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Take two Prozac and e-mail me in the morning
Indeed, there was a honeymoon period. Could I change a Monday appointment for Wednesday? Of course. Would I phone in a renewal of Prozac? With pleasure. This was really neat: no more phone tag with patients, just simple requests with simple solutions.
Not for long.
"Dear Dr. Friedman," one patient e-mailed at 3 a.m. "I am having dark thoughts and wonder if I should increase my antidepressant. Can you let me know what you think?"
It was 8:30 that morning when I opened my e-mail and read her message with alarm. What exactly were "dark thoughts"? I wasn't sure, but I had to assume the worst — suicidal feelings or thoughts — and called her immediately.
She came in later that afternoon and explained that she felt bleak and hopeless and thought she and her family might be better off with her dead.
"Why didn't you call me right away?" I asked, as I recall the conversation.
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