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Farid Sabet-Sharghi, MD

Farid Sabet-Sharghi is a psychiatrist.

Conditions

Why criminal responsibility is not a medical question

I've watched the coverage of this case the same way most of us have. Clips from the courtroom keep looping across television, podcasts, and every social feed. A mother killed her three children. The hearings are broken into bite-sized moments…

I’ve watched the coverage of this case the same way most of us have. Clips from the courtroom keep looping across television, podcasts, and every social feed. A mother killed her three children. The hearings are broken into bite-sized moments for public consumption. And in the middle of it all sits a long parade of physicians from every specialty, plus the usual lineup of forensic psychologists and psychiatrists, each one …

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Why criminal responsibility is not a medical question

Physicians

Blame culture in medicine leaves young doctors traumatized

It plays out like a modern-day digital horror movie. On my social media feed, a snippet of a horribly sad drama catches my eye: A young woman, devastated and paralyzed by an unimaginable tragedy, has taken the lives of her…

It plays out like a modern-day digital horror movie. On my social media feed, a snippet of a horribly sad drama catches my eye: A young woman, devastated and paralyzed by an unimaginable tragedy, has taken the lives of her own children. She had previously been under medical care, presenting with a complex psychiatric history that navigated the difficult waters often met with multiple therapies: antidepressants, anti-anxiety agents, and various …

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Blame culture in medicine leaves young doctors traumatized

Physicians

Moral injury in medicine is an odyssey without Ithaca

For those of us who have spent decades practicing medicine across multiple systems, the daily reality feels less like the noble healing art we trained for and more like a corporate assembly line. We watch as science-based, patient-centered care is…

For those of us who have spent decades practicing medicine across multiple systems, the daily reality feels less like the noble healing art we trained for and more like a corporate assembly line. We watch as science-based, patient-centered care is nickel-and-dimed by administrators into mere metrics. In our exhaustion, we can easily identify with Odysseus. Like the legendary king wandering the dark seas, we feel a profound sense of alienation, …

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Moral injury in medicine is an odyssey without Ithaca

Physicians

3 reforms to counter wellness influencers in practice

We spend our days in the quiet reality of clinical practice. We chase elusive diagnoses, weigh the fine distinctions of symptom presentation, and measure our clinical instincts against rigorous decades of peer-reviewed science. We sit across from human beings in…

We spend our days in the quiet reality of clinical practice. We chase elusive diagnoses, weigh the fine distinctions of symptom presentation, and measure our clinical instincts against rigorous decades of peer-reviewed science. We sit across from human beings in moments of vulnerability, applying a lifetime of anatomy, neurobiology, and pharmacology to parse real suffering from pathology.

Yet, step outside the exam room door, and we are met with a deafening …

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3 reforms to counter wellness influencers in practice

Physicians

Patient satisfaction scores punish the doctors who say no

In the digital age, we have been conditioned to trust the social proof of a high star rating. We see five stars on a retail site and immediately assume the product is excellent. But as a psychiatrist, I have learned…

In the digital age, we have been conditioned to trust the social proof of a high star rating. We see five stars on a retail site and immediately assume the product is excellent. But as a psychiatrist, I have learned that when it comes to medicine, that logic is fundamentally flawed. In fact, if you encounter a physician with 375 five-star reviews and not a single negative comment on social …

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Patient satisfaction scores punish the doctors who say no

Conditions

How ADHD in physicians collides with constant evaluation

Many individuals drawn to a career in medicine possess a driven, high-functioning intellect that often masks concurrent manifestations of neurodevelopmental idiosyncrasies, most notably attention deficit hyperactivity disorder. While this profile often contributes to the grit required for clinical training, it…

Many individuals drawn to a career in medicine possess a driven, high-functioning intellect that often masks concurrent manifestations of neurodevelopmental idiosyncrasies, most notably attention deficit hyperactivity disorder. While this profile often contributes to the grit required for clinical training, it also introduces a significant vulnerability: a heightened level of emotional variability and rejection sensitivity dysphoria.

