Has your residency as a psychiatrist influenced your political views? In particular because you have been in contact with people from other social classes, which you wouldn't have otherwise.

Oh man, what a tough question.

You know the thing about how there aren’t good people or bad people, there are just people, and there’s a little good and a little bad in every one of us?

Maybe that’s true on the margins, but on the tails it’s kind of BS.



Most of the people I meet are genuinely wonderful. A lot of them have gone through stuff I couldn’t possibly imagine without losing their compassion or basic decency. In many cases I hugely respect their willpower - the guy with excruciating chronic pain who won’t take opiates because he doesn’t want to get addicted, or the single mother working two jobs and raising her kids on a shoestring after she decided to get them away from her abusive husband. Also, a lot of these people are dealing as best they can with abusive spouses/parents/children/friends/exes/bosses, and a lot of the time I want take them aside and scream at them “YOU ARE AN AMAZING PERSON, BUT EVERYONE ELSE IN YOUR LIFE IS DYSFUNCTIONAL AND HORRIBLE AND CONSTANTLY HURTING YOU, AND I AM AFRAID YOU ARE GOING TO END UP CRAZY UNLESS YOU MOVE AS FAR AWAY AS POSSIBLE RIGHT NOW, PREFERABLY TO ALASKA, AND GET A NEW SOCIAL CIRCLE MADE ENTIRELY OF WALRUSES.” Social services offer these people bandaid solutions at best and are constantly stringing them along in order to save a few measly bucks that might mean the difference between these people flourishing and starving.

Other people I meet are so terrible it defies belief. A lot of times I secretly diagnose them with antisocial personality disorder, but I don’t know if this is meaningfully true or just a description of the fact that they are terrible. They are constantly and shamelessly committing crimes and preying on anybody who gets close to them. They have no control over their emotions and no insight into the idea that this might possibly be a good thing to have. They have no interest in changing any of this, and it almost seems like a category error because their brains don’t think in terms that abstract. Often these people end up in prison, or have just come out of prison. They will sometimes tell me stories about how everything is everybody else’s fault and the police are stupid and oppressive and pick on them for no reason and besides they just assaulted one little teenager, everyone assaults a teenager here and there and they didn’t mean to cause permanent damage, and then the police wouldn’t give them a cheeseburger in jail, this must be that police brutality thing they hear about on TV, and they are going to call the news and sue everyone involved, especially me if I don’t give them Vicodin RIGHT NOW.

I assume these groups exist among rich people as well, but part of what being rich does is give you the resources to pave over things and not be so raw about your internal life all the time.



I think I’m more sympathetic to politics on both sides at this point.

Some people are definitely right when they tell stories about poor people struggling to get by and being failed by the safety net.

And other people are definitely right when they talk about predators who we need to lock up and throw away the key (note that I’m not happy about this, and I hope we one day discover some kind of genetic engineering or something that can fix this, and then nobody will be happier than me to go and retrieve the key we threw away).



For some reason, these people keep thinking they’re talking about the same people and that they disagree with each other.