Psychiatry

Finding a pathway to hope: reflections from a psychiatrist

Physician
February 23, 2022

You may be feeling hopeless. That wouldn’t be shocking, under the current circumstances. Reading the headlines, one can’t help but remember the beginning of the pandemic, when we were reading about “flattening the curve” and overrun, understaffed hospitals.
Additionally, the dark days of winter can be a difficult time for many, even under the best of circumstances. Losses from the year become highlighted, family dynamics are under strain, and we may …

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Who will heal the physician?

Physician
February 21, 2022

I was a third-year medical student in 1999 when the landmark report titled “To Err is Human” was released by the Institute of Medicine (IOM), unveiling the uncomfortable truth about the fallibility of physicians and our medical system. I remember it vividly.

The publication’s scandalous revelation that nearly 100,000 preventable deaths occurred in hospitals each year shocked me. I recall feeling simultaneously offended and defensive at the implication …

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I risked my career to save my life

Physician
February 20, 2022

Early into my military career and as an oral and maxillofacial surgery resident, I started to acknowledge the fact that, during periods of sleep deprivation that were initially inherent to my military training hours and then surgery call requirements, I found myself thinking dark thoughts that I had never experienced before. I scheduled an appointment with a Psychiatrist and was diagnosed with depression. Scratch that. I was diagnosed with “high …

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Reflections on physician mental health and tips for sustaining it

Physician
February 17, 2022

The problem

Even in the midst of a global pandemic, mental health in medicine is rarely discussed. And yet, the circumstances of our profession create the perfect milieu for darkness. The long work hours. The regularity of tragedy and loss. The nights, weekends, and holidays you miss with those you love. The constant pressure to be perfect — to be professional, to be composed, to be vigilant, to not make any …

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Misinformation in transgender health care is harming patient care

Conditions
February 16, 2022

Living in the U.S., chances are you get some regular mail that you never signed up for — a magazine, a journal, a sales flier. As medical professionals, we also get these free journals related to our field. We don’t always have the time to fact-check a publication. And with names that appear to be legitimate, we might take information at face value. This is especially true if we are …

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Recognizing high functioning depression

Conditions
February 15, 2022

High functioning depression (or HFD) is the mental health diagnosis given to an individual who exhibits symptoms of high-level depression but manages to maintain overall functionality in life. An HFD person will often engage in activities that would be considered “normal” and healthy for a typical person, maintaining a job and even social relationships (though they may not appear as close and involved as typically expected). However, they might find …

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Mildred Mitchell-Bateman, MD: an icon in psychiatry

Physician
February 12, 2022

New Haven, West Virginia, is a small town nestled in Appalachia and located approximately eight miles from the juncture of the Ohio and Kanawha rivers. Newspaper articles from the 1950s and ’60s suggest that the town’s demographic makeup and surrounding area as nearly 97 percent Caucasian.

In 1926, as commissioned by West Virginia, a psychiatric facility was opened and named The Lakin Hospital for the Colored Insane. In the tradition of …

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What doctors need to know about psychedelic medicine

Meds
February 11, 2022

Frustration.

If you’ve treated patients with PTSD, I’m guessing that both you and your patients have experienced frustration at numerous points along the treatment course. And it’s understandable – up until this point, the efficacy of PTSD treatments has been notoriously poor. The best options aimed to diminish the severity of symptoms with a combination of therapy and daily medications.

However, the …

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Stop “shoulding” all over yourself

Physician
February 10, 2022

The first time I heard the phrase “shoulding all over yourself,” I laughed. As a gastroenterologist, I have a particular affinity for poop jokes. It might not be obvious when you read the phrase, but say it out loud, and you will hear it. I think the phrase also caught me off guard. I didn’t understand the significance of the word should. It just seemed like an ordinary word in …

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Support desperate health care workers now, before your life counts on them

Conditions
February 8, 2022

I come calling from the frontlines of COVID.

My colleagues and I are exhausted. Defeated. And on the brink of collapse.

I have been a health care worker for 15 years. I have never seen things so bad in so many ways.

