Why I like Psychiatry
Here’s part 2 of my ongoing series documenting my experiences in medical school core rotations. If you read part 1, you’ll recall that surgery wasn’t my favorite rotation in the world, and I think I articulated fairly well why that was. Luckily, after my surgery rotation I had a few months of hospital work that I really enjoyed. The first was psychiatry, which I took in July and August. Psychiatry was a blast, and it gave me back the confidence that I really can be a good physician someday. The love of learning that surgery had sucked out of me was re-infused into my soul. And here’s why:
1-Lifestyle, lifestyle, lifestyle. One of the best things about psych was that I had PLENTY of time to study and to spend time with my wife. For the entire 2 month period I was on psych I didn’t go in earlier that 7:30 or 8:00 in the morning. The latest I stayed (excluding the 4 ER calls we had over the 2 months), I never stayed past 5 pm. Sure psychiatrists can have emergencies they have to deal with (suicide ideations/attempts, homicide ideations, etc.), but for the most part you don’t have to worry too much about being called in the middle of the night. I could live with that.
2-Crazy people are pretty fun to be around. Let’s be honest, sometimes it’s pretty fun to be around people who are a bit crazy in the head. (Crazy probably isn’t a politically correct phrase, so let’s call it mentally unstable). Besides that people that are violent, all the other mentally unstables can be very intriguing in the things they say, do and think. From you manic patient (200 words a minute coming out of their mouths), to your delusional disorder (yes, the government really is out to get you), and lets not forget your schizophrenic (I don’t even know where to start on this one), you get to see things you never thought possible.
3-You can ask your patients any question in the world, and they’ll answer it. And I mean anything. From drug use, to sexual activity, to criminal records, to past abuse, to self harming activity, you have the right and the necessity to ask very personal things about your patients. And when they come to trust you and the position you’re in, they’ll often tell you everything. Once again, I heard things I never imagined before.
4-Even if they don’t answer it, you learn a lot about them. Even if you have a catatonic schizophrenic who just sits there and won’t say a word to you, watching a patient and their mannerisms can be fascinating. They may have abnormal posturing, or repetitive behaviors, or mutter incoherently, and all these things help you figure out what’s going on in their heads.
5-You get to learn every little aspect of your patient’s life. This goes along with numbers 3 and 4. In order to understand what’s going on in someone’s head to have to get the whole picture of that person’s life. And in an outpatient setting you get to see how a patient’s psyche changes over time, and you learn about pretty much everything that is happening in their life. Talk about the complete opposite of surgery.
6-Interdisciplinary teamwork is amazing. At Ben Taub inpatient psych you round as a whole interdisciplinary team with the psychiatrists, social workers, case managers, psychologists, occupational therapists, and nurses all talking together about how they can best help the patients. I learned so much about what these other health providers have to offer, that I’m sure in the future I’ll call upon their skills a lot more than I otherwise would have. Plus, interdisciplinary treatment is really the best way to go. We need to treat a whole patient, not just one aspect of their lives.
7-You can see amazing changes in people lives. The idea that psychiatrists don’t do very much is a complete lie. You can see huge, huge changes in a short period of time for many patients. When you see someone come into the hospital completely out of their minds, and in just a week they are a sane, logical, normal person again. Now obviously this isn’t the case for every patient, but almost all of them make pretty dang amazing progress in a short period of time.
8-Psychiatrists are fun people to be around. I think to be a good psychiatrist you’ve got to be able to understand what your patient’s are going through. For that reason, I think most people that do psych are a bit quirky themselves. I mean in a good way, nothing pathological or anything like that. They just have to be able to appreciate the crazies and the depressed and the manics and the anxious people. You’ve got to have a good sense of humor to survive in that field.