The inherent nature of clinical practice creates a precarious environment for those with this neurobiology. We …

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How ADHD in physicians collides with constant evaluation

Physicians

Healing a divided nation begins in a psychiatrist’s office

In the months since the United States marked its 250th anniversary, I find myself sitting in a unique vantage point. As a psychiatrist, my office acts as a microcosm of the American experience. Behind closed doors, the broad and often…

In the months since the United States marked its 250th anniversary, I find myself sitting in a unique vantage point. As a psychiatrist, my office acts as a microcosm of the American experience. Behind closed doors, the broad and often raucous headlines of our national discourse distill into the visceral, unfiltered reality of individual human experience. From this front-row seat, I witness our collective anxieties, our daily pains, and our …

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Healing a divided nation begins in a psychiatrist’s office

Conditions

Why physician burnout starts with cheap dopamine

The practice of medicine was once anchored to a physical place. Whether it was an office, a hospital, or an outpatient clinic, there was a threshold to cross, a door to close, and a boundary that separated the physician from…

The practice of medicine was once anchored to a physical place. Whether it was an office, a hospital, or an outpatient clinic, there was a threshold to cross, a door to close, and a boundary that separated the physician from the patient. Today, that fortress has vanished. We are now connected to our work on a constant basis. Between electronic messages, automated requests for prescription refills, and the endless stream …

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Why physician burnout starts with cheap dopamine

Tech

AI and critical thinking: the cost of borrowed mastery

We are currently navigating a fundamental shift in how we engage with the world, one that is accelerating the rise of modern individualism and a particular brand of digital narcissism. There is a growing erosion of the boundary between authentic…

We are currently navigating a fundamental shift in how we engage with the world, one that is accelerating the rise of modern individualism and a particular brand of digital narcissism. There is a growing erosion of the boundary between authentic intelligence, which is the slow, messy, and deeply felt process of understanding, and the appearance of intelligence, which is now just a click away through data synthesis.

We have entered an …

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AI and critical thinking: the cost of borrowed mastery

Physicians

Why medicine needs both high-tech and high-touch care

The path to a career in medicine often begins with a singular, heroic narrative: the promise to work hard and save lives. This is a noble ambition, and the surgeons and specialists who master complex procedures are essential to our…

The path to a career in medicine often begins with a singular, heroic narrative: the promise to work hard and save lives. This is a noble ambition, and the surgeons and specialists who master complex procedures are essential to our craft. But as one spends decades in clinical practice, the reality of medicine shifts. We realize that the most profound work we do often has little to do with acute …

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Why medicine needs both high-tech and high-touch care

Meds

GLP-1 weight rebound: We have seen this before

We are living through a massive, rapid shift in how we approach human health, and as I watch the excitement surrounding the new generation of glucagon-like peptide-1 (GLP-1) agonists, I can't help but see a familiar ghost in the room.…

We are living through a massive, rapid shift in how we approach human health, and as I watch the excitement surrounding the new generation of glucagon-like peptide-1 (GLP-1) agonists, I can’t help but see a familiar ghost in the room. It feels exactly like the early days of the selective serotonin reuptake inhibitor (SSRI) revolution, a time when we were all so eager for a solution that we sometimes overlooked …

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GLP-1 weight rebound: We have seen this before

Physicians

The people-pleasing in medicine that burns doctors out

We are taught from the first days of medical school that bedside manner is a clinical tool as vital as a stethoscope. We are told to listen, to mirror, and to connect. But for many of us, this directive has…

We are taught from the first days of medical school that bedside manner is a clinical tool as vital as a stethoscope. We are told to listen, to mirror, and to connect. But for many of us, this directive has quietly morphed into a high-stakes performance. If you find yourself leaving the exam room physically exhausted, not from the medicine, but from the emotional labor of managing patient reactions, you …

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The people-pleasing in medicine that burns doctors out

Physicians

Our obsession with youth is making us shallow

In my thirty years of clinical practice, I have witnessed the landscape of the human face undergo a quiet, profound transformation. It is not happening through biology, but through the scalpel, the needle, and the digital filter. For most of…

In my thirty years of clinical practice, I have witnessed the landscape of the human face undergo a quiet, profound transformation. It is not happening through biology, but through the scalpel, the needle, and the digital filter.