At the height of COVID, I was working 12-hour overnight shifts and weekend day shifts, in addition to my full-time job of helping manage a life support system called extracorporeal membrane …

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A neurosurgeon’s proposal to reduce burnout in medicine and beyond

Physician
February 7, 2022

In a previous article, I described the brain-damaging effects of allowing work-life balance to fall into disequilibrium. For example, scientists from the Karolinska Institute, in Sweden, reported that burnout may weaken the connectivity between far-flung regions of the brain and may even result in brain atrophy.

A burnout crisis in medicine has been simmering for more than a decade. In 2015, researchers from the Mayo Clinic reported on …

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The silent burden of shame

Physician
February 5, 2022

Shame.

It’s what keeps physicians silent. It’s what keeps physicians from getting the help they need.

I’ve been a successful doctor for many years, but I’ve lived with the shame of having an eating disorder. It was my secret that hardly anyone in my life knew about.

No more. My shame is gone, and I’m ready to tell you my story.

When I was in eating disorder recovery, my …

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Why do physicians stay in toxic work environments?

Physician
February 4, 2022

For the most highly educated and specialized professional on the health care totem pole, physicians put up with a ridiculous amount of nonsense in the workplace.

You are pressured to see high volumes of patients in a rapid-fire fashion (15 minutes per visit) even when it interferes with the quality of care.

You are expected to complete mundane and excessive administrative tasks and generally are not directly compensated for this time.

You are …

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Who will heal the wounded healers?

Physician
February 2, 2022

One of the most extensive studies to look at trauma in the U.S., the ACE study (Adverse Childhood Events), showed that more than 60 percent of adults surveyed had experienced one traumatic event during childhood, including enduring physical, emotional, or sexual abuse — 25 percent of women had experienced sexual abuse. This shows how prevalent abuse is in childhood and how most of us carry trauma. It does not escape …

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“Me too” instead of “me last”: Have you filled your self-care bucket today?

Physician
February 2, 2022

I began pondering this topic after I witnessed a health care professional post on Facebook her hospital system’s expectation that she return to work five days into COVID, still ill and actively symptomatic.   She needed more recuperative time but struggled to give herself permission to take it. Unfortunately, this scenario is all too common in the health care community. How did we get here?

Demoting the importance of my own health …

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How do we help physicians in the time of COVID?

Physician
February 1, 2022

There’s a phrase we use in golf when you hit one good shot after many bad ones: “That was whipped cream on sh*t.”

I used this phrase the other day in a collaborative of coaches whom I had just met (maybe not the best idea). I spoke specifically about my hospital’s wellness committee activities during the past two years during COVID. As chair of that committee, I felt like I was …

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What can we learn from Cheslie Kryst?

Conditions
February 1, 2022

“Anything that’s human is mentionable, and anything that is mentionable can be more manageable.”
– Fred Rogers

Cheslie Kryst, a former Miss USA, lawyer, and entertainment correspondent, died by suicide. She was smart, beautiful, accomplished, and young.

A police officer was quoted saying, “Not only beautiful but she was smart — she was a lawyer … she has a life that anyone would be jealous of. It’s so sad.”

The message about suicide continues …

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Recovering from burnout: a permission to pivot

Physician
January 30, 2022

From 2013 to 2017, I was in the Air Force, selected to become an oral and maxillofacial surgeon, and would soon embark on my residency journey to get there.

Up until this point, my educational path was linear. I completed undergrad and committed to dental school during my first year as I was accepted into a fast track 3:4 program which meant that I would complete three years of undergrad followed …

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Why do we obsess and repeat?

Conditions
January 29, 2022

An excerpt from Heart Medicine: How to Stop Painful Patterns and Find Peace and Freedom–at Last. Reprinted in arrangement with Shambhala Publications, Inc. Boulder, CO.

For many months, Leila could not stop ruminating about the fateful event of spilling coffee on her ex–mother-in-law’s tunic. Images from the traumatic event on her son’s wedding day returned repeatedly, intermingling with related …

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