About six months ago, I began to wonder whether the tremendous
advances in diagnostic techniques and prescriptive medicine held any
promise for those of us below the clinical cutoff point for psychological
disorder, but who nevertheless sometimes feel recurrent "after-shocks"
from one or another of life's little curveballs.
Would there someday be a test, for instance, whereby I could walk
into a physician's office, announce that I'd been feeling out of sorts
for the past, oh, two or three months, and be given an accurate
diagnosis, complete with recommended treatment (medication in combination
with therapy) that would have a 90-whatever percent chance to improve my
condition?
That's how I got roped into the offbeat idea of going through the
battery of psychophysiological, biological, and neurological tests
developed by researchers at the National Institute of Mental Health, the
Mt. Sinai School of Medicine, and the Bronx VA Medical Center. It's a
program normally reserved for people with actual personality
disorders.
Not for okay guys like me.
When I agreed to be evaluated I also agreed to an important
codicil: Whatever the results, I had to publish them. Should the tests
reveal some secret strain of trouble deep within my psyche, I would still
have to report it. There was no backing out once the process had begun.
(Since I will be writing this as a journal, I have no idea at this point
what the findings will reveal about me. Perhaps life's events have taken
their toll; perhaps the way I sort my socks is evidence of some disorder
not immediately apparent but waiting, like Banquo's ghost, to strike on a
specific cue.)
No matter how healthy I think I am, there is a nagging suspicion on
my part that these tests may "find something." As I've discovered, one
doesn't ever fully recover from divorce, for example, and perhaps the
mental prosthetics I've developed to compensate have been
inadequate.
In any case, I'm prepared for anything. At the very least, since
the program requires numerous intravenous injections and blood samples, I
suspect I'll lose my phobia of hypodermic needles.
TUESDAY, SEPTEMBER 28
TEST #1: Complete physical examination and mood profile
The Bronx VA Medical Center is a stainless-steel oasis in an
otherwise depressed neighborhood. Inside, it's a hospital like every
other--filled with the sick and the frantic.
Mina Apovian and Irene Lopez are two researchers who work with Drs.
Larry Siever and Bob Trestman in the psychiatric division. Fielding the
questions posed by the two young, attractive women is uncomfortable at
times. Mina asks me my height and weight, marital status, whether and how
much I drink or smoke, and if there's any history of mental illness in my
family. I feel like I'm on a very intense first date.
An intern enters the room and examines me, draws a blood sample for
what seems like forever (while I'm lying down so I don't faint), and asks
me to fill not one but two cups with urine (my own, I assume). Then she
tells me that for the next two weeks (the duration of the testing
protocol), I cannot drink alcohol or coffee (two of my four favorite food
groups) and puts me on a strict low-sodium diet. If I'm not depressed
already, I will be by a week from Saturday, when I finish up the program
with a CAT scan.
I end the day with an EKG (electrocardiogram) on a cold metal table
with what look like jumper cables attached to my chest and belly. When
the nurse asks me which department sent me and I answer "psychiatry," the
look on her face changes. Even the technician keeps a closer eye on
me.
THURSDAY, SEPTEMBER 30
TEST #2: Self-report scales
The Klingenstein Building at Mt. Sinai seems a bit more forgiving
in its overall demeanor--perhaps because the donut shop located right in
its lobby suggests you're merely taking a short commuter ride rather than
a long journey to recovery.
In a ridiculously small room, spartan as a nun's boudoir, a
research assistant asks me question after question from a 50+-page
document--questions ranging from my childhood ("Did I have many friends?
Did I have a best friend?"), through my adolescence ("Was I ever arrested
for anything? Did I drink/use drugs?"), and into adulthood ("Have I ever
felt unusually up/down for a period of more than one week? Did I
sleep/eat/work/have sex more or less during that time?")
A lot of the questions are vague and difficult to answer--how does
one know when one is feeling "unusually up or down"? When I answer that I
have many ups and downs (especially when the Mets are playing), he gives
me a quizzical look.
"But they don't last long," I hurry to explain. "And they're not
really 'up' ups or 'down' downs."
It occurs to me then that I'm trying to "pass" the test, as though
there were such a thing. When it's over, he mumbles a few sentences,
shakes my hand, and hustles me out. I feel like I've blown it, but I'm
not sure what "it" is. I'm a little concerned.
TUESDAY, OCTOBER 5
TEST #3: Psychophysiological and neuropsychological testing
The maddening thing about these evaluations is how repetitive the
questions are: "How am I feeling how have I been feeling any trouble
sleeping?" I go through the usual answers, feeling the same reluctance to
reveal so much of myself to yet another stranger.
Tags:
accurate diagnosis,
codicil,
cue,
curveballs,
cutoff point,
depression,
diagnostic techniques,
institute of mental health,
mt sinai school of medicine,
national institute of mental health,
neurological tests,
neurology,
personality,
personality disorders,
prosthetics,
psyche,
psychological assessment,
psychological disorder,
questionnaire,
school of medicine,
shocks,
sinai school,
socks,
suspicion,
three months
