About Me
Hi Substack, my name is Nils1. I thought about being pseudonymous but I’m not that careful about that sort of stuff and from a societal-norm perspective I think it’s important that I’m willing to own my opinions in a public way.
I grew up in New York’s Hudson Valley, which is emphatically not “upstate New York” and I will argue with you about this. For those of you who care about credentials: I graduated from a public high school, got my BSc cum laude in neurobiology and behavior from the College of Agriculture and Life Sciences at Cornell University, spent 2 years doing research of no real consequence at Weill Cornell in NYC, and got my MD from Penn State College of Medicine. I did my residency training at Tufts Medical Center in Boston.
Medicine is often called an art, not a science, and there is no subspecialty for which this is more true than psychiatry (though plastics is a close second). Unfortunately, the art in this case too much Escher and not enough Dali. This Substack is my attempt to start collecting the thoughts I have on psychiatry, putting them into words, and applying a rigorous analysis to them that I would not otherwise be forced to do if I just left them in my head.
My hope is that these essays will make you question some of the conventional wisdom in medicine (psychiatric or otherwise), and give you some useful tools for thinking about these ideas in your own way.
Thanks for reading!
Pronounced like the plural of the word nil
I just came across your blog today and realized that we have a LOT of things in common: I, too, grew up in the Hudson Valley (and no, we are NOT upstate). I'm also a bit of a nerd, love the outdoors, want to be a psychiatrist working with children on the autism spectrum. Currently, I'm a first-year FM resident at a very supportive program on the West Coast; I'm hoping to transfer to a psychiatry program. I don't really know how DMs on Substack work (or you have them disabled); I'd love to chat with you more about psychiatry and life as a resident. Also: your blog is really awesome and goes into a lot of detail about why we choose the interventions that we do.
I wandered over here from Psychiatry on the Margins. He quoted you saying something about meds not fixing an empty 30 year marriage. Well said. Those are the emotionally taxing conversations in psychiatry, not the conversations trying to convince people to take medications. It's like with the old candy shop cliche, but a nightmarish version where you and the candy shop owner and you are trying to convince your customers that they are eating too much candy.
Anyways, as a PMHNP in Oregon that sometimes wishes I had taken the medical school route and other times wishes I'd opened a tea house instead of experiencing the chronic existential crisis of psychiatry, I salute you.
And is that Dota on your profile picture? I kind of love that.