I disagree with Matt's assertion about people believing that psychiatry mistakes are scarier than surgical ones.

I do agree with what he wrote in his last paragraph. What I was thinking while I watched the video was that people with mental problems are sometimes, but not always, incapable or less effective at establishing and maintaining social bonds with other people. At the end of the day, if I can feel like I can know and interact with someone with some degree of predictability, then I am more comfortable accepting other things that may be unusual about them. I think this is where the stigma of psyc patients comes from, and consequently the fear around seeking psychiatric help.

To respond to your last question, Paras, I think that is a large part of the answer. Even when it comes to, say, vaccinations, where the medical community is completely united in their assertion that vaccines are good for people, there is still this undercurrent of popular resistance to that.

There's a sociological theory called 'sick role theory' which states that people can get out of their usual social responsibilities (such as going to school or work) without consequences if they're sick and seek and follow medical advice (which can amount to adhering to the general opinion that you should sleep lots when you have the flu, even if you don't go to the doctor). It's obvious, of course, but what was interesting was that the writer (whose name I've forgotten) specifically said that this did not apply to mental illnesses, since patients always have a better understanding of what's going on with them mentally than a outsider, even a professional one. He was writing back in the 50s (I think), when people tended to respect professionalism more than they do today. Now of course, people think that their opinion is as worth considering as their doctor's, even when their problem is objectively measurable. So I think it's not just their willingness to admit ignorance, but also a sense that, even back in the fifties, psychiatrists are more advisors than supervisors in care. And now, people are clawing back as much power as they can from professionals, generally. Our thoughts and emotions are much more an intrinsic part of our identities, so we are more reluctant to turn even a small amount of power over those aspects of ourselves over to someone else than we are when it comes to a bad knee or something. Movies play on that fear, I think, rather than being primarily responsible for creating it.

Hmm. That got long and ranty, considering I was agreeing with people.

In the hope of starting a discussion, why is wrong psychiatry scarier than wrong surgery? If someone amputates the wrong leg (it has happened) is that not a horrifying outcome?

Is this just a problem of psychiatry admitting uncertainty while the rest of medicine (erroneously) boasts absolute certainty?

That's awesome Par. What came to my mind is the following:
-Yes, psychiatry DOES have an imperfect history, as do all fields of study, but getting psychiatry wrong is way scarier than doing, say, an un-sterilzed surgery, or getting physics wrong.
-It's hard to trust psychiatry all the way because of this, and also because we still don't understand the brain 100% yet, so how can psyciatrists assure us that we're absolutely without a doubt in good hands? And also because we know so little about the brain, we can imagine all kinds of horrific things potentially happening to us, but we know what happens to legs and arms and stuff pretty clearly.

And I'm not at all slagging psychiatrists but I think that's why people still associate psychiatrists with (like he said) paranormal and paranoid ideas. The brain is still a bit of a mystery, so people lump it in subconciously with other mysteries.

I think mental problems are treated and seen differently than other diseases because it limits your ability to communicate with people in a "normal" socially established and predictable way. If someone's brain chemistry differs enough from your own, they're practically an alien. Not the same as getting, say, tetanus. It's disconcerting in a way that physical ailments aren't.

You say that now, Jess, but once you get lockjaw vigilantes are what you'll want to save you.

Tetanus is complicated, because it's not the bacteria that's the problem but rather the toxin. The toxin binds irreversibly, so neurological damage that results from bound toxin doesn't really subside, but you can give people 'tetanus immune globulin' (ie. antibodies against the toxin) to mop up unbound toxin.

Still, it's a crazy diagnosis, and certainly not what I expected, but I at least found out enough when I examined him that I got him to the neurologist.

I read Alison's post quickly and saw "vigilante," which seemed unnecessary.

Hey Par, what do you do with someone who's contracted tetanus? I thought it was kind-of, well, fast-acting and lethal.

If we were vigilant, we got it at 25, right? ... so 35's the next one?

So true!

Thanks Par, but don't worry, I stopped drinking Scotch and Drambuie together a long time ago.

Dear friends,

Please get your tetanus updated if you haven't in the last 10 years. One of my patients turned out to have contracted it.

Crazy.

Yours,

Paras