… from the Annual Meeting of the Washington State Psychiatric Association:

Drug reps. I was disappointed, though not exactly surprised, to see the cadre of pharmaceutical reps with their colorful posters for their respective drugs. I avoided eye contact (to the point that I can’t even tell you what they looked like, other than they were dressed in dark suits and wore shiny shoes). My peripheral vision nonetheless caught sight of the Rozarem table. I hate that.

The fat cats and the drug reps. Some of the uppity members of the association specifically instructed us to go speak with the drug reps because “without them, we’d have the meeting in the basement of some hospital”. They also suggested that we collect the available “free goodies”; from his brightly colored Namenda bag, he pulled out a flashlight emblazoned with some drug logo, several retractable pens of questionable quality that were plastered with names of other drugs, and other colorful and extraneous office supplies.

“As you can see, I’ve made my way around the tables,” one man proudly said, pulling open his coat to display six drug pens poking out of the pocket of his dress shirt.

I wanted to throttle them all.

Tea. Bigelow’s Constant Comment Tea, in my opinion, tastes better than the Orange and Spice Tea. I, however, prefer black teas to fruity teas.

Money and politics. Some of the association members (the same ones who were touting their “free” drug rep items above) essentially implied that in order to influence mental health legislature, psychiatrists need to proactively give large sums of money to people in politics (i.e. “I’ll scratch your back if you scratch mine”). One man dryly characterized this system as “legitimate bribery”—which it is. What a sad way to effect change—what ever happened to the individual merits of social problems? or integrity?

Suicidologists. They consistently deliver talks that contain solid scientific evidence and urgently remind us all that complacency about suicide has absolutely no place in our line of work. Their presentations are consistently engaging, stimulating, and motivating; they renew my own fervor in working with people with complex problems. I wish I could say that all of my supervisors demonstrate this level of enthusiasm.

Physicians for Social Responsibility. While in medical school, one of my classmates founded a chapter of Student Physicians for Social Responsibility (SPSR). I was the webmaster for the chapter’s SPSR website and maintained it for a year. Upon graduating from medical school, I forgot about PSR—until today.

I appreciate the “systems” view that organizations like PSR endorse: Medicine, like everything else, does not exist in a vacuum. Consider the issues of obesity in America. Education about proper nutrition (on a gross level, not a micronutrient, “you need these exact amounts of carotene, biotin, and omega-3 fatty acids in your diet” sort of way) is lacking. Highly processed and unhealthy meals at McDonald’s are significantly cheaper than healthier options (fruits, veggies, etc.) at the grocery store. Many major metropolitan areas do not offer incentives for people to become pedestrians (more exercise) and use public transportation. It doesn’t matter that doctors are constantly counseling patients to eat healthier foods and exercise more; society does not facilitate achievement of these objectives and, really, the path of least resistance is the most appealing.

Now that I actually have my medical degree, it is time to join Physicians for Social Responsibility.

Sexual conversion therapies. … in the context that they are ultimately harmful. There are obviously strong social, religious, and political forces at work in generating support for these controversial therapies (that lack any data) that tout the necessity of changing (”curing”) one’s sexual orientation from homosexual to heterosexual. The speaker (a psychiatrist who is a vocal opponent of these “reparative” therapies) provided an apt analogy: There was a time when left-handed people were forced to become right-handed, though they were never fully “converted”. I’d like to think that this is a fair comparison, though that may be an overly simplistic approach. (There are certainly enough societal pressures to be heterosexual; maintaining one’s identity as a homosexual is not the path of least resistance.)

Role models. The primary reason why I attended this conference was to receive an introduction to a specific form of psychotherapy (based off of concepts of mindfulness and acceptance) from one of the best psychotherapy supervisors I have ever worked with. I learned many skills from him and only wish that I had more opportunities to be his pupil. His ardor for and dedication to education also resonates with me.

I hope that we all have teachers that we deeply admire and idealize; not only do they inform our thinking and practices, but they also teach us to perceive the world differently. Often, this can help us to make positive changes in our environments—where “environments” may mean our friends, family, peer group, neighborhoods, schools, cities, the planet… I (idealistically) believe the butterfly effect is possible.

The last time I sat in a classroom setting for eight consecutive hours was during my second year of medical school—I had forgotten how stimulating and exhausting it could be. I love to learn—people joke that I am a sponge—and the possibility of making the world a better place (even if only one person at a time) through newfound knowledge may only be a dream, but one that I believe is worth pursuing.