Entitlement.

“Do you have any questions for me?” I asked. It’s how I usually close clinical interviews. It’s also a way to acknowledge how one-sided the interviews are.

“Will you go out on a date with me?” he replied. We were looking at each other through the window of his cell. His face was serious.

“No. Don’t ask me that again.” I want to be clear. There’s no ambiguity in that answer. “Do you have any other questions for me?” Even though I said no, I will still talk to you in my professional capacity.

He said nothing, but now he was frowning.

“Are you angry?”

“Yes, I’m mad. You said no when I asked you out on a date.” His cheeks were now red. He roared, “I HAVE SEXUAL NEEDS, TOO!”

“Good-bye, sir.” He was still shouting racial and misogynistic epithets at me as I left the area.

It’s not his request for a date that was noteworthy. That, unfortunately, has occurred before. It doesn’t happen often.

This is usually how these conversations occur:

SCENARIO 1: “Do you have any questions for me?”

“Will you have sex with me?”

“No. Don’t ask me that again.”

“Okay.”

And the subject never comes up again.

SCENARIO 2: “Do you have any questions for me?”

“Will you give me a blow job?”

“No.” (walking away)

“I’M SORRY, I’M SORRY, I WAS JUST KIDDING….”

These men usually apologize again the next time I see them.

SCENARIO 3: “Do you have any questions for me?”

“When I get out, I’ll take you to that burger place, I’ll buy you a burger and small fries, you can choose Pepsi or Coke—”

“Thank you, but no. That won’t happen.”

“But you can choose your own soda—”

If it comes up again, the requests are benign and may not make a lot of sense.

What made this man’s reaction noteworthy was his rage.

Nobody likes rejection. We all feel that visceral crushing sensation when we want something and we can’t have it. That crushing sensation is particularly harsh when we can’t have what we want due to arbitrary reasons. Like when a woman declines a date with a man.

This man and I had an interaction in a jail through the door of his cell. It was civil. To me it was a clinical interview. To him it may have been a nice and encouraging conversation. Something about the interaction made him feel comfortable enough to ask me for a date.

(Never mind the cues that indicated that such a request was inappropriate: He was in a jail cell. He knew that I worked as a physician there.)

The men in jail who have asked for dates or sex, though, recognized that they were not entitled to either. Sure, they could ask whatever they wanted. But, they also had the understanding that I could respond however I wished.

This man, though, was furious that I declined his request for a date. His reaction suggested that he could not believe that I had the gall to say no to him. How dare you say no when you were the one who asked me if I had any other questions? You started this. If my role as a physician was to help him, he had ideas as to how I could do that. Boundaries had blurred for him. He disliked that they had not blurred for me.

And, to be clear, this sort of behavior is not a function or manifestation of psychiatric illness. Some people with severe psychiatric conditions have extraordinary manners. Some people without any psychiatric conditions have vulgar manners.

If we look at the entire population of heterosexual men who are talking with a female psychiatrist:

• Some (most?) men will never think to ask for a date or sex when asked, “Do you have any questions for me?”
• Some men will think to ask that question, but won’t actually ask it.
• Some (few?) men will actually ask the question (whether earnest or not), though will not react as this man did.

And, as unpleasant as this interaction was, he did use his words to express his displeasure with me. Would he have shared his thoughts with me had I not asked him if he was angry? There are all the ways this interaction did not play out:

• He could have spit on the window (and if the window wasn’t present, his saliva would have landed on my face).
• He could have hit or punched the window.
• He could have reached through the open slot in his cell door and grabbed me.
• He could have thrown something—wet or dry—at me through the open slot.

What would have happened if this interaction had occurred outside of the jail?¹

He might have walked away.

He might have grabbed me to demonstrate his power and elevate his status.

He might have hit or punched me to express his rage.

He might have grabbed me and taken what he wanted.

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