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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