Fighting to protect the health of the economy and the health of the people are not mutually exclusive endeavors. In fact, they are strongly related. While COVID-19 does present a significant threat to the physical health of at-risk individuals, the shut-down poses a more significant threat to the mental health of all individuals. As a physician anesthesiologist practicing pain medicine and addiction medicine for the past 25 years. In my pain ...

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"In my lifetime, I have encountered those who have seemingly endured far greater states of human privation than I could ever imagine (though I try to eschew establishing comparative equivalencies [or non-equivalencies] among human suffering as much as possible because such an impossibly herculean task never ends well). And what I have come to realize is that the nexus of all ...

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By now, you’ve heard that meditation has many health benefits, including stress management. You’re probably thinking, that’s great for my single friend with time for self-care, but I’m a busy working parent, there’s no time for that! Wrong. There is time for it. Granted, it is different than what you have been traditionally taught about meditation. So, time to clear that up. Yes, there are extensive programs and ...

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I don't presume to know the individual experiences and feelings of providers and frontline workers right now during this crisis, but, as someone who has specialized in psychological trauma and traumatic grief for many years, here are some thoughts which might be helpful for some. Experiencing the unfathomable and enormity of devastating loss generates many feelings, including disbelief, shock, hopelessness, fury, despair, and, for some, giving up. How the aftermath of ...

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"The reaction to the COVID-19 pandemic in the comprehensive psychiatric emergency program (CPEP) began insidiously, with an initial sense of unease. Patients are brought into CPEP when they pose a danger to themselves or others. Often they are brought by police, but occasionally they come on their own or with concerned family members. CPEP is a locked unit, separated via locked ...

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In writing this, I feel a bit strange to contribute my thoughts on a pandemic I’ve had mostly a peripheral experience with dealing first hand. In my brief month on the medicine ward, I did interact with a patient who then was tested positive for SARS-CoV-2 (the official name for COVID-19), and subsequently, I was on a state-mandated quarantine. Asides from that experience, I have not truly seen first-hand the ...

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"Over a period of about two years, our city experienced a very large influx of seniors. One nearby town grew by over five thousand people. This, in turn, created a surge of patients coming to the hospital. As most were older, they often had multiple medical conditions. They would almost always require more complex care. The whole system became overloaded because, ...

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Whatever method you have been using for video conferences these days, we have had an unprecedented look into the lives of our colleagues, children’s schoolmates, teachers, professors, and even famous folks. While this pandemic has allowed the opportunity for a paradigm shift in the way we think about communication and the work environment, it has also raised several questions and concerns. When on my children’s Zoom “school” calls, I have ...

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"Howard wants to go to the hospital. He knows he isn't doing that great. He says he is having homicidal thoughts." This from my supervisor, Linda. Homicidal thoughts on the part of any client get our attention, especially so with Howard, because years before, he killed a man with a gun. I believe it was in a fight. "He wants you to take him to the hospital, Ray." "Sure," I say. "You think ...

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“I stayed up all night, and for what, $10 a consult?” A clearly exhausted and exasperated colleague and friend said to me one morning after his very busy call shift. As a chief resident, one of my roles is to manage the call duty schedule. As such, I frequently hear about how residents feel about call. Interestingly, many comments have to do with the economics of call: “It’s just not worth ...

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Consents have become a prominent part of health care. We sign consents for visits, procedures, medication, privacy, release of information, care of minors … the list goes on and on. We must acknowledge and respect the patient’s autonomy in their care. This is never more apparent or more important than in end of life care. Physicians encourage everyone to have an end of life plan, a living will. It is ...

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"I used to only have to deal with him touching me after school — now it's all the time." "She's doing drugs more because she lost her job last week; she started hitting me again." As a pediatrician-in-training, I've been concerned about my patients' safety with schools closed, jobs lost, and family stress at all-time highs. As a Crisis Counselor, receiving these messages on recent shifts confirmed my fears that ...

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COVID-19 is taking a toll on my mental well-being in a way I had not expected. I have a rather high distress tolerance. I am a pediatric emergency psychiatrist. Now I am a wounded healer battling anxiety and fears from the constant unknown taking place inside my body. In early March, before New York State went on pause, I woke up to an intense headache, followed by malaise, chills, throat soreness, ...

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For weeks, our health care workforce has been on the frontlines of the COVID-19 pandemic staring straight at mortality - their patients and their own.  They have been single-mindedly focused on the task at hand, doing what needs to be done while instinctually suppressing their emotional response.  The job requires this, and they have done it well. Yet, the tragic suicide of Dr. Lorna Breen has brought focus in a devastating ...

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The chart for the first patient of the morning states, “elevated blood pressure for two weeks.” As I enter the room, I see a frail, elderly woman perched gingerly in the chair. She has on large sunglasses and a fabric mask. She looks apprehensive, so I introduce myself quickly. Before COVID-19, I would shake her hand, but times have changed. Before I even sit down, she immediately shows ...

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Many of us (especially psychiatrists and physician coaches) have been warning the medical profession at large for weeks now that we are headed for unprecedented numbers of physicians, nurses, other health care workers, and first responders suffering from PTSD. A free support group of psychiatrists for physicians formed rapidly. Several articles have been written. Physician suicides during this pandemic have made the news. And the NYT finally published an article ...

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“My partner doesn’t want me to come back home now that I’ve come to the hospital. He is worried I’ll come back and infect him and his parents. I have nowhere to go”. Fear and guilt were palpable in the young woman sitting before me. She had decided to follow the recommendation of the psychiatric crisis response team and come to the Emergency Room for worsening thoughts of suicide. This dilemma ...

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In April 2020, Dr. Lorna Breen, an emergency medicine physician from New York-Presbyterian Medical Center, came to the University of Virginia Medical Center, not as a physician, but as a patient. She had been working at the height of the COVID-19 epidemic in Manhattan, and was staying with her family in Charlottesville when she committed suicide. Her father described her as a hero killed by COVID-19, another casualty in the ...

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Your alarm may still go off at the same time, but I’ll bet what happens next is not the same as it was back in February. There is no denying our daily lives have been turned upside down in both stressful and heartwarming ways. While recent stories have made headlines of news anchors in boxers while they are giving an interview, we all have our dirty little video conference secrets. ...

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My patient was a young man who wanted to be placed back on buprenorphine. He had started using again. He often missed appointments, did not pick up phone calls. So when I saw him in the room, I masked my surprise. “What makes you want to start today?” I asked. “I live with my grandma,” he said. He could not keep leaving the house for heroin.

Of the many ...

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