Bring on the crazies! Why psychiatry is awesome.

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.