The Everyman Psychiatrist

Delivering clarity in a world of chaos.

by Paul Linde, M.D.

I Haven't Seen the Evidence for Evidence-Based Psychiatry

"Patients don't read the textbook" is a perennial truism in medical education, especially in teaching students, interns, and residents how to treat patients. And for good reason. Read More

Are We Headed for a Mad Max Society?

Psychiatry is the only medical specialty that does not admit patients to the hospital based on how sick they are.

Psychiatrists in California have to dance around the state's civil commitment laws, written more than forty years ago. Read More

San Francisco's Homeless Mentally Ill: Still Neglected

The homeless mentally ill in the city of San Francisco have been so visible for so long they've become almost part of the landscape to us city dwellers--essentially invisible people who, for all intents and purposes, have disappeared. Read More

Save the Appendix! A View of DSM-5 from the Trenches

When I look at the creation of DSM-5 from the perspective of an ER Psychiatrist, I feel as if I've been left behind, disqualified, overrun by hobby horses. Read More

Whose Leg Is It Anyway?: Medical Decision-Making Part 2

While working in the psych emergency room at San Francisco General Hospital, I take a call from my medical colleague, Dr. Jones, toiling away in the "regular" Emergency Department.

"Paul, I'm gonna need your help on this one," she says.

"Okay," I say. Read More

Whose Leg Is It Anyway?: Medical Decision-Making in the ER

In considering the motivations and conduct of an ER doctor, should paternalism be such a dirty word? Determining if a medical problem represents an "imminent loss of life or limb" for a patient seems as if it should constitute a straightforward, yes-or-no, situation for an ER doctor to figure out. It is at the heart of what defines a "medical emergency." But consider the following example, in which the principles of a physician's duty for beneficence and a patient's right to autonomy come into conflict. Shades of grey predominate here. Read More

This Is Your Brain on Drugs: A View from the Psych ER

If it weren't for drugs and alcohol, I might be out of a job.

I work as an emergency psychiatrist at San Francisco General Hospital. Read More

ER Psychiatrists: The Couch Potatoes of Adrenaline Junkies

Why did I choose to work in psych emergency?

Since seven years of psychotherapy hadn't provided me with the answer, perhaps I needed the three years it took me to write DANGER TO SELF: ON THE FRONT LINE WITH AN ER PSYCHIATRIST to answer that rhetorical question. Read More