If you're not a mental health professional, your exposure to psychosis may come through a variety of channels. You may know someone with a psychotic disorder; you may have a psychotic disorder yourself. You may have taken an introductory class on psychology in high school or college, and you may be aware of psychotic episodes as events in which people lose touch with some element of reality — they may ...

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Quality of life matters. This straightforward assertion gets complicated when we discuss the treatment of depression. Depression is common, part of a family doctor's daily schedule; it can affect anyone, although certain groups are at higher risk. There have been many hypotheses as to why we as a species are susceptible to depression (and its frequent companion, anxiety), but in the day to day practice of medicine, those proposed etiologies end ...

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Medical practice is a calling. It's not a job, it's not a career -- it's a vocation. And if you really love your vocation, you'll let nothing stand in your way. Certainly not something as trivial and crass as money. After all, once you're in practice, you'll be raking it in, right? So why worry about that now, when you're just beginning your medical education? That attitude is pervasive, and it's ...

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Physicians face a host of challenges in practice, but the one that looms largest is often this — they don't know everything. It would be tempting to think that they do. As patients, we want them to. We want our doctors to tell us that they know what's wrong and how to fix it. Medical mysteries are fun on television, but in our real lives, they're profoundly unsettling and can have ...

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A patient with chronic pain and a physician walk into an exam room. This could be the set-up for a punchline, but in our current medical climate, it's more often the first step in an elaborate dance that leaves both parties feeling frustrated, belittled, and ignored. Often, this is a first-time appointment rather than an established therapeutic relationship. From the patient's perspective, here's what happens: They've been putting off this visit for ...

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The specter of the psych ward looms large in popular culture: video games, horror movies, novels — the concept of a locked inpatient psychiatric ward is shorthand for a variety of terrors. This perception is driven by a complex cocktail of factors. Psych ward patients have struggled with historical and current abuses, which are compounded by misunderstanding and ignorance around mental illness. During third year, I spent a six-week rotation in ...

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The familiarity that health care professionals develop with complex medical procedures and topics is the result of years upon years of hard work, and over time we become accustomed to the jargon. We use phrases like "lap chole" and "appy" without much thought when talking to each other and (if we have a momentary lapse) with patients. We take the fantastic array of medical specialties, procedures, and knowledge in our ...

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Medical residents take on a variety of responsibilities. Some are clear, upfront, and obvious: the responsibilities they have been training for since entering medical school. Coming up with a treatment plan and carrying it out is first and foremost their raison d'etre, and they put an enormous amount of effort into it. However, they also acquire a host of other duties. They run interference for attendings. They coordinate with nursing. ...

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How important is it for a doctor to want to be a doctor? At first glance, that question is ludicrous. The path to becoming a practicing physician is so long and tortuous that no one would do it if they didn't want to. Right? First, there's the four years of undergraduate education, then four years of medical school, then at least three years of residency. No one has ever suggested that ...

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The patient is a 27-year-old Caucasian woman: slender, well-groomed. She is sitting in the office of her urologist, and she is unconsciously twisting her hands as she interrupts the doctor, having finally worked up the nerve. "I know you told me to expect some pain for a while after the lithotripsy. But I've been having pain in my bladder, even when I don't think there are any stones. It started two ...

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