Research in psychology abounds, but “naturalistic” research does not.
I am impressed by these nice female medical doctors on the faculty of the University of California School of Medicine in San Francisco for the work they have done. Read more on Medical Student Evaluations…
Here is an article that is what researchers call a “meta-analysis.”
That means that plenty of people have done research on something. So somebody throws together the statistics from several articles, on similar things, to give them more “power.” To show that they are pointing at one strong inference of proof. Read more on Doctor’s Burn Out Like Rocket Ships…
Filed under depression, Diagnosis, Doctors, News by on Dec 8th, 2019. Comment. 
I always ask patients about alcohol.
They always minimize their use.
Mostly all of the patients who have psychopathology and make it in my door name “stress” as the causal factor in their illness. Read more on Alcohol? Who Are They Kidding?…
Filed under Alternative Medicine, News by on Nov 8th, 2019. Comment.
My French medical school professor of bacteriology, Mme. le Professeur Jeanne Orfila, stood in front of her (our) class near tears. She was not the sort of woman who frequently fell into that state, so I vividly remember the day she told us this:
“Prescribe antibiotics carefully, and only when you have to. Every time you prescribe antibiotics, you are creating more and more bacteria who will “learn” to make themselves resistant to antibiotics. So they will work less well against human disease. Read more on How Many Deaths Will It Take?…
Filed under Alternative Medicine, medicine, News by on Nov 5th, 2019. Comment.
It is bad that women get sexually harassed in the workplace.
I have often had as my patients such victims. Sometimes I start them from zero. I sound like I am barking some sort of feminist manifesto. Read more on Women Getting Equal Pay With Men…
Filed under News, Sexual Misconduct by on Nov 4th, 2019. Comment.
My medical career has so far encompassed training in multiple specialties (general and orthopedic surgery, neurological surgery, neurology, psychiatry, and psychopharmacology). I have practiced in France, Canada, the United States Army, and more States of the United States than I can name.
I have been sexually assaulted and harassed more times that I could count. “Bullying,” is common in medicine, often viewed as a necessary process of “toughening up” to deal with the all too frequent tragedies lived with by patients. Read more on Me Too…
Filed under abuse, life, Mental Illness, News, Psychiatrists, Psychology, Sexual Misconduct by on Nov 3rd, 2019. Comment.
It had been a routine email, the kind I ask my husband (total personal assistant) to arrange on my letterhead.
Although this young woman had been a psychiatric hospital inpatient for suicidality a few years ago, she was doing fairly well. We spent most of the time talking about her future education, and choice of profession. Read more on She Could Handle Money…
Filed under depression, Family, life, News by on Oct 27th, 2019. Comment.
Psychiatry is an imperfect science at best. It is by no means a “pseudoscrience,” although it is frequently blamed for being same.
I have known LOTS of honest, decent people who have (I think, sincerely) seen psychiatric research as a difficult attempt to elucidate truth about the human animal. Read more on The “Crazies” are not very violent…
Filed under Diagnosis, Doctors, Government, Mental Illness, News, Psychiatrists, Violence by on Oct 27th, 2019. Comment.
His mother had been seeing me and they had signed mutual releases. Mother wanted me to see him as soon as possible, because he was “nervous and unable to sit still at all.”
When he came, he denied a “nervousness” which his mother thought looked like “attention deficit disorder.”
I can’t treat what people don’t think they have.
He described problems with his girlfriend and his mother, since his mother had told him he could not go to a party in the home of his girlfriend’s family on the bad side of town, “where they would just as soon shoot you in the street as say ‘hello.'”
He sounded like he had pretty routine mother-and-girlfriend problems.
She contacted me on the weekend, worrying about him frequenting strip clubs, something I had not asked about and he had not told me about. Sometimes, she said he became so angry she physically feared him.
Their two narratives were simply inconsistent. I drew the line at her feeling scared of him physically.
I told her about “tough love,” and I told her if that happened again, to call the cops.
My husband reminded me of the ultimate authority in my profession — Hugh Laurie as “Dr. House” — who repeatedly said on television in public for all the world to hear, “Patients lie.”
Which one of them? Maybe both of them. I told her what I had told them; and would indeed, tell anybody who gave me the opportunity. I can try a session with the two of them together and help to resolve things, but I could not promise that it would resolve things. I would try. I always try as hard as I can to do the best that I can.
She said she knew this to be true.
I had told him and also told his mother on the phone, that the hardest thing a young man (or a young woman) ever had to do in his (her) life was establishing themselves as an individual distinct from parents. This usually meant a period of confusion before resolution. There may be (and there was) some confusion about vocational direction, too.
One can only press forward. The ability to communicate openly is precious, and irreplaceable.
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Filed under Alternative Medicine, depression, Diagnosis, Disease, Family, life, medicine, Mental Illness, Personality Disorders, Psychology, relationships by on Oct 11th, 2019. Comment.
A new patient came in this week, referred by a trusted therapist. She had been sexually abused at approximately age 7. She was depressed.
She was on a combination of an antidepressant and a sleeping pill. It seemed to work as well an anything would. The medications were the same kind of medications that I would generally use. Older, reliable, out of patent (more than 7 years old) and thus available in cheap generics.
When I asked her how much of her depression it had made go away, she said “50%.” I ordered my usual list of blood tests. They seemed exotic to her.
We couldn’t even tell if they were things she got ordered in her “annual physical.” She had some kind of blood tests done a month ago. She was reluctant to have more drawn, so I told her we could get the old ones. She looked relieved.
?Relieved?
She was visibly overweight. She had paid a well-known diet center to follow their plan. She had gotten down to her “target weight,” then gone on to gain back most of what she had lost.
She was plagued by seborrheic dematitis. This is not usually a difficult thing to control. She could cut her hair (which went down past her shoulders). She could wash it daily with the prescription shampoo that her primary doctor had (correctly) prescribed. She could wear a little cap, perhaps like the sequiny little one that I showed her I had worn that day.
It was plain to see on her face that I was frustrating her, I just seemed to have more solutions than she had problems.
She asked me if she could return for her next appointment in a month.
She was not suicidal.
I made it clear that if I waited one month I would not increase her medication, for she would have to stay on the same if I were to wait so long until seeing her.
She didn’t mind.
She was not alone among my patients to feel as she felt. I have always failed to understand patients such as she.
Her previous psychiatrist and her previous therapist, had dragged her along for approximately two years.
She had contributed to paying their living expenses, with her fees. Maybe they had improved her status some. I mean, to be fair, I had not seen what she had been like when she started.
Depression is common. Far and away the most common of psychiatric illness, no matter what measurements or statistics you believe.
There are aspects of it that clinical trials of medication have shown, time and time again, get better. Things like sleep, appetite, mood, concentration.
Enjoying life, living your dreams, and such do NOT respond to medication.
Having the desire to correct things than annoy you and make your life better; that is somewhere between spirituality and magic for many of my wide-eyed depressed patients.
Sometimes I am angry at my colleagues. They seem to have accepted the limitations put upon them by government and insurance and economics.
This does not much help the patient.
It takes more than a couple minutes in my office to pump up these things.
I have said “stay tuned” before, but now I must try to bring this message to more media.
Science exists, and ought to be serving humankind.
Stay tuned.
Filed under abuse, depression, medicine, prescription drugs by on Sep 30th, 2019. Comment.