THE COMPLICATED PATIENT
It’s complicated.” When we say this in everyday conversation, we usually mean we don’t want to talk about the subject because we either don’t have the time or we don’t have the inclination to explain to the person asking about it. Not so with our intrepid authors of this Special Report. They were willing and—as you will see—able to respond to our invitation to deploy their unique expertise to write about several different types of complicated patients.
When, as the Chair of this Special Report, I virtually sat down with the editorial staff of Psychiatric Times to brainstorm topics we took a phenomenological approach rather than an analytic one. We used our collective experience to intuit areas of psychiatric practice where complicated patients would likely be encountered without restricting our imaginations or those of our authors with a definition. Let me work backwards here and circumambulate a definition not discursively but descriptively using synonyms.
One of the more basic entries the Oxford English Dictionary gives us is “complex” as in “compound” and the opposite of simple. My favorite thesaurus, Roget’s Words for Intellectuals, lays out a verbal feast for the close cousin, “complex”: anfractuous. Full of windings and intricacies. Convoluted. Complicated; intricate; twisted and coiled. Daedal. Extremely intricate and complex; skillfully made. Inextricable. Incapable of being disentangled or united: hopelessly complex. Involute. Intricate; involved. Tortuous. Winding; full of twists and turns.1
It is certainly true that none of our articles in this Special Report deal with simple kinds of patients; and all of our authors had to assemble many moving parts for their coherent, comprehensible pieces.
We often make the mental health treatment world convoluted for those patients who are deaf or hard of hearing in ways those without hearing loss often do not appreciate. Fortunately, the article by Kimberly Mathos, DO, MPH, raises our cultural competence in being able to communicate professionally with persons who are deaf or have hearing loss so that we can make a better diagnosis and treatment plan.
Dr Geppert is Professor, Department of Psychiatry and Internal Medicine, and Director of Ethics Education, University of New Mexico School of Medicine in Albuquerque, NM; she is also Health Care Ethicist, Ethics Consultation Service, VA National Center for Ethics in Health Care. She is also an Editorial Board Member of Psychiatric Times.
1. Olsen D, Bevilacqua M, Hayes JC. Roget’s Thesaurus of Words for Intellectuals: Synonyms, Antonyms, and Related Terms Every Smart Person Should Know How to Use. Avon, MA: Adams Media; 2011.