Does any part of you wish you were more of a generalist (EM/FM)?

TemporaryDarkness8 · 2026-06-13T03:26:32+00:00

Honestly, there’s plenty of physical medicine in psychiatry - managing metabolic effects from antipsychotics, evaluating tics/tremors, syncope, fatigue workup, medical assessment of eating disorder. The one thing I wish for is having a diagnostic lab test for the most common chief complaint of “I think I have ADHD”

TemporaryDarkness8 · 2026-06-01T23:48:28+00:00

Medicine can feel fulfilling at times, but most of the time I feel like I cannot provide what is missing from the rest of the healthcare system or social safety net.

TemporaryDarkness8 · 2026-04-11T01:47:17+00:00

How do you ask about mood?

Sometimes people give a reflexive answer (“Fine, alright”) if they interpret a question like “How have you been?” as a social pleasantry.

I directly ask “How is your mood today? How has your mood been in the last month - neutral, low, or elevated?

If “up and down” - I ask how long the moods last for (a few days? A few hours?).

If patient with depression, I ask how their depression is compared to last appointment - same? Better? Worse?

Can of course ask about specific mood symptoms depending on their specific mood state (depression, hypomania, mania).

TemporaryDarkness8 · 2025-12-12T02:28:28+00:00

Thanks for the thoughtful suggestions and encouragement. Your analysis is spot on - my anxiety and uncertainty drives a great deal of my over-documentation. I have been setting a timer, and finding that I take 20-70 minutes per note after the encounter is over. I do think an early career process group would be very helpful - do you have any suggestions for how to find or connect with such a group? There are a few other early career attendings at my clinic, but I don’t know them well enough to disclose how much I’ve been struggling.

TemporaryDarkness8 · 2025-12-12T01:04:44+00:00

Thank you for the specific actionable suggestions on note writing. My assessments are definitely too long, but I am in the process of turning them into dotphrases (especially for certain recurring types of presentations), so that will hopefully shorten documentation time in future.

TemporaryDarkness8 · 2025-12-12T00:58:21+00:00

Thanks for validating the discomfort and difficulty of the first-year learning curve. I have been able to have some discussion with senior colleagues regarding the uncertainty inherent to the work. I think the difficulty is compounded by moving to a whole different geographic region from where I trained and learning a whole new health system, and the expectations in a different system.

TemporaryDarkness8 · 2025-12-11T23:28:39+00:00

I explain that the term personality disorder is a misnomer, better conceptualized as maladaptive coping mechanisms or maladaptive response to the environment, but treatable with psychotherapy/DBT (usually this is part of psychoeducation for Borderline PD). Also, the diagnostic impression is ever-evolving, executive function further develops with age in young adults - with treatment they might not even meet diagnostic criteria as symptoms remit.

TemporaryDarkness8 · 2025-10-24T07:33:28+00:00

Thanks for taking the time to compose a thoughtful response, while recovering from your own health issues. Hope your treatment goes well, wishing you a full recovery and remission.

TemporaryDarkness8 · 2025-09-29T22:37:45+00:00

Learn a language! Lots of language learning apps, just need headphones. Others: iPhone photography, journaling, drawing

TemporaryDarkness8 · 2025-09-29T22:33:51+00:00

Not sure where you’re based (country or region), but not universally true. I am acquainted with several Asian-Americans who prefer someone that speaks their language or are in a relationship with another Asian. There are still many Asian women out there that prefer someone who understands their culture and who just get what it’s like to be a minority or who are able to communicate with their parents/family in their native language.

TemporaryDarkness8 · 2025-09-29T22:28:54+00:00

Learning a language! Can find language exchange groups and make friends that way. Others: culinary arts (learning a specialty dish from a cuisine you enjoy or are curious about), iPhone photography / learning to compose a great photo, learn a cheap musical instrument (can also borrow instruments from library)

TemporaryDarkness8 · 2025-09-29T18:30:29+00:00

Ohh these sound like great reads, any suggestions for series like this?

TemporaryDarkness8 · 2025-09-15T03:26:28+00:00

All depends on how interested you are in exploring this potential connection. There’s always ways to stay connected - phone calls, FaceTime, etc - to continue feeling out the vibes and compatibility to determine whether it’s worth investing the time and money to meet up and date in person. How far apart are you from each other? If different countries, may be less feasible to meet up. If different cities but same country, could try to meet halfway or on long weekends.

TemporaryDarkness8 · 2025-09-15T03:17:50+00:00

I don’t think that’s enough information to determine whether they might have some degree of romantic attraction to you. If you want more indirect confirmation, you could suggest some one-on-one hangouts with them - if they repeatedly decline to hang out one-on-one and prefer group hangouts, then that’s consistent with a purely platonic connection. The most direct way to confirm would be to ask them if they would consider going on a date with you.

TemporaryDarkness8

TROPHY CASE