He was a small but very intelligent and articulate young man. I had seen him before, but it had been quite a while. He came to me complaining (as did his family) that he was having some trouble controlling his anger, dealing with quarrelsome students at school, and not always getting his assignments inside or outside of school completed in a timely manner. We discussed the usual ways to approach this, I ...

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For much of her adult life, Cassie (not real name) struggled to get out of bed. Taking her kids to school, let alone showering or preparing meals was often more than she could handle. Cassie has bipolar disorder, and while she had health insurance through her employer, it did not offer mental or behavioral health benefits.  The therapy and prescriptions she needed were too expensive. She was desperate, barely holding ...

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If you Google “misophonia” you might be shocked to find numerous articles discussing the tragic suicide of 52-year-old Russian-born scholar, Dr. Michelle Lamarche Marrese. Journalist Joyce Cohen was the first to report Marrese’s suicide in the New York Post piece “She could hear everything and it cost her her life.” Cohen explains that she and Marrese had been corresponding about Marrese’s struggles with misophonia for over 14 months, and that ...

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In the year it has taken for me to finish my medical residency as a junior doctor, two of my colleagues have killed themselves. I've read articles that refer to suicide amongst doctors as the profession's "grubby little secret," but I'd rather call it exactly how it is: the profession's shameful and disgusting open secret. Medical training has long had its culture rooted in ideals of suffering. Not so much for ...

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Over the past couple of months, I have had the privilege of meeting with several colleagues in my community. When I contacted them, I offered to bring them lunch if they would give me a few minutes to share an idea about a project that I am really excited about. However, what I really wanted was a chance to engage with physicians who I knew little more than their name ...

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An article released in the JAMA sites evidence that the suicide rate in America has risen by 24 percent in the last 15 years associated with a significant reduction in the numbers of psychiatric beds available. The U.S. has had a lower capacity for psychiatric patients than comparable countries in Europe for years, but between 1998 and 2013 that number dropped even further. Waiting in the ER for days This ...

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As an intern, I once cared for an elderly gentleman who came in with heart failure. In no time, we grew fond of each other. It was almost like he looked forward to my visits. He sometimes called me “sunshine.” I am not sure if he meant it in a way that meant that I woke him up every morning.  He was almost ready to go back home when he ...

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Most third medical students look forward to their psychiatry block. After twelve plus hour days and six day weeks on internal medicine, OB/GYN and surgery, the reasonable hours on psychiatry seems like a dream. While my classmates viewed psychiatry as a break, I dreaded it. This was not my first time on an inpatient psychiatry ward. My world and fate forever changed when I was twelve years old. Sometimes depression is ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 26-year-old man is evaluated for a 3-month history of depressed mood, poor concentration, decreased energy, increased sleep, and weight gain. He reports missing many days at work and that his work performance has lagged. He has no suicidal ideation. He states that his current symptoms differ markedly from his usual state ...

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Chapter 1: Physiology “I am a brain, Watson. The rest of me is a mere appendix.” - Sir Arthur Conan Doyle Bound by flesh and bone, therein lies a mystery of undefined potential which the cosmos cannot even parallel in mystery and in complexity beautiful and terrifying. It is that which allows movement to leave the study hall beneath the starry sky, professors to lull us to sonorous sweet slumber, to remember minute ...

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