Why I Wrote a Clinical Memoir

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I wrote my clinical memoir, Practice, Practice, Practice: This Psychiatrist’s Life to share the view from my side of the couch with interested lay readers. Despite 30 years in private practice, I am still astonished by public misconceptions—simultaneously fearful and unreasonably entitled—about what we psychiatrists and mental health clinicians do. Here are a few I am sure you have heard too, and how I respond.

“Don’t analyze me!” You think shrinks can see right through you without effort? No, we can’t. Getting around all those cunning booby traps you’ve set to prevent that is hard work. I always smile and say, “Relax. I’m off duty.”

“I couldn’t listen to all that misery, day after day. How can you stand it?” I love my work . It’s real and compelling, and I can’t believe my good fortune. Call me crazy, but I like it when a patient has a life changing Ah ha! moment because of me

“What is it you actually do? You’re just sitting there.” (Patients have asked me this too.) I’m not just sitting there. I’m listening. I’m thinking about what you are telling me. I’m thinking about how to best help you.

“Why should I pay you to listen to me? That’s what friends are for.” Ask yourself this: Do you have any friends who will give you their full attention for more than 5 minutes, think only about what you are saying, and speak only to what will be of service to you? Me neither.

There is nothing more thrilling than being able to catalyze real change for the better in patients’ lives, and thereby help to reduce suffering. That said, every session is an adventure and Murphy’s Law¹ prevails.

Patient ambushes! Clinician pratfalls! Back-of-the-shop scuttlebutt! I give you fly-on-the-wall views of treatments with a wide range of patients along with actual transcripts of what is going through my mind as I am working and saving the day (or trying to). What does this immersive memoir tracking decades of rural psychiatric practice expose? Flawless performance is not required for psychiatrists to be genuinely helpful to patients. Or to ourselves.

Written with candor and a light touch, these interconnected clinical and personal tales reveal a way of thinking that I believe is essential for learning actively, living fully, and doing good work with a sense of wonder year after year.

I hope curious readers are entertained, enlightened, and reassured. If readers are inspired to enter the field, even better. If seasoned practitioners chuckle wryly—Been there—I will be delighted. If mental health educators want to use this book as a teaching tool—well, that would be an honor.

Daniela V. Gitlin, MD is a rural psychiatrist in private practice in upstate New York. Practice, Practice, Practice: This Psychiatrist’s Life was selected as a Finalist by the 2021 International Book Awards in the Health: Psychology and Mental Health category. She welcomes correspondence at danielagitlin.com.

References

1. According to Murphy’s Law: anything that can go wrong, will go wrong.