How to Be Patient

This might be our nerdiest episode yet—and that’s saying something. In our Season 2 kickoff, Margaret and I sit down with Dr. Margo Funk, psychiatrist and QTC whisperer, to explore the strange, stressful overlap between psychiatry and cardiology. We talk about our worst fears on call, how to spot when an EKG is lying to you, and why it might be time to stop blaming Haldol and start looking at your T wave. There are metaphors involving horses, guns, Timberlake, and Kool-Aid. Somehow, it all makes sense. If you’ve ever been scared of EKGs, risk calculators, or calling your attending at 2AM—this one’s for you. Takeaways: I thought I understood the QT interval—until I realized I didn’t. Turns out, there’s a difference between what the EKG says and what your patient actually needs. Not all meds are the villains we make them out to be. Spoiler: Haldol gets a redemption arc. Trazodone… does not. I finally learned what that weird slope on the T wave actually means. And yes, it involves potassium. ICD storms are real—and they are terrifying. Dr. Funk explains why treating the aftermath is as critical as preventing the next one. Sometimes the bravest thing you can do is call your attending. Or carry a caliper. Or question the computer. -- Ready to take your exam prep to the next level? Go to http://www.NowYouKnowPsych.com and enter the code BEPATIENT at checkout for 20% off. Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠howtobepatientpod.com Learn more about your ad choices. Visit megaphone.fm/adchoices

