to a non-people person is to spend a number of years working for the public health system. Too many people too much need not enough funding. Some of the clinician's I've dealt with in the public system have said some really very terrible things indeed to me... I couldn't work it out... Eventually it dawned on me... They have wait lists up to their necks and there is so much pressure to get people in and walking out with a prescription in their hands as close to schedule as possible. If you are running late then it means that patients are waiting and you don't have to wait for patients. My doctors clinic back home used to be 15 minutes behind schedule on purpose so that the doctor never had to wait for a patient.

I think it wears people down in the end. Not all of them. But some of them.

I think the not caring thing (the not feeling guilty thing) is a defence. Sometimes we need to distance ourselves and say 'there is nothing we can do' because if we didn't do that then the burden of it all, the pressure of it all would be overwhelming to us.

If he did take it on board that he didn't help someone enough and that is why they killed themself... Then he might feel so bad that he couldn't go to work the next day. Then how many patients miss out? I don't know... Just trying to understand things from the other point of view.

On a related note... My t discharged a patient and he killed himself. I found the coroners inquiry online. He was absolved from blame but there were quotes from the court hearing. He sounded really messed up about it... Said that he was traumatised from it... Said that in similar circumstances next time he would admit the person instead of discharging them. The person asked him 'even though you believe that clinicially it would be the wrong thing to do' and he said 'yeah. even when i believe that clinically it would be the wrong thing to do. i did the right thing clinically in discharging him but he killed himself. i don't want other patients to do that even if it means that clinically i do the wrong thing'.

Messed up. Don't know if anyone pushed him on the 'there are 30 beds and 30 patients in those beds and then you get this patient and so who are you going to discharge' line...

I don't know what to say.

Sometimes the world seems too cold.

I'm sorry.

[Rapunzel]

(((((((((((Candy))))))))))))

I am sorry for your pain and anger about this. It is tragic, especially knowing that this man had people who loved and cared about him, and a good quality of life. I just don't want to see you let it drag you down. You have enough to deal with already. There's a quote that I keep running across that goes something like this:

"Refusing to forgive is like drinking poison and and hoping that someone else will get sick."

It's easier to let go before you have carried this around for a long time and it has gotten comfortable among your load.

Others have already looked at it from the doctor's point of view, but I want to add just a bit. It sounds cold that he said he had no remorse, but he might have had to say that for legal reasons, because if he said that he felt guilty it could be taken as an admission of wrongdoing, and that would seriously threaten his career especially with the legal quesions that already exist in this case. Losing a client to suicide is a therapist's (or doctor's) worst nightmare, but nobody can predict the future. Especially when someone doesn't want to be hospitalized, an involuntary hold can be a mistake too. Suicide rates spike right after patients are released from the hospital, and usually it isn't an option to keep them there forever. What kind of life would that be, anyway? Yes, in hindsight we can wish that the doctor had made a call at just the right time, or that someone had done something before the critical moment. It is tragic that it didn't happen.

TC,
Rap