Writing a Suicide Note

[Alone]

Hi, everybody.

I maintain a blog, The Last Psychiatrist.

I recognize this is (almost) trolling, but I have written an article about the proper documentation in a suicide assessment. This article concerns discharging the suicidal patient from an ER; I'm writing a follow-up about discharging a malingering patient. You can find the post here:

http://thelastpsychiatrist.com/2006/09/how_to_write_a_suicide_note.html

If you find it useful, please pass it along to others and/or leave comments so I know. If not, sorry for the intrusion and I'll be on my way.

Alone

P.S. If the font is too small, "Ctrl +" will enlarge it.

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[OldPsychDoc]

We enjoy your blog from time to time.
Please feel welcome to visit again.

Hi, everybody.

I maintain a blog, The Last Psychiatrist.

I recognize this is (almost) trolling, but I have written an article about the proper documentation in a suicide assessment. This article concerns discharging the suicidal patient from an ER; I'm writing a follow-up about discharging a malingering patient. You can find the post here:

http://thelastpsychiatrist.com/2006/09/how_to_write_a_suicide_note.html

If you find it useful, please pass it along to others and/or leave comments so I know. If not, sorry for the intrusion and I'll be on my way.

Alone

P.S. If the font is too small, "Ctrl +" will enlarge it.

 

[DrIng]

This is really good- I recommend everyone read it. On a related point, it helps you make better decisions when you are tired late at night to envisage the coroner reading your note...

 

[Anasazi23]

Why would it be trolling?

Your article is great. I teach my first years to pretend that every ER consult will be read on the stand in a worst case scenario.

We look forward to future contributions.

 

[primadonna22274]

This is excellent. Thanks for sharing.

 

[hamstergang]

I know this is quite a bump, but I was thinking about this thread (well, mainly the article from the OP) and had to do a bit of work to find it. The other day, we got another bad admission to our inpatient unit and I just wish more psychiatrists would read this. Some are too scared to discharge anyone who expressing SI at any point. I feel if people read this article they'll get some courage to discharge these patients. Plus, I think it gives some good ideas of what to think about when performing a risk assessment.

 

[TexasPhysician]

I really miss that blog.

 

[wannabie]

I really miss that blog.

Me too. So, so much. That blog helped nurture my interest in psychiatry...though I'm not so sure that's a good thing.

 

[Therapist4Chnge]

His blog was a great read. I lost track of it a couple years back, but previously read most of his stuff.

Any idea why he stopped updating it? (may 2014 is the last post?)

 

[deleted307836]

Great read -- thank you.

How common are dedicated psych ED positions? Is this mainly a function residents or midlevels fulfill at major metro hospitals or can attendings easily pursue this if they wish?

 

[whopper]

I got a theory who the Last Psychiatrist is but it seems to me he wants anonymity. Alone, if you are the good old LP want to reveal who are you? If not, no problem.

 

[Kevin Baker]

I got a theory who the Last Psychiatrist is but it seems to me he wants anonymity. Alone, if you are the good old LP want to reveal who are you? If not, no problem.

There's a theory the reason the site hasn't been updated is due to Alone's name being revealed. Alone has talked about the anonymity before and how remaining anonymous allows us to focus on the content and not the character behind the content. Probably best to not inquire as to Alone's identity.

 

[Therapist4Chnge]

That's what I figured. I'll keep it at appreciation of his/her prior writings.

 

[slappy]

There's a theory the reason the site hasn't been updated is due to Alone's name being revealed. Alone has talked about the anonymity before and how remaining anonymous allows us to focus on the content and not the character behind the content. Probably best to not inquire as to Alone's identity.

Now this seems contradictory to me. Why would he reveal his identity to AMSA if he wanted to keep his anonymity?

EDIT: Nvm. http://thelastpsychiatrist.com/2010/04/im_not_the_one_you_should_be_w.html

 

[NickNaylor]

I, too, enjoyed his blog, though I'm only now making it through the content.

Re: anonymity, for better or worse the author's identity is already pasted all over the place. I happened upon it when trying to find the blog itself.

 

[PikminOC]

Now this seems contradictory to me. Why would he reveal his identity to AMSA if he wanted to keep his anonymity?

EDIT: Nvm. http://thelastpsychiatrist.com/2010/04/im_not_the_one_you_should_be_w.html

What is the big deal regarding his name? If I wrote things as awesome as him, I'd let everyone know!

 

[TexasPhysician]

I, too, enjoyed his blog, though I'm only now making it through the content.

Re: anonymity, for better or worse the author's identity is already pasted all over the place. I happened upon it when trying to find the blog itself.

If his identity is known, can we organize a thread dedicated to developing a letter that everyone can send from around the world politely asking to get his hands back on that keyboard?

 

[slappy]

What is the big deal regarding his name? If I wrote things as awesome as him, I'd let everyone know!

I think he explains it best at that link I posted earlier:

I don't write anonymously because I want to protect my career-- most of my work is forensic and it's unlikely the guy whose (sic) been in jail for a year awaiting trial for drug possession is going to care about my thoughts on DWTS. I write anonymously so that you aren't distracted by my age or lack of manners or political sympathies. They don't matter.

 

[d2305]

He writes as well as birdstrike.

 

[wannabie]

I think he explains it best at that link I posted earlier:

TLP took down the articles on SSI about a year ago because (I'm assuming) it ended up affecting his career. Also, he deemphasizes his identity because he wants readers to consider only consider his arguments and not be led astray by his identity ala Foucault's "What is an Author".

I'm not sure if he was really trying to hide his name or not.

 

[Psychobabbling]

I'll try and give it a more critical read, some things I would disagree with (if I can only do one thing, it's write a lethality assessment). I'll try and get to it. Good overall. Oh and "Suicide Note" sounds rather provocative, was that the point?

 

[NickNaylor]

I read over his misgivings regarding the CATIE and STAR-D trials last night. Good stuff.

 

[whopper]

Hmm that he's a forensic psychiatrist only reinforces my theory as to who he is because suspect #1 on my list is also one.
I really enjoy this guy's blog and even if he is anonymous it's good stuff.

 

[Member 1337]

This blog is fantastic... smartly written, a bit self deprecating, always spot on... it would be nice if he adds some 2015 entries. Maybe someone who knows him can dial the bat phone...

 

[FlowRate]

TLP took down the articles on SSI about a year ago because (I'm assuming) it ended up affecting his career. Also, he deemphasizes his identity because he wants readers to consider only consider his arguments and not be led astray by his identity ala Foucault's "What is an Author".

I'm not sure if he was really trying to hide his name or not.

Necroing this thread so as not to derail the rank list thread.

Funny enough, I thought Alone/TLP was Female until I found out who he (supposedly) is.

To add some potential discussion about this particular blog post: What does everyone think about the suggestion that we write so personally/casually? It does seem to go against what we are taught.