Standing Still and Looking Back: A Memoir

By Stuart Shipko

A doctor reflects on his career, psychiatry, medicine and remarkable experiences with faith healing amidst the backdrop of the first year of the coronavirus pandemic. With intellectual honesty and candor, he achieves deep and satisfying self-understanding.

• Language: English
• Publisher: Stuart Shipko
• Release date: Dec 17, 2021
• ISBN: 9781005783969

Stuart Shipko

I have been practicing psychiatry for over 40 years. My interest in panic disorder stems from my experience as an emergency room physician, where I saw a lot of panic attacks that simulated heart attacks and other physical conditions. In the late 90's I started a website called the Panic Disorders Institute where I, and a group of informed patients with panic disorder, shared information. This multiplied my understanding and knowledge of panic disorder. The information in Surviving Panic Disorder is the information that people are seeking when seen for an initial consultation. My interest in problems with stopping Xanax and my observation of the numerous side effects and withdrawal effects of the SSRI antidepressants prompted me to share my experiences in Xanax Withdrawal and Informed Consent for SSRI Antidepressants. Xanax withdrawal gives good general information about stopping the drug or other short term benzodiazepines such as Ativan and Klonopin. Anyone considering starting or stopping a SSRI should take the time to read the book on informed consent. Standing Still and Looking Back: a Memoir is a labor of love. All memoir is, to some extent, psychotherapy. With the start of the pandemic I found myself with time on my hands. Initially it started out as a pandemic diary, but as I wrote I began to reflect on my long career, particularly experiences that I had early in my career in faith healing. Unlike my other books it is not a self help book. I hope you find it a good read!

Book preview

STANDING STILL AND LOOKING BACK

A Memoir

By

Stuart Shipko

Copyright © 2021 Stuart Shipko

All rights reserved.

DEDICATION AND ACKNOWLEDGMENT

I dedicate this book to all of the health care professionals who have been caring for patients infected with the novel coronavirus.

I wish to thank my readers and editors Dean Gean and Mary Jane Horton for their encouragement and suggestions.

Introduction

I am a 67 year old physician who has been in practice for over 43 years. First as an ER and family doctor, then later as a neurologist and a psychiatrist. Also, I am a husband to Mary Jane, father to Zachary and Chloe and grandfather to Meadow. I like to think of myself as a healer.

Realizing that the pandemic was going to be a once in a hundred-year event, my original intent was to just chronical the pandemic for a year in a diary. While it was a remarkable year, one worth keeping a diary, as I wrote I reflected more on my career, especially my early work in the 80’s when I explored faith healing.

Recently I had my annual physical examination and I mentioned to my doctor that I had been writing about healing. Her face lit up as she explained how she tells patients about the deep, ancient roots of some of the treatments she prescribes as a means of heightening the healing effect. Obviously, I am not the only doctor who has an interest in this. Healing, spiritual healing, is a topic that is almost taboo during training, yet the scientifically unexplained aspects of the doctor patient relationship would have to be of interest to anyone who works as a doctor because so many scientifically unexplainable events commonly occur during times of serious illness.

When I spoke to others who are not physicians about nontraditional medical care, I found that lots of people had a story to tell of how they were unpredictably healed. My neighbor told me that his longstanding plantar fasciitis (inflammation of the tendons on the bottom of the foot) was permanently healed in one visit by an osteopath who massaged his scalp for a while and then just tapped on the bottom of each foot. Everyone has a sense that there is more going on than meets the eye and stories like these are common.

In this book I intermingle a diary of an extraordinary year with my early experiences with healing and my identity as a doctor and a person.

Diary 3/10/20

3/10/20

If it was not for the pandemic and my ignorant landlord, I wouldn’t have closed the office. It was a big decision. As an essential service I could have kept the office open, but with the pandemic it would be difficult to focus on the patients and not my own safety.

Though we are not yet on lockdown (there are only about 1200 cases of Covid-19) the global picture is worrisome and unlike a lot of other Asian viruses that were contained in Asia, this one has spread to the United States. Just like other countries have, I imagine that we will shut down soon. To keep safe in the office, the last few days I started performing almost obsessive cleaning rituals. I know that I need to be extra cautious, but it’s difficult to distinguish between what I do for safety and what I am doing because of anxiety. I wash my hands after every patient, keep six feet away, and don’t touch my face. Between patients I wipe down the chairs, table and desk. I thought about wearing a mask but they say that it won’t protect me, just the other person. I’m happy to protect my patients, but will they protect me? Should I ask them to wear masks for my sake?

Last Tuesday I asked the landlord, also a psychiatrist, what we will be doing for coronavirus precautions. The office is in an old Victorian house with a common ventilation system. The waiting room and restrooms are common space. Although eccentric looking and definitely on the Asperger’s spectrum, he had been, for two decades, a pretty good landlord. Unexpectedly this time he wasn’t. The landlord was quite irritated by my question and snapped, I’m 180 degrees opposite from you on this.

