My husband was in the aisle seat, I was in the middle seat, and The Man was in the window seat. The Man had one white earbud in his ear; the other one was dangling in his lap. His right thumb swiped through several screens of his smartphone in less than a second. He heaved a sigh. “This is f*cking lame,” he muttered. The plane was supposed to take off 15 minutes ago. ...

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When he and I first met, he told me that he had a doctoral degree in psychology, was the CEO of the jail, and could speak 13 languages. To demonstrate, he said, “Hong tong ching chong lai tai!” He then punched the door to his cell and shouted, “GET THE F-CK OUT OF HERE, B-TCH!” I did. The next week, he answered my questions about the pencil drawings on his walls. “My name ...

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Atul Gawande posted a series of tweets, based on findings in the Senate CIA torture report, about the significant role physicians and psychologists played in torture. He comments, “But the worst for me is to see the details of how doctors, psychologists, and others sworn to aid human beings made the torture possible.” Agreed. Upon reading how these professionals used their knowledge to torture their fellow human beings I felt disappointed, ...

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Please don’t call call me a “prescriber.” Yes, I know it’s easier to say “prescriber” than “psychiatric nurse practitioner or psychiatrist.” The word “prescriber,” however, puts severe limits on what I can do and how I can help. You may believe that, because I have a license to prescribe medications, that’s all I choose to do. In fact, you may believe that’s all I know how to do. Psychiatrists can do a lot more than that. As ...

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Four adages I learned in medical training that I still speak of today: “Common things are common.” (The alternate version of this that might have more appeal to zoologists: “When you hear hoofbeats, think horses, not zebras.”) This cautions physicians to remember that it is more likely that the patient has a common condition than a rare one. Although it is prudent to consider all the possible diagnoses that might match a given ...

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Dear Jane: Thank you for asking me about my perspectives on medical school. Here are some general principles that you might find useful in your own training: 1. View everyone as your teacher. Everyone you encounter will teach you something. Be open to what they have to offer. Yes, your professors and attendings, the “official” teachers, will educate you. Patients, however, will often be your best teachers. Listen to what they say, watch how ...

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This article is making the rounds among physicians on Twitter. Much of the information in the article, unfortunately, is accurate. For some of the reasons stated there, I left the “traditional” health care system and pursued work at the “fringe.” Part of this is due to my clinical interests: I like working at the intersections of different fields. For example, I like the intersection of psychiatry and hospital medicine, which is called 
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When I was a resident one of my attendings said, “You know why patients are called ‘patients’? It’s because they have a lot of patience. For us.” Patients in hospitals do a lot of waiting. They wait for physicians. They wait for nurses. They wait to use the bathroom. They wait to undergo procedures. They wait for their IVs to stop beeping. They wait for the person next door to stop ...

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Everyone noticed him before we boarded the plane. He asked the airline representative at least three times to confirm that he had a seat. He looked like an adult, but the tone of his voice was that of a child. “Yes, you have a seat, Michael. It’s 7B.” Grey cargo pants covered his short legs. The sleeves of his striped polo shirt collected below his elbows, making his arms look even shorter ...

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As I noted earlier, hospitals permit around-the-clock observation of patients. If you don’t need around-the-clock monitoring, you don’t need to be in the hospital. Who is doing this around-the-clock monitoring? Nurses. Therefore, whether you are a patient or a physician, one of the best things you can do is get on the good side of the nurses. If you are a patient, a nurse watches over you and your care. ...

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