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Decreasing Rationality of Thought

This is the phrase my family doctor said to my face today, to describe what she claims to have been observing about my behaviour, over the years I’ve been her patient. Decreasing rationality of thought.

Because of the world we live in, and because of how often I’m told things like this by people who apparently just need an externalized excuse to cast me out of their life (you know, rather than just be an adult and accept that whatever the problem is, it might not be entirely my fault), the first things that go through my head are the times I’ve disclosed sensitive information about my changing identity to her. Those events include the time I came out as queer in her office, and could hold back the tears I felt welling up inside of me, for fear that she just wouldn’t believe me. Or the time I finally told her about my name preference and my gender identity, which also made me cry, for the same reasons. Or the time I went to her describing the anxiety, insomnia, and panic attacks I was experiencing at work, which drove me to finally ask her for a very low-dose anti-depressant, just to take the edge off.

But then I think “That can’t be it.” When I told her I’m queer, she said there’s nothing wrong with that. But that wasn’t why I was crying. I already knew there was nothing wrong with being queer. When I told her I’m trans, she said she wants to support me through the transition and make sure I access the help I need. I wasn’t afraid she’d refuse me treatment, though. She’s required to help me. It’s part of her job.

And when she gave me an anti-depressant at my request, to help combat anxiety, insomnia, and panic attacks? Well, unfortunately, she gave me citalopram, which is known for causing an increase in anxiety, insomnia and related sleep disturbances, and sometimes has been known to cause psychotic symptoms. I experienced all of these (but none of the other side effects, which are actually alleged to be more common), starting within a few days of taking the minimum dose, and persisting until I called the pharmacy in the middle of one of my anxiety episodes to explain how difficult this medication had been. They told me to stop it immediately because it sounded fucking terrible. And it was, so I listened. I can’t even explain why it happened so fast, but I’m not the only individual this has happened to, and I’ve heard it first-hand from some others. I definitely was relieved to hear, both from the pharmacist that what I was describing was awful and I should stop taking this pill immediately, and from the other people I’ve met who went through the same. This told me it’s not my fault, and I didn’t do anything wrong.

It’s also important to note that, over the past couple of years, my appointments with this doctor have slowly become reduced from an average of 15 minutes to an average of about 45 seconds. If I am exaggerating, it is very slight. I’m not a mathematician or a statistician, but I know how much more time I waste calling and having my appointments cancelled the day before, or travelling to and from this office. It’s also important to note that when I first started seeing this doctor, I had just come to this province alone and was at constant risk of having no housing. But since then, I’ve acquired a medical office diploma (more on that in a moment) and I’ve gone back to college, where I graduated with an associate degree of arts, sub-specializing in philosophy. I also successfully completed all but six of the academic requisites for an application to med school or dentistry (and when you look closely at my transcripts, I’ve done the equivalent of two or three of those courses anyways).

For people unfamiliar with university transfer programs in Canada, that’s the equivalent of a half a bachelor’s degree and it is equally as useless as it sounds. But it was still a lot of work, and it proved to me that my strength is, in fact, rational thought and philosophical abstraction (as opposed to rational processes such as math, or more technical abstractions such as… more maths). It also proved to me that when I’m encouraged and I feel in control of my life, I’m actually remarkably more proficient in mathematical thinking and analysis, than when I am constantly discouraged (such as when I was young, and was being bullied at school and receiving no encouragement at home).

I think it’s fair to suggest at this point that I’ve changed as a person, a great deal over the past few years, while I’ve been seen as a patient at this office. There was a time shortly after getting my medical office diploma and completing my practicum work that this doctor asked me to work for her, and I said no (I didn’t want to work for someone who could look up the serial number on my IUD if it so pleased them to do so). I thought that was fair to both of us at the time, and it seems to have paid off in the long-term. I also think it’s fair to suggest that the majority of these changes (if not all of them) have been positive, even in spite of the fact that going to college resulted in my experiencing bullying and harassment that brought me to the breaking point. I did one last semester after that, in which I focused all of my time and energy on fully claiming my anarcha-feminist, queer, and trans identity, both as an academic and as a random sarcastic troll on the internet.

But there was also a more private change taking place through all of this, and that was finally being referred to a psychotherapist to help me deal with my gender identity and quite lengthy history of trauma from all fronts I’ve faced. What has come out of this work (which is still ongoing) is my identity as a survivor. I have finally accepted that I deserve respect and dignity like everyone else. And I feel humbled by the fact that I’m still here to say that, considering that if 999 other people went through just a fraction of what I’ve faced, that I’d still be the only one standing. I don’t know why I’m here, standing, demanding respect, and that is what I am seeing a psychotherapist for at the present time. To find my path and purpose in life by facing everything I’ve repressed for the second time.

I just don’t understand where her assessment is coming from. I find it insulting, and degrading. It undermines my trust in her. It makes me feel like I can’t talk to her about matters we haven’t directly dealt with already. And that’s just not what a doctor should be doing for their patient.

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