9-I don’t feel like a complete idiot all the time. One of the great parts about the psych rotation is that the scope of knowledge that you have to master is much more manageable than lots of other fields of medicine. There’s only so many diseases that you’re going to be seeing most of the time, so I felt that in my two months I actually learned all the material quite well. Not that I’m saying learning the whole field of psych is easy, there are as many variants of each disease as there are diseases out there, plus each patient needs to be treated in their own unique way. But as a medical student, I didn’t feel like I was drinking out of a fire hose for the first time in over 2 years.
10-Almost everyone in the world has a little something going on in their heads. Let’s be honest, everyone in the world has their own little quirks and oddities. Most of us (hopefully) don’t have anything pathologic enough to send us to an actual psychiatrist, but no matter what field of medicine you go into, you’ll have to deal with people’s minds, personalities, and other mental problems. We all need to be aware of mental illness no matter what field of medicine we’re in.
So there’s my top ten of psychiatry. It’s a great field that helps people a lot.
Now you might think from this blog that I’ll be doing psychiatry myself. I was tempted by the idea, but I found something else that I like even better. Tune into the next blog to find out what.
Sunday, October 11, 2009
Sunday, August 9, 2009
Apology
Sorry about the length of the "surgery" blog. Just read the bolded parts to get the idea. I've also decided to set a goal of writing on the blog once a month, so at least I'll put something down every once in a while. (No more year-long breaks.)
Why I HATE surgery
So, in many of my conversations with pretty much anyone, especially fellow medical students or other people in the medical field, a question invariably comes up in conversation: "So what kind of medicine do you want to go into?" A innocent enough question, but it's also very loaded and you must be carefully answered. If you tell someone that you might potentially have a tiny bit of interest in a particular field (ex. pediatrics, psychiatry, etc.), that person will forever assume that you are SET on going into that profession. Since I don't really know what I want to do with my life, I usually answer the question honestly and say, "I'm not sure, but I am ruling some things out." I should learn to stop giving that response, because the next question that I'll ALWAYS get is, "Like what?". To which I must answer "Surgery."
Now, to any surgeons out there or any people that think about going into surgery, I apologize in advance. I recognize that surgery is an amazing field where a whole lot of good can be done for people that are in need. With modern technology we are able to do surgeries and cure diseases that we never would have dreamed possible in the past. That being said, I want to come out and say that I absolutely HATE surgery! My 3 months on my surgery rotation were the 3 worst months of my entire life (no exaggeration). The day I found out that I passed my surgery shelf exam and that I wouldn't have to repeat that rotation was the happiest day of my life (maybe a little exaggeration). People always seem very shocked by this and ask me why I hate surgery. As if it needed any explanation. But since I'm the only person in the world that seems to realize how terrible surgery is, I've made a list of reasons why I personally hate surgery and would never want to do it:
1-Work hours: "What is a personal life?" Almost all the surgeons I met were WAY overworked. Some of them practically lived in the hospital. You've always got to be on call and come in to do emergency surgeries if your patients decompensate. I'd personally like to spend time with my family once in a while. Oh, and I really don't like showing up at the hospital before 5 in the morning.
2-Surgeons are jerks. Ok, ok, that's a little harsh, let's change it and say, "Surgeons are high-strung and often very blunt." (Is that a little more PC?) Now this doesn't apply to all surgeons, but a LOT of surgeons and surgery residents are not the most pleasant people to be around. If you get in their way or don't do everything they tell you to do, and do it FAST... well you better watch out. And it's not just the surgeons themselves, but all the people in the O.R. are always very stressed. I'd rather not be around these types of people.
3-Surgeons aren't happy. Once again, not true for everyone, but lots of the surgeons and residents I knew seemed to be hating life. Didn't they go into surgery in order to do something they liked? What went wrong? Maybe it has to do with numbers 1 & 2 above.
4-Standing up for hours at a time. The worst thing in the world is when you scrub into a 6 hr surgery, and you have to stand there the whole time holding a stupid retractor. Not conducive to happy bladders, stomachs, or feet.
