Category: Psychiatry

The new mental health education mandate doesn’t go far enough

Just recently, New York and Virginia became the first two states to mandate that mental health become incorporated into school curriculums. New York passed a law for educators to teach material on mental health beginning from elementary school continuing on to high school. Virginia’s legislation intertwines mental health education with physical and health education for […]

What is it like to lose a patient to suicide?

We bear the pain in different ways. For me, it feels like you’re a combat medic and you’ve used up all your tourniquets on a wounded soldier that seems to hemorrhaging from everywhere. The blood seeps through the skin, and no matter what you do you cannot stop the soldier from choking to death on […]

Physicians don’t just suffer burnout. They suffer moral injuries.

Physicians on the front lines of health care today are sometimes described as going to battle. It’s an apt metaphor. Physicians, like combat soldiers, often face a profound and unrecognized threat to their well-being: moral injury. Moral injury is frequently mischaracterized. In combat veterans it is diagnosed as post-traumatic stress; among physicians it’s portrayed as […]

The other side of Suboxone

A lot has been written about Suboxone, the buprenorphine treatment drug. For many, Suboxone acts as an effective medication to treat opioid addiction. For others, it’s a highly-valued street drug that is commonly diverted and misused. To understand and acknowledge the darker side of Suboxone we have to look back at its history over the […]

The culture of perfection in medicine is a disease

I was always worried about doing well on board exams. I didn’t want to simply pass them; I wanted to excel. Before I took exams, rumor had it that a person would have to intentionally fail Step 1, 2, or 3 and that failing Step 2 CS was virtually impossible. The truth, I learned, is […]

When family separations become a threat to existance

The face of a 2-year-old Honduran girl, dwarfed by the adults who only appear as legs in the photo, communicates undeniable anguish. Used to represent the horror of children separated from their parents at the U.S.-Mexico border, the photo became a lightning rod for controversy when it turned out that this particular child was not […]

A physician’s gratitude

“Expressers significantly underestimated how surprised recipients would be about why expressers were grateful, overestimated how awkward recipients would feel, and underestimated how positive recipients would feel.” – Undervaluing Gratitude: Expressers Misunderstand the Consequences of Showing Appreciation The past 30 days have been unusual because of the number of professional gestures of gratitude I’ve received: I received […]

The surprising secret to mental wellness

When did it become a bragging right to say that you only get four or five hours of sleep a night? We would think it is ridiculous for someone to brag that their labs came back with only half the normal hemoglobin level as we would recognize that as clearly unhealthy. So when did we […]

Not all depression is alike. Here are the differences.

Adapted from Understanding Antidepressants. In his often-quoted beginning of Anna Karenina, Tolstoy wrote, “All happy families are alike; each unhappy family is unhappy in its own way.”  If we stretch this notion a little — going from families to individuals, and from unhappiness to depression — we come up with an interesting question, which is […]

A physician’s attempt to seek psychiatric help

Physicians all around us are dying from suicide. For me, some deceased colleagues I knew more closely, others were faces that you would pass on the wards. Even two physicians that I knew peripherally died just this past week. The issue of physician suicide is in the news now, and facts are available. At least […]