I’m a Road Runner

I’m a consult-liaison (C-L) psychiatrist and I’m always on the move. I’m kind of a road runner, that way. Part of the reason I like it is because if I sit for too long my back hurts. Sitting is also bad for your life span too; have you heard? Read more about it in the abstract below [1]. Sitting for too long is tough on me and that’s not just age, although I admit I’m a geezer. I’m restless and prone to wandering. I tried sitting in an outpatient psychiatry clinic, where the patients come to you. I gained weight. My back hurt so much I could hardly get up and down from a chair.

I usually take the stairs and avoid elevators because they’re too slow. My knees might snap and pop a little, but the residents don’t mention it–at least within earshot. It’s a hit and run consult service and I’ve posted about that in the past, A Role for the Hit and Run Psychiatry Consultation Service (HRPCS)? « The Practical Psychosomaticist: James Amos, M.D. I hike all over the hospital from the ICU to the cancer floors, and back. And that’s not counting the trips to cover what are called the Code Green events, in which a roving team of nurses and doctors manage patients who become threatening or violent, often because they’re delirious (see link Managing the Violent Patient, Parts 1 and 2 « The Practical Psychosomaticist: James Amos, M.D.).

It’s harder to conduct psychotherapy on the run, but not impossible. Microtherapy is the best approach and it just means that a C-L psychiatrist be aware that any moment can be the right moment for therapeutic listening, empathic feedback, and gentle reframing (Microtherapy on the Hit and Run Psychiatry Consult Service: with Acknowledgements to Dr. Bruce Pfohl, MD « The Practical Psychosomaticist: James Amos, M.D.).

C-L Psychiatry is not for everyone, but you don’t have to be born to be a road runner. You can try it at your own risk, though, because after a while it gets hard to stay in one place too long.

1. Katzmarzyk, P. T. and I.-M. Lee (2012). “Sedentary behaviour and life expectancy in the USA: a cause-deleted life table analysis.” BMJ Open 2(4).
Objectives To determine the impact of sitting and television viewing on life expectancy in the USA.Design Prevalence-based cause-deleted life table analysis.Setting Summary RRs of all-cause mortality associated with sitting and television viewing were obtained from a meta-analysis of available prospective cohort studies. Prevalences of sitting and television viewing were obtained from the US National Health and Nutrition Examination Survey.Primary outcome measure Life expectancy at birth.Results The estimated gains in life expectancy in the US population were 2.00 years for reducing excessive sitting to <3 h/day and a gain of 1.38 years from reducing excessive television viewing to <2 h/day. The lower and upper limits from a sensitivity analysis that involved simultaneously varying the estimates of RR (using the upper and lower bounds of the 95% CI) and the prevalence of television viewing (±20%) were 1.39 and 2.69 years for sitting and 0.48 and 2.51 years for television viewing, respectively.Conclusion Reducing sedentary behaviours such as sitting and television viewing may have the potential to increase life expectancy in the USA.

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