Some of my friends like to watch cop shows — the ones called “Police Procedurals.”  They think it is exciting to see how crimes are solved and how police interact with puzzling situations. I’ve had my encounters with the police, too.  Sometimes they are very supportive when dealing with mental patients.  Sometimes they make things worse.  I’m pleased to say that many communities now have special personnel trained in handling mental health calls, and they coordinate with caregivers well — and treat the patients with understanding and a sincere desire to help. I was called in by a therapist when a patient was chronically suicidal. The therapist had to commit the patient to a mental institution and called the police to assist. I am thankful that she also called me to try to get the patient to go along involuntarily.  When confronted by a uniformed police officer, and looking at an ambulance or police car, a patient sometimes panics. Here is what I said: Read more on The Speech That Made a Cop Cry, And A Therapist Stand by Speechless…

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I have heard just a little too much about suicide among the religious — from patients, from others, now this; to the son of a published pastor who gave an invocation for the Obama folks.

I really do feel for the family, for death of the younger generation before the older one by any means including suicide by his own hand, is a horrible thing that is anti-nature and has a profound wrongness, a too-deep effect on all involved.

I was way back in residency when I attempted to gather some statistics on the association between religion and psychiatry in Kansas, sending a basic questionnaire on feelings about mental illness (and referral patterns to mental health professionals) to a big list of Wichita area “religious professionals.”
First, I had already made the assumption from the French part of my education that not too many people actually went to church, but none of them seemed to much care about mental health professionals.

In Kansas, with the world’s worst statistics (no major support on this from my

Read more on Religion — And Suicide…

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Nobody, but nobody, including a president of the United States, can tell a doctor what to ask about in an assessments.

Assessments are supposed to be in the strictest confidence, for openers.  Anything else would be against the rules of medical confidentiality.  Patients have a right to be seen alone.  The doctor has a right to decide what needs to be said.

Picture Of Elmer Fudd HuntingI can imagine the 2nd ammendment rights activists bursting a blood vessel if doctors are reqiured to survey patients about the guns they own and how they use them.  The requirement to have doctors do this would be — most everyone will agree — anti-American.

This being said, a question about firearms is and should be standard psychiatric practice.  When you are dealing with suicidal patients, which happens all too often in psychiatry, and the patient says that he or she is thinking about this, then it is absolutely essential to know if that

Read more on Doctors Asking Patients About Guns…

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Many people are proud of the state from which they came. But I value the state they (we, all of us) can go to.

It’s called a “Resource State.”

Don’t bother looking on a map – unless it is a map of the cerebral cortex.  Yet, it isn’t clearly defined as a location in the brain either.

I know it sounds mysterious, but it is easy to access and the benefits once you get there are astronomical.  I think I need to give you some illustrations to make my point.

Once when I was in prison (that always gets attention – but actually I was employed as a prison psychiatrist and not serving time for criminal activities) I treated a young man of 28 who was doing time for armed robbery.  His problem was depression with occasional suicidal ideation. Read more on The Resource State — Your Magic Ticket To Happiness…


I have seen more than I can count of them, veterans with chronic pain symptoms.  Nobody who serves our nation should be left to suffer.

In my world – nobody at all should be left to suffer.

I’ve worked in the Veterans Affairs system in many cities in several states and in various positions.  I’ve been the doctor who sits in the office and sees them one by one, diagnosing them and prescribing treatment.  I’ve been the evaluator who examines them and decides what kind of pension or how much disability they get.  I’ve been the director of day treatment centers where we try to give these noble servants of the people everything from activities to fill up their days, to continuing therapy for problems such as PTSD, and even food and shelter. Read more on How To Help A Veteran In Pain…

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I guess people have to worship something.

I certainly have seen people idolize people before.  Sometimes, to my amazement, when my parents managed to get me in the newspaper as a child for some alleged academic achievement, it was even me. Religion is something I generally avoid with patients.  I sometimes will admit that I say things like “God love you.”  As a matter of fact, I remember that my mother-in-law, Carolyn of blessed memory, said that sometimes, and I liked the feeling, and I suspect that is when I integrated it into my conversation, at least with patients who had limited time with me and wanted to discuss religion.

