Be advised: this thread is not for serious in-depth discussion of weighty topics (we have a link for that), this thread is not for anything Culture War related. This thread is for Fun. You got jokes? Share 'em. You got silly questions? Ask 'em.
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Notes -
I was standing on the sidewalk somewhere past 3 a.m., watching the city’s Halloween detritus shuffle past like the closing credits of a movie that had gone on fifteen minutes too long.
A vampire with a torn cape was arguing with his girlfriend about whether they had enough money for the last Lyft or local equivalent. Others huddled in dark corners, clutching their heads either out of fear of the coming sun, or because they were very drunk indeed.
My own group, three people I can't claim as more than casual acquaintances, was debating whether to find an after-party or just admit moral defeat and go home. I had voted for moral defeat, but I was outnumbered.
That was when the woman with the neon-blue hair appeared. She was thirty-ish, maybe thirty-five, hair the brashest blue I've ever beheld. She was not wearing a costume, unless “minor anime protagonist” counts. One of my temporary acquaintances said something to her; she answered; they struck up a conversation. I stayed in my usual observer stance, the one I use when I am too tired to socialise but too curious to leave.
Suddenly she swivelled toward me like a radar dish acquiring a target. “You’re a doctor,” she said. I hadn't mentioned anything medical. I was wearing a leather jacket, not a white coat. I'd barely spoken ten words.
I blinked. “Yes.”
“Psychiatrist?”
This is the part where I should probably mention that yes, I am a psychiatry trainee, but HOW DID SHE KNOW? Was there some kind of pheromone? A subtle head-tilt I'd unconsciously adopted during residency? Had my listening posture somehow crossed the threshold from "politely interested drunk person at 3 AM" to "definitely went to medical school for this"?
I hesitated. Psychiatry is the one medical specialty that sounds slightly scandalous at parties, somewhere between “taxidermist” and “DJ.” But the street was almost empty, and the remaining witnesses were too drunk to remember. “Technically still a trainee, but yes.”
She nodded as though she had just solved a crossword clue in pen. "Just the way you listen," she explained, which explained nothing.
She then proceeded to discuss her experience with bipolar disorder, which I guess made sense: if you've spent enough time on the receiving end of therapeutic attention, maybe you develop a radar for it. Like how chess grandmasters can spot other chess grandmasters, or so I've heard.
She told us - told me, really - about her bipolar disorder, the way her mood chart looked like a roller coaster designed by a sadist, how she had tried lithium and Lamictal and something that started with “v” but made her gain fifteen pounds and lose the ability to spell. She spoke in the fluent, technical dialect patients acquire after they have survived long enough to become experts in their own disease.
After five minutes she hugged me, people-on-manic-spectrum hugs are like unsecured loans, and wandered off into the neon night.
The whole experience has left me bemused. Now, I like to flatter myself by thinking that I'm a decent fit for the profession, and that I'm a good listener, but being pegged from a distance by drunk women on the streets is new. Is there a "look" defining a psychiatrist? A particular way of inclining our heads and nodding noncomitally while giving the impression of rapt but not intimidating levels of attention? It can't have been the attire, though I suppose nothing precludes the profession from wearing leather jackets on our rare nights out. Or perhaps the lady is simply so used to encountering us that she had me pegged in thirty seconds. I can't do that, and I've been in the business for over a year now.
So do we become psychiatrists because we look like psychiatrists, or do we look like psychiatrists because we become them?
The answer, as usual, is “yes, and also the medication may take four to six weeks to work.”
Still, dwelling on this, there is a third, darker hypothesis: the Fisherian Runaway model.
Once upon a time, some proto-psychiatrist had a slightly softer voice and a slightly more open stance. Patients preferred him; they felt heard, so they kept coming back. Evolution (of the cultural, not genetic, sort) selected for ever more exaggerated signals of therapeutic receptivity. Over decades the specialty developed peacock feathers: bigger empathy, slower blinks, the ability to say “that sounds really hard” in seven different intonations.
The endpoint is a creature that is optimized to be recognized, the way poisonous frogs evolved neon skin to advertise their toxicity. We did not mean to become walking Rohrschach cards; it just increased patient satisfaction scores. The woman with emergency-exit hair was simply the co-evolved predator: a patient whose detection apparatus had become as refined as our camouflage.
But the next time a stranger on the street diagnoses me by vibe alone, I will not flinch. I will simply nod, the way I have practiced, and say, “Tell me more about that.”
I had a friend from Medical School. Beautiful Korean girl, super introverted, super quiet. People would just talk to her, explain things about their life. You'd figure they'd hit on her, but no, instead she got unsolicited information. I told her she'd be a good psychiatrist, guess what she ended up doing?
And at the same time, seeing her years later..... she looks more like a psychiatrist now.
I think it's a little bit of natural temperament and a certain kind of charisma that does something very specific, and at the same time the training and practice takes any innate character and accentuates it.
To some extent I figure this applies to all physicians - once you get used to people telling you about their anal leakage that changes how you interact with others in a big way.
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