"Ordinarily he is insane, but he has lucid moments when he is only stupid." (Heinrich Heine)

I have been told (by more than one acquaintance) that I have an "obsessive-compulsive disorder (OCD)." In addition, as a doctor who knows a smattering of psychological diagnoses, I can, with a modest degree of accuracy, usually tell when someone is crazy or merely deranged. I have, through 30 years or so of practicing medicine (isn’t that a strange phrase? "practicing medicine" Shouldn’t I sorta know what I am doing by now?), discovered that there is a whole lot of "deranged" running around loose in society. With those nuggets of insight, allow me to formally declare: Contrary to a widely-held notion, I am not crazy; I am, however, more than a little bit deranged. That said, and as if there is a 12-step program for those like me, let me say: "My name is Ron and I have OCD."

It might be useful to quantify just what I might be declaring. Let’s make up a scale. We will set the range of our scale, to keep it simple, from zero to 100. Zero signifies someone who is perfectly sane and has absolutely no psychosocial pathology. He is completely well adjusted, has no mother-father issues, never has mood swings, sleeps like a stone every night, has never seen a Michael Moore film and knows exactly his place in life’s grand ordering of things and people. In other words, he does not actually exist and is an imaginary "ideal." Let me reiterate: there are no perfect "zeros." Now, 100 on the scale we will assign to a level of dysfunction that can be best described (if politically correct) as a thoroughly raging lunatic. Just as there are no absolute zeros, there probably is no one who has achieved the full 100 points required for certification of supreme insanity. There are clearly many (for record-keeping purposes, they seem to be geographically confined, primarily, to the District of Columbia and government employment; but let’s not forget Kim Jung Il) who aspire to scoring 100 points, but I will leave it also as a degree of perfection yet to be attained.

In the hopes of giving our scale some points of reference, let’s assign - arbitrarily - some points to a few historical persons who typify both ends of our scale. In order not to be hauled before the bar of justice by any out of work shysters (is that an oxymoron?), I will confine my examples to those who no longer require a dependable oxygen source. I beg you not to read any nonexistent religious, racial or national bias into the following arbitrary and completely personal assessments. I apologize if anyone is offended. By the way, if you are offended, add 10 points to the score you already gave yourself; if you are downright angry, make it 20 points. Here we go:

      Score    Name

• 10 Dalai Lama
• 12 Ghandi
• 18 Mother Teresa
• 19 Billy Graham
• 50 Theodore Roosevelt (and many other American politicians, particularly Presidents)
• 72 Mahmoud Ahmadinejad (alright, he’s still sucking oxygen but also still crazy)
• 75 Adolf Hitler
• 89 Ted Bundy
• 92 Jeffrey Dahmer

With a clearer idea of where I am going with this, I place myself somewhere on the high side of the scale. Now, clearly, I would score me a good deal closer to Teddy than Jeffrey. Other folks, on the other hand, would give me a considerably higher score. I am more than confident my ex-wife would have me trouncing Hitler and, quite possibly (depending on her PMS status), giving Jeffrey a run for the scoring title. I would hope that as long as the alimony checks arrive with regularity, she wouldn’t make me the champ.

People who, fortunately, know me a little less intimately and under less adversarial circumstances would, I venture (and hope), place me around middle of this pack, give or take a few points here and there. My patients would probably rate me below 50 points; my coworkers, slightly above that median.

The point of this little digression is to drive home the point that we are all a bit looney and I freely acknowledge that I am right on up there amongst them. There is little doubt in my mind that if I don’t have full blown obsessive-compulsive personality disorder (OCPD), I have a awful close approximation of it. You see, the main difference between degrees of lunacy - at least in the minds of psychiatrists - is not a point scale but a simpler progression between:

Personality Disorders ---------> Neurosis -------------> Psychosis

People like me who are just a little nuts are diagnosed with "personality disorders." For the most part, we are fairly functional people who can have careers and families and some semblance of a life. Neurotics are a little more disabled by their disability and are, in the majority of cases, a little less functional. The psychotics are considerably hindered by their mental dysfunction and end up either in long-term therapy, institutionalized or in Congress. To paraphrase, "the District of Columbia is too small to be a republic and too large for an insane asylum." All three varieties of instability may be treated with medications but, these days, what isn’t? If going bald or having hot flashes is worth medicating, imagining that you are being watched by aliens or that you can solve poverty with new laws or taxes is certainly worth a pill or two.

