"Please walk slowly," cautioned Sunita, my interpreter, as I crept down the stony switchback trail towards the rural Nepali village of Dhulikhel. Sunita, in her petite navy ballet flats, hopped down the rocks as easily as the speckled goats grazing nearby. Emboldened by her speed, I stepped along eagerly, only to catch my size-ten neon running sneaker on a root and splat face-first into the dust. Looking up, I saw four ...

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STAT_Logo My grandmother was filled with grief as she told me by phone about life on the island of St. Thomas after Hurricanes Irma and Maria had blasted through it. “Tears keep running from my eyes uncontrollably because everyone on the island is suffering,” she lamented, then paused, too sad to continue. I could picture her in her ...

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A resident suffering from depression drinks too much and sleeps through a hospital shift the next morning. Another resident walks out of a patient room in the midst of a panic attack. As family medicine educators, how do we best handle these health concerns in our residents? The pendulum in medical training can swing in two directions. At one end, residents are indoctrinated into a macho mentality, where the need for self-care ...

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It’s 3 a.m., and I wake with a jolt. My heart is pounding out of my chest. I stumble out of bed to take a beta blocker hoping it’s enough to quiet my heart so I can doze off again. I sleep fitfully the next three hours, experiencing weird dreams and terrifying nightmares. At 6 a.m., I take my Valium. Nauseated, I lie in bed for 30 minutes, so I keep ...

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I have been working with psychiatric patients for the better part of 30 years. During this time, I have worked in psychiatric emergency rooms, prison wards, substance abuse treatment centers and inpatient psychiatric units. I have been proud of the fact that, despite working in some dangerous areas, I have never been harmed by a patient. I have been threatened, swung at — but never injured. Once a patient decided ...

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Five years ago today I was at a memorial. Another suicide. Our third doctor in 18 months. Everyone kept whispering, “Why?” I was determined to find out. So I started counting dead doctors. I left the service with a list of 10. Now I have 547. Immediately, I began writing and speaking about suicide. So many distressed doctors (and med students) wrote and phoned ...

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The prevalence of burnout among physicians is estimated to be more than 50 percent and has grown in recent years. This alarming trend is largely due to changing patient demographics, increasing cost constraints, new federal and state regulations, and other external factors that have reshaped the daily work experience of physicians. Too often today, physicians spend more time on data entry than in direct patient care. Professional burnout, ...

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"She doesn’t look like a person with an addiction problem to me," replied the physician to the psychiatrist, referring to a patient who was admitted to the hospital for confusion. She was found at home amidst an array of bottles containing various controlled substances, and a toxicology screen positive for cannabis. She was in a higher socioeconomic bracket having retired from a professional job. The psychiatrist explained that addiction crosses ...

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According to the National Institute of Mental Health (NIMH), about 9.8 million adults (or 4 percent of all adults) over the age of 18 years suffered a serious mental illness in 2015. A serious mental illness is one that affects a patient’s daily functioning. Considering all mental illness in adults in the same time period, 43.4 million adults (or 17.9 percent) who met the criteria for a ...

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A few years ago, as numbers of burnout, depression, and suicide among physicians continued to rise, the notion of “joy in medicine” was conceived. From conferences and books, to support groups and consultants, another health care-related industry popped up around improving provider satisfaction and fostering workplace wellness. It was well-intentioned, as these things often are, but like the familiar adage about roads and good intentions, joy in medicine seems poised ...

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