Perverted Justice: Dateline NBC

[Poety]

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😡 Tell me someone else saw this sick show - what is going on with these predators, i.e. WHY ARE THERE SO MANY???!!! Oy, and the MD that was on there who does EM? OMG 😱 He was trying to FOLLOW THE BOYS VOICE UP THE STAIRS!

I haven't had an ounce of forensic psych, and all I'm aware of is the saying "that is what they are attracted to sexually" My mentor is a forensic psych and he says he never lets them out of jail because they will never stop, that you can't reform someone with this sexual deviance. He compared it to me being a hetero, the same type of sexual drive.

Can someone add to this? Perhaps if I understood the pathology just a bit more than I could see past how sick/obnoxious/freaky/disgusting/abusive this kind of behavior is. Then to make matters worse, they add in a clinical psychologist that I'm sorry - looked just as crazy as the rest of them! 😱 And THIS guy is TREATING THESE DUDES? he was just creepy!!

 

[Poety]

77 views, no comments at all? Come on Mosche and OLDpsychDoc I can usually count on you two 🙂

 

[mosche]

I didn't see the special, unfortunately. I do tend to agree that child molesters, whether heterosexual or homosexual, cannot be reformed. Unfortunately, however, I feel that the debate tends to focus on the homosexual aspects of child molestation -- they (the media) will always take the sensationalistic slant/perspective; therefore, the issue becomes homophobic rhetoric as opposed to child molestation (all forms) is wrong and ought to be punished.

Just my opinion.

 

[Poety]

I didn't see the special, unfortunately. I do tend to agree that child molesters, whether heterosexual or homosexual, cannot be reformed. Unfortunately, however, I feel that the debate tends to focus on the homosexual aspects of child molestation -- they (the media) will always take the sensationalistic slant/perspective; therefore, the issue becomes homophobic rhetoric as opposed to child molestation (all forms) is wrong and ought to be punished.

Just my opinion.

Hey Mosche, this special focused on guys that were between 35-55 that pursued both little girls OR little boys - they didn't focus on one more than the other at all. I was horrified to the see the EM doc show up - I seriously hope they reported him to that hospital.

There was also a Rabbi, a sargeant in the military, school teachers, special ed teacher, and the like, IT WAS SHOCKING 😱 I agree they CANNOT be reformed, but I'm shocked to see how many there really are. On this one particular day, more than 15 guys showed up

They were trying to get the adults (posing as children) to meet up with them, and it took place in Fairfax, VA - seriously I think there is one major issue if more than 15 guys are showing up for dirty sex with little kids (boy OR girl)

Saddest thing is that if this is happening as a set up - how many really are happening without being set up, and how many children are getting fundamentally screwed by these monsters?!

 

[mosche]

Hey Mosche, this special focused on guys that were between 35-55 that pursued both little girls OR little boys - they didn't focus on one more than the other at all. I was horrified to the see the EM doc show up - I seriously hope they reported him to that hospital.

There was also a Rabbi, a sargeant in the military, school teachers, special ed teacher, and the like, IT WAS SHOCKING 😱 I agree they CANNOT be reformed, but I'm shocked to see how many there really are. On this one particular day, more than 15 guys showed up

They were trying to get the adults (posing as children) to meet up with them, and it took place in Fairfax, VA - seriously I think there is one major issue if more than 15 guys are showing up for dirty sex with little kids (boy OR girl)

Saddest thing is that if this is happening as a set up - how many really are happening without being set up, and how many children are getting fundamentally screwed by these monsters?!

I didn't even realize that it was a set-up. Perhaps if we had the finances to run more of those, we could stop this phenomenon all together. NAH. they'd just find another way to victimize their prey.

 

[silas2642]

😡 Tell me someone else saw this sick show - what is going on with these predators, i.e. WHY ARE THERE SO MANY???!!! Oy, and the MD that was on there who does EM? OMG 😱 He was trying to FOLLOW THE BOYS VOICE UP THE STAIRS!

I haven't had an ounce of forensic psych, and all I'm aware of is the saying "that is what they are attracted to sexually" My mentor is a forensic psych and he says he never lets them out of jail because they will never stop, that you can't reform someone with this sexual deviance. He compared it to me being a hetero, the same type of sexual drive.

Can someone add to this? Perhaps if I understood the pathology just a bit more than I could see past how sick/obnoxious/freaky/disgusting/abusive this kind of behavior is. Then to make matters worse, they add in a clinical psychologist that I'm sorry - looked just as crazy as the rest of them! 😱 And THIS guy is TREATING THESE DUDES? he was just creepy!!

