Name: 與 @JakeGoodman MD 一起從精神科醫生和患者的角度看心理健康護理 (Perspectives of Both a Psychiatrist and Patient Accessing Mental Health Care with @JakeGoodmanMD)
Uploaded: 2025-06-17T16:33:29.000Z
Duration: 30 min

Hello and welcome to Beyond the Diagnosis.

I'm your host, Monica, a neuroscience graduate and current medical student in Canada.

我是主持人莫妮卡，神經科學專業畢業，目前在加拿大讀醫學專業。

程度副詞

Physicians are often regarded to have a very fulfilling, desirable career.

醫生通常被認為是一個非常充實、令人嚮往的職業。

But what often that's not talked about is behind the scenes.

但往往不為人知的是幕後工作。

Today, our topic is about the mental health of physicians and physicians in training from the perspective of someone who has served their community, but has also accessed the health care service.

今天，我們的話題是從一個服務於社區、同時也獲得過醫療服務的人的角度來探討醫生和受訓醫生的心理健康問題。

I feel extremely lucky to feature Jake, a resident psychiatrist.

我覺得自己非常幸運，能為住院精神病醫生傑克做專題報道。

So I was hoping to start off the interview by just asking you to please introduce yourself and just tell us a bit more about how you got involved in the mental health advocacy space.

所以，我希望在採訪一開始，就請你介紹一下自己，並告訴我們更多關於你是如何進入心理健康倡導領域的。

I'm in my third year of psychiatry residency training.

我正在接受精神病學住院醫師培訓的第三年。

That means I completed college, four years of medical school, a year of MBA, master's in business administration, and now I'm in year three of four of my psychiatry residency training.

這意味著我完成了大學學業、四年醫學院學業、一年工商管理碩士學業，現在是精神病學住院醫師培訓的第四年的第三年。

I make videos on social media, educating people about mental health, and I help reduce the stigma associated with doctors and other health care professionals seeking help for their mental health.

我在社交媒體上製作視頻，向人們宣傳心理健康知識，並幫助減少與醫生和其他醫護人員尋求心理健康幫助相關的恥辱感。

And I've grown a community of a little over 2 million followers and supporters across social media.

我還在社交媒體上建立了一個擁有 200 多萬粉絲和支持者的社區。

So I actually came across your videos when I was learning about the whole mental health advocacy space.

實際上，我是在瞭解整個心理健康宣傳領域時看到你們的視頻的。

Would you mind sharing a bit more about sharing your own story?

您介意分享一下您自己的故事嗎？

Was that a little bit daunting in the beginning, or did that bring up any sort of emotions, or were you just from the get-go pretty open to doing so?

一開始會不會有點害怕，或者會不會有什麼情緒，還是從一開始你就很願意這樣做？

I guess I'll walk you through a little bit about my mental health journey.

我想我可以帶你們瞭解一下我的心理健康歷程。

What got me there basically, I started experiencing some symptoms of anxiety in medical school, but I didn't do anything about it.

基本上，我在醫學院時就開始出現一些焦慮症狀，但我沒有采取任何措施。

I kind of grew up with mistaken belief that physicians don't really struggle with mental health, and that they can't or don't seek treatment for mental health.

我從小就有一種錯誤的觀念，認為醫生不會真正與心理健康作鬥爭，他們不能或不會尋求心理健康方面的治療。

I grew up with this kind of idealized vision of what a doctor is supposed to look like.

我從小就對醫生有一種理想化的憧憬。

And I think I really believed that, and a large part of this is the stigma.

我想我真的相信這一點，其中很大一部分原因是恥辱感。

So I never really got help, and I wish I did.

是以，我從未真正得到過幫助，但我希望我能得到幫助。

In hindsight, I kept pushing, kept pushing.

事後看來，我一直在努力，一直在努力。

A few months into residency, I experienced a real severe depressive episode for the first time.

住院幾個月後，我第一次經歷了真正的嚴重抑鬱發作。

And at that point, I'm a doctor who treats mental health, and I really couldn't recognize that I was experiencing depression until a friend of mine and also my wife had kind of told me, hey, I think you might be depressed.

當時，我是一名治療心理健康的醫生，我真的無法意識到自己患上了抑鬱症，直到我的一位朋友和我的妻子告訴我，嘿，我覺得你可能得了抑鬱症。

It's hard to see it in yourself sometimes.

