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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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If there is one time to get scared, it is when  a drug company, a government agency, a popular magazine article or – heaven forbid – your doctor says a metabolite is “better” than the drug it came from.

A metabolite is the substance that is left after the body breaks down (metabolizes) a medication.
  
Everyone in this picture know that oxycontin — read “morphine” — has lots of addiction-type problems.  Synthesized by the Germans in 1914, it has been around for quite a while, although not terribly commercially exploited until the folks at Endo Pharmaceutical started pushing it. Read more on Pain Killers Can Be A Prescription For Disaster…

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I eagerly add my name to the list of those who want to pay tribute to those who perished in the horrific tragedy of 9/11/2001, and also to those who assisted in any way, to those survivors who were spared by either chance or the dedication of the heroic people who responded and tried to help.

Firefighters responding on 9/11As a former EMT working my way through medical school and a veteran of the US Army medical corps, I honor those who volunteer to serve, and are called upon in times of extreme need.

There are many others rushing to praise the 9/11 responders, seeking glory for praising and honoring our American heroes, and it may not be a bad thing — for one level of human need.

Read more on 9/11 Tribute Ten Years Afterward…

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The first thing you get when you “in-process” into the Army — at least the first thing I got — was dog tags.  I had to decide if I wanted my religion on my dog tags, and tell the lady at the typewriter what kind of funeral I wanted. For all my ups and downs, I decided I would die Jewish, and get a traditional funeral, and make the Army find a rabbi.  I could put that on them with no thought of guilt. I had the option of putting my faith on my dog tags.  I was warned, in the most dispassionate possible way, that some enemies of the United States of America would kill me if it said “Jewish.”  I chose a resolution some co-religionaries had chosen in World War II.  I chose “Hebrew,” feeling more in common with the ancient faith than with the heavily politicized modern tripartite (Orthodox, Conservative and Reformed) ways of filling congregations.

Then I got my “Geneva Convention” card — Lavender and black and white, it said in 22 languages, roughly the equivalent “Don’t kill me.  I’m a doctor.” 

Read more on Doctors In Danger — Real, Physical Danger…

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Number 5 in the USA Today catalog of medical changes in the past 25 years is (imagine a drum roll playing – and CYMBAL CRASH!) — antidepressants are the most popular drugs. Read more on Antidepressants Are Popular — And Dangerous…

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It’s really a cliché’ and may have some basis in reality:

A psychiatrist (Male, of course) has his patient (female, of course) lying on the couch and telling about her dreams or playing “word association” or whatever psychiatrists do – and then they have sex.

But, fellows – if you really want to score with the babes, this is not the way to do it.  Medical school and post-grad studies are darned expensive and take years.  “Ladies Night” at the bowling alley will probably get you into the sack a lot sooner. Read more on Psychiatrists Behaving Badly…

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When I was a very junior neurosurgical resident in France, I always thanked my lucky stars I had not overused coffee.  Mme. M., who ran the cafe below my apartment throughout the first part of my studies, which were mostly classroom, had an Italian espresso machine and little demitasses (half-cups) of potent brew — so potent that I could not consume more than one in the morning.  Arabica, fragrant, and aromatic, it was a true joy.

After I moved closer to the hospital center, I heard for the first time the expression “pump yourself full of coffee.” (se pomper pleine de cafe)  It was foul tasting stuff, consumed in an infinity of Styrofoam cups, and strong — really strong.  There were rumors that it came from the same “common market supplier” as the wine, which was supposed to also be from a a mixture of common market (it had not yet become the European Union) countries.  All the food was free, as we were government employees.

Nobody ever figured out where the coffee had come from.

There was an open bar 24/7, about as well outfitted as Mme. M’s.  I was afraid to be in the same room with it.  I am delighted to report that I never saw anyone use it on an on-call night.

This is the place I could access a small bed — iron tubes for headboard and rails, mattress probably stiffened with starch.  The joke, which may well have been true, was that it was Napoleonic non-issue, meant for a barracks.

After the first night I lay upon it sleepless, answering a beeper that whenever it rang told me to call the operator and they would tell me who to call, my then-young back was killing me and I was fighting tears. Read more on Save Lives — Let Doctors Sleep!…

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I know some people think I’m not a sports fan – and I’m really not – and that’s why I harp on the negative side of sports news.

sports is my religion printed on a t-shirt

Why do you think so many ball games are on Sunday?

But the truth is that I’m a humanist and a doctor, and I continually wonder why our society is so dedicated to dangerous and destructive activities that – if they were not so profitable and so glamorized – should be considered insanity.

Every time a person – especially young people – dies during an athletic contest or practice, every time there is a tragic injury or accident while “playing games” I shudder.

Somebody died at a triathlon, and somebody else had something wrong.

Of course, the uneducated and, generally speaking, minimally-informed people who comment on such things say they think it must have been something in the water.

Read more on Glorification Of Sports Is Our Modern Major Mental Illness…

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Have you ever felt that your doctor just isn’t listening to you?Now multiply that by a hundred and you will start to understand what happens when a mentally ill person has a serious physical illness.

A news story on a recent study about how patients with a psychiatric diagnosis are prioritized at the bottom of the list when presenting at an emergency room induced a flashback when I was a young and eager resident psychiatrist on ER duty.

I was dedicated and enthusiastic – some said idealistic – and proud of knowledge obtained not without difficulty.  The event I recalled was a 39-year-old schizophrenic man coming in with chest pain and trouble breathing.  Maybe he seemed a little young for a heart attack, but gasping for air, clutching his chest and crying with pain. Serious complaints that ought to be treated seriously until proven otherwise. Read more on Mentally Ill Have Low Priority In Emergencies…

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