Posts Tagged ‘Virginia’
January 2, 2013 | by Sadie Stein
“Now is the accepted time to make your regular annual good resolutions. Next week you can begin paving hell with them as usual. Yesterday, everybody smoked his last cigar, took his last drink, and swore his last oath. Today, we are a pious and exemplary community. Thirty days from now, we shall have cast our reformation to the winds and gone to cutting our ancient shortcomings considerably shorter than ever. We shall also reflect pleasantly upon how we did the same old thing last year about this time. However, go in, community. New Year’s is a harmless annual institution, of no particular use to anybody save as a scapegoat for promiscuous drunks, and friendly calls, and humbug resolutions, and we wish you to enjoy it with a looseness suited to the greatness of the occasion.”
—Mark Twain, letter to Virginia City Territorial Enterprise, January 1863
September 27, 2012 | by Sadie Stein
August 28, 2012 | by Maureen Miller
According to every epidemiological study of medical-student mental health ever published, a large percentage of us suffer from, well, something. The discussion sections of these research papers generally propose we educate one another in mental hygiene. They suggest we should practice more “mindful medicine.” And, good students, we oblige. A medical student may not come into med school knowing how to handle a “high-functioning” anxious type in clinic, but the diagnosis doesn’t require an office pamphlet. It’s visible right there in the room.
At my school, we first learn to integrate this understanding of acute and chronic anxiety into clinical practice via the required six-week psychiatry clerkship. Six weeks of immersion in “ICU psychiatry,” the psychiatry faculty argues, is not enough time to master the management of anxiety disorders, but at least it is something. Third-year medical students spend six weeks on one inpatient psychiatry ward as well as several night shifts in a CPEP (Comprehensive Psychiatric Evaluation Program), the ER for the ill at ease.
In these settings you learn to triage threat and fear until you know from anxiety. There you learn the difference between anxiety and agitation. Panic-attack patients stay in the ER for a while for cardiac and thyroid workups. Anxiety in the CPEP counts as psychosocial stressors, or Axis IV on the DSM-IV: losing your edge, losing your family’s support, your job your benefits, your place to live. Maybe you will have an adjustment disorder on Axis I, or existential anxiety that keeps you off your axis. Agitation is losing your cool, and sometimes losing your hospital gown if you’re especially feisty. For anxiety there is benzos and SSRIs; for agitation, benzos and antipsychotics and sometimes four point restraints. They call the agitation cocktail a 5+2, for 5 milligrams of Haldol and 2 milligrams of Ativan, though I saw one “frequent flyer” get a 10+4.
March 20, 2012 | by Sam Stephenson
From 1993 to 1995 I stumbled in two graduate programs, first economics and then religious studies. I was undone by advanced calculus and cultural theory—couldn’t handle the rigor of either, the puzzle of value unsolved. The abstract challenges of school were leavened by my job at Quail Ridge Books, an independent store in Raleigh. There, I shelved hardbacks and backlist paperbacks by Baldwin, Banks, Berger, (Amy) Bloom, Boland, Gass, Grumbach, Gurganus, Le Guin, L’Engle, Malamud, McCarthy, Mitchell, Munro, Walker, Wideman, (C.D.) Wright, (Charles) Wright, (Richard) Wright; I managed the magazines and literary journals, worked the cash register, and made friends with the customers.
I met the late Don Adcock there. A jazz flute player and the longtime band director at North Carolina State University, he first heard bebop in 1945 when he stepped off a battleship in San Francisco and wandered into a joint where Howard McGhee was playing. Fifty years later he would walk into the store and instantly identify whichever jazz musicians were playing on the house stereo—Tommy Flanagan, Hank Jones, Al Haig, Dexter Gordon, Zoot Sims, Lee Morgan, Bunny Berigan—and he knew all the songs, too. He often visited the store with his wife, the poet Betty Adcock, who taught at the local Meredith College as well as at Warren Wilson. Don and Betty became critical sources of encouragement for me as my writing developed, and I spent many afternoons at their Raleigh home—a modern, postwar structure with a flat roof surrounded by heavy woods.Read More »