Tender Toes

A teapot tempest was stirred up by our medical bargain report on Newsweek's story of Len Maholick's patient and his subsequent rebuttal in last month's Bulletin. While there is no need to prolong the discussion indefinitely, there have been enough offers for permission to reply, that our advisors feel further comment is in order.

In the letter which accompanied last month's published reply, the wisdom of allowing such exchanges to start was questioned, and a hope was expressed that the editorial policies and objectives of the Bulletin had been carefully weighed. The editorial board believes that these have been, and that the objectives were stated clearly enough in the editorial of the January issue. As to the wisdom of permitting acrimonious exchange, we would agree that it is unprofitable, but frankly can see no harm in the airing of different points of view.

The complained-of, exclusive focusing on the financial aspects of the affair, (monetarily titled "Where It Really Hurts" by Newsweek, and called "The Fantastic Cost of Being Neurotic" by Len in the Medical Times), followed only naturally from the detailed emphasis on the same preoccupation in both source accounts, and was a gay attempt on the Bulletin's part to point up, by reduction to absurdity, some apparently unchecked and ridiculous number juggling.

Although the Bulletin's story might have been interpreted by some as critical, it was intended primarily as light humor and without malice. To our possibly biased mind, it contained less unhumorous criticism than the original stories which cannily lumped the doctors and the chiropractor and set them apart, implying that after 17 years of fumbling and overcharging, this miserable group was put to shame by the astuteness of benevolent psychiatry.

We agree that the case presented was informative and that it served as an excellent vehicle to illustrate the psychiatric point of view that psychotherapy can be helpful. On the other hand, we will be glad to supply from our files, if anyone is interested, an equally informative record of a comparably aged, psychoneurotic female who was gainfully employed and reasonably adjusted during many years of treatment by assorted doctors and chiropractors. This lady filled out her first psychiatric questionnaire at the insistence of her pastor some 14 months ago; now after more than a year of follow-up psychotherapy she has lost none of her neuroses, but, unhappily, has lost her job, having become too sick and emotionally upset to work ever since she began her treatment. Apart from illustrating one of the pitfalls of inductive reasoning, and demonstrating that the results in individual gases may occasionally produce doctor-delusions, what all this proves we do not profess to know. We will go along with the worker in the field who defines psychotherapy as "an undefined technique applied to unspecified problems with unpredictable outcomes."

Reluctantly, we are willing to plead guilty to a callous disregard for "bankrupt emotions," but feel that such dramatic wording might have had a more effective appeal had it been directed toward the Sunday supplement readers.

However, we do offer our apologies for not realizing that we were treading so harshly on sensitive, local psychiatric toes.

(c) The Doctor's Lounge, Muscogee County (Georgia) Medical Bulletin, Vol XX, No. 1, 1962, p20

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