Someone you love says they are fine. They still eat, they still go to work, and no one asks a second time. Nneka Oluoha is an internal medicine physician and the author of a novel about a Nigerian immigrant living…
Someone you love says they are fine. They still eat, they still go to work, and no one asks a second time. Nneka Oluoha is an internal medicine physician and the author of a novel about a Nigerian immigrant living with depression. This episode is based on her article …
In a recent Psychiatric Times interview, Christoph Correll, MD, made a case that every psychiatrist should hear: Artificial intelligence should replace tasks, not people. He described a decision-support platform he helps lead at MedLink Global that would pull together the…
In a recent Psychiatric Times interview, Christoph Correll, MD, made a case that every psychiatrist should hear: Artificial intelligence should replace tasks, not people. He described a decision-support platform he helps lead at MedLink Global that would pull together the electronic health record, a short avatar-guided interview before each visit, and the conversation in the exam room, then offer two or three evidence-based treatment options. The goal, in his …
I've watched the coverage of this case the same way most of us have. Clips from the courtroom keep looping across television, podcasts, and every social feed. A mother killed her three children. The hearings are broken into bite-sized moments…
I’ve watched the coverage of this case the same way most of us have. Clips from the courtroom keep looping across television, podcasts, and every social feed. A mother killed her three children. The hearings are broken into bite-sized moments for public consumption. And in the middle of it all sits a long parade of physicians from every specialty, plus the usual lineup of forensic psychologists and psychiatrists, each one …
As a fifth-grade student, I was introduced to Japanese culture through a school program. I lived in Japan on an American military base from 1967 to 1970. I remember learning about tea ceremonies, calligraphy, and the samurai code known as…
As a fifth-grade student, I was introduced to Japanese culture through a school program. I lived in Japan on an American military base from 1967 to 1970. I remember learning about tea ceremonies, calligraphy, and the samurai code known as Bushido.
At the time, I understood very little of it. What I remembered was the idea that a person should strive to become the best version of himself every day. Not …
The lessons no one formally taught us Your pager goes off in the middle of the night. You slip out of bed, trying not to wake your spouse, and call the emergency department back from the guest room. You hope…
The lessons no one formally taught us
Your pager goes off in the middle of the night. You slip out of bed, trying not to wake your spouse, and call the emergency department back from the guest room. You hope it was a missed page so you can return to sleep, while knowing a misfired page will feel almost as frustrating as the interruption itself.
The other day, LinkedIn informed me that I was a strong match for a developmental-behavioral pediatrics section chief position at an academic medical center in the Midwest. The irony was hard to miss. Years ago, I held essentially the same…
The other day, LinkedIn informed me that I was a strong match for a developmental-behavioral pediatrics section chief position at an academic medical center in the Midwest.
The irony was hard to miss. Years ago, I held essentially the same leadership position. It nearly killed me.
The recommendation arrived complete with all the reassuring language modern recruiting systems like to use. My qualifications matched the position well. My experience aligned with the …
A trauma surgeon spent two decades on call for the worst nights of other people's lives. Then he ran his hospital's pandemic response. Then he could not function. Jeremy Heffner is a trauma surgeon, speaker, and author. This episode is…
A trauma surgeon spent two decades on call for the worst nights of other people’s lives. Then he ran his hospital’s pandemic response. Then he could not function. Jeremy Heffner is a trauma surgeon, speaker, and author. This episode is based on his article “Why frontline health care …
We get asked this all the time: "How do you do it? How do you raise kids, manage a household, remember that someone needs poster board for school tomorrow, get everyone to practice, and somehow sustain two demanding physician careers?"…
We get asked this all the time: “How do you do it? How do you raise kids, manage a household, remember that someone needs poster board for school tomorrow, get everyone to practice, and somehow sustain two demanding physician careers?” The answer is: not gracefully. We have calendars. We have systems. We have childcare. We outsource things. We occasionally feed our children cereal for dinner, and somewhere, at almost all …
Medical training hands you a ready-made group of friends. Then it ends, and many women physicians find themselves starting over alone in a new city. Cassie Burton Greenbaum is a pediatric critical care physician and the founder of Off Service…
Medical training hands you a ready-made group of friends. Then it ends, and many women physicians find themselves starting over alone in a new city. Cassie Burton Greenbaum is a pediatric critical care physician and the founder of Off Service Mom Co., a friendship matchmaking service for physician moms. …
I can finally write this essay almost five years out. That's how long it took me to fully heal. To process. To gain perspective. I graduated residency in June 2020 at the height of COVID. I, along with my family,…
I can finally write this essay almost five years out. That’s how long it took me to fully heal. To process. To gain perspective.
