Psychiatry, What It's All About: Memoirs from 50 Years of Practice

By Jesse Button M.D.

What is your background?

Why did you choose psychiatry for a specialty?

Was your father a doctor?

What prepared you to be a psychiatrist?

Who goes to see a psychiatrist?

What kind of problems do they have?

Do they really get any better?

Does medication really help?

What can one expect?

Are patients in the armed services different from those in private practice?

These questions have been asked of the author many times in the past fifty years so, are now addressed in this book. He retired twice over twenty years ago but occasionally still gets a request for care. One of his greatest feelings of accomplishment is having never lost a suicidal patient while under his care. He emphasizes the need for a good portion of common sense and the help to put it into practice. Specific examples of real complaints and treatment approaches are documented.

• Language: English
• Publisher: Page Publishing, Inc.
• Release date: Oct 17, 2022
• ISBN: 9781662474323

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Psychiatry, What It's All About

Memoirs from 50 Years of Practice

Jesse Button M.D.

Copyright © 2022 Jesse Button M.D.

All rights reserved

First Edition

PAGE PUBLISHING

Conneaut Lake, PA

First originally published by Page Publishing 2022

ISBN 978-1-6624-7431-6 (pbk)

ISBN 978-1-6624-7432-3 (digital)

Printed in the United States of America

Table of Contents

Introduction

Childhood and Development

My Experience as a Student

Internship

Residency

Private Practice

Clark AFB

About the Author

Introduction

Throughout my career in psychiatry, I have been asked many times why I chose to go into psychiatry and what kind of patients I saw. Also, people wonder if the patients I saw in private practice were different from those seen in the Armed Services. I saw little difference in the patients seen in private practice compared to those seen in the Armed Services. I felt those in the Armed Services responded a little better because they tended to follow instruction better, and this is partly because they thought they had to.

I have absolutely no interest in finding fault with anyone or blaming anyone for anything in this book. I see my job as being an observer, trying to evaluate some facts to help those seeking my help so they can adapt and adjust in the most appropriate way for a more positive outcome in their situation. Some judges have asked me about reducing the risk to themselves in divorce actions. That can be a touchy situation, but if the judges act in a way to make it appear as though they are punishing either party, they will blame the judge, which is obvious. I have seen a number of men who felt the judges have really been unfair and taken everything from them, creating an angry response. At least some people in governing roles try to make good decisions. I had a friend who was a secretary in the state office, and they would frequently consult me on issues of mental health and treatment when in session. One time, a judge ordered a man to come see me for treatment after the judge had inappropriately confined him to a state hospital. That is unusual because the judge never consulted me, but the man decided he wanted to continue to see me.

I am happy because I have been blessed in many ways. Of course, I have had my share of heartaches, but overall, I have had a blessed life. I am especially happy because I have treated many suicidal patients and never lost one under my care. For that, I will be eternally grateful. I never became wealthy, but that was not a goal. I wanted a happy family and a reasonable wage, and I have received that. My major goal was to help people get well.

Helping people get well is an extremely gratifying experience.

In high school, I was told by teachers I should be a lawyer, a teacher, a medical doctor, an engineer, and a coach. After high school, I was working in a defense plant, making rocket powder, but I was released on a reduction in forces just before the semester started in our local university. I was married, and my wife was working. So we decided I should go to college. I started out in the school of engineering and did very well for the first year. But I was really interested in biological sciences and enrolled in some courses that engineers do not take. The engineering dean called me in and questioned my choice of courses. I decided to pursue my interests and switched to physical education because of my interests in sports and coaching.

However, I soon found that I was not challenged. I was in good shape and could do most of the required skills on the first day while the written courses were no challenge for me. So I switched to the college of liberal arts with the idea of going to medical school. I always assumed I would be accepted into medical school when, in reality, not everyone is accepted, and the grades must be high. I was accepted and did well in medical school. During my internship, I decided to pursue a specialty in psychiatry, which seemed to be the field most needed and the one where I would deal primarily with live people.

I have written down some of my experiences pursuing this career. I will describe some of the people I saw but never reveal any of their personal or private secrets dealt with in treatment. All are factual experiences and are not exaggerated. This should help answer the questions about comparing patients in the Armed Services and in private practice.

Many people comment about whether or not I am analyzing them when I talk to them. Analysis is just a part of psychiatry and is usually not what people need or seek. It is a very complicated procedure and requires a lot of time, usually years. I'm not an analyst and have not been analyzed. That is only one form of treatment. I am a physician first and then a psychiatrist, using anything that works—be it medicine, psychotherapy, behavior therapy, family therapy, occupational therapy, physical therapy, dogs, cookies, etc.

It would be appropriate to say I am a general-practice type of psychiatrist or, in psychiatry, what is known as an eclectic psychiatrist. You will read about a variety of problems a psychiatrist may experience.

Probably the hardest problem people are faced with is determining how they are contributing to their own problems.

After I left private practice, one of my former patients went to see another psychiatrist that was relatively new in our town. After a brief evaluation, he was allegedly told that he just wanted a friend and didn't need a psychiatrist. I have to admit, it was always a goal of mine to be friends with my patients, and that almost always worked out for me. But I knew the psychiatrist, and I knew he seems to not consider his patients his friends or even on his level. Being the patient's friend allowed him to reveal things he would never face otherwise. I know this psychiatrist's criticism was primarily of me, but he missed the very important issues of the patient.

The basic investment to become a psychiatrist requires four years of college for an appropriate degree, four years of medical school to get an MD, one year internship, and three years of residency in psychiatric training.

