It is not breaking news that we are currently in the midst of a mental health and substance use disorder crisis. We saw a record number of overdose deaths in a 12-month period from May 2022 to May 2023. According to the CDC, overdose deaths totaled more than 112,000 during that period. There has been an all-hands-on-deck effort to curb these deaths with efforts aimed at decreasing supply, educating the …
It is a typical day on the inpatient unit. A patient is refusing medication, and I want to take her to court to compel her to take medication while her lawyer is arguing for her right to refuse.
Me: “She’s clearly psychotic. She has lost her family, and she has no place to live… all because of these delusions.”
Lawyer: “But is she behaving in a dangerous way?”
Me: “Being unable to survive …
My flights had been delayed, and I did not arrive at the hotel in downtown San Francisco until almost 1 a.m. As I exited the Uber, struggling to shoulder my briefcase and wrangle my suitcase, I was a bit startled to hear a very loud voice coming from my left. “Hey, mister, do you have a dollar or two?” I had been in the city for less than one minute, …
“A doctor must work eighteen hours a day and seven days a week. If you cannot console yourself to this, get out of the profession.”
During the 20th century, these famous words from Dr. Martin Henry Fischer (1879-1962) were often quoted to students on their first day of medical school with a veiled threat to “toughen up.” Unfortunately, remnants of this outdated “get over it or get out” attitude in …
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Attorney Andrea Sonnenberg joins us to delve into the transformative power of bibliotherapy. Join us as we explore how literature can be a potent tool for addressing mental health challenges, offering insights and solutions for individuals and …
Burnout:
“An erosion of the soul caused by a deterioration of one’s values, dignity, spirit, and will.”
– Christine Maslach (The Truth about Burnout by Maslach and Leiter)
“Shredding of the soul.”
– Rita Nakashima Brock (Director of the Shay Moral Injury Center at Volunteers of America)
The word “soul” captures our attention by speaking in a language that bypasses the superficial, connecting directly to our deepest values and thoughts. In the context of burnout …
I sat at my desk in my 6th-grade classroom, my anxiety mounting. I counted down the minutes until the big hand on the clock above the chalkboard finally reached noon. As my classmates emptied out of the room, headed to the cafeteria for lunch, my palms got cold and clammy, and I felt a growing sense of panic. I had to use the bathroom, but the prospect of entering a …
An excerpt from The Healing Book.
When Allie’s canoe tapped the dock in Iquitos, Peru, she didn’t know which was greater: her exhaustion or her anticipation. After hours on the Amazon River, she was sticky with sweat, and her arms and legs itched and ached in the wake of countless mosquito bites. However, their arrival meant she was that much closer …
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Join Laya Jalilian-Khave, a physician and post-doctoral fellow in psychiatry. Laya shares her profound journey from medical school in Tehran to practicing medicine in diverse settings, including the border regions of Iran and Afghanistan. Discover how she …
I read all the time about the strategies and measures physicians and other health care professionals take to mitigate, reduce, or immunize themselves against burnout, moral distress, and empathic strain. We have been talking about this for decades, with an increase in “burnout” as a result. It seems time to shift the paradigm to allow for more productive discussions, acceptance, and strategies. Instead of talking about burnout, resilience, and self-care …
It’s been two years since the American Academy of Pediatrics declared a national state of emergency in children’s mental health. Yet sadly, very little has changed. This year, 25 percent of youth have been diagnosed with a mental health condition. More than 20 percent of teens have seriously considered suicide, and more than 40 percent of high school students reported that they’d felt so sad …
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Toward the end of my third year of medical school, I was 25, newly married, and overwhelmed by responsibility. I hadn’t enjoyed the clinical rotations. The hours and the degree of human suffering were just too much. My husband and I fought about how unavailable I was. I had to complete my 6-week psychiatry rotation 3 hours away from home. I wasn’t sleeping well, so I went to student health …
The past months have unearthed and amplified passionately opposing opinions about international events, in particular regarding Palestine and Israel. In addition to attending protests, calling my representatives, and having conversations with people I know, I’ve been publicly sharing my feelings about Palestine and Israel. While I stand firm in what I believe, my feelings around it are complex: I’m Jewish, and I’m anti-Zionist.
We encounter complex beliefs and feelings, many of …
I have never been a very touchy-feely person. I was trained as a biologist and chemist, then went to medical school where more science on top of science was aimed at me like a gushing firehose. I learned to put science and evidence first and to try in my practice of medicine to use only the therapeutic techniques that had some evidence base. That assured me that my patients would …
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Join Holly MacKenna, an integrative psychiatrist, as we explore the challenges and nuances of acknowledging goodbyes in the world of mental health treatment and professional relationships. Discover why patients often “ghost” their providers, the impact of business …
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Join Frances Mei Hardin, an otolaryngologist, as we delve into the world of distress tolerance in medical residency training. Discover practical techniques, real-life anecdotes, and evidence-based practices to help residents navigate the intense and challenging environment of …
After reading the article “Terminal anorexia nervosa: three cases and proposed clinical characteristics,” I was grateful to have not had access to the article a year earlier – when I would have personally met criteria. I was holding on to a sliver of hope at the time that I could enter back into a quality of life worth living, though my exhausted mind wanted to allow anorexia nervosa to …
When a 24-year-old laborer’s apprentice used a chainsaw without training, they sustained a jagged laceration through their left quadriceps. When I saw them 12 months later in my general practice, their laceration was well healed. However, they remained unemployed because their untreated post-traumatic stress disorder (PTSD) was aggravated on their return to work when their boss put a chainsaw in their hands to help …
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