PTSD

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It is hard for me to digest the events of July 14 in Nice, France, as I feel especially close to them.

I was present at seven such annual patriotic ceremonies during my tenure as a student of medicine in a French government facility.  I loved the street-fair atmosphere, where I sang at the top of my lungs and danced with a whole heart.

As a medical student in government service, a terrorist attack would have mobilized me into service of France, a nation I can only love, which gave me a medical education essentially free of charge, asking only for me to prove on an exam that I had what it takes.

I wear a tiny Eiffel Tower around my neck — I stroke it as I write. Read more on Terrorism In Nice…

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I remember a supervisor from the past whom I never thought had the right personality to be a psychiatrist.  I mean, he was a little angry and domineering for my taste.  But heck — I gave him a “bye” since he worked in a prison context.

I was never attacked by a prison patient through my tours-of-duty through four (all-male) California state penal institutions.  I had a couple who ended up on their knees, crying, stroking my hands, or even asking permission to kiss me (denied, of course).

They said I was “nice” to them.  I guess I treated them like human beings — something pitifully lacking in the prison system where everything seems oppressive and depersonalizing. Read more on Assaults On Psychiatrists…

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The current rate of suicide among soldiers should make us angry, maybe enough to destroy our computers or, heaven forbid, write to congress or even try to stop war.

I checked out this institution¸ the National Center for Veterans Studies, the best I could.  I am not sure why the Department of Defense and the Department of the Air Force seem to have a love affair with this division of the University of Utah.

Of their current projects, some of the proposed studies are randomized clinical trials of various therapies as suicide preventives. I am a great believer in research.  But there is one question I am asked frequently, still, although I evaluate research but am not currently engaged in it.  People ask me if I am a doctor first or a researcher first.  There is absolutely no contest.  I am a doctor first.  I want lives saved, first. Read more on Why Soldiers Commit Suicide These Days…

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I am a veteran.

Military. American. U.S. Army.  Medical Corps.

This is truth.

WWI poster Gen Pershing and Uncle Sam

Uncle Sam Urges Gen Pershing On From France To Germany

Along with being a fairly knowledgeable physician with over 30 years experience, it still seems incredible and unbelievable to at least some of my patients.  It is not in their experience to know women who appear on the surface to be feminine and attractive who have been in the military.  Admittedly, these things were never brought up until I lost a massive amount of weight (half my body weight) but there they are.

Every time I get a chance, I thank a veteran with a handshake for defending – in these very words — “this great nation.”  This seems to be a custom that has crested, for I have not met anyone else who does this lately.

Even though I tell people I am a veteran, too, almost nobody thanks me back.

Read more on This Memorial Day, Thank The Live Veterans And Honor The Dead…

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I get blazing mad whenever one of those knee-jerk “patriots” cry, “You don’t support our troops!” if anyone should criticize the military, our government’s foreign policy or any specific wars, invasions or other actions we’ve taken in this brave new millennium.

I was in the peacetime United States Army. Since my honorable discharge, I’ve served several Veteran’s Administration medical facilities in several states, and in private practice, I’ve made a special study of the treatment of Post Traumatic Stress Disorder – which the military routinely denies even exists and doesn’t even try to treat in many VA facilities.

Yes, I was in the Army, and No – I wasn’t in combat. Nevertheless, with the idea of war always hanging over my shoulder, my life was different. I never really understood the “grunts” — the infantry without appreciable rank — who wanted nothing more than to see “action.” Read more on Can’t We All Just Get Along?…

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I remember vividly and will never forget when a home-made bomb blasted the Alfred P. Murrah federal building in Oklahoma City, Oklahoma. It was April 19, 1995, and I was in the midst of morning rounds at a major hospital’s inpatient psychiatry unit.

A lot of people were “decompensating” — going psychotic, had beliefs the world was coming to an end and needed extra medicine.

They called it the worst homegrown terrorist attack on U.S. soil up to that time in our country’s history.

I thank the basis of my personal belief system that I was not closer to the explosion at that time, and that I was not personally involved in the later and more catastrophic attack on the Twin Towers of the World Trade Center in 2001. Read more on Which Should You Choose — Therapists Or Friends?…

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Most people don’t seem to understand how disability benefits work – and that includes doctors as well as patients.  There’s a very good reason for that. The system is screwy.

Thinking that your own regular doctor might be prejudiced and just dish out disability benefits ad infinitum so you never have to go to work (Gee – where did the government get that idea?) the patient is sent to an outside doctor to do an evaluation.

I’ve done plenty of those in my day. I’ve done them for veterans and for Social Security and for worker’s comp and even such exotic things as employee plans for large corporations (such as GM and Ford) and unions (like the Railroad Workers). Read more on Diagnosing For Dollars…

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The old guys were right.

Cover of The Maltese Falcon by Dashiell Hammett (1930)I mean the really old guys, the ones who wrote over one hundred years ago.  The guys like Freud and Janet who said that mostly everything that shapes people’s lives seems to be trauma — whether or not modern authors agree.

I have seen an anorectic whose trauma was a passer-by in a crowd who told her that she was too fat for anyone to have sex with, and then keep walking. I have seen a sufferer of OCD (obsessive-compulsive disorder) who was told she was filthy when she was a kid.  She later became so excited about cleanliness she missed nights of sleep to tidy the living room.

But although very real causes of pathology, these seem too trivial to be real traumas for most people.

Others are too horrible to be denied. Read more on PTSD From Sexual Trauma — Learning That Life Is Not Always Fair…

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When we talk about sending troops out to fight with numbers that have lots of zeros on them, chance are that nobody is thinking about how the lives of the survivors will never be the same.

PTSD SoldierRecently, ABC News made an attempt, a praiseworthy attempt, to help people see at least a little of what the human devastation means. “PTSD” stands for “post-traumatic stress disorder,” which leaves lives devastated.  People come out with devastated personal relationships, often unable to maintain marriages, unable to maintain jobs, with sometimes a high potential for violence.  The devastation all too frequently progresses to suicide.

Adding to this the fact that the bureaucratic institutions do not generally encourage or even permit the most efficient means of treatment, we have a domestic mess and a domestic mortality of veterans, the very people who put their lives on the line, that is nothing short of horror.

Read more on PTSD — Often Denied, Resistant To Mainstream Treatment…

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I was in my psychiatric training.  My supervisor and clinic director had booked me to see a patient.  I was often booked for some very difficult patients, because I am good at this sort of thing.  But he warned me about this particular patient.

“She is not a patient we want to follow in this clinic.  Just see if she needs medicines, and give her a little bit.  The psychologist will do the work.”

I thought he had to be kidding, as I prided myself on being an all-around psychiatrist, and I wanted to take care of everything psychiatric.  Especially while in training, under the malpractice coverage of the University, with their supervision.

Split Personality“They say she has multiple personality disorder.  We don’t believe in that diagnosis.  We leave it, as much as we can, to the psychologists that do.  This patient is a mess.  Lots of commitments, lots of suicide attempts, lots of restraining orders.  Let the psychologist do it.  Stabilize her quickly on medication, and get her out of here, with monthly checkups, then bimonthly.
Read more on Multiple-Personalities — Rare, but they happen…

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