I didn’t know that he and I were on the same train. At the Othello stop, I got out of the last car and walked towards the front of the train. The morning chill seeped through my coat and I slid my hands into my pockets.
“Dr. Yang!”
The doors of the train were still open, and there he was: A baggy black hoodie was pulled up over his head, but it …
The surprising people who inspire
I don’t know how many times a patient has told me, “I was in therapy once, and it didn’t help.”
My response is always: “That’s like saying ‘I saw a movie once and I didn’t like it’.”
That usually breaks the ice just a little.
In primary care, we certainly run into a few patients with chronic mental health problems that could use some long-term, in-depth counseling. But usually, patients in my practice …
We need more behavioral health treatment in primary care
A few months ago, I was having lunch with a friend. He mentioned a recent outpatient surgery that he had and indicated that upon being discharged, he was given a prescription for 30 pain pills. Although the recovery was uncomfortable, the pain was not overwhelming. But, as a precaution, it was assumed that he needed this powerful pain relief to be available even after he told the provider that he …
Our role as parents in the opioid epidemic
The nights from that time run together in my memory: The cuffs of my scrub pants getting caught on the heels of my clogs because my pants were sagging; stuffing dry graham crackers I stole from the nursing stations into my mouth at 4 a.m. to stay awake while writing notes; what seemed like my pager buzzing against my hip every five minutes; feeling the enormous specter of unending work …
A story about the Patient and the Big Man
An excerpt from How to Be Sick: A Buddhist-Inspired Guide for the Chronically Ill and Their Caregivers (Second Edition). Copyright 2018 by Toni Bernhard. Excerpted with permission from Wisdom Publications.
In the years since I’ve been chronically ill, more essential to me than formal meditation has been mindfulness outside of …
The present moment as a refuge
I don’t miss making the phone calls in the middle of the night.
“Hi, this is Dr. Yang calling from the psychiatric emergency service. May I speak to Mr. or Mrs. Doe?”
“Yeah, this is Mr. Doe,” he’d reply, his voice thick and slow with sleep.
“I’m sorry to call so late. Your son is here at the hospital.” Take a breath and slow down for the next part. “He’s alive and doing OK at …
The phone calls physicians make in the middle of the night
Depression is commonly linked to career disappointments, financial setbacks, and disruption of normal routines — especially sleep pattern — as well as social pressures and conflict in personal relationships. It is this last factor that has captured my attention in relation to depression. Personal relationships, in particular, the most personal, love partnerships, have a profound impact on our mood. In fact, researchers report that unhappy marital relationships are associated with …
Personal intimacy as an overlooked antidepressant
Medicine has created a culture where public embarrassment, bullying, and passive-aggression have become pedagogy. How can we seek to care for others, when we treat our own so cruelly?
I recently met Angie (name changed), a young university student who had entered the clinical years of medical school. Like many, she was introduced to medicine as a naive, excited teen immediately out of high school — a high achiever with the …
Why do doctors treat their own so cruelly?
In the era of #MeToo, Missy Elliot, Whitney Houston, Tyler Perry, Oprah, Ashley Judd, Gabrielle Union, Teri Hatcher and, now, Padma Lakshmi — keeping kids safe and helping adults heal is our job as physicians. I am a pediatrician — and I am an incest survivor. My perpetrator was also a physician. I bore a dirty secret before I knew what a secret was. The person who hurt me was …
Don’t ignore incest: advice from an incest survivor
My medical center recently cemented an agreement with the Veterans Administration to offer care to veterans who could not be accommodated at the VA. We need paying patients, they need doctors of our caliber — establishing mutual benefit. Military veterans have always been among our patients. During my professional lifetime that has included men of my father’s generation whose young adult years encompassed World War II’s widespread draft. World War …
We have to deal with the trauma in veterans early on
I am both relieved and nervous because they say that the first year is the worst, but now I have the overarching cloud of doom following me around during second year: Step 1.
Now that I’m home, I constantly am wondering how I made it this far — in disbelief that I passed all my courses pretty well. I constantly ask myself if exams were too easy and if I’m just …
Reflections after finishing the first year of medical school
With the recent 10-year anniversary of the Mental Health Parity Act being signed into law, comes the reminder that we still have so much work to be done. Unfortunately, blatant discrimination in health insurance coverage for mental health and substance abuse has continued despite this legislation. The Parity Act required that dollar limits on mental health benefits be no lower than the dollar limits for medical and surgical benefits offered …
Is there parity in mental health or are we still dealing with a paucity?
The absence of burnout does not equal wellness. While the focus on physician burnout as an epidemic is finally gaining more attention, we may be missing a larger issue. Most physicians are not burned out. We are able to function. We get through our days, make it to some of our kids’ activities and even manage to go out to dinner on the weekends. We survive the work week as …
Physician well-being: lessons from positive psychology
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“Wisdom is nothing more than healed pain.”
–Robert Gary Lee
One of the recurring expressions I heard throughout training, from preceptors and attendings to doctors ignoring a lowly medical student/resident eating lunch in the doctor’s lounge, was: “I’m living the dream.” It didn’t take long for me to realize that it was a code meaning anything but. In the last few weeks, I’ve discussed what steps I’m taking towards personal healing and …
Let’s heal the health care community
The children of survivors are important to the Holocaust story. The children are the future of the past. For a time, it seemed that no one would be left to create a future. That history has been so carefully, lovingly chronicled. It must be preserved. If it is preserved and told, the possibility exists that there will be no more war. That is always the hope of the survivors.
This is …
Children of war: inherited bereavement
Last Friday, as I sat finishing up notes on the last of my almost 30 physicals (this number is never any surprise for us pediatricians this time of the year, it’s back to school week, so every Thomason, Dickinson, and Harrison is lining up for sports physicals and regular physicals and all sorts of clearance and medication forms that need to be filled out and turned in “yesterday.”) I took …
A pediatrician finds her “why”
I’ve had a lot of ups and downs throughout my schooling and career — not just related to my profession but personally as well. In the past, it has crossed my mind that I should probably seek professional help, but then some way or another, I would get past my issues and life would normalize. Then I would move on and forget about it.
However, after last summer, things were different. …
Why this physician sees a therapist
There exists a large, mostly-underground, growing community consisting of those iatrogenically harmed by benzodiazepines. Guilty only of following doctors orders, these patients are marginalized and misunderstood. This has been enabled, at least in part, by poor terminology.
Recently on Twitter, Michael P. Hengartner and Marnie Wedlake both posted critical questions in response to a benzodiazepine news story:
In response to …
Words can hurt those on benzodiazepines
I just heard.
A colleague, a man of integrity and warmth, a hard-working physician with ideals, ethics and many valued contributions, has taken his own life. His perspectives may have differed from mine at times, but every interaction was infused with respect. He was a good man.
Much has been written about the rate of suicide of physicians. One million Americans lose their doctors to suicide each year. Normally …
Reach out to your colleagues: This can have more impact than you can imagine
Burnout affects as many as 50 percent of physicians. Interventions have been proposed at virtually every stage of a physician’s life, from medical school to residency training to professional practice. While the rigors of medical training certainly contribute to the high levels of burnout in the profession, there are indications that the trouble begins at the undergraduate level.
I recently graduated from an undergraduate program geared toward students interested in medicine. …
Burnout doesn’t start in medical school
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