I graduated residency in June 2020 at the height of COVID. I, along with my family, including my husband, two preschoolers, a four-month-old infant, and two dogs, drove from Miami to Chicago to complete an amazing fellowship. The year was perfect, though masked, sometimes scary, and full …
Addiction. The American Board of Preventive Medicine certified me as an addiction medicine specialist so how bad can the term be? My patients called themselves addicts. Heck, they called themselves junkies and fentanyl fiends. That's not a license to stigmatize.…
Addiction. The American Board of Preventive Medicine certified me as an addiction medicine specialist so how bad can the term be? My patients called themselves addicts. Heck, they called themselves junkies and fentanyl fiends. That’s not a license to stigmatize. Nor does it mean that substance use disorder patients appreciate people outside the clan calling them that. Just treat people with respect. The affliction truly is a disease, not a …
In a recent interview with UCSF Magazine, Dr. Karthik Sarma makes a careful point about the phrase "AI psychosis." It implies chatbots cause psychosis directly, and he doesn't think the evidence supports that. He prefers "AI-associated psychosis." Heavy chatbot use,…
In a recent interview with UCSF Magazine, Dr. Karthik Sarma makes a careful point about the phrase “AI psychosis.” It implies chatbots cause psychosis directly, and he doesn’t think the evidence supports that. He prefers “AI-associated psychosis.” Heavy chatbot use, he suggests, may be a symptom of an emerging episode rather than its cause. He also says it’s unlikely that someone with no risk factors or underlying vulnerability to …
In a recent poll, people indicated interest in maintaining brain health but expressed ignorance on how to do so. In a second poll, most men believed the herpes vaccine was only for young women, while in a third poll, only…
In a recent poll, people indicated interest in maintaining brain health but expressed ignorance on how to do so. In a second poll, most men believed the herpes vaccine was only for young women, while in a third poll, only about 50 percent of women were aware of the importance of breast cancer screening. Other polls on health care information knowledge have shown similarly large awareness gaps. Given the substantial …
An excerpt from The Mindful Therapist: An Interpersonal Neurobiology Approach to Healing and Wholeness, second edition. Resonance is the coupling of two autonomous processes into a functional whole without losing the essence of each one. When we resonate with another…
Resonance is the coupling of two autonomous processes into a functional whole without losing the essence of each one. When we resonate with another person, we are changed by them but do not lose our essence in the joining. Resonance is not the same as mirroring or imitating. Resonance enables two differentiated elements of …
I love being a doctor. I do not enjoy many aspects of practicing medicine in the U.S. health care system. In the struggle to balance these truths, mentorship from several extraordinary physicians has steadied me. As gifted diagnosticians and models…
I love being a doctor. I do not enjoy many aspects of practicing medicine in the U.S. health care system. In the struggle to balance these truths, mentorship from several extraordinary physicians has steadied me. As gifted diagnosticians and models of bedside medicine, they have meant as much to me personally as the knowledge they shared.
I return to these mentors’ words often. Their guidance provides a framework I use to …
Looking at emotional maturity through an epidemiological lens may unravel the endemic status of emotional immaturity in postmodern humanity. Is its epidemic proportion a new-age phenomenon? Has its endemicity been innate since the dawn of humanity? Does it extend beyond…
Looking at emotional maturity through an epidemiological lens may unravel the endemic status of emotional immaturity in postmodern humanity. Is its epidemic proportion a new-age phenomenon? Has its endemicity been innate since the dawn of humanity? Does it extend beyond humanity into the nonhuman systems that humans devise? Humans have long invented historical myths and fictional entities in order to organize nonhumans and to prevail over them by tradition. Are …
A new scoping review in npj Digital Medicine should be read by every clinician who treats serious mental illness. Diel, Torous, and colleagues reviewed 119 articles on the mental health harms of large language model chatbots. They sorted the harms…
A new scoping review in npj Digital Medicine should be read by every clinician who treats serious mental illness. Diel, Torous, and colleagues reviewed 119 articles on the mental health harms of large language model chatbots. They sorted the harms into five categories: direct psychiatric harm, behavioral and relational harm, cognitive harm, safety failures, and governance risks. Psychosis and severe mental illness came up again and again as the …
There is a conceptual inconsistency in contemporary medicine that I have become increasingly unable to reconcile. Psychiatry recognizes psychic pain as a genuine clinical phenomenon, and suicidology has long recognized unbearable psychological pain as integral to suicidal states. Neuroscience has…
There is a conceptual inconsistency in contemporary medicine that I have become increasingly unable to reconcile. Psychiatry recognizes psychic pain as a genuine clinical phenomenon, and suicidology has long recognized unbearable psychological pain as integral to suicidal states. Neuroscience has simultaneously demonstrated that nociception, affective pain, reward, motivation, salience, stress responsivity, and emotional regulation are interconnected biological processes.
Yet when psychic pain becomes intolerable, psychiatry has remarkably little therapeutic infrastructure directed …
In community interventional psychiatry practices, the typical referral looks the same week after week. The patient is in the fifth or sixth year of a major depressive episode and carries a list of four, five, sometimes seven antidepressants they have…
In community interventional psychiatry practices, the typical referral looks the same week after week. The patient is in the fifth or sixth year of a major depressive episode and carries a list of four, five, sometimes seven antidepressants they have “failed.” They are finally sent for transcranial magnetic stimulation (TMS) or esketamine (Spravato) long after the point when those treatments would have done the most good. By the time the …
A physician says she is exhausted after months of working short-staffed. Burnout. A resident feels increasingly detached from patients after repeated 80-hour weeks. Burnout. A doctor cannot stop thinking about a patient who died unexpectedly. Burnout. A clinician feels powerless…
A physician says she is exhausted after months of working short-staffed. Burnout. A resident feels increasingly detached from patients after repeated 80-hour weeks. Burnout. A doctor cannot stop thinking about a patient who died unexpectedly. Burnout. A clinician feels powerless working in a system where patients wait months for care they need now. Burnout. Someone returns to work while grieving and discovers that the emotional reserve they once relied on …
