Tag: J. Clin. psychiatry

Flat World Psychiatry

Earlier this year, I was in Bangalore on a brief vacation, eager to see India’s recent economic progress first hand. I was not disappointed—new flyovers, crowded shopping malls, gleaming glass buildings—the city was almost unrecognizable. One pleasant evening, I was sipping a particularly tart Mojito at one of Bangalore’s many new nightspots. The place was packed—confident and hip young things milled...
[Read More]

My First Day

Dr. Venkatesh, Professor of Psychiatry and Head of the Department, had a thick mustache and a permanently disgruntled attitude. “What is schizophrenia, I say?” he asked by way of greeting, as we stood in his small office, sweating in the Bangalore summer. “Sir,” I ventured, “it’s a psychotic disorder in which there are delusions, hallucina-tions, and decreased functioning.” I’d read a few pages...
[Read More]

Where Experts Are Many

Conversation 1 The resident handed me the phone. “The psych charge nurse thinks the patient should stay in the ICU,” he said. I glanced at my watch. My outpatient clinic was in 15 minutes. We had had a hard time convincing the family and the patient about the need for psychiatric admission, and now this. I took a deep breath. “Linda, how are you?” I said, in that cloyingly pleasant tone my voice...
[Read More]

Simple Fools

Ten years ago, as an intern, I was sent to a small village about 60 miles from Mangalore for a mandatory “rural posting.” It was a foreign world and I, a young and relatively affluent city-dwelling fellow, thought that the month was a terrible imposition. One evening, I was walking around the village market and came across a small shack where tea was sold. A group of old men were gathered around a rickety table....
[Read More]

The Paranoia of Prejudice

We’ve flown 24 hours, from Bangalore to Chicago. My 6-month old son has slept most of the way in a bassinet, but my wife and I, both battling a nasty cough, are exhausted. Before we can catch our connecting flight to Springfield, we have to first clear immigration. The officer looks at our passports, asks a few cursory questions, after which we are duly photographed and fingerprinted, like all...
[Read More]

American Idols

I enjoy watching “American Idol,” and I have not missed a single episode I this season. I suspect I watch the show for the same reasons that most people do—not for the singing, which frankly is a distraction, but for the human drama: the joy, the hopes, the dreams, and, in many cases, the pain of an almost delusional belief in one’s talents. “I can be anything I want to be” is a common refrain from...
[Read More]

Sweat

Freud probably never participated in a sweat lodge ceremony, or he would have had quite a bit to say about it. There was something distinctly oedipal about the medicine woman’s description of the ceremony: “The sweat lodge,” she said, “is like the womb of Mother Earth.” Unlike the more conventional conferences I’d attended in the past, this one—for integrative medicine—was open not just to...
[Read More]

Contagion

What made you want to leave?” I asked. “I just didn’t think the doctors cared,” he replied, referring to the orthopedic surgeons, although by all accounts they’d done an excel-lent job of fixing his hip. The surgeons had frantically consulted us, ostensibly for depression, but probably because they thought he was a “difficult” patient: the evening before he’d threatened to leave the hospital...
[Read More]

Until Death Do Us Part

Sometimes, my primary care encounters teach me far more about the complexities of being human, and about life, than any psychotherapy session. I look at the name on the chart before walking into the examination room. It’s Mr. Carlson, and the nurse has noted that he has had pain in his abdomen for the last 2 days. “Mr. Carlson, how are you?” I shake his hand. His wife’s face is buried in a recent issue...
[Read More]

The Death of a Buddha

Buddha (Sanskrit): “Awakened” or “that which has become aware” Let us suppose that you, a psychiatrist from 21st-century America,are transported back in time to the 5th century B.C., to a prosperous kingdom in northern India. You are a physician and, as is common in those times and in those parts, long before it becomes a cliché in the 21st century, there is no dis-tinction between mind and body; you...
[Read More]