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Thinking Outside the [Check]Box

February 19, 2011

I got an email from an old friend a few days ago. My friend does not have cancer, but she has another “bad” illness, one of the ones where the illness and treatment play a one-two punch with her mental processes, and she was asking me about my experiences with cognitive occupational therapy.

I’m upset that my friend, my brilliant friend, is having to go through this.

I would have loved to have been able to give her a step-by-step detail of my experience, but I couldn’t, because it didn’t work out for me.

I had a complete neurological and psychological workup done which established that I was indeed cognitively impaired and that I would benefit from some cognitive occupational therapy. I went once and received a handout with advice like “Put your purse in the same place every time you walk in the door so you can find it.”

I think it’s called recursion.

If I had had the ability to put my purse in the same place every time I walk in the door then I would  not have needed cognitive therapy.

I never went back.

I eventually found a therapist, a doozy of a good one, with whom I was able to talk through my frustrations, and she gave me some pointers that have evidently worked out for me, because here I am, blogging about my life, and not just playing Warcraft all the time, my house is falling much closer to the tidy side of the tidy/chaotic spectrum, I’m making healthy meals for my family and myself, I have friends with whom I do stuff, I’m being a good example for my children in terms of  personal grooming habits, and all of the other “fumctional” checkboxes are pretty much checked.  I talked about them with my therapist.

Clean clothes. Check.

Hair brushed. Check.

House tidy. Check.

Social life. Check.

Kids taken care of. Check.

Happy.  Check. Check? Wait, what?

Depression?  Huh? As it turns out, the workup sheet of my cognitive and psychological evaluation had a sentence that stated “Patient should be evaluated for severe depression and is a potential suicide risk.”


On the one hand, depression is a deadly disease, and I’m glad that the medical profession is on the lookout for it.

On the other hand, I do not feel depressed.

I asked my therapist about that sentence.  She looked at my results and thought for a few minutes.

Therapist: “The question, “How many times a day do you think about dying.” How did you answer that?

Me: “Um. Several times a day? All the time? Whatever the maximum answer is.”

Therapist: “Do you ever think about killing yourself?”

Me: “No. Hell no. I didn’t go through cancer treatment to kill myself.”

Therapist: “Well then what do you mean when you think about death.”

Me: raises eyebrow and sneers.

Therapist: demonstrates how they teach you to not say anything in therapist school.

Me: “I had bad cancer with a low probability of survival. Of course I think about dying.”

Therapist: “Do you think about how you would like to die?”

Me: “No, I think about how I would like to not die.”

Therapist: “I think when they developed that test, they didn’t envision patients with quasi-terminal diagnoses. Most people don’t think about death because they don’t have to. If you say you’re not depressed, I believe you. It doesn’t sound like you’re depressed. Don’t worry about it.”

I don’t worry about it. Much. I’m surprisingly uncomfortable with that sentence in my medical records, but it’s not like anyone is going to sell me life insurance anyway.

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  1. a great, smart, honest read, as always. look forward to every post.

  2. Nancy Kirk permalink

    No need for anything more than I wouldn’t have gone through cancer treatment if I was going to kill myself. As an old friend of ours might say, What Is Wrong With People! Specifically, what was wrong with the person who administered the test. I am really angry at this. Sorry you couldn’t help the other friend. I relate. Sometimes a friend just wants you to listen even if she doesn’t say so.

  3. Aunt Lee permalink

    I agree with Nancy Kirk and am angry with the bureaucratic form. If you get the energy, you could insist that that sentence be removed or corrected in your medical record. You might tell them they need to change their form; it’s just making them look incompetent.

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