5-Sterile field. When you scrub into a surgery, staying sterile is vital, otherwise the patient could get a serious infection. I realize this and totally agree with this. But when your scrubbed into a case and you accidentally bump something outside the sterile field and the scrub nurse starts yelling at you, it is not a happy place to be (not that I've ever been there before.)
6-The diseases you deal with. When you pick a medical specialty, you better know what kind of diseases you're going to be dealing with, because that's what you're going to be looking at every day for the rest of your life. During my general surgery month I saw enough inguinal hernias and gallbladders to last a lifetime. Please, just let me get away from the anuses please. (Note, some surgical specialties can be pretty cool, like ophthalmology, but unfortunately they are still surgery.)
7-Can you say tedious? Six hour surgeries are six hours for a purpose, all the cleaning up, placing clamps, very carefully dissecting out things, suctioning, carefully dissecting some more, suctioning again, placing more clamps, suctioning again, looking at it for a while, suctioning again, cutting a tiny bit more, suctioning... Get the idea? In some surgeries I was so bored I almost fell asleep while scrubbed in (don't worry, I didn't).
8-Patient interaction, what's that? One of the greatest things about medicine in general is that you get to develop relationship with the patients and really get to know them and help them in their lives. The surgeon's general interview goes something like this, "I'm Dr. So-and-so. What seems to be the problem? Great, we'll schedule a surgery date for you. See you then." O.k., o.k., that's not entirely true. They usually don't even take the time to introduce themselves at the beginning or say goodbye at the end. I want to do something where I can actually interact with the patient while they're awake.
9-Anatomy 101. I'll come out and say it, I never really did like anatomy. It was definitely not my favorite part of the pre-clinical years, and I never really cared enough to learn it very well. When you're in the O.R. and cutting someone open, it usually looks like a big mess to me. I realize that this is the exact reason why some people DO want to go into surgery, but for me anatomy is a definite turn-off. (Don't worry, I'm really not as bad at anatomy as I make it sound. You don't have to worry that I won't be a competent doctor some day.)
10-Hands on. I am not a hands on type of person. I know lots of other people are, but I am not. I don't really care about doing procedures. I'd rather sit back and think about patient instead of sticking my hands into his insides. When I'm in the O.R. I'm always afraid I'm going to mess up and somehow kill that patient. Who would want to deal with that kind of stress for the rest of their lives?
11-Scrubs. Not the T.V. show, the apparel. I'll admit that scrubs are pretty comfy, and many people love to wear them all the time, but scrubs drive me nuts. There aren't enough pockets on the dang things! Where am I supposed to keep my pen, and my wallet, and my pharmacy book, and my patient sheets, and my car keys, etc. Plus, when I wear scrubs it feels like I'm just walking around in pajamas. I'd rather feel like I actually get dressed before I go to work.
12-Did I mention that surgeons are full of themselves? (Once again, I apologize to any current or future surgeons reading this. You are probably the exception to the rule, otherwise why on earth would you be reading this blog?)
O.k., I think that's enough reasons for now. I'm sure I could come up with some more if you gave me the time. Suffice it to say that Rob Blake will NEVER EVER be a surgeon.
p.s. I hope if I ever need surgery that my surgeon will not have read this blog.
Now, to any surgeons out there or any people that think about going into surgery, I apologize in advance. I recognize that surgery is an amazing field where a whole lot of good can be done for people that are in need. With modern technology we are able to do surgeries and cure diseases that we never would have dreamed possible in the past. That being said, I want to come out and say that I absolutely HATE surgery! My 3 months on my surgery rotation were the 3 worst months of my entire life (no exaggeration). The day I found out that I passed my surgery shelf exam and that I wouldn't have to repeat that rotation was the happiest day of my life (maybe a little exaggeration). People always seem very shocked by this and ask me why I hate surgery. As if it needed any explanation. But since I'm the only person in the world that seems to realize how terrible surgery is, I've made a list of reasons why I personally hate surgery and would never want to do it:
1-Work hours: "What is a personal life?" Almost all the surgeons I met were WAY overworked. Some of them practically lived in the hospital. You've always got to be on call and come in to do emergency surgeries if your patients decompensate. I'd personally like to spend time with my family once in a while. Oh, and I really don't like showing up at the hospital before 5 in the morning.
