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Dear Dr. Hanover, my Psychiatrist,
I wrote you an email just now that was most certainly a testament—proof!—of my sanity and the grace with which I bear my mental and physical afflictions, the latter of which are actually just side effects of the medication you have prescribed me (Abilify).
I was doing one of my favorite things just now—reading an email that I already sent and poring over the subtext that is the email to one’s psychiatrist.
Well, this is not that email. The purpose of this is to prove that the email I sent to you just now was a tour de force of sanity and grace and that, therefore, I’m right about everything I said and believe, period, and you should congratulate me on my compliance with treatment, the pristine state of my mental health, and thus affirm once and for all that I’m sane and cured and will no longer be needing your treatment or services. Moreover, my email is a testament to the fact that I no longer need any more of those pills and their side effects that are not just ruining my life, but to hedge my claim carefully, of which the costs are beginning to far outweigh their benefits (I’m talking about Abilify).
When I started out the email to you with a greeting (being careful to be polite and respectful by using ‘Dear’ and moreover, using that salutation to communicate that I am sane, warm, and as in control of my emotions as possible), I shortly thereafter mentioned my primary care doctor by name and my recent primary care visit to recount my many symptoms—none of which are psychiatric in nature. Why did I do this? First, I mentioned this to establish that what I’m experiencing is REAL. These are not ghostly physical and mental ailments. No. They’re measurable and someone else has recorded them. Thus, I mentioned another provider in the healthcare system with whom you are in a possible alliance and with whom you are likely complicit in my treatment to establish that I am IN on the joke that is the American medical system. At the same time, I did this effectively to play you against your disdain for Internists—because I know, I know, all specialists think that Internists/primary care doctors are “FLEAS” (“Fucking little egotistical assholes” as they call them in the secretive, skull-and-bones-like pyramid scheme of privilege that is medicine)—but my primary care PHYSICIAN actually BELIEVES that I’m sane, goddammit, and that my symptoms are real, whereas I’m not sure I can say the same for you.
Note that in the last paragraph just above I did not use the word ‘doctor,’ but, rather, physician, for the former would be too quotidian and ignorant of the term those of you on the inside of the system use. See?! I can use your medical jargon. I must, therefore, be sane, and worthy of the same respect as going through 10+ years of medical training.
While typing this letter to you (not THIS one—the one I actually sent to you through the Patient Portal), I admit that I pondered the Star Trek bobble head dolls and Buddhist texts you keep side by side your office along with your Ted Baker briefcase that is made to look older than it is (much like you in your oversized suits), the outdated DSM on your shelf, and your framed certificates from YALE MEDICAL SCHOOL AND MASS GENERAL. WHOA.
Further, in the emailed missive, when I waxed prophetic on my most recent symptoms with as much specificity and detail as I could, I was careful to stop short of analysis and to couch my symptoms in terms you could understand—“vertigo,” “CPK levels extremely elevated”—without sounding like a complete paranoid hypochondriac. My use of “extremely elevated CPK levels” was a nod to SCIENCE—the levels of some sort of enzyme in my muscles were elevated, and there’s no disputing a TEST THAT YOU GAVE ME.
I then documented each symptom I have lately experienced, from random night sweats to memory loss to an odd feeling constantly surrounding me that I’m about to die. Because even though I have read entire sections of the DSM (which is expired, or much of which is obsolete by now, I know—Did I mention I’ve read it?), I’m deferring to you, the PHYSICIAN, and your God-like status as arbiter and transmitter of health. Sure, I could have googled Abilify side effects and cited articles from a medical journal instead…. Oh? What’s that? I did cite an article from a prestigious medical journal? Yeah.
The article I cited in my email to you is from a legitimate medical journal—see? The Journal of Neuropsychiatry-something-or-other. Published recently. There’s no hidden agenda on the author’s end that I can discern, though there is an entire medical system—the system You help to direct and operate (well, not operate—you’re not the surgeon at the top of the medical pyramid after all), intended to thwart any truth much less a CURE for these ghost-like mental-and-physical ailments.
I’m not paranoid, but everything is connected, Dr Hanover.
BELIEVE ME, DR. HANOVER. Can’t you just for a moment, if but for a moment abandon the mafia-cult-conspiracy against the individual that is the world of medicine and “health” “care” and just take my words seriously for once? I am not a mere dilettante of my own health. I may “present” (that’s medical-speak, using ‘present’ as a verb for you) as a layperson of medical science, and yet, I am the one and only expert on ME—the sole expert on the side-effects of these drugs my psychiatrist (that’s YOU) is peddling and pumping me with day after day. I am an expert on the state of mind that is my own? I left a question mark there because, well, is my mind really my own anymore, or have you rented it out to Abilify, Dr. Hanover??
JUST LISTEN TO WHAT I’M SAYING TO YOU, DOCTOR. What has happened to medicine? It’s been taken over by corporations and insurance companies and extroverts. What happened to the brooding, deliberate and deliberating doctor who meditated over the state of the patient as though he was a priest for the body—the healer?
Fuck “heal thyself.” I’m without the power that is medical knowledge. I can only Google random articles on Abilify side effects and try to divine, as though through magic, what the fuck is wrong with me, for I (again deferring to you) lack the medical knowledge that you have managed to hoard, consolidate, and lord over powerless minions such as myself over the years. I’m asking you nicely, now. Heal ME by releasing me from Abilify’s clutches, Goddamn it. I’m pretty sure that the 7th circle of hell is a rare, undocumented side effect of Abilify, and I’m PAYING YOU TO LIVE IN HELL RIGHT NOW.
Thank you for your time. Thank you for reading the email I sent you, Dr. Hanover—again, not this one, but the one that I was careful to send through the patient portal just now, for it is a privilege to have email access to one’s doctor, if but through a highly secure and closely guarded patient portal—a privilege that must be used cautiously and seldom so I can demonstrate my extremely high level of sanity and with the slim hope that you’ll believe I’m sane and that you’ll fucking take me off of Abilify and put me on another drug that is really ultimately not going to be any better.
Kirkley Mehndiratta earned a BA in English and Cinema Studies from Oberlin College and studied film production at NYU’s Tisch School of the Arts as an undergraduate. She has an MA in English from Temple University. She was a Leighton Artists Colony writing fellow at Banff Centre for Arts and Creativity, and her work has been published in Turk's Head Review's best pieces of the year, 34th Parallel, The Write Launch, and Extract(s). Currently, she is at work revising a novel of historical fantasy and a memoir about bipolar disorder and family. She teaches writing to university students in Boston.