Read more on Celebrity Worship — The New Religion?…

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I wrote not long ago about the problem with sleep-deprived doctors.  Now I feel I must tell you that the person you are relying upon to perform delicate surgery may be so depressed that he’s contemplating suicide.

Why surgeons?  I used to be one and maybe I can shed some light.

Of course you can’t prove causality. Maybe just the fact that a person is a surgeon doesn’t mean he is at risk.  The same statement about “we can’t tell if there is something causing this or if this is an epiphenomenon” can be a criticism of almost any study, the way those invited to critique this study have spoken.

There is a problem, and this only hints at it.

Read more on Why Are Surgeons Committing Suicide?…

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He had tried to hang himself, and had managed to break some veins, maybe fracture a little cartilage, by the time his wife discovered him. It had been touch and go, I suppose, and a long time in the intensive care unit, but he had truly cheated death.

This 55-year old highly-credentialed university professor didn’t look the part of a depraved rapist — little or no hair, red-faced, bashful, perhaps — but that very accusation caused him such despair that he tried to take his own life.

A student had accused him of this horrible “impropriety.“

Obviously, these charges of sexual misconduct shamed him severely.  He maintained that the charge had been trumped up.  The woman who had accused him had indeed some kind of a psychiatric history.

It is not uncommon for women to make this sort of accusation.

A False Accusation May Be The Result Of A Broken HeartHe told me he did not want to hate women.  He also told me that he had a female judge.

I cannot help but think of the E.M. Forster novel “A Passage to India” which draws as accurate a psychological picture as anyone could of the sort of young woman who could make such an accusation.

Strangely enough, I could find essentially nothing about this as part of the psychological literature.  I did find a lawyer who had started a blog online, and said that this was a very large and essentially ignored problem. Read more on False Rape Accusations — Who’s The Victim?…

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She was a young female staffer in her first professional position.  What she may have lacked in experience, she made up for with a lot of heart and she extended her maximum effort for every single patient.

Dr. Goldstein posing with brain model when she was a neurosurgeon

Dr. Goldstein as a young neurosurgeon.

I had been like that in the beginning, too.  At first, you have no body of knowledge to draw upon, but you quickly learn every time a new patient comes in.  With experience, you see it becomes clear patients are more alike than different, and the work is at least a little less onerous.

But our newbie had a very few months experience with this intense clinical situation.  So every single patient was new and scary, and she gave her all. One week before she had dealt with one of the most difficult situations.

Read more on The Operation Was A Success, But The Patient Died…

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He was 19.  I saw that on his papers before I let him into the office. I knew it meant trouble.

Someone who was only 19 and was in the county mental health system had to be either big trouble or a big manipulator.  Working with adolescents is tough for me because I have to “set limits;” often yell and scream.  That is absolutely not my favorite way to be a psychiatrist, to read people the riot act.  But 19 year olds often need that.

The doctor is a catI sometimes have to be more of a surrogate mother than a psychiatrist.

He had been recently hospitalized for a “psychotic break.”  That is when someone who is alleged to be normal suddenly starts hearing voices and seeing things.  It’s not always mental illness — maybe some drugs on board, maybe some kind of stress.  At least I had the records from the hospitalization.

Yeah, drugs on board.  Some speed, some pot.  The “baby-momma” of his first child (God, was he proud) was no “fun” anymore.  She wanted things like child support — clearly not a “fun” request.

Now I have read some recent studies from other countries — this is not the kind of thing they do here — that when there is the risk of hereditary pathology you can feed a kid Omega-3 fish oil and maybe prevent this “psychotic break” —  or at least delay it. And yes — to me someone 18 or 19 years old is still a kid. Read more on You Can’t Help Me Unless You Are Like Me…

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