Thursday, July 21, 2011


This is a practice question I did the other day.

A 19-year-old man is evaluated for depression of 6 weeks duration. He enrolled in college as a freshman 5 months ago and began participating in intramural basketball, football, and soccer in addition to carrying a full academic load and having a part-time job. He smokes cigarettes and marijuana and consumes more than 12 alcoholic drinks on the weekends at parties. He is sexually active with four different partners. However, during the last 6 weeks he has seldom left his room and has stopped attending classes because he cannot concentrate; he is in danger of failing all of his classes. He feels restless, cannot sleep, has a poor appetite, and feels depressed. He can identify no precipitating event related to his change in mood, although he had a similar episode once before at age 16 years. There is no family history of mood disorders.

Which of the following is the most likely diagnosis?

(a) Bipolar disorder
(b) Dysthymia
(c) Major depressive disorder
(d) Seasonal affective disorder
(e) Situational adjustment reaction with depressed mood

(Question from MKSAP for students 4, American College of Physicians)

The answer I gave: Major Depressive Disorder
The one they said was right: Bipolar Disorder

They thought his behavior when starting college was "hypomanic".
I would just label that at "college freshman". No??

Interesting how much depends on your perspective.

So I've been studying lately, and sweating, and packing up my car wearing a dress, and sweating through the dress, and planning stuff for this weekend.
Fun things to post about coming up ...
a 30th birthday, a wedding, time in Vermont, and Buckfest.
And that's just the next 4 days!

"A question that sometimes drives me hazy: am I or are the others crazy? "
-Albert Einstein

Sunday, July 10, 2011

Summer Reading

Sorry for my absence. I've been sucked into my absolute favorite summer activity:
Summer reading.

As a kid I definitely always read more than the required 3 books.
I wasn't as good as my friend Abby who always read the ENTIRE list,
but I did my fair share.

So now that I'm doing a much milder outpatient rotation (Praise Jesus!),
I have the luxury on the weekend of staying up late reading,
sleeping in,
and first thing in the morning grabbing the book off my nightstand to start again.

Of getting so sucked into a different world that the characters start to feel like long lost friends.

Of daydreaming about reading, wondering what will happen next, whenever I'm stuck at work or in traffic.

Of, as the International Man o' Mystery found out last weekend, preferring reading to swimming in the lake, hanging out, or pretty much anything.

Here's what I've been reading:

Recommended by my friend Erica.
An engrossing story of a Dominican family that moves to NJ.
Tons of heartbreaking Dominican history, which I did not know.
It helps to have a working knowledge of Spanish to read it, especially swear words.
And a dash of magical realism as any self respecting Hispanic book should have.

Pat Conroy books make me feel as wrapped up in a warm, cozy blanket of Southern culture as if I had just had crawdads, biscuits, and boiled peanuts while sipping sweet iced tea on the veranda of my plantation home.
He spins the Southern culture into the beautifully golden but crooked web that it is.
And he's a beautiful writer to boot.

This one is up next. I want to read it before the movie comes out.

What are you reading??
What should I read next?
The summer is still young.