Category: Psychiatry

Preceding traumas lead to current ones

Anita is 37 with blonde, wild, disheveled hair. She is overweight, has bad teeth, wears too much make-up, and is severely depressed — sometimes psychotic. She tells me she often hears voices. And she constantly complains that the medicine she gets from…

Finding meaning in the intersection between marriage and medicine

When I first saw Jea-Hyoun, in a medical meet-cute straight out of a romantic comedy, she was being evaluated for thyroid cancer. I was an allergy/immunology fellow harried by a pile of paperwork. She was a patient, in the same building where she saw p…

Can a unique boarding home save my patient?

James is a tall, lanky Caucasian man, well into his 40s. He has brown curly hair and is not a bad looking fellow except for the vacant look in his large brown eyes. He is a pacer, which is a manifestation of his illness, and a consumer of excessive amo…

What Karl Marx can teach doctors about burnout

Professional burnout is widely identified using the Maslach Burnout Inventory, which defines it along psychological lines: emotional exhaustion, a feeling of depersonalization and cynicism, and a low sense of personal accomplishment. Accordingly, the p…

How physicians can deal with stress

Stress is one of the epidemics of modern-day living—especially work-related stress. At a basic fundamental level, it’s just simply a chemical reaction. Your adrenaline and cortisol levels shoot up in response to a stressful stimulus, the primitive “fig…

When primary care handles the consequences of psychiatric medication prescribing

If my hypertensive patient develops orthostatism and falls and breaks her hip, I fully expect the orthopedic surgeon on call to treat her. I may kick myself that this happened, but I’m not qualified to treat a broken hip. If my anticoagulated patient h…

The suicidal patient who couldn’t be placed

Mr. Fine is in for the eleventh time in less than a week. I work as a social worker in a hospital emergency psych unit. Mr. Fine is suicidal again. It is kind of late in the evening when I see him, although it is my first time, I am the only social wor…

How to lead a sustainable life: A physician’s victory over burnout

Eighteen months out of residency and into outpatient psychiatry private practice, for the first time since before medical school, I’m coming home actually feeling a surplus of energy to put into my life outside of clinical practice. Sure, I did m…

A physician’s story of addiction, depression, hope, and recovery

An excerpt from Long Walk Out of the Woods: A Physician’s Story of Addiction, Depression, Hope, and Recovery. As a young child’s heart rhythm faded to a stop, I walked off the hospital floor and got in my car with a plan to end my own life. For w…

A physician’s story of addiction, depression, hope, and recovery

An excerpt from Long Walk Out of the Woods: A Physician’s Story of Addiction, Depression, Hope, and Recovery. As a young child’s heart rhythm faded to a stop, I walked off the hospital floor and got in my car with a plan to end my own life. For w…