Picking up the pieces at Thanksgiving...

"Happy Thanksgiving, how are you today?" I like making rounds on holidays (that's probably why I get so many of them). The staff has a huge banquet laid out for the patients. We're trying to convey a sense of optimism and caring. Two colleagues are helping me (another reason to be thankful!).

Among our challenges: patients' conflicts with their families (either overwhelmed with the stress of increased contact, or devastated by lack of contact). Alcohol and other substances contribute to aggressive or self-destructive behavior. Patients may have been deteriorating in their homes for weeks - or longer - but the crisis only becomes clear on Thanksgiving Day, when relatives arrive and find Mom wandering, confused, her nightgown torn, the house in disarray...

Their holiday has been ruined. Hospitalization increases the stress level enormously, for patients and families. But it's nice to try to sort things out and make them better. The families need as much time with us as the patients...to give history, to ask questions. Okay, back to work.

Perhaps it's time for something lighter. In honor of the holiday, I'm pulling this out of the vault: the psychology of Spongebob. Then after rounds, it's turkey and dressing at our house...