June 17th, 2011 by AnneHansonMD in Opinion
No Comments »
The voice at the other end of the line was angry and accusatory: “You didn’t even talk to me! You never knew my son! You didn’t talk to any of us!”
I explained to her that since she had never even met the defendant, there was no way she could have any information that would be relevant to the accused’s state of mind at the time of the crime. The victim and the defendant were total strangers and there was no apparent reason for the killing, which made the crime even more tragic. Her son was dead in a random incident, in a crime that was unquestionably motivated only by the defendant’s untreated psychiatric symptoms.
The defendant’s family was equally shocked and horrified. They were all hardworking solid citizens, with no history of criminal contacts, substance abuse or mental illness. When their daughter started getting sick Read more »
*This blog post was originally published at Shrink Rap*
June 13th, 2011 by Davis Liu, M.D. in True Stories
No Comments »
Dr. Mehmet Oz recently had a piece in Time titled “What I Learned from My Cancer Scare” in which he became the the more humbled Mr. Mehmet Oz. As noted previously here, Dr. Oz last summer had a colonoscopy at age 50 and much to everyone’s surprise had a precancerous colon polyp. He was advised to follow-up again for a repeat test in 3 months.
As the Time magazine piece noted, he didn’t return for 9 months despite repeated reminders from his doctor.
From this experience, he essentially stumbled upon what has been challenging American medicine and primary care. How do we enable patients to do the right thing and get the screening tests done and treatments necessary to avoid premature death and maintain a high quality of life? As a highly trained professional, Dr. Oz knows the risks and benefits of not doing a preventive screening test. As a doctor, he knows all of the secret protocols and codespeak we use when calling patients or asking them to see us in the office for important matters. As a doctor, he also understood the importance of a repeat colonoscopy to ensure no more colon growths.
Yet he didn’t return for 9 months. Why? Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
June 5th, 2011 by Shadowfax in Opinion, True Stories
1 Comment »
In my Monday post, I posed a challenging real-life dilemma we recently faced in the ER. As always, I modified the posited case from the actual facts but the broad outlines were true to life: A young person of questionable capacity wants to refuse lifesaving treatment.
Short answer, for those not interested in the discussion: This case is a no-brainer. You intubate. In this case, sadly, the outcome was not good. As I hinted, early hypoxia in the setting of blunt chest trauma is a bad sign. The patient was intubated, but became progressively more difficult to ventilate over the next couple of days and subsequently died. The family was at the bedside and, from what I understand, they were very happy to be able to be with him in his final hours. On the other hand, due to his drug abuse, he proved extremely difficult to sedate (even on max propofol!) and was agitated and combative, in restraints, until hypoxia began to take its toll. While I am confident I did the “right” thing, the tally sheet is decidedly mixed as to whether was beneficent in its effect.
Discussion: Read more »
*This blog post was originally published at Movin' Meat*
June 2nd, 2011 by Dinah Miller, M.D. in Opinion
No Comments »
Here at Shrink Rap, we often talk about the stigma of having a psychiatric disorder. It’s funny, but society has it almost ranked, so that certain illnesses are very stigmatized–schizophrenia and schizoaffective disorder, and borderline personality disorder, to name a few, and others are pretty much socially acceptable: Attention Deficit Disorder, for example, especially among the high school/college crowd where the patient often gets identified (or self-identifies) as the source for those late-night stimulants that so many kids cop.
It’s not just the patients. Psychiatrists are also stigmatized, and that doesn’t help much when our society talks about the shrink shortage.
Exalya writes:
I’m a first (almost second) year medical student with a strong passion for psychiatry. I love listening to your podcasts; you give me hope for my future when the drudgery of first year classes is getting me down, and I feel like I always learn something useful.
That aside, I am writing to you seeking some advice. Read more »
*This blog post was originally published at Shrink Rap*
May 29th, 2011 by Steven Roy Daviss, M.D. in Research
No Comments »
You know that 1979 Boomtown Rats song, “I Don’t Like Mondays.” (This Youtube music video features a very young-looking Bob Geldof.) The song is about the 1979 shooting spree on a Monday morning at a San Diego elementary school. The shooter’s only state reason for doing it was that she didn’t like Mondays.
The silicon chip inside her head
Gets switched to overload
And nobody’s gonna go to school today
She’s gonna make them stay at home
It turns out that — contrary to popular impression that Mondays are the worst day of the week — Tuesdays are the worst day of the week. According to a piece by Chris Hall (@hallicious) on HealthCentral, Tuesdays are the worst day of the week (moodwise) while Sundays are the best. This is based on mood rating scores from 500 users of the Mood 24/7 service, which HealthCentral licenses from Johns Hopkins University. After you sign up for the free service, the software sends you a text message at random times, and you text back your mood rating for that day.
So, you’d think that the latest date of the coming apocalypse, October 21, might be on a Tuesday. But it’s not — it’s on a Friday. Maybe it will get moved again.—–
*This blog post was originally published at Shrink Rap*
The voice at the other end of the line was angry and accusatory: “You didn’t even talk to me! You never knew my son! You didn’t talk to any of us!”
