Ulysses Contracts and the “Authentic Self”

“‘In flowery meads the sportive Sirens play, Touch the soft lyre, and tune the vocal lay; Me, me alone, with fetters firmly bound, The gods allow to hear the dangerous sound. Hear and obey; if freedom I demand, Be every fetter strain’d, be added band to band.’” In the above, Odysseus addresses his crew as…

“I am your Doctor”: a prelude to power in medicine

In my acclimatization to being a resident, there are a lot of things that have taken some getting used to.  The first is claiming a greater responsibility over patient care than one had during medical school: when I sign an order now, it becomes reality—a lab is drawn, an EKG is performed, a consult to…

Let’s teach doctors there are more ways of knowing

Almost three years ago exactly, I published an essay here on Synapsis titled “In Defense of Humoralism.”  In it—to briefly summarize—I highlighted how common ways in which patients understand the etiology of their illnesses and formulate folk treatments can often be understood as humoralistic.  Consequently, physicians dismiss these ideas as superstition, as they do not…

Finding Sick: Dispatches from the Emergency Department

Steve Server// At about 3:30 am during my first week in the Emergency Department, I realized that the space was different from anywhere else in the hospital.  Though it was my second night shift in a row, I wasn’t tired.  Or if I was tired, there were too many signals, too many sights and sounds and feelings…

Medicine’s martial metaphors: “Fighting the good fight”

Steve Server // In 1977’s Illness as Metaphor, Susan Sontag offered a prescription for the “most truthful way of regarding illness—and the healthiest way of being ill” (3).  As Sontag noted, some of the ways in which humans make meaning on “the night-side of life” may hamper our ability to suffer in a “healthy” way (3).  “As long…

Our Olympian Fables: On difficult personalities

  Steve Server// The Perfectionist.  The Eccentric.  The Paranoiac.  The Loner.  The Mercurial Partner.  The Serial Dater.  The Sociopath.  The Narcissist.  The Coquette.  The Milquetoast. Archetypes of difficult personalities populate our books, our movies, and our TV shows. Where do they come from?  How do we understand their social function? It is worth considering the extent to which these archetypes are borne or at least…

Pain is complex. We should treat it that way.

Steve Server// “What sort of pain is it?” Often, when health care providers inquire after patients’ pain, we get a sort of flummoxed look.  In response, we sometimes get a confused chuckle. As first year medical students, we are trained to differentiate sorts of pain: crampy vs. electrical/burning; dull vs. sharp; localized vs. radiating.  As our medical…

Brave New World: Cyberpunk 2077’s novel depiction of mental illness

Steve Server // By now, many have heard of Cyberpunk 2077, even those not normally within the gamer-orbit.  The early rollout of the game has been plagued by game-breaking glitches and unexpectedly poor graphics and performance.  Beyond the controversial rollout—and underneath the typical blood and guts associated with violent role-playing games—Cyberpunk 2077 has something unique to say about mental…

Amphetamine and its discontents

Steve Server // Nicolas Rasmussen. On Speed: The Many Lives of Amphetamine (New York: New York University Press, 2008). It is a principle of pharmacology that one can never have on-target, desired effects without some off-target side effects.  Amphetamine is no exception to that rule.  The drug leads to higher levels of dopamine and norepinephrine…