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…
Category: Psychiatry
Core values were key to reclaiming my physician identity
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…
Start with the students: Addressing the future of physician suicide
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…
My patient isn’t doing well. Is it my fault?
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…
When a patient in jail lacks impulse control
“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 …
Stressed is desserts spelled backward
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…
Improve mental health by improving how we finance health care
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…
Could this patient have been saved?
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…
The most powerful way to provide substance abuse treatment is in a group setting
We knew that the most powerful way to provide substance abuse treatment is in a group setting. Group members can offer support to each other and call out each other’s self-deceptions and public excuses, oftentimes more effectively than the clinicians. …
Making America great again with harm reduction
I recently discovered a fact about the United States of America that should be a source of embarrassment for all Americans. What I found out is this: There is not a single safe injection site anywhere in the entire country. Safe injection sites save th…