有時很難在自己身上看到這一點。

And ultimately, I decided to get help and get treatment.

最終，我決定尋求幫助，接受治療。

I went to a therapist, and I went to a psychiatrist.

我去看了治療師，也去看了心理醫生。

I started taking medication for the first time, and I started feeling a lot better.

我第一次開始服藥，感覺好多了。

Over the months, I would just get better a little bit every single day.

幾個月來，我每天都會好一點。

It sounded like I woke up the next day, and I was like, I'm cured.

聽起來就像我第二天醒來，就覺得我痊癒了。

It was more like weeks and months and months and months.

更像是幾個星期，幾個月，幾個月，幾個月。

And finally, as I'm getting better, I'm thinking to myself, at this point, I probably had a million followers or 1.5 million.

最後，當我越來越好的時候，我在想，此時此刻，我可能有一百萬或一百五十萬粉絲。

And I'm like, I should post about this because I know that there are so many other people out there that could benefit from this that maybe are afraid of the stigma, just like I was.

我想，我應該把這件事公佈出來，因為我知道還有很多人可以從中受益，但他們也許和我一樣，害怕被人恥笑。

If they could see that there's a doctor out there who's open to taking medication and who openly says to everyone, yeah, I'm taking medication, and that doesn't make me a worse doctor.

如果他們能看到，有一位醫生對服藥持開放態度，並公開對每個人說：是的，我在服藥，但這並不會讓我成為一個更糟糕的醫生。

In fact, the fact that I'm seeking treatment to improve myself makes me a better doctor, better than I was if I was just to suffer through this depression without any help.

事實上，我尋求治療來改善自己，這讓我成為了一名更好的醫生，比我在沒有任何幫助的情況下忍受這種抑鬱要好得多。

So, I decided to take a picture of myself with a pill in my mouth with a caption, I'm Dr. Jake, physician who treats mental illness, and I take medication for my mental health.

於是，我決定給自己拍一張嘴裡含著藥片的照片，並配上這樣的標題：我是傑克醫生，治療精神疾病的醫生，我服用藥物治療我的精神健康。

順便說一句，我為此感到自豪。

我點擊了 "發佈"，病毒式傳播令人難以置信。

And that took me on a journey that I'm on today.

When I first saw that, as well, I just felt so inspired.

當我第一次看到這幅畫的時候，我也覺得很受啟發。

And seeing someone in the position where I hope to be being so open about this felt like, wow, someone really understands what it's like, and that there was a stigma in general in society.

看到有人在我所希望的位置上如此公開地談論這個問題，我感覺就像，哇，有人真的理解了這是什麼感覺，而且社會上普遍存在著這樣的偏見。

But I wasn't quite understanding about the whole culture of mental health within the medical profession.

但我不太瞭解醫學界的整個心理健康文化。

So, one thing I wanted to ask you was then, what is the culture like in terms of how accepting people are, their resources available, while you're already in the whole medical space?

那麼，我想問你的一件事是，當你已經進入整個醫療領域時，人們的接受程度和可用資源方面的文化是怎樣的？

I'll give a quick 30 second synopsis of where we came from.

我將用 30 秒鐘簡單介紹一下我們的來龍去脈。

So, I think people can understand how bad it used to be and how much better it is now.

是以，我認為人們可以理解過去有多糟糕，現在又有多好。

So, residency training was really started, like the formal residency training that we know today was really started back in the late 1800s, early 1900s, by a guy named Dr. William Stewart Halstead.

是以，住院醫師培訓真正開始於19世紀末20世紀初，就像我們今天所知道的正規住院醫師培訓一樣，是由一位名叫威廉-斯圖爾特-哈爾斯泰德（William Stewart Halstead）博士的人開始的。

He was a general surgeon out of John Hopkins, and he created one of the first residency programs, a formal residency training program.

他是約翰-霍普金斯大學的一名普通外科醫生，他創建了最早的住院醫師培訓計劃之一，即正式的住院醫師培訓計劃。

And he worked his residents ungodly numbers of hours.

他還為居民們工作了超長的時間。

I mean, they worked 24-7, 365, really no days off or anything.

我是說，他們 365 天、24 小時都在工作，真的沒有休息日什麼的。

And because he really didn't sleep, he just worked and worked and worked.

因為他真的不睡覺，他只是不停地工作、工作、工作。

And years later, it was discovered, uncovered that he actually had a substance use issue.

