I often observe — mostly with wonder and astonishment — that the US must be the most religious country in the world. Religion is not as strictly enforced as in, say, the Islamic countries. But it has permeated so many facets of our life, and so many people (according to actual polls) believe in God or a deity, the afterlife or heaven, punishment or hell and such parallel beliefs as angels among us, that we are constantly bombarded by religion or a reaction against religion as we go about our daily business. Speaking of which — while travelling recently, I read the USA Today which I found either at the hotel front desk or on some communal table in front of the breakfast bar.
That is where I found an editorial about religion, purporting to explain why religion was necessary. I mean, the author — Oliver Thomas — thinks religion is as essential to life as oxygen and water. I was raised in the Jewish religion and spent a lot of time in temple, as my father was organist and choir director all of his adult life. The only socializing my family did was at the temple, with breakfasts and holy day observances and things like that. I have always believed in a deity myself, not specifically in the way that the organized religions present it (as if to three-year-olds) and still have my own private rituals of prayer and meditation. That being said, this editorial disturbed me. Instead of ripping up the paper or making any attempt to answer it, I put it somewhere on the floor of the car hoping it would go away, but knowing that I would eventually have to deal with it in some manner. A lot of people seem to think that everything is in the world to support what they already believe. Thomas, the author, is way far out — past the people who, for example, read Ford advertisements after they buy a Ford to prove to themselves that they have made the right decision. Thomas, a member of the USA Today board of contributors (I guess you have to be able to write enough to fill their quota of space) and author of a book titled “10 Things Your Minister Wants to Tell You (But Can’t Because He Needs the Job)” writes an editorial that asks an intriguing question, but does not answer that question or prove what he contends. Read more on America: The Most Religious Country In The World…
Filed under Religion by on Sep 1st, 2010. Comment. 
She was 29 and I thought she was beautiful, although nobody else did, I am sure. No normal scales in my clinic could weigh her, but I would put her between four and five hundred pounds. Except for someone who brought her to see me ( I think, in the back of a pickup truck, but I did not press the issue) she did not leave the house. Others did her shopping, she had some kind of public assistance.
She was on the standard medication for her depression as well as her panic attacks; paroxetine (Paxil) 40 mg, to lower their intensity and frequency, and a little bit of Xanax, which is supposed to stop such attacks in their tracks. She used it sparingly, hardly at all — no really — she did not use it. It did not work. The most addictive medication doctors give for this sort of thing and she didn’t even want it because it didn’t work. I love this woman, I loved her candor. She told me the last psychiatrists had renewed these medications for the last six months, even though they didn’t work.
What was wrong??? Read more on Panic and Diabetes…
Filed under depression, Diagnosis, weight by on Sep 3rd, 2010. Comment.
I won’t even begin to start a list of the towns and cities, as it would take me too long to just remember them — much less write them down.
And with each place I’ve lived, I eventually start thinking that it is the most corrupt place I’ve ever seen — until I move to the next place.
It’s not news any more, really. From the White House through the Legislature and the state governors down to the mayors and city council and even the dog catchers (do places really have elections for dog catchers?) power corrupts and money flows to the corrupt politician. Read more on Political Ugliness and More About That Mosque…
Filed under politics, Religion by on Sep 6th, 2010. Comment.
I used to be the darling of the pharmaceutical industry. They gave me contracts to test their new drugs. They hired me to travel the country and speak at meetings of medical groups. I don’t think their current opinion is quite so flattering. I’m often asked, “Why do you hate prescription drugs? Why are you against drug companies?” And the answer is, “I’m NOT!” I strongly believe in using prescription drugs made by legitimate pharmaceutical companies in certain cases. In fact, I insist on it. If a patient who is aware of my facility in using natural treatments could do better with a prescription, that’s what I advise. If they refuse, I may decide to work with them on a second-best treatment, if it doesn’t run risk of serious illness or death. Otherwise, I tell them to find somebody else to give them natural treatments. I won’t risk their health or life. What I oppose is the politics involved with pharmaceutical companies and some of the things they have done. Read more on Why Big Pharma Gets A Bad Reputation…
Filed under big pharma, medicine, politics by on Sep 7th, 2010. 2 Comments.
