Knowledge at your tips
Marcus, a 34-year-old software engineer in Boulder, Colorado, started his cold exposure routine on a January morning when his SSRI dose felt like it had stopped working. He read a Reddit thread about Wim Hof, bought a chest freezer off Craigslist, and converted it into a 38-degree plunge tub in his garage. The first immersion … Read more
Father Luke, a Jesuit spiritual director in Saint Louis, Missouri, met with Elena once a month for two years before he gently suggested she also see a therapist. Elena, a 44-year-old hospital chaplain, had come to him originally for help discerning whether to pursue a doctorate in pastoral care. The discernment work was rich. Their … Read more
The Moment You Realize You Cannot Wait Any Longer There is a specific kind of exhaustion that comes from pretending to be fine. You attend meetings. You answer phone calls. You make dinner. But underneath the surface, something has been quietly unraveling for weeks or months. Then one night, you cannot sleep. Again. Your chest … Read more
Dr. Elena Vasquez had been running a family practice in Tucson for twelve years before she did her first real SBIRT screening. The patient was Reggie, a sixty-one-year-old retired postal worker who came in for a sore knee. Out of habit, Elena handed him the AUDIT questionnaire she had recently added to her intake packet. … Read more
Eleanor, a 64-year-old retired schoolteacher from Asheville, North Carolina, had been quietly drinking three or four glasses of wine every evening for almost two decades. Her family knew about it, the way families know these things and do not quite know what to do. The bigger worry, until that week, had been her appetite. She … Read more
Marcus, a 47-year-old construction foreman from Tulsa, Oklahoma, decided on a Sunday afternoon that Monday would be the day. He had been drinking a fifth of vodka most days for nearly fifteen years, with the occasional binge weekend stretching that to a half-gallon. His wife had begged him to stop. His doctor had warned him … Read more
Marcus, a 47-year-old corporate attorney from Greenwich, Connecticut, completed 30 days at a high-end residential program in Malibu after his second alcohol-related arrest. The clinical team’s discharge plan included intensive outpatient treatment, weekly individual therapy, two AA meetings a day, and—at the urging of his wife and his employment lawyer—a sober companion to live with … Read more
Diego, a 22-year-old engineering student from Phoenix, Arizona, took half a tablet of what his friend swore was MDMA at an outdoor electronic music festival in late June. The desert temperature was 102 degrees at sunset and the dance floor was packed against a stage with no breeze. Two hours in he started to feel … Read more
The First Question Most Patients Never Ask Out Loud You have finally decided to seek help. Maybe the anxiety has been keeping you awake until 3 a.m. for months. Maybe the depression has made even small decisions feel impossible. Or maybe someone you trust gently suggested that the constant irritability you are experiencing is not … Read more
Tanya, a 47-year-old IRS revenue agent in Kansas City, spent three weeks during 2025 Open Season with a yellow legal pad and her plan brochures spread across the dining room table. Her teenage son had been diagnosed with bipolar II in late October, and the psychiatrist who’d done the evaluation didn’t take her current GEHA … Read more