You could feel the air rushing out of her lungs and into your face if she was screaming at you.
“STOP CALLING ME A WHORE! I AM NOT A WHORE, YOU DIRTY N-GGER!”
No one, in fact, was calling her a whore.
“DON’T LIE TO ME, MOTHERF-CKER! I HEAR ALL OF YOU CALLING ME A WHORE! I HEARD IT, JUST NOW!”
Her best defense was a loud offense that included liberal use of racial …
The racial slurs didn’t hurt. Other things have hurt much more.
As a mother of three daughters, I frequently find myself singing along to the catchy tunes of Taylor Swift. Singer, songwriter, and overall superstar Taylor Swift is famous for penning undeniably captivating love songs. She is popular not only because she has the voice of an angel, a cutting edge look, and a fierce attitude, but also because she is honest and real. Taylor has an uncanny ability to put …
A psychiatrist shares her 5 secrets to love
I am a licensed clinical social worker. And, occasionally, a mental patient. Today, in this inpatient psychiatric unit, I am more a patient than a social worker.
It is Monday morning, and I am eating breakfast across from Owen, a muscular, flannel-clad, Paul Bunyan-looking patient. Little pieces of his scrambled eggs keep landing on his copper-colored beard. I sort of want to motion with my hand at where the eggs are …
The remarkable story of a psychiatrically hospitalized clinician
2015 was a year to regroup and reassess my professional goals. Immediately after residency, I did as most physicians do — apply and hope to get a job that pays well and is in a good location. Similar to the personalities of most physicians, I am a workaholic and overachiever. Therefore, since graduating residency, I strove to perform well at my job, treated my patients to the best of my ability, passed my …
How this doctor beat burnout. You can, too.
The woman in ill fitting snow pants and parka, as if there is such a thing as well-fitting snow pants and parka, clumps of blonde stuck-together hair poking out of her non-hipster cap, you know exactly what she looks like, stares at me from the sagging mid-century couch across the alcove in the café where I have set up my laptop, a scone, a huge cup of expensive coffee described …
An excerpt from Physician Suicide Letters — Answered.
When is a taboo topic no longer taboo? When is it OK to stop hiding behind euphemisms? When is it safe to tell the truth? The answer is now.
This week I uploaded 53 chapters of physician suicide letters in a Read more…
What you don’t know about medical training and culture can kill you
Some maladies that attract psychiatric attention are unequivocally brain diseases. Huntington’s disease. Brain tumors. Lead poisoning. However, these are not psychiatric diseases. Huntington’s is a genetic abnormality diagnosed and treated by neurologists. Brain tumors are managed by neurosurgeons and oncologists. Lead toxicity is treated by internal medicine. Indeed, a long list of medical and surgical diseases include psychiatric features: stroke, anoxic brain injury, meningitis, lupus, diabetic ketoacidosis, and febrile delirium to name a few. One important …
Are psychiatric disorders actually brain diseases?
Up to a third of resident physicians suffer from clinical depression or its symptoms. This was the finding of a large review of 54 studies involving 17,560 resident physicians, published in JAMA recently. In some of the studies reviewed, up to 40 percent of resident physicians reported depressive symptoms. The study found these physicians were 4.5 times more likely to suffer from depressive symptoms following beginning …
The key to preventing depression in residents? Value young physicians.
What do you do when you love your job, but it’s killing you?
That’s an easy question if it’s asked by someone else. It’s a hard question when you’re asking it of yourself. As a physician, I give advice to people all the time — other people. If you have diabetes, control your diet. If you are obese, then lose weight and exercise. If you have COPD, then you better not …
This surgeon loves her job. But it’s killing her.
I thought about you, the patient that I’m about to perform surgery on, all night last night and because I doubted myself, I took clonazepam to calm the anxiety so I could sleep. Today I’ve taken 10 mg of propranolol and some Kava, a natural supplement known to decrease anxiety.
As I start the surgery, the propranolol coursing through my veins blocking the sympathetic nervous system, I fear it will come. …
Physicians with anxiety shouldn’t suffer in silence
When I hung up my white coat for the last time and left the practice of medicine, the term, “physician burnout” was unfamiliar. It wasn’t until I stumbled across research studies many years later, in my work as a freelance writer, that I finally understood the underlying reasons that I needed to walk away. Today, you can’t read about health care without seeing the term. Does the widespread use of …
Fix the root cause of physician burnout. Not just the symptoms.
Imagine you are an ambitious new worker at a powerhouse institution. Your job performance is soaring, but you frankly work like a dog. Your weeks top out at 80 hours, you get maybe a single 24-hour block of time off every 7 days, you work weekends, and you often work up to 30 hours straight in one stint, sleep at work, and eat exclusively from food options in the building.
You …
Don’t poop where you eat: Mental health services for young physicians
The afternoon began like any other day in medical school. Students arrived at the lecture hall and took their seats. An individual with long blue-and-white hair and handlebar mustache entered the room wearing oversized fish-print pants, a loose-fitting clown shirt, and a single earing fashioned out of a bent fork. He casually strolled up to the front, introduced himself as Dr. Patch Adams, and told us …
When “healing” loses its meaning: A cynical medical resident meets Patch Adams
ADVERTISEMENT
Studies have varied in their estimates of depression in medical school students, but they all show a similarly startling trend. Medical students have a higher depression rate than their non-medical counterparts. This culminates later in life with physicians with higher than average alcohol abuse problems and higher than average suicide rates, with male MDs 1.5 times as likely, and female MDs twice as likely to commit suicide than their Read more…
Medical students are depressed, but they’re taking the wrong drugs
The letter from the insurance company was addressed to my patient. The two pages of information boiled down to one simple sentence: “After a thorough review, our decision to not cover the medication Provigil (modafinil) is unchanged.”
The letter went on to explain that there was no further recourse, and that the medication would not be approved because it was not Food and Drug Administration–approved for the condition my patient had: …
There is no oversight for prior authorizations. There should be.
My patient sat in front of me, silent. She was a beautiful, elderly woman, always well dressed in bright, matching outfits, and not a single hair out of place. Her lipstick was perfectly applied. She normally had a quick wit, joking about how she might drop a few knickknacks from my office into her handbag on her way out.
Not today. Today her tears flowed. Today was the day she grieved …
Dealing with my patients’ losses. And the losses in my own life.
While slogging through a crappy first draft of a document about the value of psychiatrists in mental health and substance use disorder services, I did a literature search for supporting evidence.
I found nothing. (1)
“So how exactly are we helpful?” I mused out loud. Maybe we aren’t: There are groups out there who do not believe that psychiatrists can or do help anyone.
I am an N of 1. …
Do psychiatrists have value? Yes, they do.
As a fourth-year medical student in a sub-internship in internal medicine, I have something that no doctor in America has. I have as much time as I want to spend with my patients. Don’t get me wrong, I am still a student. I’m still paying hospitals to let me be there, and I only have a maximum of four patients per day, but I inevitably end up spending more time …
When will we start taking mental health seriously?
“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 …
The question about education that this doctor asks every new patient
The iconoclastic psychiatrist Thomas Szasz said that mental illness was metaphorical, not real, because mental diseases lacked biological substrates. The absence of a substrate predisposes psychiatry to overdiagnosis and avoiding overdiagnosis is psychiatry’s biggest challenge. This challenge has been taken up by Allen Frances in Saving Normal. Like Szasz, Frances writes in cultured, erudite prose. Unlike Szasz, Frances believes that psychiatric illnesses are real. To save the mentally ill, to save …
DSM-5 is psychiatry’s maladaptation in the grey zone masquerading as science
Get free updates delivered free to your inbox.
