Physicians writing on KevinMD about burnout, moral injury, depression, and suicide in medicine: what causes burnout and whether the word fits, resilience training and why physicians distrust it, who leaves and why, the fear of seeking help and the licensing questions behind it, what physicians say actually helps, and, on the patient side, psychiatry, access to care, and the arguments over diagnosis and treatment. Three maintained records draw on this archive: Physician burnout: what physicians say, in their own words, Physician suicide: what physicians say, in their own words, and Mental health: what psychiatrists and physicians say, in their own words.
“Oh, I didn’t know you’re a writer,” my neighbor said as I handed her a complimentary copy of my recently published book.
“Not really,” I replied. “I’m just a physician who likes to write.”
The conversation ended, but later, I began to think: What’s the difference between a physician writer and a writer who is a physician? What should I say to somebody else who makes a comment like my neighbor? I …
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Let’s close the gap between physician writers and writers who are physicians
“Fine lines” in medicine often refer to situations where decisions are not clear-cut and require careful judgment. Perhaps the most tenuous of lines is the one between “real” childhood illnesses and those caused by Munchausen syndrome by proxy.
Munchausen syndrome by proxy (MSBP), also known as factitious disorder imposed on another (FDIA), refers to a specific form of child abuse in which a caregiver, typically a parent or guardian, fabricates, exaggerates, …
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The fine line between childhood illnesses and Munchausen syndrome by proxy
Have you ever wondered why some people always seem to be in pain? Or why someone can receive a prescription for a minor procedure and immediately feel drawn to drug use?
Scientists may have recently figured out one of the reasons for these behaviors, and they may start early in life. The developing neuron is remarkably similar to a tree. The branches are the dendrites that receive electrochemical signals from the …
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Adolescent exposure to alcohol may predispose to addiction
Meditation is a hot topic with deep roots, but sometimes it feels like it’s being pushed as a modern-day version of snake oil for what ails the spirit. Often touted as an antidote to burnout, many of us know that a meditation app won’t solve the systemic issues plaguing health care today, leading some physicians to be skeptical.
I was introduced to mindfulness meditation years ago while practicing yoga. Initially, making …
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Meditation: the ancient practice with science-backed benefits
In recent years, there has been an exponential growth in global awareness surrounding the subject of mental health. As it becomes increasingly evident that mental well-being is just as crucial as physical health, community interventions such as Mental Health First Aid (MHFA) have gained prominence. Originally conceived in Australia in 2000, MHFA has since been adopted in various countries and tailored to meet the specific mental health needs of different …
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The significance of Mental Health First Aid in communities: a comprehensive exploration
I met Dr. David Zylneck through a mutual friend when he was in the final year of his pediatrics residency. Even as a trainee, he was heavily involved in international relief work and had made several trips to Southern Africa. Over time, Dr. Zylneck and I lost contact as our careers took us in different directions. Several years later, as I was about to move to a new location to …
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Confirmation bias can lead to wrong conclusions
October is recognized as Domestic Violence Awareness Month in the United States. According to the National Coalition Against Domestic Violence, nearly 20 people in the United States are physically abused by an intimate partner per minute.
It is important to remember the vital role that health care practitioners can play in raising awareness about this issue and contributing to efforts to prevent it and care for patients impacted by intimate partner …
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Understanding and addressing intimate partner violence in health care
In a recent essay, I marveled at the qualities that will set apart tomorrow’s physicians from previous generations. And while everything I wrote I believed to be true, I suppose I neglected a major concern, a big blind spot as it were. In order to become clinicians, medical students must first enter practice. That seems obvious, but a recent report gives reason to pause and reflect on medical students’ …
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The physician of the future may not be a clinician
In 2009, the famed NPR radio series This American Life aired an episode that would forever change how we looked at college life. “#1 Party School” featured Penn State University and shed light on the rampant alcohol abuse in higher education. Over a decade later, this issue remains a persistent challenge on college campuses. This article delves into the legacy of the “#1 Party School” episode …
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Legacy of a #1 party school: college alcohol abuse today
According to a report from the U.S. Department of Justice, 37 percent of the people in prison have a history of mental health problems. This was not always the case. The United States at one time had state mental health facilities, where those with mental illness could be treated. From 1870 to 1955, these numbers increased until it peaked at almost 600,000. This was 0.36 percent of the then population …
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From mental health facilities to prisons: a concerning shift
In my search for ever-obscure rock music from my generation – not the greatest generation but the flower generation – I came across a CD collection of rare songs titled “Brown Acid: The Seventeenth Trip,” appropriately subtitled: “Heavy Rock from the Underground Comedown.” The record review began as follows: “Lucky number 17? You better believe it. We here at Brown Acid have been scouring the highways and byways of America …
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The real story behind Woodstock is not the brown acid
We have a problem with current recommendations for depression treatment. Thirty-five percent of patients will not go into remission or get any relief at all from SSRIs and SNRIs. And even when it does work, it takes about six weeks to start having an effect.
The prevailing theory was that serotonin, abbreviated 5-HT, was the “satisfaction” neurotransmitter. Just as dopamine has been considered the pleasure neurotransmitter. Using selective serotonin reuptake inhibitors …
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Can ketamine and SSRIs offer a complete depression treatment?
How did I get here? Heading to the highest place I can find, in contemplation of jumping and falling to my death. I had always feared death before this point, but now it seemed the only logical solution. I seemed to have it all going my way. So why would a medical resident in a coveted training program in one of the most beautiful parts of the country, with a …
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Overcoming depression: a medical resident’s journey