According to one source, there is a neat and tidy mnemonic for remembering the symptoms of my particular form of craziness. Since I am in the medical field, I find it appropriately ironic that the letters would spell out "Law Firms." They are:

L – Loses the point of activity due to preoccupation with detail

A – Inability to complete tasks (compromised by perfectionism)

W – Worthless objects (hoarding)

F – Friendships and leisure activities excluded due to a preoccupation with work

I – Inflexible, overconscientious not accounted for by religion or culture

R – Reluctant to delegate (unless others submit to exact guidelines)

M – Miserly (toward self and others)

S – Stubbornness (and rigidity of opinions)

As I look at the least, I see that while I clearly fit the profile, one of the sleeves and both pant legs a bit too long and the waist a shade too small on my OCPD suit as tailored by Freud & Sons, but alterations seem plausible. For instance, I am not so bad at the "L" or the "A" as I am on the "F" and the "R" and the "S." If truth be told, I have a goodly dose of "R-ness" and "F-ness." I have completely cornered the Cuckoo Nest’s entire stock of "S-ness." I used to be really, really strong in "W-ness" - but I am much better now.

I guess, all things considered, I should count my blessings. OCPD folks are capable of achieving excellent careers even if they are not the best "people persons" in town. My particular strength (or weakness, depending on how you might look at it) is my stubbornness. I, of course, would prefer to give it a more positive spin and refer to it as "firmness of purpose." In a word, I am relentless. This particular piece of my pathology has been with me longer than any of the others and, quite possibly, it was the seed from which the quirks grew.

Some of the letters I have - more or less - shed completely. At one time and in a previous residence, I was a completely pathological packrat. I kept medical articles I knew I would never get around to reading, clothes I would never be able to fit in again (even if the fashion came back into style) and sundry computer hardware some dating back to my old Texas Instruments 99/4a circa 1980. I am not sure why I kept those items. I am sure Freud and his successors would be able to explain it to me as some sort of maladaptive attempt to accumulate "wealth" so I could purchase from my father the sexual favors of my mother and...well, that’s a little TMI ("too much information") for me and, I am certain, for you.

Strangely, that compulsion melted away when I decided to move into a new residence. The new place was actually larger but, since I hired out the work of moving, it would cost me less if I just threw stuff away. Thus, referring back to the mnemonic, "M-ness" trumped "W-ness." In my experience (limited as it might be), when quirks go head to head, one quirk has to give way to the other. For my long-term mental health, this was a very positive step forward. My office may still look like a dumping ground for the Library of Congress but, by Great Caesar’s Ghost, my personal residence is neat and tidy. Battles are hard won in the world of the psychologically impaired but victory is always possible.

According to the reading I have done, there are some "self help" measures that may also help. The one I particularly enjoyed reading was this nugget:

Educating family and friends about the condition will help them to manage behavioral problems more sympathetically, and to watch out for the warning signs.

Well, that’s a mighty fine idea but it has a few flaws. Unfortunately for old OCPD sufferers such as I, we are divorced and our children are grown and long gone. Second, we don’t have any friends (see "F-ness" in the mnemonic above). So, I plaintively ask, where exactly are we to get our "sympathy" and what the heck are the "warning signs?" I did find an OCPD support group online but I have too much "S-ness" to ask help from anyone. Besides, after reading some of the posts, I realized that: "Hey, I must be only three-quarters crazy!" After a survey of what is available, I guess I will just keep on flying out of the formation.

Freud referred to us as "anally fixated." That, to me, sounds a little harsh. I really have better-than-average bowel regularity. Humm. On second thought, maybe that what old Siggy was suggesting. Well, never mind. I prefer to think of myself as just a little bit odd. And, when I look around me, I am not sure my quirks are any more debilitating than some of the wing nuts walking around the streets and hamlets of the world I live in. In fact, when compared, I am downright civilized. I will continue to hang my shirts in the closet by color, arrange my socks accordingly, do my laundry on Friday and Sunday, get up every morning at the same hour (weekends included) and all the other pleasant little oddities that keep my "I-ness" titer at tolerable levels.

We all have our own little oddities. It’s what makes us all interesting, to one degree or the other; some, admittedly, more so than the rest. To some, I may be thought entirely crazy. For me, it’s just my way of getting through the day. Fish gotta swim, birds gotta fly and I gotta be "whimsical" (which, to me, sounds a lot more pleasant than being "anal").

Waylon Jennings once said: "I may be crazy but it keeps me from going insane." From such a recognized expert as he, who can argue?