The Embed is moving on to her main diagnosis: major depressive disorder, severe and recurrent.
But I have bipolar disorder, type II! I’ve had it for forty-two years, I tell the Embed.
No, she says, I didn’t see that.
You saw me for one hour, I say. My psychologist of ten years and my psychiatrist of eight years say I’ve got bipolar disorder. What’s the problem that you can’t accept that?
That’s my story and I’m stickin’ to it, says the Embed.
You are totally invalidating me, I say. I say I have bipolar disorder, I say. This is DBT, remember? You’ve just told me that you don’t believe what I say, what my doctors say, or the reality of my life. That’s really weird. I’m not saying that your hair has grown eyes and is crawling down your face or there are six-foot-tall cockroaches walking through the door. I’m saying this is my hardcore reality.
Um-hm-mm, says the Embed.
In addition to invalidating my reality, she has just committed to paper a misdiagnosis based on not listening to the patient—although, truth to be told, it’s never about not listening to the patient: it’s about not respecting the patient. The Embed heard what I said and could probably quote back my words but she will not credit that I know what I’m talking about. The doctor never says, “My patient is smart, and knows a lot. She has spent—oh, about half a million hours with herself. I have spent one hour with her. She just might be on to something here.”
The doctor says, ‘I went to professional school and the patient didn’t, ipse dixit, I’m right.’
My nervous system is now reeling from the shock of invalidation, misdiagnosis, injustice and disrespect but for some reason I still want to hold open the door to get into the DBT class—that, in and of itself, may be proof that I’m sick. One iota more self-confidence and I’d walk away from here. But, I tell myself, DBT has such cool stuff that I want to learn. The Embed has taken courses from professors whom she didn’t like and who probably didn’t like her, but she still has learned. What is the difference between a doctor embedded in the medical system and a professor teaching in the education system?
The professor is paid to educate the ignorant; the doctor is paid to treat the sick. What if all sickness is based on ignorance? Professors need to write; doctors need to be right. The Embed, a professor in the medical system, tells me that she thinks this isn’t going to work, that when she feels this alienated, it doesn’t work, and she doesn’t think I should be in the DBT course.
I point out to her the irony: Because I have alienated her, she will not let me into the course designed to teach me how to get things done without alienating people.
I tell the Embed that I hope neither of us will make a final decision until we both have talked to my therapist, then I leave, go out and sit in the blazing sun and wonder about this woman who said, “Call me Anna” and told me her feelings were hurt.
Two weeks later, after Paul has talked to Anna, he tells me that she is sorry she made the diagnosis of narcissism. It was, well, she didn’t know exactly what to say, and, well . . .
He talked to her a long time, he said. How old is she, he asked me?
Oh, thirty-ish, I reply.
Um, he said. She talked to me like I was, well, God.
God, I giggle, thinking of all the times I’ve busted his chops.
Slowly he begins to convey the gist of the conversation. She was uncertain, ah, unsure, maybe she couldn’t picture running the group if I disagreed with her. I am very intelligent, very self-assured, quite experienced. The others in the group can’t begin to match me.
Angrily I say, you mean she felt out-classed, out-ranked and out-maneuvered by me, and therefore won’t let me in the course?
Um, something like that, he says.
Do you know, not once in my forty years in the system has anyone ever said, ‘You’re beyond this. You’ve already got it. You’re healthy and we have nothing to offer you: move on.’ I’m more intelligent and experienced than she is, so she diagnosed me as narcissistic, I shout!
Well, it was unfortunate, Paul says. She said that if you want to call her, she’ll tell you that.
If I want to call her, I yell! She wronged me! How about if she faces up and calls me? She wants to retain the power position and have me come to her!
Paul and I talk about DBT. We talk about whether I enjoy the way I’m feeling, this anger and hatred for a dishonest woman embedded in a corrupt system, who, instead of admitting her lesser competence and experience, told me I was sick. When she saw how tall I stood, she tried to diminish me so she wouldn’t feel so short. Paul and I discuss what to do about it. I tell him I could be both a learner and a teacher in the course, that I could help others learn, be a sort of unofficial assistant teacher. He nods sadly, knowing the truth of it, and knowing an embed in the system can’t handle it.
You could do something else, he says. You could write about it. So I write “Anna the Embed” and send her a copy. She does not reply.