Farewell Dr. Sonner

X-Ray from abdominal view of my dog Moishe's, heart.

X-Ray View of Moishe's Heart from lateral Position.
Notice light white areas showing possible first signs of Mitral Valve Disease.

January 14, 2009 @ 7:16 PM

Dear Dr. Sonner:

I decided not to come and see you anymore. I can't afford to see you because I no longer have enough money to pay for health insurance with Oxford. Therefore, I can’t pay out of pocket for once a month visits with you. We had spoken about this on several occasions. Despite, my fears of economic destitution, you have not been willing to change your policy, allowing me to come less frequently. In the past, I worked with doctors whom only expected me make visits 4 times a year, in order to check the status of my condition or fiddle with my medications. I would see the psychiatrist more often should my depression become less manageable.

Presently, I would self-diagnose my condition as a clinical depression with the occasional massive mood shifts towards mania. I am certainly not in remission, and definitely, beyond the state of my usual Dysthymia.

I have not called you or in your case, e-mailed you, about my emotional upheaval because I learned from the past that it was absolutely pointless. I have become accustomed to sitting in your waiting room many times over the last couple of years, in a depressive state, but made a clear decision before entering your office that I would not share this information with you. There were times that I feigned happiness in your presence when I could do nothing more than lay on my sofa and cry for days.

After three years plus, you never changed my medications in order to find a way to ease me from my emotional pain. The best you did was up my Lamictal or increase my Nardil by 15 mg. This is the same recipe of medications, plus the others, that Dr. Silverstein had prescribed me when I left his care years ago. What was the point of telling you how I felt or filling out those redundant Xerox sheets with my improvement or my decline, when I knew I would walk out the door with the same ol’ prescriptions? In other words, my old feelings of helplessness increased and I started to believe once again that no doctor could help me, let alone you. Perhaps, I am drug resistant.

I don't believe in my heart that everything has been exhausted...I need to work with a sensitive and creative physician. Someone who can work in tandem with my therapist.

There were days, I walked into your office, considering how quickly, I could get out of your office with the prescriptions in hand. I would put a smile on my face, bite down on anger, pick up the recipes and get out the door as quickly as I could. Perhaps, to you, my depression/anxiety or as you had yourself diagnosed me, on my first intake, “Bi-Polar 2 Disorder” seemed under control. In fact, I was exhausted and resigned to feigning my emotions in your presence.

I have never had to talk with any doctor through e-mails, nor has my therapist. Natasha whom also agrees that it is bizarre and unprofessional you did not want to communicate with her on the phone. It's frankly impersonal and on a fundamental level, I don't feel like you care about me. As you know I have a long history of terrible neglect. Yes, it would have been reaffirming if you could have simply picked up the phone over the last months when I did not make any appointments.

I created a lie and told you I was leaving the country for France and never mentioned a word about picking up my prescriptions prior to this fantasy trip. Instead of hearing directly from you, I began to find messages on my voice mail from one of your revolving intern secretaries. Maybe at least, a detached e-mail from you, would have made me feel like my presence and my health mattered.

I am now in a daily struggle and yet, I refuse to come back to you. This is not a personal problem with you, but completely professional. I have decided to see one of Dr. Silverstein’s colleagues who has made himself available when I need him. Again, as you know, I no longer have insurance, and having a doctor available when I need him or expects only quarterly visits is a relief to my financial worries.

Juliana