Surgeon Atul Gawande’s book, Being Mortal: Medicine and What Matters in the End, has a lot to say about the unintended consequences of doctors’ failure to acknowledge the dying process. Here’s a case of a young woman whose complicated grief over her mother’s death reflects this failure.
Our current cultural model for conditions like anxiety and depression uses language like “chemical imbalance”, implying that suffering is related to our brain chemistry. In this post, Dave Keith offers another perspective that looks at our moods as dynamic states related to the context of our living patterns.
Many doctors feel under pressure to prescribe medications to patients with even moderate anxiety or depression. But it doesn’t have to be that way: Here’s a case of a physician with courage and imagination who takes an unexpected path to help her patient.
“Chemical Imbalance” has become a generally accepted way to think about psychological conditions like depression and anxiety. But David Keith offers another perspective: In fact, emotional problems may be a sign of mental health.
Check out the moving tale of courage and pain on the part of this impressive Saudi woman.
Good physicians take a clinical history in the interest of arriving at a diagnosis. While the clinical history is a review of ‘facts’, there are in fact, few ‘facts’ about human experience. Different examiners will get different histories depending upon what they ask about. Different family members give different reports of the same set of events. In my view clinical histories are a form of fiction pretending to be ‘objective’.
The idea of being “ruthless” sounds jarring at first, until we realize how it’s an essential ingredient in healthy living, both personally and professionally. It speaks to how we maintain our integrity in the face of demands for conformity.
Dave offers his reflections about what it’s like to be a psychiatrist disguised as a family therapist. Hint: The language is different, and no medications required
This Family Medicine hospital consultation involved a mute patient who had just had her leg amputated. The hospital staff was angry at her. Then this young doctor took the time to learn what was going on and everything changed.
Understanding and changing family relationship patterns can make a huge difference for kids diagnosed with ADHD.
Part of the appeal of the “chemical imbalance” metaphor is that it people don’t have to feel ‘guilty” about their depression, or problems with their kids. But it can keep both patients and therapists from getting to the all-important bottom of things.
The logic of “chemical imbalance” persuades both patients and practitioners that context and subjective experience are not important. But that logic interferes with the understanding the person’s pain, and what it’s made of.
Check out this Op-Ed from The New York Times by Internal Medicine physician Danielle Ofri. She cites a recent Canadian study which shows that empathic, caring conversation from their physical therapists actually reduced the patients’ pain more than a medical procedure designed to treat their condition.
How Mental Distress Can Masquerade as Disease: Here’s a live case story which shows how grief can manifest as abdominal pain.
Check out actor Meryl Streep as she receives the Lifetime Achievement Awards at the Golden Globes. She is a model in courage. We need to emulate her.
Check out this insightful Op-Ed by writer Jonathan Raban. He talks about the use of language, especially, the cruel joke, as preferred weapon for dictators to demonstrate their power.