Monday, February 4, 2008

This Child Psychiatrist also uses the Stethoscope

In his NHS Doctor Blog, Dr Crippen commented on The Shrink behind Lake Cocytus: "I have never seen a psychiatrist with a stethoscope but fortunately this one has one."

I totally agree. If we do not use the Stethoscope, who will? Between The Shrink and myself, we cover both ends of the age spectrum. When I was Consultant Child Psychiatrist, I managed to “un-diagnose” a few psychiatric cases made by non-psychiatric colleagues, and not just by GPs, I hasten to add. One girl’s family was on the brink of facing prosecution because of her failure to attend school. It was left to me to discover that she had two collapsed vertebrae.

I noted in my book The Cockroach Catcher:

“…. I have often wondered if it would be such a disservice to mankind if doctors were not so understanding of the psychological side of things. The possibility of a serious illness being missed is of course a major concern when a patient seeks help for one reason or another. To put psychological conditions at the top of the list of possible diagnosis is dangerous. Given the concern over cost in most health care systems, the need to restrict the use of expensive investigation is understandable. However, with clinical reliance on sophisticated investigations especially in modern medical training, the art of physical examination is perhaps lost to this generation of newly qualified doctors…..”

It was refreshing to visit Lake Cocytus. If the truth be told, Lake Cocytus is a sort of childhood haunt of mine. I have a cousin quite a few years older and she was reading a Chinese Translation at the time. The same drawing was on the cover (Gustave Doré 1832-1883) and it fascinated me. I read it and was thankful that I did not become crazy. The few that knew me well might disagree!

1 comment:

The Shrink said...

How bizarre that the image recurred, so!

And yes, in child & adolescent services, particularly when prescribing methyl phenidate and the like, physical health has to be assessed robustly, too.