Becoming Dr. C

Somewhere along the way, my patients stopped calling me Dr. Cartwright and started calling me Dr. C.

Nobody announced it. The name arrived the way nicknames do, one person at a time, until it was simply what I was called in my office. It is a small thing, two letters, and it has come to mean a great deal to me. It carries closeness without losing respect. It sounds like someone you can talk to.

The path to that name was not a straight line, and much of it ran through the experience of being the other.

Being the other

My road into psychiatry began in Martinique and took me through a first career in finance, on trading floors and in risk management, before medicine and residency in the United States. By the time I began residency, I had already been the newcomer many times over: the one who sounded different, the one who had to learn the unwritten rules of a place by watching closely, the one whose path did not look like anyone else's in the room.

Being the other teaches you things. You learn to read a room before you speak in it. You notice who is talked over and who is talked about. You learn how much energy it takes to translate yourself, all day long, into terms other people find familiar. And you learn what it feels like to be summarized too quickly, to be seen as a category before you are seen as a person.

That last lesson turned out to matter most.

What training could not teach

Psychiatric training gives you a language for suffering: diagnoses, criteria, rating scales. They are useful, and I rely on them every day. Early on, though, I noticed that the patient in the textbook was always someone in particular, and the person sitting across from me was rarely that someone.

For the first two and a half years of my training, extra weekend shifts put me alone with patients on Saturdays and Sundays, without an attending physician in the room. There was no one to defer to. So I listened, closely, because listening was the best tool I had.

Later, at my own request, I worked in a treatment-resistant affective disorders clinic at the VA. Many of the veterans I cared for had lived lives I had not lived and could not claim to understand from the inside. Over time, colleagues began sending me the cases they could not solve. What I took from those years was a stance more than a technique: when the usual explanations have failed, stop assuming you know who this person is, and start asking.

From being the other to meeting the other

There is a trap in all of this, and I have had to watch for it in myself. Having been an outsider does not mean you understand every outsider. Shared experience can open a door. It can also tempt you to believe you already know what is on the other side.

A patient who grew up between two cultures, or who has spent years as the only one like them at work, may recognize something in me. That recognition is real, and it can be healing in itself: the relief of not having to explain the basics. But my story is not theirs. My family is not their family. The moment I mistake our similarity for understanding, I stop listening.

So I try to hold two things at once: recognition of what we share, and honest acknowledgment of what we do not. In practice, that often takes the form of a question. What does this mean in your family? How would your grandmother describe what you are going through? Is there a word for this where you grew up? Psychiatry has made formal room for these questions. The current diagnostic manual includes a cultural formulation interview, built on the understanding that people experience and describe distress through the lens of their own culture. The tool helps. The stance behind it matters more.

Humble curiosity is not politeness. It is a clinical skill, and it protects against one of the most consequential errors in my field: deciding too early who someone is.

The people's psychiatrist

Over thirteen years of independent practice in San Diego, my office has become a place where people from very different backgrounds have found a home. That is why I have come to think of myself as the people's psychiatrist.

The name does not mean that I resemble everyone who walks in; no one could. It means something simpler. Whoever you are, you will be met as a person before you are met as a diagnosis. Your story will be treated as yours. Where we share something, we can name it. Where we differ, we can name that too, and learn from it.

Much of healing happens in exactly that space: in being recognized, and in being allowed to remain particular. In hearing, within the same conversation, "you are not the only one" and "your experience is your own."

When a patient calls me Dr. C, I hear a door left open.

Keeping it open, whoever comes through it, has become the center of my work.

Sylvia Cartwright MD is a board-certified psychiatrist in independent practice in San Diego since 2013. She sees adults across California by telehealth. Read more about her training on https://www.sylviacartwrightmd.com/credentials