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What Makes A Conversation “Psychotherapy?”

Years ago I had a student who repeatedly asked me how psychotherapy works. “How is it different than a conversation?”

When I think of psychotherapy, I think in terms of the talking itself as being the aspect that helps — and yes, of course it can be used in conjunction with medications. I think of it as being structured — in terms of time and place and frequency — and being all about the patient. And whether or not it’s actually discussed, some of what works is about the relationship — most people don’t get better talking to someone they despise, and the warmth, empathy, feeling listened to and cared for, well, they’re all important. And I also think of it as being a process over time. These are all parts of my definition, however, and they may not be parts of yours. Read more »

*This blog post was originally published at Shrink Rap*

Female Cosmetic Genital Surgery: Should It Be Done?

I seem to be asked more often these days if I do vulva reduction surgery. I’ve even been asked if I “refresh” vaginas (in which I refer them to their gynecologist.) I’m happy it’s a extremely small part of my practice.

I’m also happy to see that the current issue of Reproductive Health Matters is taking a close look at cosmetic surgery, especially female cosmetic genital surgery. Read more »

*This blog post was originally published at Suture for a Living*

The Impact Of Attitude On Life

Life sometimes gets in the way of daily posting. Specifically, the treadmill of life sometimes roars too fast.

But as I strolled through the hospital this morning, there was a plain piece of white paper taped to the wall around the nurses station. Although I’m not overly religious (and even highly conflicted about which rituals are the right ones), these words from a pastor/celebrity stopped me for a moment:

Attitude

The longer I live, the more I realize the impact of attitude on life. Attitude, to me, is more important than facts. It is more important than the past, than education, than money, than circumstances, than failures, than success, than what other people think or say or do. It is more important than appearance, giftedness or skill.

It will make or break a company, a church, or a home. The remarkable thing is that we have a choice every day regarding the attitude we will embrace for that day.

We cannot change the past, we cannot change the fact that people will act in a certain way. We cannot change the inevitable. The only thing we can do is plan on the one thing that we have, and that is our attitude.

I am convinced that life is 10 percent what happens to me and 90 percent how I react to it.  And so it is with you. We are in charge of our attitudes.

As a cardiologist programmed to “alert” most of the time, words such as these help me. I haven’t seen the studies yet, but I’m guessing that positive attitudes reduce inflammation, which is good for our atria, and our arteries.

JMM

*This blog post was originally published at Dr John M*

Can Stuttering Be Contagious?

Recently I was seeing a patient who was left with somewhat of a stutter after a prior stroke. It was a long history and probably longer for the patient, who had to work very hard to be understood through an unwanted speech impediment.

Inexplicably, when I walked out of the room I started to stutter, too — I wasn’t trying to make light of the patient’s problem, and I had to stop talking for a few moments before I could speak in my normal cadence.  It was super-strange, like my brain heard the new cadence and said “Oh, that’s how you do it.”  Awful.

It was embarrassing and weird. Fortunately the patient didn’t hear it, and I apologized to the staff who did. I have no idea why my mouth-brain connection picked that anomaly to repeat. Strange.

Anyone else have this?

*This blog post was originally published at GruntDoc*

When You Get Sick: The Character Of Those Around You

There’s an endless list of bad things about being sick. But what happens to the relationships you have with people around you when you become ill?

Let me tell you about a man I know. I will call him Bill, even though that’s not his real name.

Bill is a vital man in his 60s with two grown daughters. A few years ago, he was diagnosed with a serious illness. His illness isn’t going to kill him right away, but it has profoundly affected his ability to work and enjoy all the things he used to enjoy. Worse, he has had a difficult time with his doctors figuring out what exactly is wrong and the best way to proceed.

But all of this isn’t really the hardest part for Bill. The hard part for Bill is how his friends and family have reacted. Read more »

*This blog post was originally published at See First Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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