For most of human history, an aging face was a history book. It served as a cartography of experience, where lines around the eyes mapped a lifetime of laughter, and furrows in the brow …

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Our obsession with youth is making us shallow

Conditions

When a hit medical drama glorifies physician burnout

I have spent the last few weeks watching a popular television drama set in a chaotic urban emergency department. After more than three decades of practicing psychiatry, I did not expect a network drama to affect me this way. It…

I have spent the last few weeks watching a popular television drama set in a chaotic urban emergency department. After more than three decades of practicing psychiatry, I did not expect a network drama to affect me this way. It has felt like a strange form of therapy, vividly resurrecting the ghosts of my formative years and bringing back the exhausting, exhilarating days of medical school and my time as …

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When a hit medical drama glorifies physician burnout

Physicians

What epigenetics reveals about inherited trauma

I still remember the quiet thrill of first learning about epigenetics as an emerging field. For a long time, medical science treated the genetic code as a fixed blueprint, an unyielding, unchangeable text. Epigenetics changed that narrative. It revealed that…

I still remember the quiet thrill of first learning about epigenetics as an emerging field. For a long time, medical science treated the genetic code as a fixed blueprint, an unyielding, unchangeable text. Epigenetics changed that narrative. It revealed that while the underlying script of our DNA remains the same, environmental experiences act like annotations in the margins, dictating which chapters are read and which are silenced.

Finally, we had a …

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What epigenetics reveals about inherited trauma

Conditions

Why I hesitate to sign ADHD accommodation forms

Every year, my desk fills with increasingly complex paperwork. School systems, testing boards, and corporate human resources departments request formal validation to grant specific accommodations, most commonly extended time or modified environments, for individuals diagnosed with Attention Deficit Hyperactivity Disorder.…

Every year, my desk fills with increasingly complex paperwork. School systems, testing boards, and corporate human resources departments request formal validation to grant specific accommodations, most commonly extended time or modified environments, for individuals diagnosed with Attention Deficit Hyperactivity Disorder. As a psychiatrist who has spent decades observing the human condition, I find myself increasingly reluctant to sign these forms.

This hesitation does not stem from skepticism about the condition itself. …

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Why I hesitate to sign ADHD accommodation forms

Conditions

Rethinking neuroplasticity and mental health in psychiatry

Every week, a familiar reflection settles into the corners of my mind as I look at my office desk. As a practicing psychiatrist, my days are spent navigating a gentle but persistent paradox. On one hand, my workspace is increasingly…

Every week, a familiar reflection settles into the corners of my mind as I look at my office desk. As a practicing psychiatrist, my days are spent navigating a gentle but persistent paradox. On one hand, my workspace is increasingly filled with paperwork: diagnostic standardizations, complex neuropsychological testing matrices, and formal institutional accommodation forms designed to categorize human behavior into neat, permanent columns. On the other hand, sitting across from …

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Rethinking neuroplasticity and mental health in psychiatry

Physicians

The generalist physician hiding in every specialist

The definition of a "doctor" is shifting in a way that feels increasingly fragmented. Growing up with a father who practiced for decades as a primary care physician before pursuing a residency in pediatrics, my baseline understanding of medicine was…

The definition of a “doctor” is shifting in a way that feels increasingly fragmented. Growing up with a father who practiced for decades as a primary care physician before pursuing a residency in pediatrics, my baseline understanding of medicine was rooted in the “whole doctor” model. In that world, a physician addressed the majority of a patient’s needs and sought specialized intervention only when a situation truly demanded it. Today, …

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The generalist physician hiding in every specialist

Physicians

Psychedelics in psychiatry are not a neural reset

The history of psychiatry is often a story of our own impatience. When we look back at the era of the ice-pick lobotomy, we tend to view it as a distant, primitive horror. But if we look closer, the impulse…

The history of psychiatry is often a story of our own impatience. When we look back at the era of the ice-pick lobotomy, we tend to view it as a distant, primitive horror. But if we look closer, the impulse behind it remains very much alive. It was the dream of the “quick fix,” the belief that if we could just physically alter the brain, we could bypass the messy, …

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Psychedelics in psychiatry are not a neural reset

Physicians

35 years after choosing psychiatry as a specialty

35 years ago, I stood in a hospital hallway and made a decision that would define the rest of my professional life. I was halfway through my internship year in radiation oncology, a field of high-tech linear accelerators and clear-cut…

35 years ago, I stood in a hospital hallway and made a decision that would define the rest of my professional life. I was halfway through my internship year in radiation oncology, a field of high-tech linear accelerators and clear-cut protocols, but my heart had drifted toward psychiatry. When I finally voiced my intent to switch, I didn’t find the collegial support we are taught to value in medical training. …

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35 years after choosing psychiatry as a specialty

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