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Dr Dheeraj K, MD, DM, 🇮🇳 Profile picture
Dr Dheeraj K, MD, DM, 🇮🇳
@askdheeraj
Professor & Ag Head of a Psychiatry Unit | DM #Addiction Psy-AIIMS New Delhi, MPhil (Hospital Mx) BITS Pilani, MD #Psychiatry-CMC Vellore, MBBS -MMC Chennai
Jul 26 • 8 tweets • 2 min read
Two friends and I saw over 400 FMGs (#ForeignMedicalGraduate) pass in front of our eyes. What did we all notice?
No smile. Blunt emotion.
Have seen exam takers in many exams. None of the MD/MS, MDS, MPharm, MBBS, AHS entrance exams i have seen had faces like this + Some exam takers were in their 40s!
We felt really bad. The dream of being a doctor makes them go to unknown countries, which they wouldn't have spelt in their 12th standard. They finish their course. The standards vary. They study for #FMGE. They might pass +
Jul 7 • 13 tweets • 3 min read
7/7/2005 The day that changed my life.

I passed PLAB and was working in rural areas of India for more than a year. Wanted to fly to London for the next level given 2 year validity. Had an attachment in Emergency Psychiatry in Oxford. I was planning book dates and tickets + Bombs burst in London. I was in Odisha, not really up to speed. A few weeks went by. Connected with school buddies and other friends.

They all said in unison - NO
Rules had changed. They were planning to come back.

+
Jun 8 • 13 tweets • 3 min read
Dear Shri Vishwajit Rane ji,

Thank you for coming out with clarification. However it is riddled with holes. Let me point a few.

1. Commitment to basic medical care is good. GMC in fact provides high tech care. You have Govt centers which provide basic care. + There is no reason why anyone should come on a daily basis to a medical college hospital for IM injections. Casualty exists for a purpose - dealing with medical emergencies and trauma. It is inappropriate to flood Casualty with non emergency cases. Doc was right to refuse. +
Jun 7 • 4 tweets • 1 min read
In 2006, I was helping a MSc nursing thesis in assessment of coping. I felt community dwelling adolescents had better problem solving coping than me, a young adult. I had supportant coping. I felt a bit ashamed. I shared this with our psychology madam. + She said those adolescents think they can solve life problems. When they hit adulthood they realize they can't solve all problems. They depend on themselves and are currently distant from parents and friends. They might end up in alcohol and suicide later in life +
Dec 27, 2024 • 9 tweets • 2 min read
This is Dr Raja, a year junior in UG and PG in same institutions. He is like a brother.
In 2007, he was going on leave. He was seeing a patient in op. He wanted me to follow up. When I saw the patient I realized she needed intensive work. + Image I was irate with myself for taking up responsibility. However I did my best, doing sessions on non op days. I handed over the case back to him upon his return.
17 years later, today, a JR brought a family in crisis for discussion. +
Dec 20, 2024 • 10 tweets • 2 min read
Recently had chaired a seminar on Transcultural aspects of psychotherapy. A few social work students were in attendance. They have been shadowing in my op.
We met a young graduate who revealed that he was using alcohol weekly and was smoking ganja occasionally. + He had problems with his parents and as a family they needed therapy.
He had history of mental illness and substance use was not good for him. However he was keen on continuing the use of the same.
I let it slide (rolled with resistance) and gave an appointment. +
Oct 23, 2024 • 7 tweets • 1 min read
Recently met someone who is from a Shia Muslim family who have a very syncretic faith. She prays to Hindu gods and goddesses and feels emotional peace! She studies in a Muslim college. She fears her beliefs and practices being known to her friends. So keeps a distance. In a short span of time I got some rapport. I told her, I don't care about her religious identity and beliefs and she can feel free to share without fearing judgement. I could see a sense of relief in her face.
Oct 3, 2024 • 10 tweets • 3 min read
The job I had in my UG college office got me to visit it. The new #MMC (#MadrasMedicalCollege) is at a different plane. The infrastructure is much better than what we had in the 90s.
Image This was the adda, where we used to sit and have tea and chit chat about cases we saw or topics we read with classmates and people from other batches. Image
Jul 28, 2024 • 7 tweets • 2 min read
Attended Church today.
The sermon alluded to opening of #OpeningCeremony . The pastor didn't tell us that we Christians are offended.
He was concerned that in the west offensive things are being celebrated.
Christians are easy target for cultural bullying. They expect it. They are told to expect it and stay strong in their faith.
However when west tries to destroy the pillars on which it was built, it will fall.
France of all nations has witnessed onslaught other cultures. France thinks it is stong with naive oppositionality to Christianity.
May 22, 2024 • 7 tweets • 2 min read
There are times I feel I am a fool to spend too much time with patients. Knowing details of their back stories may not change management in clear cut cases. However I just can't stop being myself from trying to know the person. Here is a thread which makes me feel it is worth it This morning I was having a chai on a roadside when I got a call from an unknown number.
"Sir Mai Kaun hoon?"
"Pehchana nahin, boliye"
"Apne humare bete ke liye xyz gift diya"
"Oh, aap...boliye kaise yaad kiya?"
"Sir I am in a community clinic...+
Apr 17, 2024 • 15 tweets • 3 min read
Small thread about my wife:

Ours was an arranged marriage. We spoke to each other 4 times on phone and met once for 15 min before engagement and marriage.

