Not a Book Review

October 2026 | Vol. 70, No. 3
By Samuel Garloff, DO, PCOM '78

Preface: In the past, when asked how to choose a psychiatrist, my answer was always “Choose a good physician who practices psychiatry.” My reasoning was straightforward: 1. A good physician develops a comprehensive differential; 2. A good physician understands the use, benefits, side effects, interactions, and metabolism of medications; and 3. A good physician consistently balances risk and benefit to select the most appropriate treatment for the patient.

How would I choose among those fulfilling the criteria above? I would add 3 additional selection requirements: 1. A psychiatrist able to tap into a patient’s affect and experience the presenting mood and emotional state; 2. A psychiatrist able to listen to the “limbic music” he/she develops by listening to the patient; and 3. A psychiatrist who realizes in real time what they don’t know and, perhaps more importantly, when simply not to know.

Keeping the above in mind, “died in his sleep” by Richard Donze, DO, is deserving of examination.

“Her fishy-sounding first account…” The use of wearable tech capable of recording heart rate, respiration, O2, apnea, dysrhythmia, etc., seems somehow to assure the wearer and those who may otherwise care that all is and will be well. The belief is that technology doesn’t deceive; it alarms and protects us. However, like the devout wearing a Cross or a Star of David or a Crescent Moon and Star, nothing wards off death. Wearing any of the preceding is a simple act of faith. A physical manifestation of affect reflective of emotion. An uncharged screen being reflective of…?

“…two years of tau tangles tangling more and more…”  Insidious, ubiquitous decline, perhaps initially denied by those close and by those providing care. But the emergence of limbic music, an unsummoned warning, leads the reader to question if access to benzodiazepines was merely happenstance.

“…wanderment…” a whimsical neologism hiding a devastating truth. A poetic masquerade.

“… swallow of almost a whole month’s 28…” Accident or design? A simple act in search of sleep or a plan to end a life ebbing away from its owner?  Was it an unplanned, unexpected ingestion, or an act of deceit by a trusted partner leaving the vial where it would be found? The finality of the outcome represents an invitation in real time for examiners, legal and medical, as well as the reader, to accept, or to acquiesce to the unknown.

Emotional evisceration, not allowing for the cessation of limbic music.

Postscript: On August 16, 2026, the osteopathic profession lost a great leader, William G. Anderson, DO, FACOS. A review of his last book, The Making of a (Pardoned) Felon, will appear in the next issue of the JPOMA. I hope you will enjoy it.