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It’s not ‘all in your head’: When other doctors give up on patients, a boundary-breaking neurologist treats them

It was through her own experiences with mental illness that neurologist Dr. Alice Flaherty learned to care for patients that other physicians had given up on.

BOSTON — Even beforehand — before the compulsive writing and the bipolar diagnosis, before the niche medical practice and the best-selling book — Dr. Alice Flaherty stuck out. She had grown up beside a duckweed-filled pond in rural New Jersey, and by the time she was a young adult, she’d become a neuroscientist in a family of engineers, a theorist among doers.

When she came home during breaks at Harvard, her father would rib her. “He’d say, ‘Yo, you talk big about pure science now, but you’re going to end up an engineer just like the rest of us,’” she recalled. “And when I went to med school, he was like, ‘See? See?’ And it’s totally true. It’s like tinkering. You tinker with the patients. It’s so fun. I love fixing broken machines.”

Her neurology work at Massachusetts General Hospital involves plenty of gadgetry — she heads up the deep brain stimulation unit, and sometimes uses electroconvulsive therapy to help patients with depression or mania — but these days, that’s not the kind of tinkering that’s at the front of her mind.

Instead, she has been toying with the boundaries of illness itself. She likes seeing patients other doctors have given up on. Many have faced questions about whether they’re really as sick as they say. For all of them, getting the proper treatment — pills or infusions or electrical currents — depends on a kind of collaboration with Flaherty, a workshop in which motivations are re-examined, stories reshaped, turns of phrase redefined.

“These poor patients are typically seen as just not wanting to get better, and I got interested in that whole thing, like if you want to get better then you’re sick,

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