When I was 12, my father got into a bicycle accident resulting in traumatic brain injury. Although I was unaware of it at the time, this day became the first day of the rest of my life. Despite having never seen either of my parents so much as have a sip of wine with dinner, I watched my father spiral into a crippling alcohol addiction that wreaked havoc on our lives. As ...

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I’ve interviewed many doctors on my podcast The Doctor’s Life. They share their stories of how they came to medicine and how they developed into the physicians that they are today. There are three common themes in these “origin stories”: The first is that many of the doctors were mentored by a physician who inspired them to pursue medicine. The second is that they were “called” ...

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The mental health community must increase its clinical acumen regarding complex psycho-pathology consisting of the avoidant personality, social impotence, and related rage. School violence has taken on epidemic proportions since two disturbed adolescents masterminded Columbine and became role models for the mentally ill young men who drive the new culture of school shootings. While the profile of the school shooter has evolved over the last couple of decades, it’s worth considering ...

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Alice wept in my arms as she described her father’s last days. He died of metastatic prostate cancer. She felt lighter as she shared beautiful memories of him. It will never be the same for Alice, nor will it be for me. I was running behind for my next patient, a healthy 86-year-old woman. I apologized for keeping her waiting. She did not mind; she knew I would give her ...

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Years ago, the police brought a middle-aged man to the hospital for evaluation on a day when I was the on-call psychiatrist. Earlier that morning, the man had walked into his psychiatrist’s office without an appointment asking to see his doctor immediately. When his demand was not met, he caused a raucous in the waiting room, tossing over tables and chairs and alarming the other patients. He refused to leave, ...

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Learned helplessness. It’s a psychological concept marked by a perceived loss of power, and it’s prevalent in medicine. We are taught early on how little we are in this colossal world. We are told what to do, when to do it, and what we will get for it. Our objections go unheard or—worse—ignored. Let me quote a paragraph from The Paradox of Choice by Barry Schwartz:

They were conducting a series of experiments on basic ...

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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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Physician burnout rates hover around 50 percent, and the adverse consequences are serious. Burnout is associated with increased medical errors, suboptimal care, turnover and personal costs, including substance use, depression, and suicide. The financial cost to health care organizations is significant: replacing a physician is estimated to cost at least $500,000. Plus, physician turnover results in care disruption, patient access issues and lost revenue for hospitals to which the physician referred ...

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Today a physician told me she lost three colleagues to suicide in the last two months. Loma Linda Hospital just lost three young doctors to suicide in 6 months. Mount Sinai had 3 docs jump in less than 2 years -- from the same building. An anesthesiologist recently told me he lost 8 of his colleagues to suicide. Each suicide should be fully investigated, ...

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Two recent posts highlight the problems facing many medical students today. The first was by an anonymous rising fourth-year student who has come to the conclusion that going to medical school was “a terrible, terrible decision.” It ended with a comment that medical school “is not fun. It’s jarring, scary, disappointing and absolutely depressing.” The second was by another anonymous student who described how miserable he (or she) has been ...

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