Is it time to rethink how we determine the capacity of our patients who are addicted to drugs? I recently began debating this question after I took care of a young woman with endocarditis. She had a long history of IV drug abuse that had led to the d…
Recently the Wall Street Journal reported on how many young people are now seeking “accommodations” at work for their anxiety, PTSD, depression, and other mental conditions. The article provoked a lively discussion split largely on age line…
It all began on Valentine’s Day when I arrived at my office and listened to my messages from the afternoon before. There was only one from a nurse at the state mental hospital. She had just seen, she said, a Mr. Lonnie M. and was calling to alert…
My identity crisis attempted its first appearance five years ago. I had decided to leave my job as a psychiatrist in an outpatient, community-based practice. My professional role had become incongruent with the doctor I had envisioned becoming. In my m…
The first day I sought counseling, I felt like I was committing a crime. Our afternoon anatomy lecture had just ended, and the entirety of our first-year medical class—clad in hunter green scrubs and reciting the intrinsic muscles of the back—paraded i…
The front-desk clerk, Ruth, comes to me and says Rose Henderson wants a cab voucher signed — which guaranteed payment. Rose could not be made to understand, Ruth tells me, that we are not permitted to sign vouchers when the person, the client, comes to…
“Under duress, we do not rise to our expectations. We fall to our level of training.” – Bruce Lee (supposedly) When I was looking for My Patient, well before his neighbor grabbed my butt, I remember noticing that most of the slots in …
Tiramisu, chocolate mousse, red velvet cake, freshly baked cookies, and warm brownies topped with ice cream. These are some of my favorite desserts and the things I start thinking about when I am under intense stress. I often gaze at the bakery section…
It takes an average of 10 years between symptom onset for mental health conditions to be accurately diagnosed and therefore treated. In addition to general misunderstandings about mental health, the nationwide shortage of mental health providers is one…
Wiley Boynton is dead. I first heard the news when Katie, a colleague, called me on my cell phone. Wiley had been taken to the hospital with a knife wound. I asked her right away: “Self-inflicted?” “I think so,” she said. A self…
