0

It happened several years ago, when one of the immigrants of Mexican origin I frequently saw as a patient in the poorer counties of California came to see me and pulled a pen and a steno pad out of her purse.  My Spanish was a bit more rudimentary than it is now. She was matronly, with mostly grayed hair in the classic bun.  She asked me if I could spend a few extra minutes with her.  I told her I would take all the time I could, and try to serve her needs. It wasn’t her, she said.  It was her youngest daughter, aged 13.  Read more on Delayed Gratification And Life…

0

My family wanted me to see “Fiddler on the Roof: because it celebrated the “shtetl” — the little Russian village like the one where my “Bobie,” my grandmother of blessed memory, lived before she emigrated to the United States. I did not see it until it reached our local movie theater.

There was one line in that musical that burned upon my personal soul more than any other.  It is from perhaps the most famous song from that production, “If I were a Rich Man.”  Tevye, the poor little old milkman is daydreaming about what his life would be like if he were a wealthy man. Read more on When The World Encourages You To Gain Weight…

0

People often want to know something about their psychiatrist.

There is this thing called “transference” where their past relationship history can certainly color what they think and feel. I have no big secrets to hide from my patients, so I can usually be direct and take only an insignificant amount of time on these issues. Usually it just takes one of my stabs at humor.

For those to whom religion is an important facet of life, I am often asked about my beliefs. I often end up saying things like, “I am very sorry I am Jewish and not the Christian you would have preferred, but do you think Christ could work through a crazy old Jewish lady like me who would work really hard to help you feel better?” A “yes” and a laugh and we get straight into the meat of things with that one. Read more on Liberal or Conservative — Different Brains or Different Opinions?…

0

Mindful Eating

As you will read elsewhere, I am back after an extended absence and I am not only in a new place, but doing new things.

My first outside project is obesity treatment, with a generous share of my methods and philosophy to help those of you who want to lose weight.

My own weight loss was quite dramatic — approx 200 lbs — and I’ve kept the weight off for about 5 years now. How did I do it — drugs? surgery? diet and exercise?

No — I used some really plain old common sense and research supplementation.  Together with the proper mindset, this is what will give anyone the longest lasting and safest weight loss possible.

I’m sharing with you a portion of a new book that I will publish soon.  Here is a taste, as we say in the dieting business: Read more on Mindful Eating…

0

I never smoked.  In my family, it was simply not an option.  My grandmother of blessed memory used to stand at the front door and kick out anybody who opened a box of cigarettes on the concrete stairs coming up to the front door, let alone anyone who actually looked as if they were or would smoke.

My father of blessed memory swore once that when he tried to bring home a buddy from Harvard who was smoking and appeared poorly dressed; my grandmother kicked him out at the door. Read more on Everybody Knows Smoking Is Bad — So Why Do Some Still Do It?…

Filed under Addictions, Government, News, politics, tobacco by on . Comment#

0

He was just 18. He had been followed by child psychiatry with a diagnosis of depression. He had long refused to take any pills.  As far as this poor, agricultural county was concerned, I was just seeing him so I could bill MediCal and fatten up the county coffers. The previous psychiatrists had simply noted he was depressed, was not suicidal, and refused any participation in his own treatment.

He was a young man of few words, with a common Hispanic name.  He sat there and twirled one of his lush curls. It became pretty obvious he wasn’t going to give me a complete history.  He said he would never take pills, not ever. To his credit, he did say I could talk to his mother, if I wanted to, but he had to be in the room and hear what she said. Someone brought her to me, from the waiting room.  She spoke only Spanish; fine with me. I learned my Spanish mostly from my patients, who in that time and place could rarely communicate well in either Spanish or English. His mother was charming, really grateful that I wanted to talk to her. She kept complimenting my clothes and elegance. I told her it was all thrift shop.  I doubt she believed me. Read more on Diagnosis From The Guts…

0

She was an administrator at the rural branch of a county mental health system. A therapist by training.

On the classical scale in the hallowed paradigms of the twentieth century, a psychiatrist like me who had sacrificed (or in other cases, put on hold or marginalized) her biological destiny — well, a psychiatrist like me would have been the head of the team.  I would have sat at the head of the table with those who had not survived anywhere near as many years of authoritative education silencing each other to hear authoritative pronouncements. But she was the chief, not me. Read more on The Language and Culture of Psychiatry…

Filed under culture, News, politics, Psychiatrists by on . Comment#

0

My telephone was cradled between my left ear and my shoulder, as I pounded the keyboard of the sluggish rural county computer with one of the requisite patient visit fill-in-the-blanks atrocities — er, I mean “reports.” Finally, I heard the person I was waiting for pick up the other end.
“Hello,” I said. “Is this doctor A…….(name unpronounceable to native speakers of English)?”
-“Yes,” he answered, “I am the only doctor here.”
“This is Doctor Goldstein. I am one of the psychiatrists at the county mental health clinic.”
-“Really? And you call me?” Read more on The County Mental Health Clinic’s Referral…

0

Okay, so my Continuing Medical Education Provider gave me every imaginable disclaimer on this one.

Abstracts at a meeting, so the demands were not as rigorous as for published articles. There could be confounding factors. A British study; maybe they aren’t wired the same way us yanks are. People who take a nap of at least a half hour during the day have lower blood pressure 4 mm. lower 24 hr. average systolic than folks who don’t. Espresso, on the other hand, raises blood pressure. This study was done on Italians.  Are they wired like us? Drinking enough espresso may also be increasing the incidence of type 2 diabetes, by some kind of an effect on long term glucose (sugar) metabolism. Read more on Helpful Hints From A Former Caffeine Fiend…

Filed under Disease, Education, medicine, News by on . Comment#

0

One of the themes that keeps coming up in those little “newslets” for 15 minutes of Continuing Medical Education each is that systematic screening for several serious diseases, like cancers, is simply not as efficient as one wishes it were. At the very least, in terms of cost, it rarely pays. Sometimes people try to identify a subset of people who should be screened; but all too often, even that is a daunting task.

Some stalwart and doubtless realistic physicians sometimes suggest–screen patients who ask for it. This seems strikingly similar to the young doctor in Amiens who told me, that if he wanted to build a practice and feed his family, he had to give everyone antibiotics. It is that ancient trend of anti-intellectualism, patients who second-guess the doctor, people who are worried about their health– And yet, these people could argue that (they have paid their health insurance and earned what they think is good care), and they are individuals and not statistics. Read more on When To Screen For Things Medical That Could Kill…

Filed under Doctors, Education, medicine, News by on . Comment#