He was just a kid. Fifteen I think, something like that, too young to have experienced too much in life at that point, but old enough to die by his own hand. His father, only a year and change older than me, had already dealt with some issues of his own. Diabetes, a member of his family on both sides for generations, had already taken its toll on him by the time ...

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I am so glad that I’m only a partially conflicted, semi-neurotic, intermittently confused middle-aged psychiatrist. It would be so much harder to be a young guy, just coming out of residency, trying to decide what to do and how and where to do it. The stress! When I finished training, career paths were relatively easy to research, vet, and decide upon. You could go into private practice, in a group or ...

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Years. Years of learning that the smallest details of a patient’s life can be the most compelling and important part of their story. Years of listening to to tales of love, anger, and loss until the patterns become less daunting and more obvious. Years of hearing things that are so bizarre, so far-fetched, so on the fringe of humanity that nothing surprises anymore, but everything still fascinates unceasingly. Years of trying every new thing ...

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You know the headlines. You read them and hear them and see them every day. Someone gets angry at the system and shoots someone or several someones in cold blood, often having planned the act, gathered the necessary firepower and ammunition ahead of time, stalked the victims, checked the schedules and shown up at the right time to do maximum damage. A family including mother and young children in a van are ...

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"51-year old female presents today with ..." Funny, the vast majority of my clinical notes last week began with that phrase, give or take a year or two. Women in their fifties who saw me in the clinic, who I spoke to via television in my telepsychiatry practice, or who I interacted with in some other way. It struck me as odd that so many women of similar age came to ...

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"My grandson has HDHD." This was intriguing. I had just asked her one of my standard psychiatric interview questions about family history of mental illness. Maybe I hadn’t heard right, but it sounded like she was telling me about a new flat screen. Had her grandson just bought a fifty-two inch LED set in time to watch the Final Four this weekend? Had he mounted it on the wall on ...

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fatigue |fəˈtēg| noun 1 extreme tiredness, typically resulting from mental or physical exertion or illness : he was nearly dead with fatigue. • a reduction in the efficiency of a muscle or organ after prolonged activity. No, this post is not a part of my twenty six installment Psychiatry A to Z series. You'll have to wait for the next one in that group, which by the way will be looking at a "T" word. ...

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Your mother has been up all night. She has Alzheimer's Disease and now it has progressed to that inevitable stage of the dementing process where she is paranoid, agitated, and confused. She fidgets and paces and walks all day. She gets out of bed multiple times each night. She has gone out the door into the back yard and tried to escape to the street, wearing only her night clothes. Sometimes ...

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It is hard to believe that those we love will die. We can't bear it. It's too harsh, too complicated, too fraught with emotional baggage and unfinished business and things never said. It's too final. Dead is dead, after all. From the moment of our birth, we are dying. Death can be painful, tragic, too soon, too quick, too slow, too easy, or too hard. So we soften it up a bit. She ...

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