Dr. Loshi Rajen
Loshi Rajen is a psychiatrist in the United Kingdom.
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Latest articles
Conditions and diseases
When I was a child, my mother left a poem that had touched her under the glass screen of my study table. It was the poem of the wise old owl, and at the bottom, the author was stated as…
When I was a child, my mother left a poem that had touched her under the glass screen of my study table. It was the poem of the wise old owl, and at the bottom, the author was stated as anonymous.
I was all but six at the time. I learned a new word: anonymous. But that is not the point of this essay. The point is that my mother told …
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Finding your voice in medicine when you’d rather listen
Conditions and diseases
Quite recently, I requested a colleague to proofread a piece of my writing. When I asked for feedback, his reply through the text bubbles on WhatsApp read: "I have not been chanced to go through it." The meaning of it…
Quite recently, I requested a colleague to proofread a piece of my writing. When I asked for feedback, his reply through the text bubbles on WhatsApp read: “I have not been chanced to go through it.”
The meaning of it was perfectly clear. Yet I caught myself correcting his sentence almost automatically in my head. Once I caught myself in the act, I stopped abruptly. I found myself wondering whether the …
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Cultural humility in psychiatry begins with curiosity
Conditions and diseases
I very recently started work at a new hospital as part of a yearly rotation while in training. This hospital has a fire board with the names of staff, followed by two small circles containing the words IN and OUT,…
I very recently started work at a new hospital as part of a yearly rotation while in training. This hospital has a fire board with the names of staff, followed by two small circles containing the words IN and OUT, and a tiny black magnet that closely resembles a knight from a portable chessboard. The idea, at least at first glance, seems deceptively simple.
Two days into my new job, a …
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Human factors in health care start with better design
Physician voices
Having returned to the United Kingdom from a vacation back to Southeast Asia, I found myself reflecting on the meaning of being an immigrant. I found myself intensely missing the sun and the food. The general miasma of security and…
Having returned to the United Kingdom from a vacation back to Southeast Asia, I found myself reflecting on the meaning of being an immigrant.
I found myself intensely missing the sun and the food. The general miasma of security and comfort that comes from being home. Of having access to not one but three cars with a full driving license, which, being Malaysian, is a huge part of one’s identity. Strip …
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The immigrant doctor who belongs to two places at once
Physician voices
I had been driving for fourteen years before I moved to the United Kingdom two years ago. Back home in Malaysia, driving had become almost instinctive. It was something I rarely thought about. But moving countries meant starting over. To…
I had been driving for fourteen years before I moved to the United Kingdom two years ago. Back home in Malaysia, driving had become almost instinctive. It was something I rarely thought about. But moving countries meant starting over. To continue working as a community psychiatry registrar, I needed a U.K. driving license.
Twice I took the practical driving test. Twice I failed. I could spend hours dissecting the examiner’s decisions, …
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How a failed driving test shook my confidence in medicine
Conditions and diseases
A few days ago, while covering a four-day stretch of on-call shifts, I was asked to step down from my usual role as a psychiatry registrar to cover a vacancy in the senior house officer rota. I have been in…
A few days ago, while covering a four-day stretch of on-call shifts, I was asked to step down from my usual role as a psychiatry registrar to cover a vacancy in the senior house officer rota. I have been in the United Kingdom for almost two years now, but during that time I have worked almost exclusively in community psychiatry. Although I had previously worked in inpatient psychiatry in Malaysia, …
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Psychological safety in medicine starts with a text
Physician voices
A friend once asked me a question that stopped me in my tracks. Not externally. Internally. I am a highly verbal person inwardly, and while the conversation continued around me, another one had already begun in my head. Earlier that…
A friend once asked me a question that stopped me in my tracks. Not externally. Internally. I am a highly verbal person inwardly, and while the conversation continued around me, another one had already begun in my head.
Earlier that day I had been cataloging the various grievances I believed had been inflicted upon me by another person I had once counted as a friend. After listening patiently for some time, …
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Why we need closure, and why we may not
Physician voices
While shadowing a senior colleague during Mental Health Act assessments in the U.K. a few months ago, I noticed something small but instructive. In his documentation for two different patients we had seen together, he referred to me as Dr…
While shadowing a senior colleague during Mental Health Act assessments in the U.K. a few months ago, I noticed something small but instructive. In his documentation for two different patients we had seen together, he referred to me as Dr followed by two different versions of what he assumed to be my surname.
Later that same day, while introducing me to colleagues who were joining us, he hesitated. Unsure which name …
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What medicine gets wrong about names
Conditions and diseases
One of the hardest questions in intellectual disability psychiatry that I have found myself grappling with over the past year as a registrar in the subspecialty is surprisingly simple: Is this person in pain? Most people assume pain announces itself…
One of the hardest questions in intellectual disability psychiatry that I have found myself grappling with over the past year as a registrar in the subspecialty is surprisingly simple: Is this person in pain?
Most people assume pain announces itself clearly. A broken bone hurts. A toothache hurts. An infection hurts. The body sounds an alarm and we respond. In practice, as I have encountered time and again, it is …
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Recognizing pain in autism when there are no words
Physician voices
At two in the morning, grief looked like psychosis. I remember being irritated before I even saw her. At the time, I was working back home in Malaysia. The emergency department fluorescent lights were too bright, my head heavy with…
At two in the morning, grief looked like psychosis.
I remember being irritated before I even saw her. At the time, I was working back home in Malaysia. The emergency department fluorescent lights were too bright, my head heavy with interrupted sleep, the air-conditioning turned low enough that the corridors felt vaguely refrigerated. Someone from the emergency department had telephoned psychiatry on call (me) requesting an urgent review of an elderly …
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The night I almost diagnosed grief as mental illness
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