My psychiatrist is a weird character.  We’ll call him Dr. B for the sake of argument and legal fees.  Dr. B never makes eye contact with me.  This would be unnerving to me if I didn’t do the same thing.  The odd part about this is that in our mutual avoidance of eye contact sometimes we wind up staring at the same thing and then neither of us knows what to do so we each try to play it off as something that someone else did only both of us know that there are only two people in the room.  It’s hard to blame a third party when there is no third party present.  Dr. B always asks seemingly unrelated questions and gauges my response time to each.  He claims to “know” what is really wrong with me yet doesn’t have the heart to tell me so I just assume I have Cancer that way I’ll be happy when I get whatever bizarre diagnosis he comes up with.

“We need to talk,” he said to me one day.  We always talk.  All we do is talk come to think of it.  What else is there for you to do with your psychiatrist?  Go into the lobby and read two and a half year old magazines?  “You’ve either got Asperger’s or you’re some sort of serial killer,” he says.  I was okay until he got to the serial killer part, then I started to question his judgment.

“Seriously, hasn’t this guy seen ‘Dexter?’” I thought.  This came two visits after I first brought up the issue.  One thing I’ve noticed with doctors nowadays is that they rarely diagnose you with something that you haven’t brought to their attention yourself earlier.  Most people are either very good at self-diagnosing themselves or very attentive commercial watchers.  My guess is it’s the latter.  We’re all so dialed in during Jeopardy! that when they get to a commercial we claim to know the answer even if no question is asked.

“The treatment won’t be that different than what you’re currently undergoing,” Dr. B said, which seemed strange because I didn’t really know what that “treatment” I had been undergoing was.  I take pills for everything.  Sometimes I play stack the bottles to try and make a pyramid out of my prescription bottles and I can get pretty close to the top before I run out of bottles.

“How is the treatment going to be any different than what I’m undergoing now?”  I asked.  It was a legitimate question because many of the different forms of treatment for Depression, General Anxiety, Panic Attacks, and Asperger’s are the same.

“You’ll be taking a slightly different, but remarkably similar form of Paxil,” he informed me.  Paxil had never done anything for me in the past, so my enthusiasm for this treatment was relatively curbed.

“Do you think it will make a big difference?”  I asked.

“No,” he said rather curtly.  I found that sharp response to be uncharacteristic of Dr. B seeing as how he has no sense of humor.  You know someone who doesn’t have a sense of humor because they’ll smile instead of laughing at something that’s utterly hilarious.  I know this because as a writer I am a good storyteller and I can tell how someone is going to react to a story well before I get to the crux of it.  Dr. B never reacts to anything in the story, he always seems to wonder what the point of it all is.  It’s as if he thinks that something of deeper meaning will be elicited if he gives no response at all.  There may be some psychological point to all of this, I don’t know, but I do know that I’ve been seeing this guy for over a decade and I’ve never seen him laugh.

“What do you think have been some of the major problems you’ve encountered as a result of your Asperger’s?”  He asked.  It seemed to me like there was a fairly obvious answer to this question.

“It affects social interaction,” I said.  “It affects simple things like how to start and end a conversation.  I can’t seem to do either.  I tense up when someone looks at me waiting for me to say something.  It also affects the give and take of basic interactions.”

“You can’t start conversations with people?”  He asked.

“I can, but I always feel incredibly self-conscious when I do so,” I replied.

“You’re a smart guy,” he said.  “Why don’t you just watch people who are good at social interactions and mimic their behavior?”

“I’ve tried, but I can’t do it.”  I said.  “It actually makes me angry that there are people who enjoy talking to other people.”

“Why does it make you angry?”  He asked, somewhat perplexed by my response.

“I don’t know how anyone can enjoy a conversation involving small talk, I mean, what’s the point?”  I asked.

“Generally, people try to establish report and then move on,” he said.

“That doesn’t make any sense to me,” I said.  I genuinely don’t know why small talk is made other than the fact that for some people it eases the tension in a room.  I always think of Winston Churchill’s advice of “only speak when it improves the silence.”

“You never make small talk?”  He asked.

“Not unless I’m trying to get something,” I responded.

“What other problems do you face because of Asperger’s?”  He asked, while furiously taking notes.

“I have a problem with give and take,” I said.

“Give and take?”  He asked.

“I can’t give and I can’t take compliments or criticism really,” I said.

“That must be a hard thing to deal with for a writer,” he said.

“You have no idea,” I said.  “People tell me my work is incredible and I sit there wondering what their angle is, what they’re getting by saying that or what kind of reaction they want out of me.”

“People can’t just be nice and civil?”  He asked.

“They can be, but what’s the point?”  I asked.

“You ask that question a lot,” he said.  “Not everything has to have a point.”

“It does to me,” I said.

“Why do you write?”  He asked.  The answer to that was simple.

“It makes me happy,” I said.

“I’d keep doing that then, but I’m putting you on a different medication and we’ll see if that does anything in a month or two,” he said as he got up and handed me the prescriptions.  I always feel uncomfortable entering and leaving a building.  I think it has to do with all of the fake pleasantries that everyone lauds at me.  The “have a good day”s and everything seem so superficial and pointless.  These people don’t care if I have a good day or not, so why encourage me to do so?  Most people don’t think about this stuff and probably with good reason.  I do think about all this stuff and at times it drives me nuts, but at the same time I really want to know why everyone puts up these fronts.  I suspect I’ll never get a good answer to these questions and will thus continue to live in a world that perpetually disappoints.


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