How to Be Patient

How to Be Patient

You may have noticed a new trend lately. Everyone is loud and proud about their mental health struggles (and thank goodness)! For practitioners, this movement is as exciting as it is frustrating. As each mental health taboo falls by the wayside as it enters the cultural zeitgeist, a new aspect of our specialty thus emerges. One we just don’t have enough hours in the day to keep track of, let alone engage with. From better understanding our patients’ (and our own) relationships with their conditions in a changing world, it’s more important than ever that we learn: HOW TO BE PATIENT! Each week, join Dr. Preston Roche (Psychiatry Resident & Digital Influencer) and Dr. Margaret Duncan (Psychiatrist & Content Creator) on their quest to better understand the patients we dedicate our lives to and the evolving paths they’re bound to travel beyond the clinic. By engaging with stories and perspectives that challenge our shared understanding of a condition, we hope you’ll similarly gain new perspectives as we look at our patients, and their mental health struggles, with further nuance and empathy. (And with Dr. & Lady Glaucomflecken producing, we've been mandated to include plenty of weird medical jokes too). Speaking of which, a key part of this is hearing YOUR stories! What’s changed your understanding of patient care? Do you have an experience that shines new light on something we’ve discussed on-air? Get in touch at: howtobepatientpod.com

Episodes

August 4, 2025 62 mins
This episode felt like a deep exhale. Margaret runs solo today, as she sat down with Dr. Hillary McBride—psychologist, author, and researcher—to talk about embodiment, trauma, and the radical act of tuning back into ourselves. We talked about what it means to feel your feelings in your body, why disconnection often begins as protection, and how pleasure, presence, and play can be part of the healing process. It’s about more than c...
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While in psychiatry we avoid using declarative or certain language about mechanisms, it can be helpful to think about the narratives that drive people to behavior that will ultimately end their life. In this episode Margaret and I review the Durkheim principles of suicidality following the four categories: anomic, fatalistic, egoistic and altruistic. We talk about how each has a distinct flavor in the clinical setting and which on...
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It’s Part 2 of our deep dive into eating disorders—and this time, we’re going even deeper. We kick off by unpacking our mock therapy session with Dr. Helen Liljenwall, which unexpectedly hit close to home for all of us. Then we take a sharp turn into the medical realities of starvation, including refeeding syndrome, the female athlete triad, and why your heart is always in the equation (literally). But what happens when patients r...
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This is Part 1 of our two-part deep dive into eating disorders—and we’re starting at the beginning. Margaret and I sit down with psychiatrist and eating disorder specialist Helen Liljenwall, MD to walk through the basics: What are the major types of eating disorders? What do they actually look like in real life? And how do we treat something that’s rooted in both biology and culture? We cover everything med school skipped—then try ...
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Margaret and I talk about what it feels like to care for patients who remind us a little too much of ourselves, especially when we’re also the ones filling out the paperwork for a psychiatric hold. We dig into what a 5150 (or 5585) really means, how to sit with that kind of authority, and the emotional mess of seeing a patient’s fear reflect your own. Psychiatric holds carry legal weight, but emotional weight, too. We talk abou...
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In this episode, Margaret and I take on burnout—what it actually is, where the term came from, and how to tell when you’re not just tired, but something deeper is cracking. We dig into the history, the Maslach Inventory, moral injury, and why burnout isn’t in the DSM (yet). We also share our own unhinged burnout moments (yes, mine involves harmonica) and explore how to tell the difference between burnout, depression, and just being...
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June 23, 2025 85 mins
This might be our nerdiest episode yet—and that’s saying something. In our Season 2 kickoff, Margaret and I sit down with Dr. Margo Funk, psychiatrist and QTC whisperer, to explore the strange, stressful overlap between psychiatry and cardiology. We talk about our worst fears on call, how to spot when an EKG is lying to you, and why it might be time to stop blaming Haldol and start looking at your T wave. There are metaphors involv...
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Season 1: complete! In this wrap-up episode, Margaret and I reflect on what it’s been like building this show from scratch—while also being full-time psychiatry residents. We talk about favorite episodes, unexpected challenges, what we’re still figuring out, and what’s ahead for Season 2. We also answer listener questions about training, creativity, psychedelics, and the eternal search for balance when your brain wants art and your...
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In Part 2 of our conversation with Dr. Nikki Haddad, we went from couples therapy theory to Simpsons cosplay, and yes—it was as chaotic and illuminating as it sounds. Margaret and I roleplay Homer and Marge in a fictional session while Nikki breaks down what’s actually happening between us (emotionally, not just cartoonishly). Along the way, we talk about heteronormativity, escapism, parenting exhaustion, and the red flags that get...
