Reporting from Canada, #10: Psychiatric Advice from a Train

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

One of the major disappointments that my wife and I had on our trip to Canada was the loss of our planned train trip from Toronto to Vancouver with my sister and her husband. It seemed just right to do because he has Parkinson disease, but could potentially maneuver well enough on a train. However, an accident beforehand prevented our going on this trip.

What was left was a bookmark provided by the touring company to use in reading the books they sent. It was “Advice from a TRAIN.” On reviewing it, it seems applicable to other aspects of life, including psychiatry. Here’s how.

• Stay on Track. That might mean not giving up on a good plan, whether personally or clinically. The family goal now is to keep looking for ways to get together while we can.
• Be in it for the Long Haul. The long haul is the importance of maintaining good family relationships. In psychiatry, treatment plans may need revision along the way.
• Whistle While You Work. If you take this metaphorically, it means to keep a positive and hopeful attitude, especially when the challenges increase by illness or external obstacles.
• Let Off a Little Steam. Especially in our time of an epidemic of physician burnout, or in encountering unexpected transportation problems, find ways to appropriately express one’s irritation.
• Pull Your Fair Share. There are many components that go into successful psychiatric treatment or a successful train trip. At least do what you can as a clinician or consumer, and do not unduly scapegoat others.
• Be on Time. It is not unusual for any kind of transportation to have some delays. The same holds true in medicine as unexpected challenges emerge in patient care. In psychiatry, though, it is especially important to keep to a planned schedule, as deviations can often have deeper meaning.
• Enjoy the Ride! Even if a train trip or treatment does not live up to expectations, there may be other positive aspects if positive reframing is used and learning obtained from the experience.

There are probably other connections between train travel and psychiatric care. Both have been subject to criticism in recent times. More innovation is needed for both. Treatment and train rides can be long or short, depending on the goals. Rarely, there can be disasters. But at its best, a long enough and comfortable enough train ride or psychiatric care of deep conversation, great beauty, and a positive response to unexpected obstacles can be invaluable.

Now, I wonder what would happen if leading representatives of both sides of our country’s political conflicts or warring international parties were put together on a train trip with limited stops. Would it turn out like the disaster in the novel Lord of the Flies or a successful dialectical resolution of opposite perspectives?

Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He presented the third Rabbi Jeffrey B. Stiffman lecture at Congregation Shaare Emeth in St. Louis on Sunday, May 19, 2024. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.