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What our patients are sometimes asking when they ask for a medication change or dose increase is a different type of help altogether - the type of counseling and wisdom and gentle prodding that we, as physicians, are able to offer but too often do not.
I focus a lot on my own work-life balance and not just because I have to write about it once a week. I feel like I am continually scanning my time, energy, and schedule to determine if I am “in balance” or not. I’ve been pleased with the changes I’ve made - some suddenly and some gradually - which are putting me closer and closer to work-life balance nirvana.
Twice in the last week, I’ve really listened to my patients who came in complaining of worsening depression and anxiety. (This isn’t to imply that these are the only two patients I actually listened to in the last week!). In both cases, the patients were already being treated for a mood disorder and had been stable for a long time. In both cases, the patients were seeking a medication adjustment. In both cases, when I finally determined the nature of the problem, I realized there wasn’t a chemical fix for their problems.
Neither of these patients was suffering from worsening major depressive disorder or generalized anxiety disorder, although they carried these diagnoses and received medication to treat them. Rather, they were having a normal response to extremely challenging professional and personal demands. It is so much easier to increase the dose of fluoxetine than to help a patient confront the truth of her life which may be that there is no easy way out - only hard work and learning how to say no.
For both of these patients, I drew from my own experiences and shared how I also struggled at times with bosses who placed insane demands on themselves, in the process indirectly placing those same demands on the people who work with them. I also sympathized with the extreme stress of trying to be there for a family member who cares less about their own problems than everyone else around them does. I was glad that I took the time to ask the necessary questions that led to self-realization for these patients.
I think looking for the pharmacologic fix is innate in human nature. Some people seek a cure in what I can prescribe, some seek the cure in high colonics or Dr. Oz’s latest vitamin recommendation, but everyone is looking for the “fix,” myself included sometimes (although I draw the line at purging toxins from my body with anything other than water). But, what our patients are sometimes asking when they ask for a medication change or dose increase is a different type of help altogether - the type of counseling and wisdom and gentle prodding that we, as physicians, are able to offer but too often do not.
So, my work-life balance challenges had an unexpected benefit this week, as I was able to share a totally different type of medical knowledge with my patients, in my best attempt to offer the right type of healing.
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