Answering Yuri, Questioning Oneself

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Psychiatrist and commentator Elissa Ely encounters a resistant patient who leads her to question the efficacy of her profession


Resistance from a patient is nothing out of the ordinary for psychiatrist Elissa Ely. She's prepared to deal with that. But what she's not prepared for is finding herself in agreement with a reluctant patient.

ELISSA ELY: He won't accept clothes from the shelter's clothing room. He eats alone, which isn't unreasonable for someone who emigrated to America from a police state. But staff worry he's depressed. They want him to meet with a psychiatrist. I do not need talking to, he told them. I need job and home.

His shirt's buttoned to the chin and a safety pin holds the chest pocket in place. This is his deposit box. It's filled with his documents and money. A safety pin doesn't guarantee safety, though. In the land of opportunity, he's been beaten and robbed already.

How's your sleep in the shelter? Are you fatigued during the day? Have you lost or gained weight? Do you keep your energy and concentration up? Do you have feelings of worthlessness and helplessness? Ever worry you're not safe?

The usual questions are woeful. Depression and paranoia are sane responses to homelessness. There are other questions that would be better to ask. Why did you come to America? Did you think life would be like this? Do you think you can survive? But he doesn't want to discuss questions, the woeful ones or the others.

There will be lunch at noon so I cannot sleep yet, he moans. Then I will sleep in park a couple of hours, maybe - sitting up, then dinner. Well, I say, would you come back next week? He gazes at me, then lifts his hands in disbelief. Heaven is his witness here. For what? he says. For to talk? Never has a concept at the center of a whole profession been exposed as so worthless. Talk is not a job. Talk is not a bed. Talk is not money. It doesn't fit in the chest pocket with a safety pin. It won't change where he sleeps tonight.

I am on a cliff, watching my field bob and float away with no response other than to wave after it. He notices the affects of his words. They're inarguable, but possibly a little harsh. So okay then, he says finally. I will come back. He seems to feel something more is called for. So thank you, he says politely, for this conversation.

SIEGEL: Psychiatrist Elissa Ely practices in Massachusetts.



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