October 6th, 2010 by Dinah Miller, M.D. in Better Health Network, Health Tips, Opinion
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“I have bipolar disorder. Can I be a doctor?” One of our readers asked this. It’s one of those questions to which there is no real answer.
Being a doctor takes a long time, it requires reliability, diligence, and a willingness to learn things you may not want to learn (organic chem anyone?) and do things you may not want to do. It requires endurance and passion. You need to be tolerant of many things: Arrogant supervisors, irritable colleagues, sick people who may not be charming and who may, in their distress, be downright nasty. You have to tolerate a militaristic order and be willing to work with a system that may be very difficult, wrong, and demand your obedience in ways that may be uncomfortable. (Oh, I am so happy to no longer be a medical student or a resident in training.)
So can you do it with bipolar disorder? Can you do it with diabetes? Can you do it with attention deficit problems? Can you do it if you’re disorganized or ugly? Read more »
*This blog post was originally published at Shrink Rap*
September 23rd, 2010 by Harriet Hall, M.D. in Better Health Network, Book Reviews, Opinion, Quackery Exposed, Research
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It infuriates me when someone misappropriates the word “science” to promote treatments that are not actually based on science. I have just read a book entitled The PTSD Breakthrough: The Revolutionary Science-Based Compass RESET Program by Dr. Frank Lawlis, a psychologist who is the chief content advisor for Dr Phil and The Doctors. There is very little science in the book and references are not provided. It amounts to an indiscriminate catalog of everything Dr. Lawlis can imagine that might help post-traumatic stress disorder (PTSD) patients.
He describes recent brain imaging studies suggesting that signs of traumatic brain injury are associated with PTSD. He thinks PTSD can no longer be considered a psychological condition, but must be approached as a complex biological, physical, psychological, and spiritual condition. He says many of these patients have brain damage. Read more »
*This blog post was originally published at Science-Based Medicine*
September 22nd, 2010 by DrRob in Better Health Network, Health Policy, News, Opinion, Research, True Stories
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The man who twirled with rose in teeth
Has his tongue tied up in thorns
His once expanded sense of time and
Space all shot and torn
See him wander hat in hand –
“Look at me, I’m so forlorn –
Ask anyone who can recall
It’s horrible to be born!
– Bruce Cockburn, from song “Shipwrecked at the Stable Door”
I found the discussion around my recent post about treating colds very interesting. Sick people come to the office to find out how sick they are. Most people don’t want to be sick, and when they are sick they want doctors to make them better.
Most people.
Some people want to be sick, and some doctors want to make people sick. I am not talking about hypochondriacs — people who worry that they may have disease and become fixated on being sick. I am not talking about malingerers — people who pretend to be sick so they can get medications. I am talking about the slippery slope of defining disease. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
September 21st, 2010 by Edwin Leap, M.D. in Better Health Network, Health Policy, Health Tips, Opinion
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This is my column in [the September 17th] Greenville News. It’s a follow-up to a recent column I wrote on the mental health “crisis” in America, as seen in our emergency rooms.
My last column addressed the unfortunate truth of the overwhelmed mental health system in South Carolina, and indeed in much of the U.S. While I lament the fiscal condition of our mental health system, and while I feel for those who truly need the help we are often powerless to supply, I would be a poor observer if I didn’t report the truth. And the second truth we must face is that much of what we call mental illness is neither truly “mental,” nor even “illness.”
Let me first state the obvious: The brain is an organ. It is incalculably complex and truly a wonder of design and engineering. But, it remains an organ despite its wonderful capacities. Therefore, it requires energy, its support structures feel pain, it may be injured and swell, it can bleed and parts of it can die when its owner has a stroke.
Sometimes the dysfunction of this fantastic organ, or of the chemicals which course through it, is manifest[ed] as mental illness. In certain cases, medications can restore the brain to normal function. Therefore, I am not suggesting that true mental illness is wicked, or reflects character flaws. I have met too many sweet, confused schizophrenics to believe either of those things. I am suggesting that too often we allow character flaws, unpleasant personalities, remorse over bad choices — and even, yes, wickedness — to masquerade as mental illness. Read more »
*This blog post was originally published at edwinleap.com*
September 16th, 2010 by Mark Crislip, M.D. in Better Health Network, Opinion, Research
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Humans love to find patterns in the world. Sometimes patterns exist, sometimes they are imaginary. Sometimes you can see a pattern that may be interesting and ignore its significance. As a resident I used to say that anyone who smokes three packs of cigarettes a day has to be schizophrenic. It was meant more as a joke when, in fact, it was later discovered that tobacco helps ameliorate the symptoms of schizophrenia. I need to pay more attention.
Part of my job is to look for patterns as a key to the patients diagnosis. Diseases and pathogens tend to (more or less) cause reproducible signs and symptoms and looking for that pattern is often the most helpful clue towards finding the diagnosis. Of course things are never as easy as one would like, as you have to consider whether you are seeing common manifestations of a common disease, uncommon manifestations of a common disease, common manifestations of a uncommon disease and, the hardest, uncommon manifestations of an uncommon disease. When I have a complex or uncertain cause, I explicitly run through that, and other, litanies so I do not miss a unusual diagnosis.
Chronic fatigue syndrome (CFS) has, at least to my way of thinking, two patterns. I see the occasional CFS patient in clinic and, I hope, pay attention to their disease patterns. I keep in mind I may be seeing a pattern that does not exist, but looking for disease patterns is what doctors are trained to do. Read more »
*This blog post was originally published at Science-Based Medicine*