Season 1: complete! In this wrap-up episode, Margaret and I reflect on what it’s been like building this show from scratch—while also being full-time psychiatry residents. We talk about favorite episodes, unexpected challenges, what we’re still figuring out, and what’s ahead for Season 2. We also answer listener questions about training, creativity, psychedelics, and the eternal search for balance when your brain wants art and your calendar says “clinic.” There’s some honesty, some gratitude, and a whole lot of behind-the-scenes chaos. Takeaways: This podcast started as exposure therapy—and became a little bit of everything. Talking into a mic is not the same as talking into a TikTok. (Spoiler: I struggled way more than I thought I would.) My favorite episodes? The ones that made us play. Guest experts, weird improv scenes, and stuff we’ll probably regret saying on camera. We’re learning in public—about psychiatry, about medicine, and about ourselves. And yeah, we definitely got some things wrong along the way. We’re not stopping. Season 2 is coming, and we’re getting even weirder (and maybe wiser) next time. -- Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠howtobepatientpod.com Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode Preston and Margaret are joined by Dr. David Roberts to explore the fascinating world of motivational interviewing (MI)—a counseling technique designed to help patients navigate ambivalence and commit to meaningful change. Dr. Roberts shares insights from his years of experience training psychiatrists and therapists, breaking down MI into practical techniques that anyone can use to foster deeper, more effective conversations. We even do a fake therapy session with our producer Aron Korney! Takeaways: Motivational Interviewing Bridges Ambivalence: MI helps people resolve mixed feelings about change by guiding them to articulate their own reasons for making a shift. Change Talk Sparks Action: Encouraging patients to express their desire, ability, reasons, and need for change strengthens their motivation to take action. Reflections Deepen Understanding: Simple and complex reflections help mirror a patient’s thoughts and feelings, making them feel heard while subtly guiding them toward insight. Pacing Matters: Being too directive can lead to resistance, while being too passive may feel ineffective—MI teaches a balanced approach that fosters real conversations. Practice Makes Progress: MI is a learnable skill that improves with intentional practice, making difficult conversations about change smoother and more effective over time. — Want more Dr. David Roberts: https://providers.uthscsa.edu/providers/david-l-roberts-1255650917/ Want more Aron Korney: Human Values Podcast: https://podcasts.apple.com/us/podcast/human-values/id1622760459 Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: howtobepatientpod.com Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode Preston and Margaret welcome their first guest, neurosurgeon and content creator Dr. Betsy Grunch (aka Lady Spine Doc), for a deep dive into pain—how we treat it, how we misunderstand it, and how the system often fails those who experience it. Takeaways: Pain Is Not Just Physical: Chronic pain isn’t just about physical damage—it involves neurological, psychological, and emotional factors that make treatment complex. Back Surgery Isn’t Always the Answer: Failed back surgery syndrome is common, often because patients receive the wrong procedure or aren’t properly prepared for surgery. Empathy Improves Patient Outcomes: Research shows that patients who feel heard and understood by their doctors have better surgical and pain management outcomes. Social Media Shapes Medical Conversations: Platforms like TikTok have transformed how patients and doctors discuss pain, sometimes for better—but also with risks of misinformation. Medical Training Can Be Dehumanizing: The culture of surgery often discourages emotional connection, but rediscovering empathy is key to being a great physician. — Want more Dr. Betsy Grunch: TikTok: https://www.tiktok.com/@ladyspinedoc?_t=8rhZfY7LgLe&_r=1 Twitter: http://www.twitter.com/ladyspinedoc Instagram: http://www.instagram.com/ladyspinedoc Facebook: https://www.facebook.com/ladyspinedoc YouTube: https://youtube.com/@ladyspinedoc LinkedIn: https://www.linkedin.com/in/drgrunch Amazon: https://www.amazon.com/shop/ladyspinedoc Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: howtobepatientpod.com Citations: Chapters 1.16 and 27.15. Sadock, Benjamin J, et al. Kaplan & Sadock’s Comprehensive Textbook of Psychiatry. 11th ed. Philadelphia, Wolters Kluwer, 2025. Oliveira CB, Maher CG, Pinto RZ, Traeger AC, Lin CC, Chenot JF, van Tulder M, Koes BW. Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J. 2018 Nov;27(11):2791-2803. doi: 10.1007/s00586-018-5673-2. Epub 2018 Jul 3. PMID: 29971708. Stanford Center for Chronic Pain and American Chronic Pain Association Guide. https://www.acpanow.com/acpa-stanford-guide.html#/ George SZ, Fritz JM, Silfies SP, Schneider MJ, Beneciuk JM, Lentz TA, Gilliam JR, Hendren S, Norman KS. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. J Orthop Sports Phys Ther. 2021 Nov;51(11):CPG1-CPG60. doi: 10.2519/jospt.2021.0304. PMID: 34719942; PMCID: PMC10508241. https://pubmed.ncbi.nlm.nih.gov/30265840/ https://www.ncbi.nlm.nih.gov/books/NBK219252/#:~:text=Pain%20is%20a%20subjective%20experience,relieving%20or%20terminating%20the%20experience. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode Preston and Margaret take a deep dive into the complex relationship between exercise and mental health. They discuss the science behind how movement impacts the brain, debunk common myths about fitness, and explore the psychological barriers that prevent people from incorporating exercise into their lives. Takeaways: Exercise Impacts Mental Health Bi-Directionally: Movement not only improves mental health, but mental health conditions can also act as barriers to engaging in exercise. Fitness Advice Often Lacks Specificity: Many healthcare providers acknowledge the benefits of exercise but rarely provide concrete strategies to help patients incorporate it into their lives. Movement Should Be Enjoyable: Finding a form of exercise that brings joy—whether it's dancing, hiking, or lifting—makes it easier to sustain and integrate into daily life. Setting Small, Achievable Goals is Key: Utilizing SMART goals (Specific, Measurable, Achievable, Relevant, Time-bound) can help create consistency without overwhelming pressure. Exercise Isn't Just About Weight: Shifting the focus from aesthetics to function, strength, and mental well-being can create a healthier and more sustainable relationship with movement. — Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: howtobepatientpod.com Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode Preston and Margaret tackle one of the most talked-about topics in mental health today—ADHD. From the historical roots of the diagnosis to the impact of modern social media trends, they explore how our understanding of ADHD has evolved over time. They discuss the challenges of diagnosing ADHD in both children and adults, the role of social media in spreading information (and misinformation), and the real-life impact of the disorder. Takeaways: ADHD Has Deep Historical Roots: The first observations of ADHD-like symptoms date back to the 1930s, when stimulants were found to improve focus in children originally treated for other conditions. Diagnosis Isn’t Always Simple: ADHD symptoms can overlap with anxiety, depression, and other conditions, making proper evaluation and history-taking crucial for an accurate diagnosis. Social Media: Help or Hinderance? While platforms like TikTok can offer community and validation, they can also contribute to misinformation and oversimplified self-diagnoses. Early Treatment Matters: Research shows that children who receive appropriate ADHD treatment, including medication, often have better long-term outcomes and lower rates of substance use. ADHD Is More Than Inattention: The condition impacts executive functioning, emotional regulation, and impulse control, which can affect relationships, careers, and daily life beyond just focusing. — Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: howtobepatientpod.com Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode Preston and Margaret explore the complex concept of rapport in healthcare. They reflect on the challenges of building meaningful connections with patients and the impact these relationships have on medical outcomes. From awkward early encounters in medical school to techniques they've developed as psychiatry residents, this episode unpacks what it means to truly connect. Takeaways: Rapport Is More Than Liking: Building rapport isn’t just about being liked; it’s about creating trust, safety, and understanding between clinician and patient. Authenticity Matters: Patients respond to doctors who show up as their authentic selves. Balancing professionalism with humanity is key to trust-building. Rapport Shapes Outcomes: Research shows that strong patient-clinician relationships lead to better health outcomes, regardless of the treatment modality used. Tailor Your Approach: Building rapport requires adapting to each patient’s unique personality and background. What works for one patient may not work for another. Empathy Is a Skill: Empathy takes practice, energy, and intentionality. It's not about agreeing with patients, but about understanding them deeply. — Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: howtobepatientpod.com Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode Preston and Margaret embrace the season with a deep dive into Seasonal Affective Disorder (SAD). From the science behind melatonin and serotonin to the cultural and emotional frameworks that shape how we experience winter, this episode covers the biopsychosocial dynamics of seasonal depression. Along the way, they share personal anecdotes, including the surprising benefits of light therapy and reframing winter as an opportunity for growth. Takeaways: Light is Power: Exposure to light regulates circadian rhythms and can significantly impact mood. Tools like light therapy boxes are clinically proven to combat seasonal depression. Medication Matters: SSRIs, bupropion, and melatonin agonists like agomelatine are effective treatments for SAD, with some meds even preventing symptoms when started early. Embrace Behavioral Activation: Joining activities like winter sports or social groups can create accountability and help maintain mental health during darker months. Reframe the Season: Viewing winter as a time for creativity, community, or solitude can transform it into a meaningful and enriching period. Self-Compassion is Key: Feeling tired or less motivated during winter is normal. Practicing self-compassion and acknowledging seasonal changes can reduce guilt and promote well-being. — Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: howtobepatientpod.com Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode Preston and Margaret dive into the science and personal experiences surrounding attachment theory. They discuss its origins, its modern-day interpretations, and how it shows up in everyday relationships. Takeaways: Attachment is Dynamic: Attachment theory isn’t a fixed diagnosis—it’s a lens to understand how people relate to others and themselves. Repair Builds Resilience: Healthy relationships are not conflict-free but can recover from disagreements and grow stronger. Pop Psych Oversimplifies: Modern discussions about attachment styles often miss the nuance and flexibility inherent in these frameworks. Therapy is Practice: Therapy can rewire attachment patterns by creating safe spaces for emotional repair and connection. Humor as a Shield: Humor can be a tool for connection but also a way to avoid vulnerability—knowing the difference matters. — Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: howtobepatientpod.com Learn more about your ad choices. Visit megaphone.fm/adchoices