2-Surgeons are jerks. Ok, ok, that's a little harsh, let's change it and say, "Surgeons are high-strung and often very blunt." (Is that a little more PC?) Now this doesn't apply to all surgeons, but a LOT of surgeons and surgery residents are not the most pleasant people to be around. If you get in their way or don't do everything they tell you to do, and do it FAST... well you better watch out. And it's not just the surgeons themselves, but all the people in the O.R. are always very stressed. I'd rather not be around these types of people.
3-Surgeons aren't happy. Once again, not true for everyone, but lots of the surgeons and residents I knew seemed to be hating life. Didn't they go into surgery in order to do something they liked? What went wrong? Maybe it has to do with numbers 1 & 2 above.
4-Standing up for hours at a time. The worst thing in the world is when you scrub into a 6 hr surgery, and you have to stand there the whole time holding a stupid retractor. Not conducive to happy bladders, stomachs, or feet.
5-Sterile field. When you scrub into a surgery, staying sterile is vital, otherwise the patient could get a serious infection. I realize this and totally agree with this. But when your scrubbed into a case and you accidentally bump something outside the sterile field and the scrub nurse starts yelling at you, it is not a happy place to be (not that I've ever been there before.)
6-The diseases you deal with. When you pick a medical specialty, you better know what kind of diseases you're going to be dealing with, because that's what you're going to be looking at every day for the rest of your life. During my general surgery month I saw enough inguinal hernias and gallbladders to last a lifetime. Please, just let me get away from the anuses please. (Note, some surgical specialties can be pretty cool, like ophthalmology, but unfortunately they are still surgery.)
7-Can you say tedious? Six hour surgeries are six hours for a purpose, all the cleaning up, placing clamps, very carefully dissecting out things, suctioning, carefully dissecting some more, suctioning again, placing more clamps, suctioning again, looking at it for a while, suctioning again, cutting a tiny bit more, suctioning... Get the idea? In some surgeries I was so bored I almost fell asleep while scrubbed in (don't worry, I didn't).
8-Patient interaction, what's that? One of the greatest things about medicine in general is that you get to develop relationship with the patients and really get to know them and help them in their lives. The surgeon's general interview goes something like this, "I'm Dr. So-and-so. What seems to be the problem? Great, we'll schedule a surgery date for you. See you then." O.k., o.k., that's not entirely true. They usually don't even take the time to introduce themselves at the beginning or say goodbye at the end. I want to do something where I can actually interact with the patient while they're awake.
9-Anatomy 101. I'll come out and say it, I never really did like anatomy. It was definitely not my favorite part of the pre-clinical years, and I never really cared enough to learn it very well. When you're in the O.R. and cutting someone open, it usually looks like a big mess to me. I realize that this is the exact reason why some people DO want to go into surgery, but for me anatomy is a definite turn-off. (Don't worry, I'm really not as bad at anatomy as I make it sound. You don't have to worry that I won't be a competent doctor some day.)
10-Hands on. I am not a hands on type of person. I know lots of other people are, but I am not. I don't really care about doing procedures. I'd rather sit back and think about patient instead of sticking my hands into his insides. When I'm in the O.R. I'm always afraid I'm going to mess up and somehow kill that patient. Who would want to deal with that kind of stress for the rest of their lives?
11-Scrubs. Not the T.V. show, the apparel. I'll admit that scrubs are pretty comfy, and many people love to wear them all the time, but scrubs drive me nuts. There aren't enough pockets on the dang things! Where am I supposed to keep my pen, and my wallet, and my pharmacy book, and my patient sheets, and my car keys, etc. Plus, when I wear scrubs it feels like I'm just walking around in pajamas. I'd rather feel like I actually get dressed before I go to work.
