And of course, the blood pressure was a little high too. These results were all marginal and not enough that we would look at him and sayhe had a thyroid problem, an adrenalin problem, or a whatever problem. But once I saw this, I told him, “Look, this is not a psychiatric problem. This is something that is treated with chemicals that slow down your thyroid and I think youwill be better.” He looked at me very surprised and said, “My mother has a slow thyroid and she takes thyroid hormones to make it faster. That’s not my problem is it?” I said, “Not exactly, but the fact that she gave birth to you suggests there may be something going on with the thyroid that is common between the two of you.But you know something? I’m not the expert on this. We’ve got to get you to a realdoctor.” This, by the way, is the way I always talk about doctors who aren’t psychiatrists. At first, he didn’t want to go to a general doctor. I mean, it took him a coupleof months to get there. Most patients seem relieved when we get a diagnosis that isn’t psychiatric for what’s going on. But to my surprise, he was the exact opposite. He had been working with —you guessed it, a psychotherapist — who told him hisproblem was insecurity and that he’d had a suboptimal upbringing. I haven’t foundanybody yet — including me –who’s had a maximally optimized upbringing. After he got the guts to make an appointment to see a doctor, the doctor told him he had something that could be controlled. He would be more relaxed and he would get better. He was given a prescription for something, probably radioactiveiodine or a radioactive version of some compound that would be taken up by thethyroid hormones and slow his thyroid down. I’m not sure exactly what the treatment was. The doctor also suggested he see a psychiatrist. I’m the only person I know in that particular continental health system who is fairly compulsive about sending my diagnostic ideas and treatment results to otherphysicians. Most often, it’s through phone calls and a letter. But at any rate,after about 3 months I never saw this young man again. He went to see another psychiatrist, whom he had told me he didn’t like and whom he had seen prior to my joining the team. He told that psychiatrist to tell me, “Say hello to Dr. Goldstein. She gave me back my life.” Huh? Well, he started taking whatever compounds he had been given. He was slowing down. He was sleeping and he was formulating plans for more education. I thought at the very least I ought to tell the psycho-therapeutic team what was going on – but I didn’t even get to do that. His psychotherapist told me he was goingto continue to treat his insecure childhood. I told him he could treat virtually the entire population in the city we were living in because nobody has a childhood that fills their needs. As a matter of fact, it’s been said that what peoplechoose in the interests of their adult life is a function of what was missing in their childhood. But, they didn’t want to give up and he kept returning to the same psychiatrist.I said to this psychiatrist, “You are not correct in prescribing psychiatric medsfor this patient. He does not require them. He should not be seen in this clinic. There is nothing more we can do for him.” “We have to continue to follow him to see how he is doing” said the other psychiatrist. I went and talked to the Chief of Psychiatry because this was not the first timeI had “cured” someone yet was unable to dismiss them from the clinic. The truth ofthe matter, the chief admitted to me, was something I had come up against a fewtimes before and several times since. It’s called capitation. It refers to the amount of money that a government entity or any agency that funds a clinic as being a function of how many patients are followed. Nobody ever gets dismissed because it’s like giving away money.