Greg Smith, MD

Greg Smith is a psychiatrist.

What do physical gait, movement, and apparent drive tell us about each other?

Greg Smith, MD

Physician

May 19, 2017

Two sisters (religious order, not biological relation, as far as I know) live in one of the condos across from us. They are very nice, older ladies, warm and pleasant, always ready with a kind word and a smile as they see others in the complex come and go. They seem, at least on casual observation, to lead very busy lives. They rise early, heading out to do whatever it …

It’s 2017. There’s no excuse to be disconnected.

Greg Smith, MD

Physician

March 16, 2017

“I attribute my success to this-I never gave or took any excuse.”
-Florence Nightingale

I was publically thanked today for doing my job. No, really. By two of my coworkers, actually. It sort of took me aback just a bit.

Over the past Christmas holiday a couple of patients, being human as we all are, forgot to get their medications squared away before the clinic was going to close for a total of …

Why do people kill themselves?

Greg Smith, MD

Physician

March 7, 2017

I use an ongoing spreadsheet to keep track of and to report my demographics and stats for each telepsychiatry consult shift I do. I’ve done thousands of consults in over two dozen South Carolina emergency departments over the last half-dozen years. We have now gone over thirty thousand consults as a group.

It never ceases to amaze me, as I fire up my computer, log on to my systems and bring …

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Why do people kill themselves?

We all have glitches. I know I do.

Greg Smith, MD

Physician

February 3, 2017

He was a small but very intelligent and articulate young man. I had seen him before, but it had been quite a while. He came to me complaining (as did his family) that he was having some trouble controlling his anger, dealing with quarrelsome students at school, and not always getting his assignments inside or outside of school completed in a timely manner.

We discussed the usual ways to approach this, I …

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We all have glitches. I know I do.

Maybe it’s the medication! (It usually never is.)

Greg Smith, MD

Meds

January 25, 2017

He came in for his routine yearly visit with me, stable for the most part in that he was living with his chronic psychotic illness and moving through the world in a fairly normal, logical way most days. He was in his mid-twenties, neat and clean. He was attending to his personal hygiene and wearing rumpled but passable casual clothes. His hair was combed, but it had not been cut …

How this psychiatrist handles burnout

Greg Smith, MD

Physician

December 27, 2016

I listened to a Planet Money podcast recently titled, Burnout. It dealt with the origin and characteristics of burnout, and I would highly recommend it.

You’ve all heard the term and have a vague knowledge of what burnout is, I’m sure. You may have experienced it yourself. It affects call center employees (as in the podcast), all sorts of service workers, doctors and other health care providers and countless others.

Looking back …

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How this psychiatrist handles burnout

All patient lives matter

Greg Smith, MD

Physician

November 18, 2016

She is tall, thin and wears torn jeans like a mannequin. A silky top flows around her, masking the thin torso, the exposed ribs. Her hair is long, fine and the ends are perfect. Her face is smooth, drawn, a bit careworn, but that is why she is here. She carries herself with an aristocratic bearing that is not learned but genetically endowed over generations. She is rich, entitled and …

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All patient lives matter

What happens when a community loses its health care providers?

Greg Smith, MD

Physician

November 2, 2016

My father worked as a middle manager in the textile industry for many years after he graduated with a degree in textile engineering from Georgia Tech in Atlanta. As far as I know, he was the first to graduate from college in his family. I can only imagine how exciting it was for him to leave the little town of Cochran, travel to the big city of Atlanta, work to …

The fine line that we walk as physicians

Greg Smith, MD

Physician

October 10, 2016

I went into medicine because I wanted to learn about the craft, become proficient at healing disease and easing suffering, and because I genuinely liked getting to know more about my patients and hearing their stories. These reasons for going into medicine as a career and staying in medicine as a vocation have not changed significantly through the last three decades.

The problem we are faced with pretty often nowadays is …

I will go on treating patients, because that is what I know

Greg Smith, MD

Physician

July 21, 2016

You’ve all heard it. Those ads about that wonderful product that will change your life. The new kind of mattress that will finally give you a good night’s sleep every night. The new electric car. The superfood. They go on about them for thirty seconds or a minute, you are enthralled, and you dream of going right out and purchasing. Ah, marketing, how powerful you are. How much we want …

My patients all want to just survive somehow

Greg Smith, MD

Physician

June 16, 2016

One of the episodes of the Walking Dead was titled “JSS.” In this brutal episode, one learned by the end of the show that one of the characters, then others after her, had learned that all they could expect to do for the moment was JSS, or just survive somehow.

