She was a depressed woman in her 50’s, on conventional antidepressants, who I saw in a clinic. She had none of the “neurovegetative” signs of depression. That means, she slept well and ate well and her mood was acceptable. All of the things that we generally measure in antidepressant response were there, so there was really not a lot more for me to do, except to renew the prescription. I did ask a few questions.
Did she have a purpose in life? Yes, she had a job in a bookstore, which she enjoyed, and grown children, who had babies of their own, and she loved to play with them, but they lived a bit of a distance away, so she could not play with them as often as she liked.
So I asked her what was the most fun in her life. She started laughing wildly, and stamping her foot. I knew this had to be a good answer, and I was ready. I thought she was going to talk about drugs or sex. I was really surprised with what she came up with.
Read more on Happy Dances and the Contact High…
Filed under depression by on Dec 3rd, 2009. Comment. 
Most of the times I am involved in “should-we-pull-the-plug” type decisions, it is at the end of life and not the beginning.
A “DNR” or “DO NOT RESUSCITATE” order simply means that if someone has a heart or lungs that cannot work on their own, the decision is made NOT to use artificial heart or lung type machines to prolong life. I have seen people sign their own documents to this effect.
As a matter of fact, I saw a DNR order signed by my father when he was in a nursing home, basically bed-bound, and it was a correct decision.
Filed under End Of Life by on Dec 3rd, 2009. 1 Comment.
Someone who “has it all;” a beauty queen from Argentina, seems to have died in an effort to improve her buttocks. A life risked, and lost, for a “firmer behind.”
Our friends at Wikipedia (I never had a patient who went for one of these) call it a “Brazilian butt lift,” so I expect it is some kind of a South American “point of interest.” The procedure, however, seems to have little to do with what happened to the ex-beauty queen.
Read more on A Tragic Loss: Beauty Queen’s Plastic Surgery Is Fatal…
Filed under medical errors by on Dec 2nd, 2009. Comment.
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.
“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…
Filed under Dissociative Disorder by on Dec 1st, 2009. Comment.
We want religious freedom, which is good. We do not want prejudice that is unfounded. We do not want people to preach or incite sedition. We have no interest in disguises of sedition as religion.
We have problems with anything that gets in the way of freedom. We love popular votes, and want to see the president of the United States elected directly some day, so the people have the sovereignty that Jefferson had in mind. Radical factions corrected by some sort of wisdom, perhaps divine in origin, that flows down among honest and intelligent and diverse groups, so that they somehow exercise a sort of internal control, and radical factions cancel each other out.
I have no idea how a referendum about minarets made it to the Swiss ballot. It seems that most people there don’t want these public symbols of the Islamic faith. There is a nice photo in the Wikipedia article of a plastic minaret of Turkish construction that someone put on a cultural center in Switzerland for what I suppose are religious reasons.
Read more on Minarets in Switzerland: Can’t We All Get Along?…
Filed under Prejudice by on Nov 30th, 2009. Comment.
I have sat silent for a long time, waiting for the news to come in from Fort Hood, waiting for people to understand and explain. Now, I have read and seen enough that I think I understand.
As always, my own life and experiences have been so rich and so diverse that I have an overwhelming memory or vision.
It was a California state prison; I have worked in a few. Religion was always especially popular within the prisons where I worked. I assumed, as did the mental health personnel in general, that it was because inmates felt so dehumanized and downtrodden that they could be expected to grasp onto anything that made them feel good. We knew and understood this.
I certainly maintained friendly associations with all chaplains. I considered them a bit idealistic, a bit naive, but I also considered myself that way. And in that feeling, that belief, that “give them the extra mile” feeling, I got some peace.
Still, I remember the day I was scared. I rarely ventured into the areas of religious worship, but once, just once, I happened to be out crossing the yard during one of the five daily times of Muslim prayer. I could not count the number of inmates, as they covered the yard.
Filed under Religion by on Nov 30th, 2009. 2 Comments.
There was one woman who gave me a bad time and to my knowledge, never did anything I recommended, although she came to see me for many months. As a matter of fact, I do not think that I ever figured out why she continued to see me for many months. It was back in my very first practice after I left academics, for I had left the “honor” that went with a University professorship thinking I could actually make some money.
I had walked into someone else’s insurance practice, and I was on all their panels, and I knew the patients would love me at least as much as they had loved her, for she was nowhere near as charming as I was.
Read more on Healthcare reform — Blame the doctors…
Filed under Healthcare reform by on Nov 24th, 2009. Comment.
This was the last item I posted on the blog Nov 6 before we took it down a few days later to start the overhaul. In case you didn’t get a chance to read it, I’m reprinting it.
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She was a saleswoman prone to bipolar mood swings, stable on a brand name prescription mood stabilizer. It had originally been marketed as an anticonvulsant and her medication was doing its job. She recently returned to full-time work after a manic attack had cost her both her marriage and the custody of her child.
“I don’t have the insurance I once did; I now sell home decoration instead of heating fuel like I used to. The money is better, but now all of a sudden the cost of my medication is really ridiculous. The generic is lots cheaper.”
Read more on What Happens When A Pill Gets Inside Your Body?…
Filed under Generic drugs by on Nov 20th, 2009. Comment.
I wanted to re-post this message now that we are starting a new round of articles. The reason is probably obvious — it’s a very personal statement. But also, it was only posted for a few days before we took the blog down to refurbish it. I hope you enjoy this.
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The opening sentence of Erich Segal’s novel Love Story asks the question, “What do you say about a girl who died?”
I think of that when I’m going to talk about Harry — my little brother.
Read more on Remembering Brother Harry — A Case of Asperger’s…
Filed under Asperger's by on Nov 20th, 2009. 1 Comment.
We always look forward to this time of year, when the holidays seem to slide down upon us like an avalanche.
The period from Thanksgiving to New Year’s Day are always a special time of year. But once they arrive, we often find outselves stressed-out, depressed — even broke.
Sign up for my newsletter in that cute box on the right and I will send you free of charge my new report 18 Ways To Enjoy The Holidays.
Whether you are having one of those traditional huge family gatherings or if it is just you and a loved one, I’ve got some suggestions to make the holiday season cheery and bright.
Enjoy!
Filed under News by on Nov 20th, 2009. Comment.