The Psychiatrist

Bright, nerdy, and awkward — three adjectives that described me as a child that most would say still describe me today. I hated school as a child. I was frequently picked on for having a speech impediment. In first grade, I once got in trouble for talking out of turn and was told by my teacher to “leave the class.” She meant for me to go to the principal’s office, but instead I left the school building. My science teacher found me down the street and brought me back to the school. She told me that if I focused on understanding the world through science I could have fun and accomplish something great. I was hooked.

My love of science never wavered from that moment but continued to expand over the last 40 years. As an adolescent in the 1970s, my focus was space satellites, computers, and dinosaurs. I started my freshman year at Temple University in the engineering department but after one year switched my major to chemistry and then later to physics. However, after realizing that I had a mild form of dyscalculia, occasionally flipping numbers in my head, I concluded that this might hinder my becoming a top-level physicist. Thus, I switched my major in my senior year to biology. I graduated with a major in biology and a minor in physics, one class shy of a double major. I attended the University of Pennsylvania to obtain a PhD in pharmacology (I specialized in neuropharmacology, the study of how molecules interact with the brain), which allowed me to combine aspects of all the scientific fields that I had studied.

One day, as I was finishing my dissertation, I complained to my roommate that many clinical medical doctors did not seem to understand pharmacology, and she said, “Well, if you’re so smart, why don’t you go back to school and become a medical doctor?” I thought about it and shortly after applied to medical school. I wanted to take my knowledge of how medications work in people out of the laboratory and into the clinical world to help people directly. I started medical school shortly after finishing my PhD. I quickly discovered that I did not like dealing with blood (I actually passed out in surgery and obstetrics). That is partly why I ended up in my current career—psychiatry. No blood! In addition, I now get to use my knowledge of neuropharmacology from graduate school to help people.

I have been a psychiatrist for the past 15 years and have treated several thousands of patients. Many have conditions such as depression, bipolar disorder, ADHD, and anxiety. The majority of my patients are on combinations of medicines because they only get a partial response to a single medicine. Complex thought goes into managing the delicate balance between providing maximal benefit while minimizing side effects from treatment. I enjoy educating my patients about why I am making these choices for them. They seem to appreciate that I explain the “why” rather than just saying “take these pills.”

I recently ran into my PhD mentor, and he asked me if I “missed science.” While it is true that I no longer do experiments with cells or on rats, I still use the scientific method with each of my patients. I observe the patient, come up with a hypothesis about what is likely to help, perform a trial treatment, observe the results, and generate a new hypothesis. I offer a unique perspective to psychiatry because I practice medicine as a scientist as well as a clinician.

I have recently expanded my practice to offer a new non-pharmacological treatment called repetitive transcranial magnetic stimulation (rTMS). It utilizes a rapidly alternating magnetic field to generate an electric field inside the brain, causing neurons to fire in specific targeted areas. (Sound familiar? I have come full circle back to physics and Faraday’s law.) By targeting areas that are underactive in depression we can alleviate symptoms for some patients without the side effects of medication. So far, I have treated a number of my most severely depressed patients with rTMS and have had amazing success. This technology is at the cutting edge of where psychiatry is heading over the next decade.

Physics extends into my personal life as well. When I am not treating patients, I enjoy spending time with my family and training together in Shotokan Karate. As a 4th-degree black belt, I use my knowledge of physics to teach other students proper application of force, energy, and momentum in self-defense techniques. The students appreciate the explanations, and it enhances their training experience.

My favorite branch of science is still physics, as it is an integral part of both my personal and professional lives. The advice my first-grade science teacher gave 45 years ago has carried me to where I am today—having fun and accomplishing great things!