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Psychiatrist on the RoadReview - Psychiatrist on the Road
Encounters in Healing and Healthcare
by Lawrence H. Climo
Bay Tree Publishing, 2009
Review by Cecile Lawrence, Ph.D., J.D.
Jan 24th 2012 (Volume 16, Issue 4)

If you have an interest in North American Cultural Studies, you are probably familiar with Story Corps.  One could call this collection of interviews  "Story Corps on the inside: video shorts in words" with a very special set of interviewees.

At age 65, the author lost his job as an employee of an urban mental health clinic, where he was senior clinical psychiatrist.  Deciding not to retire just then, he contracted with three companies that hire medical personnel to work temporarily in various locations around the U.S. With that the author gets on the road.

The word pictures in the first half of the book are like story shorts while in the second half, we're clearly in video-like territory where we experience more intensely the altered realities of those with broken minds and souls.  The word "souls" is appropriate as Climo expresses musings increasingly more expansive as we both make our way.

This book is very reminiscent also of the hero's journey, or even Cervantes' longer Novelas Ejemplares because Climo presents a focused and mostly indirect critique and interpretation of the social, political as well as medical problems of the late 20th and early 21st centuries, wending his way between history and creative writing.  Therefore, of course, this work would be of interest to those in the field of Medical Humanities. It fits also under the rubric of "travel stories" or the journals of explorers, although the spaces encountered are more those of the mind than of the geographical landscape, except for Climo's connecting the internal state of his clients in the Gallup Indian Medical Center and those he saw in the Appalachian area of North Carolina with the larger cultures from which those clients emerged or were torn.

While Climo is a good writer, using engaging metaphors to try to draw a picture of the clients' mental states and their stories, at times he uses clichés and awkward phraseology.  Yet, memorable are the moments when he expresses quotable nuggets such as the simplicity and directness of "You don't need medicine. You need someone to talk to."

His butting heads with the medical system especially when the accepted technology of the system is unable to match the presenting symptoms to an acceptable diagnosis appears later in the book.  This brings me to the curious encounters he has with TLE (Temporal Lobe Epilepsy. As Climo makes his way from assignment to assignment and within an assignment, from patient to patient he keeps seeing symptoms of what he more and more quickly concludes are TLE cases, all of which are previously incorrectly diagnosed as any one or more of the standard psychiatric ailments. His raised sensitivity to recognizing symptoms of TLE possibly came from his having worked in an inner-city clinic, although he does not make that connection. Amongst the causes of TLE are a history of violence or physical and mental abuse.  One of the more curious symptoms is that of olfactory hallucinations or smelling something burning when there isn't.

What became especially curious in reading this book in order to write a review is that in the process, I wrote notes in a notebook.  Excessive writing of notes is a symptom of TLE.  Also curious is that as I read I began to recognize in my own history the symptoms of TLE, which brought great relief to some extent as, finally, I was able to give a name to the seizure like symptoms I had been dealing with for over 20 years as a result of radiation for a left side brain tumor.  But I took care that I myself was not projecting, especially as I became more and more engrossed in the stories of fractured lives and minds, just as the author himself, as a trained psychoanalyst involved now almost solely with prescribing and tweaking prescription for psychiatric drugs, had to be also careful not to project.  While at times, especially early in the book, I felt frustrated at his not confronting the dysfunctionality of the medical system and even some of the medical personnel within it, in continuing to read I took heart as he increasingly determined that no mental illness was present even when the system would have preferred that he had found the patient mentally ill.  His descriptions of how he allowed the space to open for the patient and/or the family to see the solution themselves were especially delightful.  Read the stories about the fish oil advice for the treatment of TLE and what family members state about the eating habits of the patient. At the very end is when he reveals something about his background, which probably added greatly to his skills in empathy and insight as well as to his choice of career.

What stands out is how prevalent early social, economic, physical and mental deprivation, abuse and violence is in the backgrounds of the majority of the people caught up in the combined mental and criminal justice systems in the U.S.

 

© 2011 Cecile Lawrence

 

Cecile Lawrence, NY


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