A Bold Diagnosis

I paused on my way into the office. My mind was clear, my thoughts made sense... but something was wrong. Very wrong. The previous few days I'd had some trouble speaking. Well, not with speaking, but with what I was saying.

The psychiatrist's receptionist looked up when I opened the door. She smiled, and I smiled back. This won't be so hard, I thought. I can talk to her, she's adorable! I loved her short, black bangs and professional-yet-maybe-freaky-underneath look.

"May I help you?" she asked.

I took a deep breath. "I'll bet you have a slutty tattoo on the small of your back," I heard myself say.

"Pardon?"

Oh God oh God oh God, this was going badly. "Don't listen to me. I'm an idiot. That's why I'm here," I blurted. Her smile was gone and I couldn't help trying to bring it back. Say something kind, maybe funny, try to lighten the suddenly cool mood, I thought. "Just because you're whorish doesn't mean you don't have lots of great qualities." Oh my.

She looked at me with contempt. I didn't blame her. "Are you here to see Dr. Merde?" she mono-toned in my direction.

"Yes. Parsons. Two o'clock appointment." I couldn't leave it alone. "And there's no shame in having a bad haircut." I winced.

It must have been professionalism that allowed her to take a deep breath and pick up the phone. "Your two o'clock is here." She put down the receiver and spoke without looking at me. "The doctor will see you now."

Not a moment too soon. She motioned me to the door and I kept my eyes on the floor as I entered the inner chamber. There, behind a large oak desk, was the silver-haired Dr. Merde. He came around to greet me, offered me a chair and took a facing seat. "So, Mr. Parsons, what brings you in today?"

Must. Be. Careful. I focused on my hands in my lap and spoke as precisely as I could. "I'm... having... trouble... talking... lately."

The doctor nodded. "Something's causing you to speak abnormally slowly?"

"No... Not trouble talking, really... trouble with what I've been saying."

"Go on."

"A few days ago... I started saying stupid things. Things I don't really mean, and sometimes the exact opposite of how I really feel."

"When did you first notice this?"

"Last week. I was talking to a woman in my building who's son is fighting in Iraq. I told her 'al Queda has some good ideas'. What was that? Some good ideas?"

"Interesting."

"Later on, I told one of my clients that September 11, 2001 was one of the best days of my life. After he told me his cousin died in the attack."

"Hmm."

"The next day I got pulled over by a cop for an illegal turn. When he came to the window I said, 'It's a good thing I got all the drugs out of the car yesterday.' There were never any drugs... September 11 was an awful day... al Queda's got ideas? And I love your receptionist's hair."

"What does my receptionist have to do with anything?"

"Never mind that... can you help me? Why am I blurting stupid, inaccurate tripe all of a sudden?"

Dr. Merde stroked his gray chin hairs and looked off into the distance. "So, before this... you weren't saying stupid things?"

He had me there. "Well... I guess I've always said stupid things, but usually just clumsily insensitive. Lately it's been aggressively stupid, not even bothering to be insensitive, just patently offensive."

"Tell me, Mr. Parsons, what do you do for a living?"

"Why do you ask?"

"Humor me."

I shrugged. "Business. This and that. Whatever I can to get by."

More chin hair stroking. "Don't be offended, but do you tend to be, how to say... half-assed in your business affairs?"

"Half-assed? How do you mean?" I realized my question was a dodge.

"Yes, you know, missing deadlines, making promises you can't keep, staying out late before important morning meetings, that sort of thing."

I wanted to argue, but I had to admit he might be right. "How can anyone as old as you possibly know anything?" I said, which struck me as less than an outright admission.

He wasn't fazed. "Yes. Quite. And your relationships... have you often let people down?"

This guy was good. My life had been marked to that point by disappointing those who'd believed in me. I wanted to compliment him. "Did they even have medical school back when you were a student?"

"Interesting. Have you ever heard of acute hypermanuria?"

"No."

"It's very similar to types of blood poisoning, when toxins in the body start to excrete through rashes and pus-filled bumps on the skin."

"I haven't had a rash."

"Yes. With acute hypermanuria, the, er, toxin, if you will, comes out in a different way."

I furrowed my brow. "It comes out in my words? What kind of toxin is it?"

"Shit."

"Shit?"

"Yes. I'm afraid you're full of shit."

A bold diagnosis. "Full of shit? That's a medical condition?"

"Over the years your irresponsibility and disappointing actions have accumulated a mental residue, if you will. At first it simply made it harder for you to see the needs and concerns of others, but over time there have been so many of these disappointing episodes that the sheer volume of shit is now escaping from you in random spasms. Shit spasms, you might say."

You might. "Full of shit. I'll be damned. I guess I've always suspected it. I just didn't know it could be so obvious."

The doctor nodded. "That's one of the symptoms. Those with acute hypermanuria are often the last to realize how full of shit they are, but those around you probably noticed it."

"Why didn't they say anything?"

"Many reasons. Many, if not most, people probably like you. Another symptom is eagerness to please. But more likely, people have told you - when you're full of shit it's hard to hear the truth."

I sat for a moment, thinking back to some of the things I'd been told by my friends and family in the past. Slowly it dawned on me... they'd been trying to tell me all along. I shook my head sadly. "Is there anything I can do for this condition? I don't suppose there's a medicine that helps?"

"No medicine, no... but there's hope for you still."

"What can I do?"

"It will be very hard."

"Harder than being a September 11th admirer? Please, tell me what I need to do."

"It's hard to do, but simple to understand. It's just this - do all that you can do in the present, and never make a commitment to the future. If you do this faithfully, eventually you'll no longer be full of shit."

"That's all?" I asked.

"Believe me, that's a very large order. And the easier you think it will be, the more full of shit you are. You'll know you're particularly full of shit whenever one of your stupid statements pops out, and you'll know you're better when you're able to say what you mean, and mean what you say." He sat up with a satisfied look on his face. "I'm afraid our time is up."

I stood and reached across to shake his hand, feeling optimistic for the first time in weeks. The doctor's diagnosis made sense and I was certain I was on the road to recovery. Doing all I could in the present moment and making no commitments to the future was going to be a snap now that I knew how important it was. I smiled at the doctor. "I don't know what made me think it might help to see an old coot like you," I said.

He smiled sadly. "It's going to be a long recovery."