The Last Visit
Well, the long-dreaded parting with my psychiatrist has finally happened: thanks to my insurance, which will only pay for care received in my county of residence, yesterday was my last visit with Dr. Awesomesauce. And all I can say is I’m thankful I’m not in crisis at this point, because I’m not fond of the idea of getting my mental health care through the county clinic. Dr. A says he’s going to do everything he can to keep me on as a patient, but there’s not a lot he can do and frankly, it would take a miracle to persuade Medicaid to allow me to continue with him. That’s just the reality I have to deal with, and it sucks.
He didn’t just cast me adrift, however. He is willing to prescribe for me for as long as I need it (it may be awhile till I can get in to see someone) and gave me a list of resources in the local area, as well as some names of doctors NOT to see. I’ll probably have to find a therapist as well because most psychiatrists and psychiatric nurse practitioners aren’t like Dr. A, they only prescribe and don’t do therapy. I was lucky to have the luxury of “one-stop shopping”, as it were, and that’s probably not going to happen again.
What I fear is getting lost in a sea of other mentally ill poor folks in the clinic setting. Maybe I don’t deserve any better—I did let my bipolar get out of control and pretty much ruin my life, which is why I’m in this predicament—and I’m certainly nobody special in the great scheme of things. But with Dr. A, I’m an individual in whom he’s invested a lot of time and care; there, I’ll be just another psych patient. Which is something I’ll get used to, because I have no choice…I’ll have to be under somebody’s care for the rest of my life.
This is more than a little scary. I don’t want anyone messing with my meds—they are almost perfect just the way they are and even Dr. A is adamant that we don’t change anything. It took three years to get to this level of stability and I’m terrified a doctor or NP is going to think I’m on too much medication, or on the wrong kinds, and screw it all up for me. I know people who’ve had this happen to them and it took what seemed like forever to get back on track. And I’ve been really high-maintenance during most of the past four years…who will be there for me when the next bipolar shitstorm occurs?
But what grieves me the most is the loss of the relationship I’ve had with Dr. A. I’ve never known anyone quite like him, and I’m going to miss him sorely. How many doctors do you know who served in the Iraq War, have traveled the world, pray for their patients and do their own home canning? Not only that, but he knows things about me that even my own family doesn’t know, things I’m not proud of and would never share with anyone else, and yet he’s never looked down on me. Unfailingly supportive, kind, funny, smart…that’s what he’s been, and I can’t imagine how anyone else will ever fill his shoes. In fact, I almost feel sorry for my next psychiatrist, because Dr. A is the standard by which all future mental health care providers will be judged.
So I’ll call the mental health clinic on Monday and do whatever I have to do to get on board with them. As sad and disappointed as I am, life must go on and I need to get on their radar so I have somewhere to go when the fecal material collides with the oscillatory ventilating system. Because it will, as Dr. A reminded me yesterday; after all, bipolar is the gift that keeps on giving, though it’s been pretty easy over the past eight months or so to forget that I even have it.
I’ve had the feeling this was coming for some time. I was even prepared for it, which is why I’m not panicking. But it’s still a blow, and I am most unhappy about it.
And so it goes.