What Started Me on the Path to Whole Psychiatry?
Mother-in-law’s Thyroid Problem
In 1988, when my mother-in-law, who was ill with cancer had radiation and chemotherapy I had my first understanding of the limitations of the standard medical model. Noticing that her thyroid level [TSH] was a bit high, 8.0 (with an upper limit of 7), I sheepishly asked her internist if he would consider some thyroid hormone. Humoring me, he gave her a small dose of synthroid. This got her TSH just under the upper limit of the normal. When I asked him to give her more, as it was helping her, he refused, saying ‘She’s fine, she is in the normal range now’.
Intuition Prods Me
I didn’t have the confidence, experience or knowledge to argue, or the ability to get another opinion. My intuitive discomfort with his response prodded me to study thyroid function much more closely.
Referred Patients to Endocrinologists
While I was getting my feet wet in this area, I would regularly send my patients to endocrinologists to determine if they might have thyroid problems (based on their symptoms and borderline normal lab tests), but the answer was always the same.
Thyroid Hormone Helps Many
Eventually, when I became comfortable enough, I began to prescribe thyroid hormone and noticed that indeed it was helpful to people who I thought needed it. I eventually hired a statistician to compile my data on 104 patients, and do statistical analysis. We found that the TSH level above which thyroid illness was likely was 1.4. As it turns out 10 years later, the NHANES study indicated this exact number is the norm in the US population.
Mother-in-law’s Death Prompts Deeper Study
And so, several years my mother-in-law died, I finally had enough experience to know that she was indeed myxedematous (severely hypothyroid) and that her internist simply didn’t know better. Fortunately, her suffering has been an impetus for me to learn more and more about the underlying physiological problems that lead to chronic illness.
Reading Lab Tests Properly
I now know, that without a doubt, the quality of my mother-in-law’s life was seriously compromised by a lack of understanding of a fundamental principle of medicine: Lab tests are to be read with an understanding of function, not as black or white, normal or abnormal. Lab tests nearly always reflect a dynamic changing system, and when understood in that context, one does not wait until organ failure before treating. The goal of lab tests is to find signs of insufficiency and treat as soon as possible—way before actual disease develops. This is one of the basic underlying principles of the Whole Psychiatry model.
The Joy of Seeing Patients Get Well
My passion is helping people get their bodies and brains working properly so they have the energy and clarity to live the life they know they were meant to live is stronger than ever. The greatest professional joy and privilege I can have is to help my patients regain a sense of vibrant wellness and hear them say, “I feel better than I have in years”. Feeling better physically and mentally improves all aspects of one’s life – both personally and professionally.
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