Yeah, the ER doc was a pediatrician too. How's that for kicks? There was also a medical student from Virginia (Richmond I think-- any idea which medical school(s) are there?). Freaked me out. I read his apology and felt a glimmer of sympathy for him until I read the crap that he was writing to children-- sending porn to a twelve year old, trying to get her to masturbate, and any sympathy that may have been there disappeared in a hurry. These guys are sick

 

[Poety]

That doc was a pediatrician? thats disgusting - do you know what ended up happening with all those people? I mean seriously, they need to be kicked out and banned from every practicing medicine again. 👎

 

[silas2642]

That doc was a pediatrician? thats disgusting - do you know what ended up happening with all those people? I mean seriously, they need to be kicked out and banned from every practicing medicine again. 👎

I would like to think that the doc will never be able to practice medicine again and that the medical student will be kicked out of school. But I honestly don't know what is going to happen to these people. Here's the link to the medical student: http://www.perverted-justice.com/?archive=zoso23117 The picture freaks me out because he looks like a normal guy who you would nod at walking by on the street.

 

[Shrinky]

Hi, this will be unpopular.

I think that as physicians, and especially as psychiatrists, we need to be a little bit careful about making value judgements in regards to a population that has a DSM-IV diagnosis, no matter what we think of the behavior that is manifest by the illness. Crack addicts and sociopaths do some pretty crappy things too, but in any case we should be thinking about how to cure the disease rather than how to punish the offenders.

And maybe the cure isn't out there, but isn't this about impulse control? I wouldn't write off the idea that this, like other maladaptive behaviors, could be reformed.

 

[Anasazi23]

There is a huge danger in labeling anyone who performs a deviant behavior as having "impulse control problems." Also, allowing the DSM, of all things, to delineate between criminal behavior and psychiatric illness is a mistake. The main reason the DSM IV had a text revision is because it allowed an active child molester to escape a DSM diagnosis if he did not experience "significant distress" over the behavior.

Criminal activities are just that. I can't believe the trend that I'm seeing in the ER whereby police will bring in a criminal (wife beater, child molester, someone who commits assault, battery, or disturbs the peace) for "psychiatric evaluation" prior to hauling their sorry butts to jail. It's an attempt by law enforcement to dump another criminal on the psychiatric system rather brining them into the overcrowded jail system.

 

[Poety]

There is a huge danger in labeling anyone who performs a deviant behavior as having "impulse control problems." Also, allowing the DSM, of all things, to delineate between criminal behavior and psychiatric illness is a mistake. The main reason the DSM IV had a text revision is because it allowed an active child molester to escape a DSM diagnosis if he did not experience "significant distress" over the behavior.

Criminal activities are just that. I can't believe the trend that I'm seeing in the ER whereby police will bring in a criminal (wife beater, child molester, someone who commits assault, battery, or disturbs the peace) for "psychiatric evaluation" prior to hauling their sorry butts to jail. It's an attempt by law enforcement to dump another criminal on the psychiatric system rather brining them into the overcrowded jail system.

AMEN SAZI - and my mentor who is a forensic psychiatrist ECHOES these sentiments exactly - and to the poster above that: if you think that being a physician also means you have to leave your ideals and beliefs aside you are sadly mistaken. You can choose NOT to treat whatever population you desire as long as you do it within the confines of the law.

This is a huge debate thats going on amongst the forensic docs, and I hate to say it - but you are goign to be hard pressed to find many that want to treat deviant behavior as an "impulse control" they just don't buy it. And neither do I. But thats my perogative - psychiatrist or not, hence I am not choosing to go into forensics.

I do realize ofcourse that a patient may come in and say "I haven't done this yet, but I want to have sex with my daughter"- how will I deal with this? I have no idea yet - but thats something I hope to have a lot of mentors and teachers help me with.

Residency is to help us learn about all the different aspects of psych that we are going to be faced with - I do not believe its to challenge our moral beliefs (although some patients may) in a way that makes us uncomfortable or to sway what our own ideas about things are. ESPECIALLY AS PSYCHS - since if we are so easily deviated from our own belief system and so easy to just say "oh its a diagnosis" then we won't only be doing our patients a disservice, but society as well.

Ok, thats all I have to say <stepping down off my soap box>

 

[Shrinky]

Like I said, my position would be unpopular.

BTW, the New York Times today has a front-page piece on child marriages in sub-Saharan Africa. Do most people think it's a bad thing? Of course. But when entire cultures are engaing in an activity that is considered criminal in most places...well, I think we might have the opportunity to find a way of modifying the behavior.

Anyway, this seems to be a matter of opinion, so until there's good scientific evidence on this, we'll be left to our instincts.

 

[mosche]

Like I said, my position would be unpopular.

BTW, the New York Times today has a front-page piece on child marriages in sub-Saharan Africa. Do most people think it's a bad thing? Of course. But when entire cultures are engaing in an activity that is considered criminal in most places...well, I think we might have the opportunity to find a way of modifying the behavior.

Anyway, this seems to be a matter of opinion, so until there's good scientific evidence on this, we'll be left to our instincts.

To me this post seems to say all that needs to be said: it's illegal! Within our cultural paradigm, it's recognized as wrong; therefore, it is not allowable by law. Further, just because Africa allows it does not justify it. Many things have been legal in the past, only to be recognized as unconscionable by future generations (e.g. slavery, genocide, etc...); many would argue that child molestation is a similar taboo. Moreover, the people (some would argue that term) in the NBC special did not present themselves in a true light, ergo, they are predators who feed on UNSUSPECTING prey. Further, the predators even knew that they were out of line: they cried, begged for forgiveness, lied (it's my first time, I'll never do it again -- only in one case to show up the next day at McDonald's to do the same thing again).

Should we treat them? I will. However, I will NOT condone their behavior, nor will I try to make excuses for it. I will deal with the fact that it is wrong/illegal, and hopefully help them realize that wrong actions have repercussions! I will not tell them that a certain country in Africa condones their behavior any more than I will tell an anti-Semite that had he been born a generation sooner in Germany his actions would have been okay!

 

[Poety]

wow Mosche! I'm scared of you! 🙂

 

[Shrinky]

To me this post seems to say all that needs to be said: it's illegal! Within our cultural paradigm, it's recognized as wrong; therefore, it is not allowable by law. Further, just because Africa allows it does not justify it. Many things have been legal in the past, only to be recognized as unconscionable by future generations (e.g. slavery, genocide, etc...); many would argue that child molestation is a similar taboo. Moreover, the people (some would argue that term) in the NBC special did not present themselves in a true light, ergo, they are predators who feed on UNSUSPECTING prey. Further, the predators even knew that they were out of line: they cried, begged for forgiveness, lied (it's my first time, I'll never do it again -- only in one case to show up the next day at McDonald's to do the same thing again).

Should we treat them? I will. However, I will NOT condone their behavior, nor will I try to make excuses for it. I will let deal with the fact that it is wrong/illegal, and hopefully help them realize that wrong actions have repercussions! I will not tell them that a certain country in Africa condones their behavior any more than I will tell an anti-Semite that had he been born a generation sooner in Germany his actions would have been okay!

Is anyone here trying to condone the behavior or making excuses for it? Call me an idealist, but one of the reasons I'm getting into this biz is that I think there are myriad human ills that might have a solution in psychiatry. Keep in mind there was a time when the mentally ill were punished (think Salem) or ostracized. The fact that we know pedophilia is a)bad, b)widespread, and c)a behavior, suggests that we, as a community of thinkers, should look for a solution.

I'm not sure how you come to discussing informing pedophiles and anti-Semites where they could find sympathizers geographically or temporally. My point was that this issue is not isolated to a few perverts on Dateline.

And for what it's worth, I'm all for making racism a DSM diagnosis. At least it should be a subject of research.

 

[mosche]

Is anyone here trying to condone the behavior or making excuses for it? Call me an idealist, but one of the reasons I'm getting into this biz is that I think there are myriad human ills that might have a solution in psychiatry. Keep in mind there was a time when the mentally ill were punished (think Salem) or ostracized. The fact that we know pedophilia is a)bad, b)widespread, and c)a behavior, suggests that we, as a community of thinkers, should look for a solution.

I'm not sure how you come to discussing informing pedophiles and anti-Semites where they could find sympathizers geographically or temporally. My point was that this issue is not isolated to a few perverts on Dateline.

And for what it's worth, I'm all for making racism a DSM diagnosis. At least it should be a subject of research.

I read my post and it seemed much more vitriolic than I intended, for that I am VERY apologetic. I read your post to say that in some area of Africa people condone the behavior that is here illegal. I do not think in retrospect that that is true. I assume that in Africa, and some other cultures as well, persons are allowed/forced to marry at an earlier age. Such marriages are done with the knowledge and consent of the parents and the community in which it occurs. However, I have never heard of a society where child molestation is legal -- a society where someone can just walk up to an unsuspecting kid and molest him/her, and the parents/clan/tribe/nation turn a blind eye and take an "it's okay" stance. Rather, in such archaic communities, stoning/death is often the penalty.

As for research, I'm all for research of even the most vile attrocities. That is until said research infringes on the innocent. As for racism, I think that most evidence points to racism being a conditioned behavior.

 

[mosche]

😱

wow Mosche! I'm scared of you! 🙂

😱

 

[Anasazi23]

And for what it's worth, I'm all for making racism a DSM diagnosis.

Why?

Does it fit the definition of a mental disorder? I agree with Mosche, it's often a conditioned behavior. You're implying that racism is a thought disorder or maladaptive behavior?

At least it should be a subject of research.

It is. Thankfully not for the DSM.

39,400 hits on google "research on racism"

The true and original definition of racism involves having the power to act or subjugate the inferior race in some way. This is usually untrue today. At least in the common context of the word.

 

[Shrinky]

Why?

Does it fit the definition of a mental disorder? I agree with Mosche, it's often a conditioned behavior. You're implying that racism is a thought disorder or maladaptive behavior?

It is. Thankfully not for the DSM.

39,400 hits on google "research on racism"

The true and original definition of racism involves having the power to act or subjugate the inferior race in some way. This is usually untrue today. At least in the common context of the word.

What are you talking about. "The true and original definition?" Are you saying that, according to your terms, which I reject, that racism doesn't exist? And let me specify, I think ther should be psychiatric research in racism. I'm not talking about sociology here.

And should we run from trying to reform maladptive behavior? What about OCD? And if it is a conditioned behavior, isn't that sort of thing at the very heart of the history of this field? C'mon!

 

[Anasazi23]

My questions were partly rhetorical.

Of course racism exists all over the world and is manifested frequently.

Perhaps we could start a pilot project for the inevitable medication market for the DSM diagnosis "racist."

I'll propose two:

1. Tolerancia (not to be confused with Tolinase)
2. Harmonac

Of course, both should come in depot forms and IM short-acting injectables.

 

[Shrinky]

See...Now you're talking! Maybe even a little Race-C-T?

 

[OldPsychDoc]

My questions were partly rhetorical.

Of course racism exists all over the world and is manifested frequently.

Perhaps we could start a pilot project for the inevitable medication market for the DSM diagnosis "racist."

I'll propose two:

1. Tolerancia (not to be confused with Tolinase)
2. Harmonac

Of course, both should come in depot forms and IM short-acting injectables.

3. PoliCor, though it has the side effect of hyphenism.
😉

 

[Anasazi23]

3. PoliCor, though it has the side effect of hyphenism.
😉

PoliCor!

I love it!


The chemical structure is interesting. All the benzene ring structures are interjoining by triple carbon bonds (something thought impossible until now) in perfect symmetry with no resonation!

 

[OldPsychDoc]

http://news.yahoo.com/s/ap/20051207/ap_on_re_us/sex_offenders_hospitals

 

[ProZackMI]

😡 Tell me someone else saw this sick show - what is going on with these predators, i.e. WHY ARE THERE SO MANY???!!! Oy, and the MD that was on there who does EM? OMG 😱 He was trying to FOLLOW THE BOYS VOICE UP THE STAIRS!

I haven't had an ounce of forensic psych, and all I'm aware of is the saying "that is what they are attracted to sexually" My mentor is a forensic psych and he says he never lets them out of jail because they will never stop, that you can't reform someone with this sexual deviance. He compared it to me being a hetero, the same type of sexual drive.

Can someone add to this? Perhaps if I understood the pathology just a bit more than I could see past how sick/obnoxious/freaky/disgusting/abusive this kind of behavior is. Then to make matters worse, they add in a clinical psychologist that I'm sorry - looked just as crazy as the rest of them! 😱 And THIS guy is TREATING THESE DUDES? he was just creepy!!

First, I personally believe that most paraphilias, especially pedophilia, are permanent conditions without the possibility for rehabilitation. I might be wrong, but it's been my experience that such offenders are recalcitrant to psychotherapeutic and pharmacological intervention/tx. I believe that, unless there are mitigating/extraordinary circumstances/factors, once a child sex offended, always a child sex offender.

Second, I never saw the special. What exactly was it about?

Third, I hope your comment about the psychologist wasn't meant to imply that a psychologist is somehow inferior to an MD.

Zack

 

[Poety]

First, I personally believe that most paraphilias, especially pedophilia, are permanent conditions without the possibility for rehabilitation. I might be wrong, but it's been my experience that such offenders are recalcitrant to psychotherapeutic and pharmacological intervention/tx. I believe that, unless there are mitigating/extraordinary circumstances/factors, once a child sex offended, always a child sex offender.

Second, I never saw the special. What exactly was it about?

Third, I hope your comment about the psychologist wasn't meant to imply that a psychologist is somehow inferior to an MD.

Zack

Hi Zack, no on the psychologist - the guy REALLY WAS creepy!!! <shiver!> even if he was a psychiatrist, LSW, or whatever else - he was SPOOKY - the special has run numerous times so I'm sure you could see it again on MSNBC.

It was about dateline setting up child sex offenders by posing as children online and then having these guys come to the house to meet the children - all of them showed up - it was pretty sick stuff!

 

[ProZackMI]

Yeah, the ER doc was a pediatrician too. How's that for kicks? There was also a medical student from Virginia (Richmond I think-- any idea which medical school(s) are there?). Freaked me out. I read his apology and felt a glimmer of sympathy for him until I read the crap that he was writing to children-- sending porn to a twelve year old, trying to get her to masturbate, and any sympathy that may have been there disappeared in a hurry. These guys are sick

During my psych residency at the University of Michigan, I had a preceptor who once stated that he believed many people, if not most, let their pathology guide their career. In other words, he believed that many people entered a particular field because it filled some pathological need. Some examples he gave were:

-- surgeons and dentists (sadists who enjoyed inflicting pain and got paid to inflict it legally)
-- police and attorneys (criminals who exploit the law by using the law)
-- pediatricians (pedophiles)
-- psychiatrists and psychologists (attempting to understand/control their own intrinsic pathologies)

The list goes on. He believed that the fulfillment these individuals received, while disgusting to most people, was harmless in that no one was harmed in the long run and that it actually prevented these individuals from acting on their deviant desires. I never really believed this guy's theory, but it is food for thought.

Another point, pathology knows no bounds. One's education and position in society have little or no bearing on mental illness. Many of my most recalcitrant patients have advanced degrees (e.g., MD, PharmD, JD, PhD, MA, MBA, etc.). Although, with certain disorders, like depression, it would seem the greater the patient's intelligence, the more severe the depression, although that's necessarily always true. So, perhaps, education and intelligence might actually exacerbate one's condition?

I think what's really troubling about the case you described is that many of those offenders caught by authorities were in some form of fiduciary relationship with the children (e.g., physician, teacher, clergy). It's terrible when the neighbour, a plumber or janitor, gets caught molesting a child, but it's repugnant when his/her teacher, parent, priest, minister, doctor, or some other person in a trust relationship violates that trust.

 

[Poety]

During my psych residency at the University of Michigan, I had a preceptor who once stated that he believed many people, if not most, let their pathology guide their career. In other words, he believed that many people entered a particular field because it filled some pathological need. Some examples he gave were:

-- surgeons and dentists (sadists who enjoyed inflicting pain and got paid to inflict it legally)
-- police and attorneys (criminals who exploit the law by using the law)
-- pediatricians (pedophiles)
-- psychiatrists and psychologists (attempting to understand/control their own intrinsic pathologies)

The list goes on. He believed that the fulfillment these individuals received, while disgusting to most people, was harmless in that no one was harmed in the long run and that it actually prevented these individuals from acting on their deviant desires. I never really believed this guy's theory, but it is food for thought.

Another point, pathology knows no bounds. One's education and position in society have little or no bearing on mental illness. Many of my most recalcitrant patients have advanced degrees (e.g., MD, PharmD, JD, PhD, MA, MBA, etc.). Although, with certain disorders, like depression, it would seem the greater the patient's intelligence, the more severe the depression, although that's necessarily always true. So, perhaps, education and intelligence might actually exacerbate one's condition?

I think what's really troubling about the case you described is that many of those offenders caught by authorities were in some form of fiduciary relationship with the children (e.g., physician, teacher, clergy). It's terrible when the neighbour, a plumber or janitor, gets caught molesting a child, but it's repugnant when his/her teacher, parent, priest, minister, doctor, or some other person in a trust relationship violates that trust.

What a thoughtful post Zack, thanks so much for adding that. I think (no, I KNOW) I have the tendency to be even more repulsed by these behaviors since I have a new baby myself - I mean what I disdained before, is just absolutely revolting to me these days. Its amazing what kids do to you isn't it?

I thought the bit you added about your preceptor was interesting - and I suppose, just as is the case with many theories, they all hold at least some glimmer of truth to them to some degree. I mean they're almost stereotypical at times, and we all know that even stereotypes are true in some instances!

What sub-specialty do you practice?

 

[ProZackMI]

What a thoughtful post Zack, thanks so much for adding that. I think (no, I KNOW) I have the tendency to be even more repulsed by these behaviors since I have a new baby myself - I mean what I disdained before, is just absolutely revolting to me these days. Its amazing what kids do to you isn't it?

I thought the bit you added about your preceptor was interesting - and I suppose, just as is the case with many theories, they all hold at least some glimmer of truth to them to some degree. I mean they're almost stereotypical at times, and we all know that even stereotypes are true in some instances!

What sub-specialty do you practice?

Thanks, Poetry. As a single guy, I can only imagine what having a child does to your world view and general outlook on life. I'm a psychiatrist and I also have a law degree and will be taking the February 2006 bar examination. Due to personal reasons (mostly dissatisfaction), I plan on moving over to law (assuming I pass the bar exam!!!! <shudder!> and practicing criminal/family law or perhaps intellectual property law (i.e., patents, copyrights, and trademarks). Time will tell.

Psychiatry can be a very rewarding field, but it can also be a mentally depleting discipline. As a psychiatrist, I try to be objective and unbiased, but truth be told, I'm a human being, and when I have treated pedophiles and child murderers in the past, I had to force myself, at times, to maintain my objectivity to ensure proper tx.

Are you a med student, PhD student, MSW student, or a practitioner in one of those fields? Congrats on the baby!!! 🙂

 

[Poety]

Hi Zack,

Oy, you're actually switching out? You have GOT to elaborate on that one - were you dissatisfied with the patients? The actual work? The money? Oh do tell! I'm a 4th year med student goign through the match as we speak - you'll see a lot of neurosis floating around these boards at this time

I used to be a nurse and switched my career path too - right now I love it, but time WILL tell what the future holds. Did you treat pedophiles and child murderers because your scope was forensics? I really don't think I could handle those types of patients - I tend to prefer the psychotics myself. Give me someone with schizophrenia over the depressed/anxious/substance or axis II anyday 🙂

 

[ProZackMI]

Hi Zack,

Oy, you're actually switching out? You have GOT to elaborate on that one - were you dissatisfied with the patients? The actual work? The money? Oh do tell! I'm a 4th year med student goign through the match as we speak - you'll see a lot of neurosis floating around these boards at this time

I used to be a nurse and switched my career path too - right now I love it, but time WILL tell what the future holds. Did you treat pedophiles and child murderers because your scope was forensics? I really don't think I could handle those types of patients - I tend to prefer the psychotics myself. Give me someone with schizophrenia over the depressed/anxious/substance or axis II anyday 🙂

Good luck with your clerkships this year and I hope you kick ass on the USMLE I and II next year! 🙂 Your nursing background will be a great asset to you as a physician.

