#psychation

[lifeofayoungdoctor]

I wasn't prepared

Two days on psych, seen about 6 patients total. No one prepared me for the emotional rollercoaster I would be taken on.

[lifeofayoungdoctor]

PSYCHATION!

Started psych rotation this week and the schedule is so chill! Time to get my life back together...eat better, sleep, and exercise!

[mashupofmylife]

Clerkship 8: Psychiatry

I’m really interested in the idea of psychiatry, but went into this rotation thinking that my ideas about this speciality would not match up with reality. I didn’t just want to manage psychopharmacology. I wanted to get a chance to talk to my patients and learn about them and actually make a difference. And, true to form, my expectations didn’t match up with reality and I’m making this whole thing where I pick just one specialty that much harder on myself, because I had a great time.

I spent the first two and a half weeks on the active duty inpatient ward. My patients were dependents or active duty military service members. I was some weird magnet for young adults with command auditory hallucinations. I saw some really interesting cases, was blown away by how open most of the patients were, and tried to see how I could help. It was amazing how good at interviewing the residents were. I’d known one of the interns on this service since I was in college, and it was so much fun to have a friend at work! He was also very sweet about checking up on me throughout the rotation to answer questions and make sure I was doing okay, even when I wasn’t on his service anymore. He considered it his job to convert me to become a psychiatrist by the end of the rotation.

I spent the last two and a half weeks on the consult/liaison service. It wasn’t quite what I hoped it would be. We saw all the psych consults from the wards and the ER. Except, the residents forgot to grab us. So, really, didn’t get to see or do a whole lot for the second half of the rotation once we finished rounding on our ward consults in the morning. That really frustrated me because I feel like I missed out on a lot of learning opportunities.

I loved that I actually got to talk to my patients, and the interviews were as long as they needed to be to really help the patient and learn about them. I liked that we were able to hear our patients and not force meds on anyone on the ward. I liked that our patients wanted to get better and go home. The alliance between the patient’s command and the behavioral health team was very interesting to watch, another really unique aspect of military medicine. I also didn’t get antsy and want to move on the last week of the rotation, which has happened every other rotation this year.

Some things make me a little hesitant about psychiatry. I don’t love some of the theories. There’s not a large body of hard evidence to support a lot of the diagnoses and treatments. We end up treating symptoms rather than root causes. I also have my own issues to work out. I caught myself projecting onto my patient at least once and during a weekend call shift ended up telling a resident all about the crash, to the point that he really probably should have written a note on our chat and been able to count me as a patient. I ended up mentioning some of my issues between the crash and projecting to my ward attending, who wanted me to discuss them with my preceptor. My preceptor kind of danced around it but never really dug into it, so even more oversharing!

My parents and sister flew out to visit for almost 2 weeks. (I mean, its Hawaii. Who wouldn’t want to visit?) That cut into my PT/study time because there were a lot of expectations about seeing me evenings and weekends. After being on my own all year, it was weird to have family there and have to answer to someone else’s wants and plans. I think I may like seeing my family more one on one than all as a group for extended periods of time.

I did manage some time to explore the islands. Not as much hiking as I hoped to do (6 hikes on 4 days), more beach time than I expected. Baby shower for the first one of my med school friends to get pregnant! I totally fell off my healthier diet for most of the rotation, but still weighed in for my PT test at the lowest weight since joining the Navy. I’m glad to be leaving the island, because its a nice place to visit, but definitely not someplace I’d like to live.

[mashupofmylife]

Adorable elderly couple found me after the luau, where I volunteered to jump on stage and dance with the hula dancers, to tell me that they thought I was the best dancer up there and should have been deemed the champion.

Clearly, these are the type of life skills I’m supposed to be cultivating in medical school

[mashupofmylife]

I’m in arguable the best cardio shape of my life right now, but I still get completely winded climbing the stairs up the mountain from the hospital back to the hotel every day.

[uptomyeyeballs]

"Let's have a beer after work!"

4 beers, 2 tacos, and lots of shit talking later...

[pleasedotheneedful]

Dismissed at 11:30am. Got lunch, walked across the street to my apartment. Now in my boxers eating meatloaf and watching TV.

Of course, the trade-off is that I was asked to come to the outpatient office tomorrow morning.