Curbside consult


In the July 2015 issue, summarizing the Cape Cod symposium, PL argued that there is a need for: 

“...being willing to be biological when faced with a disease, but being willing to be existential when faced with the limits of living.”

This idea helped me to appreciate that understanding "the limits of living" from that existential view is essential to understanding how ascribing suffering to the limits of living is not dismissing them; it is not a failure of empathy.

I focus on interacting with colleagues in primary care. The quote above nails the central dilemma. Far more than 50% of consults which I receive as a psychiatrist revolve around a single question: "How bipolar is she?” Or, put another way,: "In addition to trauma, does she also have some bipolarity?" Or, in your language: Are these just "the limits of living" (albeit harsh limits, which so many patients experience), or is there also some biological component?  

In residents' shorthand, PTSD yes; but is there also something else, or is it just PTSD? 

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PL Reflection

The experience of being disastrously wrong is salutary; no economist should be denied it, and not many are.  The best, most elegant and most applauded designs can fail, and greatly to your surprise if, in persuading others of their excellence, you have persuaded yourself.

John Kenneth Galbraith

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