In this debut episode of How to Be Patient, psychiatry residents Preston Roche and Margaret Duncan open up about their personal journeys into medicine and the challenges they’ve faced in connecting with patients—and themselves. From navigating early patient interactions to grappling with their own vulnerabilities, they explore the balance between authenticity and professionalism. With humor, candid storytelling, and a dash of introspection, this episode sets the stage for a season of thoughtful discussions on empathy, growth, and the art of being present in healthcare. Get ready for the tale of two doctors! Takeaways: Empathy is a Skill: You don’t have to be born with it—learning how to connect with patients can happen over time and with practice. Authenticity Matters: Medicine isn’t about pretending to be perfect; it’s about finding a way to unify your personal identity with your professional role. Vulnerability is Strength: Struggles, failures, and even embarrassing moments can be powerful tools for connecting with others. Creativity Fuels Resilience: Exploring hobbies and personal interests, like Margaret’s Bad Art Every Day project, can help you stay grounded during stressful times. Reflection Unlocks Growth: To truly understand and support patients, start by looking inward and understanding your own emotions and biases — Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: howtobepatientpod.com Learn more about your ad choices. Visit megaphone.fm/adchoices

Margaret and I pivot into mentor mode a little in this episode, it’s targeted towards medical students and the vicissitudes of the match. We know these are tough times and we wanted to share some advice about what to look for in a psych program and how to pick a  place to train that is right for you. We also debrief the end of season 2 and take a wrap on 40 episodes! As always, thank you for listening! -- Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

