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Physician, Writer, Humankind Enthusiast

Not what we need for public safety

The Long Beach Fire Department represents one of many agencies that have adopted the use of injectable sedatives by paramedics for law enforcement purposes. Photo by Mika Baumeister on Unsplash

As if being thrown in prison for being mentally ill wasn’t scary enough for people suffering from mental illness; as if incarceration wasn’t threatening enough for a general population with increasing anxiety, depression, and substance use; as if police custody wasn’t insulting enough to mental health providers who face enough barriers to providing continuity care for patients…

Some law enforcement agencies are using potentially life-threatening medications to sedate mentally unstable people, without medical supervision.

Four months ago, the Long Beach Fire Department began training its paramedics to respond, alongside the police department, to people exhibiting mental health crises. The intervention…


A meditation on what is worth taking home

Photo by Marten Bjork on Unsplash

I had lunch recently with a woman who lives in my building, after exchanging numbers as friendly neighbors do. We were getting to know one another, and she wanted to hear more details about my work. I briefly described doing regular Ob/Gyn care, with a focus on treating pregnant women with substance use disorders. We talked about meth, fentanyl and how, during the pandemic, mental illness and overdose-related deaths have been ravaging the country.

She asked me how I don’t take work home with me. I responded that I do.

I assume…


A table, some chairs, and most importantly, you

Photo by Olivier Collet on Unsplash

With my back against a cold table, my thighs spread open and my feet precariously balanced on what feel like spatulas, I am fully aware of my place in this room. The young Family Medicine doctor leans in toward my knees, brought tightly and awkwardly together by my naked, shivering legs, and he asks me to relax my legs further. This place was not designed to relax. He touches my inner thigh and I twitch. He asks me again to relax. Me, the patient, subject, specimen on a bench. …


Because humans have sex. Because I believe in God. Because I am pro-life.

Photo: Maria Oswalt/Unsplash

I’ve worked in a county hospital, and I’ve worked in a private clinic. The waiting rooms looked different, the staff’s enthusiasm varied, and the patients of all ages came from different backgrounds, education levels, and phases of their lives. It never ceased to amaze me that despite variation in settings and situations, the look on someone’s face when seeking an abortion has mostly been the same. Eyes diverted toward the floor, shoulders curled slightly inward, hands fidgeting with one another, or arms crossed, the body is closed. She recedes into herself.

Sometimes the guilt is haunting.

She wants to focus…


Pondering Motives that Led to a Massacre in Georgia

The NY Daily News

It doesn’t take much browsing to realize there is very little information about the victims of the mass shootings in Georgia. We know a little about Delaina Yaun, and the names of the other victims: Paul Michels, Xiaojie Tan, Daoyou Feng, Elcias Hernandez-Ortiz. The Atlanta victims’ identities have not been released.

We know a lot about the murderer. We know he is a 21-year-old white male, who was quiet in high school, who frequented massage parlors, who considers himself to have a sex addiction and self-treated with mass homicide, who “eliminated temptation,” whose parents suspected him of the shootings. He…


Learning silence as a second language

Photo credit: CBS News New York / The Atlantic

I have several memories of people blaming me for being out of touch with my Japanese roots. One was a gym coach, the classic kind with a buzz-cut who wore sunglasses on our indoor basketball courts, carried a whistle around his neck and chewed gum as he told me, at 11 years old, that I didn’t “seem” Japanese. Another was a geeky college teaching assistant who, after unsolicitedly sharing his infatuation with anime, told me I should learn Japanese because “it’s actually quite a beautiful language.” …


I am no hero.

I don’t break down doors and run into the fires of my patients’ lives.

I have made some sacrifices. In twelve years of training to be a doctor, I missed weddings, baby showers, and funerals, experienced my own health cyclically decline and recover, lost sleep in quantities of years of my life I’ll never recover, grieved the loss of patients, mentors, and peers, witnessed the deterioration of my relationships, and worked through my own traumas as a women’s health care provider in a world that insists on terrorizing women [1]. As an obstetrician-gynecologist, I am finding…


Our Country’s Shameful Past and Present

From the Library of Congress: https://history.house.gov/Exhibitions-and-Publications/APA/Historical-Essays/Exclusion-to-Inclusion/Internment/

On February 19, 1942, President Franklin D. Roosevelt signed Executive Order 9066, which led to the forced relocation of Japanese Americans living on the West Coast to concentration camps. Now, 79 years later, the tendency to imagine hostile enemies within our own nation has not changed.

In response to the bombing of Pearl Harbor, Executive Order 9066 authorized the military to forcibly evacuate all persons deemed a threat to national security. This is how some 120,000 Japanese Americans, the majority of whom were U.S. …


Netflix’s trending docuseries and the exploitation of mental illness

By Tom Andrews. https://www.lataco.com/people-down-on-skid-row/

If you have heard about Netflix’s new true crime docuseries featuring the story of Elisa Lam, you’ve also likely heard scathing reviews detailing the many ways in which the producers missed the mark. If you plan to watch the series, I don’t feel bad for spoiling the end. The documentary should not have been aired as a mystery in the first place.

A summary of the story can be found in many other articles.

The tragedy of Elisa Lam is that, like 5.7 million adults in the U.S. and 45 million…


What substance use and Instaglamour might have in common

Photo by Paris Hilton, uploaded to Instagram on September 28, 2020, https://www.instagram.com/p/CFsrJRTH3wd/

“I’m so sorry,” she apologized profusely, catching her breath between sobs, “I’m trying my best.”

She called the hospital in a panic. Her neighbor had stolen her buprenorphine, a medication needed to prevent cravings and withdrawal for people who suffer from opioid addiction. The last time she went through withdrawal was three years prior, when she was using heroin and almost died from overdose. She got herself into treatment, and was abstinent from illicit drugs ever since. Now out of medication, she was in a physical turmoil of withdrawal symptoms —…

JT Nakagawa

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