I was working in psychiatry at one of those university medical centers, in a big city in the middle of a sparsely populated state. This 54 year old Caucasian farm wife had been referred to me by a surgeon — a rare state of affairs, since most of the surgeons I knew at that time and place did not believe in psychiatry and would not have referred a patient unless out of desperation. No note, no phone call to the front desk of the psychiatry clinic, no nothing. She just walked in and explained that the surgeon had basically kicked her out and said she was crazy. I asked her why they sent her. Her answer is so burned into my consciousness that I can give it verbatim these many years later.
“It really bothers me that I don’t have a belly button.” Read more on Somatization Is Something To Talk About…
Filed under Diagnosis by on Sep 8th, 2010. Comment.
It seems that the first television advertisement for medical marijuana has hit the California airwaves without a whimper. The first TV commercial just ran on a Sacramento station.
Having experience in many clinics from the Oregon border to the Mexican border, I can confirm that in most of California, medical marijuana is commonplace. It does not seem to be tremendously difficult to obtain, and I have attended many patients have valid prescriptions for it.
There is a list of conditions for which it is alleged to help, which is as long as your arm. Hearing about these conditions where cannabis is the preferred treatment usually causes me to smile, and I suspect that the list continues to grow with each new patient who wishes to use this remedy. Read more on Marijuana–The Only Drug Without FDA Approval…
Filed under Alternative Medicine by on Sep 10th, 2010. Comment.
He was 50 and he told me right up front, “I need more of the medications the other doctors give me. You can just renew them for me; that is why I am here.”
That’s probably the second most common thing a patient says to me. The most common is, “Why didn’t my other doctors tell me that?” No, I don’t just renew prescriptions, I explained to him. I told him that I need to get to know my patients, so that I can make sure that I give them the correct medications.
“I don’t want you to do that,” he said to me. “All the other doctors just give me renewals.” I told him I didn’t much care, that was not how I worked, and if he wanted renewals he would have to tell me how he was doing. Read more on Self-Medicating On Pot And Booze As A Life Plan…
Filed under Substance Abuse by on Sep 14th, 2010. Comment.
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.
I 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…
Filed under Prejudice by on Sep 15th, 2010. Comment.
I have been working with criminals longer than I care to admit. I suppose it is a condition of my accepting temporary consultation assignments, going where the need is greatest. A lot of work in prisons. Some with people later, during the parole process. Sometimes they are contrite — more often not.
I am still waiting to meet the smart criminal. The Moriarty to some law-enforcement-colleague Sherlock. The high IQ planner, the applied psychologist, the brilliant criminal.
Maybe they are so brilliant that they never get caught. Or – if crime truly does not pay – maybe they are the ones who go to those so-called “Country Club Prisons” after they have become wealthy from stock market schemes. They might get “classier” psychiatrists, males with receding hairlines and goatees who wear neckties. I know they don’t get better ones. Read more on Santa Claus, Tooth Fairy And Smart Criminals — All Myths…
Filed under Personality Disorders by on Sep 16th, 2010. 3 Comments.
She was 32 years old and a child of the streets. I wondered if she were a Down syndrome — what we medical types call the mosaic (partial) trisomy 21 — the chromosomal abnormality some still call Mongolism. This was purely an intellectual exercise, as the county health service would surely not pay for the expensive study, so I would probably never know.
Previous doctors had prescribed anti-psychotic medication, but she did not tolerate any of the various brands available through the county clinic. I had her try a little Abilify (arapiperazole) and it did seem to help when she remembered to take it. Or when she slept somewhere it would not be stolen.
Read more on Public Medicine — Cheap Is More Important Than Quality…
Filed under Public Health System by on Sep 17th, 2010.