medical advice conundrum

During my journey with cancer last year, I leaned on the medical advice from doctors who were friends, family and friends of family.  I am endlessly grateful for the input which guided my every step.

But  when loved ones ask me for professional advice, I increasingly become baffled.  I long to pass on similar generous assistance and to share information that is the bread and butter of my clinical days.   Moreover, I have no problem discussing the subjects that fascinate me endlessly.

However, sharing psychiatric input with friends and family hasn’t proven simple for me, and it seems can rapidly tend towards disaster.   I’ve been mulling over why.  Seems that for starters, the saying is “love is blind” for a reason.   Seeing the very best in others may be key to relationships, but it can be disastrous for accurate psychiatric assessment.   The suitably objective perspective is difficult or perhaps impossible here.

So I initially thought the obvious solution is to refer.  To offer names of good docs.  I know so many of them.  However, even this has proven trying.    Sometimes the referred to colleague  turns out to be a poor match, things don’t go well and frustration ensues.   Or, more often, folks do not follow through.  Instead, they  find mediocre care or no care at all.  What then?  Further input could interfere with ongoing treatment or could feel intrusive.

So I have concluded that medical advice is a serious conundrum in the world of psychiatry. Those who we most love, we often can least help.

Why share my two cents when I have reached such a gloomy conclusion anyway?  Does this downer of a  message matter?  Well, actually I think it matters a lot.   Keeping absolutely mum when asked for advice just doesn’t seem realistic.  My solution is simply to slow down.  Take a deep breath.  Think long and hard.  Offer vastly less rather than more concrete input.  Perhaps focus on information less influenced by the subjective.   Studies done, medication side effects, reasonable medical work ups and laboratory testing seem benign enough.   Perhaps offer a long list of good referrals, rather than one.   The friend then can choose amongst and feel more ownership of that choice.

I’m walking a mighty fine line here, but  I think it’s a line worth walking.  Our advice should be informed not only by the mental health information we know well but also by the inevitable, unavoidable murkiness of  vision when looking at those we know well.  Good luck with it.