A Legitimate Beef or Simply Hating on the Shrink?

A few years ago I performed a weight loss surgery evaluation on a young man, 25 years of age [1]. For reasons that I cannot go into, he was clearly unprepared for the extensive lifestyle changes that were required of him to make the surgery successful. When he was informed that my recommendation would be that he would need to need to get both nutritional and psychological counseling he blew a gasket. He hemmed and hawed, threatened to call the licensing board, promised to have his check for the service canceled, and called me a “dripping gay wad.” That seemed like such an infantile and unusual insult for a mid-20’s man to throw out so I looked it up. I found nothing.
The next day I got a call from the man’s mother. She was equally upset because the surgical team had, in fact, decided to delay surgery. I immediately explained to her the following:
– Because her son was an adult, I was unwilling to go into extensive detail about her son’s case. He could explain that information to her himself should he choose to.
– Her son was not disqualified from having the procedure; rather, that he was required to have further counseling to make him a more viable surgical candidate.
– I was not a “dripping gay wad,” whatever that meant.
Rather than listening to my points, however, she simply called me a charlatan and accused me of purposely denying her son the chance to have multiple medical problems corrected for my own personal gain [2].
This is where I lost it. What possible motive, by any stretch of the imagination, would I have to temporarily deny a morbidly obese man a surgical procedure that would clearly improve both his health and quality of life? Why, on Earth, would I do such a thing? Because I’m against the procedure in general? If I were anti-surgery I wouldn’t be part of a surgical weight loss team. Because I wanted to mandate further sessions with me for financial gain? Hardly. Not only do denied patients rarely come back to see me specifically due to being pissed off, but there are plenty of other Psychologists in this city who are better, cheaper and move conveniently located. Because I get off on making people angry? The man’s name wasn’t Dr. Steve so wrong again.


So why then? Because I noted things that qualified him as high risk. He was set-up to fail due to psychological factors. If he went forward with the surgery right then and there, as he had planned, the likelihood of success was small. However, if he addressed a few minor points, including spending more time with the dietician, his likely prognosis would be significantly better. At 25 years of age his need for surgery was not imminent and I was told a few more months would not put him at any further medical risk.
I was so irate at her accusation that I got up on the highest horse I could find and told her that she should be thanking me for protecting her son from significant medical risk.
“A good mother would be grateful that I’m not putting him in harm’s way,” I yelled into the phone.
“Did you just insinuate that I’m a poor parent?” she asked, and I could practically hear her angry breath reaching through the phone to choke me to death.
“I…I’m sorry,” I said, suddenly very ashamed.
“Whatever my son called you, he’s right. You are a Dripping Way God.”
The woman’s take prior to the shouting match is an example of mindset that gets us into trouble so much. In the face of problems people far too often say not, what can I do?, but rather who can I blame? Rather than accept what is and work within the framework given, they decided to attribute the problem to me. Some may consider this a form of resolving cognitive dissonance, where a person needs to deal with the distress of holding two contradictory ideas at the same time. I want/need to have the surgery, yet it is not going to happen, at least right now. To get rid of this feeling, I’ll blame the Psychologist. But it’s really just a rationalization, because taking responsibility is, in all honesty, a pain in the ass. It’s often easier to just lay the problem at someone else’s feet than to say I’m at fault, perhaps even flawed or defective.
But here’s the rub: there is no one to blame. No one is at fault or weak. It is what it is, and if the man did what was asked of him he would have had the surgery. Instead, though, he decided to find another hospital where they would perform the procedure without a psychological consult. That was his prerogative and people seek 2nd opinions all the time. But bypassing the psychologist via another hospital isn’t accumulating new opinions, it’s ignoring direct advice and assuming you know more. Maybe he got lucky and I was mistaken. We all know that psychology isn’t an exact science. Perhaps the surgery was a success, that I’ll never know. But had he and his mother simply followed the recommendations given he would have avoided a significant number of potential pitfalls. And he could have done everything asked of him without having to deal with the dripping gay wad again.
[1] Click on that link to read about the specific arguments both for and against weight loss surgery for morbid obesity.
[2] It is well documented that weight loss surgery can treat a number of medical issues simultaneously, such as high blood pressure, high cholesterol, diabetes, sleep apnea, etc.

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13 Responses to “A Legitimate Beef or Simply Hating on the Shrink?”

  1. Dan James says:

    You know, Dr. Rob, normally I think these things are spot on, but I’m not sure how it’s possible to take this entry seriously with such a glaring logical fallacy. I mean, come on! If you don’t know what a “dripping gay wad” is, how can you assert so categorically that you are not one? For shame, sir, for shame.
    Clearly, this term requires further investigation, so that a thorough and complete definition, etymology and list of defining characteristics can be detailed in full. Then and ONLY then can you compare yourself to those characteristics and truly assess your dripping gay wad-iness, or lack thereof. The scientific method exists for a reason!