Why am I leaving psychiatry/medicine? Well, I don't want to make you jaded, or pollute your mind with my personal baggage, but I have found psychiatry to be...not exciting and actually a disappointment. Where I am (in Michigan), the majority of psychiatrists are IMGs who, in my opinion, lack the competence and clinical skills to render effective tx, and often misdiagnose and overmedicate patients. I also find myself writing more scripts. Although I am a physician, I don't necessarily believe that all disorders are biogenetic. I don't think an SSRI or TCA is effective tx for mild reactive depression. I also think many docs, non psych as well, are quick to diagnose Depression (in its various incarnations: MDD, BAD, Dysthymia, Depressive D/O NOS, Mood D/O NOS) rather than Adjustment D/O with depressed mood (which I commonly diagnose based on OBJECTIVE sxs).

There are too many people in tx for mental disorders who don't need to be in tx. There are too many people on meds who don't need to be on meds. It's frustrating to me. There are other reasons, too, but for the most part, I think I've had enough of medicine. I started off in IM and went to psych. I think I will maintain a small IM practice. Give me a simple case of OM or allergic conjunctivitis or bronchial asthma or mild COPD or NIDDM any day over MDD or BAD or schizoaffective!

It's a good thing I'm still relatively young. If I was any older, who knows if I could move over into a new career.

 

[Poety]

Good luck with your clerkships this year and I hope you kick ass on the USMLE I and II next year! 🙂 Your nursing background will be a great asset to you as a physician.

Why am I leaving psychiatry/medicine? Well, I don't want to make you jaded, or pollute your mind with my personal baggage, but I have found psychiatry to be...not exciting and actually a disappointment. Where I am (in Michigan), the majority of psychiatrists are IMGs who, in my opinion, lack the competence and clinical skills to render effective tx, and often misdiagnose and overmedicate patients. I also find myself writing more scripts. Although I am a physician, I don't necessarily believe that all disorders are biogenetic. I don't think an SSRI or TCA is effective tx for mild reactive depression. I also think many docs, non psych as well, are quick to diagnose Depression (in its various incarnations: MDD, BAD, Dysthymia, Depressive D/O NOS, Mood D/O NOS) rather than Adjustment D/O with depressed mood (which I commonly diagnose based on OBJECTIVE sxs).

There are too many people in tx for mental disorders who don't need to be in tx. There are too many people on meds who don't need to be on meds. It's frustrating to me. There are other reasons, too, but for the most part, I think I've had enough of medicine. I started off in IM and went to psych. I think I will maintain a small IM practice. Give me a simple case of OM or allergic conjunctivitis or bronchial asthma or mild COPD or NIDDM any day over MDD or BAD or schizoaffective!

It's a good thing I'm still relatively young. If I was any older, who knows if I could move over into a new career.

Thanks Zack! and luckily, I'm done with those USMLE beasts for now - step 3 and I'm DONE DONE - speaking of exams, I heard the bar is HARD - good luck! I'm sure with all youre USMLE practice you'll do fine though.

So medicine is not what you expected huh? That totally sucks that you went through all that training just to be disenchanted. I wonder what OPD would think of all this - OPD are you there? Sazi? They're the forum attending/resident so I'd be really interested to see what their thoughts on this would be!

Do you konw if maybe you practiced in another area you may be happier? How long did you practice IM before switching and what made you switch? Ack, sorry for all the questions - I just find the whole story very interesting 🙂

 

[ProZackMI]

Thanks Zack! and luckily, I'm done with those USMLE beasts for now - step 3 and I'm DONE DONE - speaking of exams, I heard the bar is HARD - good luck! I'm sure with all youre USMLE practice you'll do fine though.

So medicine is not what you expected huh? That totally sucks that you went through all that training just to be disenchanted. I wonder what OPD would think of all this - OPD are you there? Sazi? They're the forum attending/resident so I'd be really interested to see what their thoughts on this would be!

Do you konw if maybe you practiced in another area you may be happier? How long did you practice IM before switching and what made you switch? Ack, sorry for all the questions - I just find the whole story very interesting 🙂

No problem. I matched for an IM/Psych residency, which I did, in part at Wm Beaumont in Royal Oak, MI and at the University of Michigan Medical Center. If you can, I recommend the IM/Psych or FP/Psych residency. It gives a good backup in case you want some variety in your life. I won't leave med completely, but I will leave psych.

