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When Dating a Psychiatrist, Rules of the Couch Don't Apply

Sudeepta Varma, M.D., is a PGY-3 psychiatry resident at New York University School of Medicine.

It was their first date and 30 minutes into it, "Michelle" realized that "Mark," the handsome French transplant sitting before her at Del Posto, Mario Batali's swanky New York eatery, had not asked her what she did for a living. For that matter, he hadn't really asked her much about herself. Was he just being polite by not asking what kind of work she did? Was this a French thing? Or was she just used to doing more of the listening, she wondered?

Michelle, a psychiatry resident, recounted the evening to me with mixed reviews on her cab ride home. The next morning while on her way to the hospital, she received a text message from Mark. "Bon jour! Thanks for the evening—I gotta say—I never met someone so grounded and so present before. Would you be up for a second date?" She was surprised, since she felt that the date was a bit monotonous. Was it possible for anyone to talk more about himself?

When Michelle told me her story, I laughed, realizing that I, too, had fallen victim to the same routine. Used to asking a lot of questions and not revealing much about myself, I was known as the "mystery woman" in some nonpsychiatric circles. I often ask myself, whether I was being "mysterious" or withholding. Is a psychiatrist's observant nature the reason he or she entered this profession or a result of it?

I often think to myself about the voyeuristic nature of psychiatry. In no other situation would it even be mildly appropriate to ask another individual intimate personal details including early life experiences or sexual fantasies. The work of other medical professionals does indeed parallel the invasive nature of psychiatry in some respects. Their patients often strip down to the bare for a medical exam, and depending on the nature of the exam, the patient can often find himself or herself in a compromising position, so to speak. There is something fragile, raw, and almost pious about the psychiatrist-patient relationship.

I have heard from a few psychiatrists that, had they not gone into psychiatry, they would have considered becoming surgeons. I have also, but less frequently so, heard the converse. I can think of a few surgeons who after completing surgery training, decided to go into psychiatry. I wonder whether having both professions under one's belt somehow allows the doctor to come full circle.

Psychiatrists possess a desire to delve deep into the depths of a forbidden zone, the same way a surgeon cuts open someone's sternum. Neither is a routine activity of daily living, and both can be a painful yet necessary "evil."

Not too long ago, I was at a joint holiday soiree thrown by a dermatology resident friend and her attending. It was well attended by an eclectic bunch of doctors, lawyers, singers, songwriters, belly dancers, and henna artists. Some of the invitees were the attending dermatologist's patients. I inadvertently got into a conversation of "boundary crossings" with one of the guests. I soon realized that I needed help getting my foot out of my mouth.

I do, however, at times envy my colleagues in other medical specialties who seem to have a much more personal relationship with their patients. Ralph, a college friend and now in an internal medicine group practice, often gets homemade rugulah from his patient Rosie, an 82-year-old diabetic Holocaust survivor. It's not so much about the rugulah, but the warmth and the connection implied by this relationship that I miss from my medical rotations.

Learning to balance the subtle differences between the social intercourse of the psychiatrist "on the clock" and "off the clock" is a unique challenge. We go from being active observers to loquacious participants depending on which side of the clock we find ourselves.

As for Michelle and Mark, I have yet to hear if there will be a second date.

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