Details, I promise

I promise to provide all the details to support my allegations. As I said, I have the emails my pdoc (psychiatrist) and I exchanged, the emails between me and Dr. Amen, my pdoc's Progress Notes (from each time I spoke with him), lab slips and lab results. Everything to prove, in no uncertain terms, that the care I received nearly caused my death.

It continues, however, to stick in my craw that Dr. Amen would make so specious an argument to explain away the harm that was done me as "[Your psychiatrist] was trying to save your life." I will continue to explain what happened until nobody can be unclear on the chain of events and where the blame squarely rests. Here is the abbreviated, yet entirely accurate, version.

1. I told my pdoc I was feeling suicidal. He listened and agrees.
2. He put me on Lithium, telling me nothing about it other than it's been around a long time and is coming back into favor among pdocs.
3. While he *should* have had my serum blood level of Lithium tested within a few days of starting to take the medication, he waits more than 2 weeks.
4. He neglected to tell me to get a "trough level" test -- a test 12 hours after the evening dose but before the morning dose. That would be a "low" test during the day. Knowing no better, I had the test one or two hours after the morning dose, a "peak level" reading that (as it turns out) was THREE TIMES what the trough level result would have been.
5. Unaware he had botched the ordering of the test (and that is the *generous* interpretation -- it's possible he simply didn't *know* he should be getting and evaluating trough level readings), he sent me an email and a copy of those meaningless lab results and said, "No need to increase the dose. Everything's fine." (Again, I'll provide the exact words later.)
6. Roughly a month went by, during which I was miserable and contemplating my death every waking moment of every day. If I had access to a little money and a car, so I could exit this life with dignity, the way I wanted, I'd be dead now.
7. My pdoc and I had a regularly scheduled phone talk. He recognized my situation was dire and called the cops. They took me away to a County emergency psychiatric facility on a 72 hour involuntary hold (suicide evaluation).
8. A psychiatrist in the facility told me the lab result I quoted to him (because I had memorized it when my own pdoc sent it to me), had to be wrong. The reading was inconsistent with the low dose I was taking. It was he who explained "trough level" and "peak level" blood tests.
9. I proceeded to go (with my long-suffering wife) to several more mandatory meetings with county psychiatrists, one of whom said, "Don't wait to increase your dose. Get a new blood test LATER. Increase it!"

And so I did. And here I am. No thanks to the psychiatrist Dr. Amen employed.

I need to provide a small piece of technical information, so you'll understand the story above.

- Lithium at too high a dose is toxic, perhaps lethal.
- Lithium at loo low a dose does NOTHING AT ALL. It's as though you aren't even taking it.
- Lithium at a "therapeutic dose" is like throwing a switch. It goes from having NO effect to having efficacious effects.

The "standard of care" -- the accepted medical practice -- the protocol for prescbribing Lithium involves "therapeutic drug monitoring." Start the patient on a low dose, wait a few days for it to stabilize in the patient's system, take a trough level blood test, increase the dose if indicated. There is certainly more to it, such as evaluating the patient's other medical conditions and *asking* how the patient is doing, essentially all the other things we want doctors to do for us.

What we *don't* want is for a doctor to base his decision about whether or not to increase the dose of medication on a test he ordered wrong and the results of which are so *completely* wrong as to leave the patient absolutely without any benefit from the medication prescribed.

- If he didn't know the protocol for prescribing Lithium, he should not have done it. Negligence.

- If he had once known the protocol for prescribing Lithium but had forgotten it, he should not have done prescribed it. Negligence.

- If he simply forgot to tell me to get a trough level test -- and let me interrupt to say that he and I had mutual respect and he had always kept me fully informed about my treatment -- then that verges on criminal negligence. He didn't invest the time I took to explain to you what a "trough level" test is. What was that, 10 seconds typing slowly?

I've said I only want money damages from Dr. Amen for my pain and suffering.

Fuck that. I'm going after my pdoc's license.