The last time he snapped at me like that was over 20 years ago when I commented that Paxil seems like a particularly addicting drug. With irritation and condescension, he blurted out, You can’t say that unless you do controlled, double blinded studies. He was wrong; you don’t need controlled studies to describe side effects. Paxil is a very difficult drug to stop. I was part of a team that provided written testimony on this for the 9th Circuit Court. Glaxo wouldn’t admit that the drug was addicting, but based on this lawsuit they did at least concede the need to taper it before stopping it. After that conversation, the landlord kept a distance and we hardly talked for the next 22 years. Like many psychiatrists he didn’t want to know about side effects. When side effects and withdrawal effects are carefully considered, and the patient is properly informed of them beforehand, most will not want to get started on a psychiatric drug. As Upton Sinclair once noted, It is difficult to get a man to understand something, when his salary depends on his not understanding it.

This doctor, my landlord, in addition to being a Paxil withdrawal denier, was a coronavirus denier! Speechless, all I could do was to nod. Who’d have thought? I realized that there would be no hand sanitizers, no disinfecting bathrooms and doorknobs, no air filtration or distancing, no temperature screening. People would just be coming in and out of the house, free to sneeze, cough and spittle like there was no pandemic while the same air is circulated from one room to the next. It began to sink in that if the landlord didn’t believe in the virus, he will not take precautions to keep himself healthy and could infect everyone else in the building. This worried me; the office wasn’t safe. I realized that I needed to shut down the office for my own safety, and that of my family, and not just the patients.

3/11/20

Supplies were delivered to my home from Amazon. I ordered early enough before they ran out of Lysol, Purell in little bottles in holders that fasten around a belt, masks, gloves, and antiseptic wipes.

3/12/20

After today, I am not going to see any more patients in the office. The obsessive dance became even more elaborate. I Lysoled down the office, waiting area and bathroom, and washed my hands between every patient. Patients are free to touch the outside doorknobs, but not the inside doorknobs. Credit cards were handled only by the outside edges, and afterward I doused my hands with Purell. One patient paid in cash, and after he left, I doused each side of the bills in Lysol, and put them aside to dry. Then I washed my hands again.

Thankfully there were only 3 patients today because the hygiene practices were taking up so much time that I couldn’t stay on schedule. As my concern about contagion grew, it became harder to focus on what the patients were saying. Even if I kept more than 6 feet from the patients, I was worried that, like other viruses, this could hang up in the air as an aerosol. The CDC and WHO, say it isn’t transmitted by aerosols, only large droplets that quickly fall to the ground, but other viruses spread by aerosol so I am not so sure.

As I considered the obsessive dance, with all the distancing and hand sanitizing and keeping patients from touching the door knobs and disinfecting whatever people touched, I realized that this was not workable. After today I needed to close my doors.

Even though I was not treating physically ill people, over the years I’ve noticed that patients who have the flu or a bad cold do not often cancel their appointments. They probably think that all doctors, even psychiatrists, are supposed to be OK sitting in a room with someone with a fever who is coughing and sneezing. It was too risky to keep seeing patients, especially in that old Victorian house with a Covid-denying landlord running around. Besides, I really couldn’t focus on what patients were saying anymore. I knew it was time to give it up and go home

When I got home, I began calling all the patients that had been scheduled for the next two weeks, and after making sure that they were OK and that they had enough medication refills, I rescheduled them for next month. The patients were relieved that they wouldn’t have to go out to my office to get their medications. They were just as worried about coming to see me as I was to see them.

The government loosened the rules about telepsychiatry and my plan is to see the patients online, from home, starting in a few weeks. The new rules on telemedicine are very liberal. Communications didn’t have to be HIPPA compliant, you could practice out of state, and reimbursement was the same as it was for an office visit. A therapist friend told me about a free, HIPPA compliant, telemedicine service that I could use, doxy.com. I registered with them, and got a link patients could click on for their appointments. It’s cute. If they arrive early, they are put into an eWaiting room. I emailed the doxy.com link to the patients for their rescheduled appointments, and asked them to email confirmation that they had the link for my doxy.com room.

Closing the Practice

A funny thing happened in the next couple of weeks. I was happier than usual. Much happier. I didn’t realize how dissatisfied I had become with practicing until I stepped away from it. Instead of treating people online from home, I decided that I would not only close down the office, I was going to close the practice too. The decision was a major one, because it is so final, and cannot be easily undone. But closing the practice, and letting go of all that responsibility came as a relief. I wasn’t running from psychiatry so much as feeling done with it, feeling a sense of completeness that this chapter of my life is over. Forty-three years of patient care was enough for me. I had been planning to close down in another couple years anyway, but with the unsafe office and the burden of trying to work out of my living room, it was time now.

Closing the practice is not without guilt. To use the pandemic as a reason to close down feels wrong. Especially as I continue to read about how doctors are risking their lives to care for coronavirus patients. The governor asked recently-retired doctors to go back to work. I’m running in the other direction. That special drive that makes an ER doctor intubate a coronavirus patient without protective gear, despite the plume of lung contents that will waft in their face when the tube goes in, is still a part of me. I had been an ER doctor and know how to intubate and I know how to manage a ventilator. I had a noble fantasy of returning to the ER and ICU to help treat the pandemic. Of course, in this fantasy I’m 25 and fearless, not 66 with an aged immune system.

---

The practice of psychiatry had become almost painful. It’s too much about the medications now, medications that are generally