Denying and Romanticizing Mental Illness

Reactions to mental illnesses or disorders vary. (I wrote about some of them in a 2012 essay in the pages of The New Atlantis.) I’ve noticed, however, that some of the responses among physicians differ from their reactions to other medical pathologies. There are several reasons why this might be the case, having to do with the fact...

A World of Nightmares

O Rose thou art sick. The invisible worm, That flies in the night In the howling storm:Has found out thy bed Of crimson joy: And his dark secret love Does thy life destroy. — William Blake, “The Sick Rose” As I rotate through psychiatry, I have noticed that certain facial features and dispositions uniquely characterize diseases. I...

In the Clutches of Depression

Oh, that this too, too sullied flesh would melt, Thaw, and resolve itself into a dew, Or that the Everlasting had not fixed His canon ’gainst self-slaughter! O God, God! How weary, stale, flat, and unprofitable Seem to me all the uses of this world! Fie on ’t, ah fie! ’Tis an unweeded garden That grows to seed. Things rank and...

On Evidence-Based Medicine

Physicians throw around the term “evidence-based medicine” a lot. Whether it’s an antibiotic, IV fluid, or blood-pressure pill, the decision about how to use a drug often comes down to the question: is the treatment evidence-based? But what does that mean? Evidence-based medicine is “the conscientious, explicit, and...

Pregnancy and Awkward Realities

I can’t think of a more awkward social situation for a single, twenty-six-year-old male to be in. A previous experience as the only Jew in a room full of Catholics singing songs about Jesus didn’t hold a candle to this. I was observing a group of fifteen pregnant women discussing pregnancy and getting pregnancy screening tests. Nurse...

Labor and Delivery

The obstetrics nurses rushed the stretcher through the triage station as the resident tore out of her chair and followed them. I jumped up and ran with her. It was the second night of my obstetrics rotation and there was no time for triaging this patient, who was on the verge of giving birth. And because she spoke almost no English we...

When the Patient Becomes a Specimen

He lay in the hospital bed, belly-up, staring at the ceiling. We knocked as we entered and asked the patient a barrage of questions. How was he feeling? What doctors had he seen in the past? What other medical conditions did he have? When did he first start to notice uncontrolled nosebleeds? What other symptoms did he notice? An endless...

The Costly Complications of Emergency Medical Care

During one Emergency Department (ED) shift, EMTs brought in an older woman to the hospital. She had called emergency medical services (EMS) and explained that she had low blood sugar, or hypoglycemia. Hypoglycemia can lead to coma, brain damage, and death as well as other more minor symptoms such as tremors and sweats. But when the EMTs...

Imagine

Imagine, for a moment, that your kidneys have failed. Perhaps you had longstanding, uncontrolled diabetes. Or, you might have had persistently high blood pressure (hypertension). You could not afford your medications, you refused to take them, or you never even visited your doctor and thus never knew you were sick. Whatever the...

A Day in the Life, Part 2

This post continues my description in the last one of a day in the life of a medical student on rotation, where I’ve left off at lunchtime of an inpatient service day. During the afternoon, the work of executing plans continues. If the team discharges a patient, that patient needs a follow-up appointment in clinic to make sure...