NECESSARY PHOENIX: WORKING TOGETHER TO HELP HEAL THE PRACTICE OF MEDICINE

After I completed medical school in 1983 at Tulane and Charity Hospital of New Orleans, I embarked upon a neurology training program. I decided to do the required psychiatry rotations first to “get them out of the way”. I was fascinated by neuroanatomy and physiology and considered psychiatry too “soft” a branch of medicine for my taste. But I came home at the end of each day with a smile. It was fun to work on the locked psychiatric unit. I loved my patients. I changed over to the psychiatry program, a “biopsychosocial” program with strong psychotherapy elements. When I moved from New Orleans to Portland to complete my training, I found myself unexpectedly immersed in a pharmacologic program at a hospital that locals call “Pill Hill.” After residency, I worked two years on a locked inpatient unit before going off into a suburban private practice and outpatient community mental health work. I closed my private practice in 2003. For the past eight years I have spent my professional time working for non-profit agencies in the care of my most vulnerable neighbors.

Alice Keys, M.D. Winners of the American Dream

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April 7, 2013

Since I left the psychiatric prescribing trenches and came south for the winter, I’ve been staying in a beach town within driving distance of a technology metropolis. I take breaks from my writing and walk to the beach. There, I meet and talk with the winners of the American dream. They are intelligent, highly educated and financially successful. They take their beach vacations here.
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Alice Keys, M.D. He Who Pays the Piper

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March 21, 2013

A physician I know forwarded a pharmaceutical-funded article that states “psychiatric values” are “derived largely from the liberal-democratic tradition, borne of the 18th century European Enlightenment.” I cannot use the term “enlightenment” when it comes to prescribing drugs with serious medical side-effects and efficacy in the range of an enhanced placebo effect.
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Alice Keys, M.D. About Being Paul Revere

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March 10, 2013

A reader asked why more psychiatrists don’t speak up louder against psychiatric drugs. I’d like to think there’s someone in charge who could sound the alarm. It’s nice to imagine that working doctors have the power and freedom to speak up in a forceful and visible manner. If such a doctor exists, it’s not a psychiatrist who works in the trenches. A working doctor today is not in a position to be Paul Revere.
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Alice Keys, M.D. Diagnosis Dilemma

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March 1, 2013

Not long ago I had a conversation with a psychiatrist. He told me about a diagnostic dilemma he’d run up against at work; When a judge makes an unfunded treatment mandate as part of her judgment, she pressures the doctor to make a “payable” psychiatric diagnosis. If the doctor stretches the truth out of sympathy and provides an inaccurate but payable diagnosis so that his patient can have access to medical care and money to live on, he is committing fraud that can mean heavy fines and incarceration for himself.
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Alice Keys, M.D. We Are The Ones

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February 13, 2013

My public writing has brought my mother and I closer together than we’ve been in decades. There have been disagreements. But now, my almost ninety-year-old mother tells me she reads everything I write. She recently told me that she’s glad I see things so clearly.
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Alice Keys, M.D. Don’t Go Back to Sleep

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February 8, 2013

You may think I’m slow on the uptake when I say this. And maybe I am. But I recently came to the realization that products or lifestyles that are vigorously marketed and promoted are bad for you.
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Alice Keys, M.D. “Baby Cry Too Much?”

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January 17, 2013

This is the second in my new series, “Haiku for social change”, the first having appeared on my own blog page. Since this piece is about pharmacology and psychopharmacology, I think MIA is a good home for it.
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Alice Keys, M.D. Defining Recovery

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January 3, 2013

Yesterday, Dr. Daniel Fisher emailed and asked my thoughts with regard to “recovery”. Even before I walked away from prescription-pad-only psychiatric work, others asked me about this. Other treatment providers, designated patients and family members asked what I thought they could expect to happen next and what they should do to make things better. I told them that chemical interventions are not the only, or even the essential, tool for recovery.

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Alice Keys, M.D. The Children Lead

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December 29, 2012

How is it that we allow the agendas of others to occupy our childrens’ minds? Is it possible that a stranger can know our child better than we do? Is there anything a baby needs to learn that can’t be taught by being held in a parent’s arms? Because my children’s eyes and ears and thoughts are on me every day, they are key players in my ongoing efforts to live a right life. I count on their eyes and ears and thoughts to shore me up during times of temptation. They always lead me home.
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Alice Keys, M.D. Many Small Actions Bring Big Results

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December 18, 2012

We poison ever growing numbers of children with chemicals known to cause aggression and suicidality. We routinely drug children with these so they’ll sit still and be quiet in classrooms. Now, we drug babies for crying and 3 year olds for acting frightened while locked away from their families in day care centers. Those unsuccessful in school environments are incarcerated. It ‘s a well-worn path.
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Alice Keys, M.D. Bottle Fish. Going and Doing. Being.

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December 10, 2012

It seems that all the wants I have now for going and doing are a drug withdrawal, of sorts. I have been hooked, addicted to motion, fed on credits, isolated from the earth, from my humanity and from myself.
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Alice Keys, M.D. Do Diagnoses Injure People?

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December 4, 2012

Yes, a psychiatric diagnosis can be a dangerous thing to have. But, these days, so is having any medical diagnosis. The names and words of the diagnoses themselves are not so much to blame for the harm. Rather, the harm comes through the ways the diagnoses are created and how they are used.
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Alice Keys, M.D. “But It’s Just the Way Things Are”

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November 29, 2012

My sabattical of last winter has spun off a second one. I remain uncertain of my role as a physician in a society which values pills over personal growth and change. Last summer, unplugging my life from the “American dream” seemed in order. It’s not easy to make changes with chains and weights in place. It’s not easy to think, decide and move with the financial shackles that are the bones of everyday life.
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Alice Keys, M.D. “Multigenerational Poverty”

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November 19, 2012

The practice of medicine in our country is being swallowed whole by a snake. The snake started with the poor, the black, the brown; the already disenfranchised of the deep south and inner cities many years ago. It was an easy sell to the better-off taxpayers. Who wants to give up money to take care of poor people?
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Alice Keys, M.D. Do I Have Too Many Questions This Morning?

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May 28, 2012

What if it were the sun that could cure you; would you have the courage to go and find it? Would you wear sunscreen? If it were the schools themselves that made your child unhappy and restless; would you take …
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Alice Keys, M.D. How Many Deaths Will It Take Till We Know?

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May 21, 2012

Each time I see the initials for Mad In America, MIA, I think of the Vietnam war and lost young men. I remember engraved steel MIA bracelets, each with the name and birthday of one man lost to our world. …
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Alice Keys, M.D. Is Psychiatry “Salvageable”?

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May 15, 2012

A reader in the commentary here asked me if I think “psychiatry is salvageable.” This is a timely question that requires careful consideration. First, I’ll examine this question with regard to my personal life. Then, I’ll explore this question from …
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Alice Keys, M.D. My “Head in a Bucket” Metaphor

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May 9, 2012

“How could I not have known?” This question has been asked of me, as a psychiatrist, with regard to prescribing psychiatric drugs. All those problems. How could I not have known? This question, when asked only of psychiatrists, comes with …
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Alice Keys, M.D. The Pond, Learning and Humility

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May 5, 2012

What an amazing ride I’ve had in the past few days on the tsunami of commentary from my previous post. While it’s been fun (dare I use the “F” word again in a post?) it has also left me unsettled. I’m …
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Alice Keys, M.D. Call Me “The Doctor”

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May 2, 2012

I seem to have generated unexpected ire with my biographical information. This deserves more than just a few lines in the reply section. When I hear strong reactions, I suspect an iceberg. In this case, there may be two icebergs. First, there …
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