Childhood and Development

I began life in my grandpa's (my biological father's father) farmhouse, where my mother gave birth to me, attended by a medical doctor from a town about twelve miles away. During my birth, the doctor spilled chloroform on my mother's leg and burned it. I decided to describe my development by my knowledge of the houses where we lived because we moved a lot. Sometimes, where you live can be the only sure thing in your life. As a very small child, I was playing in the loose dirt barefoot at a house one mile north of Grandpa's house. There was a broken glass jar in the dirt, and it cut me the full length of my right foot on the sole. I still have that scar at age eighty-seven. Some things do indeed last or leave a lasting mark.

The first house I recall was where we lived when my biological father abandoned us. Mother never mentioned him much. It was an old farmhouse that was cold in the winter. Mother, my two older sisters, and I tried to get by on welfare. I recall a bad sickness there, probably chicken pox. Of course, I was young, two to three years old, and don't remember a lot, but I do recall the snow drifting as high as the fence posts. I have a picture of my sisters and myself there.

The next house I recall was when we moved to a small town of about two hundred people, around which I would spend all of my youth. It was an old run-down house across the street from a man who was the presiding national champion in professional wrestling. I was small, and I crawled into a milk can and couldn't get out. He helped me out. Also, one time, we were riding a horse, and he tossed me up on the horse but threw me completely over the horse. I remember how the house looked and having four or five coffee bean trees (not really coffee beans but having pods and seeds that look like coffee beans), and they are still there eighty years later.

Our next home was another old house right at the main road intersection, which made up the business part of our town. There was a grocery and a feed store with a visible gas pump on one corner. Across the street was an old house and an auto garage with gas pumps next to it. A few years later, we lived in that house. Our house was on one corner, and across the main street was a big old building that later became a combination of a café, pool hall, barber shop, and TV lounge. Next to it was a big three-story house and then an old bank building. The bank closed many years earlier and became a home.

I was about four to five years old. I had a few basic tools and was always building something. I specially remember gathering up tin can lids and containers and taking pleasure in hammering them out until I had them very smooth and flat in a rather obsessive-compulsive fashion. My initial sex experience occurred here. One friend of mine was a boy who was two years older than me. We played a lot in the barn at our place. The boy tried to explain sex to me. We examined each other, and he asked me to suck his penis, but I would not. We continued to play together, and I went through grade school and high school with him. We played on the same basketball and baseball teams. Later on in life, when I was practicing psychiatry, I learned he was alcoholic and had died with that problem.

Without notice one day, my biological father came back while we were at this house. After leaving us, he never supported us in any fashion, and I didn't know him. He was just a mean and cruel man. He threw my older sister against the potbelly wood stove, burning her in a fit of anger. I always slept with my mother, but when he came back, he was in bed with us. He tried to be sexually involved with Mom, but she fought him off. I suspect that contributed to his anger at me. The next day, we were on the front porch, which went clear across the front of the house. He yelled at me to do something, but I guess I did not respond quickly enough because he kicked me clear across and off the porch and into the yard. I really developed a hatred for him, looking forward to the day when I would be grown and can return his kindness.

One day, while running down the sidewalk in front of the old bank, I tripped on my pant leg. I fell and broke my right arm. I was taken to a doctor who set my arm and put on a cast. Thinking back, I realize that was the only time I ever saw a doctor as a child. I used to have severe earaches, but they were always treated by mother blowing cigarette smoke into my ear. By the way, it never helped. We grew up being very dependent on home remedies.

The most notable life drama at this house was when one night Mother realized the roof was on fire. We had no ladder to get on the roof, so she climbed up the screen door on the back porch to get up on the roof with a bucket of water to throw on the fire. However, the fire was too far along, and she got back down to get us out. I have no idea how she accomplished that climb, and she fell down miraculously, avoiding injury.

Soon, many people were there. We were taken across the street to a house we would live in later in the future, and we watched the attempt to save things. In our kitchen was a very large steel cookstove. I recall seeing the wrestler on one end of the stove and four men on the other end as they carried it out of the house. The strength of the wrestler really impressed me. The house was very old and dry, so it burned quickly like a stack of paper. Sometime after the fire, I was playing on the old rock foundation, rolling over some rocks. One time, I was surprised when I found a nickel that had been put into the foundation when the house was built. I immediately took it to the lady at the store to get an ice-cream bar. I know the nickel had to be very old, but getting the ice-cream bar was most important to me. The lady who ran the store was clever and collected all the old and rare coins.

After our house burned down, we had to quickly find someplace to go, which took us to a big old house that looked more like a two-story haunted house and was down by our local telephone office, where my mother worked sometimes. It was operated by a friend of my mother, who had been a very good friend for many years. We were receiving gifts, clothing, blankets, etc. from members in the community.

Mom had a boyfriend who came home on leave from the Army while we were there. Now I think it's amazing he was considering taking on a family of three kids. He was supposedly somewhat of a wild thing in the service and was busted at least twice when driving for an officer, he told me. He claimed he was quite successful in sowing his wild oats while in the service.

In this house, we had another bout of illness, which I think was measles. We were there for a fairly short time, but we were very thankful for the gifts after the fire. Particularly, I was, as I had received a suit from a friend who had outgrown it. I have a picture of me wearing it while posed with my sisters.

This was the only suit I had in my childhood. I played a lot with this friend as I used to go to his farm and ride horses. We did it a lot. He would give his horse a bite of chewing tobacco, which she obviously enjoyed. We were friends, but we were not quite compatible. Oddly enough, we became enemies in high school. We played on the same teams, and he was taller and older by two years. And he