I worked with someone (not a physician, but that doesn’t really matter here) whose title was “assistant director.” He and I quickly recognized that we worked well together: His head brimmed with big visions and ideas, whereas my head brimmed with plans as to how to make those ideas manifest in the actual world. “He’s like a bunch of balloons,” I quipped to a colleague. “He’s got a ton of ideas ...

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To my knowledge, three people who were under my care killed themselves. The first was a young man -- late 20s, maybe? -- who I met while I was a psychiatry intern. He was hospitalized in the psychiatric unit where I had just started my rotation. I did not have the opportunity to get to know him well. Our paths crossed, at most, for two days. He had a diagnosis of ...

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I was asked to present information about mental health to a lay audience. This is both an exciting and daunting task. I imagine it’s like asking someone to talk about fish. There are so many kinds of fish! They live in many habitats! Some of them look more like snakes than fish! There are so many directions to go. I have given a “psychiatry 101” talk to many non-clinical audiences in ...

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The chief complaint was belly pain. He described the pain as both dull and crampy. It came and went, but bothered him the most on the same night of each week. The notes from the primary care doctor show a thoughtful search for the underlying cause. There were comments about activity logs, blood tests, and imaging studies. Months later, it remained a mystery: He still had belly pain. The investigations did ...

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I didn’t know that he and I were on the same train. At the Othello stop, I got out of the last car and walked towards the front of the train. The morning chill seeped through my coat and I slid my hands into my pockets. “Dr. Yang!” The doors of the train were still open, and there he was: A baggy black hoodie was pulled up over his head, but it ...

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The nights from that time run together in my memory: The cuffs of my scrub pants getting caught on the heels of my clogs because my pants were sagging; stuffing dry graham crackers I stole from the nursing stations into my mouth at 4 a.m. to stay awake while writing notes; what seemed like my pager buzzing against my hip every five minutes; feeling the enormous specter of unending work ...

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I don’t miss making the phone calls in the middle of the night. “Hi, this is Dr. Yang calling from the psychiatric emergency service. May I speak to Mr. or Mrs. Doe?” “Yeah, this is Mr. Doe,” he’d reply, his voice thick and slow with sleep. “I’m sorry to call so late. Your son is here at the hospital.” Take a breath and slow down for the next part. “He’s alive and doing OK at ...

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“Oh, you’re a psychiatrist? I hope you won’t analyze me!” I never know what people actually mean when they say that upon learning that I work as a psychiatrist. I think they’re saying, “I hope you’re not going to spend our time together trying to discern my flaws.” Nobody wants people to seek out, highlight, and exploit their vulnerabilities and faults, so I can understand that. Of course, that’s not what psychiatrists do. Anyway, ...

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"Expressers significantly underestimated how surprised recipients would be about why expressers were grateful, overestimated how awkward recipients would feel, and underestimated how positive recipients would feel." – Undervaluing Gratitude: Expressers Misunderstand the Consequences of Showing Appreciation The past 30 days have been unusual because of the number of professional gestures of gratitude I’ve received:

  • I received a clinical faculty award from psychiatry residents for my teaching efforts.
  • An hospital administrator ...

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I still feel a little anxiety whenever I ask someone about suicide. I have no fear when asking The Question -- “Have you been thinking about killing yourself?” -- but sometimes I find that I’m not breathing while I await the answer. What if this person says “yes”? This anxiety persists even though it’s literally part of my job to ask this question. Despite having asked this question thousands of times, I still ...

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There were about nine of us waiting to cross the street. Several were Asian; there were also a few black and brown men. A van approached the curb to turn. It was one of those vans with a back door that slides along a track. That back door was wide open, even though the van was in motion. As it pulled closer, we saw that there were three young white men ...

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To the intern on the trauma surgery service when I was a medical student: Thanks for occasionally wearing leather pants to work. Thanks for smiling and having a sense of humor despite having to round on thirty patients. Thanks for teaching us medical students while running a significant sleep deficit. To the internal medicine resident who wanted to become a cardiologist: Thank you for indulging me and telling me how you ...

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I don’t remember her name, but I do remember her light brown hair, the simple nose ring that looped out of her left nostril, and the calm and centered presence she had with patients. She came across as unassuming, professional, and caring. We were both in medical school, though she was two years behind me. I admired how she treated people. I don’t remember his name, but I do remember that ...

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You don’t have to like everyone under your care. And you probably won’t, which is OK. Own how you feel. If you insist on telling yourself that you should like someone when, in fact, you don’t, it will come out in other ways: The tone of your voice, the expressions on your face, the way you position your body. There might completely understandable reasons why you don’t like the person under your ...

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Some of the people under my care in the jail right now are quite ill. (This statement is always true, but it seems that the intensity of illness is greater now than usual.) As a result, the perennial question seems more urgent now: Is there any way to prevent All of This? For some of them, it seems that the answer is No. Some of them sought out psychiatric services, attended ...

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From the notes I read, it seems that other medical specialties limit “social history” to whether or not someone uses tobacco, drinks alcohol, or uses drugs. “Social history” is meant to get a sense of the context in which people live. Where do they live? Who do they live with? How did they come to live there? Where did they grow up? What sort of work do they do? How much ...

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The senior psychiatry resident at the University of Washington School of Medicine warned me ahead of time. She laughed as she said, “He’s weird. You’ll get used to him.” When I first met with him, the psychiatrist lazily spun in his chair, his left hand tucked into his pants, his thumb hanging out. After he told me his expectations as my supervisor, he patted my right thigh as he ended the ...

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One of my readers, Natalie, wondered about my thoughts about the digital pill. My initial reactions were similar to several of those who were interviewed for the article. The digital pill, which provides electronic information to confirm whether someone has ingested the medication, has great potential to become a tool of coercion. Aripiprazole (Abilify) is classified as an antipsychotic medication, which is often prescribed to people who have beliefs that machines ...

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My first memory of encountering a person who appeared to have no place to live was during my first year of college at UCLA. A man was sitting outside a mini-mart, his legs crossed and his hair long. He looked tired, and his clothes had stains on them. Feeling pity for him, I went into the mini-mart and purchased a turkey sandwich on wheat. “Here,” I said as I handed him ...

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Every now and then, when some people learn what kind of work I do, they say, “You’re doing God’s work. Thank you.” They mean well, so I accept the compliment, though I also tack on, “I also like what I do. It’s meaningful work for me.” So many of the people I see, whether in my current job or in my past jobs working in other underserved communities, have a lot going ...

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