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Kindle Notes & Highlights
Luck and circumstances make us as different from who we might have been as cats are from dogs and birds are from bugs. There must be a point in paying attention to what goes on. My father’s fame falls into the one-in-a-zillion category. Had I told someone after my first series of breaks that I might go to Harvard Medical School, they would have upped my meds and canceled my dayroom privileges.
Most adults have forgotten what they had to do to survive childhood.
If you had told me ten years ago that today my patients would routinely have to wait eight-plus hours in an emergency room to get not-very-good care, that every day my staff and I would spend hours arguing and doing paperwork to have my patients get basic medications, that there would be six-month waits to see specialists, again with the blizzard of paperwork, and that psychiatry would be essentially unavailable for children, especially ones with mental health problems, I would have asked what backward third-world country we were living in.
When I open the office on Sundays to see acutely sick kids, it takes my wife at least twice as long to check a patient in and verify insurance information as it takes me to diagnose and treat the problem. There’s an excellent chance even with all that checking that the insurer will find a way to not pay.
I grew up thinking everything would be perfect if we just had a little more money. Instead the money just blew everything apart. Humans will money themselves to death the same way some dogs and fish will eat themselves to death. If the rich were truly so productive and useful, they wouldn’t have so many hired-gun talking heads with talking points, foundations, and institutes. Eventually most kings come to believe in the divine right of kings.
Having a not entirely reasonable expectation that things will go well turns out to be exactly the sort of delusion that increases your chances for success in this world, be it getting into medical school or whatever. If in fact you are skating on thin ice, the last thing you want to do is slow down and think about it.
this is supported by research.. optimists do better. Now, how to stop thinking about it..
I wanted to be a good diagnostician. There was a way of touching people that created trust and gave relief from the day-to-day way people treated one another.
The doctor’s job was to shut up long enough to let the patient be the most important person in the room, because she was. There was an unforced and absolutely real respect for people just because they were people. And we, as doctors, were their servants. For all the things that felt wrong, that felt right. If you weren’t an idealist, why would you go to medical school?
As soon as a new hurdle is set on the path to getting into medical school (organic chemistry, higher and higher GPAs, higher and higher board scores, extracurriculars, community service, moving personal stories, et cetera), the ability to clear that hurdle spreads through the applicant pool like the ability to resist penicillin spreads through a petri dish.
Some applicants were accused of trophy collecting. It wasn’t enough to be a concert pianist, work in a first-rate research lab, or save a small South American village. It had to come from the heart.
The bad behavior of others constitutes an attractive nuisance to someone recovering from mental illness. You need all your energy and wits for things that matter. Beyond a certain point, gathering further evidence of the hurtfulness and shortcomings of one’s family, employer, et cetera is like eating the same poisonous mushroom over and over and expecting that sooner or later it will be nutritious.
Twenty-five years ago, when I had a patient with a drug problem it was a big deal. I called people and they returned my calls and my patients got treatment. Treatment doesn’t exist now, not because it wasn’t effective, but because it’s less expensive for insurers to let addicts and their families drift into poverty and join the ranks of the uninsured.
All the arts are ways to start a dialogue with yourself about what you’ve done, what you could have done differently, and whether or not you might try again.