I met a patient recently who embodied that mantra.

Small, petite, with stringy hair and sun-browned skin, she did not look the …

The stories of my medical school mentors

Greg Smith, MD

Education

May 19, 2016

Popular shows like Gray’s Anatomy, ER, and House, MD have given the television watching public a good eyeful when it comes to the inner workings of medicine, hospitals, and emergency rooms. They have also shown us how the personalities of those who take up the stethoscope and reflex hammer run the gamut from the sweet, demure, tentative types to the sons of bitches who cut first and ask questions later.

I …

The question about education that this doctor asks every new patient

Greg Smith, MD

Physician

November 24, 2015

“How far did you go in school?”

This is a question that I ask every new patient as a matter of course.

Granted, I have gotten some very odd answers, including hearing from a very successful businessman who only finished the seventh grade, or a very psychotic person who has a double master’s degree. Not implausible, but certainly not expected or the mainstream answer from the majority of my patients.

Now, leaving the …

Embrace adversity, and you will be stronger after

Greg Smith, MD

Physician

November 18, 2015

I’ve been intrigued by the recent presidential debates and interviews and analyses and pundit commentary.

One of the issues that has come up has been how the candidates handle adversity, even at this very early time in the 2016 race.

They say that Donald Trump is in it for the thrill and the fun and sheer ego-boosting ride that is pre-caucus and pre-primary politics, when the love of the American people can …

Casual Fridays don’t have a place in medicine

Greg Smith, MD

Physician

May 16, 2015

shutterstock_82606081

A disclaimer before I even get started on this post.

Some of you who know me or work with me will think that by writing this post I am talking about you or even attacking you. I am not. If you’re especially sensitive, don’t read any further.

I am simply writing something that has been kicking around in my head for a long …

A child psychiatrist: Whether I choose to be one or not

Greg Smith, MD

Physician

December 14, 2014

Dr. Kenneth Azar, a mentor of mine at the old Georgia Regional Psychiatric Hospital in Augusta, Georgia, told me something once that has always stuck with me.

He told me that in the early years of his practice, when he was living and working out in Idaho, that he was one of a very small handful of psychiatrists who served the whole state. If an adult with psychosis needed to be …

The clear, killing acid of modern life

Greg Smith, MD

Physician

July 9, 2014

Floor technician.

Environmental technician.

Life coach.

Investment and retirement strategist.

Facility safety coordinator.

Interventional cardiologist.

Cardiothoracic and vascular surgeon.

Neurodevelopmental psychologist.

Are we hiding behind out words? Worse yet, are we afraid to be who we really are?

Maintenance man.

Trash man.

Knowledgeable and experienced friend.

Salesman.

Security guard.

Doctor.

Psychologist.

I see it every day. Someone comes to me for a run-of-the-mill mental health problem, absolutely nothing to be ashamed of, and asks for help. For whatever reason, when we get to the social history …

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The clear, killing acid of modern life

Out of the many he has seen, he will do his best to help just this one

Greg Smith, MD

Physician

May 19, 2014

She looked like a whipped puppy that had had a garden hose turned on it and slunk off to a far corner of the yard to dry out in the sun.

She sat there, wizened but hard, thin and wiry, dressed in standard issue blue emergency room scrubs, thin tanned face, long stringy, wet prematurely gray hair falling limply around her shoulders. She looked down at the floor, but when her …

My best teachers are my patients

Greg Smith, MD

Physician

March 31, 2014

One good thing about doing anything for three decades or longer is that you get to see cycles and repeated events, things that fail and things that work. I hope that over the last thirty years of learning about psychiatry and mental health (and yes, I am still learning and hope to acquire that one last little piece of knowledge on my deathbed) that I have paid attention to the …

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My best teachers are my patients

Weighing a patient offers a treasure trove of information

Greg Smith, MD

Physician

March 21, 2014

As a psychiatrist, I was trained to begin the mental status examination and overall assessment of my patient as soon as I greeted them in the waiting room. Even now, three decades after finishing medical school, I follow almost the same sequence of actions in my day-to-day interactions with my patients that I did as a resident in training. Granted, there are now electronic medical records and I rarely come …

Greg Smith, MD

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