William Houghton, MD

The world is a better place without a "tyrant of the day" taking over and cracking down with rigid rules. This and other life lessons after 40 years in psychiatry.

In psychiatry, things happen slowly-but if you’re not in a hurry yourself, the patient opens a window and shows you the world.

There’s no procedure code for a visit like this. But I can’t fault my psychiatrist wife for crossing a boundary and getting too personal.

"I don’t want to climb any more cliffs. I’m looking for a slow job in a small town on the prairie," says the author in this work of fiction.

We both have the brilliant everlasting dumb luck to be fueled with oxytocin, the urge to eat and to bond. St Francis called his body “brother ass.” I call mine “brother dog.”

Insurance often pushes pills rather than talk therapy, believing drugs are less expensive (although there is a fair amount of evidence to the contrary).

Digital technology is a valuable tool, but if it dazzles us with its speed and control, there is the risk that we may forget the old way of connecting.

The face of the woman sitting across from me begins to quiver, and my job as a psychiatrist is to keep my mouth shut. I knew when she came in and said her beloved Scottie of 15 years had died how big a loss that was.

The doctor/patient relationship has become more complicated and less effective with the introduction of third-party managers into the payment process. The authors propose a middle path solution to this problem that emphasizes clear, up-front communication in order to ensure fairness, privacy and informed consent.

In this narrative of his patient, the author illustrates how the involvement of managed care in mental health treatment can thwart the therapeutic process and demean both doctors and patients.