  2. Unfortunately people confuse Agree/Disagree with Right/Wrong. They may not AGREE the diagnosis/conclusion, but that doesn’t invalidate it. The amount of projection that happens in these cases is to be expected, but it is still frustrating.
    The interesting things about bariatric evals is that the vast majority get approved, so if someone gets flagged….there is usually a very obvious reason. People don’t understand that it isn’t our job to want or not want the person to get the surgery, it is to evaluate their well being and ensure they can handle the surgery. I’d hazard a guess that the “success rate” (long term) for the surgeries would fair far better if there weren’t so many people trying to dodge the psych eval.

  3. Nathan says:

    I think its quite amusing that if you type “dripping gay wad” into google the first two links are to your site, the next link has something to do with Yoko Ono and then all the links after that are to either gay porn or websites advertising creampies or possibly a combination of the two. I didn’t want to click on them to see.

  4. Kevin says:

    That woman sounds like a helicopter parent. Parents who hover around their kids, doing everything for them, especially at times they should be considered adults. Dr. Rob, have you any experience with these kinda people? Besides this woman

  5. Ben says:

    If your disgruntled client had decided to call the licensing board, they probably would have dismissed his claim eventually…but in the course of the investigation, they also would have discovered that you discussed the case with his mother. Unless he signed a release, I have a hard time understanding why this conversation ever took place.
    Dr. Rob: Very good point, although the reality is that he simply needed to give consent. That is ideally in the form of a signed release, but a verbal agreement is acceptable. And when a client is yelling in the background about how much you suck, verbal consent is affirmed that much more.

  6. Amber says:

    Wow, a dripping gay wad and a charlatan, you sure do make wonderful impressions Doc! Your mother must be proud 😉 j/k
    Seriously though, you should not have apologized to her. I’m a mom and I know how we are…our sons do no wrong. Especially if they’re in a bad situation caused by themselves or even (gasp) possibly my poor parenting. I hope for his health’s sake that surgery went well and he’s been able to lose and keep the weight off. However, statistically he’ll back to where he was, if not heavier, within a year. It’s like quitting smoking…it’s not going to happen until you’re absolutely ready and committed.
    Good for you for not giving in to the “adult” that called you a gay wad…really

  7. Rachel says:

    My step-mom had a gastric bypass. And later, when she lost all the weight, she had all the skin taken off, a boob job and a tummy tuck all done in one session. The same surgeon who agreed to this had a patient die under his care from something really simple–like a nose job–a few weeks back.
    To me it doesn’t seem any different than an addiction. They think if they go through the ritual motions of fixing the problem, they will be cured. My step-mom is just depressed about the scars now. I can’t really blame them, or her, though. I would be just as excitable about it if I were that fat.

  8. matthew says:

    I’m pretty sure that “dripping gay wad” is in the DSM IV.

  9. sandy,phd says:

    I think you should copyright as a new projective, diagnostic technique how patient responds to your recommendations. Blaming the shrink is one pathological indicator. Having mother then call shrink to echo the blaming? Gotta qualify as Axis II something-or-other, right?

  10. Anonymous says:

    Wait… did the mother actually call you a “Dripping Way God”? And if so… what is that?

  11. Anonymous says:

    Perhaps I missed it, but has having this blog in anyway changed the manner or quality of your interactions with clients? Less douchebags hopefully…? Less unreasonable pushy motherfuckers? I’m thinking of employing this in my own practice based soley on your feedback. Yeah, I’m ridiculous sometimes.

  12. Esther says:

    Interesting. I am a shocked that you as a shrink would imply to someone’s mother that she’s a bad parent like that. Even if she is a bad mother helping professions are supposed to show compassion toward everyone. I thought that part of the point of psychological help was to avoid being judgmental. Engaging in a shouting match doesn’t seem like a good way to teach people how psychology can help them. Actually, your response to the woman came across as a little Dr. Phil-like. This is not meant as an accusation. I just think you might want to rethink some of your approaches toward everyday morons.
    Dr. Rob: This is a great point. I think people who read this site know that is not my regular approach. But because I’m human, therefore I’m flawed. I make mistakes, plenty of them, both on the job and in real life. You’re oversimplifying it a bit when you say that the point is to avoid being judmental and that we are to show compassion to everyone, but you’re dead on when you point out that I fucked up. If you think, however, that other shrinks DON’T fuck up, sometimes in small ways, others large, you’re missing the point of this site.

  13. […] feel that she can’t give a quick greeting and wish me a nice day. In fact, after being called a “Dripping Way God,” that would make for a nice change of […]