By popular demand, Margaret and Preston are back with another therapy episode. The topic this week? Acceptance and Commitment Therapy (ACT), a third wave behavioral therapy that Margaret happens to be trained in and love for her patients and her own life. In this episode we talk about the founder of ACT and its roots in behaviorism, what an ACT therapist “sounds like”, and the 6 core processes of psychological flexibility that encompass what this type of therapy does. Finally, Margaret and Preston go through their own values, and try to apply the ACT principles to two particular problems in their own lives.  Resources: Book for clinicians: ACT in Steps by Clarissa W. Ong, Michael E. Levin, and Michael P. Twohig Book for all: The Happiness Trap by Russ Harris, ACT Made Simple by Russ Harris Quick explanations from the ACT official website: https://contextualscience.org/the_six_core_processes_of_act Citations: Chapter cited for history/explanation of theory for ACT: Hayes, S.C., Strosahl, K.D., Bunting, K., Twohig, M., Wilson, K.G. (2004). What Is Acceptance and Commitment Therapy?. In: Hayes, S.C., Strosahl, K.D. (eds) A Practical Guide to Acceptance and Commitment Therapy. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-23369-7_1 Process Based Therapy: Hofmann SG, Hayes SC. The Future of Intervention Science: Process-Based Therapy. Clin Psychol Sci. 2019 Jan;7(1):37-50. doi: 10.1177/2167702618772296. Epub 2018 May 29. PMID: 30713811; PMCID: PMC6350520.Encyclopedia of Cognitive Behavior Therapy: Editors: Arthur Freeman, Stephanie H. Felgoise, Christine M. Nezu, Arthur M. Nezu, Mark A. Reinecke. -- Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, we bring on Kristin Flanary, who is currently doing her own investigation into dissociations associated with trauma from both her own experience as a survivor and as an academic. We discuss the current media landscape of trauma and dissociation, the neurological mechanisms of dissociation, and therapeutic approaches clinicians can use with a patient who is experiencing dissociation. Citations: Modesti MN, Rapisarda L, Capriotti G, Del Casale A. Functional Neuroimaging in Dissociative Disorders: A Systematic Review. J Pers Med. 2022;12(9):1405. Published 2022 Aug 29. doi:10.3390/jpm12091405 Tisserand A, Philippi N, Botzung A, Blanc F. Me, Myself and My Insula: An Oasis in the Forefront of Self-Consciousness. Biology (Basel). 2023;12(4):599. Published 2023 Apr 14. doi:10.3390/biology12040599 McIntyre CK, McGaugh JL, Williams CL. Interacting brain systems modulate memory consolidation. Neurosci Biobehav Rev. 2012;36(7):1750-1762. doi:10.1016/j.neubiorev.2011.11.001 -- Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

Today we are joined by the host of the “calling in sick” a pod run by our good friend Alex (familiarly) to discuss the rigamoroll that is navigating the healthcare system through the eyes of a patient with debilitatig conditions. Alex shares her story from Investment banker, to patient to podcaster all the while coloring things with her own levity and resilience. -- Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

This episode is a slight excursion from our regularly scheduled program. Today we are chatting with Will Flannery, who is in many ways our content “dad” if you will. We will talk about the art of including humor into our daily practive, when it goes right, when it goes left, and where we go from here. Dr. Glaucomflecken also has some fun and new projects he’d like to share with you at the end.  -- Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

Margaret and I are back with part two of our conversation with Dr. Drew Ramsey and this time, things get personal. I volunteered my real-life food log for a full nutritional psychiatry breakdown… and let’s just say my “ultra-processed protein” lifestyle did not escape unscathed. What started as a casual diet review turned into something deeper. A mentoring session about joy, creativity, and what it actually means to feed your brain. Margaret brings her psychodynamic insight, Dr. Ramsey brings the science, and I bring… a whole lot of protein powder and self-reflection. If you’ve ever tried to optimize your health but ended up missing the soul in your routine, this episode is for you. Takeaways: Why your “perfect” diet might still leave you mentally drained and what to do about it. The hidden emotional layers behind our food choices (yes, even that afternoon candy craving). How protein obsession became a modern wellness trap and what real balance looks like. The role of creativity, cooking, and joy in building true mental fitness. Why self-care means more than nutrients, it’s about structure, connection, and staying alive in this work. -- Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠⁠⁠⁠⁠⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

We sat down with Dr. Drew Ramsey to talk about something we all think we understand and don’t: how food shapes mood. In Part 1, we get practical and personal: what to reach for when you’re anxious, what to cook when you’re depressed, and how to think about nutrition when you’re busy, broke, or just not in the headspace to sauté anything. We talk simple swaps, what actually belongs on a “brain food” plate, and why perfection is the enemy of getting fed. Takeaways: Start small, eat real: One or two consistent food changes beat any “perfect diet” you’ll abandon by Thursday. Plates, not rules: Build a simple “brain-food plate” you can repeat—color, protein, fiber, healthy fat, then stop obsessing. Shop for mood, not vibes: A short grocery list can be more stabilizing than another self-help book. Cook your baseline: Have 2–3 “low-spoon” meals you can make when motivation is gone. Progress over purity: The goal isn’t clean eating; it’s consistent nourishment your future self can rely on. -- Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠⁠⁠⁠⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