12-Did I mention that surgeons are full of themselves? (Once again, I apologize to any current or future surgeons reading this. You are probably the exception to the rule, otherwise why on earth would you be reading this blog?)
O.k., I think that's enough reasons for now. I'm sure I could come up with some more if you gave me the time. Suffice it to say that Rob Blake will NEVER EVER be a surgeon.
p.s. I hope if I ever need surgery that my surgeon will not have read this blog.
Monday, October 27, 2008
Do you trust me?
Trust is an interesting thing. When you give trust to someone else, it’s pretty much like you’re saying, “I feel comfortable giving you power over some part of my life.” Think about it, there’s probably no stronger trust out there than the trust a child has in his or her parents. The child is fully confident that the parent will be able to properly feed, clothe, teach, love and respect them. As a result, the child agrees to let their parents have control over those parts of their lives.
Plenty of other relationships require trust. What about the friend that you confide a secrete or personal bit of information to. Once you’ve shown your trust by telling them something important, you’ve now given them power to do whatever they want with that information. They could either keep your secrete in confidence, spread it to everyone they see, or even use that information to hurt you. Once you’ve decided to trust someone, you’re power over what they can do with that part of your life you’ve shared with them is now out of your control. You’ve given that power and control to them.
The reason I’ve been thinking about this lately is because of my experiences in medical school. Lots of people that I’ve interacted with have put a great amount of trust in me, and they’ve done so simply because I’m a medical student. People have opened up to me very personal parts of their lives, their minds, their actions, their habits, their thoughts, and even their bodies. They’ve told and shown me things that they would never show their closest friend or relative. Any why have they done it? Because they trust that I will be able to use that information to help them and that I won’t abuse the trust they are giving me.
Now, trust can often be misplaced. In the example of my work as a medical student, people have put a lot more trust in me than I think I deserve. Even though I tell people I’m a medical student, I don’t think they really understand how little of medicine I really know at the present time. I mean, people tell me the most intimate parts of their lives, not realizing that I have no idea what’s wrong with them. Not only that, but at the stage I’m at in med school right now everything I do is just for my own practice, it has no impact on the treatment of the patient at all. It’s kind of scary to think about how trust can be so easily won just by wearing a short white coat.
Plenty of other relationships require trust. What about the friend that you confide a secrete or personal bit of information to. Once you’ve shown your trust by telling them something important, you’ve now given them power to do whatever they want with that information. They could either keep your secrete in confidence, spread it to everyone they see, or even use that information to hurt you. Once you’ve decided to trust someone, you’re power over what they can do with that part of your life you’ve shared with them is now out of your control. You’ve given that power and control to them.
The reason I’ve been thinking about this lately is because of my experiences in medical school. Lots of people that I’ve interacted with have put a great amount of trust in me, and they’ve done so simply because I’m a medical student. People have opened up to me very personal parts of their lives, their minds, their actions, their habits, their thoughts, and even their bodies. They’ve told and shown me things that they would never show their closest friend or relative. Any why have they done it? Because they trust that I will be able to use that information to help them and that I won’t abuse the trust they are giving me.
Now, trust can often be misplaced. In the example of my work as a medical student, people have put a lot more trust in me than I think I deserve. Even though I tell people I’m a medical student, I don’t think they really understand how little of medicine I really know at the present time. I mean, people tell me the most intimate parts of their lives, not realizing that I have no idea what’s wrong with them. Not only that, but at the stage I’m at in med school right now everything I do is just for my own practice, it has no impact on the treatment of the patient at all. It’s kind of scary to think about how trust can be so easily won just by wearing a short white coat.
Tuesday, October 14, 2008
To blog or not to blog?
A few years ago, when the idea of blogging started becoming a big thing, when everyone and their dog sent you an e-mail telling you that they wanted to "share their ideas with the world", I must admit that I didn't get the idea of blogging at all. "You mean people just write about whatever they want? And then they put it up on the internet for everyone to see? And people actually read these mindless babblings?" I must admit, I was a nay-sayer and an unbeliever of the realm of blog.
