18. Starting Psychiatry
Monday 9 AM starting psychiatry on the locked ward in a conference room, Eddie finds himself next to Danny, and part of a group of 8 students each in white shirt with black or blue necktie and well pressed pants, sitting at a table at the head of which is a tall, age 60's man in hospital white coat, with sparse brown hair - Maybe dyed, thinks Eddie - the few hairs combed neatly over the top of his head and with his face dominated by a prominent nose. He is Dr Lewis Fraad, who happens to be Danny's uncle, and was - rumor has it - the key mover getting Danny into the medical school.
Fraud-Freud is Lewis Fraad's nickname among the students, Eddie knows, because Fraad is a Freudian psychiatrist who, they say, overcharges and maybe seduces his famous actress patients.
"Welcome to Psychiatry, guys." He looks individually at each student then says, "Psychiatry is the diagnosis and treatment of mental disease." His eyes single out Eddie. "Mr Steinowitz, tell us: What is mental illness?"
Eddie gives puzzled look, and, following philosopher Wittgenstein, says "I don't really know, sir."
Fraad stands suddenly, reaches across table and shakes Eddie's hand vigorously. "Guys, here is a fellow after my own heart!" He chuckles. "Reminds me of me." The students give low laughs. Fraad continues:"It is vogue among the booboisie - you know Mr HL Mencken's word for what I call the dirt dumb public even including a lot of college graduates - to call anything they do not like or cannot understand - mental illness."
"For examples, the late Adolph Hitler or some guy who goes into a movie theater with a gun and kills a crowd of people or a famous person who shoots himself or anyone someone does not like. These are not cases of mental illness. These are a lot of disparate, desperate guys. (He pauses to laugh at his own word joke) In the case of Hitler it was part of his nearly successful plan to grab the world; and the guys with guns shooting into crowds may simply be trying in their confused way to solve overpopulation; and the people who commit suicide are for one reason or another impatiently, painfully tired of life or trying to end a severe physical illness that is causing a big problem.
Mental illness is a specific diagnosis of a brain disorder or pathology: it is either psychosis, which is loss of a sense of reality, or neurosis, which is a dangerous to self or others behavior based on a brain disorder but that keeps a sense of reality. Examples of psychoses are schizophrenia and manic depression; examples of neuroses are obsessive compulsive disorder or paranoid ideation.
"Now, guys, here is a good teaching description in a joke. I tell it as the rhetorical question: What is a neurotic? And my answer: A neurotic is someone who dreams of castles in air. Then I follow with: What is a psychotic? And my answer: A psychotic is someone who lives in one of the castles." Fraad looks around at the students and asks Danny. "Mr Stern, how does that joke end?" Danny who knows it well, says "Sir, it ends by asking And what is a psychiatrist?" And he answers himself: "A psychiatrist is the guy who collects the rents."
A round of laughter fills the room.
For next, click 15.19 Life on the Outside
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