Big business: a cure for big ears, girly voice


Every few years the American Psychiatric Association (APA) updates its Diagnostic and Statistical Manual of Mental and Emotional Disorders. The manual, usually called the DSM, is now in its fifth edition and sells like hot cakes.

It is worth noting that the number of psychiatric conditions has grown approximately 7,982 percent from the first edition to the latest, leaving only three people on the planet who can legitimately claim they are not kookoo. (Maybe I exaggerate a little.) I’m not going to mention who these people are because the remaining 6.3 billion will likely sue me for defamation, and Obamacare doesn’t protect you from kookoos.

You will have to guess if you are one of these people. If you don’t want to guess, you will have to buy a copy of the DSM and review its 27,812,903,225 conditions to see if any apply to you. The problem is that if you did not have a psychiatric condition when you started reading the manual, you surely will have one by the time you finish the book.

The APA is unfairly accused of inventing new psychiatric problems to provide job security for psychiatrists and Nespresso machines for all its employees. To assist the APA with its current woes, I have devised a system that would turn the DSM into an engine of economic opportunity for the entire nation and make APA the most loved professional organization in the world: Crowdsourcing updates for the DSM.

This is how this would work. People would submit new psychiatric conditions to the APA. If accepted, submitters would receive a $5 rebate every time they saw a psychiatrist and a 15 percent discount on future medications developed to treat the condition they proposed. Given that only three people on the planet are not diagnosed with a psychiatric condition, most of us will benefit from this win-win-win solution: Patients get a discount and participate in the democratic and scientific process of inventing diseases, the APA improves its tarnished reputation, and pharmaceuticals have a never-ending stream of conditions on which to try medications that never worked for their intended purpose.

In anticipation, I came up with 54 psychiatric conditions I wish to submit for inclusion in the next DSM. My top three:

• Voice-induced gender identity confusion.

• First-class envy.

• Big-ears trauma.

For years I have suffered from people confusing me with members of the opposite sex on the phone. I have yet to come up with a proper response when people on the other end of the line call me Mrs. To prevent such embarrassment I have occasionally tried to project a very manly voice on the phone, especially with service people I don’t know. Alternatively I say “this is ISAAC Prilleltensky calling,” to which people often reply “how can I help you, Ma’am?”

I’m sure I’m not the only person suffering from such a common but yet undiagnosed condition. I came up with a solution that would solve the problem forever and provide jobs not just to psychiatrists but also to surgeons and music engineers: a vocal-cord transplant. Enterprising music engineering students would devise a menu of manly voices to choose from: Luciano Pavarotti, Placido Domingo, Frank Sinatra and Marlon Brando.

“I’ll take Placido please, with a little more baritone.” I’m sure by the time I finish publishing this there will be a dozen start-up companies working on my cure.

First-class envy is a condition afflicting millions of people who fly economy, especially those who fly long hours with their knees up to their chins. We recently flew to Israel with our knees and feet kissing our foreheads. To make sure we did not think much about our leg problems, two adorable brothers, ages 8 and 5, kept kicking the back of my seat every time I started falling asleep. The only thing I could think of other than opening the emergency exit and disposing of the kids was how nice it must be to fly first class.

To cope with this malady I have a number of recommendations: Overthrow the government, nationalize the airlines and eliminate first class, develop an envy-elimination pill or just stay home.

Big-ears trauma is a particularly challenging condition, especially because I can hear so loud and clear when people on the phone say to me, “How can I help you, Ma’am?” This is probably a case of co-morbidity: Big ears, girly voice. The only thing that stops me from doing plastic surgery on my ears is saving for a vocal-cord transplant and first-class seats.

Isaac Prilleltensky is dean of the School of Education and Human Development at the University of Miami. Look for his humor blog at

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