An excerpt from The Flame Broiled Doctor: From Boyhood to Burnout in Medicine.
“So what did my bloodwork show, Doctor?” asked Liz. Liz was friendly and polite, but a textbook example of the Worried Well … healthy but neurotic patients I didn’t need to see as often as …
On TV shows, therapists decorate their rooms with leather lounge chairs, throw pillows and organza curtains that let in the light.
But Dr. Hassan’s office is in the clinic basement. The fluorescent lighting is sterile. She has a gray metal desk — I think every doctor I’ve shadowed as a medical student has had that same desk.
But I’m not here as a student.
I’ve been anticipating this appointment for a month. In …
It seems that everyone has advice about sleep these days, and we have become immune to it. “Avoid naps, caffeine and alcohol close to bedtime. Get exercise. Get out of bed if you can’t sleep. Turn off the TV and any electronic devices hours before bedtime. Enjoy a relaxing ritual. Keep to a routine.”
Please do all of these, because they actually work! Shifting your bedtime later to achieve sleep consolidation …
Eighty percent of diagnoses can be made based on the history and physical. Take the subjective and objective; throw in some medical history, family history, social history and you can figure out your assessment and plan. Doctors are the detectives of the body and the more facts, the easier it is to solve the mystery.
This is the fictional note that I wrote in my head concerning a fellow physician friend …
My intern gazed blankly at her notes from the day.
“You OK?” I asked.
Her face was quivering with restrained tears as she turned to me, “I don’t think I helped anyone today.” This was not the first time, nor would it be the last time, that I had heard those words from a resident physician.
Medical training is no joy ride. How could it be? First, there is the intellectual challenge of …
“You’re a doctor; focus on being a doctor.”
This piece of advice was recently given to me by my own father, in regards to my multiple ambitions outside of the medical field. He himself only recently retired from a long career as a surgeon, so his opinion is the result of years of experience.
His advice got me thinking.
What makes for career longevity in our field? Statistics show that more than half …
It wasn’t until I was six months into my second depressive episode that I discovered depression existed. I didn’t know it was a real disease. I didn’t know that my grandmother got electroconvulsive “shock” therapy in the 1950s. I only knew something was terribly wrong when I sat crying for 20 minutes in front of a pile of laundry one morning because the thought of choosing clothes and going through …
I had an interesting conversation with a patient in the office some time ago.
He was sent to me to evaluate abnormal liver blood tests, a common issue for gastroenterologists to unravel. I did not think that these laboratory abnormalities portended an unfavorable medical outcome. Beyond the medical issue, he confided to me a harrowing personal tribulation. Often, I find that a person’s personal story is more interesting and significant than …
No matter how well the one you love ornaments your life, they should never be an ornament. Meaning — you should never have to find them hanging in the closet like it’s some tree where each broken branch represents sadness, sickness and issues that only make sense in hindsight.
That metaphorical tree was as astonishing as Christmas morning yet as terrible as a Halloween horror. And although surreal — like Dali …
A few weeks after I started residency, two of my peers killed themselves in New York City. No one I knew was surprised.
Intern year is hell, and everybody knows it from TV shows like “Scrubs” and books like “House of God.” Old doctors tell tall tales of working a million hours without sleep before training standards got “soft,” limiting residents’ monthly work hours to 320 and requiring four days off. …
Those of us who work in pediatric intensive care have frequent encounters with the problem of suicide and attempted suicide. It has seemed to me for some years that the numbers are increasing, and this has been shown to be the case. After years of declining, the suicide rate in our country has been increasing, now at about 125 percent of the rate of several decades …
I’ve known since I was very young that I just experienced life differently than did my extroverted family members and friends. During parties, they seemed to truly enjoy the loudness and chaos of get togethers and the seemingly endless small talk, while I would secretly yearn to return home so that I could read my latest novel in peace. An older family member once told me that I would eventually …
Many patients are referred to me as a psychiatrist to treat their depression. The new patients that come to me for depressive symptoms usually expect that I will be recommending and prescribing an antidepressant for their depressive symptoms because that is what a psychiatrist does, right? Not always.
Often times these patients come to me having gone through several antidepressant trials without any successful resolution of their depressive symptoms. Well, sometimes …
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If you Google “misophonia” you might be shocked to find numerous articles discussing the tragic suicide of 52-year-old Russian-born scholar, Dr. Michelle Lamarche Marrese. Journalist Joyce Cohen was the first to report Marrese’s suicide in the New York Post piece “She could hear everything and it cost her her life.” Cohen explains that she and Marrese had been corresponding about Marrese’s struggles with misophonia for over 14 months, and that …
In the year it has taken for me to finish my medical residency as a junior doctor, two of my colleagues have killed themselves. I’ve read articles that refer to suicide amongst doctors as the profession’s “grubby little secret,” but I’d rather call it exactly how it is: the profession’s shameful and disgusting open secret.
Medical training has long had its culture rooted in ideals of suffering. Not so much for …
An article released in the JAMA sites evidence that the suicide rate in America has risen by 24 percent in the last 15 years associated with a significant reduction in the numbers of psychiatric beds available. The U.S. has had a lower capacity for psychiatric patients than comparable countries in Europe for years, but between 1998 and 2013 that number dropped even further.
Waiting in the ER for days
This …
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Most third medical students look forward to their psychiatry block. After twelve plus hour days and six day weeks on internal medicine, OB/GYN and surgery, the reasonable hours on psychiatry seems like a dream. While my classmates viewed psychiatry as a break, I dreaded it. This was not my first time on an inpatient psychiatry ward.
My world and fate forever changed when I was twelve years old. Sometimes depression is …
I was incredibly nervous going into my first day in the inpatient child/adolescent psychiatry unit. “Was this where the truly psychotic kids are? Am I going to be safe here?” I wondered as I casually introduced myself to the staff on the floor. After a morning of sitting in on group therapy led by psychologists and occupational therapists, I calmed down. Against the backdrop of the soothing soft pastel colors, …
Cheryl lost her son Sean to suicide in medical school. Just a few months ago. Her only child. Cheryl didn’t know that medical students were at high risk of suicide — until her son was dead. Nobody warned her.
Rhonda lost her daughter Kaitlyn to suicide in medical school. Unable to recuperate from the pain of her daughter’s suicide, Rhonda died by suicide …
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There are a lot of misconceptions about psychiatrists and the way we practice, mainly because our sphere of medicine is so vastly different from that of any other medical specialty (and yes, I have an MD!) Here are a few thoughts I hope will help you understand us and our field a little better.
1. Yes, we all have clocks in our offices. We watch the time to pace ourselves, not …
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