In this preston-led episode, we take a deep dive into the history of lithium and its use in psychiatry. But because Preston is very literal, we are starting at the very beginning, inside of stars where lithium was formed at the beginning of the universe. Then we will follow this wonderful atom through history and past its FDA approval in 1970 to where we are today.  Takeaways: Lithium was once sold in Seven Up as a mood-lifting ingredient—but the consequences were messy. A forgotten Australian psychiatrist helped launch lithium into psychiatry with groundbreaking trials. Despite its toxicity risks, lithium remains the gold standard for reducing relapse and suicidality. U.S. psychiatrists resisted lithium for decades—even as Europe embraced it. Preston and Margaret debate lithium’s place today: miracle stabilizer or underused relic? Citations: https://www.sciencedirect.com/science/article/abs/pii/0025556484901160 Shorter E. The history of lithium therapy. Bipolar Disord. 2009 Jun;11 Suppl 2(Suppl 2):4-9. doi: 10.1111/j.1399-5618.2009.00706.x. PMID: 19538681; PMCID: PMC3712976.https://pmc.ncbi.nlm.nih.gov/articles/PMC3712976/ Fowler, Gene. Crazy Water: The Story of Mineral Wells and Other Texas Health Resorts. No. 10. TCU Press, 1991. -- Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠⁠⁠⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

This week, Margaret and I sat down with Dr. Jhilam Biswas, psychiatrist and expert on the intersection of law and mental health, for one of the hardest—and most important conversations we’ve had on the show. Together, we take a close look at how our justice system responds to mental illness: what happens when people in crisis are incarcerated instead of cared for, and how the prison system has become a stand-in for mental health treatment in the U.S. Dr. Biswas helps us unpack the reality of solitary confinement, forced treatment, and the impossible choices clinicians face when caring for patients inside a system built for punishment, not healing. Alongside Margaret, I reflect on the human cost—on families, on providers, and on the people trapped in cycles of crisis and incarceration. This isn’t just a policy issue—it’s a deeply personal one. And it’s urgent. Takeaways: The prison system has become the de facto mental health provider—and it’s failing people in crisis. Solitary confinement and punishment often substitute for care, especially when individuals are suicidal. Clinicians face impossible ethical dilemmas, forced to provide care within systems that perpetuate harm. Alternatives to incarceration exist, but remain underfunded and underutilized. Reimagining justice requires reimagining care—building systems that prioritize treatment, not punishment. Citations: Biswas J, Drogin EY, Gutheil TG. Treatment Delayed is Treatment Denied. J Am Acad Psychiatry Law. 2018 Dec;46(4):447-453. doi: 10.29158/JAAPL.003786-18. PMID: 30593474. Biswas J. Dignity restored: the power of treatment first. CNS Spectr. 2024 Dec 23;30(1):e11. doi: 10.1017/S109285292400052X. PMID: 39714025. Advocacy:  ⁠https://www.psychiatry-mps.org/⁠ Jhilam Biswas: Dr. Biswas Website: https://psychexpertise.com/ https://www.neuroethicscollege.org/ -- Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠⁠⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

What is aphasia, really and what happens when your brain no longer cooperates with your ability to speak or understand language? In this episode, Preston and Margaret tackle the messy, frustrating, and often isolating world of language disorders, focusing on the real-life implications of aphasia. They walk through the clinical causes, what it looks like day-to-day, and how aphasia differs from other speech and cognitive issues. Along the way, they share stories of miscommunication, explore the frustrations of being misunderstood, and dig into how patients and clinicians can better work together when words are hard to find. Takeaways: Aphasia isn’t about intelligence—it’s about access. There’s more than one kind of aphasia—and none of them are simple. Communication breakdowns aren’t just frustrating—they’re isolating. Not all “word-finding problems” are created equal.. Listening might be the most important clinical skill we overlook. Citations: Main paper discussed during episode: https://pmc.ncbi.nlm.nih.gov/articles/PMC2854959/pdf/jcn-2-149.pdf Aphasia and the Diagram Makers Revisited: an Update of Information Processing Models Kenneth M. Heilman, M.D. The James E. Rooks Jr. Distinguished Professor, Department of Neurology, University of Florida College of Medicine, and VAMC, Gainesville, Florida -- Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices