Psychiatry
Posttraumatic growth: Embracing the healing and transformation
An excerpt from The Unexpected Gift of Trauma. Copyright © 2023 by Edith Shiro. Reprinted by permission of Harvest, an imprint of HarperCollins.
When a traumatic experience shatters our world and we’re left to pick up the pieces, the idea that we can heal, and actually transform as a result of …
The real story behind Woodstock is not the brown acid
In my search for ever-obscure rock music from my generation – not the greatest generation but the flower generation – I came across a CD collection of rare songs titled “Brown Acid: The Seventeenth Trip,” appropriately subtitled: “Heavy Rock from the Underground Comedown.” The record review began as follows: “Lucky number 17? You better believe it. We here at Brown Acid have been scouring the highways and byways of America …
Exploring changing definitions of addiction [PODCAST]
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Join L. Joseph Parker, a research physician, as we delve into the evolving definitions of addiction, particularly in the context of chronic pain management. Explore the historical shifts in diagnostic criteria, the challenges faced by chronic pain …
Can ketamine and SSRIs offer a complete depression treatment?
We have a problem with current recommendations for depression treatment. Thirty-five percent of patients will not go into remission or get any relief at all from SSRIs and SNRIs. And even when it does work, it takes about six weeks to start having an effect.
The prevailing theory was that serotonin, abbreviated 5-HT, was the “satisfaction” neurotransmitter. Just as dopamine has been considered the pleasure neurotransmitter. Using selective serotonin reuptake inhibitors …
Overcoming depression: a medical resident’s journey
How did I get here? Heading to the highest place I can find, in contemplation of jumping and falling to my death. I had always feared death before this point, but now it seemed the only logical solution. I seemed to have it all going my way. So why would a medical resident in a coveted training program in one of the most beautiful parts of the country, with a …
It’s time for burnout to become a quality metric
I completed a fellowship in quality improvement, making quality metrics an integral part of my career for the past 15 years.
At times, these metrics can be frustrating, especially when reimbursement is tied to constantly shifting targets.
Yet, health systems invest hundreds of thousands of dollars in order to improve quality metrics because Medicare mandates it.
This led me to contemplate:
What if Medicare included burnout as a quality metric?
What if health systems were …
Are health care workers being gaslit about burnout?
When an animal is shot and bleeds to death, does it “suffer from a bleed out”? No, the hunter shot and killed it – that’s the truth, and that’s the main narrative. “Bleeding out” was a natural consequence. Yet in health care, it feels as though the narrative has been cleverly turned on its head and reflected back to health care workers as “suffering from burnout,” giving the culprit workplace …
Coupling behavioral health prescriptions with measurement-based care
It can be difficult for patients with substance use disorders, depression, anxiety, or obsessive-compulsive disorder to seek care and commit to a regular schedule of behavioral health care visits. However, telehealth and telepsychiatry have vastly enabled both access and compliance with care. That being said, medication should not be prescribed without proper oversight and care, regardless of whether the doctor is assessing the patient online or in person.
During the …
Surgeon suicides: Unveiling a silent crisis
When I read The Guardian article, “US surgeons are killing themselves at an alarming rate. One decided to speak out,” I felt like throwing up.
I’m sickened so many surgeons are dying. I’m grateful Dr. Cunningham is speaking out. I’m relieved she is alive.
But I felt nauseated that Carrie Cunningham’s pain is being used to tout physician “health” programs (PHPs) as the solution to physician suicide while these programs have actually led …
Reflections on human suffering
I was in my upstairs office when I heard the doorbell ring. I ran downstairs to open the door, unable to see through the opaque window who was on the other side. I opened the door, and there stood an elderly Black man and woman, well dressed, with leaflets and literature. I immediately recognized that this was an unsolicited proselytization.
“Can I help you,” I inquired. The woman handed me a …
Nature’s role in relieving physician burnout
In today’s corporate health care world, physicians are exposed to high levels of stress in the course of carrying out the duties of their profession, making them susceptible to experiencing burnout. Burnout has far-reaching implications not only for doctors but also for patients and the health care system that employs them. Burnout among doctors increases the risk of depression, anxiety, sleep disturbances, fatigue, alcohol and drug misuse, premature retirement, and …
Kick start your writing with a surprise
One of the most memorable scenes in Goodfellas occurs early on, when the audience is introduced to most of the crew at the Bamboo Lounge. Henry Hill (Ray Liotta) and Tommy DeVito (Joe Pesci) get into a tense exchange. Tommy seems to get offended after Henry calls him funny. “I’m funny how, Tommy wants to know?” “I mean, funny like a clown? I amuse you? I make you laugh?”
Unknown to …
Love in a world full of hate: a beacon of hope
In a world often marred by division, conflict, and hatred, the concept of love may seem like a fragile flower struggling to bloom amidst a harsh and unforgiving landscape. However, it is precisely in such a world that the power of love shines most brilliantly. Let us explore the importance of love in a world full of hate and consider insights into how individuals and communities can foster love to …
Ghosting in mental health
In psychiatry, we are trained to prepare our patients for the end of treatment. Treatment planning focuses on goals and strategies to help the person eventually end their need for therapy and external interventions. Interestingly, even with this anticipation of ending our relationship as part of the focus, it is not unusual for patients to disappear.
Ghosting doctors and treatment personnel is sadly commonplace in the mental health space. I have …
The cost of silence: Dr. Nakita Mortimer’s tragic story
When I received an email from her in March, it was exceptionally helpful and genuine. You could tell she exuded that class president energy and was a true leader. Dr. Mortimer sounded excited for residency to begin.
We met each other across the green at the mandatory, unpaid 4-day orientation. She seemed laid-back and content. I remember the one week of electives we were granted was scheduled early for her. By …
The future of U.S. health care: 2030 and beyond
What will the U.S. health care industry look and feel like in 2023?
If you want to call the U.S. health care a “system” today, what will that “system” look like in the year 2030, and how will it handle the health care needs of an older, sicker population?
With nearly everyone calling for system change and reform, including “burn it to the ground” and more, let’s look at the demographics of …
Alcohol’s impact: hangovers and health risks
In July, we all got at least one day off to celebrate a very American holiday, Independence Day. If I were a betting man, I would say that many, if not most of you, participated in at least one of those grand old American pastimes: eating hotdogs or apple pie, barbecuing, going to a baseball game, floating in the pool, watching a movie, or … drinking alcohol. After your celebration …
Understanding childhood mental health [PODCAST]
Halloween is almost here. Why aren’t you writing?
Sir Isaac Newton dedicated as much, if not more, of his time to the study of alchemy than he did to the natural order of the universe, but most of his work as an alchemist remained unpublished until long after his death when a metal chest full of his belongings was auctioned in 1936. The great man of science, the first of the Age of Reason, was simultaneously the last …
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