Constantine Ioannou is a psychiatrist.
It is a typical day on the inpatient unit. A patient is refusing medication, and I want to take her to court to compel her to take medication while her lawyer is arguing for her right to refuse.
Me: “She’s clearly psychotic. She has lost her family, and she has no place to live… all because of these delusions.”
Lawyer: “But is she behaving in a dangerous way?”
Me: “Being unable to survive …
I walk onto the inpatient unit on a Monday morning. The feeling of discomfort begins to overwhelm me. Perhaps this was due to being forced back to inpatient, but I felt it had to do with changes in the process.
I started my training at a time when therapy was a central part of education. Understanding even the most psychotic patients was a key element of our field. I do not …
During my psychiatric residency, I had the good fortune to train with a number of public and administrative psychiatrists. These individuals focused their attention on the care of the severely ill and the underserved and understood the systems of care that exist to provide this care. They also taught me the problems within the system and how it often creates more problems for the patients than it solves.
My story begins …
For many years, I have treated individuals with substance use disorders. I have found this work to be both gratifying and frustrating. Part of the frustration stems from interactions with governmental agencies and families.
The families are, of course, fearful and frustrated. They are watching their loved ones “die” before their eyes and want someone to fix it. It is difficult to understand that their loved one’s brain has changed, that …
I began my career in psychiatry with the desire to work with dying patients. This is an odd way to begin, but I had begun my career with interest in oncology and eventually discovered the field of psycho-oncology. After graduating, the first population I worked with was HIV infected individuals when an HIV diagnosis was a certain death sentence. The work centered on helping the individual accept their impending death …
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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