Sarah Chan

Time

Time is such a funny thing. We are told it is our most valuable resource, and I agree. It took my turning 40 to realize the true value of the time we have on this planet, made more precious given the state of things. In conversations I have with people

psychiatry

Walk with me: A Day in Clinic

9-10am : A young woman wrestling with a traumatic past, fighting her way to a better future but unable to leave her past behind her. In my mind's eye, she is a lone warrior amongst cannibals who happen also to be her family. She pretended to be them for

Tough lessons on the Job: Addictions

This is a case of a young man who had developed intense paranoia after using methamphetamine extensively.  While in my care, he was stabilized on medication, and he stopped using drugs.  I wish I could say it was because of addictions treatment that he stopped using drugs but it was

The Impossible Job: When Help becomes Harm

A 56 year old man, Roy, comes to see me after his family doctor raised concerns about his benzodiazepine use. He was taking 1 mg of Ativan most days, and when his panic attacks were particularly bad, he could take up to 4 mg. On top of this, he was

Conversations with patients: Healthy marriages have irreconcilable differences

In these essays, I feature interactions I have had with my patients that I have found to be meaningful and thought-provoking. Any details about the patient’s identity have been modified to protect patient privacy and confidentiality. Part of what I love in the work I do are the insights

On Caring, Part 2: A missing part of the Curriculum in Medical Education

As someone trained in science, I thought how I cared for patients was related to how much knowledge and expertise I could cram into my brain.  In school, we were never praised for developing strong relationships with patients, but for how much medical minutiae we knew.  It is no wonder

On Caring

In the next two posts, I will be writing about what it means to care, as a physician, as a psychiatrist, as a person. I apologize in advance if the posts have some repetition and are not polished. I am still figuring this out, and I want these posts to

Conversations with patients: You are more than you know

In these essays, I feature interactions I have had with my patients that I have found to be meaningful and thought-provoking.  Any details about the patient’s identity have been modified to protect patient privacy and confidentiality. Wayne is a 40 year old man who has struggled all his life

How to Get Help for Someone with Mental Illness? Part 3: "Care" on a CTO, a review of the process

I am often very grateful and impressed to live in a society where a community treatment order (a CTO) can exist.  To review, a CTO legally allows a psychiatrist to administer treatment to a patient against his/her will over a longer period of time.  When they work, the CTO

How to Get Help for Someone with Mental Illness? Part 2: Community Treatment Order (CTO)

Last month, I talked about how to get someone who does not want psychiatric care seen by a physician or psychiatrist even if against the person's will.  This does not mean a patient will get treatment, but if appropriate, a Form 1 gives a psychiatrist up to 3

How to Get Help for Someone with Mental Illness? - Part 1

I had a reader ask me this question, and it is an excellent one. I'm surprised this subject hadn't come to mind for this column given how often I have fielded this question from my own family members and other physicians. Please keep in mind, the

Responsible Joy part 2

When starting out on the journey of creating a life you can feel proud of, here are some basic guidelines: 1) Spend no more than 1-2 hours playing videogames or on social media/Youtube.  These past-times will consume as much of your time as possible, which is to say even

Responsible Joy

A 34 year old male with a PhD who has not been able to find any lasting employment in his field since he graduated presents with a life-long lack of motivation and lack of joy.  He grew up in a family where he was highly criticized and given no choice

The Impossible Job: Reporting to the Ministry of Transportation

Just today, I spent 30 minutes trying to fill out forms from the ministry of transportation for two of my clients. In these forms, they ask the following questions: Does this person have any problems with their judgement, attention or cognition? Is there a need for a functional driving assessment?

The Impossible Job: It is so much more than helping someone feel better.

I have been wrestling with my relationship to my work for quite some time now. I have sought out therapy, mentorship and peer support for what it is that I do and I am so grateful for this support. I was hoping, with all the resources I have poured into

Just another day when you practice therapy in a family medicine clinic.

Conversations with patients: Social Media

In these essays, I feature interactions I have had with my patients that I have found to be meaningful and thought-provoking.  Any details about the patient’s identity have been modified to protect patient privacy and confidentiality. Holly is a petite woman in her late teens.  She has curly blonde

Dearest Sister,

I had seen this patient for therapy for about 3 years. We stopped after she moved out of the province. She recently wrote me a letter updating me on her life, and gave me consent to publish a part of the letter here. In this excerpt, she reflects on a

Treatment considerations in First Episode Psychosis

Below is an example of how a patient's psychosis may present to me at the First Episode Psychosis clinic where I work.  In parentheses are some of the specific symptoms that would qualify this patient for a diagnosis of psychosis and a referral to our clinic. The patient

8 Years as a Psychiatrist: A Review

I recently audited all the patients I saw in my general adult psychiatry clinic, in a random month in 2022.  What I found confirmed what I already knew to be true:  Most of my patients do not benefit from medications alone. Here were my statistics of what patients needed from

The Big 5

Let's say you've decided to focus on your mental health. Before you start anything, I recommend you take stock of these five aspects of your life: 1. Sleep 2. Diet and exercise 3. Recreational drugs and alcohol 4. Social Connectedness 5. Personal pursuits/hobbies I call

Conversations with patients: Violence on a psychiatric unit

In these essays, I feature interactions I have had with my patients that I have found to be meaningful and thought-provoking.  Any details about the patient’s identity have been modified to protect patient privacy and confidentiality. Kristin came into my care after a 3 week hospital admission to an

Picture this. Using Imagery in Psychotherapy

When I am with a patient, time and distractions fade out.  I listen to the story the patient is telling me, and within that I am listening for the story he is telling himself.  I focus on what is being said, how it is being said, while at the same

Looking for a Therapist: A primer on psychotherapy

I have come to appreciate some simple truths as I hit mid-life that a former, younger version of myself would have dismissed with a smug smile and a raised eyebrow as if to say, "maybe for you".  One of these simple truths is...life is hard. I have

Should I take medication for my mental health?

Taking medication for mental health is a very personal decision.  Patients tell me of the stigma they feel when on medications classified as antidepressants or antipsychotics. When deciding to take a medication for mental health, the principals from other realms of medicine apply: 1. Know why you are taking the