Esther Gabrielle Rosengarten

I attribute my success to maintaining curiosity, humility, and a genuine willingness to understand people beyond surface-level presentations. I believe that deeply listening to patients, staying open-minded, and continuously learning from each clinical and life experience has allowed me to develop a more effective and meaningful approach to mental health care. Remaining grounded in humility has also helped me grow throughout my career, adapt to complex challenges, and stay focused on providing thoughtful, patient-centered care.

The best career advice I ever received came from Peter Gundersen, who helped write the DSM-5. I asked him what personality disorder was most prevalent in psychiatrists, and he said narcissism. He explained that after decades of listening to people's problems and helping them, and realizing you are able to help them, you can fall into this trap of thinking you know what your patient is thinking and what's best for them more than they do. That advice taught me to never lose the pulse, to always keep in mind that you are the visitor. It's like traveling to somebody's world, and the goal of psychiatry is not to bring these people that are lost back to your world. The goal is that you have to learn every street, bridge, and alley in their world, and once you've figured out their map and you know their world well, to guide them back to their home in that world.

I would give them the same advice that Peter Gundersen gave me: go in with humility and curiosity, and learn from your patients. Never lose the pulse. Always keep in mind that you are the visitor. Every time you meet somebody, it's like going into somebody's world, like traveling to their world. The goal of psychiatry is not to bring these people that are lost back to your world. That's not the goal. The goal of psychiatry is that you have to learn every street, bridge, and alley in their world. And once you've figured out their map and you know their world well, to guide them back to their home in that world. You have to really understand all the cultural and social perspectives that come from a person's past, present, and future, and the conflicts between what they want, what their parents wanted, what society wants, and what life will allow them to be. It takes time to understand all of that. Never fall into the trap of thinking you know what your patient is thinking and what's best for them more than they do. Always see yourself before you jump in and try to change things.

We've known for a long time that depression was going to become one of the top pandemics in the world. When I worked with the Chester Pierce Global Psychiatry Department at Massachusetts General Hospital and Harvard, we knew that depression was going to be a pandemic because we looked at the numbers, and there was a sense that stress was increasing in the world. We were not building societies that encouraged people to have basic things in their lives that allow you to maintain health - what I call the fundamentals. If you're not doing your fundamentals like sleeping properly, eating right, getting out or socializing once in a while, then there's nothing I'm going to be able to do. I could throw as many meds as I want at you, but we're going to be swimming against the current. The big social experiment happening right now is dealing with this mental health pandemic. There's also the challenge that providers have to market themselves in today's world, which is like the Twilight Zone for me. There are so many people who need help out there, yet there are so many psychiatric providers that can't find patients. On the opportunity side, I believe we're realizing that things overlap and influence each other - the gut causes inflammation, inflammation can cause depression. We're discovering the connection between not sleeping, not eating properly, drinking too much coffee, and what is going on chemically within people's brains. The more psychiatry moves forward, the more we realize that we can reverse engineer certain disorders that we thought we could never cure, like bipolar type 2, through neuroplastic development.

The values that guide both my professional and personal life are compassion, curiosity, integrity, humility, and authenticity. I prioritize understanding before judgment, believing that meaningful care and connection begin with truly listening and seeking to understand another person’s experience. I am committed to lifelong learning, continually expanding my knowledge and perspective to better serve others. At the core of everything I do is a deep commitment to service, ensuring that my work remains grounded in purpose, respect, and genuine care for the people I support.