Psychiatrists treating patients who can’t talk: Sounds fishy, doesn’t it?
Well, I do it 2-3 days per week, and as strange as it may sound, it makes perfect sense.
Let me explain.
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Can you imagine doctors referring to patients as idiots, morons, or imbeciles? And, doing so not because of disliking their patients but as actual diagnostic labels?
It is difficult to conceive, but just a few decades ago the use of these particular terms was completely acceptable. Each was used to describe individuals with varying degrees of mental retardation (MR).
In my work with some older individuals with developmental disabilities, I have had the opportunity to review medical records from 50-60 years ago. (I know it’s difficult to believe, but some records that old still exist!) It is a surreal experience to see these terms used as casually as “depression” or “diabetes” is used in charts today. Yes, that’s correct, progress notes began with phrases such as, “This 18 year-old female moron,” or “This 22 year-old male imbecile.”
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The prescription of medications for diagnoses, to age groups, or in doses other than the FDA-approved ones, is a common, legal, and necessary practice in medicine today. This practice is known as off-label use or off-label prescribing. Those new to this issue may wonder why physicians and other prescribers would ever deviate from prescribing in territory where the FDA has not given their stamp of approval.
In the ideal world, clinical trials would be conducted for all patient populations and diagnoses for which various medications might be useful. In reality, though, this is neither practical nor possible. Consequently, many patient populations and many patients with particular diagnoses would have few treatment options available if the medical establishment avoided off-label prescribing.
For example, child psychiatry is a huge area where millions of mentally ill children and adolescents depend on off-label medications. The field of general pediatrics is no different. The fact is that most medications are not tested in children. But, does that mean that
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One of my favorite news stories this year was about a lovely woman who lives in a nursing home in England. Her name is Ivy Bean. She turned 104 this fall and is the oldest user of Twitter (Twitter name: Ivybean104). As of this post she had over 54,000 followers. Prior to using Twitter she used Facebook heavily and maxed out her 5,000 friend limit.
There is a CNN article about her here. The article mentions how she always has an open mind and is willing to try new things. I’ve personally noticed the positive tone of her Twitter posts. Okay, open mind and positive attitude, 104 years young and enjoying life. Maybe there’s a lesson there for the rest of us!
Moving on, the other two people are
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