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In this episode, we sat down with Dr. Nikki Haddad—Margaret's residency best friend, couples and sex therapist, and one of the most thoughtful psychiatrists I know—to break down what makes romantic relationships so damn hard. We get into myths we’ve carried (and tried to shake), how sexual issues are rarely just about sex, and why our training in medicine doesn’t prepare us to talk about any of this. Nikki then walks us through the...
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May 5, 2025 56 mins
We opened up the inbox and wow… y’all really came through. In this first-ever Q&A episode, Margaret and I answer your questions about coping during med school, surviving feedback, dealing with emotional exhaustion in residency, and why outpatient goodbyes feel like actual breakups. I also overshare about marathon training (again), Margaret brings the wisdom and the theater metaphors, and we all learn what bald eagles actually sound...
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April 28, 2025 77 mins
This week, I learned I have a pelvic floor. And yes, I realize I’m a doctor and should’ve known that already. Margaret and I talk with pelvic floor physical therapist and viral educator Dr. Alicia Jeffrey-Thomas, who somehow made me breathe through my butt on mic. We cover everything from incontinence and pelvic pain to TikTok fame, trauma-informed care, and the surprisingly emotional world of core stability. Alicia breaks down the...
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April 24, 2025 4 mins
In the last episode, Preston demonstrated to Margaret how to properly conduct a mindfulness meditation session. Due to popular demand, the sage spiritual guide is back. Takeaways: Preston can’t lead a meditation Margaret shouldn’t let him try — Watch on YouTube: @itspresro Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc. — Produced by Dr Glaucomflecken & Human Content Get in Touch: howtobepatientpod.com Music: “Peacefu...
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In Episode 16, Preston and Margaret dive into the chaos of overnight residency, the reality of sleep deprivation, and how mindfulness can backfire when your brain just won’t sit still. From ruined meditations to hot girl walks through hospital hallways, they unpack what real-world coping actually looks like—before, during, and after the hardest moments. Takeaways: Coping doesn’t always look like calm. Sometimes it looks like sour...
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In Episode 15, Preston and Margaret open a bottle—of questions, stories, and science—about alcohol use disorder. What do we get wrong about “moderate” drinking? Why is detox more dangerous than most people realize? And how does alcohol quietly reshape identity, relationships, and the brain itself? With their signature blend of honesty and humor, they explore the unexpected ways drinking shows up in medicine, the myths that keep us ...
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In Episode 14, Preston and Margaret dive into social anxiety disorder and the loneliness epidemic. From embarrassing childhood memories to awkward club encounters, they explore how social anxiety shows up in everyday life and how it differs from normal nerves. They also discuss the surgeon general’s definition of loneliness, the role of social media in increasing perceived judgment, and the neuroscience behind facial recognition, f...
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March 31, 2025 87 mins
In this episode, Preston and Margaret take a deep dive into the science of running, exercise culture, and its impact on mental health. They explore the history of running, how it went from an obscure activity to a cultural phenomenon, and the physiological and psychological mechanisms that make it such a powerful mental health tool. They also unpack the identity crisis that can come with being an athlete, how running became the mil...
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In this episode Margaret takes the lead as she welcomes art therapist, psychotherapist, and author Amelia Knott to discuss the ethics of being online, parasocial relationships, and the impact of social media on mental health. We explore the blurred lines between personal and professional identities in digital spaces, the therapeutic power of art, and how social media fosters both connection and disconnection. Takeaways: Parasocia...
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In this episode we are joined by Priyanka Patel, a pharmacist, content creator, and soon-to-be author, to discuss mental health misinformation, ADHD, and the challenges of navigating online discourse about mental health. Priyanka shares her personal journey with ADHD, the barriers she faced in getting a diagnosis, and how social media both helps and harms conversations about neurodivergence. Takeaways: Not All Mental Health Conten...
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In this episode we sit down with genetic counselor Julia Castro to demystify the world of genetic testing and counseling. They explore how genetic information can help (or sometimes confuse) patients, why more testing isn't always better, and the ethical dilemmas of knowing too much about your future health. Takeaways: Genetic Counseling is More Than Just Testing: It’s about helping patients navigate uncertainty, understand their...
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