多年後，人們發現，他其實有藥物使用問題。

He struggled with cocaine addiction and would work extremely long hours under the influence of cocaine.

他曾與可卡因毒癮作鬥爭，並在可卡因的影響下長時間工作。

Now, he created this structure and it had spread throughout the country.

現在，他創建的這一結構已經遍佈全國。

So, whether you were in Baltimore or you're in Chicago, this culture of work, work, work, work, work was already established.

是以，無論你是在巴爾的摩還是在芝加哥，這種工作、工作、工作、工作、工作的文化已經形成。

And it wasn't until the 1980s when an individual died in a hospital due to a medical error made by a resident doctor working 18 hours straight that a work hour restriction was made.

直到 20 世紀 80 年代，一名住院醫生連續工作 18 個小時後，因醫療失誤導致一人在醫院死亡，才對工作時間做出了限制。

That case was the case of Libby Zion in the 1980s, 18-year-old girl that passed away due to this medical error.

這個案例就是 20 世紀 80 年代的利比-錫安（Libby Zion）案，18 歲的女孩因為這個醫療失誤而去世。

So, they created this 80-hour work week back in the 80s.

是以，早在上世紀 80 年代，他們就創造了 80 小時工作制。

Prior to that, there was no work hour restrictions.

你可以每週工作 130 個小時，真的。

So, now we have 80-hour work hour restrictions, 80-hour work week.

是以，現在我們有 80 小時的工時限制，每週工作 80 小時。

There used to be really no restrictions on the amount of time that you could spend in the hospital.

過去，住院時間真的沒有任何限制。

Now, I'm not saying this is good by any means.

There's a limit of 28 hours in the hospital, which is horrible, but it used to be even worse.

住院時間限制為 28 小時，這太可怕了，但以前更可怕。

And so, there's this culture of work till you drop and never complain.

於是，就有了這種 "工作到死，從不抱怨 "的文化。

這種情況已經持續了 100 多年。

And there's also a culture of not reaching out for help when you're struggling.

還有一種文化是，當你遇到困難時，不要去尋求幫助。

And that's due to stigma from colleagues and supervisors that if you reach out for help, maybe you're weak, you may be viewed as weak.

這是因為同事和上司認為，如果你向他人求助，也許你就是弱者，你可能會被視為弱者。

Stigma that we put on ourselves that, you know, we've worked this hard to get here, we don't need help.

我們給自己打上的烙印是，我們辛辛苦苦才走到今天，我們不需要幫助。

But one of the overarching themes here is also a fear of what could happen if you reach out for help and see a psychiatrist or get mental health treatment.

但是，這裡最重要的主題之一也是擔心如果你尋求幫助，去看心理醫生或接受心理健康治療會發生什麼。

And that fear is largely based on what will happen when you apply for your medical license.

而這種恐懼在很大程度上是基於申請醫療執照時會發生的情況。

Because when you apply for your medical license after college, medical school, residency, there's a bunch of questions on this form.

因為當你在大學、醫學院和實習醫生畢業後申請行醫執照時，這張表格上會有一堆問題。

And one of those questions, in most states, in most states, there's a question regarding your mental health.

其中有一個問題，在大多數州，都有一個關於你精神健康的問題。

It may be something like, have you sought treatment for a mental illness?

可能是這樣的問題：你是否尋求過精神疾病的治療？

It's some variation of a question like that.

And due to the fear of checking that box and somehow jeopardizing their medical license, many doctors in training, resident doctors, medical students, they never seek help at all, and they suffer in silence.

由於害怕打勾會危及自己的行醫執照，許多正在接受培訓的醫生、住院醫生、醫學生根本不尋求幫助，默默忍受著痛苦。

Although, and you know, this kind of brings us a bit to the solutions and how things are getting better.

儘管如此，你知道，這也讓我們想到了一些解決方案，以及事情是如何變得更好的。

There has been some major changes that are pushing the culture.

一些重大變化正在推動文化的發展。

There was a physician named Dr. Lorna Breen, who was an emergency medicine physician who was really working on the front lines of the COVID-19 pandemic back in New York City, and she unfortunately passed away from suicide.

有一位名叫洛娜-布林（Lorna Breen）的醫生，她是一位急診科醫生，當時正在紐約市 COVID-19 大流行的第一線工作，不幸因自殺去世。