And...the money isn't bad. The hours aren't bad. I work with some great people and, for the most part, have some decent patients, although, they tend to be mostly depressives and folks with GAD, PD, or Adjustment D/O. Not many psychotics, schizoaffectives, or schizophenics. Maybe if I had some more patients with such colourful diagnoses, I wouldn't be so bored with my career! 🙂

And, yes, from what I hear, the Michigan Bar Exam is a toughie. I'm already practicing and studying and feel okay, but you never know.

Day 1 - 15 essays, 10 points each; 7 or higher is passing. The essays are on 24 possible areas of law (contracts, torts, criminal, property, personal property, secured transactions, UCC, worker's comp, family law, negotiable instruments, business corporations, evidence, civil procedure, constitutional law, etc.).

Day 2 -100 multiple choice questions in the morning and 100 in the afternoon. These 200 questions are based on six basic areas of law (criminal, constitutional, evidence, contracts/UCC, torts, and property). OY!

I'm not looking forward to this hellacious exam. Do you want to take it for me? 🙂

Xanax, take me a away!

 

[Poety]

Day 1 - 15 essays, 10 points each; 7 or higher is passing. The essays are on 24 possible areas of law (contracts, torts, criminal, property, personal property, secured transactions, UCC, worker's comp, family law, negotiable instruments, business corporations, evidence, civil procedure, constitutional law, etc.).

Day 2 -100 multiple choice questions in the morning and 100 in the afternoon. These 200 questions are based on six basic areas of law (criminal, constitutional, evidence, contracts/UCC, torts, and property). OY!

I'm not looking forward to this hellacious exam. Do you want to take it for me? 🙂

Xanax, take me a away!

😱 😱 😱

Oh that is just UGLY - and I personally agree with you on the scope of patients you had - I DEFINITELY prefer the psychotic realm, and I don't know HOW I would fare if I had mostly depressed patients especially since I happen to have an issue with treating depressed (I've even brought this up to my preceptors - saying I really can't STAND how they suck the life out of me!)

So we'll see how it all pans out I guess. Hopefully things won't be that bad for me 😳

Good luck on the exam! And keep posting here!

 

[ProZackMI]

😱 😱 😱

Oh that is just UGLY - and I personally agree with you on the scope of patients you had - I DEFINITELY prefer the psychotic realm, and I don't know HOW I would fare if I had mostly depressed patients especially since I happen to have an issue with treating depressed (I've even brought this up to my preceptors - saying I really can't STAND how they suck the life out of me!)

So we'll see how it all pans out I guess. Hopefully things won't be that bad for me 😳

Good luck on the exam! And keep posting here!

Thanks...yeah, treating depressed folks can be...tedious. Especially if you, yourself, have any bouts of depression. I'm generally euthymic, but it's normal to experience normal reactive depression from time-to-time. A few years ago my mother died; she was 56 and in poor health. I was depressed for a few weeks and remember thinking that a few of my patients were depressed for reasons "less" severe than my reason for being depressed. I actually said this to one patient, a 20 year-old girl who had just broken up with her boyfriend and wanted meds to help her get over the horrible trauma of the break-up.

I just stared at her and thought "WHO CARES! IT COULD BE WORSE, HONEY, HE COULD HAVE DIED IN A HORRIBLE ACCIDENT!" Of course, I didn't say anything and just let her prattle on incessantly about how bad her life was, etc. I wanted to tell her about my mom, show her copies of my student loan bills, and explain how draining people like her were on people like me.

So, if you let your guard down, look out; it can come back to bite you on the butt. That's why I strongly encourage you to check into IM/Psych, Peds/Psych, FP/Psych, or even EM/Psych. Keep your medical/clinical skills strong and always have a back-up! Many other specialties look down on us psychiatrists. I don't like it, but I see it frequently from other docs. It's even worse when you're talking to a surgeon and you tell him/her that you're a psychiatrist and a lawyer. One guy told me "So you are the epitome of a useless piece of crap, eh?" NICE 🙂

Heh...good luck, Poetry. You have great listening skills. How much do I owe you for letting me prattle on incessantly?

Zack
🙂

 

[Poety]

Thanks...yeah, treating depressed folks can be...tedious. Especially if you, yourself, have any bouts of depression. I'm generally euthymic, but it's normal to experience normal reactive depression from time-to-time. A few years ago my mother died; she was 56 and in poor health. I was depressed for a few weeks and remember thinking that a few of my patients were depressed for reasons "less" severe than my reason for being depressed. I actually said this to one patient, a 20 year-old girl who had just broken up with her boyfriend and wanted meds to help her get over the horrible trauma of the break-up.

I just stared at her and thought "WHO CARES! IT COULD BE WORSE, HONEY, HE COULD HAVE DIED IN A HORRIBLE ACCIDENT!" Of course, I didn't say anything and just let her prattle on incessantly about how bad her life was, etc. I wanted to tell her about my mom, show her copies of my student loan bills, and explain how draining people like her were on people like me.

So, if you let your guard down, look out; it can come back to bite you on the butt. That's why I strongly encourage you to check into IM/Psych, Peds/Psych, FP/Psych, or even EM/Psych. Keep your medical/clinical skills strong and always have a back-up! Many other specialties look down on us psychiatrists. I don't like it, but I see it frequently from other docs. It's even worse when you're talking to a surgeon and you tell him/her that you're a psychiatrist and a lawyer. One guy told me "So you are the epitome of a useless piece of crap, eh?" NICE 🙂

Heh...good luck, Poetry. You have great listening skills. How much do I owe you for letting me prattle on incessantly?

Zack
🙂

Aww I'm sorry about your mom Zack. I hope you took some time for yourself during that period.

It seems like you've definitely had a tough time with psychiatry. I can see how draining this field can be - especially if you're not one to listen all day long. I completely understand about keeping up the medical skills too, and I've actually often thought of a dual residency but unfortunately I didn't apply (and I'm matching this year). Perhaps I will find my niche and balance with research, and a few fellowships under my belt - I'm definitely the multi-boarded type of a person 🙂

Did you ever think of changing the scope of your practice to be more hospital based? Maybe you're true love is just IM though and thats where the problem lies. I'm not one to make judgements on what choices you made - but sometimes we choose the wrong area in a field and experiencing a different one can be wholly satisfying.

As far as letting my guard down, I've been blessed to have done 8 years of nursing prior to entering medical school so I've honed my skills at seperating thank goodness. It took me a long time before I stopped letting patients get to me - and though it might seem cold, I found that once I did that, I was much more efficient and a better caregiver to them. Currently I spend most of my time with the psychotic patients so they are very entertaining - I hope that doesn't fade 🙂

 

[pschmom1]

Hi ProZack, I too am in MI and curently an undergrad at UofM. I plan to specialize in psychiatry and work in MI but after your posts, I will pay close attention to my surroundings and keep an open mind. Of course one would like to hear nothing but the best reguarding the career they persue in the state that they live in, but it is nice to hear from people like you to keep things in prospective. I am sorry to hear about your mom, as I too have lost my mother due to cancer (another reason I chose to persue medicine) and can relate to how you feel when people complain about smaller things. Although, these are friends and not in a clinical setting, but when people freak out over a breakup and act like the world is over, and crab about how terrible their life is, I too sometimes want to say "if that's your only problem and your only loss than pick your a$$ up and move on cause your lucky to have what you DO have". But I guess If you haven't experienced the big things, than the little things to me, or us, seem big to the person experiencing them. On another note, do you have any advice for a future MI med student interested in psych? Although I'm at UofM currently, my school of choice for med school is Wayne State SOM. By the way, good luck on the bar. Do you think the bar is harder than the mcat or vice versa?
Wow, I just realized that I became so wrapped up in the last few posts, that I forgot what this thread was actually about 😀 . I did see the Dateline special and it just goes to show that you can't really trust or judge anyone on their apperience or profession. So sad that there are people like that out there and everywhere 🙁

 

[DrBowtie]

FYI.
Fri. 8pm EST.
Dateline update on this story.

 

[Poety]

Thanks Brett! And who is in your avatar?

 

[DrBowtie]

Thanks Brett! And who is in your avatar?

Tucker Carlson.

 

[DrBowtie]

BUMP...Dateline is on now. I think the update is coming on soon.

 

[mosche]

Not much of an update, unfortunately! I did learn that I ought to keep my computer in a "public area" when my kids hit puberty. Oh, they are "investigating" the men from the tape.

Poety, where's the indignation?

 

[Poety]

I would have seen this dam thing if I WASN'T ON DELTA ON A DELAYED FLIGHT AS USUAL MOSCHE!

 

[mosche]

I would have seen this dam thing if I WASN'T ON DELTA ON A DELAYED FLIGHT AS USUAL MOSCHE!

That's "damN"! 😛

Point to ponder: Why is it so much fun to pick on Poety? 😕

 

[Poety]

Because I have TARGET stamped on my head thats why 🙁 😛 😱

 

[mosche]

👍

Because I have TARGET stamped on my head thats why 🙁 😛 😱

👍

 

[Poety]

MOSCHE DON'T MAKE ME GO BORDERLINE ON YOUR ARSE OK?~

Speaking of lines... dateline, that is. We got off topic again - I'd like to return to the topic of anonymous predators - and I'd also like an ethical discussion to ensue regarding whether or not anonymous forums should not necessarily be so "anonymous" i.e. should there be a way to track who we are? Should there always be some type of a consequence when interacting with others in this world? Or is it ok to be completely anonymous when dealing with the public in any form?

thoughts? MOSCHE BIG MOUTH I KNOW YOU HAVE SOMETHING TO SAY 🙄 😛 so post it!