Where the Sick are the Most Cherished and Revered

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He was young and had never smoked. Yet at age 56 he was diagnosed with metastatic lung cancer. Cancer had gone to his liver by the time they found it. Then the negotiations began.

Could he get in to see an expert within days not weeks? Would his insurance authorize the tests the doctor wanted? How much time could he and his wife, who would need to take care of him, take off without losing their jobs and also be able to pay the bills? When he was feeling very sick could he be seen at the time of his…


Kristina--this is important stuff and I am glad you are giving it voice. As a psychiatrist I hate to hear when someone copes with an N by saying : "F--- then, they are pieces of s---." They are cultivating the same devaluing that a narcissist uses to deal with conflict. You can stand strong and look them in they eye and say "I do not like that" or "I do not agree with you." You may be scarred but you must keep your dignity intact for the future. Please keep up this writing.


Will it lead to a world war again?

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On May 29, 1919, Arthur Eddington tried, for the third time, to confirm Einstein’s theory of General Relativity. He sent an expedition to the African island of Principe and went himself to the Brazilian town of Sobral to observe a solar eclipse. If Einstein was right, the eclipse would show a small displacement of light rays exactly as predicted by his equations. The weather cooperated and a few months later Eddington presented his findings to the world. The rays of light bent just as Einstein said they would. …


A careful review of your psychiatric history is due before receiving this label

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In psychiatric practice, a sad but common thing to hear is, “I’ve tried everything, and nothing works.” The person giving this history may have any disorder: Depression, Bipolar Disorder, OCD, or others. The story is, unfortunately, the same: many years of hard work without much relief. What should the clinician do? Diagnose them as treatment-resistant and move on to those treatments?

I do not believe, after 25 years of psychopharmacology practice, that this is the right way to go. After my many years of clinical practice as well as teaching medication use to psychiatric residents at Yale, I have heard…


Disability, Chronic Illness, and Passing Your Time

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Nothing to Do

For me, a chronically ill, disabled individual, there is a phrase that I can only speak to people like me. If you speak it, it has a different meaning.

“I have nothing to do.”

I recently lost a connection I had to a volunteer job. This job, though quite small, was my connection to the world. Now, I have nothing to do. And if I say that to my friends, they kindly acknowledge my disappointment, but do not understand what this job meant to me.

My life, your life, is…


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I was raised in a Roman Catholic community where most people went to church. Early in my teens it struck me that although most people seemed to be strong believers, outside of church they would talk about non-Catholics with no sense of dissimilarity or inequality. Being Jewish, Baptist, or nothing in particular was no different than being Irish or being an accountant. Our system of beliefs in the most important things in life was just one among others outside of church.

I liked this live-and-let-live attitude. But on another level, I didn’t understand how belief worked (as I did not…


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As a psychiatrist who studies the effects of social change on mental health, I was very interested to know how the COVID pandemic would affect our emotional well-being. The question here is not about being infected with COVID. Rather, it encompasses all of the effects on people’s lives as a result of the pandemic. I was among many experts who predicted significant increases in the entire spectrum of mental disorders as a result of COVID in affected communities. My own predictions included a further layer of negative consequences than those forecasted by my colleagues.

In general, I am sad to…


A psychiatrist explores cultural bias and the history of medicine

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One of the first patients I saw in medical school was an elderly man dying of metastatic colon cancer, which had spread to his bones and was excruciatingly painful. I was shocked and heartbroken when I saw him beg the doctor for more pain medicine than the modest doses he was receiving. When I asked the attending physician if we could increase the dosage, I was told “no, he’d become an addict.” This was incorrect, illogical, and inhumane — as it turned out, the man died in agony. He would have never become an addict and even if he did…


A psychiatrist notes the life moments that hurt most

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In my out-patient psychiatric practice, I recently treated a young man who had, among other problems, severe acne. He told me that his dermatologist had begun a new treatment. My patient asked the doctor how long before there might be results. The dermatologist replied, “It depends on your emotional state.” Something inside the young man leapt with excitement to hear this, as he thought he might finally have the chance to talk about his chronic anxiety. But the dermatologist simply concluded the appointment and told him to return in a month.

This patient did well in treatment with me. In…


Only solid training and consistent education of practitioners can protect us

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Among the various medical specialties, some have the difficult job of distinguishing normal life changes from illness. How much weight should a pregnant woman gain? When should a toddler learn to walk? How sad should you be after a major loss in life? For each question, there are clear normal and clear problematic areas. There is also much room for uncertainty. Competent clinicians recognize the gray zones and know how to work with patients to navigate their way through.

However, gray zones are also fertile grounds for fads to develop. We have all seen them in pregnancy, child-rearing, and these…

Mark D Rego

Dr. Rego has practiced psychiatry for over 30 years. He also teaches at Yale Medical School. He is writing a book on mental illness. https://markdregomd.com/

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