Lunch.
During my first year in New York, I packed my lunches in plastic grocery bags from Morton Williams. That is where I purchased cartons of frozen Shop Rite veggies, picked through Cortland apples, saw...
View ArticleAn Open Letter to All the Patients I Have Ever Cared For.
Originally written during my second year of residency. Now that I am an attending, I believe more than ever that patients “are our best and most effective teachers”. Dear Patient(s), Thank you for...
View ArticleDoctor as Patient.
It had been about two years since I last saw a primary care doctor. I was still living in New York City. My initial—and only—appointment with that physician lasted nearly an hour. The front desk clerk...
View ArticleBook Recommendations.
In an effort to post more often (and why not start on the first day of the year?), allow me to recommend some books. I read these books in 2012. You may wish to read them in 2013. The Three Christs of...
View ArticleDaily Schedule: Geriatric Adult Home.
A sample agenda as the consulting psychiatrist at a geriatric adult home: 8:20am. Arrive at the concrete building. Wave through the locked glass door at the woman sitting behind the desk. She pushes a...
View ArticleDaily Schedule: Homeless Outreach Team.
A sample agenda as the consulting psychiatrist with a homeless outreach team: 8:17am. Arrive at the office, which is in a tall building that is a short walk from the New York Stock Exchange. Speak with...
View ArticleDaily Schedule: Assertive Community Treatment.
A sample agenda as the consulting psychiatrist with an assertive community treatment (ACT) team: 7:55am. No one is at the office yet. Insert a key into the gate in front of the building. The gate makes...
View ArticleCPR and Informed Consent.
Radiolab recently aired a show called “The Bitter End” that discusses the end-of-life care preferences of physicians and non-physicians. Physicians are much more likely to decline “heroic” measures,...
View ArticleSaying Good-Bye.
I originally wrote the post below over five years ago. It’s about a teenager I worked with for about six months at a residential treatment center. I still think about him from time to time; I hope that...
View ArticleStoicism.
“I HEAR THEM! THEY ARE CALLING ME A CHEAP PROSTITUTE!” Her shouting is like a gas: It completely fills the space, regardless of the size of the container. The sound originates deep in her abdomen and...
View ArticleWhen I Grow Up…
When I grow up, I want to be a drunk. I want to wake up feeling restless and uncomfortable. It’ll be neat to drag myself out of bed to open that first bottle of wine. I’ll drink all of it within an...
View ArticleAutomated Psychiatrist Machine.
Are you tired of waiting fifteen minutes only to spend ten minutes with your psychiatrist? Do you hate rearranging your busy schedule, fighting traffic, and trolling for a parking space just to spend a...
View ArticlePersonality Disorders (VII): Where Does the Borderline Variety Come From?
Though I finished my last post with questions about treatment for antisocial personality disorder, I am going to change course and instead discuss the other two personality disorders for my talk first....
View ArticlePersonality Disorders (VIII): The Definition of Borderline.
If you haven’t read the proposed etiologies of borderline personality disorder first, please do so. An understanding of its causes makes the criteria seem less… judgmental and harsh. Following is the...
View ArticlePersonality Disorders (IX): Definition and Etiology of the Dependent Type.
There is very little data about dependent personality disorder. Psychoanalytic theorists have discussed their ideas about how this condition comes about, but there are few papers that discuss the...
View ArticlePersonality Disorders (intermission).
Forgive the lull in posts here about personality disorders. I am scheduled to deliver my talk this Friday. I’m directing my efforts towards creating a visually pleasing presentation and discussing the...
View ArticlePersonality Disorders to Difficult Interactions (I).
I successfully delivered my talk on personality disorders recently. The second half of the talk strayed from personality disorders to a discussion about how to manage difficult interactions with...
View ArticleContrast.
She was a petite woman. She thrust her shoulders back and her dark hair cascaded down in waves towards her slender waist. Her burgundy and white dress gently bounced with each step she took in her...
View ArticleDifficult Interactions (II).
Another reason to stop talking in the midst of a difficult clinical interaction1 is to recognize what you are thinking and adjust the language accordingly. The words we use to describe events, even if...
View ArticleReliability.
“There are images of my internal organs everywhere. Someone is collecting them.” “How do you know that?” “The sun produces radiation. It’s the same radiation that is used in X-rays. The sun shines, my...
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