Wednesday, February 1, 2023

Robert Sharpe, MD (contracted part-time psychiatrist) again

This guy may become one of my favorite overseers down on the Elgin plantation.

Yesterday, I attended a monthly staffing for Shanovia, the young mother whose baby was conceived on the plantation and born last May. (While mom was enslaved... again, I sure hope people, like taxpayers, will ask: How did that happen? Is that supposed to happen?)

Shanovia had called me the day before, in tears and very hard to understand. I spent about 15 minutes trying to figure out why she was crying. The only thing I got out of her at that time was the name Gerry Marinas. I think she said Gerry was a nurse who was always calling her a liar. Actually I thought Shanovia said lifer. Calling her a lifer would have meant Gerry was telling her she was never going to get out, which clearly would have been reportable mental abuse.

Shanovia was unable to stay in the staffing very long. She was crying and saying she just couldn't be there, just couldn't do it. I think the social worker was able to ask her how she was doing, but she only answered very softly, "Lots of anxiety."

The Administration representative (there always is one when, and maybe only when, I attend a staffing), was Dr. Welch, who had been unable to hear Shanovia from wherever she was Zooming. So Dr. Welch asked Shanovia to please repeat what she had just said. Dr. Sharpe preempted it though; he instantly answered for Shanovia, "Lot of anxiety." I thought that was condescending; he could have at least waited a second to give her a chance to speak for herself. So I tried to lighten it up a bit by saying, "Dr. Sharpe, did you just say that you have a lot of anxiety?" People laughed, but Shanovia didn't apparently feel any better, she reiterated that she wanted to leave, she had to get out.

I told the team that I would represent Shanovia for purposes of this monthly staffing, and Dr. Welch confirmed, after checking, that there wasn't any reason we couldn't do that. Shanovia said that was fine, she just couldn't stay, she just couldn't do it. So she went to her room to cry some more.

My main reason for wanting the staffing to continue was to have the opportunity to ask Gerry Marinas directly whether he had called Shanovia a lifer or a liar. He denied both. He said he didn't even know what a lifer was (the term was unfamiliar to him), and he would never call any patient a liar, "...especially not Shanovia!" If I had been quicker, I would have asked why "especially" not Shanovia? Was that because she's clearly such a truthful person? Because she is delicate and Gerry knew calling her a liar could trigger her? Because he knew she is well represented by counsel who might come back at him and make it a problem? I missed the opportunity to clarify this.

The conversation then proceeded to Shanovia's ability (said to be fair), to apply "adaptive coping mechanisms" when she is stressed. The definition of "adaptive coping mechanisms" was interesting in that apparently "adaptive/maladaptive" has lately replaced "healthy/unhealthy" as the proper value scale. I'm not sure why: it's Elgin Mental Health Center after all, it's not Elgin Mental Adaptation Center. Right? 

The final item was brought up by Dr. Welch, who asked Dr. Sharpe whether he had recently changed or added to Shanovia's medications. From the way she asked this question, it was apparent to me that she already knew the answer, but she wanted it to be on the record for my benefit. Curiouser and curiouser.... I do my best never to be opinionated about medications in any specific case. Taking or not taking any drugs should be the patient's informed choice alone. Of course, I can have my own opinion about whether any patient has been given sufficient information to make an intelligent choice.

It turns out that Dr. Sharpe had started Shanovia on the SSRI Zoloft about a month ago. One piece of information she should have been given (and maybe she was) is that SSRI's are known to occasionally cause one very serious side effect known as "akathisia". The main sign of akathisia is a sense of restlessness and intense need to move. Symptoms include feeling irritable, stressed, impatient, or panicked. It may cause you to feel like jumping out of your skin. Akathisia from Dr. Sharpe's Zoloft is almost certainly worse than being called a liar by Gerry Marinas.

Perhaps akathisia would make you feel like you just can't stay in your monthly staffing. You might describe your intense irritation, stress, impatience or panic as "a lot of anxiety." And you might cry a lot. But akathisia can also be so severe that it could drive a person to suicide. I'm just sayin'.... 

There are a few Elgin overseers who might be glad if Shanovia were no longer around. And I do believe they tried to kill that baby, about a year ago.


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