About a year ago, before the pandemic hit, I was at the local fitness center, having just completed a group exercise class, when my former residency program director entered the room. I hadn’t seen him in 20 years. He looked exactly the same, give or take a few grey hairs. We smiled and heartily greeted each other. We’d known each other since I was a medical student. When I did …
What if the hierarchy in medicine was dismantled?
As doctors, we are taught the art of assessing our patients through the doctor-patient relationship. We learn a series of open-ended questions to gain insight into our patients’ values and thoughts regarding their personal health. We learn how to evaluate lab values and make diagnoses. Through all of this, we strive to make optimal decisions for our patients to avoid the legal ramifications of medical errors and because physicians thrive …
Managing stress with coping strategies for the perfectionist-driven physician
In addition to the medical risks of COVID-19, the pandemic’s occupational hazards are numerous for health care workers. The threat of walking into the clinic or hospital and being exposed to the increasingly contagious novel coronavirus is a now-familiar reality for the many physicians caring for patients. It is astounding to think about these surreal conditions as the pandemic approaches its one-year mark. As doctors, we have met this new …
Hazard to our health: Moral injury undermines care
This excerpt is adapted from Stress in Medicine: Lessons Learned Through My Years as a Surgeon, from Med School to Residency, and Beyond.
I will never forget the moment when I learned that a longtime physician friend had taken his own life. My friend was …
The culture of silence works against medical professionals’ wellness
I have been searching for something all of my life. Some would call it happiness; others call it success. No matter what I achieve, the goalposts seem to keep moving.
Perhaps this sounds familiar.
Maybe you realize that it is all an endless chase.
Maybe you are tired of:
Stop chasing the eternal search for happiness
This topic always takes me back. To the time my life stopped and flipped upside down. I never understood how people could drop to their knees in public and have a moment of agony or grief. I guess the pain I had felt up to that moment was not strong enough to knock me to my knees. But that day … it was enough.
The repeated missed phone calls. The wailing …
Talk to me. Talk to us. Talk about That Topic.
Recent events in our mid-west region prompted us to bring the topic of physician suicide forward with our residents and fellows. They received this information in a weekly mindfulness email they receive as part of our internal coaching program:
Losing a colleague or friend to suicide is a tragedy to those who survive and it can be devastating. With such tragedy can come feelings of sadness, grief and confusion. The feeling of loss that can …
Reflecting on the tragedy of physician suicide
As a diagnostic radiologist, I could not have imagined anything more amazing than having the privilege of using “x-ray vision” to peer inside my patients’ bodies in search of the etiologies behind their symptoms and illnesses. But over time, I felt incredibly stressed, anxious, imbalanced, and overwhelmed, and I developed many symptoms and illnesses of my own, including migraines, tinnitus, vertigo, body pain, reflux, and intermittent paresthesias. My hands would …
The Rx we were never taught to write
In the mid-1990s, a few pharmaceutical companies made broad claims regarding the safety and efficacy of opioid medications for pain management. These claims were based on limited research that did not fully account for these drugs’ potentially harmful effects. As a result, we are now facing an opioid epidemic across the United States.
Now, New Jersey joined several other states by legalizing marijuana for recreational use. While there are clear differences …
Marijuana legalization: an unpopular view
Me: “Hey buddy, how was your day?”
Salem: “Meow meow meow!”
Me: “Really? That sounds so cool! What else did you do today? I missed you so much!”
My favorite part of each day is coming home to my sweet boy, Salem. He is a 2-year-old cat that I adopted from the Capital Area Humane Society in Lansing, MI. He is the light of my life, even amidst all the darkness that exists. …
Emotional support animals for health care providers
COVID-19 has shed light on a pre-existing condition in medicine – our health care system has failed to tend to its workforce’s well-being. While generally privileged, physicians are an underserved population about their own mental health care.
Numerous articles and countless interviews have focused on the pandemic’s deleterious impact on physicians’ mental health and well-being. But this is not a new problem, nor is it caused by a lack of resilience. …
Physicians are an underserved population about their own mental health care
Some forms of trauma are obvious: natural disasters like earthquakes, floods, fires, being physically assaulted, wrongfully terminated, becoming suddenly very ill. Trauma is divided into so-called big T and little t experiences, but the distinction is misleading.
While physical assault (big T trauma) can lead to serious sequelae such as loss of a sense of safety, chronic hypervigilance, post-traumatic stress disorder (PTSD); a dissolved intimate relationship, being bullied, being emotionally or …
Trauma is ever-present in the practice of medicine
It was September 11, 2001. My dad had cheated on my mom again, the building that I worked in at that time had received an anonymous tip that we were a potential target for the terrorist attacks, and my mom, who needed a reprieve from my dad’s crap, was vacationing in Florida and was worried for me and my well-being. Plus, my dad was threatening to kill himself, and I …
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An excerpt from Becoming a Doctors’ Doctor: A Memoir.
After about six months of my residency in internal medicine, I began to feel something was missing, though at the time I couldn’t quite put my finger on it. Then, after a series of general medicine rotations, I …
Training in psychiatry would give me the opportunity to understand suicide far better
The mood hung in the air like a clenched jaw, a clenched fist, and slumped shoulders. I watched a fellow patient shuffle by the nurses’ station with his little paper cup. You know, the ones that are an inch or two tall and wide with a slight lip; the kind you see strictly in hospitals. I knew it was brimmed with multiple meds the colors of the rainbow. And, of …
A physician hung himself. That could have been me.
I write this now as both a time capsule and a vision of hope at the bitter end of 2020. At this point, a COVID-19 vaccine (the vision of hope) has been developed by several companies but has not yet received widespread distribution. Realistically, I know we are in for more quarantines, social distancing, and mask-wearing for at least another 9 to 12 months (sorry!).
My clinical work in psychiatry has …
COVID malaise, and more COVID-19 coping tips from the trenches
Therapy is a treatment intended to heal a disorder. That’s the medical perspective anyway, and it’s not wrong, but it’s maybe only part of the picture. Therapy frequently begins by addressing a primary complaint or problem in a collaborative relationship that grows over time. And during that time, while the client is assessing trustworthiness, the clinician continues to work towards an effective therapeutic alliance. How this exactly occurs depends a …
A physician’s perspective on what therapy is
It’s a Friday in January 1997. Another two-week block of nights behind me, 75 hours a week with a weekend off in between. However, working 5 p.m. to 8 a.m. means waking at 4 p.m. to dress, grab 15 hours-worth of food, drive 20 minutes to the parking deck, and run 10 minutes to the reading room by 5 p.m.
As a second-year resident, working alone covering all radiology services for …
Long-term sequelae of a life in medicine
Back in January of 2020, the average physician burnout rate was a staggering 42 percent. However, as COVID cases continue to surge, that statistic is now undoubtedly larger. Physicians are exhausted, both physically and mentally. They’ve watched colleagues suffer extensively or even die as a result of contracting COVID from infected patients. There is not enough staffing to support the needs of the increasing patient load. Resources like basic equipment …
Physician burnout during COVID: Bringing ancient practices to modern medicine
As if COVID-19 weren’t bad enough during the pandemic, another public health crisis – substance use disorder (SUD) – has gone from bad to worse, while access to behavioral health services is shrinking.
As of September, more than half (52%) of community behavioral health organizations have seen an increase in demand for services, and half of those that offer SUD services saw their demand jump in the previous three months. At …
The COVID-19 vaccine won’t solve major substance use disorder treatment gaps
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