Telemedicine and Donald Trump

telemedicine

Oh, Donald.

I was driving along one day, listening to one of my favorite radio stations, when the news and highlights segment featured commentary on last week’s Republican National Convention.  A listener then called in and offered the following:

“I mean SERIOUSLY, people want to elect someone with a diagnosis??  He’s got Oppositional Defiant Disorder, he JUST refuses to quit!!”

My face did a little, “Huh, did I miss something?” expression.

Political leanings and opinions aside, I’m pretty sure this listener WASN’T a licensed medical professional.  None in his right mind would risk diagnosing anyone—anyone and/or Donald Trump—via telemedicine on the radio.

What I began contemplating was the justification behind this caller’s, shall we say, opinion.  He believed ‘The Donald’:

(1) had a diagnosable disorder that’s already wrought with controversy in the Health & Human Services field, but that such a disorder was characterized by,

(2) “just refusing to quit.”

I took offense to that.

“Just refusing to quit” could have meant a lot of things to this man, to be fair.  But as he wasn’t a medical professional, and this was in no way a medically-inclined radio station or show, I doubted the presence of much nuance in his frustrated exasperations.

I knew—or hoped—the caller was just looking for a laugh.  What I felt instead was offense at the callousness with which a general member of society can feel justified in ‘diagnosing’ another human being, whom he does not personally know, nor whom he has ever personally evaluated.

My mind immediately turned to Charles Kinsey, a man in Miami who DID EXACTLY WHAT I DO FOR A LIVING.  Charles Kinsey, for those who don’t know, was an unarmed man shot by police as he lay on the ground, trying to calm an autistic man who had wandered away from a group home.  Charles Kinsey and I share job descriptions.  I can (thankfully) count on one hand the number of times I have had to enact an emergency protocol to follow a wandering/bolting autistic person, which sometimes included my own sister.  There are demographic differences between Mr. Kinsey and myself, but even the phrase, “I’m a behavior therapist, I’m trying to help this person, he’s autistic” doesn’t guarantee safety!

But I digress.

The state of mental health in our nation is at a controversial watershed.  We have become so used to the defense of individuals’ behavior on the basis of mental conditions, that even telemedical diagnoses of presidential candidates occurs on the radio.  We want complete acceptance of people’s conditions, but we’re going about it in the wrong way!  What we risk is a callousness, an insensitivity on the basis of desensitization to psychiatric conditions.

We witnessed this with the “R-word,” the word “retarded” used in the derogative.  People grew callous to the condition of mental retardation, they no longer fearfully respected the conditions and interventions necessary for people whose brain functioned differently than their own.

I also grew offended that the justification for this mental disorder was a “refusal to quit.”  I’d like to point out that I refuse to quit!  I graduated with my Masters, got my certification, moved out, became a supervisor, and published a book, all by 25, because I refused to quit.  People I’ve interviewed for jobs, people I’ve interviewed for scholarship recipients, people I’ve befriended, they all describe themselves as having a perseverance that “doesn’t allow them to quit.”  In the face of sexual assaults, women who have overcome great harm will describe their torches carrying them back into some sense of normalcy as the innate desire to forge ahead despite circumstance.  The greatest achievements—from antiseptics to The Theory of Relativity to filtered water to the Tesla—all came from a fierce refusal to quit.  Tenacity and determination are needed in times of distress.  They are what our police, firefighters, and military need as they forge ahead protecting our lives.  How dare anyone patholgize this!

I’m no friend of the DSM-5 methodology, I’m sure that’s no surprise.  But I’m also not a fan of people throwing around conditions and diagnoses like the next big Twitter hashtag.  I would challenge the radio listener’s “diagnosis” of Donald Trump on the basis that ‘Oppositional Defiant Disorder’ is more than simply a “refusal to quit”—what most people would revere as tenacity—because he does something just as dangerous.  He is contributing to society’s overall habituation of mental disorders.  What happens with habituation is tantamount to stigmatization.  In neither case is help for the affected sought, and habituation threatens the serious nature and intervention of a true diagnosable case, simply because people can no longer tell the difference.  Leave the diagnosing to the doctors, even if it involves The Donald.