One of the episodes of the Walking Dead was titled “JSS.” In this brutal episode, one learned by the end of the show that one of the characters, then others after her, had learned that all they could expect to do for the moment was JSS, or just survive somehow. I met a patient recently who embodied that mantra. Small, petite, with stringy hair and sun-browned skin, she did not look the ...

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Popular shows like Gray’s Anatomy, ER, and House, MD have given the television watching public a good eyeful when it comes to the inner workings of medicine, hospitals, and emergency rooms. They have also shown us how the personalities of those who take up the stethoscope and reflex hammer run the gamut from the sweet, demure, tentative types to the sons of bitches who cut first and ask questions later. I ...

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“How far did you go in school?” This is a question that I ask every new patient as a matter of course. Granted, I have gotten some very odd answers, including hearing from a very successful businessman who only finished the seventh grade, or a very psychotic person who has a double master’s degree. Not implausible, but certainly not expected or the mainstream answer from the majority of my patients. Now, leaving the ...

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I’ve been intrigued by the recent presidential debates and interviews and analyses and pundit commentary. One of the issues that has come up has been how the candidates handle adversity, even at this very early time in the 2016 race. They say that Donald Trump is in it for the thrill and the fun and sheer ego-boosting ride that is pre-caucus and pre-primary politics, when the love of the American people can ...

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shutterstock_82606081 A disclaimer before I even get started on this post. Some of you who know me or work with me will think that by writing this post I am talking about you or even attacking you. I am not. If you’re especially sensitive, don’t read any further. I am simply writing something that has been kicking around in my head for a long ...

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Dr. Kenneth Azar, a mentor of mine at the old Georgia Regional Psychiatric Hospital in Augusta, Georgia, told me something once that has always stuck with me. He told me that in the early years of his practice, when he was living and working out in Idaho, that he was one of a very small handful of psychiatrists who served the whole state. If an adult with psychosis needed to be ...

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Floor technician. Environmental technician. Life coach. Investment and retirement strategist. Facility safety coordinator. Interventional cardiologist. Cardiothoracic and vascular surgeon. Neurodevelopmental psychologist. Are we hiding behind out words? Worse yet, are we afraid to be who we really are? Maintenance man. Trash man. Knowledgeable and experienced friend. Salesman. Security guard. Doctor. Psychologist. I see it every day. Someone comes to me for a run-of-the-mill mental health problem, absolutely nothing to be ashamed of, and asks for help. For whatever reason, when we get to the social history ...

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She looked like a whipped puppy that had had a garden hose turned on it and slunk off to a far corner of the yard to dry out in the sun. She sat there, wizened but hard, thin and wiry, dressed in standard issue blue emergency room scrubs, thin tanned face, long stringy, wet prematurely gray hair falling limply around her shoulders. She looked down at the floor, but when her ...

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One good thing about doing anything for three decades or longer is that you get to see cycles and repeated events, things that fail and things that work. I hope that over the last thirty years of learning about psychiatry and mental health (and yes, I am still learning and hope to acquire that one last little piece of knowledge on my deathbed) that I have paid attention to the ...

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As a psychiatrist, I was trained to begin the mental status examination and overall assessment of my patient as soon as I greeted them in the waiting room. Even now, three decades after finishing medical school, I follow almost the same sequence of actions in my day-to-day interactions with my patients that I did as a resident in training. Granted, there are now electronic medical records and I rarely come ...

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