And to tell you the truth, deep down I still am. I mean, what the heck does the word "blog" mean anyway? I think that most of the blog posts out there are not worth the 30 seconds it would take to skim over them. Why would I want to know the opinion of some faceless entity on subjects ranging from politics to religion to pop culture? Why would I want to delve into the psyche of other random people when I am barely aware of my own feeling and thought processes most of the time?
And that's where I have my epiphany, and the whole reasoning behind the world of computer bloggers suddenly comes into focus for the very first time. Blogs aren't created because the blogger really thinks that his/her opinions are going to go out there and change the world. They don't write for other people. They write for themselves. There's something about writing that helps you organize your thoughts and look at your life in a new light. Humans are set apart from the rest animal kingdom by the fact that they are self-aware. They are able to analyze not only what they think and feel, but analyze why they think and feel that way. When you write, you can take the endless train of thought that normally zooms through your head, rarely making a stop for any maintenance, and plop them down into something concrete. Suddenly your thoughts become words you can read on a page. They are physical, visible things, and they often look different then they did when when they were an endless stream of commentary running in your mind.
That brings me to my next question: if any writing is useful for examining your life, why not write a book, or essays, or articles, or short stories, or anything that is a little more "literary" than a blog? The answer: Motivation. The idea of doing all the research and preparation, and then doing all the writing and revising necessary to actually write something like that makes me tired and drives the desire to write right out of me. A blog is a quick easy way to spew out your ideas in a quick and dirty way. Are most blogs innovative, new, fresh, literary, refined or important? No. Is it worth your time to actually read most blogs? Probably not. Does blogging actually help the blogger analyze his/her life and become more self-aware? Hopefully.
So, here we go. I am fully aware that I will most likely post hardly anything on this blog. I fully expect that no one will ever read it. Nothing I say will be important or will "change the world". But, hopefully I actually take time to write something every once in a while, and in so doing can take a little time to take stock on how my life's doing. Happy blogging!
And to tell you the truth, deep down I still am. I mean, what the heck does the word "blog" mean anyway? I think that most of the blog posts out there are not worth the 30 seconds it would take to skim over them. Why would I want to know the opinion of some faceless entity on subjects ranging from politics to religion to pop culture? Why would I want to delve into the psyche of other random people when I am barely aware of my own feeling and thought processes most of the time?
And that's where I have my epiphany, and the whole reasoning behind the world of computer bloggers suddenly comes into focus for the very first time. Blogs aren't created because the blogger really thinks that his/her opinions are going to go out there and change the world. They don't write for other people. They write for themselves. There's something about writing that helps you organize your thoughts and look at your life in a new light. Humans are set apart from the rest animal kingdom by the fact that they are self-aware. They are able to analyze not only what they think and feel, but analyze why they think and feel that way. When you write, you can take the endless train of thought that normally zooms through your head, rarely making a stop for any maintenance, and plop them down into something concrete. Suddenly your thoughts become words you can read on a page. They are physical, visible things, and they often look different then they did when when they were an endless stream of commentary running in your mind.
That brings me to my next question: if any writing is useful for examining your life, why not write a book, or essays, or articles, or short stories, or anything that is a little more "literary" than a blog? The answer: Motivation. The idea of doing all the research and preparation, and then doing all the writing and revising necessary to actually write something like that makes me tired and drives the desire to write right out of me. A blog is a quick easy way to spew out your ideas in a quick and dirty way. Are most blogs innovative, new, fresh, literary, refined or important? No. Is it worth your time to actually read most blogs? Probably not. Does blogging actually help the blogger analyze his/her life and become more self-aware? Hopefully.
So, here we go. I am fully aware that I will most likely post hardly anything on this blog. I fully expect that no one will ever read it. Nothing I say will be important or will "change the world". But, hopefully I actually take time to write something every once in a while, and in so doing can take a little time to take stock on how my life's doing. Happy blogging!
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