I don't think the people today who start hearing voices, stop eating and sleeping, and run amuck are likely to get good treatment. Having more knowledge, better diagnostic capabilities, better medications with fewer side effects, can't make up for the fact that most patients are being treated by doctors, therapists, and hospitals, who are operating under constraints and incentives that reward non-treatment, non-hospitalization, non-therapy, non-follow-up, non-care. Lost to follow-up is the best outcome a health insurer can hope for.

Life for the unwell is discontinuous and unpredictable. Things just come out of nowhere. People try but mostly do a lousy job of taking care of you.

I don't think the people today who start hearing voices, stop eating and sleeping, and run amuck are likely to get good treatment. Having more knowledge, better diagnostic capabilities, better medications with fewer side effects, can't make up for the fact that most patients are being treated by doctors, therapists, and hospitals, who are operating under constraints and incentives that reward non-treatment, non-hospitalization, non-therapy, non-follow-up, non-care. Lost to follow-up is the best outcome a health insurer can hope for.

The most radical, audacious thing to think is that there might be some point to working hard and thinking hard and reading hard and writing hard and trying to be of service

Once you've been talked to by voices, it's not possible to go back to a world where talking voices is not possible.

I saw a study the other day showing that some atypical anti-psychotic was at least as good as mood stabilizers in preventing suicide. It's a very good thing to decrease suicide but we should care at least a little if I'm not killing myself because I feel better or if I just can't remember where I put the damn gun.

I take care of military families. Their sacrifices are very real.