She was a MD gen physician in a corporate hospital in Hyderabad and I was a DPM psychiatrist in a mission hospital. 1/10 She had just got a job as Assistant Professor of Medicine in a Govt Medical College in Andhra Pradesh and I was about to get an MD seat in Vellore. She dropped that job and followed me. She could have had an academic career here too. 2/10
Apr 3, 2024 • 15 tweets • 3 min read
After a long time I got tears while seeing a patient. As much as I tried to hide it I couldn't. I acknowledged it openly and told why I was moved.

Here is the story: #Psychiatry #PsychX #MedX #PsychTwitter #MedTwitter
1/14 Recently a couple brought their daughter to see me, as suggested by a neurologist friend on mine.
Parents were happy that the file came to me but the patient who had a mask sat there with eyes closed refusing to communicate with me.

2/14
Jan 7, 2024 • 9 tweets • 2 min read
The problem with anti-psychiatry is not that it critiques the worst of psychiatry. It uses the worst understanding of few psychiatrists to undermine best contribution of #psychiatry to the society.
#mentalhealth If @ReadReadj had argued about medicalization of social distress and critiqued practice of psychiatrsts' unnecessary use of medication and not offering psychosocial interventions I would have fully supported him.
Oct 28, 2023 • 5 tweets • 1 min read
Had a talk on " #Dementia and caregivers of Dementia" in St Andrew's Kirk, Egmore Chennai. More than 60 attended. Given that there were many caregivers from homes, decided to do it in Tamil. Our discussions overshot into lunch time and no one bothered about it. ❤️the interaction Image When I was a medical student, I wanted to go and see the beautiful Church in Gothic Architecture. Watchman didn't allow me. In another attempt, I succeeded to enter and see the majestic building. Was very happy to get invited by the counseling department of the church.
Feb 4, 2023 • 9 tweets • 2 min read
More than a decade ago, I was a young psychiatrist who went to conferences with enthusiasm to learn and make friends. I met a medical representative from a certain company. He was an energetic gentleman. He told to about his kids, his family etc. On one side he was a cut throat businessman and on the other side he was very deeply spiritual. He was training his kids to be priests in a gurukul.
I met him in every conference. He would identify me from far and would come and update about himself.
Jan 21, 2023 • 7 tweets • 2 min read
I see a discussion on #MedTwitter about countering/ accepting unscientific practices of patients.
My take has changed over time.
When I was young, I was like an activist. I was driven with zeal to educate and smash wrong beliefs with evidence and arguments. As months rolled by I realized those with whom I had passionately argued to drive a point were not following up.
When I trained in psychiatry under a senior Prof KS Jacob, I was surprised that he being an atheist would encourage people to visit their temple or dargah.
Jan 20, 2023 • 7 tweets • 2 min read
Was site appraiser for FMGE for a TN site. Had some conversations with candidates. Sharing few which gives a peek into lives.
Me: hello, how was the exam?
FMG: a bit tough sir.
Me: OK. Where are you from?
FMG: Ukraine
Me: When did you return?
FMG: long time ago + ...I am married and have a child.
Me: That's great ma. Good that you are re-entering medicine. Did you take any coaching?
FMG: self study sir
Me: It isn't wrong to take coaching ma. Everyone is taking. It might help pass sooner.
All the best
FMG: (smiles) Thank you sir
Nov 16, 2022 • 9 tweets • 2 min read
Many years ago I met a young girl who was still in school who had attempted suicide.
I asked her what had happened. She didn't open her mouth. Tears rolled down her eyes.
Her family told me Chennai police had informed them that they found her in a public place. The girl had gone missing for one day and reunited with her family. However she attempted suicide.
She survived.
It took a long time for us to develop rapport with her to listen to her story.
She was in class XI and was aspiring to do MBBS. She had got more than 90% in X.
Nov 16, 2022 • 4 tweets • 1 min read
Our dept of Child and Adolescent psychiatry consultants call me to help out in few special cases of adolescent boys with externalizing disorders and adolescent girls with addiction issues.
Today I met a young girl who had multiple issues. + Cluster B personality + Opioid dependence.
She also had a different style of haircut. I asked about it and told her I liked it.
We then went on to discuss various aspects of her Rx. She even agreed to come as a day care patient to occupational therapy dept. +
Nov 8, 2022 • 6 tweets • 2 min read
I met an old lady who had #schizophrenia. She was on antipsychotics for more than 50 years. Never remitted. Had delusions of infidelity on her husband. He loved her and brought up his kids. The kids are grown up and married now. She was also a cancer survivor. Docs repeated the same medicines as there weren't too many problems even though she was not fully well too.
I took a bold decision to start her on #Clozapine, a drug with risks but also better efficacy. Discussed with her and family.
Oct 25, 2022 • 7 tweets • 3 min read
A year ago I got a call from a Prof of Developmental Pediatrics. He asked me if he could transfer a patient whom he has been seeing for the past 16 years. The patient was 19 years old. He had cerebral palsy and he could not speak, though could hear and understand instructions. Met the boy with his mom. The boy was suicidal. It was heart breaking to see him cry on the first visit. He felt rejected by his dad, who was a mechanic. His dad would say words like "less intelligent" and "dumb". I phoned his dad. Requested him to come and see me.